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Using Harvards Healthy Eating Plate as a guide, we recommend eating mostly vegetables, fruit, and whole grains, healthy fats, and healthy proteins. We suggest drinking water instead of sugary beverages, and we also address common dietary concerns such as salt and sodium, vitamins, and alcohol. Its also important to stay active and maintain a healthy weight.

The Healthy Eating Plate summarizes the best evidence-based dietary information available today. As nutrition researchers are continually discovering valuable information, The Healthy Eating Plate will be updated to reflect new findings.

Want to learn more? Use the Healthy Eating Plate & Healthy Eating Pyramid, both created by the Department of Nutrition at Harvard School of Public Health, as your guides for choosing a healthy diet and creating healthy meals. To get started, here are 10 tips for healthy eating!

The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The Nutrition Source does not recommend or endorse any products.

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What Should I Eat? The Nutrition Source - Harvard University

Grant Williams / Instagram

Basketball fans know the nutritional needs of intense athletes like NBA players differ from those of the average person. Yet the fundamentals of healthy food choices and eating a well-balanced diet remain the same. Ever wondered what a day-to-day diet plan looks like for a basketball player during the season?

The Manual has chatted with NBA star Grant Williams to find out. Grant is currently part of the Charlotte Hornets line-up but was initially drafted by the Boston Celtics in the 2019 NBA draft. From our chat with Grant, weve learned that he is passionate about making smart nutrition choices and prioritizing his protein consumption. Weve gathered the inside scoop on what Grant Williams eats on game day.

Starting his day with enough protein to fuel his workout and training is key for Grant. During the season, Grant strives to maintain a regular schedule, which helps his body adapt to a routine. His day begins with breakfast around 8:30 to 9:00 a.m., where he aims to eat a well-rounded meal with lots of healthy protein.

Some examples of healthy breakfast items he might choose include protein pancakes or an omelet. From here, he typically heads to practice or to the gym. Since Grant enjoys a bigger breakfast, lunchtime usually consists of a lighter meal, sometimes, which includes Quest Nutritions protein bars and snacks.

We asked Grant about his flavor (so we know which one to try) and he noted that the Cookies and Cream and Birthday Cake bars are his personal favorite. He also mentioned he will grab a Quest protein bar or protein shake as a snack in between breakfast or lunch if needed, or if he feels like he needs some more fuel for his workout. Choosing protein bars or shakes allows him to closely monitor how much protein he consumes, but he does not track strict macros at this time.

Grants dinner time will vary depending on what time that nights tip-off is, but he gave us an example based on a standard 7:30 p.m. tip-off. Grants pre-game dinner usually happens around 4:30, allowing him to digest enough and prepare for the demands of the game. The options for dinner vary quite a bit, as Grant noted he is a big advocate of eating a wide variety of foods and colors.

He noted that it is important to get color in your meals from a variety of fruits, veggies, and grains and that he actively tries to expand his palate by trying new things. Though he loves Brussels sprouts (but hated them as a kid), he tries to switch up his dinner-time vegetables with lots of variety, such as broccoli, asparagus, mushrooms, etc. Alongside vegetables, he also chooses many different protein options for dinner time, such as chicken, steak, salmon, or halibut. In our interview, Grant also noted that he is a huge fan of Asian cuisine and loves to have teriyaki salmon as a go-to pre-game meal.

Paying attention to his nutrition choices not only allows Grant to crush the game but keeps him focused on maintaining long-term health. He actively tries to eat at least one vegan meal per week, guided by his trainers and nutrition staff.

Despite all these healthy choices, Grant, like everyone else, cannot eat healthy 100% of the time. When asked about the everything in moderation approach, Grant fully agreed, stating that you simply cannot punish yourself by eating the same thing every day. When on the road with his teammates, Grant allows himself to indulge in fast food and sweet treats now and then. One of his favorite cheat day meals is Popeyes. With a moderation approach, he limits consumption of unhealthy foods, alcohol, and sugar but doesnt eliminate these things from his diet.

For Grant, maintaining awareness about what he puts in his body helps him stay on track. This includes becoming more aware of appropriate portion control and also paying attention to the quality of foods he consumes. He noted that he strives to eat organic foods whenever possible and also takes a mindful eating approach to maintain a generally healthy and well-balanced diet.

To conclude the interview, we asked Grant about his #1 takeaway tip for nutrition. He replied: Understanding your body is critical, so pay attention to things and educate yourself. This includes popular holistic health approaches too, such as taking turmeric to help fight inflammation in your joints. Grants whole approach is all about living the happiest, healthiest, and longest life possible while still enjoying the occasional treat.

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NBA's Grant Williams reveals his game day diet (and more fitness tips) - The Manual

Fiction and fine dining are having a moment. In April, New York magazine put out a nostalgic ode to scene-y restaurants known for their literary patrons. And seemingly on the same tide, the novelist Gary Shteyngart wrote a much-circulated New Yorker piece about his quest for the perfect martini (among other vittles).

But appetites and art regularly collidefor a certain milieu anywayin the Grub Street Diet. For the uninitiated: in this vertical, celebs who are Having a Moment painstakingly narrate a weeks worth of their edible intake. Some Diets are flexes, hinting at lives of epicurean splendor on par with Shteyngarts. Others may bum you out with their commitment to a leftovers-based naturalism. Either way, the Diets a pretty fun slice of life.

Inspired by the trends (and a recent high density of writers accepting the Grub Street challenge), Ive been dreaming up some hypothetical food diaries for the fictional. Bon Apptit!

The Grub Street Diet of William Stoner (fromStoner)

Woke up with the sun, but lingered in bed this morning due to a sense of looming dread. Edith boiled me an egg, which was unusually kind of her. I chased that with some too-bitter black coffee and dry toast. She watched me eat in a grim, charged silence, but did not partake herself.

Was teaching back to back sessions all day, so couldnt get much of a munch in. I did manage a few cups of campus coffee at my desk, and my new colleague Lomax dropped in to offer a handful of sustaining peanuts just as I was getting lost in a book. Lomax reminded me of the faculty party were meant to throw this evening, which Id completely forgotten about. I called Edith, who tensely informed me that it had all been taken care of. All I had to do was pick up a few bottles of gin from the bootlegger on my way back.

