David C Nieman

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This editorial sets the research agenda for nutrition science through 2030, arguing that the field must move beyond isolated nutrient studies toward systems-level thinking that accounts for food access, environmental constraints, and human behavior together. The authors contend that food technology has not delivered on its promises and that nutrition, food security, and sustainability must be treated as inseparable. The piece frames the coming decade as a shift from reductionist science toward integrated approaches that balance human health with planetary sustainability.

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Broccoli contains a health-promoting compound called sulforaphane, but it only forms when an enzyme called myrosinase converts its inactive precursor — and the gut does this conversion inefficiently. This randomized crossover trial found that adding mustard seed powder (a source of myrosinase) to a broccoli seed extract supplement doubled the amount of sulforaphane absorbed, compared to broccoli extract alone. Four specific gut bacterial genes also predicted how well individuals converted the precursor on their own, suggesting a personalized nutrition angle.

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This large multinational study surveyed over 6,000 children aged 6 to 13 in 12 countries across the COVID-19 pandemic and found that wellbeing dropped and mental health symptoms increased, though both returned close to pre-pandemic levels after two years. Depression screening rates roughly doubled during the pandemic, with girls, children with pre-existing health conditions, and those affected by school closures hit hardest. Family contact, outdoor play, and time with pets were the most commonly used coping strategies.

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Researchers followed male marathon runners for 10 years to see whether repeated strenuous racing permanently damages the right ventricle of the heart. The right ventricle temporarily weakened after each marathon but fully recovered within days, and function remained normal after a decade of competition. Left ventricular function changed modestly but stayed within normal limits, suggesting that long-term marathon running does not cause lasting right heart damage in most recreational athletes.

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This randomized crossover trial tested two weeks of betaine supplementation in cyclists and found a modest but statistically significant improvement in 60 km time trial performance — about 1.4 minutes faster. The supplement strongly activated the one-carbon metabolism pathway, increasing several related compounds in the blood, but had no effect on gut permeability or muscle damage markers. The results suggest betaine's performance benefit works through metabolic pathways rather than reducing exercise-induced gut stress.

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Researchers compared adults with healthy versus unhealthy lifestyles using combined metabolomics, proteomics, and epigenomics data, identifying 96 enriched biological pathways that distinguished the two groups. The healthy lifestyle group showed lower bile acids, reduced innate immune activation, better fat metabolism, and higher HDL remodeling — and the integrated analysis also revealed unexpected links between lifestyle and cancer and insulin resistance pathways. The study builds a multi-omic molecular fingerprint of what a healthy lifestyle looks like at the biological level.

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An analysis of a clinical trial for people at ultra-high risk of developing psychosis found that those who took less than 75% of their study medication — whether omega-3 fatty acids or placebo — had more than four times the rate of transitioning to full psychosis compared to adherent participants. The association held regardless of whether the person was on omega-3s or placebo, meaning non-adherence itself predicted worse outcomes. The finding highlights treatment engagement as a critical target in early psychosis intervention.

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This narrative review summarizes how different exercise intensities affect immune function — from moderate activity, which strengthens immunity and reduces chronic inflammation, to prolonged strenuous exercise, which can temporarily suppress immune defenses. The review covers the mechanisms behind these effects, the additional role of environmental stress like heat and altitude, and provides practical guidance for choosing exercise protocols that support immune health. It also identifies gaps in research on personalized exercise and the interaction between environment and immunity.

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This editorial introduces a special journal issue on sports nutrition, summarizing current knowledge and emerging directions in the field. It highlights the need for rigorous science to inform decisions about performance and recovery strategies for athletes. No original data is presented.

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A three-arm crossover trial tested whether hemp fiber supplements reduced gut leakiness in cyclists after 2.25 hours of hard riding. Gut permeability measured by a urine sugar test did not change with hemp fiber. However, metabolomics analysis found that hemp fiber significantly shifted levels of multiple beneficial metabolites in the blood, including compounds linked to serotonin, bile acid, and anti-inflammatory pathways. The results suggest hemp fiber affects internal metabolism even when it does not measurably change gut barrier integrity.

