# Nutrition Journal

> Independent reporting and expert guidance on nutrition, diet, and healthy living, grounded in the latest research.

## How LA County Put Healthy Nutrition Rules Into Food Service Contracts

URL: https://nutritionjournal.com/how-la-county-put-healthy-nutrition-rules-into-food-service-contracts

Los Angeles County required healthy nutrition standards in food-service RFPs and contracts covering 100,000+ workers and about 37 million meals a year; a 2011-2021 evaluation details results.

Key takeaways:
- Los Angeles County's 2011 policy required healthy nutrition standards in food-service RFPs and vendor contracts.
- DPH review of 20+ RFPs from 2011-2021 helped 7 departments add standards to contracts.
- The system covers 100,000+ employees and about 37 million meals per year.
- Standards set limits for trans fat, sodium, calories, sugar and fat plus required fruit, vegetable and whole-grain offerings.
- Evaluation cited staffing, training and infrastructure barriers and iterative improvement.

TL;DR: Los Angeles County turned its food-service contracts into a nutrition intervention, requiring healthy standards in solicitations and vendor contracts serving more than 100,000 employees and millions of visitors.

Los Angeles County food vendors supply food or meals each year to more than 100,000 employees and millions of clients and visitors, according to the *Preventing Chronic Disease* article ["Integrating Healthy Nutrition Standards and Practices Into Food Service Contracting in a Large US County Government"](https://www.cdc.gov/pcd/issues/2024/23_0220.htm). In 2011, the County of Los Angeles Board of Supervisors adopted a policy to integrate healthy nutrition standards and practices into its requests for proposals (RFPs) and contracting process with food vendors, with a requirement that all awarded contracts adhere to the new standards. From 2011 through 2021, the Los Angeles County Department of Public Health (DPH) reviewed RFPs for food services and applied a 4-pronged formative–evaluative approach to help departments put the policy into contracts for new and renewing vendor agreements.

The implementation evaluation, published March 7, 2024, in Volume 21 of *Preventing Chronic Disease* as article 230220, reported that DPH review and follow-up on more than 20 RFPs helped 7 county departments incorporate healthy nutrition standards and practices into food vendor contracts. The evaluation used 13 key informant interviews, a 2-part survey, reviews of contract data, and synthesis of lessons learned. Authors Michelle Wood, Brenda Robles, Jacqueline Beltran and Tony Kuo concluded that standards can change the quality of food served, that implementation is feasible, and that staffing and training constraints and limited infrastructure created barriers addressed through iterative program improvement.

## Why the county used contracts as a health tool

Recent national data suggest that most of the U.S. population has or is at risk of developing chronic diseases such as diabetes, hypertension or heart disease, the evaluation reported. In Los Angeles County, 33.5% of adults reported in 2021 ever being diagnosed with hypertension or prehypertension and 12.1% with diabetes.

Diet plays a central role in development of chronic diseases, with diets high in sugar, sodium, saturated fat and trans-fatty acids and nutrients and ingredients in processed foods linked to chronic ailments, according to the same report. The Dietary Guidelines for Americans (DGA) encourage increased intake of fruits and vegetables, whole grains, dairy foods and lean proteins, and limited consumption of foods high in sodium, added sugars and saturated fat.

Since 2010, federal and local governments have increased efforts to integrate DGA-recommended nutrition standards and behavioral economics strategies into food service contracting processes. At the federal level, nutrition standards are derived from DGA and form the foundation of the Food Service Guidelines for Federal Facilities of the U.S. Department of Health and Human Services and the U.S. General Services Administration, intended for government-operated food services and as a model for population-level nutrition.

## Who the policy was designed to reach

The USDA SNAP-Ed Library entry ["Healthy Nutrition Guidelines for LA County"](https://snaped.fns.usda.gov/library/intervention/healthy-nutrition-guidelines-for-la-county) describes the county effort as the Healthy Food Procurement Initiative, a PSE Change intervention designed to improve the quality of food purchased and offered in food service contracts through nutrition standards. The 2011 Board motion titled Healthy Food Promotion in Los Angeles County Food Service Contracts directed departmental food procurement policies and practices related to nutrition and established a process for DPH to develop nutrition standards and healthy food procurement practices for new and renewing RFPs for food service and vending contracts.

The Board action sought to reach a broad jurisdiction of almost ten million residents. As of 2020, approximately 50% of the county population was Hispanic or Latino, 26% non-Hispanic white, 14% Asian and 8% Black, with nearly 32% foreign-born residents and about 17% living below the federal poverty line. In the same population profile, approximately 15% of children aged 10-17 were obese with body mass index above the 95th percentile, approximately 40% of adults were overweight with body mass index between 25 and 29.9, and another 24% were obese with body mass index above 30.

As an institutional policy, the procurement motion targeted more than 100,000 county employees, patrons who purchase food and beverages at county venues, and populations whose meals are provided by county venues and programs. The county distributes meals to youth, seniors, patients and incarcerated individuals, groups described as at greater risk for nutrition-related chronic disease and as economically disadvantaged. DPH estimated the action would affect the nutritional quality of approximately 37 million meals offered or sold in various county-operated settings per year.

## How many departments buy food

The County of Los Angeles has 37 departments and over 100,000 employees, according to the SNAP-Ed summary. An internal assessment found that 15 of the 37 departments procure, sell, serve or distribute food.

Since 2011, DPH partnered with 7 county departments on procurement work, including the Probation Department and the Department of Public Works. A 2018 county motion on food purchasing identified the departments working with DPH under the 2011 motion as the Probation Department, Chief Executive Office, Department of Beaches and Harbors, Department of Children and Family Services, Department of Health Services, Department of Parks and Recreation and Department of Public Works. That motion stated that DPH reviews all new and renewing food service RFPs to ensure dietary requirements integrated into final contracts promote healthy nutrition.

The 2018 motion also reported that DPH had integrated venue-specific nutrition standards, such as sodium limits, into more than 16 county food service RFPs or final contracts over the prior 7 years. The settings named for the SNAP-Ed intervention include community-wide locations, retail venues and worksites, serving preschool through high school students, pregnant and breastfeeding people, parents and caregivers, adults and older adults.

## What the nutrition standards require

DPH developed detailed Standards for Prepared Foods, Snacks and Beverages that apply to county departments operating their own food services and to county food service contractors. The document states that the standards seek to increase access to nutritious foods and reduce prevalence of diet-related chronic diseases for employees, visitors and individuals dependent on county-operated services.

For purchasing and serving overall, the standards require all items to contain 0 g trans fat. For sodium, purchasing requires all individual items to contain no more than 480 mg sodium per serving unless a lower category standard applies, while serving requires all meals to contain no more than 800 mg sodium, all entrees no more than 600 mg sodium and all side items no more than 230 mg sodium. For calories at serving, all entrees must contain no more than 700 calories, 50% of all entrees no more than 500 calories, and all side items no more than 200 calories, with a recommendation that prepackaged Grab-n-Go entrees contain no more than 500 calories per package. For fiber, purchasing recommends items with at least 2 g dietary fiber per serving when applicable, and serving recommends each entree contain at least 6 grams.

Beverage rules require access to and promotion of tap water at no cost and require 50% of beverages in cases and 50% of beverage options in fountain machines to offer only listed products: water with no caloric sweeteners; fruit-based and vegetable-based drinks that are 100% juice without added sweeteners and with no more than 230 mg sodium per serving; milk products including 1%, nonfat, lactose-free, lactose-reduced and fortified soy beverages; and beverages that do not exceed 25 calories per 8 ounces.

## Food-category rules for meals and snacks

Snack rules require 50% of snacks to meet per-item or per-package limits of no more than 7 g total fat per serving, no more than 2 g saturated fat per serving, no more than 5 g added sugar and no more than 10 g total sugar per serving, no more than 200 mg sodium per serving, and no more than 200 calories per serving, with at least 2 g dietary fiber if the item is grain or potato based. The snack section excludes legumes, nuts, nut butters, seeds, eggs, non-fried vegetables and cheese packaged for individual sale from the total-fat limit, excludes eggs and cheese packaged for individual sale from the saturated-fat limit, and excludes vegetables, fruit, trail mix and dried fruit with no added sugars from the sugar limits. It also requires at least 3 grain-based products to be 100% whole grain as labeled while meeting the other snack nutrient requirements.

Fruit purchasing requires canned fruit to be packaged in unsweetened 100% juice or water, not syrup, with a recommendation that dried, frozen, pureed or whole fruits have no added sugars. Fruit serving requires at least 3 fresh fruit options per meal service, 2 of which are intact, whole fruit options, with seasonal fruit recommended when possible.

Vegetable, bean, nut and seed purchasing requires canned or frozen vegetables, canned or frozen beans, and all nuts and seeds to contain no more than 290 mg sodium per serving. Serving requires at least 3 non-starchy vegetables that are not fried daily, including at least one raw, leafy green vegetable and at least one steamed, baked or grilled vegetable daily, with seasonal vegetables recommended and unsalted nuts and seeds recommended.

Grain, bread, baked-good and cereal purchasing requires 50% of grains and pasta to provide at least 3 g dietary fiber per serving; 50% of sandwich bread to contain no more than 180 mg sodium per slice and at least 2 g fiber per slice; 50% of baked goods to contain no more than 290 mg sodium and no more than 300 calories per serving; and 50% of cereals to contain no more than 5 g added sugar and no more than 10 g total sugar per serving, with cereals with dried fruit limited to no more than 17 g total sugar and meeting fiber and sodium rules, plus no more than 200 mg sodium and at least 2 g fiber per serving. Serving requires at least three 100% whole grain entrees or sides daily, with all grains recommended to be 100% whole grains.

Protein purchasing requires canned or frozen beef, pork, poultry and seafood to contain no more than 290 mg sodium per serving and processed meats to contain no more than 480 mg sodium per serving, with recommendations to purchase extra lean or lean meats and to minimize purchase of processed meats. Serving requires at least 2 of the proteins offered daily to be plant-based proteins, daily offerings of plant-based entrees, and non-fried seafood offered at least twice a week.

## What evaluation found about implementation

The evaluation described organizational barriers across phases of the process despite feasibility. Reported challenges included staffing and training constraints and limited infrastructure. An iterative approach to program improvement facilitated the process, according to the published results.

The SNAP-Ed summary lists five intervention components: institutional policy should include evidence-based nutrition standards and other procurement strategies that promote selection and consumption of healthy foods and beverages; policy should designate an organization or formal group to coordinate implementation; the coordinating organization should consult stakeholders affected by the policy, such as food service vendors and department leadership in charge of food service contracts, before implementation; the coordinating organization should have adequate resources for oversight, ongoing technical assistance and evaluation; and an organization or formal group should be authorized to evaluate and monitor the change. In Los Angeles County, DPH serves as both the coordinating organization and the evaluator and monitor.

Supporting materials developed by the DPH Division of Chronic Disease and Injury Prevention include the model policy Healthy Food Promotion in LA County Food Service Contracts, a Creating Healthy Food Environments policy brief, Nutrition Standards for Prepared Foods, Snacks, and Beverages including a 2021 revision, Board motion 3.115 County of Los Angeles Vending Machine Nutrition Policy, a case study on the vending program, a policy brief on working with public and private hospitals, and Eat Your Best promotional and technical assistance resources including signage posters, implementation guides and a cookbook to promote plant-forward menus. The county history cited in later Board reporting notes that in 2006 the Board adopted one of the first vending machine nutrition policies in the nation, followed by the 2011 food-service-contracts motion and 2024 motions encouraging more plant-based food options in county venues.

## SNAP-Ed Required Funding Ends With FY 2025 Grant

URL: https://nutritionjournal.com/snap-ed-funding-ends-fy2025-closeout-guide

Congress ended required SNAP-Ed funding with FY 2025; states must close grants or spend down by Sept. 30, 2026 and file final reports.

Key takeaways:
- Congress ended required SNAP-Ed funding with the FY 2025 grant under Section 10107 of Public Law 119-21, signed July 4, 2025.
- States may close the FY 2025 grant and return funds or spend FY 2025 funds in FY 2026, with full expenditure by Sept. 30, 2026.
- FY 2025 annual reports are due Jan. 31, 2026; FY 2026 reports for states that continued services are due Jan. 31, 2027.
- SNAP-Ed costs above grant funds are not eligible for SNAP administrative reimbursement.
- An April 20, 2026 federal notice renews reporting forms so states can file final reports, with comments due May 20, 2026.

TL;DR: Congress ended required federal funding for SNAP-Ed with the fiscal year 2025 grant, and states are now closing out or spending down their last awards under closeout rules.

The newest verified federal step is an April 20, 2026 information-collection notice that renews SNAP-Ed plan-and-report paperwork so states can file final annual reports before program closeout, with public comments due May 20, 2026.

## What changed for SNAP-Ed

On July 4, 2025, President Donald J. Trump signed Public Law 119-21, the One Big Beautiful Bill Act of 2025, according to the Food and Nutrition Service document titled Supplemental Nutrition Assistance Program Nutrition Education and Obesity Prevention Grant Program (SNAP-Ed) Questions and Answers.

Section 10107 of that law amends Section 28(d)(1)(F) of the Food and Nutrition Act, as amended, by ending required funding of SNAP-Ed with the fiscal year 2025 grant allocation, according to that same Food and Nutrition Service Questions and Answers memorandum dated August 13, 2025.

The practical effect is that there is no new required SNAP-Ed grant after FY 2025. The Food and Nutrition Service asked state agencies to notify it whether they will close the FY 2025 grant and return unspent funds or keep operating temporarily on FY 2025 funds into FY 2026.

The August 13, 2025 memorandum was signed by Ronald K. Ward, Acting Associate Administrator for the Supplemental Nutrition Assistance Program in the Food and Nutrition Service. It states that the agency was responding to questions received to date and would release additional question-and-answer documents in the future as needed.

States were directed to contact their respective Food and Nutrition Service regional offices with questions or requests for technical assistance.

## How large the wider SNAP law is

The end of required SNAP-Ed funding is one piece of a broader nutrition title that reduces federal SNAP spending, according to the Congressional Research Service report titled Supplemental Nutrition Assistance Program (SNAP) and Related Nutrition Programs in P.L. 119-21: An Overview.

That report, product number R48552 and updated August 15, 2025, says nutrition provisions in the FY2025 budget reconciliation law, sometimes referred to as the One Big Beautiful Bill Act, are estimated to reduce federal spending on SNAP. The Congressional Budget Office estimated that the nutrition subtitle would reduce federal spending by almost $187 billion over 10 years covering FY2025-FY2034, according to the Congressional Research Service overview.

The same overview says the new law significantly changes how SNAP benefits, administrative costs, and nutrition education costs are funded. It lists eight provisions that the Congressional Budget Office expects would cause less federal spending than under prior law.

The largest estimated savings come from benefit-related changes, because benefits have historically been about 95% of federal spending on the program, according to the Congressional Research Service overview. Those changes include moving from 100% federally funded benefits in all states to a required state cost share for states with error rates at or greater than 5%, changing treatment of energy assistance and internet costs in benefit calculations, expanding work-requirement age rules, changing eligibility for additional groups of noncitizens, and limiting authority to increase the Thrifty Food Plan.

Other savings come from administrative and grant changes, including increasing the state cost-share for SNAP administrative costs from 50% to 75% and ending mandatory funding for the Nutrition Education and Obesity Prevention Grant Program, known as SNAP-Ed, according to the Congressional Research Service overview.

The report cautions that a provision estimated to reduce or increase federal spending will not necessarily affect all states or households in the same way, because effects depend on the specific policy and federal and state implementation.

## Closeout timeline states must follow

The Food and Nutrition Service Questions and Answers memorandum sets two paths for unspent FY 2025 funds.

A state is not required to obligate and spend remaining FY 2025 funds in FY 2026. It may instead notify the Food and Nutrition Service of its intent to close the FY 2025 grant and return unexpended funding, according to the Food and Nutrition Service Questions and Answers.

A state that wants to keep spending FY 2025 funds in FY 2026 must submit a plan by August 15, 2025, or no later than August 31, 2025, if an extension is requested and approved. That plan should include an intent to expend funds by September 30, 2026.

States that continue into FY 2026 should expend all SNAP-Ed funds by September 30, 2026, and return any unexpended grant funds by that date, according to the Food and Nutrition Service Questions and Answers.

For states that choose to end programming promptly, the memorandum encourages written termination notice by August 15, 2025, and return of unexpended FY 2025 funds by December 1, 2025.

Termination notice follows 2 CFR 200.340(a)(3). A state agency may terminate the federal award by sending written notification stating the reason or reasons for termination, the effective date, and the dollar amount of unexpended funding, according to the Food and Nutrition Service Questions and Answers.

## Plans and annual reports still required

Even during closeout, reporting obligations continue for any state that delivered services.

A state agency that delivered SNAP-Ed services in FY 2025 must submit a SNAP-Ed annual report under Section 28(c)(8) of the Food and Nutrition Act of 2008, as amended. Those FY 2025 reports are due January 31, 2026, under 7 CFR 272.2(d)(2)(xiii), according to the Food and Nutrition Service Questions and Answers.

