Firefighters face significantly elevated cancer risks due to chronic exposure to carcinogenic fire effluents and occupational stressors. In 2022, the World Health Organization classified firefighting as a carcinogenic occupation, linking it to increased incidences of cancers, including mesothelioma, bladder, prostate, colon and melanoma. Drawing on UK-specific data where possible, this narrative review explores how dietary strategies, particularly the Mediterranean diet, may complement existing protective measures in mitigating these risks. It investigates specific food-based nutrients that show promise in addressing risks associated with fire effluent contaminants, examining nutrient-mediated mechanisms and their relevance to firefighter health. The review also highlights the distinct combination of challenges firefighters face in adopting healthier dietary patterns, including disrupted routines, group eating cultures and gaps in nutritional education. While the evidence for firefighter-specific dietary interventions is still emerging, this review highlights the potential of sustainable dietary strategies to significantly reduce cancer risks and improve long-term health outcomes. Finally, it calls for targeted research and interventions to refine these strategies and deliver tangible health benefits for firefighters worldwide.

To achieve infectivity, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, must first traverse the upper respiratory tract mucosal barrier. Once infection is established, the cascading complexities of the pathophysiology of COVID-19 makes intervention extremely difficult. Thus, enhancing the defensive properties of the mucosal linings of the upper respiratory tract may reduce infection by SARS-CoV-2 and indeed by other viruses such as influenza, which have been responsible for the two major pandemics of the last century. In this review we summarise potential opportunities for foods and nutrients to promote an adequate mucosal immune preparedness with an aim to assist protection against infection by SARS-CoV-2, to maximise the mucosal vaccination (IgA inducing) response to existing systemic vaccines, and to play a role as adjuvants to intranasal vaccines. We identify opportunities for vitamins A and D, zinc, probiotics, bovine colostrum and resistant starch to promote mucosal immunity and enhance the mucosal response to systemic vaccines, and for vitamin A to also improve the mucosal response to intranasal vaccination. It is possible that an entirely different virus may in the future, by way of convergent evolution, utilise a similar upper respiratory tract infection pathway. A greater research focus on mucosal lymphoid immune protection in partnership with nutrition would result in greater preparedness for such an event.

Weaning and introduction to a solid diet result in physiological stress in piglets. This can be offset by using complex diets. The terms ‘complexity’ and ‘complex diets’ are used in practice and academia but are not precisely defined. The aim of this review was to identify the ingredients in weaner diets, their inclusion levels and how the number of ingredients or complexity of diets influences weaner performance, intestinal and systemic health, environmental sustainability and antibiotic use. Not all diets are formulated equally. Some prioritise meeting the weaner’s nutritional needs, while other diets seek to align health promotion and adaptation to the environment. As diet composition is of vital importance for young piglets, the components needed in these complex diets must be defined. Healthy, environmentally adapted pigs have excellent growth performance. We therefore recommend use of a new term, ‘gut health supporting diets’, to encompass the many concepts associated with diet complexity.

The concept of the protein transition represents a shift from a diet rich in animal proteins to one richer in plant-based alternatives, largely in response to environmental sustainability concerns. However, a simple swap by replacing dairy protein with plant protein will lead to lower protein quality and a lower intake of key micronutrients that sit naturally within the dairy matrix. Owing to antagonistic effects within the plant food matrix, micronutrients in plant sources exhibit lower bioavailability which is not reflected in food composition data or dietary guidelines. The dairy matrix effect includes moderation of blood lipid levels in which calcium plays a key role. Protein recommendations often take a muscle-centric approach. Hence, strategies to increase the anabolic potential of plant proteins have focused on increasing total protein intake to counter the suboptimal amino acid composition relative to dairy protein or leucine fortification. However, emerging evidence indicates a role for nutrient interactions and non-nutrient components (milk exosomes, bioactive peptides) of the dairy matrix in modulating postprandial muscle protein synthesis rates. To ensure the food system transformation is environmentally sustainable and optimal from a nutrition perspective, consideration needs to be given to complementary benefits of different food matrices and the holistic evaluation of foods in the protein transition. This narrative review critically examines the role of dairy in the protein transition, emphasising the importance of the food matrix in nutrient bioavailability and muscle health. By considering both nutritional and sustainability perspectives, we provide a holistic evaluation of dairy’s contribution within evolving dietary patterns.

