Carrie Helen Stevenson Ruxton

A sponsored symposium was held at the International Congress on Nutrition to discuss the role of the fruit matrix in modulating the impact of 100% fruit juice (FJ) on markers of glycaemic control and vascular health and to present two recent studies. Structural, nutrient, and non-nutrient components of FJ, which comprise the fruit matrix and include polyphenols, pectins, vitamins, and minerals, have been shown in previous studies to influence postprandial metabolic responses. While the free sugar content of FJ and sugar-sweetened beverages (SSBs) can be similar, the fruit matrix distinguishes FJ from SSBs, the latter typically lacking in micronutrients and containing added sugars. Epidemiological studies consistently report that higher polyphenol intakes are associated with a lower risk of CVD, while some randomised controlled trials on citrus juices (rich in the flavanone, hesperidin) find beneficial effects for vascular function and blood pressure. Other randomised controlled trials report that FJ has neutral effects on cardiometabolic markers, which may be due to intra-individual differences in the digestion and absorption of polyphenols. The symposium concluded that the benign influence of the fruit matrix justifies the categorisation of FJ as a type of processed fruit, and not an SSB, for public health and regulatory purposes.

A Rank Forum was convened to discuss the evidence around food insecurity (FIS), its impact on health, and interventions which could make a difference both at individual and societal level, with a focus on the UK. This paper summarises the proceedings and recommendations. Speakers highlighted the growing issue of FIS due to current economic and social pressures. The health implications of FIS vary geographically since food insecure women in higher income regions tend to be living with overweight or obesity, in contrast to those living in low-to-middle-income countries. This paradox could be due to stress and/or metabolic or behavioural responses to an unpredictable food supply. The gut microbiota may play a role given the negative effects of low fibre diets on bacterial diversity. Solutions to FIS involve individual behavioural change, targeted services and societal/policy change. Obesity-related services are currently difficult to access. Whilst poverty is the root cause of FIS, it cannot be solved solely by making healthy food cheaper due to ingrained beliefs, attitudes and behaviours in target groups. Person-centred models, such as Capability-Opportunity-Motivation Behavioural Change Techniques and Elicit-Provide-Elicit communication techniques, are recommended. Societal change or improved resilience through psychological support may be more equitable ways to address FIS. They can combine with fiscal or food environment policies to shift purchasing towards healthier foods. Policy implementation can be slow to enact due to the need for strong evidence, consultation and political will. Eradicating FIS must involve co-creation of interventions and policies to ensure a consensus on solutions.

Background: Ready-to-eat cereals (RTECs) are a large, heterogeneous category of cereals designed to fit into busy lifestyles with minimal preparation time. Methods: This systematic review evaluated nutrient intake data from seven national surveys. Using PubMed and Science Direct (1 January 2004 until 16 September 2024), we investigated RTECs in relation to their contributions to macro, micronutrient and food group intakes, breakfast/diet quality and effects on health with focus on non-communicable disease (NCD) prevention. The search was restricted to Systematic Reviews (SRs), meta-analyses (MAs), randomised controlled trials (RCTs) and observational studies. Fifty-one publications were obtained. Studies related to health outcomes and NCD risk were graded using an updated Scottish Intercollegiate Guidelines Network approach. Results: Grade A evidence: Based on high-quality MA, SRs, or RCTs, this showed that RTEC consumption was associated with improved nutrient intakes (particularly fibre and micronutrients), reduced cardiovascular disease and mortality. One good-quality Grade A meta-analysis showed that total whole grain intake which included cereals was associated with a reduced risk of total cancer. Grade B evidence: Based largely on observational evidence, this showed that RTEC consumption was associated with reduced risk of overweight and obesity, body mass index and composition improvements and type 2 diabetes risk. For food group intakes, breakfast/diet quality and lipid profiles, more well-designed studies were needed (Grade D evidence). Conclusions: There is consistent evidence that RTECs generally have positive or neutral effects on nutritional status and NCD prevention. Strongest evidence exists for RTEC and micronutrient intakes, reduced risk of cardiovascular diseases (CVDs), body weight regulation, and reduced type 2 diabetes risk. Public health messaging should recognise that RTECs, especially whole-grain, higher-fibre and lower-sugar varieties, may help to reinforce micronutrient intakes and a range of health outcomes.

Vitamin C intakes and key contributors in the UK population: preliminary results from the NDNS years 9 -11 Authors: Emily Royle1 , Alyson Hill1 , | POSTER

Hen’s eggs (from Gallus gallus domesticus) provide choline, folate, vitamin D, iodine, B vitamins and high-quality protein and are no longer viewed by national bodies as a risk factor for hypercholesterolaemia and cardiovascular disease (CVD). Yet, questions remain about the benefits and risks of eating eggs regularly. This review evaluates recent high-quality evidence from randomised controlled trials (RCT) and meta-analyses of observational studies and considers new areas of interest, such as weight management, protein metabolism, allergy risk and sustainability. In several RCT, eggs increased muscle protein synthesis and lowered fat mass, which could support optimal body composition. Eggs within a meal improved satiety, which could translate into lower energy intakes, although more RCT are needed. In observational studies, higher egg consumption was associated with a null effect or a modest reduced risk of CVD. For type 2 diabetes (T2D) incidence and risk of CVD in people with T2D, there were inconsistencies between observational and RCT data, with the former noting positive associations and the latter seeing no effect of higher egg intake on markers of T2D and CVD. Sustainability metrics suggest that eggs have the lowest planetary impact amongst animal proteins. To lower allergy risk, earlier introduction of eggs into weaning diets is warranted. In conclusion, the balance of evidence points to eggs being a nutritious food suggesting there are broad health benefits from including eggs in the diet at intakes higher than that currently consumed by European populations.

