The aim of this review is to describe nutrition strategies that may help to meet the ever-increasing global demand for chicken meat in a sustainable manner. This may include decreased reliance on imported feedstuffs through replacement of imported protein (e.g., soybean meal) with locally available alternatives such as canola or grain legumes, as well as a reduction in crude protein content in feeds through a precision use of amino acids and enzymatic supplements. Challenges, opportunities and research needs associated with alternative feed ingredients are illustrated, and potential risks or benefits to the health of birds, consumers and their environment are discussed. It is concluded that the long-term sustainability of chicken meat requires a multifactorial approach that relies on improved feed formulation practices based on use of local ingredients, reduced crude protein, optimizing feed processing (e.g., particle size), and use of feed additives (e.g., enzymes, synthetic amino acids, pre- and pro-biotics) whilst considering their impact on efficiency of production as well as animal, human and environmental health.
There is a lack of comprehensive reviews examining workplace health promotion (WHP) interventions targeting nutrition; most of the reviews focus on productivity-related outcomes. This narrative review, based on articles extracted from PubMed between January 2015 and July 2024, aims at providing a critical analysis of the current evidence regarding WHP interventions, and proposes practical principles for companies and human resource management to develop more effective WHP initiatives. The review includes 54 eligible randomized controlled trials conducted in various workplace settings across high-income countries, involving a general adult working population of both sexes, with or without metabolic chronic diseases. Among the 54 eligible articles analysed, 8 different strategies were identified for environmental, 6 for educational, and 5 for behavioural interventions. A combined educational and behavioural intervention was the solution most frequently applied (24 studies). Less than half of the studies were effective. Outcomes that improved most frequently in WHP interventions were waist circumference (11/20 studies evaluating this outcome), consumption of unhealthy food/nutrients (10/17), vending machines or worksite cafeteria purchases (4/5), and metabolic syndrome (2/4). 46% of the WHP interventions tackled ≥ 2 healthy lifestyle domains promoted by the World Health Organization, and 71% used technology. WHP programmes often fail due to poor design, but with evidence-based, tailored strategies and international guidelines, they could drive lasting, widespread benefits. Effective frameworks should balance scientific rigor with practical tools to ensure engagement and impact, providing concrete benefits for the employees, their families and the entire society.
Perinatal depression is a common disorder that can manifest during pregnancy and the postpartum period, severely affecting both the mother and the baby. Dietary factors have been associated with an increased risk of perinatal depression. We analyzed the association between adherence to certain dietary patterns before and during pregnancy and postpartum and perinatal depression. A scoping review of the available literature was conducted reporting the main findings following the PRISMA 2020 statement. The search strategy was last reproduced in December 2024 in MEDLINE, Web of Science and Scopus databases. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale and the Revised Cochrane risk-of-bias tool for randomized trials. The protocol has been published on OSF (https://doi.org/10.17605/OSF.IO/AV8TP). 11 studies (6 cohort studies, 4 cross-sectional studies, and 1 randomized clinical trial) conducted in various countries were included in the mapping review. These studies evaluated the dietary intake of the participants at different times during the perinatal period and identified several dietary patterns. 9/11 studies showed a significant inverse association between adherence to the Mediterranean Diet or healthy patterns, characterized by high intake of vegetables, fruits, fish and seafood and perinatal depression. In contrast, 4/11 studies showed that adherence to Western dietary patterns and the consumption of ultra-processed foods was associated with higher risk of perinatal depression. Adherence to healthy dietary patterns may be negatively associated with perinatal depression. Conversely, Western diet and the intake of ultra-processed and pro-inflammatory foods are directly associated with a higher risk of perinatal depression.