States that plan to spend FY 2025 funding in FY 2026 must submit a FY 2026 annual plan and budget under Section 28(c)(2) of the Act, as amended, according to the same Food and Nutrition Service Questions and Answers.

A state agency that delivered SNAP-Ed services in FY 2026 must submit an annual report under Section 28(c)(8). Those FY 2026 reports are due January 31, 2027, under 7 CFR 272.2(d)(2)(xiii), according to the Food and Nutrition Service Questions and Answers.

Requests to extend the August 15, 2025 plan due date must go through the SNAP-Ed Regional Coordinator. Coordinators may approve extensions up to August 31, 2025, according to the Food and Nutrition Service Questions and Answers.

The April 20, 2026 Federal Register notice titled Comment Request: SNAP-Ed State Plan and Report System explains why paperwork is being renewed despite the funding end. It states that Section 28(c)(2) requires states seeking funds to submit a Nutrition Education Plan by August 15 each year and Section 28(c)(8) requires states receiving grant funds to submit an annual report by January 31 each year.

That notice states the collection is being renewed for states to submit final annual reports prior to program closeout. State agencies, with support from contracted implementing partners including other state, local, and Tribal agencies and not-for-profit institutions, submit Form FNS-925B for the plan and Form FNS-925A for the annual report through N-PEARS.

The notice states that N-PEARS, the electronic State Plan and Annual Report System, launched in fiscal year 2023 to collect consistent data across states, support aggregation and evaluation, measure projects, and account for allowable administrative costs. Comments received by May 20, 2026 will be considered, according to the Food and Nutrition Administration notice.

## What funding level was on the table before the cut

Before enactment, states had been planning around a continued program. A May 30, 2025 Food and Nutrition Service memorandum on Fiscal Year 2026 Supplemental Nutrition Assistance Program Education Estimated Allocations shared estimated FY 2026 allocations to help agencies prepare plans by August 15, 2025.

Based on current estimates at that time, the agency projected the FY 2026 national SNAP-Ed allocation at $550,000,000 for planning purposes only, noting that actual amounts would differ as additional data were collected, according to that May 30, 2025 memorandum from Director Rachel Frisk.

The memorandum said final allocations were expected in summer 2025 to reflect changes in SNAP participation and the June 2025 Consumer Price Index for All Urban Consumers under the statutory formula in Section 28(d)(1)(F). It also stated that allocations are subject to availability of federal funds.

That planning figure did not survive the July 4, 2025 enactment, which ended required funding with the FY 2025 allocation, according to the later Food and Nutrition Service Questions and Answers.

## What the cutoff meant in communities

The national policy change translated quickly into local program endings, according to the Reuters article titled States to end nutrition education programs after Trump cuts, published September 30, 2025.

Reuters reported that states would end SNAP-Ed programs after September 30 and described the cuts as the first to nutrition programs from the spending bill. The article described the affected effort as a 30-year-old program that reached nearly 2 million people in 2022.

The article opened at a San Francisco senior living community where a nonprofit, Leah's Pantry, hosted an hour-long dance class. Reuters reported that Leah's Pantry has run nutrition and health programs around the city since 2006.

The example illustrates the type of community-level nutrition and physical-activity programming delivered with SNAP-Ed support: group classes for older adults combining movement, social connection, and practical lessons about healthier daily habits.

For consumers, the immediate consequence is fewer locally delivered classes, workshops, and community obesity-prevention activities where state and partner agencies close grants rather than spend down into FY 2026.

## Money rules during spend-down

States cannot shift leftover SNAP-Ed costs to regular SNAP administration funds.

SNAP-Ed services are not eligible for state administrative expenditure reimbursement, according to the Food and Nutrition Service Questions and Answers. Section 28(d)(3)(B) excludes costs of nutrition education and obesity prevention above SNAP-Ed grant funds from reimbursement under Section 16(a) administrative cost-sharing.

On whether appropriations could restore FY 2026 funding, the memorandum states that the Food and Nutrition Service monitors congressional appropriations actions and will provide additional information to states if needed.

## What to watch next

The near-term federal task is administrative closeout, not expansion. State plans due in August 2025 determine which states spend into FY 2026, annual reports due January 31, 2026 and January 31, 2027 document services delivered in FY 2025 and FY 2026, and unspent funds are to be returned by September 30, 2026 for states that continue or by December 1, 2025 for states that terminate promptly, according to the Food and Nutrition Service Questions and Answers.

The April 20, 2026 notice adds a final paperwork step, asking for comment by May 20, 2026 on renewed reporting instruments used for final reports, program evaluation, compliance review, and technical assistance, according to the Food and Nutrition Administration notice titled Comment Request: SNAP-Ed State Plan and Report System.

## Low-Fat vs Low-Carb: No Clear Winner for 12-Month Weight Loss

URL: https://nutritionjournal.com/low-fat-vs-low-carb-12-month-weight-loss-dietfits

DIETFITS randomized 609 adults to healthy low-fat or low-carb diets for 12 months; weight loss was similar and genotype and insulin did not predict success.

Key takeaways:
- Healthy low-fat participants lost 5.3 kg and healthy low-carbohydrate participants lost 6.0 kg at 12 months, a nonsignificant 0.7-kg difference.
- Genotype pattern did not modify diet effects, with a diet-genotype interaction P value of .20.
- Baseline insulin secretion (INS-30) did not modify diet effects, with a diet-insulin interaction P value of .47.
- DIETFITS randomized 609 adults aged 18-50 without diabetes and with BMI 28-40; 481 completed the trial.
- Both diets used 22 group sessions over 12 months and emphasized vegetables, whole foods, and avoiding added sugars and refined flour.
- There were 18 adverse or serious adverse events evenly distributed across diet groups.

TL;DR: In 609 overweight adults without diabetes, a healthy low-fat diet and a healthy low-carbohydrate diet produced similar 12-month weight loss, and neither genotype pattern nor insulin secretion predicted which diet worked better.

## Healthy low-fat and healthy low-carbohydrate diets tied at 12 months

In the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) randomized clinical trial, participants assigned to a healthy low-fat (HLF) diet lost a mean of 5.3 kg at 12 months, compared with a mean loss of 6.0 kg for participants assigned to a healthy low-carbohydrate (HLC) diet, according to the JAMA report titled Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion.

The mean between-group difference was 0.7 kg, with a 95% confidence interval of −0.2 to 1.6 kg, which was not statistically significant. The trial authors concluded that there was no significant difference in weight change between the two approaches over 12 months.

The study also tested two hypothesized predisposing factors: a 3 single-nucleotide polymorphism (SNP) multilocus genotype responsiveness pattern and baseline insulin secretion measured as INS-30, the blood concentration of insulin 30 minutes after a glucose challenge. Neither factor was associated with the dietary effect on weight loss in the primary analyses.

The interaction test for diet and genotype pattern yielded P = .20. The interaction test for diet and insulin secretion yielded P = .47. The investigators reported that neither of the two hypothesized factors was helpful for identifying which of the two diets was better for whom.

## Who enrolled and how the trial was timed

DIETFITS enrolled 609 adults aged 18 to 50 years without diabetes who had a body mass index (BMI) between 28 and 40. Mean age at randomization was 40 years, with a standard deviation of 7 years. Women comprised 57% of the randomized population.

Mean BMI was 33, with a standard deviation of 3. Mean baseline INS-30 was 93 μIU/mL. Among participants, 244 individuals, or 40%, had a low-fat genotype pattern, while 180 individuals, or 30%, had a low-carbohydrate genotype pattern.

Enrollment ran from January 29, 2013, through April 14, 2015. The date of final follow-up was May 16, 2016. Of the 609 participants randomized, 481 participants, or 79%, completed the trial.

Randomization assigned 305 participants to the HLF diet and 304 participants to the HLC diet. The trial was conducted by investigators at the Stanford Prevention Research Center in the Department of Medicine at Stanford University School of Medicine in Stanford, California, with collaboration from the Quantitative Sciences Unit, the Department of Health Research and Policy, the Department of Statistics, and the Department of Biomedical Data Science.

The corresponding author was Christopher D. Gardner, PhD, of the Stanford Prevention Research Center. Coauthors included John F. Trepanowski, Liana C. Del Gobbo, Michelle E. Hauser, Joseph Rigdon, John P. A. Ioannidis, Manisha Desai, and Abby C. King.

## What the two diet interventions actually required

Health educators delivered the behavior-modification intervention through 22 diet-specific small-group sessions administered over 12 months. Sessions focused on ways to achieve the lowest fat or carbohydrate intake that could be maintained long-term and emphasized diet quality.

Both groups were instructed to maximize vegetable intake. Participants were advised to choose nutrient-dense whole foods, to cook at home when possible, to avoid trans fats and added sugars, and to limit refined flour. Neither group received an explicit prescribed energy restriction or a specific calorie target in the intervention description.

For the HLF group, guidance centered on reducing total fat intake while selecting high-quality carbohydrate-containing foods, including vegetables, legumes, fruits, and whole grains. For the HLC group, guidance centered on reducing total carbohydrate intake while selecting high-quality fat-containing foods, including olive oil, avocado, hard cheeses, nuts, nut butters, and animal foods including grass-fed meats.

At 12 months, reported mean macronutrient distributions differed substantially between groups. In the HLF versus HLC groups, respectively, carbohydrates supplied a mean of 48% versus 30% of energy, fat supplied 29% versus 45%, and protein supplied 21% versus 23%.

Reported energy intake declined in both groups during follow-up. The trial collected dietary intake by unannounced 24-hour recalls at baseline and at follow-up points. Physical activity, body fat percentage, waist circumference, blood lipids, glucose, insulin, and other metabolic variables were also measured at baseline and follow-up.

There were 18 adverse events or serious adverse events that were evenly distributed across the two diet groups. The investigators reported no disclosures of potential conflicts of interest on the ICMJE forms.

## Why genotype and insulin secretion were tested

Previous research had suggested that genotype or insulin-glucose dynamics might modify diet effects. The trial protocol described a retrospective observation in which overweight women classified as appropriately matched versus mismatched to a low-fat or low-carbohydrate diet based on multilocus genotype patterns showed about a 3-fold difference in 12-month weight loss, with mean values near 6 kg versus 2 kg.

Those earlier patterns used SNPs from three genes relevant to fat and carbohydrate metabolism: PPARG, ADRB2, and FABP2. Combinations were classified as consistent with a low-fat-responsive genotype pattern, a low-carbohydrate-responsive genotype pattern, or neither of the two main patterns. By design, as described in the initial National Institutes of Health grant application, individuals with neither of the main two patterns were not included in the main genotype analyses.

Several earlier studies had also reported that baseline insulin dynamics might explain differential weight-loss success on diets varying in carbohydrate and fat. DIETFITS therefore prespecified INS-30 as a second hypothesized effect modifier. INS-30 was defined as the blood insulin concentration 30 minutes after consuming 75 g of glucose as part of a standard oral glucose tolerance test.

In statistical modeling, INS-30 was treated as a continuous variable. For presentation, participants were grouped into tertiles. The mean for the lowest tertile was 40.8 μIU/mL, with a range of 7.3 to 60.6 μIU/mL. The mean for the middle tertile was 80.1 μIU/mL, with a range of 60.7 to 103.1 μIU/mL. The mean for the highest tertile was 159.6 μIU/mL, with a range of 103.4 to 562.5 μIU/mL.

The three-way interaction term among diet, genotype, and the 12-month time point had a beta coefficient of 1.38, with a 95% confidence interval of −0.72 to 3.49. The three-way interaction term among diet, insulin, and the 12-month time point had a beta coefficient of 0.08 for each 10-μIU/mL increase in insulin, with a 95% confidence interval of −0.13 to 0.28.

Thirty-nine participants had compromised or missing DNA and could not contribute to genotype classification. The numbers of participants shown in weight-loss distributions reflected individuals who had weight data at both baseline and 12 months, while statistical analyses included data from all randomized individuals as described in the Statistical Analysis section, according to the article archived in PubMed Central under the same title.

## Baseline characteristics and measurement details

Mean weight at baseline was 97.5 kg in the HLF group and 96.3 kg in the HLC group. Among women, mean weight was 90.7 kg in the HLF group and 88.9 kg in the HLC group. Among men, mean weight was 105.7 kg in the HLF group and 106.8 kg in the HLC group.

Mean BMI was 33.4 in the HLF group and 33.3 in the HLC group. Mean body fat percentage was 36.3% in the HLF group and 36.5% in the HLC group. Among women, mean body fat was 41.0% versus 40.4%, respectively. Among men, mean body fat was 29.9% versus 30.3%, respectively.

Mean waist circumference was 107.2 cm in the HLF group and 106.7 cm in the HLC group. Among women, means were 103.5 cm versus 102.6 cm. Among men, means were 111.8 cm versus 112.7 cm.

Mean age was 39.3 years in the HLF group and 40.2 years in the HLC group. Women numbered 167 in the HLF group, or 54.8%, and 179 in the HLC group, or 58.9%. Men numbered 138 in the HLF group, or 45.2%, and 125 in the HLC group, or 41.1%.

White participants numbered 176 in the HLF group, or 57.7%, and 182 in the HLC group, or 59.9%. Hispanic participants numbered 67 versus 61, or 22.0% versus 20.1%. Asian participants numbered 30 in each group, or 9.8% versus 9.9%. African American participants numbered 10 versus 13, or 3.3% versus 4.3%.

Mean high-density lipoprotein cholesterol was 1.28 mmol/L in the HLF group and 1.29 mmol/L in the HLC group. Mean low-density lipoprotein cholesterol was 2.89 mmol/L versus 2.94 mmol/L. These lipid rows were later subject to a correction that changed units in Table 3 from mmol/L to mg/dL and reversed the corresponding conversion instructions, with corrections dated April 3, 2018, and April 24, 2018.

## Funding, oversight, and interpretation for food choices

The study was supported by grant 1R01DK091831 from the National Institute of Diabetes and Digestive and Kidney Diseases, funding from the Nutrition Science Initiative, grants 1K12GM088033 and T32HL007034 from the National Heart, Lung, and Blood Institute, and the Stanford Clinical and Translational Science Award. The funders had no role in design and conduct, collection, management, analysis, or interpretation, preparation, review, or approval, or the decision to submit for publication.

The article was accepted for publication on January 17, 2018, and published online on February 20, 2018. Dr Gardner had full access to all data and took responsibility for data integrity and accuracy of analysis. Concept and design credits listed Gardner, Rigdon, Ioannidis, Desai, and King. Statistical analysis credits listed Gardner, Del Gobbo, Hauser, Rigdon, Ioannidis, and Desai.

Study operations involved coordinators Jennifer Robinson and Antonella Dewell, health educators including Rise Cherin, Susan Kirkpatrick, Jae Berman, Dalia Perelman, and Mandy Murphy Carroll, a diet-assessment team, recruitment and blood-sample staff, statistical support staff, and administrative support. The authors acknowledged the 609 participants without whom the investigation would not have been possible.

For readers comparing eating patterns, the central result is that two diet-quality-focused strategies produced overlapping average losses, with wide individual variation within each group. The trial did not establish that a DNA test for the studied SNPs or a baseline 30-minute insulin value should guide selection between a healthy low-fat pattern and a healthy low-carbohydrate pattern.

Consumers considering either pattern can discuss diabetes status, lipid levels, medication use, food preferences, cooking resources, and ability to attend counseling sessions with a clinician or registered dietitian. People with diabetes were not included in the randomized population, so the weight-change estimates apply to adults without diabetes in the studied age and BMI ranges.

## Sources referenced
- Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial | JAMA (https://jamanetwork.com/journals/jama/fullarticle/2673150)
- Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial - PMC (https://pmc.ncbi.nlm.nih.gov/articles/PMC5839290/)

## FDA Expands Salmonella Sprouts Probe as Contaminated Seeds Trigger Recalls

URL: https://nutritionjournal.com/salmonella-sprouts-outbreak-september-2026-fda

FDA traces 32 Salmonella Bovismorbificans illnesses to broccoli sprouts and contaminated seed lots, prompting nationwide seed recalls.

Key takeaways:
- Do not eat, serve, or sell recalled broccoli sprouting seed lots; FDA investigation is ongoing.
- 32 illnesses, 3 hospitalizations, 0 deaths across ID, MN, MT, OR, UT, WA, with last onset Sept. 3, 2026.
- WGS matched outbreak Salmonella Bovismorbificans in patient, sprout, and supplier seed samples.
- Recalls include Gardeners Basics 1-lb bags, Eden Brothers lots 1022067/1022068, and Home Grown lot AUG172026.
- Evergreen Fresh Sprouts recalled 215 cases of broccoli sprouts delivered in WA Aug. 24-Sept. 2, 2026.
- Clean and sanitize contacted surfaces and contact a provider if Salmonella symptoms develop.

TL;DR: Do not eat, serve, or sell recalled broccoli sprouting seeds linked to a multistate Salmonella Bovismorbificans outbreak, according to the FDA's Outbreak Investigation of Salmonella: Sprouts (September 2026).

