nutrition research articles 2021

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List

Nutrition, Food and Diet in Health and Longevity: We Eat What We Are

Suresh i. s. rattan.

1 Department of Molecular Biology and Genetics, Aarhus University, 8000 Aarhus, Denmark

Gurcharan Kaur

2 Department of Biotechnology, Guru Nanak Dev University, Amritsar 143005, India

Associated Data

Not applicable.

Nutrition generally refers to the macro- and micro-nutrients essential for survival, but we do not simply eat nutrition. Instead, we eat animal- and plant-based foods without always being conscious of its nutritional value. Furthermore, various cultural factors influence and shape our taste, preferences, taboos and practices towards preparing and consuming food as a meal and diet. Biogerontological understanding of ageing has identified food as one of the three foundational pillars of health and survival. Here we address the issues of nutrition, food and diet by analyzing the biological importance of macro- and micro-nutrients including hormetins, discussing the health claims for various types of food, and by reviewing the general principles of healthy dietary patterns, including meal timing, caloric restriction, and intermittent fasting. We also present our views about the need for refining our approaches and strategies for future research on nutrition, food and diet by incorporating the molecular, physiological, cultural and personal aspects of this crucial pillar of health, healthy ageing and longevity.

1. Introduction

The terms nutrition, food and diet are often used interchangeably. However, whereas nutrition generally refers to the macro- and micro-nutrients essential for survival, we do not simply eat nutrition, which could, in principle, be done in the form of a pill. Instead, we eat food which normally originates from animal- and plant-based sources, without us being aware of or conscious of its nutritional value. Even more importantly, various cultural factors influence and shape our taste, preferences, taboos and practices towards preparing and consuming food as a meal and diet [ 1 ]. Furthermore, geo-political-economic factors, such as governmental policies that oversee the production and consumption of genetically modified foods, geological/climatic challenges of growing such crops in different countries, and the economic affordability of different populations for such foods, also influence dietary habits and practices [ 2 , 3 ]. On top of all this lurks the social evolutionary history of our species, previously moving towards agriculture-based societies from the hunter-gatherer lifestyle, now becoming the consumers of industrially processed food products that affect our general state of health, the emergence of diseases, and overall lifespan [ 1 , 4 ]. The aim of this article is to provide a commentary and perspective on nutrition, food and diet in the context of health, healthy ageing and longevity.

Biogerontological understanding of ageing has identified food as one of the three foundational pillars of health and survival. The other two pillars, especially in the case of human beings, are physical exercise and socio-mental engagement [ 5 , 6 , 7 ]. A huge body of scientific and evidence-based information has been amassed with respect to the qualitative and quantitative nature of optimal nutrition for human health and survival. Furthermore, a lot more knowledge has developed regarding how different types of foods provide different kinds of nutrition to different extents, and how different dietary practices have either health-beneficial or health-harming effects.

Here we endeavor to address these issues of nutrition, food and diet by analyzing the biological importance of macro- and micro-nutrients, and by discussing the health-claims about animal-based versus plant-based foods, fermented foods, anti-inflammatory foods, functional foods, foods for brain health, and so on. Finally, we discuss the general principles of healthy dietary patterns, including the importance of circadian rhythms, meal timing, chronic caloric restriction (CR), and intermittent fasting for healthy ageing and extended lifespan [ 8 , 9 ]. We also present our views about the need for refining our approaches and strategies for future research on nutrition, food and diet by incorporating the molecular, physiological, cultural and personal aspects of this crucial pillar of health, healthy ageing and longevity.

2. Nutrition for Healthy Ageing

The science of nutrition or the “nutritional science” is a highly advanced field of study, and numerous excellent books, journals and other resources are available for fundamental information about all nutritional components [ 10 ]. Briefly, the three essential macronutrients which provide the basic materials for building biological structures and for producing energy required for all physiological and biochemical processes are proteins, carbohydrates and lipids. Additionally, about 18 micronutrients, comprised of minerals and vitamins, facilitate the optimal utilization of macronutrients via their role in the catalysis of numerous biochemical processes, in the enhancement of their bioavailability and absorption, and in the balancing of the microbiome. Scientific literature is full of information about almost all nutritional components with respect to their importance and role in basic metabolism for survival and health throughout one’s life [ 10 ].

In the context of ageing, a major challenge to maintain health in old age is the imbalanced nutritional intake resulting into nutritional deficiency or malnutrition [ 11 , 12 ]. Among the various reasons for such a condition is the age-related decline in the digestive and metabolic activities, exacerbated by a reduced sense of taste and smell and worsening oral health, including the ability to chew and swallow [ 13 , 14 ]. Furthermore, an increased dependency of the older persons on medications for the management or treatment of various chronic conditions can be antagonistic to certain essential nutrients. For example, long term use of metformin, which is the most frequently prescribed drug against Type 2 diabetes, reduces the levels of vitamin B12 and folate in the body [ 15 , 16 ]. Some other well-known examples of the drugs used for the management or treatment of age-related conditions are cholesterol-lowering medicine statin which can cause coenzyme Q10 levels to be too low; various diuretics (water pills) can cause potassium levels to be too low; and antacids can decrease the levels of vitamin B12, calcium, magnesium and other minerals [ 15 , 16 ]. Thus, medications used in the treatment of chronic diseases in old age can also be “nutrient wasting” or “anti-nutrient” and may cause a decrease in the absorption, bioavailability and utilization of essential micronutrients and may have deleterious effects to health [ 11 ]. In contrast, many nutritional components have the potential to interact with various drugs leading to reduced therapeutic efficacy of the drug or increased adverse effects of the drug, which can have serious health consequences. For example, calcium in dairy products like milk, cheese and yoghurt can inhibit the absorption of antibiotics in the tetracycline and quinolone class, thus compromising their ability to treat infection effectively. Some other well-known examples of food sources which can alter the pharmacokinetics and pharmacodynamics of various drugs are grape fruits, bananas, apple juice, orange juice, soybean flour, walnuts and high-fiber foods (see: https://www.aarp.org/health/drugs-supplements/info-2022/food-medication-interaction.html (accessed on 13 November 2022)).

It is also known that the nutritional requirements of older persons differ both qualitatively and quantitatively from young adults [ 11 ]. This is mainly attributed to the age-related decline in the bioavailability of nutrients, reduced appetite, also known as ‘anorexia of ageing,’ as well as energy expenditure [ 12 , 17 , 18 ]. Therefore, in order to maintain a healthy energy balance, the daily uptake of total calories may need to be curtailed without adversely affecting the nutritional balance. This may be achieved by using nutritional supplements with various vitamins, minerals and other micronutrients, without adding to the burden of total calories [ 12 , 17 , 18 ]. More recently, the science of nutrigenomics (how various nutrients affect gene expression), and the science of nutrigenetics (how individual genetic variations respond to different nutrients) are generating novel and important information on the role of nutrients in health, survival and longevity.

3. Food for Healthy Ageing

The concept of healthy ageing is still being debated among biogerontologists, social-gerontologists and medical practioners. It is generally agreed that an adequate physical and mental independence in the activities of daily living can be a pragmatic definition of health in old age [ 7 ]. Thus, healthy ageing can be understood as a state of maintaining, recovering and enhancing health in old age, and the foods and dietary practices which facilitate achieving this state can be termed as healthy foods and diets.

From this perspective, although nutritional requirements for a healthy and long life could be, in principle, fulfilled by simply taking macro- and micro-nutrients in their pure chemical forms, that is not realistic, practical, attractive or acceptable to most people. In practice, nutrition is obtained by consuming animals and plants as sources of proteins, carbohydrates, fats and micronutrients. There is a plethora of tested and reliable information available about various food sources with respect to the types and proportion of various nutrients present in them. However, there are still ongoing discussions and debates as to what food sources are best for human health and longevity [ 19 , 20 ]. Often such discussions are emotionally highly charged with arguments based on faith, traditions, economy and, more recently, on political views with respect to the present global climate crisis and sustainability.

Scientifically, there is no ideal food for health and longevity. Varying agricultural and food production practices affect the nutritional composition, durability and health beneficial values of various foods. Furthermore, the highly complex “science of cooking” [ 21 ], evolved globally during thousands of years of human cultural evolution, has discovered the pros and cons of food preparation methods such as soaking, boiling, frying, roasting, fermenting and other modes of extracting, all with respect to how best to use these food sources for increasing the digestibility and bioavailability of various nutrients, as well as how to eliminate the dangers and toxic effects of other chemicals present in the food.

The science of food preparation and utilization has also discovered some paradoxical uses of natural compounds, especially the phytochemicals such as polyphenols, flavonoids, terpenoids and others. Most of these compounds are produced by plants as toxins in response to various stresses, and as defenses against microbial infections [ 22 , 23 ]. However, humans have discovered, mostly by trial and error, that numerous such toxic compounds present in algae, fungi, herbs and other sources can be used in small doses as spices and condiments with potential benefits of food preservation, taste enhancement and health promotion [ 23 ].

The phenomenon of “physiological hormesis” [ 24 ] is a special example of the health beneficial effects of phytotoxins. According to the concept of hormesis, a deliberate and repeated use of low doses of natural or synthetic toxins in the food can induce one or more stress responses in cells and tissues, followed by the stimulation of numerous defensive repair and maintenance processes [ 25 , 26 ]. Such hormesis-inducing compounds and other conditions are known as hormetins, categorized as nutritional, physical, biological and mental hormetins [ 27 , 28 , 29 ]. Of these, nutritional hormetins, present naturally in the food or as synthetic hormetins to be used as food supplements, are attracting great attention from food-researchers and the nutraceutical and cosmeceutical industry [ 27 , 30 ]. Other food supplements being tested and promoted for health and longevity are various prebiotics and probiotics strengthening and balancing our gut microbiota [ 31 , 32 , 33 ].

Recently, food corporations in pursuit of both exploiting and creating a market for healthy ageing products, have taken many initiatives in producing new products under the flagship of nutraceuticals, super-foods, functional foods, etc. Such products are claimed and marketed not only for their nutritional value, but also for their therapeutic potentials [ 10 ]. Often the claims for such foods are hyped and endorsed as, for example, anti-inflammatory foods, food for the brain, food for physical endurance, complete foods, anti-ageing foods and so on [ 34 , 35 , 36 ]. Traditional foods enriched with a variety of minerals, vitamins and hormetins are generally promoted as “functional foods” [ 37 ]. Even in the case of milk and dairy products, novel and innovative formulations are claimed to improve their functionality and health promotional abilities [ 38 ]. However, there is yet a lot to be discovered and understood about such reformulated, fortified and redesigned foods with respect to their short- and long-term effects on physiology, microbiota balance and metabolic disorders in the context of health and longevity.

4. Diet and Culture for Healthy and Long Life

What elevates food to become diet and a meal is the manner and the context in which that food is consumed [ 4 ]. Numerous traditional and socio-cultural facets of dietary habits can be even more significant than their molecular, biochemical, and physiological concerns regarding their nutritional ingredients and composition. For example, various well-known diets, such as the paleo, the ketogenic, the Chinese, the Ayurvedic, the Mediterranean, the kosher, the halal, the vegetarian, and more recently, the vegan diet, are some of the diverse expressions of such cultural, social, and political practices [ 1 ]. The consequent health-related claims of such varied dietary patterns have influenced their acceptance and adaptation globally and cross-culturally.

Furthermore, our rapidly developing understanding about how biological daily rhythms affect and regulate nutritional needs, termed “chrono-nutrition”, has become a crucial aspect of optimal and healthy eating habits [ 39 , 40 ]. A similar situation is the so-called “nutrient timing” that involves consuming food at strategic times for achieving certain specific outcomes, such as weight reduction, muscle strength, and athletic performance. The meal-timing and dietary patterns are more anticipatory of health-related outcomes than any specific foods or nutrients by themselves [ 41 , 42 , 43 , 44 ]. However, encouraging people to adopt healthy dietary patterns and meal-timing requires both the availability, accessibility and affordability of food, and the intentional, cultural and behavioral preferences of the people.

Looking back at the widely varying and constantly changing cultural history of human dietary practices, one realizes that elaborate social practices, rituals and normative behaviors for obtaining, preparing and consuming food, are often more critical aspects of health-preservation and health-promotion than just the right combination of nutrients. Therefore, one cannot decide on a universal food composition and consumption pattern ignoring the history and the cultural practices and preferences of the consumers. After all, “we eat what we are”, and not, as the old adage says, “we are what we eat”.

