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Nutrition has long been considered more the domain of medicine and agriculture than of the biological sciences, yet it touches and shapes all aspects of the natural world. The need for nutrients determines whether wild animals thrive, how populations evolve and decline, and how ecological communities are structured.The Nature of Nutritionis the first book to address nutrition's enormously complex role in biology, both at the level of individual organisms and in their broader ecological interactions. Stephen Simpson and David Raubenheimer provide a comprehensive theoretical approach to the analysis of nutrition--the Geometric Framework. They show how it can help us to understand the links between nutrition and the biology of individual animals, including the physiological mechanisms that determine the nutritional interactions of the animal with its environment, and the consequences of these interactions in terms of health, immune responses, and lifespan. Simpson and Raubenheimer explain how these effects translate into the collective behavior of groups and societies, and in turn influence food webs and the structure of ecosystems. Then they demonstrate how the Geometric Framework can be used to tackle issues in applied nutrition, such as the problem of optimizing diets for livestock and endangered species, and how it can also help to address the epidemic of human obesity and metabolic disease Drawing on a wealth of examples from slime molds to humans,The Nature of Nutritionhas important applications in ecology, evolution, and physiology, and offers promising solutions for human health, conservation, and agriculture.

Background: The concept of vitamins has evolved over the past century from compounds preventing classical deficiency diseases to nutrients recognized for supporting long-term health. Despite their central role in science and public health, existing definitions often fail to clearly characterize and distinguish vitamins from other bioactive compounds and do not capture the complexity of their nutritional requirements. Method: This article reviews the historical origins and current definitions of vitamins. Results: We identify the limitations of existing definitions and present a contemporary, physiologically informed definition as a discussion proposal. Our proposal no longer relies solely on the prevention of classical hypo- or avitaminoses. Conclusions: By incorporating the concept of conditional essentiality, this framework also tries to clarify the distinction between classical vitamins and other bioactive substances, reflecting variable dietary requirements under different conditions.

Obesity is associated to chronic low-grade metabolic inflammation and hypovitaminosis D. Among extra-skeletal effects, an important role in inflammation has been described for vitamin D (25(OH)D). Phase angle (PhA) is a bioelectrical impedance analysis (BIA) parameter that represents an indicator of cellular health in chronic inflammatory states. However, it is still unknown whether a low 25(OH)D levels might correlate with PhA in obesity. Considering the lack of evidence correlating the 25(OH)D levels with PhA in obesity, the aim of this study was to investigate their possible relationship in a group of patients with obesity stratified according to body mass index (BMI) categories. Four hundred and fifty-five adult subjects (219 males and 236 females; 36 ± 11 years) were enrolled. Body composition, including PhA, was assessed using a BIA phase-sensitive system. Serum levels of 25(OH)D was determined by a direct competitive chemiluminescence immunoassay. Most of the participants were affected by grade III obesity (24%) and had 25(OH)D deficiency (67%). Subjects with 25(OH)D deficiency had highest BMI (p < 0.001). Stratifying the sample population according to the BMI classes, 25(OH)D levels decreased significantly along with the increase in BMI (p < 0.001), with the lowest 25(OH)D levels in the class III obesity. In addition, stratifying the sample population according to 25(OH)D categories, BMI and fat mass (FM) decreased, while PhA increased significantly along with the 25(OH)D categories (p < 0.001). The 25(OH)D levels showed significant positive associations with PhA (r = −0.59, p < 0.001), and this association remained significant also after adjusting for BMI and FM (r = 0.60, p < 0.001). The lowest values of PhA were significantly associated with the severity of obesity (OR 0.3, p < 0.001) and of 25(OH)D deficiency (OR 0.2, p < 0.001). To compare the relative predictive power of body composition parameters associated with the 25(OH)D levels, we performed a multiple linear regression analysis. The most sensitive and specific cut-off for 25(OH)D levels to predict the PhA above the median was >14 ng/mL (p < 0.001). In conclusion, we provided preliminary insights into a novel link between 25(OH)D levels and PhA in the setting of obesity. This association uncovered a new potential usefulness of PhA as expression of cell membrane integrity and predictor of inflammation in low 25(OH)D status that might help in identifying high-risk patients with obesity who could benefit from careful 25(OH)D supplementation.