I arrived home to a fine display of sliced cold ham and turkey, pickled apricots, and [a] varied garniture of tiny tomatoes, celery stalks, olives, pickles, crisp radishes, and little raw cauliflower ears. All great snacks, but without a centerpiece I feared our guests would leave hungry. My colleagues trickled in, and many did get soused. But Lomax took the (metaphorical) cake. He and I wound up talking deep into the night about everything under the sun: our lonesome childhoods, our body shame, our senses of looming dream. I felt a bolt of kinship. But in the morning, the portal is closed. For my friend was gone.

Edith was also in a foul mood when the sun rose again, so did not make me eggs.

The Grub Street Diet of Fermina Daza (from Love in the Time of Cholera)

Jumped out of bed well before dawn, because 1) I have chores and 2) its my birthday!!! Decided to start the day off with some trusty favorites: chamomile tea and soup. But then my husband insisted I let him take over the days meal prep, because he wanted to treat me. This was very moving, but also concerning? Because before this morning, I was not sure he knew how to boil water on his own.

The good doctor wound up exceeding my expectations in the kitchen. He whipped up a huge brunch of eggs and cafe con leche. I was so moved by the gesture I didnt see the need to remind him of my lactose-intolerance. For dessert, we had guavas, which were sweet and evocative, but not as sweet as I remembered them being when I ate them straight off the tree, in childhood. But I suppose this is the way of getting older. The second time around never tastes as sweet

The rest of my birthday was pretty dull. I did chores, beginning with cleaning up the mess Dr. Urbino left me in the kitchen. And then I prepared our dinner, which is always a taxing prospect. (My husband is great, but in addition to being a non-chef, he is a very finicky eater. He claims to be able to tell when a meal has been prepared without love, and has a weird thing for out-of-season vegetables.) But as it was still technically My Day, I decided to make this eggplant dish, because I went to a gala last week where they served this amazing pureed eggplant, and now its all I can think about. Which is very funny, because I used to really hate the texture.

We ate our mains on the terrace, then followed dinner with brandies and some little imperial cakes and candied flowers. The doctor fell asleep before me, as usual. But I had stranger dreams.

The Grub Street Diet of David (from Giovannis Room)

Woke around 3 p.m., hungover. The holy trinity of coffee, cigarette, and cognac for breakfast did the trick.

Took a late lunch with friends at a rather nice restaurant on the rue de Grenelle. Had a vin chaud and some good bread. I think we also had a piece of fish? But I was distracted from the main course, because I was preoccupied with finding the most polite way possible to ask my host for another 10,000 franc loan. Sweet Jacques complied, of course; we went to the bar after, to celebrate my staying in Paris. There, cognac followed cognac followed cognac followed another vin chaud; I lost track, to be honest. But I made a diverting acquaintance in our waiter, who joined us at the end of his shift. He insisted on drinking a Coca-Cola while I had another cognac. (Just because.)

Our set was kicked out of the joint at five oclock in the morning. But by then wed gotten hungry again, so we piled into a taxi towards Les Halles. The morning streets were bare and dingy. I saw the greengrocers setting up their fruit stalls. We wound up facing the dawn at a dreadful, chic place. One of those overhyped, expensive tourist joints where young Americans guzzle wine at a zinc counter. I ordered my holy trinity, but this new friendGiovanniinsisted on a new kind of breakfast, for champions. Champagne and a few dozen oysters. He claims that is really the best thing after such a night.

From the next days perspective, Im not sure if I believe him. (Woke up hungover. And with very bad breath.) But I plan to see Giovanni again. You know, to test the theory.

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The Grub Street Diets of your favorite fictional characters. - Literary Hub

The ketogenic diet rose to popularity in the early 2000s with the mantra fat is not the enemy. But a study covered in the March 2024 issue of Current Problems in Cardiology suggests that the diet which focuses on foods high in fats and deemed very low in carbohydrates is neither as effective as previously believed nor healthy in the long-term.

The paper, published by Joanna Popiolek-Kalisz, MD and PhD, found several issues with it. The first was weight-loss related. While many people who followed the diets parameters experienced rapid weight loss (typical following any significant shift in your eating habits), it was likely mostly water weight and failed to result in any permanent positive changes within the body.

The ketogenic diet does not fulfil the criteria of a healthy diet, Popiolek-Kalisz states in the paper. On the contrary, when it comes to overall heart health, the low-carb pattern is more beneficial than very low-carbohydrate (including the ketogenic diet). Specifically, because of the keto diets emphasis on fats, those adhering to it typically have a higher rate of LDL cholesterol, which is associated with a higher risk of heart disease, clogged arteries, and death.

Low-carb dietary plans include the Atkins diet, the paleo diet, and the South Beach diet. Other studies have noted that the keto diet can lead to major vitamin and mineral deficiencies (as well as a surplus of fat-soluble vitamin K, which is also unhealthy for the heart) and increased kidney stones.

According to the International Food Information Councils annual study, more than half of Americans follow a diet or a specific eating pattern but the high-fat keto diet dropped in popularity by 4 per cent this year compared to 2023. That downward trend will likely only continue.

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A New Study Suggests The Keto Diet May Actually Be Harmful To Your Health - British Vogue

Ever heard of the Atlantic diet? It's currently trending, with Google Searches around the topic currently at breakout - which means it's being Googled more than ever before.

A disclaimer, before we start - we're sceptical of popular diet fads here at Marie Claire UK and never promote restrictive or dangerous routines that promise the world and nearly always fail to deliver. Healthy living is about balance, after all, and focusing on what nutrient-dense foods you can add to your diet, not which you should be taking away.

That said, when I saw this new approach to nutrition spiking on Google engines this month, it caught my intrigue. Why? Well, because it's significantly similar to the ever-popular (and research-backed) Mediterranean way of eating, which has been riding a wave of popularity recently. Both focus on plants, whole foods and healthy fats, and so its easy to see why experts talk about the approach to nutrition quite so highly.

The Atlantic diet is (literally) a stones throw from the Mediterranean way of eating, requiring no complicated ingredients or restrictions. In fact, chances are you're already eating in a fairly similar way.

Why take the time to read up on the new trending approach to food? Simply, because the diet boasts some impressive benefits. Just like its geographical relative (were going with cousin), the Atlantic diet is associated with increased longevity and a reduction in chronic diseases such as cardiovascular disease, stroke and diabetes.

Intrigued? Us too, which is why we turned to the experts to get their take. Keen to learn what exactly the Atlantic diet is, plus how it differs from the Mediterranean diet? Then you'll have to keep scrolling. Read more expert-backed, science-approved MC UK nutrition content with our guides to healthy snack ideas,healthy smoothie recipes, and healthy dinner recipes, which promise to make piling your plates with nutrients easy. Plus, don't miss our explainer on what to eat before a workout, from a nutritionist.