5. Conclusions and Perspectives

Food is certainly one of the foundational pillars of good and sustained health. Directed and selective evolution through agricultural practices and experimental manipulation and modification of food components have been among the primary targets for improving food quality. This is further authenticated by extensive research performed, mainly on experimental animal and cell culture model systems, demonstrating the health-promoting effects of individual nutritional components and biological extracts in the regulation, inhibition or stimulation of different molecular pathways with reference to healthy ageing and longevity [ 45 ]. Similarly, individual nutrients or a combination of a few nutrients are being tested for their potential use as calorie restriction mimetics, hormetins and senolytics [ 46 , 47 , 48 ]. However, most commonly, these therapeutic strategies follow the traditional “one target, one missile” pharmaceutical-like approach, and consider ageing as a treatable disease. Based on the results obtained from such experimental studies, the claims and promises made which can often be either naïve extrapolations from experimental model systems to human applications, or exaggerated claims and even false promises [ 49 ].

Other innovative, and possibly holistic, food- and diet-based interventional strategies for healthy ageing are adopting regimens such as caloric- and dietary-restriction, as well as time-restricted eating (TRE). Intermittent fasting (IF), the regimen based on manipulating the eating/fasting timing, is another promising interventional strategy for healthy ageing. Chrono-nutrition, which denotes the link between circadian rhythms and nutrient-sensing pathways, is a novel concept illustrating how meal timings alignment with the inherent molecular clocks of the cells functions to preserve metabolic health. TRE, which is a variant of the IF regimen, claims that food intake timing in alignment with the circadian rhythm is more beneficial for health and longevity [ 39 , 40 , 41 , 50 ]. Moreover, TRE has translational benefits and is easy to complete in the long term as it only requires limiting the eating time to 8–10 h during the day and the fasting window of 12–16 h without restricting the amount of calories consumed. Some pilot studies on the TRE regimen have reported improvement in glucose tolerance and the management of body weight and blood pressure in obese adults as well as men at risk of T2D. Meta-analyses of several pilot scale studies in human subjects suggest and support the beneficial effects of a TRE regimen on several health indicators [ 39 , 50 ]. Several other practical recommendations, based on human clinical trials have also been recommended for meeting the optimal requirements of nutrition in old age, and for preventing or slowing down the progression of metabolic syndromes [ 39 , 40 , 41 , 50 ].

What we have earlier discussed in detail [ 4 ] is supported by the following quote: “…food is more than just being one of the three pillars of health. Food is both the foundation and the scaffolding for the building and survival of an organism on a daily basis. Scientific research on the macro- and micro-nutrient components of food has developed deep understanding of their molecular, biochemical and physiological roles and modes of action. Various recommendations are repeatedly made and modified for some optimal daily requirements of nutrients for maintaining and enhancing health, and for the prevention and treatment of diseases. Can we envisage developing a “nutrition pill” for perfect health, which could be used globally, across cultures, and at all ages? We don’t think so” [ 4 ].

Our present knowledge about the need and significance of nutrients is mostly gathered from the experimental studies using individual active components isolated from various food sources. In reality, however, these nutritional components co-exist interactively with numerous other compounds, and often become chemically modified through the process of cooking and preservation, affecting their stability and bioavailability. There is still a lot to be understood about how the combination of foods, cooking methods and dietary practices affect health-related outcomes, especially with respect to ageing and healthspan.

An abundance of folk knowledge in all cultures about food-related ‘dos and don’ts’ requires scientific verification and validation. We also need to reconsider and change our present scientific protocols for nutritional research, which seem to be impractical for food and dietary research at the level of the population. It is a great scientific achievement that we have amassed a body of information with respect to the nature of nutritional components required for health and survival, the foods which can provide those nutritional components and the variety of dietary and eating practices which seem to be optimal for healthy survival and longevity.

Finally, whereas abundant availability of and accessibility to food in some parts of the world has led to over-consumption and consequent life-style-induced metabolic diseases and obesity, in many other parts of the world food scarcity and economic disparity continue to perpetuate starvation, malnutrition, poor health and shortened lifespan. Often, it is not a lack of knowledge about the optimal nutrition, food and diet that leads to making bad choices; rather, it is either our inability to access and afford healthy foods or our gullibility to fall prey to the exaggerated claims in the commercial interests of food producing and marketing companies. We must continue to gather more scientific information and knowledge about the biochemical, physiological and cultural aspects of nutrition, food and diet, which should then be recommended and applied wisely and globally, incorporating the social, cultural and environmental needs of all. After all, “we eat what we are”, and not merely “we are what we eat”!

Funding Statement

One of the authors, GK, was funded by the Department of Science & Technology (DST) under Cognitive Science Research Initiative (CSRI), Government of India, grant (DST/CSRI/2018/99). This funding agency has no role in study design, manuscript writing, and data interpretation.

Author Contributions

Both authors (S.I.S.R. and G.K.) conceptualized and wrote the paper equally. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Informed consent statement, data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

• Search by keyword
• Search by citation

Page 1 of 37

Higher oxidative balance score was associated with decreased risk of erectile dysfunction: a population-based study

Erectile dysfunction (ED) is a prevalent condition that is thought to be significantly impacted by oxidative stress. The oxidative balance score (OBS) has been built to characterize the state of antioxidant/pr...

• View Full Text

Correction: Effect of soy isoflavone supplementation on blood pressure: a meta-analysis of randomized controlled trials

The original article was published in Nutrition Journal 2024 23 :32

National trends in nine key minerals intake (quantity and source) among U.S. adults, 1999 to march 2020

Changes in economy and dietary guidelines brought a great shock to diet quality and meal behaviors, but if these transformations have extended to minerals intake and their sources was still poorly understood. ...

Causal relationship of interleukin-6 and its receptor on sarcopenia traits using mendelian randomization

Previous research has extensively examined the role of interleukin 6 (IL-6) in sarcopenia. However, the presence of a causal relationship between IL-6, its receptor (IL-6R), and sarcopenia remains unclear.

Development and application of the Meal and Snack Assessment (MESA) quality scale for children and adolescents using item response theory

Meals differ in terms of food items and nutritional quality. The aim of the present study was to propose a scale to measure the meals quality of schoolchildren according to food processing degree, perform a pr...

Estimating effects of whole grain consumption on type 2 diabetes, colorectal cancer and cardiovascular disease: a burden of proof study

Previous studies on whole grain consumption had inconsistent findings and lacked quantitative assessments of evidence quality. Therefore, we aimed to summarize updated findings using the Burden of Proof analys...

Nonlinear relationship between oxidative balance score and hyperuricemia: analyses of NHANES 2007–2018

Limited data regarding the correlation between oxidative balance score (OBS) and hyperuricemia highlights the necessity for thorough investigations. This study aims to examine the link between OBS, which incor...

Effects of whole grains on glycemic control: a systematic review and dose-response meta-analysis of prospective cohort studies and randomized controlled trials

Whole grains have recently been promoted as beneficial to diabetes prevention. However, the evidence for the glycemic benefits of whole grains seems to conflict between the cohort studies and randomized contro...

Remnant cholesterol is an effective biomarker for predicting survival in patients with breast cancer

Breast cancer is the most common malignancy in women worldwide. The relationship between remnant cholesterol (RC) and the prognosis of patients with breast cancer has not been clearly reported. This study inve...

Epidemiological study of pediatric nutritional deficiencies: an analysis from the global burden of disease study 2019

Nutritional deficiencies (ND) continue to threaten the lives of millions of people around the world, with children being the worst hit. Nevertheless, no systematic study of the epidemiological features of chil...

Association between watching eating broadcast “Mukbang and Cookbang” and body mass index status in South Korean adolescents stratified by gender

It has been suggested that Mukbang and Cookbang, a type of eating broadcast originating from Korea and gaining popularity, may contribute to obesity. However, despite suggestions that Mukbang might contribute ...

The global diet quality score as an indicator of adequate nutrient intake and dietary quality – a nation-wide representative study

The Global Diet Quality Score (GDQS) was developed to be a simple, timely and cost-effective tool to track, simultaneously, nutritional deficiency and non-communicable disease risks from diet in diverse settin...

Development of a sustainable diet index in US adults

A transformation towards healthy diets through a sustainable food system is essential to enhance both human and planet health. Development of a valid, multidimensional, quantitative index of a sustainable diet...

Maternal vitamin D status and risk of gestational diabetes mellitus in twin pregnancies: a longitudinal twin pregnancies birth cohort study

Gestational diabetes mellitus (GDM) is a common complication of pregnancy, with significant short-term and long-term implications for both mothers and their offspring. Previous studies have indicated the poten...

Correction: Dietary intake and gastrointestinal symptoms are altered in children with Autism Spectrum Disorder: the relative contribution of autism-linked traits

The original article was published in Nutrition Journal 2024 23 :27

A late eating midpoint is associated with increased risk of diabetic kidney disease: a cross-sectional study based on NHANES 2013–2020

Modifying diet is crucial for diabetes and complication management. Numerous studies have shown that adjusting eating habits to align with the circadian rhythm may positively affect metabolic health. However, ...

Traditional japanese diet score and the sustainable development goals by a global comparative ecological study

Reducing the environmental impact of the food supply is important for achieving Sustainable Development Goals (SDGs) worldwide. Previously, we developed the Traditional Japanese Diet Score (TJDS) and reported ...

Association between dietary magnesium intake and muscle mass among hypertensive population: evidence from the National Health and Nutrition Examination Survey

Magnesium is critical for musculoskeletal health. Hypertensive patients are at high risk for magnesium deficiency and muscle loss. This study aimed to explore the association between magnesium intake and muscl...

Adult dietary patterns with increased bean consumption are associated with greater overall shortfall nutrient intakes, lower added sugar, improved weight-related outcomes and better diet quality

Limited evidence is available that focuses on beans within American dietary patterns and health. The purpose of this study was to identify commonly consumed adult dietary patterns that included beans and compa...

Validity and reproducibility of the PERSIAN Cohort food frequency questionnaire: assessment of major dietary patterns

Dietary patterns, encompassing an overall view of individuals’ dietary intake, are suggested as a suitable means of assessing nutrition’s role in chronic disease development. The aim of this study was to evalu...

Associations of dietary patterns and longitudinal brain-volume change in Japanese community-dwelling adults: results from the national institute for longevity sciences-longitudinal study of aging

The association of dietary patterns and longitudinal changes in brain volume has rarely been investigated in Japanese individuals. We prospectively investigated this association in middle-aged and older Japane...

Association between serum 25-hydroxyvitamin D and vitamin D dietary supplementation and risk of all-cause and cardiovascular mortality among adults with hypertension

The relationship between vitamin D status and mortality among adults with hypertension remains unclear.

Effect of soy isoflavone supplementation on blood pressure: a meta-analysis of randomized controlled trials

Previous experimental studies have suggested that the consumption of soy isoflavones may have a potential impact on lowering blood pressure. Nevertheless, epidemiological studies have presented conflicting out...

The Correction to this article has been published in Nutrition Journal 2024 23 :53

The effects of L-carnitine supplementation on inflammation, oxidative stress, and clinical outcomes in critically Ill patients with sepsis: a randomized, double-blind, controlled trial

Sepsis, a life-threatening organ dysfunction caused by a host’s dysregulated response to infection with an inflammatory process, becomes a real challenge for the healthcare systems. L-carnitine (LC) has antiox...

Metabolic syndrome risk in adult coffee drinkers with the rs301 variant of the LPL gene

Metabolic syndrome (MetS), a cluster of metabolic and cardiovascular risk factors is influenced by environmental, lifestyle, and genetic factors. We explored whether coffee consumption and the rs301 variant of...

Towards objective measurements of habitual dietary intake patterns: comparing NMR metabolomics and food frequency questionnaire data in a population-based cohort

Low-quality, non-diverse diet is a main risk factor for premature death. Accurate measurement of habitual diet is challenging and there is a need for validated objective methods. Blood metabolite patterns refl...

Circulating concentrations of bile acids and prevalent chronic kidney disease among newly diagnosed type 2 diabetes: a cross-sectional study

The relationship between circulating bile acids (BAs) and kidney function among patients with type 2 diabetes is unclear. We aimed to investigate the associations of circulating concentrations of BAs, particul...

Dietary intake and gastrointestinal symptoms are altered in children with Autism Spectrum Disorder: the relative contribution of autism-linked traits

Dietary and gastrointestinal (GI) problems have been frequently reported in autism spectrum disorder (ASD). However, the relative contributions of autism-linked traits to dietary and GI problems in children wi...

The Correction to this article has been published in Nutrition Journal 2024 23 :40

The effect of bovine dairy products and their components on the incidence and natural history of infection: a systematic literature review

Dairy products and their components may impact immune function, although the current evidence base has some research gaps. As part of a larger systematic literature review of dairy products/components (includi...

Food sufficiency status and sleep outcomes in older adults: the National Health and Aging Trends Study (NHATS)

Studies investigating the relationship between food insecurity and sleep among older populations are limited. This study aimed to cross-sectionally examine the associations between food sufficiency status and ...