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A study of 25 cyclists found that the abundance of a single gut bacterium — Prevotella copri — explained about two-thirds of the variation in post-exercise inflammation levels. Higher P. copri abundance strongly predicted higher levels of pro-inflammatory oxylipins derived from arachidonic acid after a 2.25-hour cycling bout. Lower gut microbiome diversity was also linked to more inflammation, suggesting that gut bacteria composition is a major personal factor determining how the body responds to hard exercise.

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A survey of cardiothoracic surgeons, residents, and OR staff identified the top problems medical students have in the cardiac operating room: not understanding their role, chatting inappropriately, and breaking sterility. Staff wanted students to be active participants who ask questions and help with minor tasks. The findings point to specific gaps that targeted pre-OR education resources could address, potentially improving student engagement and interest in cardiothoracic careers.

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This perspective piece critiques how psychiatric diagnoses are made, arguing that current classification systems have stalled and that new frameworks are urgently needed. Three alternative approaches — RDoC, HiTOP, and Clinical Staging — are evaluated for how well they could trigger a genuine shift in how mental illness is understood and treated. The authors see these frameworks as complementary rather than competing, but acknowledge that none is ready to replace the current system on its own.

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A study following ultra-high-risk individuals for psychosis found that those with persistent but not yet full-blown psychotic symptoms had outcomes that looked much more like people who later developed psychosis than like people who recovered — even though their baseline profiles were similar to the recovered group. The divergence in symptoms and function began early, within the first six months, but predicting who would stay symptomatic required following patients over time rather than relying on a single baseline assessment. These findings argue for more intensive, sustained intervention for people who don't quickly improve.

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A survey of over 8,000 adolescents aged 14 to 17 across multiple countries found that wellbeing declined and psychopathology increased during the COVID-19 pandemic, though the changes were modest in size and largely reversed after two years. Depression screening rates doubled, with girls, youth with pre-existing conditions, and those affected by school closures most vulnerable. The most effective coping strategies reported by teenagers were internet use, exercise or walking, and social contact.

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This large multinational COH-FIT study of 121,066 adults identified the specific modifiable and non-modifiable factors most strongly linked to mental health during the pandemic, using network analysis to rank which factors had the most interconnected influence. The highest-centrality factors included country income, age, gender, history of mental disorder, COVID restrictions, stress levels, and social interaction. Identifying these high-leverage factors gives public health planners specific targets for protecting mental health during future crises.

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A small randomized trial tested whether training mental health providers in Acceptance and Commitment Therapy (ACT) — which challenges rigid us-versus-them thinking — would reduce self-stigma in their patients. After the training, patients of trained providers showed less internalization of mental illness stereotypes, though awareness, agreement, and emotional hurt were not significantly affected. The results are preliminary but suggest that clinician mindset changes can have real downstream effects on patients' self-perception.

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A 4-week cranberry beverage supplement modestly altered immune-related blood proteins and slightly elevated certain pro-inflammatory oxylipins after a 2.25-hour cycling bout, but did not change gut microbiome composition or muscle damage markers. Metabolomics confirmed that cranberry compounds were absorbed and metabolized. The overall picture is that cranberry polyphenols have a small but detectable effect on the innate immune response to intense exercise, without major gut or anti-inflammatory benefits.

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The global COH-FIT adult survey found that wellbeing declined by roughly 11 points and psychopathology worsened by 13 points (on 100-point scales) during the pandemic, with rates of depression screening more than doubling. Risk was highest in people with mental disorders, women, those in low-income countries, and healthcare workers. Mental health largely returned to pre-pandemic levels after two years, and exercise and walking were the most effective coping strategies reported.

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Using over a thousand clinical high-risk individuals followed for up to 16 years, researchers built a model to predict who would develop psychosis and found that severity of disorganized speech, unusual thought content, negative symptoms, and longer time before seeking help were the strongest predictors. However, the model's accuracy drifted significantly when tested on more recently enrolled patients, suggesting that the profile of people seeking early psychosis care has changed over time. This finding warns against using older prediction models without re-validation.

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A scientific roundtable reviewed the evidence on blueberry health benefits across five domains: cardiovascular health, diabetes prevention, brain function, gut health, and exercise recovery. The consensus found encouraging evidence for blueberry anthocyanins in all five areas, largely mediated through gut microbiome interactions. Key research gaps remain around optimal dose, study population diversity, and mechanistic clarity, particularly for cognitive and metabolic outcomes.