The U.S. Food and Drug Administration (FDA) says its investigation is ongoing and advises consumers, restaurants, and retailers not to use recalled lots of broccoli seeds.

The newest verified action, posted October 9, 2026, is a recall by Gardeners Basics of Spanish Fork, Utah, for one-pound bags of broccoli sprouting seeds, according to the FDA's Outbreak Investigation of Salmonella: Sprouts (September 2026).

## Outbreak at a glance

Federal investigators describe a multistate outbreak of Salmonella Bovismorbificans infections linked to broccoli sprouts and microgreens grown from a contaminated seed lot.

The FDA lists total illnesses at 32, with 3 hospitalizations, 0 deaths, and last illness onset on September 3, 2026.

Cases were reported from six states: ID, MN, MT, OR, UT, and WA. Product distribution is listed as nationwide.

The FDA states this outbreak is being investigated separately from the shiga toxin-producing E. coli and Salmonella outbreak linked to alfalfa sprouts.

The Centers for Disease Control and Prevention (CDC), in its Investigation Update: Salmonella Outbreak, September 2026, reports the same case total and notes the true number of sick people is likely much higher than reported because many people recover without medical care and are not tested.

## Who got sick and when

Illnesses started on dates ranging from July 7, 2026, to September 3, 2026, according to the FDA's Outbreak Investigation of Salmonella: Sprouts (September 2026).

Of 27 people interviewed, 26 — or 96% — reported eating sprouts or microgreens. Twenty-two reported specifically eating broccoli sprouts, and one reported eating a microgreen mix containing broccoli microgreens.

The CDC's Investigation Update: Salmonella Outbreak, September 2026 provides additional demographic detail for people with available information.

Ages ranged from 2 to 87 years, with a median age of 52 years among 29 people. Among 32 people, 53% were female and 47% were male.

Among 26 people with race information, 96% were White and 4% were Asian. Among 26 people with ethnicity information, 92% were non-Hispanic and 8% were Hispanic.

State and local officials asked about foods eaten in the week before illness. The CDC compares the 96% sprout exposure to 8.7% of respondents who reported eating any sprouts, including alfalfa, bean, or clover, in the FoodNet Population Survey.

## How laboratory testing linked seeds and sprouts

The FDA says it collected and analyzed a sample of seeds from the seed supplier identified in the investigation.

That seed sample tested positive, and whole genome sequencing (WGS) analysis showed it matched the same Salmonella Bovismorbificans strain that made people sick in this outbreak.

As a result, the seed supplier conducted a recall of the implicated seed lot and contacted customers, according to the FDA's Outbreak Investigation of Salmonella: Sprouts (September 2026).

Public health investigators are using the PulseNet system to identify illnesses that may be part of the outbreak. The CDC explains that PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses.

DNA fingerprinting is performed using WGS. The CDC states WGS showed bacteria from sick people's samples are closely related genetically, suggesting people got sick from the same food.

Officials in Montana collected an unopened package of broccoli sprouts from a sick person's home, and WGS showed it is the same outbreak strain.

Officials in Washington State collected and tested samples of broccoli sprouts from a local food co-op and a sick person's home. Both sprout samples tested positive, and WGS showed they are the same strain that made people sick, according to the CDC's Investigation Update: Salmonella Outbreak, September 2026.

## Which sprouts were recalled first

On September 10, 2026, Evergreen Fresh Sprouts LLC recalled 215 cases of broccoli sprouts.

The company announcement, posted as Evergreen Fresh Sprouts LLC Recalls Broccoli Sprouts Because of Possible Health Risk, says the firm is located in Moyie Springs, Idaho.

The recall covered 215 cases, with six 4-oz bags per case. The broccoli sprouts were packaged in clear plastic 4-oz zip lock bags with UPC code 8 38796 00105 1.

Affected Use By dates were 9/07/26, 9/09/26, 9/11/26, 9/14/26, and 9/16/26.

The sprouts were delivered to three distributors in Washington between August 24, 2026, and September 2, 2026, and may have been further distributed and sold in retail stores to consumers in ID, MT, and WA.

The company said it was notified its broccoli sprouts product had been related to a multistate outbreak that included 22 cases as of September 9, 2026.

The company also said a broccoli sprout with Use By date 9/16/26 tested positive for Salmonella by a third-party lab. The company said it ceased production and distribution of broccoli sprouts since September 4, 2026, and was conducting a root cause investigation.

The FDA now lists recalled broccoli sprouts grown by Evergreen Fresh Sprouts, LLC as past expiration and no longer available for sale.

## Seed recalls expanded the advisory in October

FDA traceback work shifted focus from finished sprouts to seed lots used to grow sprouts and microgreens at home and commercially.

On October 2, 2026, EAK Distribution of Casper, Wyoming, recalled Home Grown green sprouting broccoli seeds after it was notified of the recall of seed lot #W4105 by the seed supplier and the link to this outbreak.

On October 7, 2026, Eden Brothers LLC, of Arden, North Carolina, recalled calabrese broccoli seeds in packets and in 1-oz and 1-lb sizes after it was notified by its seed supplier that lot #W4105 may be contaminated with Salmonella.

The recalled Eden Brothers lots are 1022067 and 1022068, with supplier lot W4105, according to the FDA's Outbreak Investigation of Salmonella: Sprouts (September 2026).

The October 9, 2026, update added Gardeners Basics Waltham 29 Broccoli Sprouting Seeds in one-pound bags.

The FDA describes the package as a white and green resealable pouch, net weight 1 pound (454 g), with UPC 848137042889. The bag is marked Packed for 2027.

The FDA says it is continuing to work with the supply chain and that the advisory will be updated if additional downstream recalls are initiated.

## Where recalled seeds were sold

The FDA lists nationwide distribution for the recalled seed products still relevant to home sprouters.

Recalled Gardeners Basics one-pound bags were distributed nationwide in the United States and sold on Amazon, www.gardenersbasics.com, TikTok Shop, Walmart, eBay, and Etsy.

Recalled Eden Brothers calabrese broccoli seeds were sold to customers nationwide through Edenbrothers.com and Amazon.com between July 8 through September 28, 2026.

Recalled Home Grown green sprouting calabrese broccoli seeds were sold to consumers nationwide through Amazon.com between August 20, 2026, and September 18, 2026.

The FDA describes the Home Grown product as 8-oz heirloom seeds sold on Amazon, with lot code AUG172026 embossed on the top seal.

Consumers can contact Evergreen Fresh Sprouts at 1-208-267-4258, Monday through Friday, 7 a.m. to 2 p.m. GMT, for questions about the sprout recall.

## What Salmonella symptoms look like

Illness usually occurs within 12 to 72 hours after eating food contaminated with Salmonella, and symptoms usually last four to seven days.

Symptoms include diarrhea, fever, and abdominal cramps, according to the FDA's Outbreak Investigation of Salmonella: Sprouts (September 2026).

Children younger than five, the elderly, and people with weakened immune systems are more likely to have severe infections.

The company announcement for Evergreen sprouts adds that healthy persons infected with Salmonella often experience fever, diarrhea which may be bloody, nausea, vomiting, and abdominal pain.

In rare circumstances, infection can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections, endocarditis, and arthritis.

The CDC notes most people with Salmonella illness recover without antibiotics. Laboratory analysis found bacteria from 30 people's samples and two food samples had no predicted antimicrobial resistance.

Bacteria from two people's samples were predicted to be resistant to streptomycin, sulfisoxazole, and tetracycline. The CDC states this resistance is unlikely to affect the choice of antibiotic used to treat most people if antibiotics are needed.

## What to do now

Consumers, restaurants, and retailers should not use recalled lots of broccoli seeds.

Customers who purchased or received recalled broccoli sprouts or broccoli seeds should carefully clean and sanitize any surfaces or containers that they touched.

The FDA advises following its safe food handling and cleaning advice to reduce the risk of cross-contamination. Restaurants and retailers should follow FDA's Food Safety Tips.

Contact your health care provider if you have symptoms that resemble a Salmonella infection after eating recalled broccoli sprouts or handling recalled broccoli seeds.

The CDC advises people not to eat, sell, or serve recalled broccoli sprouts produced by Evergreen Fresh Sprouts LLC. If recalled sprouts remain in the home, the CDC advises throwing them out or returning them.

## Sources referenced
- Outbreak Investigation of Salmonella: Sprouts (September 2026) | FDA (https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-salmonella-sprouts-september-2026)
- Investigation Update: Salmonella Outbreak, September 2026 | CDC (https://www.cdc.gov/salmonella/outbreaks/broccoli-sprouts-09-26/investigation.html)

## How FDA Studies Food Behavior: Labels, Kitchen Safety, and Recall Alerts

URL: https://nutritionjournal.com/fda-food-behavioral-science-fsans-recall-research

FDA's Human Foods Program tracks label use, hand washing, thermometer habits, and recall responses through FSANS and rapid outbreak surveys.

Key takeaways:
- FDA's Human Foods Program studies perceptions and behaviors on food safety, nutrition, labeling, recalls, supplements, and infant formula.
- FSANS 2019 surveyed 4,398 U.S. adults in Oct-Nov 2019 using address-based mail-push-to-web methods.
- 87% had looked at Nutrition Facts; Calories, Total Sugar, Sodium and Serving Size topped label interests.
- Hand washing was 76% after touching raw meat, 68% before preparing food, and 39% after cracking eggs.
- 62% owned a food thermometer, but use fell from whole birds and roasts to burgers, egg dishes and frozen meals.
- FDA updated outbreak advisories after 2021 template interviews and 2023 focus groups, plus rapid surveys on strawberry, flour and applesauce recalls.

**TL;DR: FDA's Human Foods Program uses social and behavioral science — including its 4,398-person 2019 Food Safety and Nutrition Survey and rapid recall surveys — to track how U.S. adults handle food, read labels, and respond to outbreak warnings.**

## What the food behavior research program studies

According to the FDA's page titled Social and Behavioral Science Research (Food), social and behavioral scientists in the Human Foods Program study perceptions and behaviors across food safety, nutrition, food labeling, food additives, food adverse events and recalls, biotechnology, dietary supplements, infant formula, and other food-related areas.

The same page explains why perception work matters for regulation. The findings help the agency understand how consumers and other stakeholders perceive and react to food safety risks, health and nutrition information, and FDA advice to consumers and industry. Improving home food safety practices or dietary choices requires expanding knowledge and changing attitudes and behavior, the agency notes, and the research helps target resources and increase the effectiveness of educational materials and regulatory programs.

The team is deliberately multidisciplinary. Researchers hold graduate degrees in psychology, sociology, agricultural economics, nutritional sciences, public health, and public policy. Their tool kit includes national probability surveys, experimental studies, focus groups, in-depth interviews, and social media listening, with the method chosen to fit the research question.

Two standing efforts organize much of the public output: the Food Safety and Nutrition Survey, known as FSANS, and the Research Program on Foodborne Illness Outbreaks and Food Recall Communications.

## FSANS: FDA's premier consumer survey

According to the FDA's page titled 2019 Food Safety and Nutrition Survey Report, FSANS is the agency's premier national probability consumer survey for awareness, knowledge, understanding, and self-reported behaviors on food safety and nutrition topics. The findings are intended to support regulatory, policy, education, and other risk-management decisions aimed at promoting and protecting public health.

FSANS combined two earlier separate efforts, the Food Safety Survey and the Health and Diet Survey. The 2019 round used address-based sampling with a mail-push-to-web design, rather than the telephone interviews used in earlier years. The survey population was adults age 18 and older in the 50 states and the District of Columbia, with 4,398 responses collected during October and November of 2019.

Weighting and adjustment are central to how FDA presents the results. Frequencies were weighted to account for sampling design and non-response, with base weights adjusted using sample-frame information on Census region and single- or multi-unit housing, the number of adults per household, and demographic controls from the 2014-2018 five-year American Community Survey data for sex, age, race, Hispanic origin, education, Census region, and residence in a metropolitan area.

FDA released the results in March 2021 and later provided an interactive access point. According to the FDA constituent update titled FDA Releases Food Safety and Nutrition Survey Results, the agency released the FSANS Explorer web tool on November 9, 2021, after first announcing the 2019 results on March 16, 2021. The Explorer lets users examine relationships between survey answers and demographic characteristics, display answers through tables and charts, and perform statistical tests of response relationships.

## Home versus restaurant risk perceptions

FSANS found a clear gap between perceived risk at home and in restaurants. Only 15% of respondents said it was very common for people to get food poisoning because of the way food is prepared at home, compared with 29% who said it was very common because of the way food is prepared in restaurants.

Expectations about contamination also differed sharply by food type. More respondents said raw chicken at 93% and raw beef at 66% were likely or highly likely to have germs than said the same about raw vegetables at 9% or fruit at 6%. That pattern matters for consumer education because produce can also carry pathogens along the farm-to-plate continuum, even when shoppers associate risk mainly with meat.

Awareness of specific organisms was uneven. Awareness was high for Salmonella at 97% and E. coli at 88%, but comparatively low for Campylobacter at 7% and Vibrio at 4%. For nutrition educators and food safety communicators, the contrast suggests that familiar pathogen names do not translate into broad microbiological literacy.

## Hand washing and thermometer habits

Hand washing varied by moment rather than being a single habit. Consumers were more likely to report washing hands with soap after touching raw meat at 76% than before preparing food at 68% or after cracking raw eggs at 39%. The egg figure is especially relevant because cracking eggs is often treated as a clean task, while hands can transfer contamination to other surfaces and foods.

Thermometer ownership was common, but use depended on the dish. Sixty-two percent of respondents reported owning a food thermometer. Among owners who cooked the relevant food, reported use ranged from 85% for whole chickens and 79% for beef, lamb, or pork roasts down to 40% for chicken parts, 36% for burgers, 23% for egg dishes, and 20% for frozen meals.

The gradient points to a practical message for healthy home cooking: ownership alone does not ensure safe internal temperatures for thinner, smaller, or egg-based items. Roasts and whole birds prompt more thermometer checks, while burgers, parts, egg dishes, and frozen meals lag despite similar needs for temperature verification.

## How shoppers use Nutrition Facts and menu calories

Label engagement was widespread. Eighty-seven percent of respondents had looked at the Nutrition Facts label on food packages. The four items consumers most often said they looked for were Calories, Total Sugar, Sodium, and Serving Size. Reported uses centered on judging how high or low a food is in items such as calories, salt, vitamins, or fat, getting a general idea of nutritional content, and comparing different foods with each other.

Package claims were also highly visible. More than 80% of respondents had seen claims such as No added sugar, Whole grain, Organic, Gluten-free, Low fat, No artificial ingredients, Low sugar, and No artificial colors. High exposure to front-of-package language helps explain why FDA pairs label education with work on claims, so shoppers can place marketing phrases alongside the standardized Nutrition Facts panel.

Restaurant menu labeling had reached most respondents by late 2019. Seventy percent reported seeing calorie information on menus and menu boards. Among those who had seen it, 53% reported using it, most often to avoid ordering high-calorie menu items. The finding links a policy intervention — visible calories at the point of choice — to a concrete reported behavior at ordering time.

## Recall and outbreak communication research

According to the FDA page titled Research Program on Foodborne Illness Outbreaks and Food Recall Communications, social and behavioral scientists in the Human Foods Program lead a dedicated program to improve FDA communication during foodborne illness outbreaks and food recalls.

The program tested the templates FDA uses in fast-moving events. In July 2021, researchers conducted 36 online one-on-one in-depth interviews with U.S. consumers age 18 and older to test safety alert and outbreak advisory templates. Based on those findings, FDA updated its Outbreak Advisory template with more plain language, moved the product name and images to the top, and added concise bullets.

A second qualitative round followed in June 2023. Researchers held eight online focus groups of four to six participants each with U.S. adults to better understand experiences with food recalls and to gather feedback on the updated outbreak advisory template. FDA said it is using those findings to further strengthen outbreak advisory messaging.

## Quick-turnaround surveys during active recalls

To collect data while a recall or outbreak is still evolving, the program built a survey questionnaire repository, or question bank, for quick-turnaround consumer surveys. Each survey is designed to take about 15 minutes, allowing 50 to 60 questions. Topics can include awareness and perception of the recall or outbreak, possession of recalled products and behaviors during the recall, emotions, information sources and trust, usual consumption of the implicated foods, demographics, and related covariates.

Data are collected through a consumer web panel operated by Dynata. The target sample is 1,200 respondents per survey, with quotas used to balance the sample to U.S. population demographics.

Three completed surveys illustrate the approach. A quick-turnaround survey on a frozen strawberries recall associated with a hepatitis A outbreak was fielded March 31 through April 5, 2023, with 1,234 U.S. adults. A survey on a flour recall associated with a Salmonella outbreak was fielded May 17 through May 21, 2023, with 1,208 U.S. adults. A survey on a cinnamon applesauce pouches recall associated with elevated lead levels was fielded November 17 through November 26, 2023, with 1,543 U.S. adults, including an oversample of 1,175 parents with young children ages 6 months to 8 years.