Effects of vitamin D supplementation on liver fibrogenic factors, vitamin D receptor and liver fibrogenic microRNAs in metabolic dysfunction-associated steatotic liver disease (MASLD) patients: an exploratory randomized clinical trial

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a global metabolic problem which can lead to irreversible liver fibrosis. It has been shown that vitamin D and its receptors contribute to fi...

Validity of food and nutrient intakes assessed by a food frequency questionnaire among Chinese adults

Studies regarding the validity of the food frequency questionnaire (FFQ) and the food composition table (FCT) are limited in Asian countries. We aimed to evaluate the validity of a 64-item FFQ and different me...

Association of sugar intake from different sources with cardiovascular disease incidence in the prospective cohort of UK Biobank participants

The relation between incident cardiovascular disease (CVD) and sugar might not only depend on the quantity consumed but also on its source. This study aims to assess the association between various sources of ...

Association of dietary inflammatory index and the SARS-CoV-2 infection incidence, severity and mortality of COVID-19: a systematic review and dose-response meta-analysis

Several studies have reported the association between dietary inflammatory index (DII) and the SARS-CoV-2 infection risk, severity or mortality of COVID-19, however, the outcomes remain controversial.

Breakfast quality and its sociodemographic and psychosocial correlates among Italian children, adolescents, and adults from the Italian Nutrition & HEalth Survey (INHES) study

Breakfast quality, together with regularity of breakfast, has been suggested to be associated with cardiometabolic health advantages. We aimed to evaluate the quality of breakfast and its socioeconomic and psy...

The association between lifelines diet score (LLDS) with depression and quality of life in Iranian adolescent girls

It has been proposed that a greater degree of adherence to a healthy dietary pattern is associated with a lower risk of depression and a poor quality of life (QoL). The Lifelines diet score (LLDS) is a new, ev...

Diet in secondary prevention: the effect of dietary patterns on cardiovascular risk factors in patients with cardiovascular disease: a systematic review and network meta-analysis

Improving dietary habits is a first-line recommendation for patients with cardiovascular disease (CVD). It is unclear which dietary pattern most effectively lowers cardiovascular risk factors and what the shor...

Prognostic potential of nutritional risk screening and assessment tools in predicting survival of patients with pancreatic neoplasms: a systematic review

The nutritional evaluation of pancreatic cancer (PC) patients lacks a gold standard or scientific consensus, we aimed to summarize and systematically evaluate the prognostic value of nutritional screening and ...

40 years of adding more fructose to high fructose corn syrup than is safe, through the lens of malabsorption and altered gut health–gateways to chronic disease

Labels do not disclose the excess-free-fructose/unpaired-fructose content in foods/beverages. Objective was to estimate excess-free-fructose intake using USDA loss-adjusted-food-availability (LAFA) data (1970–...

Relationship between trajectories of dietary iron intake and risk of type 2 diabetes mellitus: evidence from a prospective cohort study

The association between dietary iron intake and the risk of type 2 diabetes mellitus (T2DM) remains inconsistent. In this study, we aimed to investigate the relationship between trajectories of dietary iron in...

Dietary pattern and precocious puberty risk in Chinese girls: a case-control study

The role of dietary intake on precocious puberty remains unclear. This study aimed to investigate the association between the amount and frequency of dietary intake and the risk of precocious puberty in Chines...

Tracking progress toward a climate-friendly public food service strategy: assessing nutritional quality and carbon footprint changes in childcare centers

Public food procurement and catering are recognized as important leverage points in promoting sustainable and healthy dietary habits. This study aimed to analyze changes in nutritional quality and carbon footp...

Avocado intake and cardiometabolic risk factors in a representative survey of Australians: a secondary analysis of the 2011–2012 national nutrition and physical activity survey

Avocados are a rich source of nutrients including monounsaturated fats, dietary fibre and phytochemicals. Higher dietary quality is reported in studies of consumers with higher avocado intakes. The present stu...

Components in downstream health promotions to reduce sugar intake among adults: a systematic review

Excessive sugar consumption is well documented as a common risk factor for many Non-Communicable Diseases (NCDs). Thus, an adequate intervention description is important to minimise research waste and improve ...

Improving economic access to healthy diets in first nations communities in high-income, colonised countries: a systematic scoping review

Affordability of healthy food is a key determinant of the diet-related health of First Nations Peoples. This systematic scoping review was commissioned by the Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women...

Associations between estimation of salt intake and salt-restriction spoons and hypertension status in patients with poorly controlled hypertension: a community-based study from Huzhou City, Eastern China

As the prevalence of hypertension increases in China, it is advised to use salt-restriction spoons (SRS) as a lifestyle modification. This study aimed to examine the associations between estimated salt consump...

Potassium levels and the risk of all-cause and cardiovascular mortality among patients with cardiovascular diseases: a meta-analysis of cohort studies

Abnormal blood potassium levels are associated with an increased risk of cardiometabolic diseases and mortality in the general population; however, evidence regarding the association between dyskalemia and mor...

Combined versus independent effects of exercise training and intermittent fasting on body composition and cardiometabolic health in adults: a systematic review and meta-analysis

Exercise training (Ex) and intermittent fasting (IF) are effective for improving body composition and cardiometabolic health overweight and obese adults, but whether combining Ex and IF induces additive or syn...

Correction: Associations Between Plant-Based Dietary Patterns and Risks of Type 2 Diabetes, Cardiovascular Disease, Cancer, and Mortality – A Systematic Review and Meta-analysis

The original article was published in Nutrition Journal 2023 22 :46

The association between hyperuricemia and insulin resistance surrogates, dietary- and lifestyle insulin resistance indices in an Iranian population: MASHAD cohort study

Previous studies have reported insulin resistance (IR) to be associated with hyperuricemia. In this study, we aimed to assess the possible associations between the empirical dietary index for IR (EDIR), the em...

• Editorial Board
• Manuscript editing services
• Instructions for Editors
• Sign up for article alerts and news from this journal
• Follow us on Twitter

Annual Journal Metrics

2022 Citation Impact 5.4 - 2-year Impact Factor 5.3 - 5-year Impact Factor 1.507 - SNIP (Source Normalized Impact per Paper) 1.136 - SJR (SCImago Journal Rank)

2023 Speed 21 days submission to first editorial decision for all manuscripts (Median) 181 days submission to accept (Median)

2023 Usage  2,353,888 downloads 3,953 Altmetric mentions 

• More about our metrics

Nutrition Journal

ISSN: 1475-2891

• General enquiries: [email protected]

Privacy and cookies policy

We use cookies on our website to help us understand how you use the site and to make improvements. These may be used to track your visit to our website or to enable us to personalise your browsing experience, and they may be shared with Google Analytics so that your data can be processed. Privacy and cookies policy

2021 Global Nutrition Report

The 2021 Global Nutrition Report provides a concise data-focused update on the state of diets and nutrition in the world. Independent analysis of the best data on nutrition is critical for evidence-based, timely and effective actions to ensure we deliver on our global commitment to end poor diets and malnutrition.

Poor diets and resulting malnutrition in all its forms are unacceptably high across the world, creating one of the world’s greatest current societal challenges. The need for bolder, sustained and better coordinated action on nutrition that goes far beyond the nutrition community has never been greater.

• English PDF 45.0kB
• French PDF 134.2kB
• Spanish PDF 134.1kB

Executive summary

The 2021 Global Nutrition Report sets out progress towards the global nutrition targets, evaluates the impact of poor diets on our health and our planet, assesses the nutrition financing landscape, and provides a comprehensive overview of reporting on past Nutrition for Growth (N4G) commitments.

• English PDF 463.1kB
• French PDF 881.2kB
• Spanish PDF 877.4kB
• Japanese PDF 1.3MB

Chapter One

A world free from malnutrition: An assessment of progress towards the global nutrition targets

At the current rate of progress, the global nutrition targets will not be achieved by 2025. We assess performance against the targets, examine how the Covid-19 pandemic is further impeding progress, and pose some of the short- and long-term responses urgently needed to bring the world back on track.

• English PDF 624.8kB
• French PDF 465.5kB
• Spanish PDF 429.6kB

Chapter Two

What we eat matters: Health and environmental impacts of diets worldwide

Diets affect both human and planetary health, with a quarter of all adult deaths attributable to poor diets, and current food demand responsible for more than a third of greenhouse gas emissions. This chapter presents new estimates of the associated health and environmental impacts of our diets today.

• English PDF 836.1kB
• French PDF 621.7kB
• Spanish PDF 608.6kB

Chapter Three

More money for nutrition, more nutrition for the money: Financing nutrition

Current financing challenges, exacerbated by the economic downturn triggered by Covid-19, threaten to increase malnutrition. We examine the global resourcing needs, and collective effort required of stakeholders to address malnutrition and build human capital, to raise more financing and to deliver more impact with the money we have.

• English PDF 684.3kB
• French PDF 537.8kB
• Spanish PDF 535.7kB

Chapter Four

From promise to action: Progress towards the 2013 and 2017 Nutrition for Growth commitments

This chapter assesses progress towards the 2013 and 2017 Nutrition for Growth commitment goals and examines the alignment of the N4G commitment goals with the global nutrition targets. We also present findings on the effect of the Covid-19 pandemic on stakeholders’ ability to achieve their commitment goals in 2020.

• English PDF 633.4kB
• French PDF 481.8kB
• Spanish PDF 480.3kB

Shareable definitions of the terms we have used across the report

Acronyms and abbreviations

A list of the acronyms and abbreviations we have used across the report.

Authorship, acknowledgements and suggested citation

Authorship of the report, thanks to those involved in creating it and a suggestion for how to cite it

Endorsements

Endorsements of the 2021 Global Nutrition Report.

Dataset and metadata

The data, metadata and technical note used for the 2021 Global Nutrition Report

appendix one

Appendix: Chapter 2 methodology and data sources

We estimated the mortality and disease burden attributable to dietary and weight-related risk factors by calculating population impact fractions (PIFs), which represent the proportions of disease cases that would be…

Share 2021 Global Nutrition Report

• English 2021 Global Nutrition Report (PDF 3.9MB) Launch presentation - 2021 Global Nutrition Report (PDF 1.5MB)
• French 2021 Global Nutrition Report French (PDF 3.1MB)
• Spanish 2021 Global Nutrition Report Spanish (PDF 3.0MB)

Download the 2021 Global Nutrition Report

• Frontiers in Sustainable Food Systems
• Nutrition and Sustainable Diets
• Research Topics

Insights in Nutrition and Sustainable Diets: 2021

Total Downloads

Total Views and Downloads

About this Research Topic

We are now entering the third decade of the 21st Century, and, especially in the last years, the achievements made by scientists have been exceptional, leading to major advancements in the fast-growing field of sustainable food systems. Frontiers has organized a series of Research Topics to ...

Important Note : All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Topic Editors

Topic coordinators, recent articles, submission deadlines.

Submission closed.

Participating Journals

Total views.

• Demographics

No records found

total views article views downloads topic views

Top countries

Top referring sites, about frontiers research topics.

With their unique mixes of varied contributions from Original Research to Review Articles, Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author.

• Wellness RX Jacksonville

15 Trending Nutrition Research Articles from 2021

Share this:.

March is National Nutrition Month so here is a report that takes a look at some trending nutrition research articles from the American Society for Nutrition’s four journals: The Journal of Nutrition ,  The American Journal of Clinical Nutrition ,  Advances in Nutrition , and  Current Developments in Nutrition . This are 15 articles that were mentioned the most in news and social media this year.

• Copy link to clipboard
• Report newsfeed post

Interested in more newsfeed posts like this? Go to the Wellness RX Jacksonville blog.

Connect with thousands of patients and caregivers for support and answers.

• Hosted and moderated by Mayo Clinic.
• Safe and secure.