Article 12(c) of the Nutrition and Health Claims Regulation (NHCR) prohibits authorised health claims in consumer-facing commercial communications which make reference to the recommendations of individual doctors or health professionals. However, this has been controversial amongst dietitians and nutritionists who work in commercial settings. Given the lack of empirical data, a survey was conducted amongst UK-based nutrition professionals to assess their knowledge of, and attitudes to, Article 12(c). The findings revealed confusion about the scope of the regulation and how it applies to working practices, with a considerable proportion of respondents being unable to recognise examples of commercial communications or health claims, indicating a need for additional training. There was also a broad interpretation of what nutrition professionals could, and could not, say about a hypothetical food product. This paper explores current guidance in Great Britain and debates the proportionality and fairness of Article 12(c), which, at present, does not regulate authorised health claims made by influencers or celebrities in commercial communications to consumers. It could be argued that consumers are better protected by the articulation of health claims by nutrition professionals who are guided by codes of practice rather than by unqualified, unregulated individuals. Hence, it is essential to level the regulatory playing field either by revising the NHCR to amend Article 12(c) or by updating the guidance to apply an interpretation of the Article's intention which enables a broader role for nutrition professionals in commercial communications. Such action would also be consistent with the UK's better regulation agenda to ensure evidence-based, proportionate regulation for industry.

The 10th International Yakult Symposium was held in Milan, Italy, on 13–14 October 2022. Two keynote lectures covered the crewed journey to space and its implications for the human microbiome, and how current regulatory systems can be adapted and updated to ensure the safety of microorganisms used as probiotics or food processing ingredients. The remaining lectures were split into sections entitled “Chances” and “Challenges.” The “Chances” section explored opportunities for the science of probiotics and fermented foods to contribute to diverse areas of health such as irritable bowel syndrome, major depression, Parkinson’s disease, immune dysfunction, infant colic, intensive care, respiratory infections, and promoting healthy longevity. The “Challenges” section included selecting appropriate clinical trial participants and methodologies to minimise heterogeneity in responses, how to view probiotics in the context of One Health, adapting regulatory frameworks, and understanding how substances of bacterial origin can cross the blood–brain barrier. The symposium provided evidence from cutting-edge research that gut eubiosis is vital for human health and, like space, the microbiota deserves further exploration of its vast potential.

Nutrition messages are a central part of policy making as well as communication via product information, advertising, healthcare advice and lifestyle campaigns. However, with amplified information (and misinformation) from a growing number of sources, inconsistent and conflicting food landscapes, and limited engagement from the public, nutrition messaging tensions have become more accentuated than previously. In this review, we focus on the challenges facing those wishing to effect dietary change through communication; and identify opportunities and future research questions. Beginning with a new working definition and taxonomy for the term ‘nutrition message’, we consider the evolution of public health nutrition messages from the past century and discuss which types of messages may be more effective. We then turn to the challenges of implementation and highlight specific barriers to recipients' understanding and change. While the evidence has many gaps and there is a need for systematic evaluation of nutrition messages, research indicates that recipients are more likely to act on fewer messages that provide clear benefits and which resonate with their perceived health needs, and which are relatively straightforward to implement. Effectiveness may be improved through consideration of how nutrition messages can be designed to complement key non-health drivers of food choice (taste, cost) and societal/cultural norms. Consistency can be achieved by aligning the wider food and messaging environment to desired public health actions; that is by ensuring that retail settings provide and signpost healthier choices, and that mass media nutrition messages work with, not against, public health advice.

A Nutrition Society member-led meeting was held online on 18th January 2021 to discuss the role of observational studies in developing public health policy and dietary guidelines. In addition, participants debated media reporting of observational studies and the implications for public perception and trust in science. Speakers outlined the benefits of observational studies and how they fit within the suite of research tools available for estimating dietary intakes and determining their impact on health and disease risk. However, there are clear limitations, such as conscious and unconscious bias, measurement error, confounding and representativeness of populations. Researchers can overcome some of these issues with careful design, awareness of inter-individual variation, open and transparent reporting of findings, and hypothesis-driven statistical analysis to avoid multiple testing errors. Although there is evidence that data provided by nutritional epidemiology can be misleading, strong and thoughtful methodology including pre-registration, risk of bias assessment, awareness of confounders, and evidence grading can minimise potential bias, particularly when conducting systematic reviews. Translation of relative risk into population health impact is important and feeds into the need for responsible lay communication of results via mass media, especially regarding assumptions about cause and effect. Although use of mass media can bring benefits to academia, responsible dissemination is essential and starts with the press release. In conclusion, nutritional epidemiology is an important tool for exploring the risk/benefits of dietary patterns and contributing to health improvement via dietary guidelines, evidence-based policy and responsible lay communication provided its limitations are fully understood.