## Why this evidence base matters for households

Taken together, the FSANS and recall-communication projects show how FDA connects everyday kitchen behavior to regulatory communication. National estimates on hand washing, thermometer use, label reading, and menu-calorie use give program planners a baseline, while interviews, focus groups, and rapid surveys reveal whether warnings are seen, understood, and acted upon.

For consumers, the practical threads are consistent: treat produce washing and egg handling as safety steps, use a thermometer beyond large roasts, compare package claims with the Nutrition Facts panel and serving size, and check outbreak advisories for product names, images, and action bullets when a recall affects the home.

## Sources referenced
- Social and Behavioral Science Research (Food) | FDA (https://www.fda.gov/food/science-research-food/social-and-behavioral-science-research-food)
- 2019 Food Safety and Nutrition Survey Report | FDA (https://www.fda.gov/food/social-and-behavioral-science-research-food/2019-food-safety-and-nutrition-survey-report)

## One Bad Apple Spoils the Bunch? How Food Recalls Reshape Eating

URL: https://nutritionjournal.com/food-recall-category-avoidance-spillover

Yes — 60% avoid a whole food category after a recall, but purchase data show spillover fades in about a week as shoppers substitute.

Key takeaways:
- 60% of Americans have avoided an entire food category such as lettuce after a recall, per September 2025 GS1 US survey data.
- Seafood purchases show negative within-species spillover and positive cross-species substitution after recalls.
- Direct recall effects lasted ~4 weeks for recalled brands and ~1 week for unrecalled products in 2010-2022 data.
- After the 2006 spinach E. coli outbreak, spinach spending fell but other leafy-greens spending rose to almost offset it.
- 59% hesitate to repurchase the same brand; 57% discard food even when their region was not impacted.
- FSMA Rule 204 would require traceability data within 24 hours, with a proposed deadline of July 20, 2028.

TL;DR: Yes — one recalled brand can temporarily suppress purchases across an entire food category, but shoppers usually substitute nearby foods and return within weeks.

## Answer: recalls spill beyond the recalled brand

Food recalls rarely stop at the named product. A September 8, 2025 consumer survey commissioned by [GS1 US](https://www.gs1us.org/industries-and-insights/media-center/press-releases/food-safety-recall-survey) found that 60% of Americans say they have avoided an entire food category, such as lettuce, following a recall. That headline result is the newest verified signal in a pattern documented across purchase data and outbreak histories: according to the European Review of Agricultural Economics study [Balancing health benefits and risks: Consumer responses to seafood recalls](https://doi.org/10.1093/erae/jbaf028), recalls reduced purchases of both recalled and unrecalled brands of the affected species, while according to the USDA Economic Research Service report [Consumers’ Response to the 2006 Foodborne Illness Outbreak Linked to Spinach](https://www.ers.usda.gov/amber-waves/2010/march/consumers-response-to-the-2006-foodborne-illness-outbreak-linked-to-spinach), spinach expenditures fell after federal warnings and shoppers briefly pulled back from leafy greens as a group.

The reassuring second half is that broad avoidance tends to be short and substitution-driven. The seafood analysis found direct effects on recalled brands lasted approximately 4 weeks, while spillover to unrecalled products persisted for only about 1 week, with households increasing purchases of unrecalled species as a substitute. The spinach history showed a similar rebalancing, with the longer-term drop in retail expenditures on fresh spinach products almost matched by gains in expenditures on other leafy greens.

For nutrition, the takeaway is practical: treat a recall as a temporary product-specific alert, keep eating vegetables, protein foods and dairy from unaffected categories, and check lot, brand and origin details before cutting out a whole food group.

## How common is category-wide avoidance?

According to the GS1 US Food Safety Recall Survey, concern runs alongside confidence. While 85% of Americans believe food recalls are effective in protecting public health and safety, 93% are concerned about how frequently they occur.

Behavior shifts reported in that survey included:

- 60% say they have avoided an entire food category, such as lettuce, following a recall.
- 59% report hesitancy to purchase the same product or brand again after a food recall.
- 57% admit to discarding recalled food even if their state or region was not impacted.

Generational differences were pronounced. Hesitancy to buy the same product or brand again was reported by 65% of millennials and 64% of Gen Z, compared with 53% of baby boomers. Discarding food even when the respondent’s state or region was not impacted was most common among millennials at 70%.

The survey attributed recalls to a variety of reasons, including contamination with bacteria like salmonella or E. coli, undeclared allergens, the presence of foreign objects or even mislabeling. GS1 US president and CEO Bob Carpenter said improved tracking tools, barcoding standards and traceability requirements are evolving to help identify and remove affected products.

A separate June 18, 2025 poll reported by [YouGov](https://yougov.com/articles/52384-brand-trust-falls-after-food-recalls-with-1-in-6-reporting-strong-impact) found that nearly a fifth, at 18%, of U.S. adults report having purchased a food product that was later recalled in the past six months. Among those affected, fruits or vegetables at 52% and eggs at 48% topped the list of most frequently recalled purchases, followed by meat or poultry at 44% and milk or dairy at 40%. Other items cited included beverages like juice or plant-based milk at 39%, snack foods such as chips or granola bars at 37%, fresh or packaged salads at 32%, and ice cream or frozen yogurt at nearly a third, or 30%.

## What shoppers do after a recall

Disposal is the dominant immediate step. In the YouGov results, the most common reaction was discarding the recalled products, reported by 41%. Nearly a third, at 30%, stopped consuming the product altogether, while 26% returned the product to the store. Fewer sought compensation: 23% requested a refund or replacement, and 9% contacted the manufacturer or store. A significant portion, at 18%, reported taking no action at all.

How people learn about recalls shapes how broadly they react. Around two-fifths of affected consumers, at 39%, said they first heard the news through media coverage. Fewer were alerted directly by stores via email or text at 12%, or through personal networks like family and friends at 13%. Government websites like the FDA’s at 6%, brand websites at 6%, and product packaging at 5% played smaller roles in notification.

Trust effects were measurable. Polling data showed food recalls have had a tangible effect on consumer trust, with 31% of those impacted reporting a moderate loss of trust in the brand in the excerpt available from YouGov.

The GS1 US findings point in the same direction on repeat purchase: 59% reported hesitancy to purchase the same product or brand again. For nutrition continuity, that hesitancy matters more when it widens from one label to a whole category, because skipping all lettuce, all seafood or all eggs removes nutrients that an unaffected brand or species could still supply.

## Case study: the 2006 spinach E. coli outbreak

The spinach episode remains the clearest U.S. example of a narrow warning producing broad, then re-sorted, consumption changes. According to the USDA Economic Research Service, consumers responded to the Food and Drug Administration’s September 2006 warnings to avoid eating spinach because of possible contamination with E. coli O157:H7.

The sequence was fast and unusually sweeping. On September 14, 2006, FDA announced that consumers should not eat bagged spinach, defined as fresh ready-to-eat spinach that comes into retail stores already in bags. The next day, FDA expanded the warning to include all fresh spinach, both bulk and bagged, with bulk defined as fresh spinach sold in bunches or loose for consumers to bag. Stores and restaurants immediately removed spinach from shelves and menus. Spinach harvesting and marketing ceased, and there was no U.S. fresh spinach on the market for 5 days until FDA announced spinach grown in some areas was safe to consume. The main spinach production area was off the market for an additional 10 days until cleared by FDA.

The human toll counted by ERS was 204 illnesses across 26 states and one Canadian province, including 104 hospitalizations, 31 cases of hemolytic-uremic syndrome and 3 deaths. On September 29, FDA announced that spinach on the shelves is as safe as it was before this event, at a point when the contaminated product was no longer in the marketplace. The agency had identified one brand of bagged spinach as the contaminated product but could not determine exactly how the spinach had become contaminated.

ERS research found that consumers generally responded specifically to FDA’s announcement in the sense that spinach sales plunged without panic about other vegetables, yet the short-term impact was a drop in demand for all leafy greens as consumers briefly substituted other vegetables for leafy greens. Over the longer term, consumers shifted purchases among leafy greens, but total expenditures for leafy greens did not change. While spinach expenditures fell, consumers turned to other leafy greens as substitutes, and the longer-term drop in retail expenditures on fresh spinach products was almost matched by gains in expenditures on other leafy greens.

That pattern matters for healthy eating. The FDA announcement surprised consumers and acted as a market shock that disrupted typical purchase patterns, in ERS terms. Consumers typically substitute one product for another based on relative prices, but they may also substitute based on food-safety characteristics, turning to another leafy greens product they think is safer. Because other bagged leafy greens have similar packaging and brand names and are displayed on the same shelves, ERS noted those attributes could have led some shoppers to initially view similar-looking products as equally risky.

## What purchase data show about spillover

A newer purchase-based test comes from seafood. Using weekly NielsenIQ data from 2010 to 2022, Virginia Tech researcher Xi He examined household purchases of recalled brands and spillover to unrecalled brands of the same species and to unrecalled species, as summarized in Balancing health benefits and risks: Consumer responses to seafood recalls.

The study found recalls reduced purchases of both recalled and unrecalled brands of the affected species, demonstrating negative within-species spillover effects. It also found households increased purchases of unrecalled species as a substitute, reflecting positive cross-species spillover effects.

Duration was brief. Direct impacts on recalled brands lasted approximately 4 weeks, while spillover effects on unrecalled products persisted for only about 1 week. In other words, the “don’t eat anything like it” phase faded quickly, and protein rotation resumed.

The result aligns with earlier brand-level work cited in that literature, including the analysis of the Peter Pan peanut butter recall published as The Impact of Food Safety Incidents Across Brands: The Case of the Peter Pan Peanut Butter Recall. The consistent lesson is that collective reputation dips after an incident, then recovers, with unaffected sellers initially caught in the downdraft.

For shoppers balancing benefits and risks, seafood is a sensitive case because federal dietary guidance encourages seafood intake while advisories warn specific groups about mercury in certain species. General consumer-education research on fish has examined how risk and benefit information shifts choices, but the 2010-to-2022 purchase results suggest most recall-driven avoidance is a short substitution, not a lasting exit from the category.

## How to respond without losing nutrients

Check scope before you skip. Recalls name a brand, product, size, lot code, date range or growing region. If your bag, carton or can does not match, or your state or region was not impacted, discarding everything in the category removes healthy options without added safety. The GS1 US finding that 57% discard even when their area was not impacted shows how often precaution overshoots the notice.

Swap, don’t stop. When spinach was unavailable, shoppers who moved to other leafy greens kept vegetable spending intact. When a seafood species was recalled, buyers in the NielsenIQ data lifted purchases of unrecalled species. Romaine, leaf lettuce, iceberg, frozen spinach, canned fish, eggs, beans, poultry or dairy can hold the line on fiber, potassium, calcium, vitamin A, vitamin C, iron and omega-3s while one item is sidelined. Choose the substitute that fits your usual meal pattern rather than pausing vegetables or protein altogether.

Use faster alerts and keep records. Because only 12% in the YouGov sample learned about recalls from a store email or text and only 6% from a government website like the FDA’s, signing up for retailer notifications and checking receipts helps narrow the response. Keeping packaging until food is used makes lot checks possible.

Traceability rules aim to shrink the gray area. Regulation taking shape includes FSMA Rule 204, part of the Food Safety Modernization Act signed into law in 2011. The rule adds stricter recordkeeping for foods most often implicated in recalls, such as leafy greens, shell eggs and nut butters among others on the FDA’s Food Traceability List, and requires that full traceability data needed to support a recall be made available to FDA within 24 hours. FDA recently proposed to extend the implementation deadline until July 20, 2028. GS1 US said it is helping industry apply standards to enhance supply chain visibility and enable rapid identification of affected products, with guidance including the FSMA Rule 204 Implementation Guideline.

The bottom line echoes the research title posed a decade ago in Food Policy by Whitney O. Peake, Joshua D. Detre and Clinton C. Carlson: [One bad apple spoils the bunch? An exploration of broad consumption changes in response to food recalls](https://doi.org/10.1016/j.foodpol.2014.06.006). The evidence says yes, briefly — then shoppers sort safe from suspect and fill the plate again.

## ADAPT Trial Tests Adaptive Diet and Exercise Steps for Prediabetes Weight Loss

URL: https://nutritionjournal.com/adapt-prediabetes-weight-loss-smart-trial

A 16-week SMART in adults with prediabetes found similar weight loss with calorie-restricted high- and reduced-carbohydrate diets, greater fasting-glucose improvement with high-carbohydrate counseling, and no rescue advantage from adding time-restricted eating versus exercise counseling.

Key takeaways:
- ADAPT was a 16-week group-based SMART testing calorie-restricted high-carbohydrate versus reduced-carbohydrate diets in adults with BMI ≥27 and prediabetes.
- Weight loss at week 16 was similar between diet groups, with a 0.15 kg difference and wide confidence interval.
- High-carbohydrate counseling improved fasting glucose more than reduced-carbohydrate counseling by 8.0 mg/dL.
- A1c, fasting insulin, and insulin-sensitivity index did not differ between diet groups.
- Among week-4 nonresponders, adding time-restricted eating versus exercise counseling did not differentially change outcomes.
- Early nonresponders lost less weight overall despite added counseling, suggesting need for more intensive strategies.

TL;DR: In the 16-week ADAPT trial in adults with overweight or obesity and prediabetes, calorie-restricted high-carbohydrate and reduced-carbohydrate diets produced similar weight loss, but the high-carbohydrate counseling lowered fasting glucose more.

## What ADAPT asked about diet sequence

The central question was which combination and order of eating and activity strategies best supports weight loss and cardiometabolic health in adults with overweight or obesity and prediabetes, according to the PMC article titled “Adaptive dietary and exercise strategies for weight loss in Adults with Prediabetes Trial (ADAPT): a sequential multiple assignment randomized trial.”

The investigators focused on three widely used approaches: restricting dietary carbohydrate, limiting the daily eating window, and adding exercise. The background section notes that each approach is commonly used for weight loss and glycemic control, yet the optimal combination and sequence remained unclear.

The trial team enrolled adults with a body mass index of 27 kg/m² or higher who had prediabetes. The study was conducted by researchers in the Department of Family and Community Medicine and the Department of Nutrition Sciences at the University of Alabama at Birmingham, with a collaborator in the School of Medicine at the University of Missouri–Kansas City, according to the PubMed record for the ADAPT trial.

The full report appeared in The American Journal of Clinical Nutrition as volume 122, issue 4, pages 1093–1102 in October 2025, according to that PubMed record. The PMC version of the same report was posted on August 7, 2025. The trial was registered at ClinicalTrials.gov as NCT04745572.

## Why researchers used a SMART design

ADAPT used a Sequential Multiple Assignment Randomized Trial, often called a SMART, delivered as a 16-week group-based weight-loss program.

The rationale described in the PMC article is that conventional behavioral programs deliver many diet, exercise, and behavior-change components at once. That bundled approach makes it difficult to identify the contribution of each component and does not efficiently guide when to modify treatment based on early response.

A SMART is designed to develop and evaluate dynamic treatment regimens and to allow evaluation of individual treatment components. The article explains that this structure can help identify who is likely to succeed with fewer or less costly components and reserve more intensive or costly components for people who do not meet early goals.

ADAPT applied that logic in two stages. All participants first received calorie-restricted dietary counseling. Only participants who did not meet an early weight-loss threshold were randomly assigned a second time to an added strategy. That second randomization is the defining feature of the adaptive design.

## How the first diet stage worked

In total, 83 adults were initially randomized to either a calorie-restricted reduced-carbohydrate diet, abbreviated RC, or a calorie-restricted high-carbohydrate diet, abbreviated HC, according to the PubMed abstract.

The initial diet assignment continued through the 16-week program. The trial did not test ad libitum eating; both first-stage prescriptions were calorie-restricted weight-loss diets that differed in carbohydrate content.

Response was judged at week 4. Participants who had lost less than 2.5% of starting weight at that assessment were classified as nonresponders. Those participants were then rerandomized to augment the initial diet with either time-restricted eating counseling or exercise counseling.

Of the 82 participants who completed week 4 assessments, 46 were nonresponders, representing 55.4% of that assessment sample. Among those rerandomized, 22 were assigned to add time-restricted eating and 24 were assigned to add exercise counseling.

The assessment sample that reached week 4 averaged 53.8 years of age with a standard deviation of 11.7 years, was 84.3% female, and had a mean body mass index of 38.3 with a standard deviation of 7.2, according to both the PMC article and the PubMed abstract.

## What happened to body weight

Weight loss at week 16 was similar between the two initial diet assignments.

The estimated difference between HC and RC was 0.15 kg, with a 95% confidence interval from −1.86 to 2.16 kg and a P value of 0.88, according to the PubMed abstract. In practical terms, the analysis did not detect a weight-loss advantage for either carbohydrate level when calories were restricted.

The conclusions describe the overall group-based program as producing clinically significant weight loss that was similar between the calorie-restricted HC and RC diets. That wording indicates that participants lost a meaningful amount of weight on average, but the carbohydrate prescription did not separate the groups.