Neuromuscular disorders (NMDs) are a heterogeneous group of conditions characterised by progressive muscle weakness, motor impairment, and risk of malnutrition, affecting the quality of life (QoL) of patients. While pharmacological treatments are essential for the management of symptoms, the role of diet, nutrition, and other lifestyle factors remains underexplored. This narrative systematic review, performed on PubMed, Web of Science, and Scopus following PRISMA guidelines, aimed to investigate the relationship between lifestyle, the progression of NMDs, and the QoL. A total of 30 studies (n = 5055 patients) met inclusion criteria. According to our search strategy, the most representative lifestyle factors were diet (70%), physical activity (53.3%), and emotional perception and care (36.7%); seven papers (23.3%) evaluated three or more lifestyle aspects. Overall, both quantitative and qualitative deficiencies emerged: calories, proteins, lipids, and fibres, as well as vitamin C, vitamin E, zinc, selenium, and calcium, were lower than recommended. A reduced consumption of fruits, vegetables, legumes, nuts, and seeds, replaced by ultra-processed foods, was detected. Diets optimised for calorie and nutrients intake, rich in anti-inflammatory foods, have shown benefits both in mitigating oxidative stress and muscle degeneration. Regarding other aspects of lifestyle, although physical activity was associated with improved motor performance and QoL, adherence was low, particularly among females. Negative emotional status emerged as a critical factor influencing patients’ overall well-being. Even in the most complex neuromuscular disease settings, addressing nutrition and dietary habits, in the context of lifestyle, could support patients and their families throughout the disease course and improve their QoL.
College students (those enrolled in two- and four-year postsecondary institutions) with caregiving responsibilities for children or other dependents face unique challenges balancing academic and caregiving duties. This scoping review aimed to describe the prevalence of food insecurity among United States college student caregivers and their experiences with food insecurity, dietary quality/intake, academic outcomes, and food security programming. A search of peer-reviewed and grey literature was conducted in four databases: CINAHL, Google Scholar, Embase, and Medline. Identified articles were evaluated against inclusion criteria. Of 162 articles identified, 61 articles met eligibility criteria and underwent data extraction and descriptive analysis. Forty-two articles (69%) reported the prevalence of food insecurity among college student caregivers, with prevalence ranging from 9% to 79%. Single parents, students of colour, LGBTQ+ individuals, and those with multiple dependents had increased food insecurity risk. Thirteen studies examined dietary patterns, finding caregiving students prioritised feeding their children, reduced their own meal sizes, and chose low-cost, low-nutrient foods due to budget constraints. Academic challenges included difficulties in time management and scheduling stress. No studies examined Grade Point Average (GPA) or academic performance. Thirteen studies identified the use of food assistance programmes. Food assistance programmes were underutilised due to limitations such as restricted pantry hours and availability. Housing insecurity frequently co-occurred with food insecurity. Food insecurity disproportionately affects college student caregivers compared to non-caregiving students. Comprehensive programming is needed to support food and nutrition security, including connections to government and university food assistance programmes, childcare services, and programme modifications to reduce barriers to academic success for caregiving students.
Food insecurity (FI), defined as unreliable access to healthy, nutritious food, is a major health concern in higher-income countries, primarily due to its association with an increased risk of obesity. Supermarket-based interventions may influence population-level food purchasing behaviour, an antecedent to consumption. It is unclear whether there are specific characteristics that these interventions should employ to resonate with vulnerable groups. This scoping review aimed to explore the characteristics of supermarket-based interventions that sought to support healthier and/or more environmentally sustainable food purchasing for people living with obesity, overweight (PLWO/Ow), and/or FI.A systematic literature search, conducted in Medline, Embase, CINAHL, Scopus, and Web of Science databases, identified 35 eligible studies, representing 43 interventions. Title and abstract screening and data extraction were conducted independently by two reviewers. Most interventions focused on supporting the purchase of healthy food items. No study applied a validated measure of FI. Area-level demographic data were used to identify FI-related characteristics (i.e., area of low income, low socio-economic status) and, in some cases, those living with obesity. Interventions utilised the behaviour change levers of price (n = 8), promotion (n = 2), placement (n = 7), nudges (n = 4), and education (n = 2), or a combination of these (n = 20). High heterogeneity in the way behavioural change levers were operationalised and combined, alongside the use of proxy measures to identify FI and PLWO/Ow, makes it difficult to determine the most supportive intervention characteristics. This presents challenges in understanding how to best facilitate changes in purchasing patterns in favour of heathy, sustainable food items in this population.