Adolescent girls are vulnerable and deserve the utmost attention to complement their nutrition. This scoping review endeavours to identify the determinants of malnutrition among adolescent girls in Pakistan and to comprehend the interventions to improve their health and nutritional status. This review of the literature was conducted using Google Scholar, PubMed/Medline, Scopus and Web of Science for articles published between 2015 and 2024. MeSH terms used for search were as follows: adolescent, youth, health, malnutrition, nutrition interventions, systems approach. In addition, reports from the WHO, the UN, the World Bank, the Government of Pakistan and other organisations were also critically reviewed. Moreover, this paper has used the Pathways framework, which advocates multi-sectoral approaches for poverty reduction. In most developing countries, the compromised nutritional status of adolescent girls, compounded by poverty, has life-long health and economic consequences, as well as their infants having nutritional deficits. They are expected to grow as stunted children. Abundant evidence has shown that nutrition-sensitive and nutrition-specific interventions can improve their nutritional status and that of subsequent generations. There is a dire need to involve key stakeholders from health, education, nutrition, population, women’s development, social welfare and other relevant sectors. It is imperative to design interventions for adolescent girls in each country’s context to break the intergenerational cycle of malnutrition and to improve economic productivity. Political commitment and effective governance along with policy coherence are required for their healthy transitions into adulthood.

Many people with rheumatoid arthritis (RA) believe that certain foods may influence disease activity. Elimination reintroduction diets and oral food challenges are dietary strategies used to identify foods that may exacerbate symptoms. This review summarises and appraises the literature on elimination diet interventions that include food reintroductions or oral food challenges in adults with RA. It describes study design, measures used to assess the effects of food exclusion and challenge, foods identified that may affect RA symptoms, and the measures used to assess the outcome of excluding those foods. A search of five databases, two thesis repositories and Open Grey was conducted to identify records published from inception to January 2025, using terms related to RA, elimination diets and food sensitivity. Eligible records were screened independently by two reviewers, and data extraction followed Joanna Briggs Institute guidelines. Data are presented using a narrative synthesis approach with descriptive data analysis. In total, forty-eight records met inclusion criteria comprising twenty intervention studies (sample sizes 4–94) and seventeen case studies, conducted across twelve countries (1949–2024). Interventions included single-food exclusions, few-food diets, low-allergen meal replacements and fasting protocols. Reintroduction methods varied from a single-food challenge to multiple reintroductions, with five studies using blinded challenges. Outcome measures included physician- or participant-observed symptom changes, clinical assessments and laboratory measures, though these were heterogeneous. Findings reveal a lack of standardised protocols, dated methodologies and limited contemporary research. Controlled studies are needed to establish evidence-based protocols, investigate mechanisms, and guide dietary strategies as adjuncts to RA pharmacological treatment.

Entomophagy (eating edible insects) could potentially address human deficiencies of iron, zinc and vitamin B12. This article aims to summarise available evidence about the iron, zinc and vitamin B12 content of raw and processed edible insects and compare these with the nutritional needs of different human life stages. A systematic literature search using specific keywords (edible insects, iron content, zinc content, vitamin B12 content and nutritional composition) in Web of Science and Scopus databases was performed. Forty-six studies were reviewed. To ensure standardised comparisons, articles with nutrient-enriched edible insects were excluded. The quality of records was assessed using standardised protocols. Results indicate that edible insects are generally either ‘sources of’ or ‘rich in’ iron, zinc and vitamin B12 required for optimal nutrition and health of different human life stages. Moreover, iron, zinc and vitamin B12 contents of edible insect species were generally either comparable to or higher than that of (lean) beef, (lean) pork, poultry and kidney beans. Most insect species were oven processed with little/no species-specific data for other processing methods. Variations in micronutrient content existed between processing methods and among oven-processed edible insects. Data inaccuracies, poor data quality control and lack of insect-specific official analytical methods contributed to fairly high variations and made comparisons difficult. Based on available data, edible insects can potentially address human deficiencies of iron, zinc and vitamin B12 despite the observed variations, data gaps and lack of edible insect matrix-specific official methods, in addition to limited human bioavailability and efficacy studies.

