Abstract Lithium is a mainstay treatment in bipolar disorder and is used in various psychiatric conditions. Micro or trace doses have also been suggested to have potential neuropsychiatric effects. Dietary supplements containing lithium are available in the US, but no studies have evaluated their labelling regarding dosing, health claims, or precautionary practices. Products from the Dietary Supplement Label Database (DSLD) marketed between 2011 and 2025 were reviewed, with composition and dosing derived from declared labelling. Lithium amounts, mood-, cognitive-, and suicide-related claims, and precautions for pregnancy/breastfeeding, kidney, and antidepressant use were assessed, and associations with dosing were analysed using Mann–Whitney U tests with correction for multiple comparisons. Of 439 products, 99 met inclusion criteria. Forty-one percent were lithium-only, with reported elemental lithium ranging from trace amounts to 25 mg (median, 1.5 mg). Some elemental lithium amounts were comparable to the lowest manufactured doses of lithium carbonate. Lithium-only products contained higher elemental lithium than combination products ( p < 0.05), and lithium orotate was the predominant salt (52.5%). Products with mood-related claims had higher reported elemental lithium than those without (5 vs. 1 mg; p < 0.05), whereas no association was observed for cognitive claims. No products made suicide-related claims. Kidney- and antidepressant-related precautions were not associated with elemental lithium amounts, while products with pregnancy/breastfeeding precautions had higher reported content than those without (3.25 vs. 0.5 mg; p < 0.05). These findings highlight variability in dosing and labelling, with certain labelling features correlated with declared lithium amounts, possibly reflecting conventions in lithium use.
Energy drinks are widely consumed for their caffeine content and related ergogenic effects. Many energy drinks also contain additional ingredients purported to enhance both physical and cognitive performance; however, it remains unclear whether these benefits are attributable solely to caffeine or the synergistic effect of other ingredients. The purpose of this study was to assess the effects of an energy drink vs. a caffeine-matched control on measures of sustained attention. Using a randomised, double-masked design (n = 116), subjects were assigned to an energy drink (C4 - Nutrabolt®) or a caffeine-matched control (200 mg caffeine). The following assessments were conducted before and approximately 45 min after consuming an energy drink or caffeine-matched control: psychomotor vigilance test (PVT), MemTrax (memory), handgrip strength, and wall-sit endurance. Both the energy drink and the caffeine-matched control improved pre vs. post for the PVT (i.e. reaction time improved); however, there were no differences in the delta score. The energy drink group showed a significant decrease in the MemTrax assessment (% correct), whereas reaction time increased, with no change in the control group. However, there were no differences in the delta score between groups for either the % correct score or reaction time. There were no significant differences in the handgrip or wall-sit assessments between the two groups. There are no significant differences between the effects of consuming an energy drink or caffeine. Both beverages improved sustained attention and alertness likely due to the effects of caffeine. There were no differences in memory, handgrip strength, or wall-sit endurance.
In Japan, a version of the Japanese Food Guide, specifically developed for pregnancy and lactation (JFGST-P/L), promotes healthy dietary habits. In the mid- to-late stages of pregnancy, it is especially important to consume the recommended additional calories and nutrients. Adherence to these guidelines also plays a key role in achieving appropriate gestational weight gain (GWG). This study investigated the relationship between adherence to these guidelines and GWG among women in the mid- to late stages of pregnancy. Data were obtained from the Maternal and Child Cohort Study, conducted at the National Center for Child Health and Development (Setagaya-ku, Tokyo, Japan). The degree of adherence to the JFGST-P/L was evaluated using scores calculated from responses to a semi-quantitative food frequency questionnaire. The participants were classified into quartiles (Q1-Q4) based on their adherence scores. GWG was classified as inadequate, adequate, or excessive according to the Ministry of Health, Labour and Welfare guidelines. The degree of JFGST-P/L adherence was divided into quartiles, and a multinomial logistic regression analysis was performed. Furthermore, the Q1 group was compared with the Q2-Q4 groups to examine the association with the risk of insufficient GWG. In the quartile analysis, no clear dose-response relationship was observed between JFGST-P/L adherence and GWG. Conversely, among Q1, an increased risk of insufficient GWG was noted compared to the Q2-Q4 group (Unadjusted OR 1.389, 95%CI 1.008-1.913). In this study, the lowest degree of adherence to the JFGST-P/L among pregnant women was associated with inadequate GWG.