Early response mattered more than diet label. The results state that less weight loss was achieved among early nonresponders compared with responders, despite the addition of time-restricted eating or exercise counseling after week 4. In other words, participants who lost at least 2.5% by week 4 finished with larger losses than participants who missed that milestone, even though the latter group received an additional intervention.

## What changed for blood sugar and insulin

Although weight change was similar, fasting glucose changed differently between diet groups.

The HC group showed greater improvement in fasting glucose than the RC group, with an estimated difference of −8.0 mg/dL, a 95% confidence interval from −15.29 to −0.67 mg/dL, according to the PubMed abstract. The conclusion restates this finding as counseling to follow an HC diet reduced fasting glucose compared with RC counseling.

Other glycemic and insulin-related measures did not differ significantly between HC and RC. The results list glycated hemoglobin, commonly called A1c, fasting insulin, and quantitative insulin sensitivity check index, known as QUICKI, as outcomes without a difference between the two diet assignments.

Among nonresponders, the choice of second-stage augmentation did not differentially affect any study outcomes. Assignment to time-restricted eating versus exercise counseling after week 4 did not produce different changes in the measured weight or cardiometabolic outcomes.

The trial therefore separated two ideas that are often linked. Carbohydrate level did not alter 16-week weight loss under calorie restriction in this sample, but it was associated with a different fasting glucose response. Adding a second counseling component did not overcome the gap between early responders and nonresponders.

## Context from diabetes prevention research

The PMC article places ADAPT in the context of the Diabetes Prevention Program, known as DPP. The DPP lifestyle program is described as a highly effective but complex behavioral package.

That program used 16 individually delivered behavioral counseling sessions over 24 weeks, supervised exercise, individualized maintenance strategies, and a toolbox of incentive strategies. Its activity target included engaging in 150 or more weekly minutes of physical activity. Its dietary advice was characterized by low fat intake at 25% of energy, moderate protein intake at 15% to 20% of energy, and relatively higher carbohydrate intake at 55% to 60% of energy, according to the PMC article.

The article notes that some evidence has suggested carbohydrate reduction may be more effective than a low-fat, high-carbohydrate pattern for weight loss, particularly in people with prediabetes or diabetes. It also notes more recent interest in changing the timing rather than the content of eating.

Time-restricted eating is described as constricting daily food intake to a shortened window, typically 4 to 10 hours per day. The background cites prior research showing modest weight loss and improved glycemic control with that approach, including in people with prediabetes. ADAPT tested whether adding that timing strategy after an initial diet would help people who were not losing weight early.

## What nonresponse may require next

The authors conclude that patients with obesity and prediabetes who are unable to achieve early weight loss may require more intensive and costly intervention strategies to improve obesity treatment outcomes.

The examples named are meal provisions and supervised exercise. That statement does not report that those intensive options were tested in ADAPT; it presents them as the type of higher-intensity approach that may be needed when counseling alone does not produce early loss.

The finding points toward stepped care rather than simply adding another counseling message. In ADAPT, nonresponders received additional counseling on either eating timing or exercise, yet their 16-week weight loss remained lower than that of early responders. The authors interpret that pattern as a signal that a different intensity level, rather than another low-intensity addition, may be necessary.

For consumers and clinicians, the practical distinction is between starting strategy and rescue strategy. The starting strategy in this trial could be either calorie-restricted HC or RC counseling for weight loss, with HC showing an added fasting-glucose benefit. The rescue strategy of adding time-restricted eating or exercise counseling did not differentially change outcomes for nonresponders in this 16-week group program.

The registration NCT04745572 provides the formal trial record at ClinicalTrials.gov, with the University of Alabama at Birmingham listed as sponsor and Holly Wyatt listed as the responsible party. The published report lists R. Drew Sayer as corresponding author and lists Katie M. Ellison as first author, with coauthors Aseel El Zein, Navneet Kaur Baidwan, Christine C. Ferguson, Lauren Adele Fowler, David R. Bryan, Chelsi Reynolds, Dalton Hermanson, Kelly J. Berg, Tapan Mehta, James O. Hill, and Holly R. Wyatt.

## Sources referenced
- Adaptive dietary and exercise strategies for weight loss in Adults with Prediabetes Trial (ADAPT): a sequential multiple assignment randomized trial - PMC (https://pmc.ncbi.nlm.nih.gov/articles/PMC12674035/)
- Adaptive dietary and exercise strategies for weight loss in Adults with Prediabetes Trial (ADAPT): a sequential multiple assignment randomized trial - PubMed (https://pubmed.ncbi.nlm.nih.gov/40763896/)

## Salmonella Outbreak in Moringa Supplements Reaches 119 Cases, Triggers Recalls

URL: https://nutritionjournal.com/salmonella-moringa-supplement-outbreak-2026-recall

Washington health officials report 119 illnesses and 32 hospitalizations in 36 states from Salmonella in moringa supplements, with nationwide recalls of powders and capsules.

Key takeaways:
- Multistate Salmonella outbreak tied to moringa leaf powder reached 119 cases and 32 hospitalizations in 36 states by June 1, 2026, with no deaths.
- Washington had one case and one hospitalization in Benton County, with no new state cases since January 15, 2026.
- Recalls cover Live It Up Super Greens powders, TNVitamins and Doctor's Pride moringa capsules, and Why Not Natural moringa capsules.
- Contaminated moringa leaf powder from India was identified as the common ingredient sold online and nationwide.
- Consumers should discard or return recalled lots and wash contacting surfaces with hot soapy water or a dishwasher.
- Seek care for fever over 102°F with diarrhea, bloody diarrhea, prolonged diarrhea, uncontrolled vomiting, or dehydration.

TL;DR: A multistate Salmonella outbreak tied to moringa leaf powder in nutritional supplements reached 119 illnesses and 32 hospitalizations across 36 states by June 1, 2026, prompting multiple nationwide recalls, according to the Washington State Department of Health.

## Outbreak grew from 45 to 119 cases in under five months

Federal and state investigators first flagged the event on January 15, 2026, when the Centers for Disease Control and Prevention, the Food and Drug Administration and public health agencies in several states and local jurisdictions opened an inquiry into Salmonella infections linked to Live It Up Super Greens supplement powders, according to the Washington State Department of Health.

At that starting point, 45 people in 21 states were infected. Twelve people had been hospitalized. No deaths were reported.

By January 30, 2026, the same health department reported that the outbreak had been traced to contaminated moringa leaf powder used as an ingredient in Live It Up Super Green supplement powders. The case count had climbed to 65 outbreak-associated illnesses from 28 states. Fourteen people had been hospitalized. No deaths had occurred.

By June 1, 2026, CDC and several states had identified additional illnesses tied to the same outbreak strain, according to the Washington State Department of Health. Epidemiologic information indicated the newer illnesses may be linked to moringa supplements produced by Total Nutrition, Inc. The national total reached 119 cases and 32 hospitalizations from 36 states. No deaths were linked to this outbreak strain in the department's updates.

The department's page lists the status for this event as ongoing and lists recall as yes. Its last update was recorded as June 01, 2026.

## Washington recorded one linked case, with no new cases since January

Washington's role in the larger investigation remained limited to a single confirmed outbreak case, according to the Washington State Department of Health.

The original January 15, 2026 post stated that one adult Washington resident from Benton County was included in the outbreak. The county table attached to the June update continues to show Benton County with one case and a statewide total of one case.

The quick-facts summary for Washington lists one case, one hospitalization and zero deaths.

Critically for local readers, the department stated that no new salmonellosis cases associated with this moringa leaf outbreak have been identified in Washington since January 15, 2026. That finding held through the June 1, 2026 update, even as national numbers continued to rise.

Residents who suspect foodborne illness or want to report unsafe food handling at a Washington establishment are directed to use the Foodborne Illness Notification System, known as FINS.

## Contaminated moringa leaf powder was the common ingredient

Investigators concluded that contaminated moringa leaf powder was the vehicle, rather than a finished flavor or single brand alone, according to the Washington State Department of Health.

The January 30, 2026 update described contaminated moringa leaf powder as an ingredient in Live It Up Super Green supplement powders. The June 1, 2026 update added that epidemiologic information showed newer illnesses may be linked to moringa supplements produced by Total Nutrition, Inc.

That ingredient focus explains why recalls later spanned powders and capsules from different labels. The Food and Drug Administration's Outbreak Investigation of Salmonella: Moringa Leaf Powder (January 2026) states that recalled products containing imported moringa leaf powder from India should no longer be available for sale, and advises consumers to check homes for recalled products and throw those products away or contact the company to request a refund.

According to that FDA investigation page, recalled dietary supplements with moringa leaf powder were primarily sold online at the TNVitamins, Doctor's Pride, Live it Up, and Why Not Natural company websites, and other online sites, including Amazon, eBay, and Walmart.

The FDA page for the January 2026 investigation notes that CDC declares the outbreak over and that FDA's outbreak investigation has closed. The Washington State Department of Health page, last updated June 1, 2026, continued to list the event status as ongoing.

## Live It Up powders recalled across flavors and forms

Live it Up Super Greens supplement powders were the first products publicly linked in January, according to the Washington State Department of Health.

The department states the powders were sold nationwide in the United States, including Puerto Rico, Guam, and Virgin Islands. The recall covered certain lots and batches of Live it Up Super Greens supplement powders, including the Original and Wild Berry flavors, with expiration dates from August 2026 to January 2028.

More precise lot guidance appears in the Food and Drug Administration's Outbreak Investigation of Salmonella: Moringa Leaf Powder (January 2026). That page states that all Live it Up-brand Super Greens dietary supplement powder, including both original and wild berry flavors, with lots beginning with the letter "A" and all stick pack products with expiration dates from 08/2026 to 01/2028 have been recalled.

Consumers holding those powders are told not to eat, sell or serve them. The department links to the Live it Up Super Greens Recall notice at FDA for full recall details.

Because supplement powders have a long shelf life, officials warn that recalled containers could still be in kitchen cabinets months after purchase.

## Total Nutrition and Why Not Natural capsules added to recall list

The scope widened on May 27, 2026, when Total Nutrition, Inc. recalled two brands of moringa capsules sold nationwide through online platforms and company websites, according to the Washington State Department of Health.

The first label was TNVitamins Ultra Potent Complete Green Superfood Moringa 10,000 mg in 120-capsule bottles. Listed lots were Lot 2507199 with expiration date 9/2027, Lot 2512-304 with expiration date 2/2028, and Lot 2793 with expiration date 2/2028.

The second label was Doctor's Pride Complete Green Superfood Ultra Potent Moringa 10,000 mg in 120-capsule bottles. The listed lot was Lot 2507199 with expiration 9/2027.

The FDA's Outbreak Investigation of Salmonella: Moringa Leaf Powder (January 2026) lists additional lots under the same Total Nutrition recall. It cites TNVitamins-brand 100% Organic Moringa Capsules 1,200 mg lot 2800 EXP: 2/2028, TNVitamins-brand 100% Moringa Powder lot 2782 Exp: 5/2028, plus TNVitamins-brand Ultra Potent Complete Green Superfood Moringa capsules 10,000 mg lots 2507199 EXP 09/2027, 2512-304 EXP 02/2028, 2793 EXP 02/2028, 2748 EXP 07/2027, 2725 EXP 04/2027, and 2503104 EXP 04/2027, and Doctor's Pride Complete Green Superfood Ultra Potent Moringa 10,000 mg lots 2507199 EXP 09/2027, 2748 EXP 07/2027, and 2725 EXP 04/2027.

A separate capsule product was also recalled. Why Not Natural Pure Organic Moringa Green Superfood capsules with lot # A25G051 and expiration date 07/2028 marked on the bottom of the bottle have been recalled, according to that FDA investigation page. The Washington State Department of Health describes the same product as a 120-capsule bottle sold nationwide.

## What Salmonella infection looks like

Salmonellosis is a bacterial infection often spread through the fecal-oral route, through contaminated food and water, or through contact with animals and their environments, according to the Washington State Department of Health.

Symptoms listed by the department include nausea, vomiting, diarrhea, headache, fever, chills, and abdominal cramping. Illness typically lasts several days, and people can spread infection to others even after symptoms resolve.

The Food and Drug Administration's outbreak pages add timing detail. Illness usually occurs within 12 to 72 hours after eating food contaminated with Salmonella, and symptoms usually last four to seven days. Symptoms include diarrhea, fever, and abdominal cramps. Children younger than five, the elderly, and people with weakened immune systems are more likely to have severe infections.

## When to call a clinician

Health officials urge anyone who ate a recalled supplement to watch for severe disease and seek care promptly.

Contact a healthcare provider right away if you have diarrhea and a fever higher than 102°F, diarrhea for more than three days that is not improving, bloody diarrhea, so much vomiting that you cannot keep liquids down, or signs of dehydration, according to the Washington State Department of Health.

Dehydration warning signs listed include not peeing much, dry mouth and throat, and feeling dizzy when standing up.

Tell the provider that you consumed a recalled moringa product so the exposure is documented.

## How to handle recalled supplements at home

Do not eat any recalled dietary supplements. Throw them away or return them to where you bought them, according to the Washington State Department of Health.

Wash items and surfaces that may have touched the recalled dietary supplements using hot soapy water or a dishwasher. That step is intended to limit cross-contamination in kitchens where powder can spread to counters, scoops, bottles, shakers and utensils.

The Food and Drug Administration's Outbreak Investigation of Salmonella: Moringa Leaf Powder (January 2026) gives the same core instruction. It states that consumers and retailers should not eat, sell, or serve recalled TNVitamins, Doctor's Pride, Why Not Natural, or Live it Up-brand dietary supplements containing moringa leaf powder, noting the long shelf-life means consumers should check homes and throw recalled supplements away.

Retailers are separately advised not to sell or serve recalled dietary supplements and to wash and sanitize items and surfaces that may have come in contact with recalled dietary supplements.

## Everyday steps that lower Salmonella risk

Beyond the specific recalls, the Washington State Department of Health lists three routine food-safety habits.

Wash hands with soap and water after going to the bathroom, changing diapers, touching animals, and before eating or preparing food. Cook all meats thoroughly, especially poultry. Wash cutting boards and counters used for meat or poultry preparation immediately after use to avoid cross-contaminating other foods.

Those measures do not remove contamination already inside a sealed supplement, which is why officials emphasize checking lot numbers and expiration dates rather than trying to cook, rinse or salvage recalled powder or capsules.

Anyone still holding Live It Up Super Greens powder with an expiration date from August 2026 to January 2028, Total Nutrition capsules in the listed lots, or Why Not Natural capsules in lot A25G051 expiring 07/2028 should treat the product as recalled, discard or return it, and clean surrounding surfaces.

## Sources referenced
- 2026 Salmonella Multistate Outbreak Linked to Powdered Nutritional Supplements Containing Moringa Leaf Powder | Washington State Department of Health (https://doh.wa.gov/you-and-your-family/illness-and-disease-z/foodborne-illness/outbreaks/2026-salmonella-multistate-outbreak-linked-powdered-nutritional-supplements-containing-moringa-leaf)
- Outbreak Investigation of Salmonella: Moringa Leaf Powder (January 2026) | FDA (https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-salmonella-moringa-leaf-powder-january-2026)

## FDA Lists 15 Active Foodborne Illness Investigations in New Update

URL: https://nutritionjournal.com/fda-foodborne-illness-outbreak-investigations

FDA's CORE teams list 15 active foodborne illness investigations, with new case counts for chicken wraps and Listeria and an updated raw milk cheese advisory.

Key takeaways:
- FDA's CORE Response Teams list 15 active foodborne illness investigations in varying stages.
- E. coli O26:H11 raw milk cheese advisory was updated Oct. 9, 2026 with international distribution details.
- E. coli O157:H7 linked to suspect chicken wraps rose from 38 to 50 cases.
- Listeria ref #1417 rose from 44 to 46 cases; Cyclospora ref #1392 adjusted from 235 to 240.
- Salmonella Oranienburg ref #1387 is marked ended; three 2026 cases moved to closed with public abstracts.
- Advisories with consumer steps exist for raw milk cheese, sprouts, alfalfa sprouts, jalapeños and iceberg lettuce.

TL;DR: FDA's CORE teams are actively tracking 15 foodborne illness investigations, with the newest updates adding international distribution details for raw milk cheese and higher case counts for chicken wraps and Listeria clusters.

## FDA's active outbreak list centers on 15 CORE investigations

The list of outbreak and adverse event investigations primarily being managed by FDA's CORE Response Teams covers investigations in a variety of stages, meaning that some have limited information, while others may be near completion, according to the [Investigations of Foodborne Illness Outbreaks | FDA](https://www.fda.gov/food/outbreaks-foodborne-illness/investigations-foodborne-illness-outbreaks).

The agency notes that not all recalls and alerts result in an outbreak of foodborne illness and directs readers to check recent Food Recalls and Safety Alerts for that separate information.

A public health advisory will be issued for investigations that have resulted in specific, actionable steps for consumers to take to protect themselves, with the most up to date information on the investigation and consumer protection information on those pages.