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A beet-based supplement containing nitrates, caffeine, vitamin C, B-vitamins, and medicinal mushrooms reduced several inflammation-related proteins in cyclists after a 2.25-hour ride, specifically dampening proteins involved in complement activation and immune cell migration. It also raised two anti-inflammatory oxylipins and increased blood nitrate levels. The findings support a 2-week beet supplement as a multi-component countermeasure to exercise-induced inflammation.

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An untargeted metabolomics study comparing adults with healthy versus unhealthy lifestyles identified 486 metabolites and 16 biological pathways that differed between groups. Healthy adults had lower bile acids, higher vitamin D, more beneficial gut-derived plant metabolites, and a distinct amino acid profile — together forming a molecular signature consistent with longer life expectancy and lower chronic disease risk. Body composition was the strongest single driver of the metabolic differences between groups.

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A study of four surgical residency selection committees found that human reviewers could barely distinguish AI-generated personal statements from human-written ones — with only 55% accuracy and poor agreement between reviewers. Meanwhile, interviewers were seven times more likely to offer an interview to a perceived human author. As AI writing improves, the traditional personal statement may lose its value as a differentiating tool, and the residency application process may need to be restructured accordingly.

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This is a published correction to an earlier article on a digital therapy platform for young people with mental health problems. No new data is presented.

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A 20-year systematic review of 87 controlled trials found that regular exercise reliably reduces C-reactive protein, IL-6, and TNF-alpha in patients with autoimmune diseases including rheumatoid arthritis, lupus, and multiple sclerosis. Multi-modal exercise programs — combining aerobic and resistance training — produced the largest benefits. Single acute exercise sessions were not helpful and sometimes transiently increased inflammation, so clinical programs should focus on sustained moderate exercise.

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A network analysis of nearly 1,000 psychiatric patients across multiple diagnoses found that existential concerns — particularly autonomy and identity — were the most central nodes connecting to depression and anxiety symptoms. Loss of autonomy and identity uncertainty acted as hubs linking existential distress to clinical symptoms, suggesting these are high-priority intervention targets. The study adds a transdiagnostic lens to therapy by showing that addressing existential concerns could reduce symptom burden across disorders.

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A multi-cohort proteomics study tested whether blood protein levels could predict which high-risk individuals would later develop psychosis — and found that a previously published prediction model performed no better than chance in a new, larger sample. Some complement proteins showed weak group-level associations with transition, but none survived correction for multiple comparisons. The findings caution strongly against applying small-sample proteomics findings clinically without robust replication.

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The SELFIE trial tested a blended digital intervention combining face-to-face sessions and a smartphone app to improve self-esteem in 174 youth who had experienced childhood adversity. The intervention produced a moderate improvement in self-esteem that persisted at 6-month follow-up, along with benefits in positive affect, quality of life, and psychopathology. The study supports expanding access to this kind of low-intensity, technology-supported mental health intervention for trauma-exposed youth.

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Surveys of OR staff, nurses, and surgeons at an academic medical center identified that medical students most commonly fail to understand their role, break sterility, and lack situational awareness in the operating room. Two-thirds of respondents said students are not adequately prepared with basic surgical skills before entering the OR. The findings argue for pre-rotation training resources focused on OR etiquette, sterility, and basic procedural knowledge.

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This randomized crossover trial tested whether eating 330 grams of mango daily for two weeks would reduce post-exercise inflammation in cyclists after a hard 2.25-hour ride. Despite clear evidence that mango-derived gut metabolites were absorbed, mango had no effect on the large post-exercise spike in 49 oxylipins — the lipid mediators that coordinate inflammation. Mango did not act as an exercise anti-inflammatory supplement under these conditions.

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A digital peer- and clinician-moderated mental health platform (ENYOY) was tested in 131 Dutch youth with emerging mental health complaints over 12 months. Psychological distress dropped and psychosocial functioning improved significantly, with large effect sizes; gains held at one-year follow-up. The coaching calls were rated most helpful, and the platform showed promise as an accessible early-intervention tool that could help prevent more serious mental disorders.