Ok, first things first: if youve never heard of the Atlantic diet youre in the right place. As the name suggests, its a way of eating common along the Atlantic coast.

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The Atlantic diet refers to a dietary pattern found commonly in Northwest Spain and Portugal, explains doctor and nutritionist Dr Sarah Cooke. It is based around whole foods, minimally processed foods and home-cooked meals. The foods consumed are generally seasonal and farmed locally.

As you might expect, this way of eating is based on lots of fresh fish, seasonal fruits and vegetables, potatoes, nuts, legumes, bread, cereals and olive oil. Additionally, the diet contains a moderate amount of dairy products and lean meat, particularly pork, creating a well-balanced and inclusive diet.

The highly requested Mediterranean Chicken Bowl recipe

While not as widely studied as the Mediterranean diet, the research into the Atlantic diet is compelling, to say the least.

It seems it's no coincidence that people living in the Atlantic regions of Spain and Portugal have among the lowest rates of heart disease in the world.

Here's the science bit: studies such as this one, published in the Journal of the American Medical Association, show that following an Atlantic diet for six months resulted in a reduced risk of developing metabolic syndrome, a cluster of conditions that increases the risk of heart disease and diabetes.

Further research, published in the journal Nutrients reveals that, combined with an active lifestyle, the Atlantic diet is associated with lower total cholesterol and triglycerides (fatty acids in the blood), lower rates of obesity and lower pulse wave velocity values.

Scientific benefits aside, there are excellent reasons to consider eating in a more Atlantic-style way.

"This pattern of eating has positive effects for long term health," agrees Dr Cooke. "Eating seasonally encourages plant diversity in our diets, which is great for gut health and the diet is also rich in micronutrients such as iodine, calcium, zinc and selenium, important for immune health (zinc), thyroid function (iodine), healthy bones and brain health, among others."

The inclusion of plenty of locally-sourced fish in the diet provides not only essential fats and protein, but is an excellent source of omega-3 acids, essential for brain and heart health, as well as reducing inflammation in the body.

As a general rule, inflammation in the body isn't a good sign. Case in point: the World Health Organisation ranks chronic inflammatory diseases (such as stroke, cancer, heart disease and diabetes) as the greatest threat to human health.

However, the Atlantic diet has been shown in studies (such as this one, published in the Journal of Atherosclerosis) to lower inflammation, as well as reduce blood pressure and blood fat in the majority of people.

"We know that processed foods and the inflammation they cause are linked to many chronic diseases and obesity," says Dr Charlotte Norton, chief medical officer of The Slimming Clinic. " The fact that these arent present in the Atlantic Diet is an important part of how it benefits health and overall wellbeing."

Additionally, the Atlantic diet focusses on locally sourced, sustainable ingredients and meals cooked from scratch, upping their nutrient content further.

"The combination of whole grains, vegetables, pulses, nuts, fruits, and fibre in the Atlantic diet are rich in antioxidants, vitamins and minerals," says Dr Norton, "These are all important for overall health, as well as key for a healthy heart and blood pressure."

At first glance, the two ways of eating seem remarkably similar, but there are a few key differences.

"The Atlantic diet contains more starchy carbs in the form of pasta and potatoes, rice and bread than the Mediterranean diet, which is primarily plant-based," says registered nutritionist Karen Preece Smith.

"As such, it may feel less restrictive for some people. As meat, red wine and dairy are encouraged on the Atlantic diet, it may also feel more flexible and accommodating as a lifestyle approach longer term and therefore more sustainable than it's Mediterranean counterpart."

Keen to give the Atlantic diet a go? We don't blame you - it sounds utterly delicious.

But if you're wondering how to go about it, we've got you covered. The good news is that, with the exception of limiting processed foods, there aren't too many rules. It's more about enjoying a sustainable and largely fresh diet.

"Think about the origin of your food - did it fly, swim or grow from the ground? If so, include it in your diet," says Preece Smith. "Once you have worked out the daily foundations of meat, fish, plants and healthy fats (such as olive oil), then you can include a serving of fibre such as a starchy vegetable, bread or rice, along with some dairy such as cheese or yoghurt."

Don't forget the focus is on local, seasonal produce - Dr Cooke recommends aiming for around five servings of sesonal fruit and vegetables per day, alongside wholegrains, beans and pulses. And don't forget to cook with olive oil!

But above all, food is about enjoyment - and the best way of eating will always be one that brings you joy and is achievable and sustainable with your lifestyle.

"Remember, this style of eating is as much about community and traditional values as it is the food itself," advises Preece Smith, "so enjoy preparing meals at home from scratch and sharing them with friends and loved one, alongside an Atlantic diet-approved glass of red wine!". Sounds good to us.

Never has healthy eating looked (and tasted!) so good. The debut book from Emily English (aka Em the Nutritionist) is packed with recipes we can't wait to try on rotation. Keen to try some Em The Nutritionist recipes without buying the book? She shares her go-to's, here.

The Science of Nutrition by Rhiannon Lambert

Rhiannon Lambert has made a name for herself as one of the UK's most respected nutritionists, so you can be sure that this book will impart research-backed nutrition wisdom you can trust.

The White Company heart serving bowl

Looking for the perfect dish to serve up your Atlantic diet dishes? Look no further - this stoneware dish is ovenproof for oven-to-table eating.

Originally posted here:
As A Health Expert, I'm Sold On The Atlantic Diet. Here's Why - Marie Claire UK

Understanding the biological processes of getting older could help us lead longer lives, and stay healthier later in life and a new study links the speed at which our brain ages with the nutrients in our diets.

Researchers from the University of Illinois and the University of Nebraska-Lincoln mapped brain scans against nutritional intake for 100 volunteers aged between 65 and 75, looking for connections between certain diets and slower brain aging.

They identified two distinct types of brain aging and the slower paced aging was associated with nutrient intake similar to what you would get from the Mediterranean diet, shown in previous studies to be one of the best for our bodies.

"We investigated specific nutrient biomarkers, such as fatty acid profiles, known in nutritional science to potentially offer health benefits," says neuroscientist Aron Barbey, from the University of Illinois.

"This aligns with the extensive body of research in the field demonstrating the positive health effects of the Mediterranean diet, which emphasizes foods rich in these beneficial nutrients."

Importantly, the researchers didn't rely on the study participants to report on their diets. Instead, they analyzed blood samples to look for nutrient biomarkers: solid scientific evidence for what these elderly individuals were eating and drinking.