Despite increasing efforts to promote and support breastfeeding, the United States continues to have some of the lowest exclusive and sustained breastfeeding rates globally. Foreign-born immigrants and refugees specifically have been reported to have high initiation but low exclusive breastfeeding (EBF) rates. This scoping review aims to explore what is known about strategies to support breastfeeding among foreign-born mothers in the United States using the Arksey & O’Malley framework for scoping reviews and PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Six databases were searched using a comprehensive search strategy and 2103 articles were identified, of which 31 met eligibility criteria and discussed 33 specific breastfeeding interventions. The articles describe a range of interventions, including breastfeeding promotion and education (n = 30), hands-on breastfeeding support (n = 9), material support like giving breastfeeding supplies and food (n = 16), social support (n = 18) and social marketing campaigns (n = 1) to promote community support for breastfeeding. Common strategies for implementing these interventions include individual counselling (n = 21), group breastfeeding education (n = 17), informational materials (n = 12) and family support promotion (n = 11). In total, 87·3% of the immigrant mothers targeted by these breastfeeding support interventions were Hispanic, and 4·5% and 7·0% were mothers of African and Asian descent, respectively. This study reveals limited data and key gaps in efforts to preserve the culture of breastfeeding and promote EBF among multicultural immigrant and refugee families, particularly non-Hispanic groups. Addressing these gaps will improve optimal infant feeding practices among foreign-born mothers in the United States and, consequently, maternal and infant health outcomes.
Digital technologies provide a convenient and scalable approach to dietary assessment and personalised feedback, facilitating behaviour change. This is essential for reducing the prevalence of non-communicable diseases at a population level. However, the evaluation of the acceptability and feasibility of dietary feedback delivered via online platforms has not been thoroughly investigated. By utilising the term ‘system architecture’ to describe the essential components of the digital approach to capturing dietary feedback, this systematic review outlines the platform, dietary assessment methodology, reference values for assessing dietary intake and elements of personalised dietary feedback. When reported, the acceptability and feasibility of personalised feedback were captured. OVID Medline, OVID Embase, Scopus via Elsevier and Cinahl Plus via EBSCO identified 5839 studies. Search terms included dietary assessment, feedback and digital technologies. In total, twenty-eight studies involving 301 271 participants were included. Food frequency questionnaires were the most commonly used dietary assessment method, accessed via web-based platforms. Dietary intake was commonly assessed using a diet quality index, and feedback was provided on food groups, often combined with a diet quality score or macronutrient analysis. While participant acceptance of personalised dietary feedback was generally high, the overall completion rates for acceptability questionnaires were low, and feasibility was seldom reported. Methods used to measure acceptability and feasibility varied, preventing comparisons across studies. Study quality was high; however, future research would benefit from the involvement of stakeholders and end-users in designing feedback messages.
Modifiable health behaviours, including suboptimal dietary patterns, contribute to the global burden of disease. Messaging to raise awareness about health and nutrition behaviours is an important first step toward behaviour change and promotion of healthy dietary patterns. The aim of this rapid review was to systematically identify best practice recommendations and evidence for the development and characteristics of persuasive health and nutrition messages for awareness raising among adults. Academic reviews and grey literature reports published in English after 2010 that focused on the development or characteristics of general health or nutrition-specific messaging for awareness raising were eligible. MEDLINE Complete, CINHAL, Global Health, Embase and websites of public health organisations were searched between April and July 2024. Data was synthesised narratively. From 12 507 records, 31 were included (27 reviews and 4 reports). There was consistent support for an audience-centred approach to messaging, including audience segmentation, message tailoring and testing with target audiences. It was recommended that messages be disseminated through multiple channels, including mass and social media to facilitate repeat exposure. Message characteristics, including use of narratives, simple language, keeping messages short, conveying the general gist rather than detailed information and utilising imagery, were considered best practice for persuasive messaging. Nutrition messages that are audience-centred, tailored, thoroughly tested and incorporate elements such as narratives, imagery and simple language are likely to be accepted and persuasive among adults. Findings can be used to inform effective nutrition messaging for awareness raising in research and nutrition promotion settings.
