Proceedings of the Nutrition Society最新文献

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.

Healthy ageing and longevity have emerged as urgent public health priorities amid global population ageing and declining birth rates. This review synthesises empirical evidence highlighting the essential role of diet and nutrition in preventing chronic diseases and supporting functional independence in later life. The review was organised using a problem-solving approach to address three core questions: 'What' evidence links food and nutrition with positive health outcomes; 'Why' do specific dietary components affect biological ageing - via mechanisms such as nutrient sensing, inflammation modulation and caloric restriction; and 'How' culturally tailored, person-centred dietary interventions should be developed for better adoption. Findings from centenarian populations suggest that low-energy (i.e. foods with low energy density, such as fruit and vegetables, whole grains), nutrient-rich and diverse diets may help prevent or delay age-related diseases, supporting the notion that food could be used as medicine. Moreover, addressing barriers such as food insecurity and limited access to culturally appropriate healthy food options, particularly in low-income and rural communities, is crucial for achieving equitable health outcomes. Finally, the review calls for integrating personalised nutrition strategies into clinical care and public health initiatives. These efforts can enhance healthspan, improve quality of life and reduce the broader social and economic burdens associated with ageing populations.

Personalised nutrition aims to deliver targeted advice to promote dietary behaviours that are beneficial to health based on individual characteristics. Given the financial implications (for providers and participants) of characterising, developing, implementing, communicating and supporting individual behaviour change there remains potential for personalised nutrition to widen health inequalities within populations. Some commentators promote a universal approach to achieve wider population-level benefit. Universal approaches attempt to provide a whole systems perspective with individual outcomes, potentially smaller in scale, impacting at the population level. In the UK the national food-based guidance, the Eatwell Guide, is used to communicate advice on diet consistent with UK government dietary recommendations based on robust, independent assessment of the best available evidence by the Scientific Advisory Committee on Nutrition. Effort was taken in ensuring all UK government recommendations in 2016 (when the UK's national food-based guidance was last reviewed following changes in dietary recommendations on carbohydrates and sugars) could be achieved at a population level based on available and recognised foods. There is evidence that moving towards a diet consistent with national food-based guidelines has positive benefits for health and the environment. There is debate about the cost of a healthy diet and the impact of including elements of sustainability elements. This commentary considers how developments in healthy eating indices may be beneficial as a universal approach could provide opportunities to support individuals move towards healthier diets. It also raises questions about the evidence requirements and timing of any future amendments to the UK's Eatwell Guide.

As the global population ages, the prevalence of cognitive decline is rising, creating urgent demand for proactive strategies that support brain health and healthy ageing. Ergothioneine, a unique dietary amino-thione absorbed via the OCTN1 transporter, has recently gained attention for its potential as a neuroprotective, longevity-promoting compound. This review synthesizes growing evidence from observational, interventional and mechanistic studies. Observational data consistently associate low blood ergothioneine levels with cognitive impairment, neurodegenerative diseases, cardiovascular disorders, frailty and mortality. Interventional trials in older adults suggest that ergothioneine supplementation may improve cognition, memory, sleep quality and stabilize neurodegeneration biomarkers, with no safety concerns at doses up to 25 mg/day. Mechanistic studies reveal that ergothioneine acts through multiple pathways: mitigating oxidative stress, reducing neuroinflammation, preserving mitochondrial function and potentially modulating neurogenesis and NAD⁺ metabolism, although some mechanisms require further investigation. Beyond cognition, ergothioneine shows promise in supporting other physiological systems relevant to ageing, including cardiovascular, metabolic, gut, eye, auditory, liver, kidney, immune, skin and lung health. Together, current evidence positions ergothioneine as a promising nutritional intervention for promoting cognitive resilience and systemic health in ageing, although larger, long-term interventional trials are needed to confirm causality and optimize use.

This review examines the relationship between diet and functional dyspepsia (FD), a prevalent disorder of gut-brain interaction affecting 8% of the global population and characterised by postprandial fullness, early satiety and epigastric pain or burning. Despite 40-70% of FD patients reporting symptom onset within minutes of eating, standardised dietary recommendations remain limited. The pathophysiological mechanisms underlying food-related symptoms in FD involve complex interactions between altered gastric accommodation and emptying, visceral hypersensitivity, duodenal immune activation and small intestinal microbial dysbiosis. Current evidence most strongly supports dietary lipids as potent triggers of dyspeptic symptoms, likely mediated through cholecystokinin pathways and heightened visceral sensitivity. Additionally, emerging research indicates potential benefits of fermentable carbohydrate restriction, with the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet showing promise particularly for patients with postprandial distress syndrome. Other dietary factors such as alcohol, coffee, food chemicals, bioactive compounds and meal patterns may also influence FD symptoms though current evidence remains insufficient to inform clinical practice. While existing evidence provides a foundation for understanding diet-symptom relationships in FD, significant gaps remain in translating mechanistic insights into personalised dietary recommendations. Future research should focus on developing evidence-based dietary strategies tailored to FD subtypes, ensuring nutritional adequacy while addressing the complex interplay between nutrient sensing, duodenal immune activation and gut microbiota in symptom generation.