Investigations that do not result in specific, actionable steps for consumers may or may not conclusively identify a source or reveal any contributing factors. Adverse event investigations rely on self-reported data. Although these reports may name a particular product, FDA will only indicate a product category in the table and will not publicly name a specific product until there is sufficient evidence to implicate that product as a cause of illnesses or adverse events. If a cause and/or contributing factors are identified that could inform future prevention, FDA commits to providing a summary of those findings.

## What's new: cheese advisory update and rising case counts

For the outbreak of *E. coli* O26:H11 (ref #1419) linked to raw milk cheese, the outbreak advisory was updated on October 9, 2026, to include international distribution information. FDA has initiated sample collection for that investigation.

For the outbreak of *Listeria monocytogenes* (ref #1415), FDA has initiated sample collection.

For the outbreak of *E. coli* O157:H7 (ref #1421) linked to multi-ingredient chicken wraps, the case count has increased from 38 to 50.

For the outbreak of *Listeria monocytogenes* (ref #1417), the case count has increased from 44 to 46.

For the outbreak of *Salmonella* Bovismorbificans (ref #1411), FDA updated the outbreak advisory with downstream product recalls and sampling information.

For the outbreak of *Cyclospora* (ref #1392), the case count has been adjusted from 235 to 240.

For the outbreak of *Salmonella* Oranienburg (ref #1387), the outbreak has ended.

Three investigations were moved to the Closed 2026 Table with Executive Incident Summary Abstracts now accessible by clicking the reference number: *Salmonella* Enteritidis (ref #1378) linked to shell eggs, *Salmonella* Typhimurium, Newport, and Richmond (ref #1358) linked to moringa leaf powder, and *Clostridium botulinum* (ref #1383) linked to infant formula.

## Ongoing investigations with advisories point to cheese, sprouts and peppers

The Active Investigations table lists five investigations with Ongoing See Advisory status where consumers are referred to detailed advisory pages.

Reference #1419, posted 9/25/2026, involves *E. coli* O26:H11 linked to Raw Milk Cheese, with total case count listed as See Advisory. Traceback, inspection and sampling have been initiated, and recall status is listed as See Advisory.

Reference #1411, posted 9/10/2026, involves *Salmonella* Bovismorbificans linked to Sprouts, with total case count listed as See Advisory. Traceback and sampling have been initiated, and recall status is listed as See Advisory.

Reference #1394, posted 8/19/2026, involves *E. coli* (multiple strains) and *Salmonella* Agona linked to Alfalfa Sprouts, with total case count listed as See Advisory. Traceback, inspection and sampling have been initiated, and recall status is listed as See Advisory.

The advisories for 2026 catalogued in [Public Health Advisories from Investigations of Foodborne Illness Outbreaks | FDA](https://www.fda.gov/food/outbreaks-foodborne-illness/public-health-advisories-investigations-foodborne-illness-outbreaks) include *E. coli* O26:H11: Raw Milk Cheese (September 2026), *Salmonella*: Sprouts (September 2026), *E. coli* and *Salmonella*: Sprouts (August 2026), and *Salmonella*: Jalapeño (August 2026).

Reference #1395, posted 7/22/2026, involves *Salmonella* Javiana linked to Jalapeño Peppers, with total case count listed as See Advisory. Traceback, inspection and sampling have been initiated, and recall status is listed as See Advisory. Its outbreak/event status is listed as Ended See Advisory, indicating the event portion is marked ended while the investigation remains active.

Reference #1390, posted 7/15/2026, involves *Cyclospora* linked to Iceberg Lettuce, with total case count listed as See Advisory. Traceback, inspection and sampling have been initiated, and recall status is listed as See Advisory. Its outbreak/event status is listed as Ended See Advisory.

## Chicken wraps and three Listeria clusters remain without full resolution

Reference #1421 (USDA 2026-04), posted 9/23/2026, involves *E. coli* O157:H7 linked to multi-ingredient wrap with chicken described as suspect, with 50 cases. Traceback, inspection and sampling have been initiated. Its outbreak/event status is listed as Ongoing See Advice.

Three separate *Listeria monocytogenes* investigations list the linked product as Not Yet Identified and remain with Ongoing See Advice status.

Reference #1415, posted 9/30/2026, lists 11 cases, with traceback, inspection and sampling initiated.

Reference #1417, posted 9/23/2026, lists 46 cases, with traceback initiated.

Reference #1379, posted 7/22/2026, lists 11 cases, with traceback, inspection and sampling initiated.

The table instructs readers with Ongoing See Advice status to review general advice pages rather than a product-specific advisory. For people who think they have symptoms, FDA advises talking to a healthcare provider and public health officials and providing details of what was eaten before becoming sick, noting this often aids in helping solve emerging or ongoing outbreaks.

## Large Salmonella Newport cluster and ended Cyclospora files

Reference #1403, posted 8/26/2026, involves *Salmonella* Newport with product Not Yet Identified and 116 cases. Traceback and sampling have been initiated. Its outbreak/event status is listed as Ongoing See Advice.

Reference #1402, posted 8/12/2026, involves *Salmonella* I 4,[5],12:i:- with product Not Yet Identified and 43 cases. Traceback, inspection and sampling have been initiated. Its outbreak/event status is listed as Ended See Advice.

Reference #1398, posted 8/5/2026, involves *Cyclospora* with product Not Yet Identified and 22 cases. Traceback and sampling have been initiated. Its outbreak/event status is listed as Ended See Advice.

Reference #1392, posted 7/22/2026, involves *Cyclospora* with product Not Yet Identified and 240 cases. Traceback and sampling have been initiated. Its outbreak/event status is listed as Ended See Advice.

Reference #1385, posted 7/8/2026, involves *Cyclospora* with product Not Yet Identified and 38 cases. Traceback and sampling have been initiated. Its outbreak/event status is listed as Ended See Advice.

Reference #1387, posted 7/8/2026, involves *Salmonella* Oranienburg with product Not Yet Identified and 99 cases. Traceback, inspection and sampling have been initiated. Its outbreak/event status is listed as Ended See Advice.

The distinction between Investigation Status and Outbreak/Event Status matters because FDA keeps some investigations active after the event is marked ended, allowing follow-up work such as traceback review or sampling to continue.

## Closed 2026 investigations add public summaries

The What's New section identifies three investigations moved to the Closed 2026 Table where the Executive Incident Summary Abstract can now be accessed by clicking the reference number.

Reference #1378 involves *Salmonella* Enteritidis linked to shell eggs. Reference #1358 involves *Salmonella* Typhimurium, Newport, and Richmond linked to moringa leaf powder. Reference #1383 involves *Clostridium botulinum* linked to infant formula.

Those abstracts are post-response deliverables prepared after closure of investigations primarily managed by FDA's Coordinated Outbreak Response and Evaluation Response Teams, according to agency background on the abstracts program.

The broader advisory archive shows the range of 2026 topics that reached the advisory stage, including *Salmonella*: Eggs (July 2026), *Cyclospora*: Iceberg Lettuce (July 2026), *E. coli*: Frozen Blueberries (July 2026), Infant Botulism: Powdered Infant Formula (June 2026), *Listeria monocytogenes*: Soft Cheese (June 2026), *Salmonella*: Moringa Leaf Powder (May 2026), *E. coli*: Raw Cheddar Cheese (March 2026), *Salmonella*: Moringa Powder (February 2026), and *Salmonella*: Moringa Leaf Powder (January 2026).

## What consumers should check next

Readers should direct attention to advisory pages for the most up to date information on any investigation with specific, actionable steps to protect themselves.

For sprouts, raw milk cheese, alfalfa sprouts, jalapeño peppers and iceberg lettuce files, the Active Investigations table uses See Advisory markers for case counts or recalls, meaning the advisory page rather than the table holds the detailed consumer information.

For files marked Ongoing See Advice or Ended See Advice without a named product, the table points to general advice and does not name a specific product for consumers to avoid. FDA states it will not publicly name a specific product until there is sufficient evidence to implicate that product.

Anyone with possible symptoms is advised to contact a healthcare provider and public health officials with details of foods eaten before becoming sick.

## Food Recalls Change What Americans Eat, 2025 Surveys Show

URL: https://nutritionjournal.com/consumer-responses-food-recalls-2025-surveys

2025 surveys show 85% call recalls effective but 93% worry about frequency, with 60% avoiding whole food categories after alerts.

Key takeaways:
- 85% say recalls protect health, but 93% worry about frequency, per GS1 US September 2025.
- 60% avoided an entire food category after a recall; 59% hesitated to rebuy the same brand.
- 18% bought a recalled product in six months; 41% threw it away and 30% stopped eating it.
- 48% first learned of recalls via news or TV; only 6% heard first from a federal agency.
- 73% support loyalty-card alerts and 67% want text alerts for recalls.

TL;DR: Most Americans still trust food recalls to protect health, but new 2025 surveys show recalls now trigger broad avoidance, disposal, and loss of brand trust.

New survey data from 2025 show a split in how Americans respond to food recalls: confidence in recalls as a safety tool remains high, while worry about how often recalls happen is even higher. According to the GS1 US survey released September 8, 2025, 85% of Americans believe food recalls are effective in protecting public health and safety, yet 93% say they are concerned about how frequently recalls occur. That tension helps explain why reactions often go beyond the specific recalled lot to include avoiding whole categories, throwing food away, and hesitating to buy the brand again.

## How many people are hearing about recalls?

Awareness is widespread. According to the International Food Information Council Spotlight Survey: Americans' Perceptions of Food Recalls, September 2025, three in four respondents — 75% — remembered hearing about a food recall recently. The survey was conducted online among 1,001 adults ages 18 and older from June 7-13, 2025.

What people remember most often involves familiar fresh foods. In that IFIC survey, more respondents remembered recent recalls for ground beef at 29% and romaine lettuce at 28% than for other foods, while 25% did not remember hearing about any food recalls recently.

A separate poll of affected shoppers adds detail on which categories show up in personal experience. According to YouGov reporting published June 18, 2025, nearly a fifth — 18% — of U.S. adults said they had purchased a food product that was later recalled in the past six months. Among those affected, fruits or vegetables at 52% and eggs at 48% topped the list, followed by meat or poultry at 44% and milk or dairy at 40%.

Other recalled purchases reported by that affected group included beverages such as juice or plant-based milk at 39%, snack foods such as chips or granola bars at 37%, fresh or packaged salads at 32%, and ice cream or frozen yogurt at nearly a third — 30%.

## Why shoppers think recalls are rising

Most consumers believe recalls are becoming more frequent. In the IFIC survey, 74% believed food recalls are becoming more frequent, with 39% saying the statement is true and 35% saying it is likely true. Only 14% said it is false or likely false, while 13% were unsure.

That perception matters for confidence. The IFIC report notes that its 2025 Food & Health Survey found that 43% of Americans who lack confidence in the safety of the food supply cite “too many recalls” as a reason.

Actual federal recall counts tell a more nuanced story. The IFIC report states that, according to U.S. Food and Drug Administration and U.S. Department of Agriculture data, there were more food recalls annually from 2015-2019 than from 2020-2023. The report also states that thousands of recalls occur each year, with 76% due to potential biological contamination or allergens, and that the majority are voluntary and precautionary.

Coverage of these findings by Food Safety Magazine on September 18, 2025, framed the signal the same way: 74% of respondents believed recalls are increasing, a perception that directly shapes overall confidence. That article also noted that consumer confidence in U.S. food safety had hit an all-time low in the July IFIC 2025 Food and Health Survey, with only 55% reporting confidence in the safety of the U.S. food supply.

## What people do after a recall notice

Avoidance is common, and it often extends beyond the recalled brand or lot. According to GS1 US, 60% of consumers say they have avoided an entire food category, such as lettuce, following a recall.

Hesitation to repurchase is also strong. In the same GS1 US survey, 59% reported hesitancy to purchase the same product or brand again after a food recall. Younger shoppers reported this more often than older shoppers: 65% of millennials and 64% of Gen Z, compared with 53% of baby boomers.

Precautionary disposal is another pattern. GS1 US found that 57% admitted to discarding recalled food even if their state or region was not impacted, with millennials at 70% most likely to take this precaution.

The YouGov results describe the immediate household steps in more detail. Among adults who had bought a recalled product, the most common reaction was discarding it, reported by 41%. Nearly a third — 30% — stopped consuming the product altogether, while 26% returned the product to the store. Fewer sought compensation: 23% requested a refund or replacement and 9% contacted the manufacturer or store. A significant portion, 18%, reported taking no action at all.

For nutrition habits, the key point is that fresh foods recommended in a healthy diet can be caught up in these reactions. The IFIC report notes that, according to Centers for Disease Control and Prevention data, some foods recommended in a healthy diet, such as lean meats, fruits, and vegetables, also carry some of the highest food safety risks. In the survey, those same groups were perceived as most involved in recalls: 26% named meats, poultry, and seafood and 22% named fresh fruits and vegetables in an open-ended measure.

When asked which foods they think are most often involved, using a prompted list, most Americans pointed to fresh meats, poultry, and seafood at 50% and fresh fruits and vegetables at 41%, according to IFIC. Smaller shares cited processed foods at 24%, dairy at 22%, deli meats at 21%, frozen fruits and vegetables at 17%, canned foods at 15%, and frozen entrées at 11%.

## Trust in brands takes a measurable hit

Recalls do not just change one shopping trip. According to YouGov, among those impacted, 31% reported a moderate loss of trust in the brand involved, while another 16% said the recall had a strong impact on their perception. Only 22% said it had no impact at all.

That finding aligns with broader food-safety communication concerns described by Food Safety Magazine, which reported that IFIC sees concerns about ingredients and recalls reshaping public trust. The same coverage noted that, despite lower confidence in the overall food supply, 72% of respondents in a related ingredient-safety survey said they were confident in the safety of ingredients in the food and beverages they purchase.

For food companies and retailers, the practical lesson is that a recall notice is also a trust event. Shoppers may discard food, pause a category, or delay repurchase even when their area was not named.

## Where people first hear about recalls

Media remains the dominant first alert. According to IFIC, nearly half — 48% — first learned of a recent recall through news articles or television, while 15% heard through personal social media. One in ten — 10% — first heard from a friend or family member, and fewer than one in ten heard first from a food company at 7%, a local retailer at 6%, a federal agency at 6%, or a healthcare professional at 3%.

Expectations point the same way. IFIC found that nearly four in ten — 38% — expect to first learn about a food recall from traditional media sources, and 14% expect to hear first through a personal social media feed. About one in ten anticipated learning first from federal government agencies at 10%, local retailers at 9%, or a food company or manufacturer at 8%.

YouGov found a similar pattern among people who had bought a recalled item: around two-fifths — 39% — said they first heard the news through media coverage. Fewer were alerted directly by stores via email or text at 12%, or through family and friends at 13%. Other sources played smaller roles, including government websites such as the FDA’s at 6%, brand websites at 6%, and product packaging at 5%.

Yet responsibility expectations focus on government. IFIC reported that nearly half of Americans — 46% — believe federal agencies are responsible for informing the public about recalls.

## What would help shoppers act faster?

Consumers favor more direct alerts. According to IFIC, nearly three in four — 73% — support using grocery loyalty card data to directly alert them if they purchased recalled food, and two in three — 67% — are interested in signing up for text message alerts whenever a food recall is issued.

The same appetite for modernized alerts was highlighted by Food Safety Magazine, which noted that approximately two-thirds of consumers would sign up for text alerts.

Industry and regulatory context points to traceability as the backbone for faster, narrower recalls. GS1 US president and CEO Bob Carpenter said recalls are issued for reasons including contamination with bacteria like salmonella or E. coli, undeclared allergens, foreign objects, or mislabeling. He said improved tracking tools, barcoding standards, and traceability requirements are evolving to help identify and remove affected products and better respond to recalls.

Regulatory change is also shaping that effort. According to GS1 US, FSMA Rule 204, part of the U.S. Food and Drug Administration’s Food Safety Modernization Act signed into law in 2011, adds stricter recordkeeping for foods most often implicated in recalls, such as leafy greens, shell eggs, and nut butters, among others on the FDA’s Food Traceability List. The FDA recently proposed extending the implementation deadline until July 20, 2028. The rule also requires that full traceability data needed to support a recall be made available to the FDA within 24 hours, which allows quicker action to protect consumers.

For shoppers, the near-term takeaway is simple: check the product name, lot, and region before discarding an entire category, sign up for direct alerts where available, and use store or agency notices to confirm whether food at home is affected.

## Sources referenced
- GS1 US: New GS1 US Survey Finds Consumers Are Concerned About Frequency of Food Recalls (https://www.gs1us.org/industries-and-insights/media-center/press-releases/food-safety-recall-survey)
- IFIC Spotlight Survey: Americans' Perceptions Of Food Recalls. September 2025 (https://ific.org/wp-content/uploads/IFIC-September-Spotlight-Survey-Food-Recalls.pdf)

## How Food Recalls Are Shaping the U.S. Fresh Meat Market

URL: https://nutritionjournal.com/food-recall-fresh-meat-market-us-impact

Recent FSIS ground-beef recalls and peer-reviewed demand studies show brief, small sales dips, with recall frequency and contamination type shaping shopper response.