Malnourished infants under six months (u6m) are a vulnerable but insufficiently prioritised group, with low levels of consolidated evidence to guide outpatient and community-based care. This study synthesised evidence on outpatient and community-based management of malnourished infants u6m, focusing on intervention strategies, outcomes, barriers, and policy implications. Following the JBI framework and PRISMA guidelines, this review included information published in English between 2007 and 2025 about the outpatient or community-based management of malnourished infants u6m or mother–infant dyads. Four databases and multiple institutional websites were searched, supplemented by grey literature. Data were extracted on various study features, interventions, and outcomes. A total of 26 studies were included, with only five published since the 2023 updated guidelines of the World Health Organization (WHO). Evidence was concentrated in studies from sub-Saharan Africa and South Asia. Several studies described outpatient care as feasible and acceptable in multiple contexts, with reported recovery rates ranging from 65% to 91%; however, methodological heterogeneity limits comparability across studies. Breastfeeding support, maternal health, and culturally adapted interventions were described as important indicators. Tools such as the MAMI clinical care pathway, MUAC, and the MAMI WAZ look-up chart were described as effective, but require further validation and contextual testing. Major barriers that were mentioned included shortages of trained staff, inconsistent protocols, and policy reluctance to scale outpatient models. Outpatient and community-based care for malnourished infants u6m aligns with recent WHO guidance on managing ‘at-risk’ infants. However, widespread adoption requires stronger evidence-based management or tools, integration into health systems, and national policies. Strengthening research and programmatic consensus will be essential to improve outcomes for this vulnerable population.
Frailty is an ageing-related syndrome of physiological decline, heightening vulnerability and increasing risk of adverse health outcomes. Nutritional deficiencies, particularly in vitamins B 9 , B 12 and D, are prevalent among the elderly owing to physiological changes and reduced food intake. Research suggests a correlation between low levels of these vitamins and an elevated risk of frailty. Vitamin B 9 , crucial for DNA synthesis and cell division, shows potential in frailty prevention, although evidence regarding supplementation remains inconclusive. Similarly, vitamin B 12 , essential for nerve function and red blood cell formation, presents conflicting findings regarding its impact on frailty prevention. Vitamin D, essential for bone health and muscle function, is linked to frailty risk, yet studies on the efficacy of supplementation yielded mixed results. The mechanisms involving these vitamins, including their roles in DNA methylation and inflammation regulation, highlight the need for further research to clarify their direct impact on frailty prevention. Maintaining optimal levels of vitamins B 9 , B 12 and D may reduce frailty, but older individuals need a complete approach that includes proper nutrition, physical activity and other preventive measures.
Collagen supplementation (CS) has emerged as a promising therapeutic approach with potential benefits for managing metabolic syndrome (MetS)-related risk factors. This narrative review integrates human evidence with preclinical mechanistic insights into the metabolic actions of collagen. Anti-obesity effects are attributed to increased satiety, gastric distension, GLP-1 secretion and enhanced fatty acid oxidation mediated by PPAR-α activation and AMPK signalling. In type 2 diabetes, collagen improves glucose homeostasis by enhancing insulin sensitivity, upregulating GLUT-4 and inhibiting dipeptidyl peptidase IV (DPP-IV), thereby prolonging incretin activity (GLP-1 and GIP) and supporting β-cell function. The antihypertensive effect of collagen peptides (CP) is primarily linked to angiotensin-converting enzyme (ACE) inhibition, which reduces angiotensin II levels while promoting bradykinin-mediated vasodilation and nitric oxide release. In addition, CP has shown potential in improving lipid profiles by modulating PPAR-γ and AMPK, increasing HDL-C and reducing LDL-C and triacylglycerols. Emerging evidence also supports a role for collagen in restoring gut microbiota balance, increasing short-chain fatty acid production and reducing pro-inflammatory and oxidative pathways, contributing to systemic metabolic regulation. Overall, these findings suggest CS exerts multi-targeted benefits on MetS components through modulation of endocrine, inflammatory and metabolic pathways. Nevertheless, larger, long-term clinical trials are warranted to determine optimal dosing regimens, evaluate long-term efficacy, and further elucidate microbiota-mediated effects.