Fatty acids, like those in fish and olive oil, and antioxidants such as vitamin E, present in spinach and almonds, were among the beneficial biomarkers identified, as well as carotenoids, plant pigments found in carrots and pumpkin that have previously been found to lower inflammation in the body and protect cells from damage. Another beneficial biomarker associated with slower aging in this research was choline, which is contained in high concentrations in egg yolks, organ meats and raw soybean.

The researchers assessed brain aging through both MRI brain scans and cognitive assessments. This pair of approaches gave a picture of practical mental agility along with the more subtle details of neuron configuration.

"This allows us to build a more robust understanding of the relationship between these factors," says Barbey.

"We simultaneously examine brain structure, function and metabolism, demonstrating a direct link between these brain properties and cognitive abilities."

The evidence is now mounting that nutrition plays a significant role in how the brain ages, and each new study helps in providing more insight about how our brains are closely connected to every other part and function of the body.

This research only captured a snapshot in time, and isn't comprehensive enough to prove cause and effect. However, similar conclusions were reached by a 2023 study, which followed participants for 12 years and also found a connection between the Mediterranean diet and lower cognitive decline.

Next, the team wants to look at clinical trials across a significant amount of time to see how diet and nutrition might affect brain aging. It's possible that simple tweaks to what we eat could help cut down the risk of neurodegenerative diseases such as Alzheimer's.

"The present study identifies particular nutrient biomarker patterns that are promising and have favorable associations with measures of cognitive performance and brain health," says Barbey.

The research has been published in npj Aging.

Continued here:
Scientists Discover Key Food Nutrients Linked to Slower Brain Aging - ScienceAlert

Study population

The study was approved by ethics committees in both Sheba Hospital in Israel (No. 5484) and the First-affiliated hospital of Sun Yat-Sen (SYS) University in China (No.[2021]GH1457; No.[2019]GH0367; No.[2017]073), and the research complies with all relevant ethical regulations. This study was conducted in Guangdong province in Southern China and Israel (Jan 2019 to April 2021). Several populations were analyzed (Fig.1). In China, newly diagnosed and treatment-nave CD patients were included, along with healthy urban residents of Guangzhou, a modernized metropolitan community with a population of 16 million, and healthy residents of Shaoguan district, a rural underdeveloped community 300km north of Guangzhou. Participants were asked about the amount of time they spent in an urban environment in the last year (How long have you stayed in a city in the last year?) with answers including less than 10%, 1050%, and above 50%. Newly diagnosed CD patients and healthy controls from Israel were included as another layer of a Westernized control cohort. CD diagnoses of all patients were harmonized and based on clinical history, physical examination, laboratory work, radiological findings, and endoscopic and histological features as previously established in the European Crohns and Colitis Organization consensus statement36. Written informed consent was obtained from all participants.

Data regarding enrolled subjects were recorded in a structured manner that included demographic, clinical, laboratory, endoscopic, and pathological features for the indicated group and participants (Fig.1). Laboratory tests included C-reactive protein (CRP). Endoscopic evaluations included gut segmental involvement. Stool specimens were collected into a collection tube at least 3 weeks following any antibiotic treatment. Stool samples were aliquoted and frozen immediately in 80C. Ileal biopsies were gathered during diagnostic colonoscopy and stored in RNAlater and frozen at 80C. Due to COVID-19 outbreak limitations, samples were processed locally within each country of origin. Samples from both cohorts were analyzed using a similar bioinformatic pipeline; direct comparisons between groups were performed within each country of origin.

Patients from both cohorts underwent environmental and dietary exposure surveys. Gender was determined based on self-report. For environmental exposure, we used the questionnaire developed by the International Organization of IBD (IOIBD), with some modifications. The questionnaire consists of 87 questions covering 25 different topics proposed to be environmental risk factors for CD. Although it was not formally validated by the IOIBD, this questionnaire has been previously used in epidemiological studies investigating triggers of IBD37,38, including one conducted in South-East Asia and China39. IOIBD questions relate to five main different areas: (1) Childhood factors up to 20 years including breastfeeding, appendectomy, tonsillectomy, eczema, vaccinations (tuberculosis, pertussis, measles, rubella, diphtheria, tetanus, polio), childhood infections (measles, pertussis, rubella, chickenpox, mumps, scarlet fever) and pet ownership; (2) food habits including daily, weekly or less frequent consumption of fruit, vegetables, egg, cereal, bread, coffee, tea, juice, sugar, and fast food; (3) smoking habits (current smoker, non-smoker, ex-smoker); (4) sanitary conditions such as the availability of in-house water tap, hot water tap or flush toilet; and (5) others factors including daily physical activity, the oral contraceptive pill and stressful events before diagnosis. We also included in the IOIBD questionnaire items about antibiotic use before and after the age of 15 years, use of toothpaste, and the presence of amalgam teeth filling during childhood or later in life. In addition, we added a specific question specifying the amount of time spent in an urban environment in the last year with answers including less than 10%, 1050%, and above 50%. Although the IOIBD questionnaire explores the role of diet before the diagnosis of IBD, we added an additional comprehensive FFQ (Food frequency questionnaire), conducted by a trained dietician. This tool included over 600 food items, with an FFQ list that prioritized the foods/beverages accounting for at least 80% of the total energy intake and the between-person variance in previously collected dietary intake data from the adult Israeli population40,41. Personnel from both Sheba and SYS were similarly trained in the dietary interview method and the equivalent FFQ was used after translation to Chinese and adaptation to the Chinese diet. In Israel, a computerized FFQ version was used that automatically computes the average daily nutrient content of an individual patients diet including macro and micronutrients, and food item servings. In China, the data were extracted manually and the portion of a specific food, and micro and micronutrient consumption were summarized. Data regarding exposures and diet are summarized in Supplementary Dataset1. The Sheba FFQ output included 62 features, while the SYS one included 28 features.

Principal component analysis (PCA) was performed to summarize variation in Israel and China FFQ data, separately, using R prcomp function with data scaled and centered. FFQ components were correlated to PC1 and PC2 values using Spearmans correlation, and the top 10 FFQ features by maximal Spearmans rho correlation to PC1 or PC2, with p0.05, are shown to highlight the main components affecting variance in dietary intake. Spearmans correlation was calculated between all FFQ component pairs, separately for Israel, China rural, and China urban and CD. Correlation heatmaps were generated showing Spearmans rho values, clustered using R hclust function with Euclidian distances.