Already have an account? Sign In

• Download PDF
• Share X Facebook Email LinkedIn
• Permissions

Prioritizing Nutrition Security in the US

• 1 Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
• 2 Georgetown University Law Center, Washington, DC
• 3 World Central Kitchen, Washington, DC
• Invited Commentary Food Is Medicine: The Promise and Challenges of Integrating Food and Nutrition Into Health Care Dariush Mozaffarian, MD, DrPH; Jerold Mande, MPH; Renata Micha, RD, PhD JAMA Internal Medicine
• Viewpoint US Dietary Guidelines and Lifting the Total Dietary Fat Ban Dariush Mozaffarian, MD, DrPH; David S. Ludwig, MD, PhD JAMA
• The JAMA Forum Food Insecurity and a Threatened Safety Net Diana J. Mason, PhD, RN JAMA
• Research Letter Risk Factors Associated With Food Insecurity in the Medicare Population Jeanne M. Madden, PhD; Prathwish S. Shetty, MSc; Fang Zhang, PhD; Becky A. Briesacher, PhD; Dennis Ross-Degnan, ScD; Stephen B. Soumerai, ScD; Alison A. Galbraith, MD, MPH JAMA Internal Medicine
• Original Investigation Receipt of Unemployment Insurance and Food Insecurity During the COVID-19 Pandemic Julia Raifman, ScD; Jacob Bor, ScD; Atheendar Venkataramani, MD, PhD JAMA Network Open

The prevalence of nutrition-sensitive conditions such as obesity and type 2 diabetes has increased substantially in the US during the past 30 years. These conditions, combined with other diet-related ones such as cardiovascular diseases and certain cancers, are associated with the majority of morbidity, mortality, and health care spending nationally. Simultaneously, income inequality has increased, with accompanying self-reported food insecurity disproportionately affecting individuals with lower incomes. Food insecurity has been defined as the state of being without reliable access to a sufficient quantity of affordable, nutritious food, and in 2019 was estimated to affect 10.5% of US households. 1 Food insecurity and poor nutrition are closely linked: individuals who report being most food insecure also have higher risks of developing obesity, diabetes, hypertension, coronary disease, stroke, cancer, and associated conditions, even after adjusting for other risks such as age, sex, employment, marital status, race/ethnicity, smoking, insurance status, family size, education, and income. 2

• Invited Commentary Food Is Medicine: The Promise and Challenges of Integrating Food and Nutrition Into Health Care JAMA Internal Medicine

Read More About

Mozaffarian D , Fleischhacker S , Andrés JR. Prioritizing Nutrition Security in the US. JAMA. 2021;325(16):1605–1606. doi:10.1001/jama.2021.1915

Manage citations:

© 2024

Artificial Intelligence Resource Center

Cardiology in JAMA : Read the Latest

Browse and subscribe to JAMA Network podcasts!

Others Also Liked

Select your interests.

Customize your JAMA Network experience by selecting one or more topics from the list below.

• Academic Medicine
• Acid Base, Electrolytes, Fluids
• Allergy and Clinical Immunology
• American Indian or Alaska Natives
• Anesthesiology
• Anticoagulation
• Art and Images in Psychiatry
• Artificial Intelligence
• Assisted Reproduction
• Bleeding and Transfusion
• Caring for the Critically Ill Patient
• Challenges in Clinical Electrocardiography
• Climate and Health
• Climate Change
• Clinical Challenge
• Clinical Decision Support
• Clinical Implications of Basic Neuroscience
• Clinical Pharmacy and Pharmacology
• Complementary and Alternative Medicine
• Consensus Statements
• Coronavirus (COVID-19)
• Critical Care Medicine
• Cultural Competency
• Dental Medicine
• Dermatology
• Diabetes and Endocrinology
• Diagnostic Test Interpretation
• Drug Development
• Electronic Health Records
• Emergency Medicine
• End of Life, Hospice, Palliative Care
• Environmental Health
• Equity, Diversity, and Inclusion
• Facial Plastic Surgery
• Gastroenterology and Hepatology
• Genetics and Genomics
• Genomics and Precision Health
• Global Health
• Guide to Statistics and Methods
• Hair Disorders
• Health Care Delivery Models
• Health Care Economics, Insurance, Payment
• Health Care Quality
• Health Care Reform
• Health Care Safety
• Health Care Workforce
• Health Disparities
• Health Inequities
• Health Policy
• Health Systems Science
• History of Medicine
• Hypertension
• Images in Neurology
• Implementation Science
• Infectious Diseases
• Innovations in Health Care Delivery
• JAMA Infographic
• Law and Medicine
• Leading Change
• Less is More
• LGBTQIA Medicine
• Lifestyle Behaviors
• Medical Coding
• Medical Devices and Equipment
• Medical Education
• Medical Education and Training
• Medical Journals and Publishing
• Mobile Health and Telemedicine
• Narrative Medicine
• Neuroscience and Psychiatry
• Notable Notes
• Nutrition, Obesity, Exercise
• Obstetrics and Gynecology
• Occupational Health
• Ophthalmology
• Orthopedics
• Otolaryngology
• Pain Medicine
• Palliative Care
• Pathology and Laboratory Medicine
• Patient Care
• Patient Information
• Performance Improvement
• Performance Measures
• Perioperative Care and Consultation
• Pharmacoeconomics
• Pharmacoepidemiology
• Pharmacogenetics
• Pharmacy and Clinical Pharmacology
• Physical Medicine and Rehabilitation
• Physical Therapy
• Physician Leadership
• Population Health
• Primary Care
• Professional Well-being
• Professionalism
• Psychiatry and Behavioral Health
• Public Health
• Pulmonary Medicine
• Regulatory Agencies
• Reproductive Health
• Research, Methods, Statistics
• Resuscitation
• Rheumatology
• Risk Management
• Scientific Discovery and the Future of Medicine
• Shared Decision Making and Communication
• Sleep Medicine
• Sports Medicine
• Stem Cell Transplantation
• Substance Use and Addiction Medicine
• Surgical Innovation
• Surgical Pearls
• Teachable Moment
• Technology and Finance
• The Art of JAMA
• The Arts and Medicine
• The Rational Clinical Examination
• Tobacco and e-Cigarettes
• Translational Medicine
• Trauma and Injury
• Treatment Adherence
• Ultrasonography
• Users' Guide to the Medical Literature
• Vaccination
• Venous Thromboembolism
• Veterans Health
• Women's Health
• Workflow and Process
• Wound Care, Infection, Healing
• Register for email alerts with links to free full-text articles
• Access PDFs of free articles
• Manage your interests
• Save searches and receive search alerts

• Search by keyword
• Search by citation

Page 1 of 21

Effect of food sources of nitrate, polyphenols, L-arginine and L-citrulline on endurance exercise performance: a systematic review and meta-analysis of randomised controlled trials

Increasing nitric oxide bioavailability may induce physiological effects that enhance endurance exercise performance. This review sought to evaluate the performance effects of consuming foods containing compou...

• View Full Text

Correction to: Supplement intake in half-marathon, (ultra-)marathon and 10-km runners – results from the NURMI study (Step 2)

The original article was published in Journal of the International Society of Sports Nutrition 2021 18 :64

Nine weeks of high-intensity indoor cycling training induced changes in the microbiota composition in non-athlete healthy male college students

The gut microbiota constitutes a dynamic microbial system constantly challenged by environmental conditions, including physical exercise. Limited human studies suggest that exercise could play a beneficial rol...

Edema-like symptoms are common in ultra-distance cyclists and driven by overdrinking, use of analgesics and female sex – a study of 919 athletes

Ultra-endurance cyclists regularly report various extents of bodily decline during long-distance bicycle rides, including potential kidney function-related symptoms such as swelling of body parts and urine cha...

Beetroot juice — a suitable post-marathon metabolic recovery supplement?

Red beetroot ( Beta vulgaris L. ) is a multifunctional functional food that reportedly exhibits potent anti-inflammatory, antioxidant, vasodilation, and cellular regulatory properties. This vegetable has gained a f...

Effects of sodium bicarbonate supplementation on exercise performance: an umbrella review

We aimed to perform an umbrella review of meta-analyses examining the effects of sodium bicarbonate supplementation on exercise performance.

Association of energy availability with resting metabolic rates in competitive female teenage runners: a cross-sectional study

Resting metabolic rate (RMR) has been examined as a proxy for low energy availability (EA). Previous studies have been limited to adult athletes, despite the serious health consequences of low EA, particularly...

Effects of glucose ingestion at different frequencies on glycogen recovery in mice during the early hours post exercise

When a high-carbohydrate diet is ingested, whether as small frequent snacks or as large meals, there is no difference between the two with respect to post-exercise glycogen storage for a period of 24 h. Howeve...

Resting energy expenditure in elite athletes: development of new predictive equations based on anthropometric variables and bioelectrical impedance analysis derived phase angle

An accurate estimation of athletes’ energy needs is crucial in diet planning to improve sport performance and to maintain an appropriate body composition. This study aimed to develop and validate in elite athl...

Effects of chronic betaine supplementation on performance in professional young soccer players during a competitive season: a double blind, randomized, placebo-controlled trial

Various nutritional strategies are adopted for athletes to maintain and to improve performance during the competition season. Betaine may enhance performance during a competitive season by increasing the testo...

Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis

Previous narrative reviews have concluded that dietary nitrate (NO 3 − ) improves maximal neuromuscular power in humans. This conclusion, however, was based on a limited number of studies, and no attempt has been ma...

The effect of omega-3 fatty acids on a biomarker of head trauma in NCAA football athletes: a multi-site, non-randomized study

American-style football (ASF) athletes are at risk for cardiovascular disease (CVD) and exhibit elevated levels of serum neurofilament light (Nf-L), a biomarker of axonal injury that is associated with repetit...

Supplement intake in half-marathon, (ultra-)marathon and 10-km runners – results from the NURMI study (Step 2)

The primary nutritional challenge facing endurance runners is meeting the nutrient requirements necessary to optimize the performance and recovery of prolonged training sessions. Supplement intake is a commonl...

The Correction to this article has been published in Journal of the International Society of Sports Nutrition 2021 18 :75

Effects of carbohydrate and caffeine mouth rinsing on strength, muscular endurance and cognitive performance

Carbohydrate (CHO) and caffeine (CAF) mouth rinsing have been shown to enhance endurance and sprint performance. However, the effects of CHO and CAF mouth rinsing on muscular and cognitive performance in compa...

Effects of 30 days of ketogenic diet on body composition, muscle strength, muscle area, metabolism, and performance in semi-professional soccer players

A ketogenic diet (KD) is a nutritional approach, usually adopted for weight loss, that restricts daily carbohydrates under 30 g/day. KD showed contradictory results on sport performance, whilst no data are ava...

International Society of Sports Nutrition position stand: sodium bicarbonate and exercise performance

Based on a comprehensive review and critical analysis of the literature regarding the effects of sodium bicarbonate supplementation on exercise performance, conducted by experts in the field and selected membe...

The effects of phosphocreatine disodium salts plus blueberry extract supplementation on muscular strength, power, and endurance

Numerous studies have demonstrated the efficacy of creatine supplementation for improvements in exercise performance. Few studies, however, have examined the effects of phosphocreatine supplementation on exerc...

Prevalence, factors associated with use, and adverse effects of sport-related nutritional supplements (sport drinks, sport bars, sport gels): the US military dietary supplement use study

Sport-related nutritional supplements (SRNSs) include sport drinks, sport bars, and sport gels. Previous studies indicate that 25–35 % of athletes and 25–50 % of military personnel report using these supplemen...

Mitochondria-targeted antioxidant supplementation improves 8 km time trial performance in middle-aged trained male cyclists

Exercise increases skeletal muscle reactive oxygen species (ROS) production, which may contribute to the onset of muscular fatigue and impair athletic performance. Mitochondria-targeted antioxidants such as Mi...

Standardized astragalus extract for attenuation of the immunosuppression induced by strenuous physical exercise: randomized controlled trial

This paper aimed to verify how a supplementation of rower’s diet with Astragalus Membranaceus Root (AMR) modulated their immune system response to maximal physical exertion.

Initiating aerobic exercise with low glycogen content reduces markers of myogenesis but not mTORC1 signaling

The effects of low muscle glycogen on molecular markers of protein synthesis and myogenesis before and during aerobic exercise with carbohydrate ingestion is unclear. The purpose of this study was to determine...

The effects of dietary nitrate supplementation on endurance exercise performance and cardiorespiratory measures in healthy adults: a systematic review and meta-analysis

Nitrate supplementation is thought to improve performance in endurance sports.

Nicotinamide mononucleotide supplementation enhances aerobic capacity in amateur runners: a randomized, double-blind study

Recent studies in rodents indicate that a combination of exercise training and supplementation with nicotinamide adenine dinucleotide (NAD + ) precursors has synergistic effects. However, there are currently no hum...

Temporal trends in dietary creatine intake from 1999 to 2018: an ecological study with 89,161 participants

We described here the annual variations in mean dietary creatine intake from 1999 to 2018 in U.S. children and adults using National Health and Nutrition Examination Survey (NHANES) database.

Flexible vs. rigid dieting in resistance-trained individuals seeking to optimize their physiques: A randomized controlled trial

The purpose of this study was to compare a flexible vs. rigid diet on weight loss and subsequent weight regain in resistance-trained (RT) participants in a randomized, parallel group design.

Regular consumption of cod liver oil is associated with reduced basal and exercise-induced C-reactive protein levels; a prospective observational trial

Dietary supplement use among recreational athletes is common, with the intention of reducing inflammation and improving recovery. We aimed to describe the relationship between omega-3 fatty acid supplement use...

Chronic capsiate supplementation increases fat-free mass and upper body strength but not the inflammatory response to resistance exercise in young untrained men: a randomized, placebo-controlled and double-blind study

Acute capsaicinoid and capsinoid supplementation has endurance and resistance exercise benefits; however, if these short-term performance benefits translate into chronic benefits when combined with resistance ...