The increasing focus on longevity and cellular health has brought into the spotlight two key compounds, urolithin A (UroA) and spermidine, for their promising roles in autophagy and mitophagy. Urolithin A, a natural metabolite derived from ellagitannins, stimulates mitophagy through pathways such as PTEN induced kinase 1 (PINK1)/Parkin RBR E3 ubiquitin protein ligase (PRKN), leading to improved mitochondrial health and enhanced muscle function. However, spermidine, a polyamine found in various food sources, induces autophagy by regulating key signaling pathways such as 5′ AMP-activated protein kinase (AMPK) and sirtuin 1, thus mitigating age-related cellular decline and promoting cardiovascular and cognitive health. While both UroA and spermidine target cellular maintenance, they affect overlapping as well as distinct signalling pathways. Thus, they do not have completely identical effects, although they overlap in many ways, and offer varying benefits in terms of metabolic function, oxidative stress reduction and longevity. This review article aims to describe the mechanisms of action of UroA and spermidine not only on the maintenance of cellular health, which is mediated by the induction and maintenance of autophagy and mitophagy, but also on their potential clinical relevance. The analysis presented here suggests that although both compounds are safe and offer substantial health benefits and are involved in both autophagy and mitophagy, the role of UroA in mitophagy places it as a targeted intervention for mitochondrial health, whereas the broader influence of spermidine on autophagy and metabolic regulation may provide more comprehensive anti-ageing effects.
Cognitive decline is a hallmark of brain ageing. Leucocyte telomere length (LTL) has emerged as a candidate biomarker related to brain ageing and neurodegeneration; however, reported associations with cognition and brain structure vary across cohorts. Long-chain omega-3 polyunsaturated fatty acids (PUFA), notably docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), exert anti-inflammatory and antioxidant effects that may, in some contexts, relate to slower telomere attrition. Here, we synthesise evidence on n-3 PUFA, telomere biology and cognitive outcomes, integrating clinical, epidemiologic and experimental data. We emphasise biological plausibility (oxidative stress/inflammation, membrane remodelling, mitochondrial function and expression of telomerase reverse transcriptase (TERT) through PI3K/Akt/mTOR, NRF2 and epigenetic modifications) while acknowledging heterogeneous human findings and methodological considerations (assay variability, life-course timing, cognitive domains and biomarker stratification). We outline priorities for future studies to clarify causal pathways and inform dietary strategies that support healthy cognitive ageing.
