Proceedings of the Nutrition Society最新文献

Musculoskeletal disorders and age-related musculoskeletal decline are major contributors to the burden of ill health seen in older subjects. Despite this increased burden, these chronic disorders of old age receive a relatively small proportion of national research funds. Much has been learned about fundamental processes involved in ageing from basic science research and this is leading to identification of key pathways that mediate ageing which may help the search for interventions to reduce age-related musculoskeletal decline. This short review will focus on the role of reactive oxygen species in age-related skeletal muscle decline and on the implications of this work for potential nutritional interventions in sarcopenia. The key physiological role of reactive oxygen species is now known to be in mediating redox signalling in muscle and other tissues and ageing leads to disruption of such pathways. In muscle, this is reflected in an age-related attenuation of specific adaptations and responses to contractile activity that impacts the ability of skeletal muscle from ageing individuals to respond to exercise. These pathways provides potential targets for identification of logical interventions that may help maintain muscle mass and function during ageing.

In 2023, the UK government announced a Major Conditions Strategy, publishing 'The case for change and our strategic framework', which set out the focus on cancers, diabetes, dementia, mental ill health, musculoskeletal disorders, CVD and chronic respiratory diseases. Together, these conditions account for 60% of total disability-adjusted life years lost to early death or ill health in England, and one in four adults has at least two (multimorbidity). This review considers some of the key dietary risks for these major conditions and population policies that may improve diets and reduce risks. UK Government dietary recommendations, based on independent risk assessment and advice from the Scientific Advisory Committee on Nutrition, are encapsulated in the national food model, the Eatwell Guide. Based on key sources of dietary data - chiefly consumption data from the National Diet and Nutrition Survey and consumer purchase data from Kantar - most people do not meet dietary recommendations. This review considers how science and evidence inform health improvement policy. This includes policies that encourage healthier food choices, such as labelling and public procurement standards to those that minimise the impact of the less healthy choice such as sugar and salt reduction and reformulation. The review also considers nutritional approaches to managing some non-communicable diseases. Given the role nutrition and excess weight play in the onset, prognosis and quality of life for those living with one or more of the major conditions, there are huge potential gains from even small dietary improvements across population groups.

Loss of skeletal muscle strength and mass (sarcopenia) is common in older adults and associated with an increased risk of disability, frailty and premature death. Finding cost-effective prevention and treatment strategies for sarcopenia for the growing ageing population is therefore of great public health interest. Although nutrition is considered an important factor in the aetiology of sarcopenia, its potential for sarcopenia prevention and/or treatment is still being evaluated. Nutrition research for sarcopenia utilises three main approaches to understand muscle-nutrition relationships, evaluating: single nutrients, whole foods and whole diet effects - both alone or combined with exercise. Applying these approaches, we summarise recent evidence from qualitative and quantitative syntheses of findings from observational and intervention studies of healthy older adults, and those with sarcopenia. We consider protein supplements, whole foods (fruits and vegetables) and the Mediterranean diet as exemplars. There is some evidence of beneficial effects of protein supplementation ≥ 0·8 g/kg body weight/d on muscle mass when combined with exercise training in intervention studies of healthy and sarcopenic older adults. In contrast, evidence for effects on muscle function (strength and physical performance) is inconclusive. There is reasonably consistent epidemiological evidence suggesting benefits of higher fruits and vegetables consumption for better physical performance. Similarly, higher adherence to the Mediterranean diet is associated with beneficial effects on muscle function in observational studies. However, intervention studies are lacking. This review discusses how current evidence may inform the development of preventive and intervention strategies for optimal muscle ageing and nutritional public policy aimed at combatting sarcopenia.