In Europe, organic food must comply with specific regulations which do not include nutritional criteria. The ability of organic food to meet the nutritional needs of children is not assessed. This narrative review discusses the nutritional composition (macronutrients, micronutrients) of organic food compared with conventional products and its clinical relevance with a paediatric focus, as well as the health impact of these differences and of contaminants which interfere with metabolism. Other potential differences, particularly regarding the direct/indirect exposure to other contaminants in conventional food, are not addressed in this review. The composition of some organic food may differ from conventional food. Protein content was lower in cereals and eggs. A lower n-6:n-3 polyunsaturated fat (PUFA) ratio was observed in milk, meat and eggs. Long-chain PUFA and vitamin E may be higher in milk, meat and fish, as well as some minerals and antioxidants (phenolic compounds, vitamin C) in fruits, vegetables and starchy food and carotenoids in fruits and vegetables. Epidemiological studies suggest an association between organic diets and lower prevalence of childhood obesity, type 2 diabetes and metabolic syndrome, whereas the protective effect on allergy and cancer is controversial. Some organic food may be of greater nutritional interest for children’s diet than conventional food. Standardised studies comparing food composition and diet in children are needed. Considering the lower toxicologic risk and the sustainability of organic food, the Committee on Nutrition encourages the use of organic food, provided that such food is affordable, alongside specific baby food which is subject to strict specific European Union regulations.

At present, the treatment of Alzheimer’s disease involves only symptomatic medications which have continually demonstrated little efficacy, primarily due to the presence of biological barriers. Despite efforts, researchers have yet to discover a therapeutic treatment that delays neurodegenerative progression or restores associated Alzheimer neuropathological processes. For centuries, Hericium erinaceus (HE) has been used predominantly in Asian countries for its culinary and medicinal purposes; however, this mushroom has not yet been utilised in western pharmacology. This review systematically investigates evidence pertaining to the use of HE as a potential future therapeutic treatment for the prevention and delayed progression of Alzheimer’s disease, by highlighting any fundamental neurotrophic and neuroprotective properties. In total, three human clinical trials and thirteen animal-model studies were included in review. The use of HE demonstrated positive significant differences in results obtained from behavioural, histological and biochemical assessments from both human clinical trials and animal model studies accentuating its utility for the improvement of cognitive function. In addition, erinacine-A-enriched HE appears to demonstrate the highest bioactive potency of all HE extracted compounds, providing the greatest effects while also showing transportability ease across biological barriers. In conclusion, evidence suggests that intake of HE may be an appropriate and relevant future therapeutic treatment for the prevention and delayed progression of Alzheimer’s disease; however, continued research is necessary to provide further significant evidence of this relationship, through an increased quantity of human clinical trials.

The iron regulation mechanisms are not exactly the same between adulthood and the early postnatal period. Also, neonatal iron status is different in full-term versus preterm infants because the prenatal/gestational period, when hepatic iron accumulates, is shortened. Newborns, especially premature infants, are at high risk of iron deficiency due to inadequate iron stores, which constitute the primary source of iron to satisfy the neonate’s increasing iron requirements. In addition, frequent blood transfusions and congenital haemochromatosis may induce iron overload in the affected neonate. To understand the cause of neonatal iron deficiency/overload and to promote the development of effective therapeutic interventions in humans, different animal models have been generated by genetic engineering, low-/high-iron diets, phlebotomy/transfusion and surgical manipulation. These models use various laboratory and domestic animals to study iron imbalance. They serve as surrogate models for experiments that are ethically or practically unfeasible to conduct on human neonates. Although an animal model for studying neonatal iron disorders may not fully replicate the complexities of human diseases, it is designed to model specific aspects of these conditions. Combined data from multiple models can help to offset the limitations inherent in each individual model. In this review, we outline approaches to induce neonatal iron disorders, current animal models of full-term and preterm neonates, and recommendations for diagnosis.