At the Sheba site (Israel), fecal42,43,44 and biopsy7,8,9,10 DNA extraction, and PCR amplification of the variable region 4 (V4) of the 16S rRNA gene using Illumina adapted universal primers 515F/806R was conducted using the direct PCR protocol [Extract-N-Amp Plant PCR kit (Sigma-Aldrich, Inc.)]42,43,44. At the SYS site (China), fecal DNA samples were extracted using the OMEGA Soil DNA Kit (Omega Bio-Tek, Norcross, GA, USA) following the manufacturers instructions. PCRs of the variable region 4 (V4) of the 16S rRNA were conducted and amplicons were pooled in equimolar concentrations into a composite sample that was size selected (300500bp) using agarose gel to reduce non-specific products from host DNA. Sequencing was performed on the Illumina MiSeq platform at Sheba or the NovaSeq platform at Shanghai Personal Biotechnology Co., Ltd (Shanghai, China). Samples from both cohorts were analyzed independently using a similar bioinformatic pipeline. Reads were processed in a data curation pipeline implemented in QIIME 2 version 2021.445,46. Reads were demultiplexed according to sample-specific barcodes. Quality control was performed by truncating reads after three consecutive Phred scores lower than 20. Reads with ambiguous base calls or shorter than 150bp after quality truncation were discarded. Amplicon sequence variants (ASVs) detection was performed using Deblur47, and duplicate samples from different runs were joined, resulting in 323 samples with a median of 55,844 reads/sample (IQR 50,43562,947) for China, and 158 samples with a median of 23,595 reads/sample (IQR 13,54936,505) for Israel. ASVs present in less than 1% of the samples were removed. Additionally, candidate contaminant ASVs were filtered using dbBact14 by removing ASVs with the f-score mean for (water, soil, mus musculus) higher than homo sapiens, resulting in 1668/3642 ASVs for China and 1290/2838 ASVs for Israel after filtering. ASV taxonomic classification was assigned using a naive Bayes fitted classifier, trained on the August 2013 Greengenes database. Taxonomy assigned by 16S is indicated by the specific ASV number, and the sequence associated with each ASV number is indicated in Supplementary Dataset2 and in the relevant supplementary datasets. All samples were rarefied to 33k reads for and diversity analysis for China samples, and 4k reads for Israel samples, to avoid read number effects. Faiths phylogenetic diversity48 was used as a measure of within sample diversity, and Unweighted UniFrac was used as a measure of between sample -diversity49, using a phylogenetic tree generated by SAT-enabled phylogenetic placement (SEPP)50. The resulting distance matrix was used to perform a Principal Coordinates Analysis (PCoA). Heatmaps were generated using Calour version 2018.10.1 with default parameters51.

PERMANOVA: quantifications of variance were calculated using PERMANOVA with the adonis function in the R package Vegan52, on the rarefied Unweighted UniFrac distance values. The total variance explained by each variable was calculated while accounting for age and gender in the model (except for when looking at the contribution of age and gender, when only age or gender can be controlled for). PERMANOVA was calculated independently for each group (China CD, urban, rural-urban and rural, and Israel CD and control) and for each questionnaire and FFQ component. Multivariate Association with Linear Models (MaAsLin2) was used with R package version 1.8.0, to test for specific differentially abundant ASVs between: rural and rural-urban samples controlling for age and gender, China CD and urban controls controlling for age and gender, and Israel CD and controls, using both stool and biopsy samples, controlling for age, gender, sample type (stool or biopsy) and patient ID as the random variable. MaAsLin2 was also used to identify ASVs correlated with dietary consumption of fat, iron, and protein separately, within all China controls, controlling for age, gender and group (urban, rural-urban or urban). A false discovery rate (FDR) cutoff of 0.25 was used for all MaAsLin2 analysis53, and FDR cutoff of 0.1 is indicated.

Rural and Health indices: per-sample health index was calculated as previously described11. Briefly, a set of ASVs that were significantly increased or decreased across multiple human diseases compared to controls was identified. Using these ASVs bacteria, for each sample the log of the ratio of health-associated bacteria (98) to disease-associated bacteria (32), following rank transforming the samples, was calculated and defined as the health index (with higher values indicating a better health-associated microbiome). A similar approach was used to define a rural index for each sample, as follows: Using an independent dataset of rural and urban Chinese samples5, we identified 76 and 42 ASVs significantly higher/lower in the rural community respectively (using a rank-mean test with dsFDR<0.154, implemented in Calour51). The rural index was then calculated for each SOURCE sample as the log of the ratio of the rank-transformed frequencies of the ASVs from the rural and urban ASVs. Age matching between sample groups was performed by binning ages into 10 year bins, and equalizing the number of samples in each age bin between the two sample groups by randomly dropping samples.

dbBact term enrichment analysis: significantly enriched dbBact14 ontology terms between two ASV sets (e.g., higher/lower in rural community or positively/negatively correlated with dietary factor) were identified using the dbBact-calour plugin. Briefly, dbBact contains annotations linking ASVs to ontology-based terms, based on manual analysis of over 1000 amplicon experiments. For the current experiment analysis, for each term, a dbBact annotation-based score is calculated for each ASV, and the distribution of the score across the two ASV groups is compared to random permutations (of ASV group labels), using a permutation-based rank-mean test with dsFDR multiple hypothesis correction. For the term-specific Venn diagrams, the number of ASVs associated with the term in at least one dbBact experiment is shown for each ASV group, with the central (gray) circle showing the total number of ASVs in dbBact associated with the term. The study was conducted and is currently reported according to the STORMS guidelines55 (information in Supplementary Dataset1).