Many dietary interventions have been conducted in rheumatoid arthritis (RA) with quantitative outcomes the key focus; qualitative research exploring participant experiences remains limited. The autoimmune protocol (AIP) diet is an elimination reintroduction approach designed for autoimmune conditions. This study explored the experiences of nine adults with RA who completed an eight-week AIP dietary intervention, with semi-structured interviews conducted immediately post-intervention and again one year later. Interviews explored participants' motivations, challenges, enablers, and perceived effects of the intervention, their experiences with food reintroduction, and the degree to which dietary changes were sustained. Thematic analysis identified three themes related to initial intervention experiences. Open to change, captured initial motivations, trust in the protocol and willingness to attempt substantial dietary change. Navigating dietary transition described the mental, practical, and social strategies used to manage challenges and support adherence. Reflections on benefits and looking ahead, captured perceived health changes and intentions for future dietary practices. At one-year follow-up, three further themes were identified. Personalised reintroductions and responses highlighted how participants observed the effects of foods on RA and health. Finding and sustaining balance reflected the ongoing process of negotiating dietary structure with flexibility, particularly in social contexts. Reflections on wellbeing and future intentions encompassed perceived benefits, persistent challenges, and plans for ongoing dietary management. High initial adherence was facilitated by participant motivation and structured study support. The reintroduction protocol was perceived as burdensome, however, most participants sustained meaningful dietary change, even without ongoing formal guidance.
Prebiotics are selectively utilised dietary substrates that may influence depression through gut microbiota-related pathways, but population-level estimates of intake and associations with depression are limited. This repeated cross-sectional study estimated intake of International Scientific Association for Probiotics and Prebiotics (ISAPP)-recognised prebiotics and examined associations with depression among US adults using National Health and Nutrition Examination Survey (NHANES) 2015-2018 and NHANES August 2021-August 2023, analysed as independent survey periods. Estimated intakes of galactooligosaccharides and inulin-type fructans were assigned to foods using published source-food values, Food and Nutrient Database for Dietary Studies food codes, and ingredient-level information for mixed dishes. Depression was defined as Patient Health Questionnaire-9 score of 10 or greater. Survey-weighted analyses estimated intake distributions, and logistic regression models estimated ORs and 95% CIs for depression per 5 g/day higher estimated prebiotic intake in restricted adult samples. Mean estimated prebiotic intake was 6.44 g/day in NHANES 2015-2018 and 6.09 g/day in NHANES 2021-2023. In NHANES 2015-2018, higher estimated intake was associated with lower odds of depression overall (OR: 0.69; 95% CI: 0.49-0.98) and among females (OR: 0.65; 95% CI: 0.45-0.94), but not among males. In NHANES 2021-2023, estimated intake was not associated with depression overall (OR: 1.03; 95% CI: 0.74-1.43) or in sex-stratified models. These repeated cross-sectional findings provide nationally representative estimates of intake of ISAPP-recognised prebiotics and indicate that the inverse association observed in 2015-2018 was not replicated in 2021-2023. Prospective studies are needed to clarify whether prebiotic intake is associated with depression risk.
Coeliac disease (CD) is an autoimmune disease resulting in lifelong intolerance to gluten. Treatment of CD is a gluten-free diet (GFD). High gluten-free (GF) food costs contribute to GF-food insecurity (GF-FI) in households with children with CD. The study objective was to describe parental perceptions of the barriers/facilitators of GF-food security (GF-FS) and the health policies parents deem necessary to combat GF-FI. A subset analysis of a cross-sectional study examining household and child socio-demographic, child diet quality and GFD adherence, food environment, and GF-FI in parent-child dyads (n = 59) using validated questionnaires. Virtual interviews included 13 open-and-closed ended questions examining parent perceptions related to barriers/facilitators of GF-FS and health policies to address GF-FI. Questions were validated for face-and-content using an iterative process with parental responses deductively coded using the 5As of food insecurity theoretical framework. High GF-food costs (>90%) and the lack of effective GF-food specific health policies (∼94%) were the most commonly cited barriers to GF-FS, particularly in GF-FI households. Social media (>60%) was used to share information related to tax credits (15%) affordability, accessibility, and availability of GF-foods (75%). Parents deemed child tax credits (∼75%), development of food policies focused on education in schools (∼34%), dietary prescriptions (25%) and official recognition of CD as a disability (∼26%) as important to address GF-FI. In conclusion, parents perceive high GF-food costs and lack of effective GF-food health policies as important mediators of GF-FI. Social media platforms were widely used by the community to share information and solutions to address GF-FI.