This review aims to highlight some of the key bioactive functionalities that a range of components in milk can potentially make to reduce risks to health at key life stages. Such functionalities cannot be adequately explained by traditional estimates of nutrient supply. The benefits of gangliosides from the milk fat globule membrane (MFGM) for neonatal neurodevelopment are examined along with milk proteins for growth stimulation of children via the proteins' ability to stimulate insulin-like growth factor-1 (IGF-1). Exosomes in bovine milk and their miRNA are bioavailable, with an animal study indicating that placenta development and embryo survival were both enhanced. Concerning bone health, the unique characteristics of the casein micelle for supplying Ca, P and Mg to the GI tract were considered. The so-called dairy food matrix and the hypotensive effect of some peptides from milk proteins may be compensatory factors for SFA regarding CVD risk. The recent rise in use of glucagon-like peptide-1 (GLP-1) receptor agonists for adiposity reduction and improving glycaemic control is noted alongside evidence that milk proteins can stimulate GLP-1 synthesis potentially reducing GLP-1 receptor agonist need in high milk protein consumers. Other functionality included the ability of whey proteins to stimulate synthesis of skeletal muscle protein, crucial for bone protection and glycaemic control and the role of milk/Ca for reducing colorectal cancer risk. Perhaps the most exciting functionality is that of polar phospholipids in the MFGM potentially improving cognition and reducing the risk of dementia in the elderly. Clearly more human studies are needed.

Longer life expectancy and growing income inequality have prompted an increasing interest in understanding the impact of ageing on nutritional requirements in order to optimise intakes, increase the number of years lived in good health and reduce morbidity and associated health and social care costs. Food insecurity reduces access to nutritious and healthy food. Understanding the evidence base on the impacts of food insecurity and the maintenance of food security for older people is crucial to informing policy and intervention. The increase in numbers of older people experiencing food insecurity is a public health emergency and is associated with under and malnutrition. Food insecurity can be experienced at any stage of the life course but has been more widely studied with families and children where poverty is a major driver. Food insecurity in later life has been less well explored by academics, but differs from that experienced in earlier years due to additional complexities, as physical and cognitive health amplify the impact of poverty. Additionally, factors which can appear to be relatively small in impact can act in a cumulative way to push people towards food insecurity. This review will draw on research about older people's food practices, contexts and experiences in relation to food insecurity in later life and offers a model of food insecurity that has the potential to guide focused public health efforts in order to support the older population to be food secure.

Intrinsic capacity, introduced by the WHO, represents a shift in focus from treating disease to maintaining physical and mental capacities individuals as they age. It encompasses five interrelated domains: vitality, sensory, cognition, psychology, and locomotion. Vitality refers to the body's physiological reserve and is shaped by processes such as energy metabolism, immune function, and neuromuscular integrity. By definition, vitality is closely linked to nutritional status, which plays a central role in maintaining resilience and health in older adults. However, integrating nutritional status into the vitality domain presents several challenges due to inconsistent definitions and varied measurement approaches. This review examines these challenges and explores possibilities for integrating nutritional status in the vitality domain. The absence of standardised nutrition-related indicators limits comparability across studies and constrains the practical application of intrinsic capacity in both research and clinical contexts. To strengthen the role of intrinsic capacity in nutritional monitoring, it is essential to reach consensus on which nutritional indicators to include and how to score them consistently. Addressing these methodological challenges will support the use of intrinsic capacity in identifying early signs of nutritional decline and guiding timely interventions to promote healthy ageing.

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.

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.

The 58th Annual Scientific Conference of the Nutrition Society of New Zealand, held in Christchurch in 2024, brought together 187 delegates under the theme 'Kotahitanga: Bridging Research, Industry and Practice'. This theme reflected the society's commitment to uniting diverse sectors to address key nutrition challenges across the life course. Kotahitanga refers to unity and collective action. Topics included nutrition in ageing and chronic disease, infant and toddler nutrition, gut health, sustainable food systems and food safety. Presentations on sarcopenia and Parkinson's disease emphasised the need for greater awareness and tailored nutrition strategies for older adults. The Muriel Bell Lecture celebrated the legacy of New Zealand's first State Nutritionist and called for continued leadership in evidence-based nutrition and encouraged nutritionists to communicate research to the public. A panel on science communication offered practical strategies for engaging the public and countering misinformation. The conference reinforced the importance of collaboration, advocacy and practical application in advancing nutrition.