For samples from the Sheba site, DNA was purified using the PowerMag Soil DNA isolation kit (MoBio) optimized for the Tecan automated platform. DNA was diluted to 1.5ng, and Illumina libraries were prepared using Nextera DNA library preparation kit, Ref# 15028211; by Tecan Freedom Evo 200 robot device. Nextera DNA Unique Dual Indexes Sets AD from IDT were used for library preparation. Library concentration was measured using the iQuantTM dsDNA HS Assay Kit, ABP biosciences (Cat# AP-N011), and library size was quantified by automated electrophoresis nucleic acid QC -Tape-Station system. Libraries were sequenced by a NextSeq 500 device with IlluminaNS 500/550 High Output V2 75 cycle kit, Cat# FC-404-2005. SYS samples site, the extracted DNA was processed to construct metagenome shotgun sequencing libraries with insert sizes of 400bp by using Illumina TruSeq Nano DNA LT Library Preparation Kit. Each library was sequenced by the Illumina HiSeq X-ten platform (Illumina, USA) with PE150 strategy at Personal Biotechnology Co., Ltd. (Shanghai, China). Samples from both cohorts were analyzed independently using a similar pipeline (https://github.com/biobakery). Reads were first decontaminated and trimmed using KneadData v0.12.0, then samples under 7M reads PE (or 3.5M SE) were excluded. The average number of reads after the quality control process was 52,508,783.72 (11,833,357.89) PE and 8,773,250.37 (2,135,013.94) SE for the Chinese and Israeli cohorts respectively. Taxonomic profiles were generated using MetPhaln v4.0.056, from which the functional profiles were generated using HUMAnN v3.657. Default parameters were used for all modules, besides defining concatanating PE reads using the -cat-final-output parameter in KneadData. Taxonomic and functional features were filtered out if they didnt have abundance greater than 0.01% in at least 10% of the samples.

For the Sheba samples (n=37), extraction solution (ES: 75% methanol and 25% water and six internal standards) was mixed with fecal smear, sonicated for 10min, centrifuged at 14,000g for 10min at 4C, and stored at 80C until submission for LC-MS metabolomics analysis. LC-MS analysis was conducted as described58. Briefly, Dionex Ultimate ultra-high-performance liquid chromatography (UPLC) system coupled to Orbitrap Q-Exactive Mass Spectrometer (Thermo Fisher Scientific) was used. The resolution was set to 35,000 at a 200 mass/charge ratio (m/z) with electrospray ionization and polarity switching mode to enable both positive and negative ions across a mass range of 671000m/z. The UPLC setup consisted of ZIC-pHILIC column (SeQuant; 150mm2.1mm, 5m; Merck). Stool extracts were injected, and the compounds were separated with mobile phase gradient, starting at 20% aqueous (20mM ammonium carbonate adjusted to pH 9.2 with 0.1% of 25% ammonium hydroxide) and 80% organic (acetonitrile) and terminated with 20% acetonitrile. Flow rate and column temperature were maintained at 0.2ml/min and 45C, respectively, for a total run time of 27min. All metabolites were detected using mass accuracy below 5ppm. Thermo Xcalibur 4.1 was used for data acquisition. Peak areas of metabolites were determined using MZmine2.5359 by using the exact mass of the singly charged ions (m/z) and the retention time of metabolites was predetermined on the pHILIC column by analyzing an in-house mass spectrometry metabolite library that was built by running commercially available standards. Thermo TraceFinderTM 4.1 software was used for validation, by comparing the peak areas of the internal standards determined by both software. A total of 405 of 545 of the predefined metabolites library passed the threshold of peak intensity and were included in the analyses.

For the SYS samples, a targeted metabolomic analysis using a Q300 kit (Metabo-Profile, Shanghai, China) was performed. Lyophilized samples (~5mg) were mixed with 25l of water and homogenized with zirconium oxide beads for 3min. One hundred twenty l of methanol containing internal standard was added and then homogenized for another 3min, centrifuged at 18,000g for 20min, and 20l of supernatant was transferred to a 96-well plate. The plate was sealed and incubated at 30C for 60min, after which 330l of ice-cold 50% methanol solution was added to dilute the sample. Then the plate was stored at 20C for 20min, followed by 4000g centrifugation at 4C for 30min. One hundred thirty-five l of supernatant was transferred to a new 96-well plate with 10l internal standards in each well. A liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) system (ACQUITY UPLC-Xevo TQ-S, Waters Corp., Milford, MA, USA) was used to quantitate all targeted metabolites. To diminish analytical bias within the entire analytical process, the samples were analyzed in duplicates that were randomly analyzed. The quality control (QC) samples, internal standard calibrators, and blank samples were analyzed across the entire sample set. The raw data files generated by UPLC-MS/MS were processed using the MassLynx software (v4.1, Waters, Milford, MA, USA) to perform peak integration, calibration, and quantitation for each metabolite. A total of 185 of 305 metabolites passed the threshold of peak intensity and were included in the analyses.

Ninety-two metabolites overlapped between the 185 SYS dataset and the 405 in the Sheba cohort, and these were used to test correlations as independent validation. Overall, the normalized metabolite levels (each metabolite value was divided by the sum of total metabolites value per sample) were used for all downstream analyses in both Sheba and SYS cohorts.

Principal coordinates analysis (PCoA) was performed on the metabolomics data using Canberra distances as a measure of between sample -diversity. Multivariate Association with Linear Models (MaAsLin2) was used with R package version 1.8.0, to test for specific differentially abundant metabolites between China rural and rural-urban samples controlling for age and gender, and for China CD and urban controls controlling for age and gender, using FDR cutoff of 0.25.

At the Sheba site, RNA and DNA were isolated from terminal ileum (TI) biopsies obtained during diagnostic colonoscopy using the Qiagen AllPrep RNA/DNA Mini Kit. PolyA-RNA selection, fragmentation, cDNA synthesis, adapter ligation, TruSeq RNA sample library preparation (Illumina, San Diego, CA), and paired-end 75bp sequencing were performed. Median reads depth was ~ 39M (3146M IQR) in Sheba. Samples were sequenced at the NIH -supported Cincinnati Childrens Hospital Research Foundation Digestive Health Center. At the SYS site, mRNA was purified from total RNA using poly-T oligo-attached magnetic beads. The strand-specific cDNA sequencing libraries were generated using NEBNext UltraTM Directional RNA Library Prep Kit for Illumina (NEB, USA), and index codes were added. Samples were purified (AMPure XP system) and clustering of the index-coded samples was performed on a cBot Cluster Generation System using HiSeq 4000 PE Cluster Kit (Illumina, NEB, USA). After cluster generation, the stranded, poly-A selected libraries were sequenced on an Illumina NovaSeq 6000 platform by Novogene Bioinformation Technology. One hundred fifty bp paired-end reads were generated to a median depth of 42.3M (39.946.6M IQR) reads for China samples, and 38.2M (3238.2M IQR) reads for Israel samples. Reads were quantified by kallisto60 version 42.5 using Gencode v24 as the reference genome. Kallisto output files were summarized to gene level using R package tximport version 1.22.061. Protein coding genes with Transcripts per Million (TPM) values above 1 in at least 20% of the samples were used in downstream analysis.