This special issue of the JNS presents a selection of abstracts and outputs from the 23rd edition of the IUNS International Congress of Nutrition (IUNS-ICN Paris 2025), held in Paris from 24 to 29 August 2025. The Congress, themed 'Sustainable Food for Global Health', brought together students, researchers, academics, practitioners, and policy stakeholders from across the globe to share advances in nutritional science and address contemporary challenges in nutrition and health. A total of 3,805 delegates from 123 countries participated. This wide international participation reflected the global nature of the IUNS-ICN Paris 2025 and supported the exchange of perspectives across all areas of nutritional science.
In the context of the rapidly evolving modern food environment, there is a need for dietary assessment tools to accurately assess current food intake. The objective of this research was to develop and validate a new food frequency questionnaire (FFQ). A 265 item web-based, self-administered FFQ (PREDICT-FFQ-v1) was developed using information from two FFQs and US and UK cohort level data. Over a 1-month period, 68 participants completed the PREDICT-FFQ-v1 and six 24-h recalls (reference tool; Intake24). Relative validity was assessed using Bland-Altman plots, cross-classification food group analysis, and Spearman's rank correlation for food groups and nutrients. From the Bland-Altman plots, the median bias between the PREDICT-FFQ-v1 and Intake24 were energy (414 kcal (95%CI 289 to 609) (1734 kj (95% CI 1208 to 2549)), carbohydrate (2.3 %EI, 95%CI 0.08 to 3.68), fat (2.5 %EI, 95%CI 0.23 to 3.52), protein (-1.14 %EI, 95% CI -1.64 to -0.23), and fibre (1.86 g/1000 kcal, 95% CI 1.05 to 2.65). Cross-classification by quartiles of diet quality (plant-based diet index) categorised >76% of participants into the same or adjacent quartiles. Correlation coefficients for food groups assessed using both tools ranged from 0.38 (legumes) to 0.78 (meat), and for energy-adjusted nutrients ranged from 0.28 (total fat) to 0.82 (alcohol). The PREDICT-FFQ-v1 captures intakes of foods that are commonly consumed in modern diets, with greater resolution at the food level than previous tools. The PREDICT-FFQ-v1 has acceptable relative validity in comparison to 24-h dietary recall and provides a valuable alternative for assessing dietary intake in nutritional epidemiology.
Diabetic retinopathy (DR) is a leading cause of preventable blindness, particularly in regions with poor glycemic control and limited access to structured education. Theory-driven interventions such as the Theory of Planned Behaviour (TPB) may enhance self-care and improve clinical outcomes. To evaluate the effectiveness of a TPB-based self-care education programme on glycemic control, knowledge, self-care behaviours, and TPB constructs among patients with diabetic retinopathy. This quasi-experimental pretest-posttest-controlled study was conducted between September 2024 and August 2025 among 200 patients with diabetic retinopathy attending a tertiary diabetes centre in Erbil, Iraq. Participants were allocated to an intervention group (n = 100) receiving a structured three-session TPB-based education programme or a control group (n = 100) receiving standard care. Outcomes were assessed at baseline and 3 months. The primary outcome was HbA1c. Secondary outcomes included diabetes knowledge, self-care practices, and TPB constructs. Statistical analyses included paired and independent t-tests, chi-square tests, and effect size estimation. At 3 months, HbA1c significantly decreased in the intervention group (-0.50%) but increased in controls (+1.06%), yielding a significant between-group difference (-1.50%, 95% CI: -1.93 to -1.07; p < 0.001; d = 0.97). Significant improvements were observed in systolic blood pressure, total cholesterol, and LDL cholesterol. Diabetes knowledge improved markedly, with 56% achieving high knowledge versus 0% in controls (p < 0.001). Self-care behaviours and TPB constructs also improved significantly (all p < 0.001). A brief TPB-based education programme significantly improved glycemic control and self-management in patients with DR. This low-cost intervention offers a scalable strategy for reducing diabetes-related complications in resource-limited settings.
