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- Democratising participatory health promotion: power and knowledge involved in engaging European adolescents in childhood obesity preventionPublication . Baillergeau, Evelyne; Veltkamp, Gerlieke; Bröer, Christian; Helleve, Arnfinn; Kulis, Ewa; Lien, Nanna; Luszczynska, Aleksandra; Mendes, Sofia; Rito, Ana; Moerman, Gerben; Sauvage Nolting, Rein de; Klepp, Knut-IngePublic policy aimed at preventing undesired phenomena has increasingly sought to engage representatives of the target population. Little is known, however, about how power dynamics function to shape the processes and outcomes of risk governance engagement interventions. In order to study the ways in which, and the extent to which, power differentials can be reduced in participatory health promotion initiatives, we develop a conceptual framework synthetising theories of participatory action, phenomenology and governmentality. Based on the empirical research into youth participation in the EU project CO-CREATE, involving 15–19-year-old adolescents in five European countries (2019–2021), we show that diverse forms of knowledge may become available in engagement interventions. We analyse the use and relative inclusion and exclusion of these different forms of knowledge in terms of a three-level framework of different depths of democratisation in participatory health promotion: risk management, risk definition and risk negotiation. Advanced democratisation can only be achieved if risk negotiation is carried out in ways which embrace and encourage a range of different, and potentially conflicting forms of knowing.
- Food Choice, Nutrition, and Public HealthPublication . Santos, Mariana; Assunção, RicardoMaintaining a healthy diet throughout life helps prevent all forms of malnutrition, thereby reducing the risk of non-communicable diseases (NCDs) and related conditions . Dietary habits, lifestyle choices, and social factors significantly influence our health. Recently, we have seen shifts in food consumption patterns driven by various factors. These include the increased availability of processed foods, rapid urbanization, and changing lifestyles. The types, amounts, and frequency of consumed foods and beverages define dietary patterns, which have been evolving in recent decades due to the emergence of new or adapted eating habits. Common examples of dietary patterns include the ‘Western dietary pattern’ and the ‘Mediterranean dietary pattern’. Other significant patterns are the ‘prudent dietary pattern’, which emphasizes a high intake of vegetables, fruits, legumes, whole grains, fish, and seafood, and the ‘vegetarian/plant-based dietary pattern’, which entirely omits meat and animal products. Understanding the individual motives that drive certain food choices is crucial for changing consumption habits, promoting healthier behaviors, and fostering sustainability. This Editorial introduces the Special Issue “Food Choice, Nutrition, and Public Health” and highlights key topics on this subject.
- Glyphosate in the Iberian Peninsula: Evaluating risks to Iberian wildlifePublication . Baptista, Catarina Jota; Marques, Gonçalo Nogueira; Gonçalves, Luísa Lima; Assunção, Ricardo; Martinez-Haro, MónicaGlyphosate [N-(phosphonomethyl)glycine] (GlyP) is an herbicide extensively used worldwide, including the Iberian Peninsula. It is mainly used in agricultural landscapes but also in urban areas, in railways, and even in water bodies. Despite glyphosate’s large use, there is a paucity of research on its exposure and its potential effects on wildlife living treated environments. In recent years, an increasing number of studies have warned about the effects of this herbicide namely, on oxidative stress, and on liver and kidney in different taxa. Additionally, some studies also suggested endocrine disruption capacity in reptiles or genotoxicity in fish. Most of these studies have been carried out on experimental animals, in laboratory conditions, so the real exposure and potential effects on wildlife is largely unknown. In this context, this review is intended to help understand the ecological consequences that glyphosate may be exerting on wildlife that inhabit the Iberian Peninsula.
- Mapping the Quantitative Dose–Response Relationships Between Nutrients and Health Outcomes to Inform Food Risk–Benefit AssessmentPublication . Mateus, Gabriel; Ferreira-Pêgo, Cíntia; Assunção, RicardoIn the context of the global food system transformation towards sustainable and healthy diets, risk–benefit assessment supported by quantitative dose–response relationships between nutrients and health outcomes is crucial for evaluating the public health impact of dietary modifications, particularly those involving novel foods. The primary aim of this review was to establish a foundational basis for RBA by compiling and synthesising quantitative dose–response relationships identified through a comprehensive literature review. This review encompassed the last 15 years up to March 2025, utilising databases such as PubMed, Scopus, and Web of Science. This review prioritised recent meta-analyses of observational studies and randomised controlled trials with a low risk of bias, as assessed using the ROBIS tool. This review identified significant dose–response relationships across 12 nutrients and their associations with various health outcomes. While dietary fibre has demonstrated broad protective effects, cereal fibre has been found to be the most beneficial for colorectal cancer prevention. Calcium has been shown to have inverse associations with several cancers, although high dairy intake may increase the risk of prostate cancer. Haem iron was linked to an increased risk of several chronic diseases, whereas non-haem iron showed less consistent associations. Zinc exhibited a potential U-shaped relationship with colorectal cancer risk. These findings underscore the complexity of nutrient–health relationships, highlighting the importance of considering dose–response gradients and nutrient sources. Although this overview primarily summarises quantitative associations without exploring in-depth mechanistic or population-specific details, it underscores the complexity of nutrient effects, including nonlinearity and source dependency. This analysis offers a valuable foundation for future risk–benefit assessments of various food scenarios, thereby informing dietary recommendations and public health strategies.