Weighted gene co-expression network analysis (WGCNA) to identify modules of co-expressed genes25,62 was implemented utilizing R WGCNA package version 1.72-1, using the Sheba cohort as described63,64. The analysis was performed on TI transcriptomics data. WGCNA was implemented for the identification of co-expressed gene clusters; we used pairwise correlations between gene expression profiles and the signed hybrid version of WGCNA. Similarities of gene co-expression are converted to adjacency values (power adjacency function), with a parameter of 12. Average linkage hierarchical clustering on TOM-based dissimilarities is implemented to detect modules of strongly correlated genes across samples. For each module, the first principal component, referred to as the eigengene, was considered to be the module representative. A module summarized the expression levels of all the genes in a given module. Included parameters were cluster sensitivity parameter (deepSplit) of 2 to identify balanced gene modules, a minimum number of genes in a module (minModuleSize) was set to 30 genes, maxBlockSize was set to 20,000 to include all genes in one block. The same modules of co-expressed genes were applied to the SYS transcriptomics dataset. We focused on modules significantly associated with disease, with p0.05 in at least one of the two cohorts. Nine out of 14 modules were associated with disease. Module eigengenes were additionally correlated (Students asymptotic p value) to dietary factors, and to fecal metabolites. Metabolomics data was log-scaled and cleaned, with zeroes replaced by a fifth of the lowest value per metabolite, and values with over 4 standard deviations from the mean were trimmed to 4 standard deviations from the mean, to avoid extreme values driving correlations. BenjaminiHochberg FDR correction was applied separately to diet and metabolomics results. Correlations with FDR0.25 were considered significant. This module eigengenes correlation analysis was performed independently for the Sheba and SYS datasets. ToppGene65 and ToppCluster software were used to perform Gene Set Enrichment Analyses (GSEA) of the protein-coding genes within the modules in the WGCNA TI analysis.

For each of the Sheba TI transcriptomics WGCNA disease-associated modules, we defined modules associated with metabolites as fecal metabolites with significant correlation (FDR0.25) to that module eigengene. An exact binomial test was used to test the consistency of metabolites correlation to TI WGCNA modules, between all samples and CD samples only in the Sheba cohort. For the 416 significant module-metabolites correlation calculated using all samples, a correlation was considered consistent if it changed in the same direction in CD samples, looking at Spearmans rho. 406 out of 416 correlations were consistent. The probability of success was calculated as pall*pcd+(1pall)*(1pcd), with pall representing the percentage of positive correlations in all samples, and pcd representing the percentage of positive correlations in CD samples, to account for the unbalanced positive to negative correlations ratio. HAllA (Hierarchical All-against-All significance testing) version 0.8.20 was used to identify potential correlations between these modules associated metabolites and Israeli FFQ components, stool 16S ASVs, and stool metagenomics (MGX species, pathways, and ECs). HAllA was used with Spearman correlation and FDR cutoff of 0.25.

We applied sparse Partial Least Squares (sPLS) regression between pairs of omics19 including -metagenomics (species, pathways, and ECs), stool metabolomic, and host TI transcriptomics (using disease-related WGCNA modules PC1 values). This method aims to maximize the shared variation between a pair of omics while accounting for the sparsity in the data. As a measure of the identified shared variation, we calculated the Spearman correlation between the first components of each omic. Significance was evaluated by generating 100 permutations of the feature table, and counting the number of permutations that yielded a higher correlation value than the one calculated for the original data. DIABLO20 (Data Integration Analysis for Biomarker discovery using Latent variable approaches for Omics studies) was used to simultaneously maximize the shared variation between each omics and differentiate between the health conditions. To uncover the relationship between the omics features and the disease state, we focused on the 10 loadings with the highest correlation to the first and second components. Both sPLS regression and DIABLO were calculated using the MixOmics package66. According to the recommendations in the MixOmics package, the number of components was chosen by a minimal balanced error rate using the centroid distance method. In addition, HAllA version 0.8.20 was used to identify potential correlations between China rural and rural-urban metabolites, FFQ components, and stool 16S ASVs, using Spearman correlation and FDR cutoff of 0.25.

Statistics used for transcriptomics, microbiome, and metabolomics were performed in R, and details are under these specific sections. Overall, Pearsons chi-square test or Fishers exact test was used for categorical variables, Spearmans rank correlation was used for continuous variables, and the MannWhitney U test for categorical variables, with BenjaminiHochberg Procedure for FDR correction using 0.1 or 0.25 as indicated.

Further information on research design is available in theNature Portfolio Reporting Summary linked to this article.

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Diet-omics in the Study of Urban and Rural Crohn disease Evolution (SOURCE) cohort - Nature.com

For patients withprostate cancer, a primary concern is that the disease may progress to an advanced stage that becomes life-threatening. New findings show that eating a diet rich in fresh fruits, vegetables, and grains may significantly lower the chances of prostate cancer spreading.

[1]

Consuming a primarily plant-based diet may be associated with better prostate cancerspecific outcomes, adding to a list of other numerous health benefits, including a reduction in diabetes, cardiovascular disease, and overall mortality, says lead authorVivian Liu, a clinical researcher affiliated with the department of epidemiology and biostatistics at the University of California in San Francisco. Making small changes in ones diet to eat more plant-based foods and less animal-based food each day is beneficial and the more [plants] you eat, the better.

RELATED: 9 Scientific Benefits of Following a Plant-Based Diet

The investigation involved more than 2,000 men who at study start were 65 years old on average and had a diagnosis of nonmetastatic prostate cancer meaning it had not yet spread to other parts of the body. Participants each completed a comprehensive diet and lifestyle questionnaire that provided a detailed picture of their eating habits.

Over an average of 6.5 years, 190 participants experienced cancer progression and 61 died from prostate cancerspecific causes. Based on analysis of this data, Liu and her team determined that those who consumed the highest amounts of plant-based foods had a 47 percent lower risk of prostate cancer spreading compared with men who consumed the lowest amounts of plant-based foods.

Liu said that the results also point to an inverse relationship between plant-based consumption and dying prematurely, although information was insufficient to make a meaningful estimate as to a percent reduction in mortality risk.

In relation to the lowest level of plant-based consumption, the highest level meant eating 1.9 more portions of vegetables, 1.6 additional servings of fruit, and 0.9 more servings of whole grains every day.

To get a sense of what this means in real-life terms, a standard serving of fruit may be one medium apple, banana, orange, or pear. A half-cup of brown rice is considered a single serving of grains, while a single portion of vegetables may be a half-cup cooked or 1 cup raw broccoli, carrots, and the like.