Chronic kidney disease (CKD) poses a global health challenge, with dietary protein intake being a key factor in disease management. This review synthesises evidence on the impact of different protein intake strategies, including low-protein diet (LPD), very-low-protein diet (VLPD), high-protein diet (HPD) and plant-based diet (PBD), on CKD progression and patient outcomes. The review explores personalised nutrition strategies and identifies gaps in the literature. A systematic search of PubMed, Cochrane Library, Web of Science and Scopus was conducted, covering studies published from 1982 to 2024, including randomised controlled trials (RCT), observational studies and meta-analyses involving adult patients with CKD. The findings suggest that LPD and VLPD may slow CKD progression, particularly when supplemented with ketoanalogues, but adherence and long-term benefits remain uncertain. PBD are associated with reduced renal burden and improved metabolic health, although achieving adequate protein intake from plant sources requires careful planning. HPD, particularly those rich in animal protein, may exacerbate CKD progression, although recent research indicates that higher protein intake may benefit specific populations, such as older adults with mild-to-moderate CKD. In conclusion, managing protein intake in CKD is complex and necessitates a personalised approach. While LPD and PBD offer potential benefits, their long-term success is contingent upon patient adherence, individualised dietary management and further research into their sustained effects. Future research should focus on long-term RCT and the development of personalised nutrition strategies incorporating emerging technologies and multidisciplinary care to optimise CKD management.

Intake of high quantities of dietary proteins sourced from dairy, meat or plants can affect body weight and metabolic health in humans. To improve our understanding of how this may be achieved, we reviewed the data related to the availability of nutrients and metabolites in the faeces, circulation and urine. All protein sources (≥20% by energy) increased faecal levels of branched-chain fatty acids and ammonia and decreased the levels of butyrate. Some metabolites responded to dairy and meat proteins (branched-chain amino acids) as well as dairy and plant proteins (p-cresol), which were increased in faecal matter. Specific to dairy protein intake, the faecal levels of acetate, indole and phenol were increased, whereas plant protein intake specifically increased the levels of kynurenine and tyramine. Meat protein intake increased the faecal levels of methionine, cysteine and alanine and decreased the levels of propionate and acetate. The metabolite profile in the faecal matter following dairy protein intake mirrored availability in circulation or urine. These findings provide an understanding of the contrasting gut versus systemic effects of different dietary proteins, which we know to show different physiological effects. In this regard, we provide directions to determining the mechanisms for the effects of different dietary proteins.

Modifying the food environment holds promise for instilling healthier behaviours in children and may be an effective public health strategy for preventing childhood obesity and adverse health outcomes. The school food environment is a valuable setting to influence most children’s dietary behaviours from an early age, yet evidence suggests that the New Zealand and Australian school food environment is not conducive to healthy food and drink consumption. The present study aimed to investigate the level of compliance in New Zealand and Australia with government guidelines for food and drink availability within schools and the subsequent effect on food consumption and purchasing behaviours of children. A systematic review utilising three databases, PubMed, Scopus and the Cochrane Library, was conducted. The research covered peer-reviewed studies from both New Zealand and Australia that met predefined inclusion criteria. Fifteen studies focused on assessing food availability within schools on the basis of government guidelines, and ten studies explored food purchasing and consumption by students influenced by changes to the school food environment. Results showed low compliance with government healthy food guidelines for schools, and significant socioeconomic disparities. Western Australia’s clear targets as well as the mandatory monitoring systems in place stand out as being a significant enabler of greater compliance with government food policies. Interventions aimed at improving healthy food availability and promoting healthy options in the canteen may positively influence student purchasing and consumption habits. Strategies such as feedback models and incentivisation hold promise for promoting healthier school environments and influencing children’s food choices.

The purpose of this review is to examine the effects of hesperidin and hesperetin on liver disorders. Metabolic dysfunction-associated steatotic liver disease is a complicated disorder influenced by many factors, including inflammation, diabetes and obesity. Currently, the most prominent treatment method is lifestyle changes. If left untreated, it can progress to cirrhosis, liver fibrosis and liver cancer. Hesperidin, which is a flavanone glycoside polyphenolic plant compound, belongs to the flavanone class and was first isolated from citrus peel. Hesperidin includes aglycone hesperetin and rutinoside sugar. It is the most dominant form of flavonoid in citrus fruits. In our review, we discuss the effects of these phytochemicals on liver diseases, focusing on their relationship with inflammation, blood sugar regulation and blood lipids. Hesperidin and hesperetin are seen as promising agents for many diseases. Their antioxidant and anti-inflammatory properties support this view. Although their low water solubility limits their potential effects, many studies have demonstrated their benefits. They are thought to play an effective role in inflammatory processes, particularly in liver diseases. More studies are required to find the optimum dosage and to use them as a therapeutic agent for the liver.