- Obesity rise plateaus in developed nations and accelerates in developing nationsPublication . NCD Risk Factor Collaboration ConsortiumGlobal reporting of obesity is commonly based on comparisons over multiple decades and lacks a granular and systematic analysis of its dynamics. We used 4,050 population-based studies with measured height and weight data on 232 million participants to assess the worldwide dynamics of obesity from 1980 to 2024. The rise in obesity decelerated in school-aged children and adolescents throughout the 1990s in many high-income countries, and subsequently plateaued in most at age-standardized prevalences spanning 20 percentage points, from 3-4% for girls in Japan, Denmark and France to 23% for boys in the USA. There were indications of a small decline in obesity in children and adolescents in some high-income western countries (for example, Italy, Portugal and France) since the 2000s. Similar trends were seen in some countries in Central and Eastern Europe. In adults, the rise in obesity slowed down in high-income western countries about a decade after children, followed by a plateau or possibly a small reversal of the rise in some countries (for example, Spain). In most low-income and middle-income countries, the annual absolute change in prevalence has remained stable or increased over time, even though prevalence has surpassed that of high-income countries. These highly varied dynamics suggest that the social, economic and technological trends that influence the availability, affordability and use of different foods may have helped control the rise in obesity in high-income countries, but require policy interventions in low-income and middle-income countries.
- A scoping review of the health effects of fermented foods in specific human populations and their potential role in precision nutrition: current knowledge and gapsPublication . Humblot, Christèle; Alvanoudi, Panagiota; Alves, Emilia; Assunção, Ricardo; Belovic, Miona; Bulmus-Tuccar, Tugce; Chassard, Christophe; Derrien, Muriel; Fevzi Karagöz, Mustafa; Karakaya, Sibel; Laranjo, Marta; Th Mantzouridou, Fani; Rosado, Catarina; Pracer, Smilja; Saar, Helen; Tap, Julien; Treven, Primož; Vergères, Guy; Pertziger, Eugenia; Savary-Auzeloux, IsabelleBackground: Diets and specific foods have a significant impact on health, and individual responses to nutritional factors vary. This variability among humans can be considered a basis for developing personalized or precision nutrition. Fermented foods (FF) contain a wide range of macro- and micronutrients, bioactive compounds, and live or dead microorganisms. FF represent a diverse range of products and have garnered significant interest due to their potential health benefits. However, consistent evidence remains limited, possibly due to heterogeneity in individual responses. Objectives: The objective of this review is to assess and compile existing evidence on the variable responses of populations to FF and to determine whether FF could be integrated into a precision nutrition strategy. Design: Interventional and observational human studies were systematically collected. The publication identified the main factors likely to contribute to variable responses to FF across all health outcomes. The question was systematically addressed to assess the available evidence and identify knowledge gaps, guiding future research. A pragmatic approach was employed, following EFSA health claim guidelines, which require an assessment of food characteristics and mechanisms of action, as well as conducting a systematic search of human interventional studies. A similar approach was used to analyze data extracted from observational studies. The population included all humans (healthy and non-healthy, of all ages), encompassing both observational and interventional studies. The intervention consisted of the ingestion of any FF, while the control was defined as the absence or lower consumption of FF or consumption of a corresponding non-FF. Outcomes included all markers of the population's health status. Results: The main factors contributing to variable responses to FF across all health outcomes were related to initial phenotypic characteristics (biological sex, geographical origin, hormonal status, and age), baseline health status [metabolic syndrome [MetS], chronic metabolic pathologies, cancer, and psychological disorders], and genetic background. Additionally, since the gut microbiota is person-specific and influences metabolic responses, particular attention was paid to its functions and role in the variability of population responses to FF. Conclusion: Collectively, this review represents a first step toward evaluating the feasibility of using FF in tailored nutritional strategies.
- Urinary multi-mycotoxin exposure in the Portuguese population and associated sociodemographic determinantsPublication . Maris, Elias; Namorado, Sónia; Chen, An; Pero-Gascon, Roger; De Boevre, Marthe; De Saeger, Sarah; Silva, Maria João; Alvito, PaulaEuropean human biomonitoring (HBM) studies have increasingly adopted multi-mycotoxin approaches to capture complex exposure scenarios encountered in real-life diets. This nation-wide study provides the characterization, for the first time, of the mycotoxin profile of 295 urine samples collected from the Portuguese population in the continent and islands (archipelagos of Madeira and Azores), using an optimized and validated LC-MS/MS method for the characterization of 39 mycotoxins/metabolites. Nearly all study participants (99.3%) were exposed to at least one mycotoxin, with around half (54.2%) being co-exposed to only 2 detectable mycotoxins. Free-deoxynivalenol (free-DON, 84.7%) and tenuazonic acid (TeA, 95.6%) were the most prevalent mycotoxins. Citrinin (CIT, 11.5%), α-zearalenone (α-ZEL, 10.5%) and ochratoxin A (OTA, 9.5%) showed detection rates near 10%. Median concentrations (P50) for the two predominant mycotoxins were 0.79 μg/L (0.72 μg/g creatinine) for free-DON and 2.45 μg/L (2.08 μg/g creatinine) for TeA, with maximum values of 11.77 μg/L (10.06 μg/g creatinine) and 90.91 μg/L (114.15 μg/g creatinine), respectively. Sociodemographic patterns showed lower exposure in the Centre region and higher free-DON exposure in southern Portugal and the archipelagos. TeA exposure differed significantly by region and was lowest in the Lisbon Metropolitan Area and Algarve compared to the Center reference region. Low educational levels and spring sampling correlated with higher exposure for both toxins, but only education levels showed statistical significance in the linear regression analyses. For both TeA and free-DON, no differences in exposure were observed by sex, occupational status, or degree of urbanization. Overall, these findings underscore the importance of continuous surveillance, particularly under the current climate change scenario, and highlight the relevance of integrating human biomonitoring into national food safety and public health strategies.
- Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adultsPublication . NCD Risk Factor Collaboration group; Rito, AnaBackground: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.