Nutrition 21 (United States)

Introduction This case report presents the methodology and the outcomes of a Personalized Nutrition intervention with a menopausal female over seven weeks and two online consultations. The report details the pathophysiological reasoning approach to the patient assessment and the recommendation of interventions with the supporting clinical evidence and learnings. Case A 47 year old working mother (Patient A) with maternal family history (FH) of osteoporosis (OP), a body mass index (BMI) of 24.2 kg/m2 and a waist-to-hip ratio (WHR) of 0.86. Patient A had seen her medical practitioner (MP) regarding fatigue, lack of concentration and low mood and was prescribed hormone replacement therapy (HRT). Patient A’s sleep and mood remained unstable, and she presented with late afternoon fatigue, lower belly bloating and mild headaches. A chiropractor had diagnosed scoliosis. Patient A was seeking support for energy and bone health. Analysis of dietary recall and frequency data indicated that her current macronutrient intake was contributing to blood sugar imbalance, influencing energy levels and impacting hypothalamic-pituitary-adrenal (HPA) axis function, potentially exacerbated by a change in estrogen levels. A FH of OP encouraged the practitioner to promote bone health. Adjusted macronutrient intake was recommended to support blood sugar balance, increase and sustain energy and promote muscle synthesis. A supplementation plan with regular weight-bearing exercise aimed to support bone mineral density. Caffeine reduction, yoga and meditation to help rebalance the HPA axis. Patient A reported an increase in energy, a reduction in snacking and improved sleep. There was no change to her mood and bloating persisted. Her headaches worsened and the MP prescribed amitriptyline (10 mg) toward the end of the therapy period. Her bone health was not measured. Conclusions This case provides observational evidence of the potential efficacy of personalized nutrition utilizing pathophysiological reasoning to assess health status, an evidence-based approach to support intervention decisions and coaching skills to embed dietary change.

Antibiotic alternatives are urgently needed to enhance growth performance, maintain gut ecosystem equilibrium, and support the immune system of broilers. Pomegranate peel (PP) by-product comprises 50% of the fruit and possesses antioxidants, anti-inflammatory, antibacterial, as well as fungicidal aspects. This study specifically aimed to evaluate, over a 35-day feeding period, the impact of dietary inclusion of graded levels of pomegranate peel by-products (0.1%, 0.3%, and 0.5%) on growth performance, carcass traits, antioxidants, gene expression of intestinal markers, and cecal microbial balance in broiler chickens to determine the most effective fortification level for optimizing health and productivity. A total of 240 male one-day Cobb500® broiler chicks were randomly split up into four distinct groups, with 3 replications (20 chicks/replicate). G1, the control group, was offered a base diet. The fortified groups, G2, G3, and G4, were offered a base diet enriched with various concentrations of PP by-products (0.1%, 0.3%, and 0.5%), respectively. The chicks offered a diet enriched with 0.5% PP achieved a substantial (p < 0.05) improvement in final BW development, cumulative BWG, FCR, as well as percentage of dressing yield, breast, and bursa versus the control group. Serum TAC, CAT were also jejunalGPx levels were also substantially elevated (P < 0.05) in PP-fortified groups versus the control group. Furthermore, mRNA expression of FABP2 was significantly upregulated in all PP-enriched groups compared to the control group. In the G4 (0.5% PP) enriched group, the greatest expression level was registered. However, there was no discernible variation in IL-1β across groups. Incorporation of 0.5% PP by-products significantly balanced cecal microbial composition, exhibited by a notable elevation in Lactobacillus population and a reduction in coliform counts. In conclusion, broiler diets supplemented with PP by-product, especially at 0.5%, maximize productivity and efficiency through fostering BWG, FCR, antioxidant status, and balanced gut health biomarkers.