Effects of acute ingestion of caffeinated chewing gum on performance in elite judo athletes

Previous investigations have found positive effects of acute ingestion of capsules containing 4-to-9 mg of caffeine per kg of body mass on several aspects of judo performance. However, no previous investigatio...

The effect of multi-ingredient intra- versus extra-cellular buffering supplementation combined with branched-chain amino acids and creatine on exercise-induced ammonia blood concentration and aerobic capacity in taekwondo athletes

This study aimed to investigate the effect of multi-ingredient intra- (BA) versus extra- (ALK) cellular buffering factor supplementation, combined with the customary intake of branched-chain amino acids (BCAA)...

Broad Spectrum Polyphenol Supplementation from Tart Cherry Extract on Markers of Recovery from Intense Resistance Exercise

Tart cherry supplementation has been shown to enhance recovery from strenuous exercise due to its antioxidant properties. The majority of these studies used tart cherry juice, with a significant calorie conten...

Elite squash players nutrition knowledge and influencing factors

There is a reported mismatch between macronutrient consumption and contemporary macronutrient guidelines in elite standard squash players. Suboptimal dietary practices could be due to a lack of nutrition knowl...

The role of age in the physiological adaptations and psychological responses in bikini-physique competitor contest preparation: a case series

The increased popularity of the bikini-physique competitions has not translated to greater research identifying the influence of age on adaptations during contest preparation. The purpose of this case series w...

Effects of antioxidant supplementation on oxidative stress balance in young footballers- a randomized double-blind trial

Intensive physical exercise that competitive sports athletes participate in can negatively affect their pro-oxidative–antioxidant balance. Compounds with high antioxidant potential, such as those present in ch...

Redox and autonomic responses to acute exercise-post recovery following Opuntia ficus-indica juice intake in physically active women

The aim of this study was to investigate if the supplementation with Opuntia ficus-indica (OFI) juice may affect plasma redox balance and heart rate variability (HRV) parameters following a maximal effort test, i...

Effects of 14-weeks betaine supplementation on pro-inflammatory cytokines and hematology status in professional youth soccer players during a competition season: a double blind, randomized, placebo-controlled trial

Systemic elevations in pro-inflammatory cytokines are a marker of non-functional over reaching, and betaine has been shown to reduce the secretion of pro-inflammatory cytokines in vitro. The aim of this study ...

Body composition changes in physically active individuals consuming ketogenic diets: a systematic review

To achieve ideal strength/power to mass ratio, athletes may attempt to lower body mass through reductions in fat mass (FM), while maintaining or increasing fat-free mass (FFM) by manipulating their training re...

Effects of two different doses of carbohydrate ingestion on taekwondo-related performance during a simulated tournament

Carbohydrate (CHO) ingestion enhances exercise performance; however, the efficacy of CHO intake on repeated bouts of exercise simulating a taekwondo tournament is unknown. Therefore, the purpose was to compare...

Taurine in sports and exercise

Taurine has become a popular supplement among athletes attempting to improve performance. While the effectiveness of taurine as an ergogenic aid remains controversial, this paper summarizes the current evidenc...

Metabolic, hormonal and performance effects of isomaltulose ingestion before prolonged aerobic exercise: a double-blind, randomised, cross-over trial

Isomaltulose has been discussed as a low glycaemic carbohydrate but evidence concerning performance benefits and physiological responses has produced varying results. Therefore, we primarily aimed to investiga...

Performance effects of periodized carbohydrate restriction in endurance trained athletes – a systematic review and meta-analysis

Endurance athletes typically consume carbohydrate-rich diets to allow for optimal performance during competitions and intense training. However, acute exercise studies have revealed that training or recovery w...

The effect of probiotic supplementation on performance, inflammatory markers and gastro‐intestinal symptoms in elite road cyclists

Elite athletes may suffer from impaired immune function and gastro-intestinal (GI) symptoms, which may affect their health and may impede their performance. These symptoms may be reduced by multi-strain probio...

A large-scale observational study linking various kinds of physical exercise to lipoprotein-lipid profile

Being a major cardiovascular risk factor, dyslipidemia is a critical problem in public health. Recommendations in performing regular physical exercise are important to prevent dyslipidemia.

Development and validation of a food frequency questionnaire for Japanese athletes (FFQJA)

Food frequency questionnaires are considered an effective method for assessing habitual dietary intake, but they must be developed or validated with the target population. Portion size, supplement use and food...

Change in eating habits and physical activities before and during the COVID-19 pandemic in Hong Kong: a cross‐sectional study via random telephone survey

Hong Kong is a densely populated city with a low incidence and mortality of coronavirus disease 2019 (COVID-19). The city imposed different levels of social distancing including, the closure of sports venues a...

Correction to: Analysis of food and fluid intake in elite ultra-endurance runners during a 24-h world championship

An amendment to this paper has been published and can be accessed via the original article.

The original article was published in Journal of the International Society of Sports Nutrition 2020 17 :36

Correction to: Serum and urinary concentrations of arsenic, beryllium, cadmium and lead after an aerobic training period of six months in aerobic athletes and sedentary people

The original article was published in Journal of the International Society of Sports Nutrition 2020 17 :43

Correction to: Erythrocyte concentrations of chromium, copper, manganese, molybdenum, selenium and zinc in subjects with different physical training levels

The original article was published in Journal of the International Society of Sports Nutrition 2020 17 :35

Serum levels of bone formation and resorption markers in relation to vitamin D status in professional gymnastics and physically active men during upper and lower body high-intensity exercise

To compare serum levels of bone turnover markers in athletes and non-athletes, and to evaluate the relationship between serum levels of vitamin D metabolites and exercise-induced changes in biomarker levels.

Copper concentration in erythrocytes, platelets, plasma, serum and urine: influence of physical training

Physical training produces changes in the extracellular and intracellular concentrations of trace minerals elements. To our knowledge, only three compartments have been studied simultaneously. The aim of the p...

Sex differences and considerations for female specific nutritional strategies: a narrative review

Although there is a plethora of information available regarding the impact of nutrition on exercise performance, many recommendations are based on male needs due to the dominance of male participation in the n...

Journal of the International Society of Sports Nutrition

ISSN: 1550-2783

• Submission enquiries: Access here and click Contact Us
• General enquiries: [email protected]

Healthy Living Guide 2021/2022

A digest on healthy eating and healthy living.

Over the course of 2021, many of us continued to adapt to a “new normal,” characterized by a return to some pre-pandemic activities mixed with hobbies or habits that have emerged since 2020’s lockdowns. On the topic of food and eating, according to one U.S. consumer survey the year marked a decrease in certain behaviors that had changed abruptly during 2020. For example, fewer Americans reported that they were “snacking more” (18% in 2021 vs. 32% in 2020) or “eating more in general” (11% in 2021 vs. 20% in 2020). However, consumers also signaled a decrease in cooking at home (47% in 2021 vs. 60% in 2020); while other survey findings underscored significant disparities in food security. Beyond food, the COVID-19 pandemic continues to generate a wide range of unique and individual impacts, and the emergence of new disease variants is a sobering reminder of the urgency for increased vaccination globally, especially in low- and lower-middle-income countries.

As we all continue to navigate the twists and turns of this pandemic, we once again invite you to do what you can to incorporate healthy behaviors into your daily life. This year’s edition revisits the core themes of eating well, being active, and getting enough sleep with selected research highlights, as well as a closer look at some popular nutrition and lifestyle topics. We hope that you find it useful, and we wish you a very healthy and fulfilling 2022.

Download a copy of the Healthy Living Guide (PDF) featuring printable tip sheets and summaries, or access many of the full online articles through the links below. 

Key features this issue:

• A blueprint for building healthy meals
• Exploring aquatic foods
• Are anti-nutrients harmful? 
• Navigating information on food packages
• The science of cravings
• Anti-inflammatory diet review
• Clearing up confusion on soy and health
• Spotlight on collagen
• Yoga for exercise
• High-intensity interval training
• Workout supplement review
• Updates on sleep

Plus: Test your healthy living knowledge

Hint: the answers can be found throughout last year’s Healthy Living Guide. Access the full edition here if you haven’t checked it out!

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts

Articles in 2021

On-Farm Experimentation to transform global agriculture

Building productive relationships between farmers and scientists is critical to developing new innovation pathways to solve the challenges of contemporary agriculture. On-farm experimentation (OFE) is an effective approach that brings agricultural stakeholders to support farmers’ own management decisions for agricultural innovation, with digitalization playing a key role in motivating and enabling OFE.

• Myrtille Lacoste
• Andrew Hall

Global maps of cropland extent and change show accelerated cropland expansion in the twenty-first century

High-resolution satellite observations provide an accurate and cost-effective solution to monitoring national and global progress towards Sustainable Development Goals. With a new global cropland dataset, this study reports that during the first two decades of the twenty-first century, the global cropland area increased by 9%, whereas the per-capita cropland area decreased by 10% and the per-capita annual cropland net primary production increased by 3.5%.

• Peter Potapov
• Svetlana Turubanova
• Jocelyn Cortez

Polycyclic aromatic hydrocarbons in meat

Costs of healthy, sustainable diets around the world.

• Anne Mullen

Engineering broad-spectrum resistance

Deterring unsafe pork sales

• Annisa Chand

Simulating grazing beef and sheep systems

Ovalbumin production without poultry

An anticipatory life-cycle assessment of industrial-scale ovalbumin production using Trichoderma reesei culture indicates that this cellular agriculture approach could have lower global warming potential than ovalbumin purified from egg whites.

• Deepti Diwan
• Minaxi Sharma
• Vijai Kumar Gupta

A natural experiment of dietary change

Social disruption during the COVID-19 pandemic triggered highly varied changes in diet and lifestyle. It has offered a unique opportunity to study drivers of behaviour change in the general population, building the crucial evidence base needed to tackle major challenges for transforming food systems.

• Pauline F. D. Scheelbeek

Finance for nutrition

The ‘toxic cocktail’ of the COVID-19 pandemic, climate and conflict has slowed progress on nutrition. Where long-standing budgets for nutrition have been constrained in these times, broad stakeholder engagement and non-traditional approaches to nutrition financing are needed.

Benefits of China’s land consolidation

The merging of small farms into fewer large ones is a key part of China’s food security and rural revitalization strategy. Yet, the benefits of implementing large-scale farms vary under different land consolidation pathways.

Shocks to food systems in times of conflict

Armed conflicts have devastating humanitarian consequences, both direct and indirect. A crucial yet overlooked outcome is the disruption of local agricultural production and the consequent erosion of food security in war-ridden regions.

• Tobias Kuemmerle
• Matthias Baumann

Venture capital accelerates food technology innovation

Start-ups are now the predominant source of innovation in all categories of food technology. Venture capital can accelerate innovation by enabling start-ups to pursue niche areas, iterate more rapidly and take more risks than larger companies, writes Samir Kaul.

The impact of conflict-driven cropland abandonment on food insecurity in South Sudan revealed using satellite remote sensing

Conflicts pose a serious threat to food security. Using remote sensing, this study reveals the location and extent of war-related cropland abandonment and its impact on food insecurity in South Sudan from 2016 to 2018—and offers a basis for timely aid provision.

• Victor Mackenhauer Olsen
• Rasmus Fensholt
• Alexander V. Prishchepov

Consolidation of agricultural land can contribute to agricultural sustainability in China

The consolidation of small farms into large-scale agricultural enterprises may have important socioeconomic and environmental consequences. Based on 40,000 rural surveys, ecological modelling and geostatistical analysis, this study assesses the spatial feasibility and cost-effectiveness of land consolidation in China, and its impact on a set of sustainability indicators.

• Jiakun Duan
• Chenchen Ren

Ovalbumin production using Trichoderma reesei culture and low-carbon energy could mitigate the environmental impacts of chicken-egg-derived ovalbumin

An anticipatory life cycle assessment of ovalbumin produced using cellular agriculture demonstrates sustainability gains with limited trade-offs, particularly when produced using low-carbon energy sources.

• Natasha Järviö
• Tuure Parviainen
• Hanna L. Tuomisto

Opportunities and challenges for upscaled global bivalve seafood production

Unfed bivalve mariculture could fill the gap in demand for nutritious and sustainable seafood. This Review explores the bivalve value chain, examining how improved production practices and food processing could address consumer requirements for increased food safety and greater availability of appealing bivalve food products.

• David F. Willer
• Richard J. Nicholls
• David C. Aldridge

Dietary shifts can reduce premature deaths related to particulate matter pollution in China

Population growth and dietary changes affect ammonia emissions from agriculture and the concentration of particulate matter in the atmosphere. This study quantifies the adverse health impacts associated with these processes in China using a mechanistic model of particulate matter formation and transport. It also compares them with direct health impacts of changing diets upon premature death from food-related diseases.