The long-chain omega-3 polyunsaturated fatty acids (LC n-3PUFA) eicosapentaenoic acid (EPA; 20:5n-3), docosapentaenoic acid (DPA, 22:5n-3) and docosahexaenoic acid (DHA; 22:6n-3) are beneficial for health. The aim of this review is to provide an overview of worldwide dietary recommendations for LC n-3PUFA across life-stages for general healthy populations from technical and scientific documents (TSD) that underpin food based dietary guidelines (FBDG) or TSD from expert groups. Using the Food and Agriculture Organization global online repository of FBDG and structured Google searches, forty-two TSD were identified for inclusion. Seventy-one percent of TSD included quantitative dietary intake recommendations which varied widely across life-stages with gaps for some groups, 62% included health messages related to LC n-3PUFA consumption, 33% discussed supplementation and 29% gave guidance on high intakes. The most frequently recommended intakes for adults were 250 mg/day EPA + DHA and 250 mg/day EPA + DHA plus an additional 100-200 mg/day DHA in pregnancy. This overview is useful for nutrition science, medical, industry and consumer communities since it identifies the recommendations available and the gaps of interest to national or international groups wishing to set dietary intake recommendations for LC n-3PUFA. Low dietary intake of LC n-3PUFA from seafood is a risk factor for suboptimal health. Intake recommendations can be challenging to achieve. Most countries for which data are available show that LC n-3PUFA intakes fail to meet recommended targets, highlighting the need for accessible, innovative, sustainable alternative EPA + DHA sources e.g. bio-enriched foods and supplements to support higher population intakes, LC n-3PUFA status and health benefits.
This systematic review examined the associations of dietary factors such as nutrients, food intake, dietary patterns and dietary biomarkers with structural and functional brain MRI biomarkers, focusing on macrostructural, microstructural, lesion and perfusion measures, and functional activity/connectivity. Articles published in English were systematically searched in PubMed, Embase and PsycInfo up to 19 July 2024. A total of thirty-eight prospective cohort studies (twenty-three cross-sectional and fifteen longitudinal analyses) and thirteen intervention studies were included. Cross-sectional analyses revealed heterogenous associations: baked fish correlated with larger hippocampal volumes (β = 0·21), while oily fish, dairy products and tofu adversely related to ventricle grade. Pro-inflammatory dietary patterns were positively associated with silent infarct risk (DII Q4 v. Q1, OR = 1·77), whereas anti-inflammatory patterns tended to favour brain preservation. Longitudinal studies demonstrated more consistent protective associations: green tea consumption (+100 mL/d) reduced hippocampal atrophy by 0·024%/year, prudent dietary patterns preserved +203 mm3 left hippocampal volume over 4 years and higher plasma carotenoids decreased medial temporal lobe loss by 0·02 cm3/year. However, null findings were common across multiple dietary factors. Interventions showed limited structural benefits (effective in only two of six studies), while polyphenol-rich supplements more consistently improved cerebral perfusion and functional connectivity. Longitudinal and intervention studies demonstrated more consistent patterns than cross-sectional analyses; however, current evidence remains limited for clinical translation. Findings from cross-sectional analyses, despite being from prospective cohorts, require careful interpretation. Further replication across diverse populations and standardised long-term studies are needed before translating these associations into clinical practice.
Malnutrition results from inadequate nutrient intake, assimilation or utilisation, negatively impacting clinical outcomes and quality of life. It likely compromises gut barrier integrity, increasing intestinal permeability (IP), which impairs nutrient absorption or utilisation and increases the risk of infections and inflammation. This systematic review aims to examine the current evidence on the association between malnutrition and IP, identifying existing research gaps. A systematic search was conducted on PubMed, Scopus and Web of Science up to June 2024. According to PECOS strategy, ‘P’ = malnourished individuals or at risk of malnutrition, assessed for intestinal permeability; ‘E’ = malnutrition or risk of malnutrition; ‘C’ = well-nourished individuals; ‘O’ = increased intestinal permeability; and ‘S’ = all study types. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was followed, and Study Quality Assessment Tools (NIH) were used for methodological quality analysis. Sixteen studies met the inclusion criteria, with a moderate/high risk of bias. Malnourished individuals exhibited increased IP across various conditions (e.g. anorexia nervosa, cancer and liver cirrhosis) or setting (hospital and community). A wide heterogeneity was observed in malnutrition assessment tools, which consider different parameters such as body mass index, body weight loss and food intake. Similarly, diverse biomarkers/methods for assessing IP, including direct and indirect approaches, were used. Despite methodological heterogeneity, findings show an association between malnutrition and increased IP. Standardised research, including comprehensive biomarker panels, is needed to improve comparability, facilitating the development of targeted interventions for preventing malnutrition and managing its complications.
