Philip C. Calder

The 2025–2030 Dietary Guidelines for Americans (DGAs) issued nutrition recommendations, some of which have been praised by the nutrition community while others have been questioned based on the lack of supporting evidence. The recommendations about calorie control, emphasis on nutrient density, vegetables, fruits, and whole grains, and limiting added sugars, sodium, and alcohol are based on strong evidence and have been carried forward from previous DGAs. The recommendations to limit ultra‐processed foods and added sugars both per meal and per product have been well‐received. The controversial recommendations relate to the type of fat recommended (e.g., “healthy” fats that include butter and beef tallow) and the omission of guidance about seed oils high in unsaturated fatty acids, notably polyunsaturated fatty acids. The food‐based guidance (consuming full‐fat dairy products, butter and beef tallow, and animal products such as red meat) does not align with the long‐standing recommendation to limit saturated fat to < 10% of calories. Concerns have also been expressed about the higher protein recommendation as well as the recommendation to consume 20 g (or more) with each meal. Moreover, there are questions about the placement of animal foods at the top and whole grains at the bottom of the new “food pyramid”. Herein we summarize the evidence in support of, and in disagreement with, the controversial new DGAs. Global dietary recommendations both in support of and not in alignment with some of the DGAs are reviewed. Strategies for widespread adoption of the DGAs are mentioned.

Background: Nutritional safety has traditionally focused on preventing excessive nutrient exposure, yet chronic micronutrient inadequacy may also impair physiological function and health resilience. As the European Commission prepares to harmonise maximum permitted levels for food supplements and fortified foods, understanding long-term population intake trends is increasingly important. We assessed changes in micronutrient intakes and adequacy among adults in four European countries. Methods: Repeated, cross-sectional, secondary analyses of published adult (≥18 years) micronutrient intakes over approximately two decades were conducted using publicly available, non-harmonised national dietary surveys at non-contemporaneous time points in the Netherlands, Ireland, France and the United Kingdom (n = 17,261). Mean, lower-tail (5th centile; UK 2.5th) and upper-tail (95th centile; UK 97.5th) intakes were evaluated against dietary reference values, and changes in population intake estimates over the past two decades were examined. Results: Intakes of several micronutrients declined substantially, with mean and lower-tail intakes of vitamins D and A, riboflavin, folate and of calcium, iron and iodine decreasing by up to 50% in some population groups, indicating widening intake disparities and increasing risk of chronic insufficiency. Although improvements in some micronutrients were consistent with fortification policies and dietary changes, inadequacies remained widespread, including for vitamin D across all countries, iron in women, potassium in UK women, selenium in most populations and copper in Irish women. Folate intake in UK women and vitamin A intake in France were marginal. Conclusions: Declining intakes of several micronutrients and persistent inadequacies indicate emerging nutritional safety concerns in Europe. Population intake trends and chronic insufficiency should be explicitly considered in nutritional safety assessments, maximum permitted level discussions and modelling and future public health policy.

Studies have shown that omega‐3 fatty acids may protect against cardiovascular diseases (CVDs) and related metabolic conditions. UK Biobank is a large cohort study that includes data on plasma omega‐3 fatty acids at study entry and health outcomes during the follow‐up period. The aim of this research is to explore the association between plasma omega‐3 fatty acids (total omega‐3 fatty acids, docosahexaenoic acid (DHA) and non‐DHA omega‐3 fatty acids) and cardiometabolic health outcomes by systematically reviewing publications from UK Biobank. Three databases (EMBASE, MEDLINE, CINAHL) were searched in September 2025 using key words. Based on inclusion/exclusion criteria, 16 publications were selected for inclusion (two cross‐sectional and 14 longitudinal with a follow‐up of 11 to 14 years). Sample size varied between 20,338 and 273,834 across the included studies. Eleven studies reported on CVD outcomes and five on metabolic outcomes. Plasma total omega‐3 fatty acids and DHA were inversely associated with risk of coronary heart disease, CVD mortality, heart failure, haemorrhagic stroke and severe fatty liver disease. Plasma total omega‐3 fatty acids were also inversely associated with risk of prediabetes and type‐2 diabetes, while plasma DHA was also inversely associated with risk of coronary heart disease mortality, ischemic stroke and fatty liver disease. It is concluded that publications based on UK Biobank consistently demonstrate a significant association between higher levels of total omega‐3 fatty acids or DHA in plasma and lower likelihood of poor cardiometabolic health outcomes, providing support for guidance for the population to achieve recommended intakes of these fatty acids.