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A proteomics study comparing adults with healthy vs. unhealthy lifestyles found that just 39 of 725 measured blood proteins differed meaningfully between groups. Healthy adults showed 18 proteins down — indicating lower innate immune activation — and 21 proteins up, pointing to better fat metabolism and HDL cholesterol remodeling. Adiposity was the strongest predictor of these protein differences, confirming that body fat is a central driver of the immune and metabolic signature of poor lifestyle.

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Eighteen days of blueberry supplementation (equivalent to one cup per day) shifted the oxylipin profile of untrained adults after 90 minutes of muscle-damaging eccentric exercise. Blueberries lowered levels of a pro-inflammatory oxylipin (diHOME) and raised levels of several anti-inflammatory DHA and EPA-derived compounds. These shifts correlated with the gut-derived blueberry phenolics in urine, suggesting that gut bacteria process blueberry compounds into anti-inflammatory signals — but blueberries did not reduce muscle soreness or damage.

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A systematic review and meta-analysis of 12 trials found that high-intensity interval training (HIIT), alone or combined with other exercise, significantly reduced both cancer-related fatigue and cancer-related pain compared to usual care. Effect sizes were moderate for fatigue and small-to-moderate for pain. The findings support HIIT as a practical tool for managing two of the most debilitating side effects of cancer and its treatment.

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Four weeks of astaxanthin supplementation (8 mg/day) did not reduce exercise-induced muscle damage, cytokines, or oxylipins in runners after a 2.25-hour bout. It did, however, prevent post-exercise drops in 82 immune-related proteins — particularly immunoglobulins — which recovered within 24 hours in the astaxanthin group but not in the placebo group. Astaxanthin appears to support immune protein maintenance after hard exercise, without broadly suppressing the inflammatory response.

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The COH-FIT survey — used in multiple pandemic mental health studies — was formally validated across 30 languages and over 22,000 adults. The composite psychopathology score (P-score) was confirmed as a valid and reliable measure of multidimensional mental health, with five underlying dimensions (anxiety, depression, post-traumatic, psychotic, and psychophysiologic symptoms) that held up consistently across age, sex, and language. This validation gives the instrument credibility for use in global mental health research.

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Surgeons and hernia experts were interviewed to describe the cognitive and physical steps involved in a complex hernia repair called transversus abdominis release. The analysis identified 80 specific subtasks, 36 cognitive behaviors, 17 decision points, and 9 fundamental principles. This is the first structured framework for teaching and assessing this procedure, providing a foundation for training programs and objective evaluation tools.

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A digital mental health platform for Dutch youth with emerging mental health complaints was tested for usability and user experience across three phases of user research. The platform showed adequate to high usability scores, and users found it safe, accessible, and helpful — especially the coaching calls. Five major usability problems were identified for the development team to fix, and users requested more peer activity on the social networking feature.

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A 4-week almond supplementation trial (57 g/day) in untrained adults found that almonds modestly reduced muscle damage markers, preserved leg strength, and improved mood after 90 minutes of eccentric exercise. Almonds also shifted the plasma oxylipin profile — raising a beneficial 12,13-DiHOME and lowering a harmful 9,10-DiHOME — an effect correlated with gut-derived almond phenolics in urine. The results suggest almonds support metabolic and muscular recovery from unaccustomed exercise.

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A proteomics analysis of people at clinical high risk for psychosis found that a 6-month increase in blood omega-3 fatty acids was linked to changes in 24 proteins, predominantly in the complement and coagulation pathway. Specifically, complement protein C5 mediated the relationship between omega-3 increases and reduced positive symptom severity, and coagulation factors mediated improvements in cognition. The study identifies a molecular pathway through which omega-3s may exert their effects in early psychosis.

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A secondary analysis of the NEURAPRO trial found that omega-3 supplements did not improve cognitive function in ultra-high-risk individuals compared to placebo over 6 months — and the placebo group actually showed slightly better improvement on composite cognitive scores. Blood levels of omega-3s also did not predict cognitive change, suggesting that adherence to the supplement is not the explanation. The results argue against omega-3s as a cognitive intervention in this population.

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This perspective piece argues that physical inactivity should be formally recognized as a risk factor for acute respiratory infections, on par with its established role in chronic disease. Large-scale studies during COVID-19 consistently showed that unfit or inactive individuals had worse outcomes. The author calls on physical activity guideline committees to explicitly add "reduced risk of respiratory infections" to the recognized benefits of exercise.