BackgroundThe EAT-Lancet Commission has proposed a global reference diet aimed at promoting both human health and environmental sustainability. While adherence to this dietary pattern has been associated with reduced risks of chronic disease and lower environmental impact, concerns remain about its ability to meet nutritional requirements - particularly among older adults. The aim was to explore the association between adherence to the EAT-Lancet diet and nutrient intake and adequacy among 70-year-old adults in Gothenburg, Sweden.MethodsThis cross-sectional study included 861 participants from the Swedish population-based Gothenburg H70 Birth Cohort Study (mean age 70.5 years, 55% women). Dietary intake was assessed using a validated diet history interview, and adherence to the EAT-Lancet diet was scored based on 14 food components. Nutrient intake was evaluated against age- and sex-specific recommended intake (RI) levels. Cardiometabolic risk markers and biomarkers of nutritional status, including homocysteine and haemoglobin, were measured. Linear and logistic regression models were used to examine trends across sex-specific tertiles of diet adherence, with sensitivity analyses adjusting for energy intake and comparing adequacy based on average requirement (AR) thresholds.ResultsHigher adherence to the EAT-Lancet diet was linked to higher intake of fibre and polyunsaturated fats, and lower intake of saturated fat and alcohol. Mean protein intake per kilogram body weight/day was similar across adherence tertiles. Intake of beta-carotene, folate, vitamin C, magnesium, potassium, and iron was higher with greater adherence, while retinol equivalents, vitamin B12, niacin equivalents was lower– patterns that remained consistent after energy adjustment. Despite lower B12 intake, homocysteine levels were lowest in the group with highest adherence, and anaemia prevalence did not differ. Micronutrient adequacy improved with higher adherence for vitamin E, folate, vitamin C, magnesium, potassium, and iron. Similar results were observed using average requirement (AR) thresholds in sensitivity analyses.ConclusionsAdherence to the EAT-Lancet diet was associated with a more favourable nutrient profile in this cohort of older adults, without evidence of widespread micronutrient inadequacy. These findings suggest that environmentally sustainable diets can support adequate nutrition when well-balanced, even in nutritionally vulnerable populations such as older adults.

•Low serum levels of vitamins B9, B12, C, and D, as well as magnesium and iron, were seen in patients with the coronavirus disease of 2019•Lower levels of vitamin D, zinc, and magnesium can induce more severe disease•We recommend addressing the deficiency of micronutrients to prevent severe coronavirus disease of 2019 This study aimed to compare the serum level of micronutrients with normal amounts, and assess their association with the severity of disease and inflammatory cytokines in patients with coronavirus disease 2019 (COVID-19). The present cross-sectional study included 60 patients admitted to the intensive care unit with COVID-19. We recorded data on demographic characteristics, anthropometric information, and medical history. Serum levels of inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, interferon-gamma, tumor necrosis factor-alpha, interleukin-6), vitamins (A, B9, B12, C, D, E), and minerals (magnesium, zinc, iron) were measured. A radiologist assessed the severity of lung involvement according to patient computed tomography scans. The severity of illness was evaluated with the Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, oxygen saturation, and body temperature. Independent associations among the serum levels of micronutrients with the severity of COVID-19 were measured. Median patient age was 53.50 years (interquartile range, 12.75 years). Except for vitamin A and zinc, serum levels of other micronutrients were lower than the minimum normal. Patients with APACHE score ≥25 had a higher body mass index (P = 0.044), body temperature (P = 0.003), erythrocyte sedimentation rate (P = 0.008), C-reactive protein (P = 0.003), and lower oxygen saturation (P = 0.005), serum levels of vitamin D (P = < 0.001), and zinc (P = < 0.001) compared with patients with APACHE score <25. We found that lower serum levels of vitamin D, magnesium, and zinc were significantly and independently associated with higher APACHE scores (P = 0.001, 0.028, and < 0.001, respectively) and higher lung involvement (P = 0.002, 0.045, and < 0.001, respectively). Lower serum levels of vitamin D, zinc, and magnesium were involved in severe COVID-19.

AbstractObjectiveTo determine the efficacy of high dose folic acid supplementation for prevention of pre-eclampsia in women with at least one risk factor: pre-existing hypertension, prepregnancy diabetes (type 1 or 2), twin pregnancy, pre-eclampsia in a previous pregnancy, or body mass index ≥35.DesignRandomised, phase III, double blinded international, multicentre clinical trial.Setting70 obstetrical centres in five countries (Argentina, Australia, Canada, Jamaica, and UK).Participants2464 pregnant women with at least one high risk factor for pre-eclampsia were randomised between 2011 and 2015 (1144 to the folic acid group and 1157 to the placebo group); 2301 were included in the intention to treat analyses.InterventionEligible women were randomised to receive either daily high dose folic acid (four 1.0 mg oral tablets) or placebo from eight weeks of gestation to the end of week 16 of gestation until delivery. Clinicians, participants, adjudicators, and study staff were masked to study treatment allocation.Main outcome measureThe primary outcome was pre-eclampsia, defined as hypertension presenting after 20 weeks’ gestation with major proteinuria or HELLP syndrome (haemolysis, elevated liver enzymes, low platelets).ResultsPre-eclampsia occurred in 169/1144 (14.8%) women in the folic acid group and 156/1157 (13.5%) in the placebo group (relative risk 1.10, 95% confidence interval 0.90 to 1.34; P=0.37). There was no evidence of differences between the groups for any other adverse maternal or neonatal outcomes.ConclusionSupplementation with 4.0 mg/day folic acid beyond the first trimester does not prevent pre-eclampsia in women at high risk for this condition.Trial registrationCurrent Controlled Trials ISRCTN23781770 and ClinicalTrials.gov NCT01355159.