Those eating high quantities of plant-based foods were also eating lower amounts of animal-based foods on average, one less serving of dairy (such as a cup of milk or two slices of cheese), slightly fewer eggs, and marginally less meat.

According toNatasha Gupta, MD, a research assistant professor in the department of urology at NYU Grossman School of Medicine in New York City, these results add to a growing body of literature highlighting the benefits of plant-based diets in terms of a reduced prostate cancer risk, as well as improved quality of life.

[2]

As to why a plant-based diet is beneficial, Gupta highlights that fruits and vegetables are rich in substances like phytochemicals and antioxidants, which may prevent harmful cellular changes.

On the other hand, animal-based foods like processed meat and red meat are known carcinogens according to theWorld Health Organization, and dairy has been linked to worse prostate cancer outcomes, says Gupta, who was not involved in this study. A plant-based dietary pattern naturally shifts away from these harmful foods to more helpful foods.

[3]

While about 6 in 10 prostate cancers are diagnosed in men who are age 65 and up, Liu stresses that dietary changes can still make a difference in this older population.

It's not too late, she says. You don't have to make a 180-degree change to your diet. Just focus on small changes to eat more plant-based foods and less animal-based food each day. Greater consumption of plant-based food after a prostate cancer diagnosis has also recently been associated with better quality of life, including sexual function, urinary function, and vitality so its a win on many levels.

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Prostate Cancer May Spread More Slowly With a Plant-Based Diet - Everyday Health

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Five fruit and veg a day may just keep prostate and colorectal cancer at bay, according to new research.

A review of dozens of separate studies, published in the International Journal of Cancer, found that healthy diets with a rich variety of plant-based foods were associated with a lower risk of mortality from colorectal cancer, while unhealthy diets and intake of sugary drinks were linked to a higher risk of mortality.

In another study of 2,062 men diagnosed with prostate cancer, those with the highest intake of plant foods had a lower risk of prostate cancer progression compared with those who ate fewer plant-based foods. These findings were published in JAMA Network Open.

As part of their meta-analysis, the researchers from the International Agency for Research on Cancer and the World Health Organization analyzed 5 randomized controlled trials (RCTs) and 35 observational studies, which, in total, comprised of 30,242 individuals with colorectal cancer, 8,700 of whom died during the course of the study, 2,100 of which due to colorectal cancer.

Individuals living off Mediterranean and plant-based diets had lower risk of mortality than those eating unhealthy, Western diets. As for specific foods, whole grains and coffee (caffeinated or decaffeinated) were particularly noted for their link to lower risk of death. Sugary and artificially-sweetened drinks, on the other hand, were associated with worse cancer outcomes.

This comprehensive and rigorous review of the current state of evidence offers useful guidance on some of the diet and lifestyle factors that could improve cancer survival, and potentially help people living with and beyond cancer enjoy longer, healthier lives, said Dr. Helen Croker, assistant director of research and policy at World Cancer Research Fund International and co-author of the review.

At the same time, it shows a clear need for more well-designed intervention and cohort studies to support the development of robust recommendations for colorectal cancer patients and health professionals. As we are seeing an increase of people diagnosed with colorectal cancer at younger ages, it is more important than ever that health advice is based on high-quality research.

As part of the JAMA Network Open study, 2,062 men with biopsy-proven, nonmetastatic prostate cancer were enrolled across the US between 19992018 and asked to complete a diet and lifestyle questionnaire.

Between this first round of assessments and the follow-up appointments which, on average, occurred 6.5 years later 190 of the mens cancers progressed and 61 died.

The researchers observed that the men who regularly ate more plant-based foods had a 47% lower risk of cancer progression.

Compared with men who ate fewer plants, men with high plant-intake scores typically ate 1.9 additional servings of vegetables, 1.6 additional servings of fruit, 0.9 more servings of whole grains, 1.0 less serving of dairy, 0.4 less servings of animal fat, slightly less egg and marginally less meat.

Although such high plant-based index scores werent associated with a reduced risk of progression overall, such an ultra-green diet was associated with a 55% lower risk of cancer progression among 680 individuals with more advanced cancers.

The researchers from the University of California, San Francisco, concluded that plant-based diets may help keep prostate cancer progress at bay, although they say future research and replication of their findings are needed.

References: Tsilidis K, Markozannes G, Becerra-Toms N, et al. Post-diagnosis adiposity, physical activity, sedentary behaviour, dietary factors, supplement use and colorectal cancer prognosis: Global Cancer Update Programme (CUP Global) summary of evidence grading. Internat. Journ. of Canc. 2024. Doi: 10.1002/ijc.34904

Liu VN, Van Blarigan EL, Zhang L, et al. Plant-Based Diets and Disease Progression in Men With Prostate Cancer. JAMA Netw Open. 2024. doi:10.1001/jamanetworkopen.2024.9053

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Plant-Based Diet Can Reduce Severity of Colorectal and Prostate Cancer - Technology Networks

Athletes need to replenish their energy, and the number of calories they need can be difficult to fit in.

British number one padel tennis player Tia Norton explains that her replenishment routine was influenced by some, perhaps, surprising advice from nutritionist. One of the things that I've taken away from it is eating a full fat diet is actually much, much better for performance. So I'm not cutting out full fat milk, bacon, cheese etc. Since I have incorporated full fat into my diet, I'm enjoying it much more because I'm not having to restrict myself.

Fruit, including the fast-digesting carb of bananas, is a handy pre-training snack and one that can be also used for a quick sugar injection during many sporting activities.

However, the kinds of energy-boosting snacks and drinks that are targeted at the average gym-goer are sometimes pushing your sweet tooth according to Matt Gardner, head of nutrition at Virgin Active. He feels that they should be used when people are caught short and cant find an alternative.

Producer Nina meets a group of people involved in Bite Back, a youth activist organisation campaigning against junk food. They tell her that the range of junk food available in sports shops is staggering and includes a rainbow of energy drinks, many of which boast that they contain electrolytes and B vitamins, but dont say as much about the amount of ultra-processed products, chemicals and sugar within.

Many of the protein bars are essentially chocolate bars; meanwhile some of the products were just chocolate but labelled with slogans like "I Love Football", "Man of the Match" and "Game On" to promote an association with sport.

Alice, one of the Bite Back activists believes that junk food has become the cultural wallpaper. She adds: We could do 24 hours of sport every single day of the week, and that still wouldn't be enough to combat the flood of junk food that's just constantly pumped towards us.

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BBC Radio 4 - The Food Programme - Seven things we learned about nutrition for sport. - BBC

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