Alanine, commonly found in meaty foods and popular as a sports supplement, has interactions with neurotransmitters and brain energy supply, but its impact on mental health remains uncertain. This two-sample Mendelian randomisation (MR) study aimed to investigate causal associations of plasma alanine with major mental disorders-depression, bipolar disorder, schizophrenia, anxiety, and attention-deficit hyperactivity disorder (ADHD) and to further explore sex-specific associations using available data, considering potential sex disparity. We utilised genetic variants from the UK Biobank to predict plasma alanine (N = 115,074) and obtained their genetic associations with depression (N cases = 194,180 and N controls = 521,663), bipolar disorder (N cases = 46,418 and N controls = 563,769), schizophrenia (N cases = 52,017 and N controls = 75,889), anxiety (N cases = 19,529 and N controls = 212,855), and ADHD (N cases = 46,418 and N controls = 402,606) from genome-wide association studies (GWASs) in the Psychiatric Genomics Consortium (PGC) and FinnGen Biobank. MR estimates were primarily derived using the inverse variance weighted (IVW) method, with weighted median, MR-Egger, and MR-RAPS applied as sensitivity analyses. MR-PRESSO was used to detect pleiotropy and outliers. Genetically predicted alanine was nominally associated with a lower risk of schizophrenia overall (OR 0.88, 95% CI: 0.79-0.99) and in males (OR 0.88, 95% CI: 0.77-0.99), which were not significant after multiple testing. No association was detected in females (OR 0.92, 95% CI: 0.80-1.05). There was no evidence linking plasma alanine to depression, bipolar disorder, anxiety, or ADHD. These findings suggest that alanine might have an inverse association with schizophrenia, which may be more evident in males, but has no psychiatric side effects on other mental disorders. Replication in larger studies is warranted.
Intestinal inflammation can lead to inflammation-related diseases such as IBD, so modulation of inflammatory responses is crucial for maintaining homeostasis in the gut and alleviating intestinal inflammation. Autophagy may play a functional role in inflammatory responses and inflammatory signalling pathways. In addition, probiotics can influence important signalling pathways that lead to inflammation. Thus, our objective was to investigate the impact of probiotics on autophagy gene expression to prevent or reduce inflammation by targeting the autophagy signalling pathway. A relative real-time PCR assay was performed to evaluate gene expression involved in the autophagy process after exposing the HT-29 cell line to sonicated pathogens and adding a native potent Lactobacillus/Bifidobacterium cocktail before, after, and simultaneously with inflammation. In general, the native potential Lactobacillus/Bifidobacterium mixture was able to significantly increase autophagy gene expression in all phases and our selected probiotics can influence all phases of the autophagy signalling pathway. Our native Lactobacillus/Bifidobacterium cocktail exhibited a significant impact on the expression of autophagy genes throughout all treatments, particularly during the pre-inflammatory phase. Consequently, our selected probiotics can potentially serve a preventive function in an in vitro model of inflammation.
Dietary fibre improves metabolic health, yet comparative evidence across different fibre sources remains unclear. This systematic review evaluates metabolic effects of oat β-glucan, rice bran, and unripe banana flour in adults, assessing glycaemic, lipid, and mechanistic effects, synthesising their physiological pathways across distinct fibre types (viscosity-driven, phytochemical-mediated, and resistant starch fermentation mechanisms). Following PRISMA 2020 guidelines, PubMed, Scopus, and Web of Science were searched up to June 2025. A total of 602 records were identified, and after removing 146 duplicates, 456 were screened. Forty-four full texts were assessed, and 15 studies were included. Risk of bias was evaluated using RoB 2.0 and Newcastle-Ottawa. Outcomes included glycaemic markers, insulin response, lipid profile, blood pressure, body composition, and mechanistic biomarkers. Studies (n = 15; sample sizes 10-154; durations 3 days-12 weeks) demonstrated heterogeneous dosing and formulations. Oat β-glucan consistently improved postprandial glucose, insulin AUC, and LDL-C, with modest effects on waist circumference and blood pressure. Rice bran improved blood lipids consistently, while glycaemic effects were mixed. UBF resistant starch was associated with reduction in fasting glucose, HOMA-IR, and body weight, although findings are based on small, short-duration trials. However, variability in study design and limited mechanistic assessments restricted cross-fibre synthesis. The available evidence suggests modest improvements in glycaemic and lipid outcomes. Differences in responsiveness likely reflect variations in fibre structure, viscosity, and fermentability, suggesting complementary physiological pathways. Standardised dosing, longer interventions, and mechanistic biomarkers - including SCFA profiles, incretin response, and bile acid signalling - are needed to clarify inter-individual variability and guide fibre-based interventions.