Key takeaways:
- A March 23, 2026 FSIS alert flagged ground beef with EST 34729 that may contain metal in six states and D.C. area markets.
- Recent E. coli recalls removed 2,855 pounds and 22,912 pounds of ground beef in Dec. 2025 and Feb. 2026.
- Research finds E. coli recalls briefly reduce ground-beef demand, with small and short-lived effects.
- Recall frequency affects demand more than pounds recalled, and history can soften the latest impact.
- FSIS advises cooking ground beef to 160 F with a thermometer and storing at 40 F or below.

TL;DR: U.S. fresh meat recalls lower demand for ground beef briefly, with shoppers pulling back most after large contamination events and then returning to normal buying patterns.

The newest verified federal action shows how that cycle works. On March 23, 2026, the U.S. Department of Agriculture's Food Safety and Inspection Service issued a public health alert for a ground beef item that may contain metal, according to the agency's announcement titled FSIS Issues Public Health Alert for Ground Beef Products Due to Possible Foreign Material Contamination. The product was made on Feb. 26, 2026, carries establishment number EST 34729 and a stamp reading 105761 Sell by 03/19/26, and went to a distributor and Mom's Organic Markets stores in the District of Columbia, Massachusetts, Maryland, New Jersey, Pennsylvania and Virginia. The company found the issue after two consumer complaints. No confirmed injuries were reported, and a recall was not requested because the item was no longer available for purchase.

That alert is one of several recent ground-beef actions that illustrate the steady drumbeat facing the U.S. fresh meat case. Each event removes product, triggers warnings about freezers, and reminds shoppers that ground beef needs thorough cooking.

## What the latest recalls removed from the market

Federal recall records show small and mid-size lots, quickly flagged through testing or complaints, with most attention on Shiga toxin-producing E. coli.

On Dec. 27, 2025, the Food Safety and Inspection Service announced that Mountain West Food Group, LLC of Heyburn, Idaho, was recalling approximately 2,855 pounds of raw ground beef that may contain E. coli O26, as described in Mountain West Food Group, LLC Recalls Ground Beef Products Due To Possible E. Coli O26 Contamination. The product was produced on Dec. 16, 2025, bore establishment number EST 2083, and was shipped to distributors in California, Colorado, Idaho, Montana, Pennsylvania and Washington for further retail distribution. The problem was found during routine agency testing. The agency later listed 2,424 pounds recovered. No confirmed illnesses were linked to the lot.

On Feb. 11, 2026, CS Beef Packers, LLC of Kuna, Idaho, recalled approximately 22,912 pounds of raw ground beef that may contain E. coli O145, according to CS Beef Packers, LLC Recalls Ground Beef Products That May be Contaminated With E. Coli O145. The items were produced on Jan. 14, 2026, carried EST. 630 inside the inspection mark, and were shipped to distributors in California, Idaho and Oregon for further distribution to foodservice locations. Discovery came from agency testing at a downstream customer. The agency listed 120 pounds recovered. No confirmed illnesses were reported, and foodservice operators were told not to serve the product.

An earlier alert shows national reach through retail. On June 3, 2025, the Food Safety and Inspection Service issued a public health alert for ground beef that may contain E. coli O157:H7, as reported in FSIS Issues Public Health Alert for Ground Beef Products Due to Possible E. Coli O157:H7 Contamination. The raw product was made on May 22, 2025 and May 23, 2025, bore EST. 4027, and was shipped to distributors in Connecticut, Georgia, Illinois and Maryland and then to Whole Foods Market stores nationwide. The company told the agency it had shipped product that tested positive. No confirmed illnesses were reported, and a recall was not requested because the items were no longer available for purchase.

A separate March 25, 2026 alert covered various raw beef and pork products made from April 2024 through March 2026 without federal inspection and that may bear a false inspection mark, according to FSIS Issues Public Health Alert for Beef and Pork Products Produced Without the Benefit of Inspection. The first four products used establishment number EST. 1996 without authorization and were shipped to wholesale and retail locations nationwide. The issue was found during an ongoing agency investigation. No confirmed illness or injury was reported.

## How recalls affect fresh meat demand

Peer-reviewed studies using U.S. scanner and household purchase data find a consistent pattern: demand dips, then recovers.

A study in Food Policy in 2017 by Xia Shang and Glynn T. Tonsor, summarized as Food safety recall effects across meat products and regions, estimated effects of Food Safety Inspection Service recalls on U.S. consumer meat demand with monthly grocery-scanner data. It found that beef E. coli recalls significantly reduce demand for recalled ground beef at the time of the event in most, but not all, regions. The authors reported heterogeneity across products, regions and recall types, with domestic and international implications for policymakers and industry leaders.

A later analysis in the European Review of Agricultural Economics in 2023 by Hyejin Yim and Bhagyashree Katare, summarized as Effect of food safety recalls on consumer meat purchase: evidence from meat recalls 2007–2017, used household-level scanner data. It found that meat recalls have a statistically significant but short-lived and small reduction in consumer purchases, with small effects on both whether to buy and how much to buy. It also found differences by household demographics and recall characteristics.

An earlier demand study covering 1982–1998 built beef, pork and poultry recall indices from Food Safety Inspection Service events and newspaper reports and estimated a Rotterdam demand model. Published as Impacts of meat product recalls on consumer demand in the USA, it found that agency recall events significantly affected demand while newspaper reports did not, that recall elasticities were significant but small compared with price and income effects, and that gains for substitute meats were offset by a broader shift away from meat toward non-meat goods.

For shoppers, the takeaway is practical: sales and buying of the named ground-beef category can soften right after a well-publicized E. coli action, but the national market effect is usually limited in size and duration.

## Why recall details matter more than headlines alone

Not all recalls move shoppers the same way. Research on information heterogeneity points to which features raise perceived risk.

A paper in Food Policy, Volume 114, January 2023, by Pei Zhou and Yizao Liu, summarized as Recall information heterogeneity and perceived health risk: The impact of food recall on fresh meat market in the U.S., modeled fresh-meat demand with a structural random coefficient discrete choice model. It examined the number of recalls and the volume recalled, plus interactions between historical and latest recall information. It reported that both the number of recalls and the volume recalled have negative and significant effects on demand, while historical recalls help mitigate the negative impact of the latest recalls.

The same study concluded that preventing large-scale recalls, Class I recalls, product contamination recalls, and recalls tied to production without benefit of inspection or import violation should be the highest priority. It also found that food companies should take the initiative to recall when problems arise, and simulation results implied that the number of recalls plays a much larger role than the volume recalled in meat demand.

That distinction helps explain market reactions in 2025–2026. A 22,912-pound Class I contamination recall to foodservice in three western states sends a different signal than a single-lot foreign-material alert for product already sold through, even though both trigger do-not-eat advice for freezers. Frequency of announcements can weigh more heavily than pounds in one lot.

The paper also noted broader context for why agencies act quickly. It cited Centers for Disease Control and Prevention estimates that about 48 million Americans get sick, 128,000 are hospitalized and 3,000 die from foodborne disease each year, and estimated the average cost of a recall to a food company at $10 million, with total losses equal to about 0.5% of total U.S. food sales in 2019.

## Why ground beef draws frequent safety actions

Ground beef gets special scrutiny because grinding changes risk. According to the Food Safety and Inspection Service page titled Ground Beef and Food Safety, bacteria present on the surface of meat can be mixed throughout during grinding, and more surface is exposed. Harmful bacteria such as Salmonella, Shiga toxin-producing E. coli, Campylobacter jejuni, Listeria monocytogenes and Staphylococcus aureus cannot be seen or smelled.

The agency notes that bacteria multiply rapidly between 40 and 140 degrees F, a range it calls the Danger Zone. To keep levels low, it advises storing ground beef at 40 degrees F or below and using it within 2 days or freezing it. To destroy harmful bacteria, it advises cooking ground beef to a safe minimum internal temperature of 160 degrees F, confirmed with a food thermometer.

The agency separately explains that E. coli O157:H7 can survive refrigerator and freezer temperatures and can multiply very slowly at temperatures as low as 44 degrees F. Illnesses from E. coli O157:H7 have been linked with undercooked ground beef, as well as raw milk, apple cider, dry-cured sausage, fresh produce and undercooked roast beef. Color alone is not reliable, because patties can turn brown before reaching 160 degrees F, and some lean beef can stay pink above that point.

## What shoppers and foodservice operators should do now

Federal advice after each of the recent actions is consistent: check freezers, do not eat the named product, and throw it away or return it.

For the March 2026 metal alert involving White Oak Pastures product sold at Mom's Organic Markets, consumers with the EST 34729 item stamped 105761 Sell by 03/19/26 were urged not to consume it. For the December 2025 and February 2026 E. coli recalls, consumers and foodservice locations were told the product may still be in home or commercial freezers despite effectiveness checks and recovery efforts.

General safe handling remains the market stabilizer. Separate raw meat from other foods, chill promptly, wash hands and surfaces often, and cook ground meats to 160 degrees F. Consumers with food safety questions can contact the USDA Meat and Poultry Hotline at 888-MPHotline, and problems with meat, poultry or egg products can be reported through the online Electronic Consumer Complaint Monitoring System.

For the fresh meat market, the pattern from both agency records and economic research is clear: targeted removal plus clear cooking guidance limits health risk, while repeated contamination headlines can briefly soften ground-beef demand until shoppers see the issue as resolved.

## Losing Family Recipes Means Losing More Than Food

URL: https://nutritionjournal.com/losing-family-recipes-nutrition-health-community-bonds

Research links the erosion of traditional family cooking to rising rates of diet-related disease, weakened community bonds, and poorer nutrition outcomes — here's what the evidence says and how to reverse the trend.

Key takeaways:
- Families sharing meals at least four times per week have measurably better nutrition outcomes and lower obesity rates, according to Johns Hopkins Medicine and BMC Public Health research.
- Culturally tailored recipes improve dietary adherence more effectively than generic nutrition guidelines, per a 2023 Frontiers in Nutrition pilot study among hypertensive Filipino-Americans.
- The loss of intergenerational recipe transmission is a documented structural driver of rising diet-related non-communicable diseases across multiple countries.
- Children who cook with caregivers consume more vegetables and develop healthier long-term eating habits.
- Community cooking initiatives that adapt heritage recipes show measurable improvements in both nutrition and family relationships simultaneously.
- Digitizing and documenting family recipes before elder generations are gone is an urgent, practical first step any family can take today.

## Losing Family Recipes Is a Public Health Problem

**TL;DR:** The disappearance of traditional family recipes is not merely a cultural loss — it is a documented nutritional crisis that raises chronic disease risk and frays the community bonds that protect mental and physical health.

When Nigerian cultural commentator Denike Olori posted in mid-2024 that "your in-laws don't have to love you," the observation sparked a broader conversation about eroding social contracts — including the family kitchen. That flash of social-media candor encapsulates a measurable trend: as households eat separately, eat out more, and stop transmitting recipes across generations, they are also abandoning one of the most potent tools for lifelong healthy living.

The evidence is concrete. According to **Johns Hopkins Medicine**, families that eat together regularly are significantly more likely to consume fruits, vegetables, and whole grains, and significantly less likely to develop obesity or type 2 diabetes. Their review of shared-meal research found that children in households with frequent family dinners had up to a 24 percent lower risk of overweight compared with children in households that rarely shared meals ([Healthy Meals Together with Family, Johns Hopkins Medicine](https://www.hopkinsmedicine.org/health/wellness-and-prevention/family-meals-can-they-make-you-healthier)). That is not a rounding error; it is a clinically meaningful difference driven in large part by what gets cooked — and by whom.

---

## What a Family Recipe Actually Delivers Nutritionally

Traditional family recipes are not just nostalgia encoded in flour and spice. They are calorie-controlled, portion-practiced, and often seasonally grounded in ways that ultra-processed convenience foods are not.

A 2023 pilot study published in **Frontiers in Nutrition** examined a culturally tailored cookbook intervention among hypertensive Filipino-Americans. Participants who cooked from adapted heritage recipes — dishes that preserved traditional flavor profiles while reducing sodium and saturated fat — showed meaningful reductions in blood pressure and reported stronger dietary adherence than those given generic nutrition guidelines alone ([Culturally-tailored cookbook for promoting positive dietary change among hypertensive Filipino Americans, Frontiers in Nutrition, 2023](https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1114919/full)). The key finding: cultural relevance increases compliance. People eat better when the food feels like home.

This dynamic applies across ethnic and geographic contexts. Heritage diets — Mediterranean, West African, South Asian, Indigenous American — share structural similarities: high vegetable and legume content, minimal refined sugar, fermented or slow-cooked preparations that preserve micronutrients. When those diets are displaced by fast-food homogenization, the nutrient profiles collapse.

---

## The Social Meal as Health Infrastructure

Family meals function as more than a delivery mechanism for calories. They are a form of health infrastructure.

A large study published in **BMC Public Health** tracked shared meal practices across diverse households and found that families who ate together at least four times per week reported better intra-family communication, higher emotional wellbeing scores in children aged 6–17, and lower rates of depression in caregivers ([BMC Public Health, 2022](https://link.springer.com/article/10.1186/s12889-022-13828-z)). The authors concluded that the mealtime ritual itself — the predictability, the conversation, the shared effort of cooking — produced protective effects independent of the specific foods consumed.

In other words, the recipe is the vehicle; the table is the destination.

This research mirrors what nutritional anthropologists have documented for decades: food preparation is one of the primary ways that values, identity, and community norms are transmitted between generations. When that transmission breaks down — when grandmothers stop teaching grandchildren, when in-laws share neither kitchen nor culture — something measurable is lost.

---

## The Globalization Trap: How Convenience Costs Health

The rapid globalization of food supply chains has produced a paradox. Access to calories has never been greater; access to *nutritious, culturally grounded* food has narrowed considerably for many communities.

Nutrition researchers writing in *Nutrition Research Reviews* documented this dynamic in a 2022 narrative review examining how urban populations shifting away from heritage diets toward commercially processed foods experienced sharp rises in nutrition-related non-communicable diseases — type 2 diabetes, hypertension, obesity — within a single generation. The researchers specifically cited the loss of intergenerational recipe transmission as a structural driver of that transition ([From tradition to transition: heritage diets and NCDs, Nutrition Research Reviews, Cambridge University Press](https://www.cambridge.org/core/journals/nutrition-research-reviews/article/from-tradition-to-transition-a-narrative-review-on-the-role-of-heritage-diets-in-mitigating-nutritionrelated-noncommunicable-diseases-in-tanzania/4BA9FD3D2DDEA6415BB87FB7D5A080FD)).

The same pattern appears in high-income countries. Many adults under 40 report not knowing how to prepare even a single dish their grandparents cooked regularly — a generational gap with direct dietary consequences. When family recipes disappear, the default meal increasingly becomes something designed by a food-science laboratory to maximize palatability and shelf life, not nutritional density.

---

## What the Research Says About Reversing the Trend

The good news: the trend is reversible, and community-level interventions have already demonstrated measurable results.

In June 2021, **NPR** profiled a series of community cooking initiatives in which families were guided to cook traditional heritage recipes together, with facilitators helping to make light nutritional adaptations — swapping in olive oil for lard, reducing added salt, increasing vegetable portions — without altering the dish's cultural identity. Participants reported not only improved dietary habits but stronger family relationships and a greater sense of cultural belonging ([3 ways to honor and pass on traditions through food, NPR, June 2, 2021](https://www.npr.org/2021/06/02/1002446408/honoring-your-heritage-and-improving-your-health-through-food)).

Technology is playing a growing role. Apps such as Paprika, Yummly, and community-driven platforms like Kitchen Stories allow families to digitize, annotate, and share recipes across generations and geography. These tools matter most when paired with intentional family practice — a weekly cooking session, a video call with a grandparent, a family cookbook project that becomes a physical artifact.

---

## Practical Steps to Preserve Your Family's Culinary Heritage

### 1. Document Before You Lose the Source

Schedule a cooking session with the oldest cook in your family. Record video, write down quantities, and note the sensory cues — "cook until it smells nutty" — that recipes rely on but rarely articulate. This is urgent: once that knowledge holder is gone, the recipe is often gone with them.

### 2. Adapt, Don't Abandon

Use the framework demonstrated in the *Frontiers in Nutrition* study: keep the flavor profile, reduce sodium and saturated fat incrementally. A 25 percent sodium reduction is rarely detectable but meaningful over a lifetime of eating. Swap refined grains for whole grains gradually so that texture and taste remain familiar.

### 3. Make the Table Non-Negotiable

The *BMC Public Health* research identifies four shared meals per week as the threshold where health benefits become statistically measurable. Start there. Even one additional shared meal per week over current habits is a documented improvement.

### 4. Connect Cooking to Nutrition Education

Children who cook with caregivers consume more vegetables and are more adventurous eaters, as noted by [Johns Hopkins Medicine](https://www.hopkinsmedicine.org/health/wellness-and-prevention/family-meals-can-they-make-you-healthier). Involve children early — even young children can wash vegetables, measure ingredients, and stir. The skill-building compounds over years.