• Xueying Liu
• Amos P. K. Tai
• Hon-Ming Lam

Diet and lifestyle behaviour disruption related to the pandemic was varied and bidirectional among US and UK adults participating in the ZOE COVID Study

Big data collected through apps can facilitate large-scale study of diet and lifestyles. Information from the ZOE COVID Study indicates the variety and extent of impacts that the COVID-19 pandemic has had on the diets and lifestyles of adults in the United States and the United Kingdom.

• Mohsen Mazidi
• Emily R. Leeming
• Sarah E. Berry

Consequences of an alternative emission metric

GWP* is an alternative emission metric that better represents the short-lived character of methane, but its application is not straightforward and can have a substantial impact on the design of mitigation policies in agriculture.

• Jan Peter Lesschen

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

• Open access
• Published: 17 May 2024

The impact of healthy nutrition education based on traffic light labels on food selection, preference, and consumption in patients with acute coronary syndrome: a randomized clinical trial

• Fereshteh Sadeghi 1 ,
• Shahzad Pashaeypoor 1 ,
• Akbar Nikpajouh 2 &
• Reza Negarandeh 3  

BMC Public Health volume  24 , Article number:  1332 ( 2024 ) Cite this article

Metrics details

Acute Coronary Syndrome is the most common heart disease and the most significant cause of death and disability-adjusted life years worldwide. Teaching a healthy eating style is one preventive measure to prevent the disease’s recurrence. This study aimed to determine the effect of healthy nutrition education with the help of traffic light labels on food selection, preference, and consumption in patients with acute coronary syndrome.

This randomized, single-blinded clinical trial was conducted with 139 participants (66 in the intervention group and 73 in the control group) from January 2021 to August 2021 in Shaheed Rajaie Hospital, Tehran, Iran. The control group received standard training. The intervention group, besides this, received additional bedside training with an educational poster on traffic light labels from the research team during their final hospitalization days. Data were collected using a researcher-made questionnaire on food selection, preference, and consumption.

The Brunner-Munzel test showed no significant difference between the two groups in terms of selection ( P  = 0.127), preference ( P  = 0.852), and food consumption ( P  = 0.846) in the baseline, while after the intervention, there were significant differences in selection ( P  > 0.001), preference ( P  > 0.001), and consumption ( p  < 0.004). Comparing the difference between the two groups in the difference between the before and after scores for selection ( p  < 0.001), preference ( p  < 0.001), and food consumption ( p  = 0.011) with the Brunner-Munzel test indicated a significant difference in all outcome variables.

Conclusions

Teaching healthy eating styles with the help of traffic light labels affected food selection, preference, and consumption and led to healthier diets in these patients.

Clinical trial registration number

Clinical trial registration: It was prospectively registered in the Iran Clinical Trials Registration Center on this date 30/10/2020 (IRCT20200927048857N1).

Peer Review reports

Acute coronary syndrome (ACS) is the most common heart disease and the most significant cause of death and disability-adjusted life years (DALYs) worldwide [ 1 ]. ACS is a group of clinical symptoms corresponding to acute myocardial ischemia and has a significant clinical and financial impact. Clinical variants of ACS include unstable angina and acute myocardial infarction (AMI) with or without ST-segment elevation [ 2 ]. Globally coronary artery diseases cause approximately 7 million yearly deaths [ 3 ]. Coronary artery diseases are also the first cause of death in people over 35 years of age in Iran and cause 39.3% of all deaths in the country [ 4 ].

These patients are discharged from the hospital after treatment, but due to the chronic nature of the disease, people who survive the first ischemic attack are at greater risk for cardiovascular events in the future [ 5 ]; ACS patients are 20% more at risk than people without coronary artery disease during the five years after an ischemic attack [ 6 , 7 ]. The most important behavioral risk factors for cardiovascular diseases are inactivity, an unhealthy diet, and smoking. By changing these risk factors, many cases of cardiovascular diseases can be prevented [ 8 ]. Secondary prevention guidelines encourage these patients to consume heart-protecting foods (fruits, vegetables, olive oil, and whole grains) and avoid consuming heart-damaging foods such as sweet drinks, processed meats, and foods containing trans fatty acids. It is also encouraged to limit the amount of sodium consumption.

Despite the availability of these guiding principles, previous studies have reported poor patient adherence to this advice, as patients, especially in low-income countries, tend to maintain their pre-heart attack diet [ 9 ].

The extraordinary increase in food-related diseases is due to poor eating habits [ 10 ]. Unfortunately, even consumers who are motivated to choose healthy foods sometimes fail to accurately assess the healthiness of food due to barriers to understanding nutrition information and utilizing it [ 11 ].

Nutritional information is provided through nutritional education [ 12 ]. Nutritional education programs can increase nutritional knowledge and improve nutritional behaviors and therefore help prevent many chronic diseases such as cancer, diabetes and cardiovascular diseases [ 13 ]. The findings of Pem et al.‘s study showed that a nutrition education program is a promising strategy for nutritional behaviors. Participants who received nutrition education had fundamental changes in their behavior, knowledge, and attitude towards healthier eating, the amount of fruit consumption increased while the consumption of snacks rich in sugar and fat decreased. However, the consumption of vegetables, energy intake, body mass index and physical activity level did not change after training [ 14 ]. In Mohammadi et al.‘s study, the educational method was effective in improving the level of nutritional awareness, weight loss motivation, and people’s performance, but people’s attitudes towards the correct consumption of food did not change [ 15 ].

The traffic light label (TLL) is a type of front-of-package food labeling (FOPL) proposed by the British Food Standards Agency in 2006. The TLL is an effective tool for conveying complex nutritional information that, by being placed on the front of food packaging, can potentially contribute to reducing the consumption of products with high levels of fat, salt, and sugar. A feature of this label is that it categorizes according to color, with “little” recognized by green, “medium” by yellow, and “high” by red. The amount of energy is also shown in white [ 10 ]. In Iran, since 2014, the Food and Drug Organization has required TLL with five factors (energy, fat, salt, sugar, and trans fat) on all packaged food products, except for some exceptions. The energy is shown in kilocalories; the other factors are in grams per 100 g or 100 ml of the food. By providing nutritional information on the front of food packaging, TLL helps people choose food according to their physical conditions and personal needs and thus reduces the burden of chronic diseases [ 16 ]. This label can be understood without having nutritional literacy, so it has the potential to be used by the majority of people in society [ 17 ]. In addition, the need to disclose nutritional information can encourage food manufacturers to improve the nutritional profile of their products [ 18 ].

Previous evidence has shown that food labeling in a cafeteria in Boston, as well as in a sports recreation venue in Canada and a restaurant in Taiwan, increased the purchase of healthier products and decreased the purchase of unhealthy products [ 19 , 20 , 21 ]. In contrast, a study in England and Australia reported no change in the sale of healthier products after introducing the TLL label [ 22 , 23 ]. Despite the limited studies investigating the effect of TLL on the selection and consumption of food items in healthy populations, no study was found that used TLL to educate patients with a history of hospitalization. Therefore, we hypothesized that introducing TLL to ACS patients would improve their food choices, preferences, and consumption, enabling them to prevent chronic diseases. This study was conducted to determine the effectiveness of using TLL in patient education on food selection, preference, and consumption in ACS patients.

Study design

In this randomized, single-blind clinical trial, from January 2021 to August 2021, we enrolled 170 patients with ACS and who met the eligibility criteria. They had been referred to Shaheed Rajaie Cardiovascular Medical & Research Center, Tehran, Iran.

Study population

The inclusion criteria were: ACS diagnosis confirmed by a cardiologist, age 20 to 60 years, first admission due to ACS attack in Shaheed Rajaie Hospital, absence of communication and cognitive problems (with self-report and patient file contents), lack of vision problems or color blindness, having the ability to understand the Persian language, being able to read and write, and not having a history of participating in educational classes on the same subject. Exclusion criteria were: having special dietary restrictions, being hospitalized again during the study, death, or unwillingness to be in the study.

Intervention

During the course of their hospitalization, all participants were provided with standard training. In addition to this, the intervention group received supplementary training on Traffic Light Labelling (TLL) from the research team, facilitated through an educational poster. This additional training was administered bedside in the concluding days of their hospital stay. Each training session lasted 15 to 20 min. The training encompassed an overview of the TLL system and a detailed explanation of types of fat. An exemplar packaged food product, labeled with green (indicating salt), red (indicating sugar and fat), and yellow (indicating trans fatty acid), was utilized to illustrate the TLL system.

Randomization

After taking the informed consent and conducting the pre-test, the participants were randomly assigned to two groups: routine care (control) and TLL food label training (intervention).

Measuring study outcomes

Demographic information.

Demographic information includes age, gender, marital status, place of residence, body mass index, level of education, occupation, type of insurance, household income, smoking, family history of heart attack, family history of angina pectoris, history of diabetes, a history of high blood pressure, and a history of high cholesterol.

• Food preference

The questionnaire pertaining to food preferences comprised four dichotomous questions, wherein participants were presented with a choice between healthy and unhealthy options. The options included a preference for low-salt (healthy) versus salty (unhealthy) cheese, high-fat (unhealthy) versus low-fat (healthy) milk, sugar-containing (unhealthy) versus sugar-free (healthy) soft drinks, and solid (unhealthy) versus liquid (healthy) vegetable oil. A scoring system was implemented where the selection of an unhealthy option was awarded one point, while the choice of a healthy option garnered two points.

Food selection

The food selection questionnaire comprised ten items. The respondents indicated their choice on a Likert scale ranging from 1 (never) to 5 (almost always) [ 5 ]. Choosing healthier food in this questionnaire means that the participants buy packaged food based on the nutrition label. That is, they read the nutrition label when buying food, specifically in search of information on the amount of sugar, salt, fat and trans fatty acid and other nutritional information. A higher score means healthier food choices.

• Food consumption

The food consumption questionnaire asked about the frequency of 32 food items harmful to heart health and how much food they ate during the previous month. They received 1 point for eating something six or more times a month and 5 points for never eating it. If the participants used fewer of these items, they would get a higher score, indicating a healthier consumption.

Validity and reliability of the questionnaires

The food preference, selection, and consumption questionnaires was developed for this study by generating questions through a comprehensive review of existing literature. These questions were deliberately designed to encompass three distinct domains: preference, choice, and consumption of food. (please see supplementary file ). To ensure face and content validity, the questions were meticulously reviewed by an expert panel. This panel was composed of faculty members from various disciplines, providing a multidisciplinary perspective on the content. The reliability of the questionnaire was done by the test-retest method for 20 samples. The intra-cluster correlation coefficient was estimated for food selection, food preference, and food consumption questionnaires, and the results were ICC: 0.90 (95% CI: 0.75, 0.96), ICC: 0.99 (95% CI: 0.97, 0. 99), and ICC: 1, respectively. Internal consistency was also estimated using Cronbach’s alpha method, and it was 0.79 for food selection, 0.63 for food preference, and 0.72 for food consumption.

Sample size and statistical analysis

The sample size for comparing two independent means with an effect size of 0.5 was calculated using G*power. The type I error was 0.05, and the type II error was 0.20. The sample size was 67 per group, but it was increased by 20% to 85 people to allow for dropouts.

Data entry and cleaning were performed using SPSS software. Descriptive statistics and inferential tests were applied to compare the individual and disease characteristics of the two groups. chi-square or Fisher exact tests were used for comparing categorical variables between the intervention and control groups. Next, the assumptions for mixed model ANOVA were checked. The data violated the normality and homogeneity of variance assumptions, so a nonparametric alternative was employed. The Brunner-Munzel test was used to compare the scores of the three outcome variables at baseline and post-intervention, as well as the difference scores between pre-and post-intervention. The Brunner-Munzel test is a nonparametric test of the null hypothesis that when values are taken one by one from each group, the probabilities of getting large values in both groups are equal. The analysis was conducted using JAMOVI software version 2.3.18.0. A significance level of p  < 0.05 was adopted for all tests. The study was blinded as the statistician did not know the allocation of the patients.

This study was approved by the Organizational Ethics Committee of the Tehran University of Medical Sciences Faculty of Medicine and was registered in the Iranian Clinical Trials Registration Center on this date 30/10/2020 (IRCT20200927048857N1). Before participating in the research, an informed consent form was signed by all participants. It was explained to the patients that refusing to be part of the study would not affect their treatment. Patients were also assured that their identity would remain anonymous and their data would be confidential.

Two hundred and sixty people were checked for eligibility to participate in the study, from January 2021 to August 2021 and 87 were excluded due to not meeting the inclusion criteria. Three people refused to sign informed consent to participate, and 31 people (12 in the control and 19 in the invention groups) did not attend to post-test. Finally, the data of 66 people in the intervention group and 73 in the control group were analyzed (Fig.  1 ).