Allergies are a growing public health concern worldwide. This meta-analysis investigated the association between adherence to the Mediterranean diet (MD) and the occurrence/severity of respiratory allergic conditions. Electronic databases (PubMed, Scopus, Science Direct, and EBSCO) were searched for studies published up to April 2024. Eligible studies reported OR with 95% CI for asthma, wheezing (respiratory symptom associated with allergic airway disease), rhinitis, or eczema. Food allergy was evaluated only qualitatively due to insufficient data. The risk of bias was assessed using the National Heart, Lung, and Blood Institute tool, and random-effects models were applied to account for heterogeneity. A total of twenty-three studies involving 111,583 participants met the inclusion criteria. Individual studies could contribute to more than one condition-specific analysis if they reported outcomes for multiple allergic conditions. Pooled analyses demonstrated a significant protective effect of MD against asthma (n = 11, log OR: -0.18; 95% CI: -0.34, -0.02), wheezing (n = 6, log OR: -0.29; 95% CI: -0.56, -0.03), and rhinitis (log OR: -0.54; 95% CI: -1.00, -0.08), with stronger effects in Mediterranean populations. No significant association was observed with eczema (pooled log OR: 0.09; 95% CI: -0.02, 0.20). Heterogeneity was moderate across analyses. Publication bias was evaluated using forest plots and Egger's test. These findings suggest that MD adherence was associated with lower odds of asthma, wheezing, and rhinitis, but does not influence eczema risk. Further longitudinal studies with standardised methodologies are needed to confirm causality. Promoting MD adherence may offer a valuable population-level strategy for allergy prevention. Systematic review registration: PROSPERO-CRD42023408724.
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.
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.
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.
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.
The rapid expansion of omics technologies has created new opportunities to understand inter-individual variations in metabolic responses to diet. Such advances are particularly relevant for Asian populations, which exhibit distinct metabolic characteristics, including increased visceral adiposity, reduced β-cell reserves, and heightened susceptibility to type 2 diabetes at lower BMI levels, compared to Western populations. This review synthesizes the current evidence on metabolomic and genomic biomarkers associated with metabolic health in Asians and outlines the mechanistic pathways through which diet influences these biomarkers. Metabolomic signatures, such as lysophosphatidylcholines, micronutrient-derived metabolites, amino acid profiles, and oxidative stress indicators, have demonstrated strong potential for the early detection of metabolic dysfunction. In addition, carbohydrate-related markers of glycemic excursions, microbiome-derived metabolites, and diet-responsive fatty acid profiles may help capture the heterogeneity in postprandial regulation and diet responsiveness. Genetic variants enriched in Asian populations, including TMEM182- and NPC1L1-related polymorphisms, further modulate lipid metabolism, adipogenesis, and glycemic regulation. We also highlighted β-cell and nutrient-handling loci (e.g. KCNQ1, TCF7L2, SLC30A8, FUT2/6, BCMO1, and FADS1/2) as mechanistic anchors for biologically stratified dietary personalization. We discuss nutrient-metabolite interactions - particularly those involving dietary fibre and legumes - within culturally patterned Asian diets and highlight culturally consistent dietary strategies supported by multi-omics evidence. Finally, we propose a translational framework for implementing precision nutrition in Asia, emphasizing analytical standardization, clinician training, digital health integration, and equity considerations. Together, these insights underscore the potential of multi-omics approaches to inform individualized dietary recommendations and improve metabolic health across diverse Asian populations.
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.