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Global population ageing is increasing the burden of chronic disease, functional decline, and loss of independence. For most organs, decline in function starts during the 5th decade of life. Micronutrient (MN) insufficiencies/deficiencies are common and may accelerate biological ageing. MNs are required to support multiple physiologic processes, including mitochondrial homeostasis. Age-related declines in organ function are tightly linked to mitochondrial dysfunction, oxidative stress, inflammageing, and immunosenescence. Selected MNs (vitamins B, C, D, E, iron, selenium, zinc) are critical cofactors for mitochondrial function, antioxidant defence, immunity, and resolution of inflammation. Inadequate MN intakes require specific repletion strategies beyond diet for correction. Low intake, (patho)physiological changes, and common medications jointly contribute to compromised MN status. Emerging trials suggest that correcting MN deficiency may restore mitochondrial function and thereby promote healthy ageing. Optimizing intake over the lifespan represents another means to support healthy ageing. Nevertheless, MNs do not work individually but as a web, and may behave differently in different individuals. Further, low status of the n-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is common in older adults, which favours inflammation and functional decline. EPA+DHA work in combination with MNs on inflammation containment. Routine risk assessment, selected biomarker measurement from midlife onwards, and well-designed trials are needed to complement an insufficient status. MN and EPA+DHA optimization should be integral to healthy ageing strategies.

Oral nutritional supplements (ONS) are essential adjuncts in managing malnutrition in hospitalised older people. This study aimed to explore the adherence and palatability of a new porridge supplement (PS) compared to a standard drink-based supplement (DS) in hospitalised older adults. A single-centre multi-method randomised controlled crossover study was conducted on adults aged ≥65 years at risk of malnutrition (Malnutrition Universal Screening Tool score 1–4). Each participant was prescribed PS (16 g protein; 249 kcal) and DS (18 g protein; 306 kcal) twice per day for 4 days in crossover sequence. ONS leftovers were weighed, and adherence calculated (% consumed). Palatability ratings were assessed with a 7-point Likert scale, and interviews were conducted with 9 older adults and 5 staff to explore product acceptability. Twenty-seven older people (mean age 80 years, 17 female) participated. Median daily PS intake (26.31% [IQR 10.23–48.02]) was significantly lower compared to DS (66.8% [IQR 26.29–75.37]), and texture of PS was significantly disliked compared to DS. There were no significant differences in the absolute volume consumed between products, and supplements did not replace normal dietary intake. Changes in physical ability and appetite, the hospital culture (e.g., staff attitudes), and palatability (e.g., thickness and taste) of products influenced ONS acceptability. To improve patient-centred nutritional care, participants requested a wider in-hospital range of food-based supplementation with natural ingredients and enhanced training for staff in nutritional care.

Background/Objectives: The POLA index is a comprehensive tool for evaluating the nutrient-dense, immune-supportive, and anti-inflammatory properties of the diet, but its multi-component structure may limit routine use. We aimed to identify simple dietary markers associated with a lower follow-up incidence of COVID-19 or influenza, as well as the anti-inflammatory properties of the diet, and to compare a simplified screening tool with the full POLA index. Methods: This prospective observational study included 146 healthy adults aged 25–45 years from two Polish cohorts examined in 2020 and 2022 (cohort/year adjusted). Habitual diet was assessed using at least 5-day food records, and nutrient adequacy was expressed relative to Polish dietary reference values. Classification and regression tree analyses were used to identify the most informative dietary predictors of the reduction in risk of infection, and logistic regression models were used to evaluate associations after adjustment for sex, diet type, physical activity, marital status, year of cohort and waist-to-height ratio. Results: During follow-up, 39/146 participants (26.7%) reported COVID-19 or influenza. Interactive tree analysis identified dietary fiber in g per kg/m² of BMI ≥ 1, and magnesium adequacy as the key discriminators. In StrongPOLA, participants not meeting the cut-offs of ≥1 g fiber per kg/m² of BMI and ≥130% of the magnesium reference value had a higher incidence of COVID-19 or influenza than those meeting both of those cut-offs (34.9% vs. 2.7%); however, this estimate was large and imprecise, with a wide confidence interval (the adjusted OR = 14.9 (95% CI: 1.89–118.06)), and should, therefore, be interpreted cautiously. In RapidPOLA, the participants not meeting the cut-offs of ≥1 g fiber per kg/m² of BMI and ≥110% of the magnesium reference value (i.e., 352 mg/day for women and 462 mg/day for men) had a higher observed incidence of COVID-19 or influenza than those meeting both of those cut-offs (36.4% vs. 12.1%); the adjusted OR was 3.4 (95% CI: 1.18–8.75). RapidPOLA showed good agreement with the favorable result of the POLA classification (κ = 0.65). Conclusions: Dietary fiber in g per kg/m² of BMI and magnesium adequacy appear to be practical markers of a broader nutrient-dense, immune-supporting, and anti-inflammatory dietary pattern associated with a lower follow-up incidence of COVID-19 or influenza in young adults without comorbidities. RapidPOLA may be useful as a simple screening tool for a nutrient-dense, immune-supportive, and anti-inflammatory (NUTRIDIMAF) diet in young people without obesity and comorbidities, whereas StrongPOLA may serve as a stricter reference profile. The proposed cut-offs require external validation in independent and more diverse cohorts.