The CONSORT diagram shows the participants’ flow through each stage of a randomized trial

Most participants in both groups were aged 50 to 60 (42 in the intervention and 47 in the control). The intervention and control groups were homogenous in demographic and medical history variables ( p  > 0.05) except for diabetes history ( P  = 0.012) (Table  1 ).

The baseline scores of the three outcome variables did not differ significantly between the two groups, indicating their comparability at the start of the intervention. However, after the intervention, the scores of the three outcome variables showed significant differences between the two groups, favoring the intervention group. To control for the effects of the baseline scores, the difference scores between pre- and post-intervention were calculated and compared using the Brunner-Munzel test. The results revealed a significant difference in scores of the three outcome variables, confirming the effectiveness of the intervention.

According to the Brunner-Munzel test, before the intervention, the selection of packaged foods between the control and intervention groups was not significantly different ( P  = 0.127), but it became significantly different after the intervention ( P  < 0.001). The pre-test and post-test differences were calculated, and the comparison of their median showed a significant difference between the two groups ( p  < 0.001), showing that the intervention group had a higher median (Table  2 ). This result means the intervention group chose healthier food.

The results of the Brunner-Munzel test shows that the food preferences before the intervention were not significantly different between the control and intervention groups ( P  = 0.852). But after the intervention, the intervention group obtained a higher score in terms of preference ( P  < 0.001). This was also seen in the comparison of the median of the pre-test and post-test differences ( p  < 0.001) (Table  3 ). This result means the intervention group preferred healthier food.

The results of the Brunner-Munzel test shows that food consumption was not significantly different before the intervention between the two groups ( P  = 0.846), but the difference was significant after the intervention ( P  = 0.004). This was also seen in the comparison of the median of the pre-test and post-test differences ( p  = 0.011) (Table  4 ). This result means the intervention group consumed healthier food.

This study found that the intervention group, who received routine patient education by hospital staff and TLL label training by the research team, scored higher than the control group, who received only routine patient education by hospital staff. This result means the intervention group chose, preferred, and consumed healthier food than the control group. These findings suggest that teaching the use of TLL can enhance the effectiveness of patient education and help reduce the burden of ACS in the long run.

The findings from this study are consistent with previous studies that reported positive effects of TLL on food purchasing and consumption behaviors [ 19 , 20 , 24 ]. However, they contrast with some studies that found no relationship between TLL and sales of healthier products [ 22 , 23 ]. These discrepancies may be due to differences in the settings, populations, and methods of the studies.

To understand the complex nutritional information on food labels by the participants of the intervention group, even the participants who had a low level of education, we taught them to use the TLL label to prefer, choose and consume healthier food with only a few colors. Therefore, teaching the use of TLL can enhance the effectiveness of patient education and help reduce the burden of ACS in the long run.

For instance, Sonnenberg et al. conducted a study in an American hospital in 2010. They labeled foods sold in a cafeteria. A customer survey was carried out during a 2-week baseline period and a 7-week intervention period, with purchases monitored throughout. The study found that traffic light food labeling increased consumer awareness of food and beverage healthiness at the point of purchase. More consumers reported looking at nutrition information during the labeling intervention than the baseline period, and those who noticed the labels bought a higher proportion of healthy items.

Similarly, Olstad et al. used traffic light labels to improve food choices in a recreational and sports venue in Canada. They monitored product sales one week before and one week after food product labeling. The traffic light icons (green, yellow, and red) were placed on the menu screen or directly on the product shelf, and explanatory sheets were placed in the study environment. The study concluded that nutrition guidance labels effectively increased the sale of healthy foods and reduced the sale of unhealthy foods.

In Iran, Esfandiari et al. conducted a study to investigate the effectiveness of education on awareness, attitude, and performance based on the color indicator of appropriate food products. Students’ knowledge, attitude, and performance about the nutritional color indicator were measured using a questionnaire. Training was conducted face-to-face using an educational pamphlet. The questionnaire was filled out again by the participants 3–6 months after the training. The results show improvements in knowledge, attitude, and performance scores compared to before the training.

In contrast, Sacks et al.‘s study in the United Kingdom examined consumer food purchasing changes after TLL labeling to evaluate the label’s impact on the “healthiness” of purchased foods. The sales of two groups of products (prepared foods and sandwiches) were divided according to their healthiness. Comparisons were made before and four weeks after TLL labeling. The results show that the sales of prepared foods increased immediately after introducing the traffic light label. However, the sale of sandwiches did not change significantly after the introduction of labels. There was no association between changes in product sales and product healthiness [ 22 ].

A study conducted by Sacks and colleagues in Australia analyzed the changes in online food purchases over a period of 10 weeks, following the implementation of the Traffic Light Nutrition Information (TLNI) system. Four colored traffic light symbols indicated the amount of fat, saturated fat, sugar, and sodium. These were displayed for 53 products in the intervention store alongside the product list. No nutritional information was provided in the comparison shop. No association was seen between the sales changes in the two stores and the health value of the products [ 23 ].

This study had some limitations. First, it only assessed the short-term effect of patient education using TLL, so the long-term impact remains unknown. Second, it did not measure the effect of patient education using TLL on nutritional variables such as anthropometric, biochemical, clinical, and dietary indicators. Therefore, future studies should examine these endpoints and follow up with ACS patients for extended periods to evaluate the sustainability and impact of TLL label training on their health outcomes. The study also faced a limitation due to not completing the post-test, leading to the loss to follow-up of many participants. To mitigate this, we compared the demographic characteristics of participants who completed the post-test and those who didn’t. The analysis shows no significant differences in age, gender, or education level between these groups, suggesting that the attrition is unlikely to have introduced a significant bias in our results.

The present study was a randomized controlled trial (RCT) aimed at assessing the efficacy of traffic light labeling (TLL) training on food selection, preference, and consumption among individuals who recently experienced acute coronary syndrome (ACS). The findings indicate that combining TLL training with standard hospital patient education yields superior results compared to the latter alone. Although the study was restricted to ACS patients, it is recommended that future research extend this to healthy individuals with cardiovascular risk factors, as well as those with a history of ACS who have been discharged for a significant period. The results underscore the importance of incorporating TLL education into nutritional guidance for ACS patients and suggest integrating TLL training into hospital education programs. Moreover, placing TLL educational posters in hospital cafeterias and near vending machines may foster healthier dietary habits among patients and staff. The study further proposes extending TLL training to other environments such as schools, workplaces, and supermarkets to promote healthier eating habits in the wider public. It is important to note, however, that this recommendation is only applicable to countries that use TLL on their products, and other countries may require different types of education. Additionally, this educational strategy should be considered as a single component of a patient’s education plan for healthy nutrition.

Data availability

The data that support the findings of this study are available from the corresponding author, [Reza Negarandeh], upon reasonable request.

Abbreviations

Traffic light labeling

• Acute coronary syndrome

Young S. Healthy behavior change in practical settings. Permanente J. 2014;18(4):89.

Article   Google Scholar  

Vedanthan R, Seligman B, Fuster V. Global perspective on acute coronary syndrome: a burden on the young and poor. Circul Res. 2014;114(12):1959–75.

Article   CAS   Google Scholar  

Alhassan S, Ahmed H, Almutlaq B, Alanqari A, Alshammari R, Alshammari K. Risk factors associated with acute coronary syndrome in northern Saudi Arabia. Search of a perfect outfit. J Cardiol Curr Res. 2017;8(3):00281.

Google Scholar  

Chan MY, Du X, Eccleston D, Ma C, Mohanan PP, Ogita M, et al. Acute coronary syndrome in the Asia-Pacific region. Int J Cardiol. 2016;202:861–9.

Article   PubMed   Google Scholar  

ROSHANGHIAS M, SAHEBALZAMANI M, FARAHANI H, ADHAMI MF. Treatment plans adherence of patients underwent coronary artery bypass graft surgery in Tehran’s. Social Secur Hosp. 2019.

Switaj T, Christensen S, Brewer D. Acute Coronary Syndrome: current treatment. Am Family Phys. 2017;95:232–40.

Singh A, Museedi AS, Grossman SA. Acute coronary syndrome. StatPearls [Internet]. 2021.

Avinash A, Venkatesh P. Review on prevention of cardiovascular disease. UPI J Pharm Med Health Sci. 2022:09–14.

Huber D, Henriksson R, Jakobsson S, Mooe T. Nurse-led telephone-based follow-up of secondary prevention after acute coronary syndrome: one-year results from the randomized controlled NAILED-ACS trial. PLoS ONE. 2017;12(9):e0183963.

Article   PubMed   PubMed Central   Google Scholar  

Vidgen HA, Gallegos D. Defining food literacy and its components. Appetite. 2014;76:50–9.

Graham DJ, Orquin JL, Visschers VH. Eye tracking and nutrition label use: a review of the literature and recommendations for label enhancement. Food Policy. 2012;37(4):378–82.

Yolcuoğlu İZ, Kızıltan G. Effect of nutrition education on diet quality, sustainable nutrition and eating behaviors among university students. J Am Nutr Association. 2022;41(7):713–9.

Sasanfar B, Toorang F, Rostami S, Yeganeh MZ, Ghazi ML, Seyyedsalehi MS, et al. The effect of nutrition education for cancer prevention based on health belief model on nutrition knowledge, attitude, and practice of Iranian women. BMC Womens Health. 2022;22(1):213.

Pem D, Bhagwant S, Jeewon R. A pre and post survey to determine effectiveness of a dietitian-based nutrition education strategy on fruit and vegetable intake and energy intake among adults. Nutrients. 2016;8(3):127.

Mohammadi S, Khademi Ashkezari M. Investigating the benefits of a nutrition training course for weight loss, increasing nutritional awareness, changing food consumption concerns, and increasing motivation for healthy living. Med J Mashhad Univ Med Sci. 2020;63(1):2238–45.

Sameni R, Eslami A, Afshar A, Ghafarzadeh J. Investigation on the level of awareness and aattitude of consumers regarding the Traffic Lights Nutrition Information in the label of Food and Beverage products in Karaj. 2021.

Teran S, Hernandez I, Freire W, Leon B, Teran E. Use, knowledge, and effectiveness of nutritional traffic light label in an urban population from Ecuador: a pilot study. Globalization Health. 2019;15(1):1–5.

Roberto CA, Khandpur N. Improving the design of nutrition labels to promote healthier food choices and reasonable portion sizes. Int J Obes. 2014;38(1):S25–33.

Sonnenberg L, Gelsomin E, Levy DE, Riis J, Barraclough S, Thorndike AN. A traffic light food labeling intervention increases consumer awareness of health and healthy choices at the point-of-purchase. Prev Med. 2013;57(4):253–7.

Olstad DL, Vermeer J, McCargar LJ, Prowse RJ, Raine KD. Using traffic light labels to improve food selection in recreation and sport facility eating environments. Appetite. 2015;91:329–35.

Chen H-J, Weng S-H, Cheng Y-Y, Lord A, Lin H-H, Pan W-H. The application of traffic-light food labelling in a worksite canteen intervention in Taiwan. Public Health. 2017;150:17–25.

Sacks G, Rayner M, Swinburn B. Impact of front-of-pack ‘traffic-light’nutrition labelling on consumer food purchases in the UK. Health Promot Int. 2009;24(4):344–52.

Sacks G, Tikellis K, Millar L, Swinburn B. Impact of ‘traffic-light’nutrition information on online food purchases in Australia. Aust N Z J Public Health. 2011;35(2):122–6.

Esfandiari Z, Marasi MR, Estaki F, Sanati V, Panahi E, Akbari N, et al. Influence of education on knowledge, attitude and practices of students of Isfahan University of Medical Sciences to traffic light inserted on food labeling. Tehran Univ Med J TUMS Publications. 2019;77(1):54–62.

Download references

Acknowledgements

We would like to express our special thanks to all patients who participated in this study. Moreover, we are grateful to the Shahid Rajaee Hospital staff and authorities. We also sincerely appreciate the financial support of the Tehran University of Medical Sciences.

This study was founded by the Tehran University of Medical Sciences (Grant number: 49518).

Author information

Authors and affiliations.

Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

Fereshteh Sadeghi & Shahzad Pashaeypoor

Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

Akbar Nikpajouh

Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

Reza Negarandeh

You can also search for this author in PubMed   Google Scholar

Contributions

RN and FS and ShP Conceived and designed the analysis, FS and AN and ShP Collected the data, RN and FS Contributed data or analysis tools, RN Performed the analysis, FS Wrote the paper, final all authors read, commented, and approved the manuscript.

Corresponding author

Correspondence to Reza Negarandeh .

Ethics declarations

Consent for publication.

Not applicable.

Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

This study was approved by the Organizational Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.MEDICINE.REC.1399.550). Written informed consent was obtained from all participants for study participation.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Sadeghi, F., Pashaeypoor, S., Nikpajouh, A. et al. The impact of healthy nutrition education based on traffic light labels on food selection, preference, and consumption in patients with acute coronary syndrome: a randomized clinical trial. BMC Public Health 24 , 1332 (2024). https://doi.org/10.1186/s12889-024-18805-2

Download citation

Received : 23 November 2023

Accepted : 09 May 2024

Published : 17 May 2024

DOI : https://doi.org/10.1186/s12889-024-18805-2

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Traffic light labels
• Healthy eating style
• Healthy food selection

BMC Public Health

ISSN: 1471-2458

• Submission enquiries: [email protected]
• General enquiries: [email protected]

Married to the job no more: Craving flexibility, parents are quitting to get it

The number of Americans who are up and quitting their jobs has been growing for months. From low-wage, frontline employees to more affluent workers and executives, this turnover tsunami is sweeping through the entire workforce. Parents, who have faced some of the harshest conditions during the COVID-19 pandemic, are joining this exodus with gusto.

As part of our research on the Great Attrition , we found that parents were more likely to have left their jobs over the past several months than their nonparent counterparts. Reasons include exhaustion from the competing pressures of working from home and juggling childcare responsibilities, struggles with returning to the office but not finding consistent childcare, and reevaluating their overall work–life balance. Parents are looking for more flexible work opportunities, from taking time off and starting their own businesses to turning to gig roles. 1 Kathryn Dill and Josh Mitchell, “Workers quit jobs in droves to become their own bosses,” Wall Street Journal , November 29, 2021.

According to our survey data, 2 Our survey data on parents and nonparents comes from a survey of employees in Australia, Canada, Singapore, the United Kingdom, and the United States in August 2021. The employee survey included 5,774 people of working age, though for specific exhibits included in this article, only the relevant data on parents and nonparents were included. While we did not focus on nonparent caregivers in this survey, many of our recommendations would apply to that group as well. this trend will continue for the next several months, if not more, with non-White parents planning to leave at higher rates than their White counterparts. For instance, fully half of non-White fathers we surveyed said they were planning to leave their jobs. Non-White mothers are planning to leave at higher rates than White mothers, at 43 percent to 34 percent (Exhibit 1).

Companies don’t want to lose large numbers of workers of any stripe. But this trend among non-White parents—as well as the large numbers of women who have left the workforce since the pandemic started—is compounding the challenges organizations face as they pursue goals related to diversity, equity, and inclusion. McKinsey research has shown that inclusive organizations have a competitive advantage  in attracting and retaining talent, among other positive business factors.

Parents also tend to belong to a crucial category: midtenure employees who play key managerial and individual-contributor roles. 3 2022 employee experience trends: The 4 things your people need you to know , Qualtrics, November 2021. They are leaders or are on the leadership track. Any organization that loses this cohort can take a big hit to its institutional knowledge, including its managerial capabilities and mentorship pipeline.

What’s more, managers who are parents, and in particular women, provide much of the social support in organizations. Our Women in the Workplace 2021 report revealed that women managers have supported employee well-being throughout the pandemic at a higher rate than their male counterparts (Exhibit 2). Losing these women could erode an organization’s social fabric, further intensifying the cycle of grief and burnout  that companies have been grappling with since the pandemic began.

For all these reasons, it is crucial for organizations to create an environment that will accommodate and retain parents. But that means they have to understand why parents are looking for alternatives in the first place.

Why they’re leaving

Our research shows that the problems that all employees are grappling with—not feeling valued by their organization or manager, not feeling a sense of belonging, and not having a good work–life balance—affect parents and nonparents alike. However, there are key factors contributing to why parents are leaving that are distinct from nonparents. Of more than 20 possible reasons given for leaving their job in the past six months, parents cited caring for family as a top five reason, while nonparents cited family near the bottom of the list, at number 18.

Similarly, workload and the ability to work remotely were among the top ten reasons that parents left their job but were toward the bottom of the list for nonparents (Exhibit 3).

These results are consistent with McKinsey research on the future of remote work , which has shown that employees with young children are more likely to prefer primarily remote-working models and flexible work locations, with only 8 percent suggesting that they would like to see a fully on-site model in the future.

Where they’re going

Our survey shows that parents are significantly more likely to start a new business compared with their nonparent counterparts. The data suggest that they will continue to be more likely to do so over the next several months, with 45 percent of parents more likely than their peers without children to leave to start a new business (Exhibit 4).

Although our survey showed more workers in all categories doing gig work because they prefer it, parents are 6 percent more likely to take gig jobs than nonparents. Lower-income individuals are more likely to be driven to gig work out of necessity, the survey shows, and parents among this group more so than nonparents (Exhibit 5). One of the reasons, the lower-income respondents said, is that this type of work affords them more flexibility to care for family.

How to keep them

It’s abundantly clear that organizations have to move quickly if they want to retain working parents and others with caregiving responsibilities. Addressing their needs for increased flexibility  is the first place to start. But how?

Many companies have addressed the attrition problem with blunt instruments, including pay raises and extra paid time off. While money and time off are always welcome, more precise tools are needed. McKinsey research throughout the pandemic has shown that the best companies listen closely to their employees  and craft responses tailored to their needs. In the case of parents, even more than other groups, this means focusing on work–life balance and health while treating remote work and schedule flexibility—formerly viewed as perks—as table stakes.

Here are three areas where organizations can be more bold and creative in their thinking about how to retain parents:

Embrace radical flexibility. This goes beyond giving parents and other caregivers extra paid time off to take care of family needs. What if an employee needs every Tuesday afternoon off to care for a child or other family member? The response might be to give them a free floating day per week that they can take whenever they need it, no questions asked. Maybe some parents would love taking off from 3:00 p.m. until after dinner, then logging back in as needed after the kids are in bed.

Companies might create radically flexible roles, allowing all employees to cut back to 60 percent workweeks or downshift to a less-demanding role for a time, with the understanding that they can ramp back up when ready. They could even break positions into pieces, allowing job sharing, or hiring someone to do 20 percent of a job one day a week, for example. These radically flexible roles already exist in some more advanced healthcare settings, where nurse staffing demands are constantly changing. Per diem and part-time nurses are able to pick up variable-length shifts as needed to cover gaps and meet patient care needs as well as their personal need for flexibility.

Models of this nature could be considered for other roles in other industries, establishing new paradigms that provide greater flexibility for workers as companies increasingly update their focus to evaluating employees on deliverables rather than time spent at work.

Get more creative with childcare support. Some companies have provided in-house subsidized childcare or concierge services. These are welcome policies that can be viewed not as short-term emergency actions but as long-term adjustments.

For example, Patagonia’s on-site childcare drives its nearly perfect retention of new mothers and reduces overall turnover of parents to 25 percent below the general employee population, the company says. Patagonia believes parents’ engagement, loyalty, and productivity have also been enhanced by the benefit. 4 Talent Blog , “Why Patagonia CHRO Dean Carter sees onsite child care as a bedrock benefit,” blog entry by Bruce M. Anderson, September 10, 2019.

However, many parents may still be reluctant or unable to return to the office with their child, essentially rendering those services useless to them. Companies can go above and beyond these options by offering parents off-site, including at-home, childcare that is either fully or mostly subsidized. This will not only show a personalized commitment to employees but it will also help them maintain the flexibility they desire. Organizations can also expand the use of parental-leave programs by encouraging all parents to participate in them, not just mothers . By equalizing and normalizing participation in these programs, companies can create a more equitable environment for their entire workforce.

Let them go—and make a concerted effort to get them back. Having gone through a prolonged global pandemic, many employees need a break. This is a normal and increasingly common response to an abnormal event.

Some companies have already developed processes that allow parents who have taken leave to adjust to returning to work, recognizing that the childcare and other responsibilities that prompted their departure  likely have not disappeared. In addition to accommodating their childcare needs, companies can offer on-ramp programs that help returning parents update their skills to get up to speed.

Organizations can also conduct a different type of exit interview, asking, “What would it take to keep you here? If we accommodate your needs, would you be willing to stay for a pilot program to test how it works?” This approach would rely in part on training leaders and managers to elicit an honest appraisal from employees about what led them to this point.

Organizations that think they can wait out this period without responding to employees’ concerns about flexibility may face a rude awakening as parental attrition in particular gets worse. They also risk increasing burnout throughout their entire workforce  if more individuals leave and existing employees have to fill those gaps.

Companies that experiment with how to design jobs that will appeal to parents—and anyone looking for more flexibility—are acknowledging reality: no matter how dedicated they may be to their jobs, individuals are more than employees. Parents need to take care of their children, adult children may need to take care of aging parents, and we all need to take care of our own health and well-being. Companies that get creative with solutions are meeting this need for flexibility with a flexible response—a welcome model for everyone.

Aaron De Smet is a senior partner in McKinsey’s New Jersey office, Bonnie Dowling is an associate partner in the Denver office, Marino Mugayar-Baldocchi is a research science specialist in the New York office, and Joachim Talloen is a senior research science analyst in the Waltham, Massachusetts, office.

The authors wish to thank Taiwo Ajayi and Sasha Zolley for their contributions to this article.

This article was edited by Barbara Tierney, a senior editor in the New York office.

Explore a career with us

Related articles.

‘Great Attrition’ or ‘Great Attraction’? The choice is yours

Women in the Workplace 2022

What employees are saying about the future of remote work

Internet use statistically associated with higher wellbeing, finds new global Oxford study

Links between internet adoption and wellbeing are likely to be positive, despite popular concerns to the contrary, according to a major new international study from researchers at the Oxford Internet Institute, part of the University of Oxford.

The study encompassed more than two million participants psychological wellbeing from 2006-2021 across 168 countries, in relation to internet use and psychological well-being across 33,792 different statistical models and subsets of data, 84.9% of associations between internet connectivity and wellbeing were positive and statistically significant. 

The study analysed data from two million individuals aged 15 to 99 in 168 countries, including Latin America, Asia, and Africa and found internet access and use was consistently associated with positive wellbeing.   

Assistant Professor Matti Vuorre, Tilburg University and Research Associate, Oxford Internet Institute and Professor Andrew Przybylski, Oxford Internet Institute carried out the study to assess how technology relates to wellbeing in parts of the world that are rarely studied.

Professor Przybylski said: 'Whilst internet technologies and platforms and their potential psychological consequences remain debated, research to date has been inconclusive and of limited geographic and demographic scope. The overwhelming majority of studies have focused on the Global North and younger people thereby ignoring the fact that the penetration of the internet has been, and continues to be, a global phenomenon'. 

'We set out to address this gap by analysing how internet access, mobile internet access and active internet use might predict psychological wellbeing on a global level across the life stages. To our knowledge, no other research has directly grappled with these issues and addressed the worldwide scope of the debate.' 

The researchers studied eight indicators of well-being: life satisfaction, daily negative and positive experiences, two indices of social well-being, physical wellbeing, community wellbeing and experiences of purpose.   

Commenting on the findings, Professor Vuorre said, “We were surprised to find a positive correlation between well-being and internet use across the majority of the thousands of models we used for our analysis.”

Whilst the associations between internet access and use for the average country was very consistently positive, the researchers did find some variation by gender and wellbeing indicators: The researchers found that 4.9% of associations linking internet use and community well-being were negative, with most of those observed among young women aged 15-24yrs.

Whilst not identified by the researchers as a causal relation, the paper notes that this specific finding is consistent with previous reports of increased cyberbullying and more negative associations between social media use and depressive symptoms among young women. 

Adds Przybylski, 'Overall we found that average associations were consistent across internet adoption predictors and wellbeing outcomes, with those who had access to or actively used the internet reporting meaningfully greater wellbeing than those who did not'.

'We hope our findings bring some greater context to the screentime debate however further work is still needed in this important area.  We urge platform providers to share their detailed data on user behaviour with social scientists working in this field for transparent and independent scientific enquiry, to enable a more comprehensive understanding of internet technologies in our daily lives.' 

In the study, the researchers examined data from the Gallup World Poll, from 2,414,294 individuals from 168 countries, from 2006-2021.  The poll assessed well-being with face-to-face and phone surveys by local interviewers in the respondents’ native languages.  The researchers applied statistical modelling techniques to the data using wellbeing indicators to test the association between internet adoption and wellbeing outcomes. 

Watch the  American Psychological Association (APA) video  highlighting the key findings from the research.

Download the paper ‘ A multiverse analysis of the associations between internet use and well-being ’ published in the journal Technology, Mind and Behaviour, American Psychological Association.

DISCOVER MORE

• Support Oxford's research
• Partner with Oxford on research
• Study at Oxford
• Research jobs at Oxford

You can view all news or browse by category