Nutritional cosmetology represents an emerging interdisciplinary field that explores the profound connections between dietary intake, gut microbiota, and the health and appearance of skin, hair, and nails. This comprehensive review synthesizes current evidence on the role of nutrition and probiotics in enhancing external appearance through internal interventions. The gut-skin axis provides a mechanistic framework for understanding how dietary components and gut microbiota influence dermatological health through immune modulation, metabolite production, and systemic signaling pathways. Probiotics, defined as live microorganisms conferring health benefits when administered adequately, have demonstrated promising effects in various dermatological conditions, including acne, psoriasis, atopic dermatitis, and rosacea, through oral and topical applications. Beyond skin health, emerging evidence suggests potential benefits of probiotic interventions for hair growth, scalp conditions, and nail integrity, expanding the scope of nutritional cosmetology. This review examines the types of probiotics, their mechanisms of action, clinical applications, practical considerations for their use, and future research directions in this rapidly evolving field. By integrating nutritional science with dermatological outcomes, nutritional cosmetology offers a holistic approach to beauty and health, emphasizing the critical role of diet and gut microbiota in external appearance. As research continues to elucidate the complex interactions between nutrition, microbiome, and dermatological health, personalized approaches and technological innovations are likely to enhance the efficacy and application of nutritional interventions for cosmetic benefits.

Abstract Plant-based milk alternatives (PBMAs) such as soy, almond and oat are an increasingly popular alternative to cow’s milk across the world, due to more people following vegan diets, being more aware of allergies and a drive towards sustainability. However, policies guiding their fortification vary between territories. Cow’s milk provides crucial micronutrients such as calcium, vitamin B12 and iodine which may not be substituted by PBMAs. This case study explores the nutritional value and safety considerations of PBMAs, highlighting the SACN/COT 2025 review’s findings that identified nutritional gaps particularly in oat and almond milk. Safety concerns over contaminants and sugar content are discussed, and evidence of risk analysed. The study looks at other drivers towards food fortification as models for future practice. It concludes by highlighting the need for evidence-based, harmonised international standards to ensure PBMAs support healthy diets and meet consumer needs. Information © The Author 2025

Abstract Background Food-based dietary guidelines (FBDGs) provide recommendations on diets that aim to decrease disease risk and environmental impact, while remaining culturally acceptable for the population. Using mathematical optimization to define such diets, these objectives can be operationalized as components of the objective function. Objectives To develop a framework for (i) deriving an indicator that quantifies diet-related disease burden and (ii) evaluating different weighting schemes within a three-dimensional diet optimization model. Methods To address objective (i), disability-adjusted life years (DALYs) from the Global Burden of Disease Study (GBD) and a diet-specific burden estimate based on observational data were transformed into a model-compatible indicator using linear interpolation. To address objective (ii), a linear diet optimization model was developed. It included constraints on nutrients and acceptability, and a three-objective function that minimized disease burden (DALYs), environmental impact (greenhouse gas emissions and land use), and, as a proxy for cultural acceptability, deviation from the observed diet. Forty-two model variations with different weighting schemes were computed and compared regarding component outcomes. Results In proof-of-concept analyses, the derived health indicator aligned closely with values reported in the literature: 90% (based on GBD) and 99% (based on the observational data) of diet-related DALYs were captured. Among the 42 model variations, strong synergies were observed between health and environmental outcomes. Optimizing exclusively for disease burden or environmental impact resulted in substantial deviations from the observed diet, underscoring the importance of considering cultural acceptability. Model stability improved with the inclusion of all three components. Conclusion The proposed methodology enables the integration of DALYs and provides insights about various weighting schemes to establish a diet optimization model that minimizes disease burden, environmental impact, and deviation from the observed diet, and serves as the basis to derive FBDG for Germany.

Childhood cancer survivors often develop long-term adverse effects, which may be caused by direct mutagenesis of cytotoxic agents. Some of these agents generate distinctive DNA imprints (mutational signatures), as exemplified by platinum chemotherapeutics. Here, we examined chemotherapy mutagenesis in paediatric tissues by deploying a duplex sequencing method (NanoSeq), which enables mutation calling from single DNA molecules. We surveyed whole genomes of paediatric liver, blood and other tissues, obtained from surgical resections and at post-mortem. Platinum signatures pervaded all tissues extensively, elevating mutation burdens of paediatric tissues to levels seen in adults. Remarkably, we found a tissue-specific mutational signature in the liver. We examined the functional potential of mutations by gene focused NanoSeq, which revealed that platinum agents cause a vast repertoire of cancer causing variants across normal tissues, such as leukaemogenic mutations in blood. This finding may conceivably link cancer treatment in childhood to mutation-driven long term sequelae.