Coffee is one of the most known and consumed beverages worldwide. Only three species are used in commercial coffee production, that is, Coffea arabica L. (Arabica coffee), Coffea canephora Pierre ex A. Froehner (Robusta coffee) and Coffea liberica Hiern (Excelsa coffee). The world population consumes approximately two billion cups of coffee per day, making it an important commercial resource of bioactive compounds in world markets. High interest in coffee consumption described in the literature is due not only to its organoleptic properties (for example, desirable bitterness, amount of flavours and aromas) but also to its ability to stimulate the central nervous system.

It is now known that there are more than 1000 compounds in coffee beverages, several of which have a bioactive activity. Recent studies show that consuming three to four cups of coffee per day, that is, moderate consumption according to the European Food Safety Authority, may be beneficial for health.

The main objective of the proposed review is to provide a comprehensive overview of bioactive compounds in coffee and other caffeine-containing beverages and their effects on neurodegenerative proteinopathies.

Autism spectrum disorder (ASD) is a neurodevelopmental condition. Omega-3 fatty acid insufficiency has been linked to ASD. This umbrella meta-analysis was performed to investigate the effects of omega-3 supplementation on clinical manifestations in participants with ASD. Based on the PRISMA statement, databases including Web of Science, PubMed and Scopus were systematically searched for published meta-analyses on the effect of omega-3 supplementation on ASD up to December 2023. To assess the risk of bias, the assessment of multiple systematic reviews (AMSTAR)-2 was utilised. The outcomes were core and non-core symptoms of ASD including social withdrawal/lethargy, cluttering speech, hyperactivity, irritability and stereotypy. Seven meta-analyses eventually remained in the umbrella review. The results revealed that omega-3 fatty acid supplementation caused a significant reduction in cluttering speech in studies conducted on age ≤8 years (effect size (ES) −0·30; 95% confidence interval (CI) −0·55, −0·06; P = 0·02). Omega-3 supplementation caused a significant reduction in hyperactivity in participants ≤8 years (ES −0·30; 95% CI −0·55, −0·06; P = 0·02) and in participants who received the supplements for more than 14 weeks (ES −0·30; 95% CI −0·55, −0·06; P = 0·02). A dosage of ≤1000 mg/d of omega-3 supplementation led to a significant increase in the stereotypy/restricted and repetitive interests and behaviours (ES 0·19; 95% CI 0·03, 0·35; P = 0·02). This umbrella review revealed that omega-3 fatty acid may be a beneficial supplement to control cluttering speech and hyperactivity in children with ASD who are 8 years old or younger.

As the Mediterranean diet (MDi) has demonstrated a powerful preventative effect on various medical conditions, a positive effect on oral health may also be speculated. Tooth loss, pain or tooth mobility may discourage the consumption of specific food types, affecting MDi adherence. The aim of this study was to investigate the association between adherence to MDi and oral health in adult populations. The study protocol was registered in Open Science Framework (https://osf.io/vxbnh/) and adhered to PRISMA-ScR guidelines. The principal research questions were: (1) Does better oral health enable adults to better adhere to MDi? and (2) Does better adherence to MDi enable adult individuals to have better oral health? The content of three databases, Clarivate Analytics’ Web of Science, Scopus and PubMed was searched without language, date or any other restrictions. The search results were imported into the Rayyan environment, and from the initial 1127 studies identified, only 20 remained after the exclusion process. Three articles composed the first group, revealing significant associations between various oral health parameters and adherence to MDi, with large variations in methodology and no safe conclusions. The studies investigating the effect of the level of adherence to MDi on various oral parameters were more numerous and revealed negative associations with the prevalence of periodontal disease and upper aero-digestive tract cancer. Further studies to explore the existence and direction of the association between oral health and MDi are needed, with public health interventions encouraging adherence to the MDi to reduce the burden of oral conditions and other non-communicable diseases.