Growing evidence has linked both the onset and symptoms of various mental disorders to lifestyle factors such as diet, exercise and sleep. The link between diet and mental health, in particular in depressive disorders, has gained interest in recent years. Previous reviews assessing the link between the Mediterranean diet (MedDiet) and mental health predominantly focused on depression, whilst others failed to integrate a summary of possible underlying mechanisms related to a link between MedDiet and mental health to complement their findings. In the present review, we provide a comprehensive synthesis of evidence on the MedDiet and diverse mental health outcomes complemented by narration of the potential mechanisms involved. A literature search was conducted across MEDLINE, PsycINFO, Scopus, Cochrane library, Google Scholar, CINAHL and Embase databases. A total of 10 249 articles were found through the primary literature search and 104 articles (88 observational and 16 interventional studies) were eligible for inclusion. The MedDiet has been associated with favourable mental health outcomes in adult populations, including reduced depressive and anxiety symptoms, lower perceived stress, and improved quality of life and overall wellbeing, both in healthy individuals and those with comorbidities, across diverse geographical settings. Mechanisms involved include the antioxidant, anti-inflammatory potential of the MedDiet and its effect on gut microbiota. Further research is warranted to rigorously establish causal inferences and to guide the optimal incorporation of Mediterranean diet principles into comprehensive prevention and treatment strategies aimed at improving mental health outcomes.
Sub-Saharan Africa (SSA) is currently undergoing rapid urbanisation, a transition that is closely linked to the adoption of sedentary lifestyles and Westernised dietary habits. This shift has contributed to a substantial rise in obesity and diet-related non-communicable diseases (DR-NCDs), placing a significant strain on already burdened healthcare systems. Among the key modifiable risk factors driving this epidemiological transition are changes in dietary patterns. Western-style diets have been shown to promote inflammation and trigger metabolic and immune dysregulation, factors that underlie the development of DR-NCDs. Conversely, many Tanzanian heritage diets incorporate a diverse array of nutrient-rich foods prepared using techniques that minimise the use of oils, sweeteners and preservatives. These diets predominantly use whole grains, legumes and fruits, foods high in dietary fibre and nutraceuticals. Nutraceuticals are known to have both immunomodulatory and metabolic benefits and could potentially counteract the negative effects associated with Western-style diets. However, the limited scientific documentation of these heritage diets endangers future research into their potential health benefits. This underscores the need for targeted efforts to preserve and promote traditional dietary practices. In this review, we summarise the diversity of heritage diets from four distinct tribes in Northern Tanzania – the Maasai, Chagga, Pare and Hadzabe – who have historically exhibited low rates of DR-NCDs but are now experiencing rapid urbanisation and lifestyle changes. We briefly describe the dietary patterns of these tribes and examine the potential links between the declining usage of traditional dietary practices and the rising prevalence of DR-NCDs in Tanzania.
A major driver of the link between poor water, sanitation and hygiene (WASH) and child stunting is hypothesised to be a sub-clinical condition of the small intestine termed environmental enteric dysfunction (EED). This systematic review aimed to collate research investigating the association between biomarkers of EED and child linear growth outcomes. A systematic search of literature was conducted to identify articles that contain a measure of a domain of EED and its association with linear growth outcomes published up to 31 December 2024. Data pertaining to the measure of EED and child linear growth, as well as study characteristics, were extracted and tabulated. A total of eighty-one studies comprising 31 996 children were included, which suggested that all EED domains, including intestinal damage and repair, intestinal absorption and permeability, microbial translocation, intestinal inflammation and systemic inflammation, were associated with child linear growth. Nuances in the measurement of association were apparent and impacted the observation of significant associations. This review found that whilst the role of EED in child stunting is relatively well established, there are challenges faced in measuring biomarkers in relation to linear growth with possible ambiguities. These issues are discussed in detail to provide aid in interpretation of existing studies and to inform future studies of this kind.