Through the Sustainable Development Goals (SDGs) program, the target is to address all forms of malnutrition and reduce stunting and wasting in toddlers by 2030. This movement involves policymakers working together to reduce the prevalence of stunting in Indonesia. The objective of this study was to analyze and prioritize, through the Hierar chical Analytical Process (AHP), public policy strategies to accelerate the reduction of stunting in the city of Tasikmalaya. Methods: This research was conducted using a mixed method, including a qualitative approach for interviews and a quantitative approach for prioritization analysis using AHP. The sampling technique used a purposive sampling, with 14 respondents, with the inclusion criteria were: more than 5 years of experience in nutrition policy, representation from key institutions, and a decision-making level of middle to upper management. Interviews were conducted to obtain information on strategic issues in stunting management in Tasikmalaya City. The selection of these alternative policy strategies will be determined in focus group discussions (FGDs) held at government institutions. AHP analysis is carried out using Expert Choice software version 10. Results: Based on the Analytical Hierarchy Process from respondents, the most important alternative strategy is the macronutrient intake intervention. This was determined through an evaluation based on four key criteria: budgetary readiness, infrastructure, institutional sustainability, and community readiness. For example, providing locally sourced food supplements, such as eggs and milk, to toddlers is considered the most rapid and effective way to address stunting in toddlers. This research found that three months of Food Supplement support resulted in increased weight, as well as improvements in nutritional status. Most toddlers experienced weight gain during the support period. Conclusion: Macro-nutrition interventions are clearly superior to other program strategies because this program can be sustainable. The government has to provide more macronutrient interventions for toddlers .

Background Food waste crises result in significant environmental, nutrition, and economic losses.In Sleman, Indonesia, household food waste (HFW) is the main cause of waste emergency.Mama4Planet addressed this issue by empowering mothers to reduce HFW, exploring their crucial role in sustainable food systems.The program included cadres training and cadre-led education for local mothers, followed by gamification to encourage practices.Objectives To evaluate Mama4Planet's impact on mothers' knowledge, attitudes, and practices regarding HFW reduction in Sleman, Indonesia.Methods Trained mothers (cadres) and local mothers were recruited using purposive sampling.Cadres' knowledge (preand post-test), attitudes (in-depth interviews), and practices (HFW weight before and after the intervention) were measured.Paired t-tests were used to analyse pretest-posttest and HFW weight comparisons.Qualitative data were analysed using thematic analysis.Results Cadres' knowledge showed significant improvements (p<0.05)across three training topics: Introduction to Climate Change (n=16, mean change 0.63, 95% CI 0.53), Food Purchasing and Storage (n=13, mean change 1.23, 95% CI 0.45), and Healthy Meal Preparation and Consumption (n=8, mean change 1.13, 95% CI 1.1).The intervention also led reduction of 64.28% in HFW among cadres (baseline 0.89 kg/ household/day, 95% CI 1.20, p<0.01) and 56.53% among local mothers (baseline 0.29 kg/household/day, 95% CI 0.15, p<0.01).Following the program, mothers expressed increased awareness and commitment to HFW reduction and initiated food management strategies at both household and community levels.Conclusions Mama4Planet program significantly improved mothers' knowledge, attitudes, and practices on HFW reduction in Sleman, Indonesia.This highlights the potential of empowering mothers as key drivers for HFW reduction initiatives.Future research can explore the program's long-term impacts and benefits on nutrition and household economics.

Policy changes require stakeholder buy‐in, therefore, the timely delivery of tailored evidence provided to all stakeholders involved in policy discussions is important. This paper reports the evidence generation and delivery processes undertaken in Burkina Faso, Nigeria, and Senegal in support of bouillon fortification discussions. We identified stakeholder‐specific evidence needs, tapped existing data and new data to generate that evidence, and packaged and delivered it to stakeholders. Evidence needs included the levels of micronutrient inadequacy (with/without existing and other hypothetical fortification programs), the potential contributions of bouillon fortification to reduce micronutrient inadequacy and (for some micronutrients) child mortality, the cost and cost‐effectiveness of bouillon fortification programs, and the contribution of bouillon to total sodium intake. Evidence on technical and commercial issues was also required. Stakeholder‐specific understanding and ownership of evidence was essential; achieving both required continual interaction and trust. New bouillon evidence delivery channels were developed in each country and linked to existing decision‐making bodies. A shared vocabulary and understanding of issues and evidence, and the continual innovative redelivery of evidence, were critical to success; persistence and innovations in evidence delivery paid dividends. Concrete policy changes regarding bouillon fortification were secured in Nigeria; policy discussions continue in Burkina Faso and Senegal.