The recommended dietary allowance (RDA) for vitamin C differs greatly (40–110 mg/d) across countries. In addition, vitamin D deficiency is, effectively, a pandemic, with a prevalence of approximately 25% to 80% across countries according to the findings in the recent scientific literature. However, these phenomena are attributable to a serious error in the concept and definition of RDA, which was developed in 1941. The current definition of RDA is the average daily dietary nutrient intake level that is deemed sufficient to meet the nutrient requirements of almost all (97–98%) healthy individuals. This is an extremely high intake level for a specific nutrient affecting only a few individuals (the upper 2.5%) of the generally healthy population. The RDA should be redefined by investigating at which intake level of a specific nutrient the incidence of a specific disease or mortality increases or decreases based on prospective cohort studies.

Older adults are frequently cited as an at-risk population for vitamin D deficiency that may in part be due to decreased cutaneous synthesis, a potentially important source of cholecalciferol (vitamin D3). Previous studies found that cutaneous D3 production declines with age; however, most studies have been conducted ex vivo or in the photobiology lab. The purpose of this study was to characterize the response of vitamin D metabolites following a 30-min bout of sun exposure (15-min each to the dorsal and ventral sides) at close to solar noon in younger and older adults. Methods: 30 healthy individuals with skin type II/III were recruited; a younger cohort, aged 20–37 (n = 18) and an older cohort (n = 12), age 51–69 years. Exposure was at outer limits of sensible sun exposure designed to enhance vitamin D synthesis without increasing risk of photo ageing and non-melanoma skin cancer. Serum D3 concentration was measured at baseline, 24, 48 and 72 h post-exposure. Serum 25(OH)D was measured at baseline and 72 h post-exposure plus 168 h post-exposure in the older cohort. Results: D3 increased in response to sun exposure (time effect; p = 0.002) with a trend for a difference in D3 between cohorts (time*group; p = 0.09). By regression modeling of continuous data, age accounted for 20% of the variation in D3 production. D3 production decreased by 13% per decade. Despite changes in D3, however, serum 25(OH)D did not change from baseline to 72 or 168 h post exposure (p > 0.10). Conclusions: Serum D3 concentration increased significantly in response to outdoor sun exposure in younger and older adults. While ageing may dampen cutaneous synthesis, sunlight exposure is still a significant source of vitamin D3.

Background Cancer treatment itself and particularly chemotherapy unavoidably affects host cells, often producing a variety of side effects, e.g., nausea, vomiting, diarrhea, and fever, and further decreases in appetite, physical activity, and body weight. These effects, combined with biochemical and histological injuries to major organ systems, may result in a profound nutritional insufficiency. This study aimed to determine the nutritional status of patients receiving chemotherapy. Methods A prospective study was conducted among 64 adults newly diagnosed cancer patients of various sites, admitted to the Oncology Department at European Gaza Hospital (EGH), and scheduled for the first cycle of chemotherapy. The nutritional status of each patient was assessed using the Subjective Global Assessment (SGA) and anthropometry before commencing the first cycle of the chemotherapy regimen (pre) and after completing the chemotherapy regimen (post). Additionally, biochemical and dietary intake assessments were also performed. Results Nutritional status worsened after the completion of a chemotherapy regimen. It has been found that 80.3% of patients suffered from malnutrition (moderate and severe) after the completion of the chemotherapy regimen based on SGA in comparison to 35.9% who were malnourished before commencing the first cycle of chemotherapy. The results reported the presence of a functional vitamin B12 deficiency, such that there is a drastic reduction in serum vitamin B12 levels (355.0(IQR 115.0) to 219.0(IQR 177.0) pg/mL, P  < 0.001), accompanied by a significant increase in it is related metabolites methylmalonic acid (MMA) (3.9(IQR 3.0) to 49.7(IQR 32.0) ng/mL, P  < 0.001), and homocysteine (Hcy) (3.90(IQR 0.85) to 12.60(IQR 7.05) ng/mL, P  < 0.001) after the completion of chemotherapy regimen. Dietary intake in terms of macronutrients and micronutrients changed significantly after the completion of chemotherapy regimen. Conclusions Cancer patients who received chemotherapy were at risk of malnutrition hence it is a wise practice to conduct thoroughly and deep nutritional assessment for each patient at the baseline, during treatment and after the completion of chemotherapy regimen.