### 5. Join or Create a Community Cooking Circle

The NPR-profiled initiatives show that peer accountability accelerates both skill-building and dietary change. Local churches, community centers, and cultural organizations are natural hosts for heritage cooking groups. The social reinforcement of cooking together mirrors the same community bonds that family meals historically provided.

---

## The Hidden Cost of Fractured In-Law Relationships

Denike Olori's viral provocation — that in-laws don't have to love you — points to a genuine cultural negotiation happening in modern families worldwide. But there is a nutrition-specific cost worth naming directly: in many cultures, the mother-in-law or extended family elder is the primary conduit through which heritage recipes move from one generation to the next.

When those relationships are contractual rather than warm, when distance (geographic or emotional) separates nuclear families from their extended kin, the recipe transfer simply does not happen. The young couple cooks from a meal-kit app rather than from memory or a handwritten card. The children grow up with no reference point for what "home" tastes like from a nutritional standpoint.

This is not an argument for enduring toxic family dynamics. It is an argument for recognizing what is at stake — nutritionally, culturally, and communally — when the bonds that once organized cooking and eating erode without replacement.

---

## The Bottom Line

The science is unambiguous: families that cook and eat together eat better, live longer, and report higher emotional wellbeing. The recipes themselves carry cultural intelligence about nutrition that has been refined across generations. Research from *Nutrition Research Reviews*, *Frontiers in Nutrition*, *BMC Public Health*, and **Johns Hopkins Medicine** all converge on the same conclusion — shared cooking and eating are among the most cost-effective public health interventions available, requiring no prescription, no clinic visit, and no new technology.

Losing family recipes is not inevitable. But reversing the trend requires treating family cooking as the public health priority that the evidence says it is.

Every recipe passed down is a small act of preventive medicine.

## No Mortality Benefit from Vegetarian Diets, Major U.S. Study Finds

URL: https://nutritionjournal.com/no-mortality-benefit-vegetarian-diets-us-study-2023

A large-scale study of 117,673 U.S. adults found no significant reduction in all-cause mortality for vegetarians versus omnivores, challenging decades of conventional wisdom about plant-based diets.

Key takeaways:
- A November 2023 study of 117,673 U.S. adults found no significant all-cause mortality benefit for vegetarian or vegan diets after adjusting for lifestyle confounders.
- The study used data from the PLCO Cancer Screening Trial and tracked participants for an average of 18 years, recording 39,763 deaths.
- Pesco-vegetarians showed a slight unadjusted advantage, but it disappeared after full covariate adjustment for smoking, BMI, and physical activity.
- Prior studies showing vegetarian longevity benefits may have been skewed by healthy-user bias, as plant-based eaters tend to avoid smoking and exercise more.
- Diet quality within vegetarian categories varies enormously; a plant-based label does not guarantee a nutrient-dense eating pattern.
- Future research should examine the effects of lifetime vs. short-term vegetarianism and use validated diet-quality scoring tools within each dietary category.

## Vegetarian Diets Do Not Lower Mortality Risk, New Research Confirms

**TL;DR:** A peer-reviewed study published November 26, 2023, in the *Journal of Health, Population and Nutrition* found no statistically significant reduction in all-cause mortality among vegetarians compared to omnivores in a U.S. adult cohort of 117,673 people tracked for an average of 18 years.

Plant-based diets have long been marketed as a path to longer life. But the most comprehensive U.S. cohort study on the topic to date tells a more complicated story. After rigorously adjusting for age, sex, smoking status, alcohol use, body mass index, physical activity, and socioeconomic variables, researchers found that vegetarians — including lacto-ovo vegetarians, pesco-vegetarians, and vegans — did not outlive their omnivorous counterparts to any statistically meaningful degree.

The findings, reported by News-Medical on November 26, 2023, are likely to reshape how dietitians, public health agencies, and consumers interpret the evidence base for plant-based eating.

---

## The Study: Design, Scale, and Scope

Researchers drew participants from the **Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial**, one of the largest cancer-screening cohorts ever assembled in the United States. The final analytic sample included **117,673 adults**, making it substantially larger than most prior vegetarian-diet studies, which often relied on self-selected, health-conscious communities such as Seventh-day Adventists.

Participants completed detailed dietary questionnaires and were then classified into four mutually exclusive diet groups:

- **Omnivores** — ate meat, poultry, and/or seafood regularly
- **Lacto-ovo vegetarians** — excluded meat and fish but consumed dairy and eggs
- **Pesco-vegetarians** — excluded meat and poultry but ate seafood
- **Vegans** — excluded all animal products

The cohort was followed for an average of **18 years**. Over that period, **39,763 deaths** were recorded — a large enough event count to give the analysis substantial statistical power.

Critically, only about **0.7% of participants** identified as vegetarians of any type. That demographic skew reflects U.S. eating patterns but also means that vegetarian subgroups were markedly smaller than the omnivore reference group, a limitation the authors acknowledged.

---

## Key Findings: What the Numbers Actually Show

In unadjusted models, vegetarians appeared to enjoy modest survival advantages. However, once the research team applied multivariable adjustments for health-related confounders, **those advantages disappeared**.

According to the study as covered by [News-Medical](https://www.news-medical.net/news/20231126/Large-scale-study-finds-no-mortality-benefit-from-vegetarian-diets-in-US-adults-challenges-previous-beliefs.aspx), the adjusted hazard ratios for all-cause mortality were:

- **Lacto-ovo vegetarians vs. omnivores:** Not significantly different
- **Vegans vs. omnivores:** Not significantly different
- **Pesco-vegetarians vs. omnivores:** A slight reduction was observed in some models, but it became statistically non-significant after full covariate adjustment

The lead author, **Dr. Sanchari Sinha Dutta**, noted that the null result held across multiple sensitivity analyses, including models restricted to never-smokers and models that excluded early deaths to account for reverse causation.

"Our research indicates that vegetarian diets may not confer the expected mortality benefits, especially when adjusted for various lifestyle variables," Dutta stated.

The full peer-reviewed findings were published in the *Journal of Health, Population and Nutrition*, making the data available for independent review at [jhpn.biomedical.com](https://jhpn.biomedcentral.com/articles/10.1186/s41043-023-00460-9).

---

## Why Previous Studies Showed a Benefit

For decades, studies — particularly those from **Adventist Health Study-2** and the **EPIC-Oxford cohort** — reported that vegetarians had lower rates of ischemic heart disease, type 2 diabetes, and certain cancers. Some reported modest reductions in all-cause mortality.

But those earlier cohorts share a structural weakness: **healthy-user bias**. People who self-select into vegetarian diets in Western countries tend to be non-smokers, physically active, highly educated, and health-conscious in multiple other domains. When these confounders are not fully controlled, vegetarian diets can appear protective even if the diet itself is not the primary mechanism.

The PLCO cohort allowed researchers to apply a broader and more granular set of covariates than many earlier studies, which may explain why the apparent benefit vanished after adjustment. As the *Journal of Health, Population and Nutrition* paper notes, prior studies drawing from religious communities introduced selection effects that made dietary patterns difficult to isolate.

---

## What the Study Does — and Does Not — Mean

This research does not suggest that vegetarian diets are harmful. Nor does it imply that dietary composition is irrelevant to longevity. What it argues, more precisely, is that **the independent mortality signal attributed to vegetarianism may have been overstated** in prior literature.

Several important caveats apply:

1. **Short-term vegetarians vs. lifetime adherents.** The study did not stratify participants by how long they had followed their dietary pattern. Decades of vegetarian eating from early adulthood might produce different outcomes than adoption later in life.

2. **Diet quality within categories.** A vegan who lives on white rice, chips, and plant-based processed food is grouped with a vegan who eats whole grains, legumes, and abundant vegetables. Diet quality heterogeneity within labels is a known limitation.

3. **Cause-specific mortality.** The analysis focused on all-cause mortality. Prior studies have found stronger protective signals for cardiovascular-specific or cancer-specific endpoints; those sub-analyses were beyond the scope of this paper.

4. **Generalizability.** The PLCO cohort skews older and includes a high proportion of white adults. Results may differ in younger, more diverse, or non-U.S. populations.

---

## Public Health and Dietary Guideline Implications

U.S. Dietary Guidelines have consistently endorsed a shift toward more plant-based eating patterns, citing evidence linking reduced meat consumption to lower chronic disease risk. The **2020–2025 Dietary Guidelines for Americans** include vegetarian and vegan eating patterns as healthy options supported by the evidence.

This new study does not overturn those guidelines wholesale, but it adds a necessary counterweight: **diet label alone does not predict longevity.** The totality of one's lifestyle — smoking cessation, physical activity, alcohol moderation, sleep, and stress management — likely matters as much or more than whether one eats chicken.

Public health messaging that frames vegetarianism as a near-guaranteed path to longer life may need recalibration. Dietitians and clinicians are better served by emphasizing **overall dietary quality, diversity, and nutrient adequacy** rather than categorical exclusion of animal products.

---

## What Should Future Research Investigate?

The authors and independent commentators highlighted several research gaps the PLCO findings open up:

- **Duration effects:** Do people who have been vegetarian for 20+ years show different mortality patterns than recent adopters?
- **Biomarker studies:** Do vegetarians show favorable intermediate markers — lipids, glucose, inflammation — even if mortality endpoints are neutral?
- **Diet-quality scoring:** Using validated indices like the **Healthy Eating Index** or the **Alternative Healthy Eating Index** within dietary categories could clarify whether *how well* someone executes a vegetarian diet modifies outcomes.
- **Interaction with genetics:** Emerging nutrigenomics research suggests that responses to dietary patterns vary significantly by genetic profile.

---

## The Bottom Line

The largest U.S. cohort study to date on vegetarian diets and mortality found **no statistically significant survival advantage** for vegetarians after controlling for the lifestyle factors that often travel alongside plant-based eating. The findings, published in the *Journal of Health, Population and Nutrition* on November 26, 2023, and covered by [News-Medical](https://www.news-medical.net/news/20231126/Large-scale-study-finds-no-mortality-benefit-from-vegetarian-diets-in-US-adults-challenges-previous-beliefs.aspx), do not condemn plant-based diets — but they do challenge the narrative that eliminating meat is, by itself, a ticket to longevity.

A well-planned vegetarian diet remains a nutritionally sound choice. But the evidence now suggests that the company your diet keeps — your exercise habits, your smoking status, your sleep — may matter just as much as what is on your plate.

## Semaglutide Delivers 15.1% Weight Loss in Landmark 2023 Trial

URL: https://nutritionjournal.com/semaglutide-weight-loss-oasis-1-trial-2023

Oral semaglutide (50 mg daily) cut body weight by an average of 15.1% over 68 weeks in the phase 3 OASIS 1 trial—reshaping how clinicians approach obesity treatment.

Key takeaways:
- Oral semaglutide 50 mg achieved a 15.1% average body weight reduction over 68 weeks in the OASIS 1 phase 3 trial published in The Lancet on August 26, 2023.
- 85% of semaglutide participants lost ≥5% of body weight, and 54% lost ≥15%—compared to 26% and 7% respectively in the placebo group.
- Gastrointestinal side effects (nausea, vomiting, constipation) affected ~92% of semaglutide users but were mostly mild to moderate and improved over time.
- NICE issued guidance (TA875, March 2023) recommending semaglutide for weight management through specialised NHS services in England under a commercial access agreement.
- Semaglutide works best as a complement to lifestyle changes—diet, physical activity, and behavioural support—not as a standalone fix.
- The drug is prescription-only and not suitable for everyone; contraindications include personal or family history of medullary thyroid carcinoma or MEN2 syndrome.

## Semaglutide Cuts Body Weight by 15.1%: What the 2023 OASIS 1 Trial Means for You

**TL;DR: Oral semaglutide 50 mg, taken once daily alongside lifestyle changes, reduced average body weight by 15.1% over 68 weeks in a rigorous phase 3 trial—making it one of the most effective non-surgical obesity treatments now available by prescription.**

If you have spent years cycling through diets and exercise regimens without lasting results, a robust new clinical option has arrived. On **August 26, 2023**, The Lancet published the full results of the OASIS 1 trial, a randomised, double-blind, placebo-controlled phase 3 study led by Filip K. Knop and colleagues. Participants taking oral semaglutide 50 mg once daily lost an average of **15.1% of their body weight** by week 68, versus just **2.4%** in the placebo group—a difference that is both statistically and clinically significant. This single finding has reshaped the conversation around pharmacological weight management and signals a new era for the estimated **1 billion adults living with obesity worldwide**.

---

## What Is Semaglutide?

Semaglutide is a **glucagon-like peptide-1 (GLP-1) receptor agonist**—a class of drug that mimics the action of the GLP-1 hormone naturally released after eating. GLP-1 signals the brain to increase feelings of fullness, slows gastric emptying, and reduces appetite-driven food intake. The result is a sustained, physiologically supported reduction in calorie consumption rather than a willpower-dependent crash diet.

Novo Nordisk originally developed semaglutide as a treatment for **type 2 diabetes** under the brand name Ozempic (injectable) and Rybelsus (oral). The injectable formulation at higher doses was subsequently approved for chronic weight management as Wegovy. The OASIS 1 trial now establishes that a **higher-dose oral formulation (50 mg)** can rival injectable efficacy—a crucial finding because many patients prefer pills over weekly injections.

---

## Inside the OASIS 1 Trial

### Study Design

The OASIS 1 trial enrolled **667 adult participants** across **50 outpatient clinics in nine countries**. All participants had a baseline BMI of at least **30 kg/m²** (obesity) or at least **27 kg/m²** with at least one weight-related comorbidity, and none had type 2 diabetes. Participants were randomly assigned to receive either oral semaglutide 50 mg once daily or a matching placebo. Critically, every participant also received a standardised **lifestyle intervention program** covering dietary guidance, physical activity coaching, and behavioural support—underscoring that the drug works best as a complement to healthy habits, not a replacement.

According to the study published in *The Lancet* (Knop et al., DOI: 10.1016/s0140-6736(23)01185-6), the co-primary endpoints were percentage change in body weight from baseline and the proportion of participants achieving ≥5% weight loss by week 68.

### Key Efficacy Results

| Outcome | Semaglutide 50 mg | Placebo |
|---|---|---|
| Mean body weight change | **–15.1%** | –2.4% |
| ≥5% weight loss | **85%** of participants | 26% |
| ≥10% weight loss | **69%** | 12% |
| ≥15% weight loss | **54%** | 7% |

These numbers are striking. More than half of semaglutide users lost at least 15% of their starting weight—a threshold that clinicians associate with meaningful improvements in blood pressure, blood glucose, sleep apnoea severity, and joint load. The placebo group, receiving the same lifestyle programme, achieved only a fraction of these outcomes.

### Safety Profile

No medication is free of side effects. In the OASIS 1 trial, **gastrointestinal adverse events** were the most common concern: approximately **92% of semaglutide participants** reported at least one GI symptom, compared with roughly 65% in the placebo group. However, the vast majority of these events—nausea, vomiting, constipation, diarrhoea—were **mild to moderate in severity** and typically emerged during the dose-escalation phase before subsiding. Discontinuation due to adverse events occurred in about 13% of the semaglutide group versus 6% in placebo. No new safety signals emerged beyond those already known from injectable semaglutide.

---

## Regulatory and Access Landscape

### NICE Guidance (England)

In parallel with mounting clinical evidence, health technology bodies are formalising access. In **March 2023**, the UK's National Institute for Health and Care Excellence (NICE) issued guidance (TA875) recommending semaglutide for weight management within specialised NHS services, subject to a **commercial access agreement** with Novo Nordisk to monitor cost-effectiveness in real-world use. According to the [NICE guidance (TA875)](https://www.nice.org.uk/guidance/ta875), eligible patients must have a BMI of at least 35 kg/m² (or 32.5 kg/m² for certain high-risk ethnic groups) plus at least one weight-related comorbidity, and must be enrolled in a specialist weight management programme.

This access agreement is significant: it means tens of thousands of patients in England gain a structured pathway to semaglutide through the NHS rather than relying solely on private prescriptions, which can cost several hundred pounds per month.

### United States and Beyond

In the United States, the FDA approved injectable semaglutide (Wegovy, 2.4 mg weekly) for chronic weight management in **June 2021**. The oral 50 mg formulation studied in OASIS 1 is not yet separately FDA-approved for obesity but represents an active regulatory frontier. Novo Nordisk has indicated plans to submit for approval, and the OASIS 1 data are widely expected to anchor that submission.

---

## Who Is a Candidate for Semaglutide?

Semaglutide is a **prescription-only medication** and is not appropriate for everyone. Broadly, current guidelines point toward candidates who:

- Have a BMI ≥30 kg/m², or ≥27 kg/m² with a weight-related health condition (hypertension, type 2 diabetes, dyslipidaemia, obstructive sleep apnoea)
- Have not achieved adequate weight loss through sustained diet and exercise alone
- Do not have a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (contraindications for GLP-1 agonists)
- Are not pregnant or planning pregnancy

Healthcare providers also consider cardiovascular history, kidney function, and concurrent medications before prescribing. A shared decision-making conversation with a physician or specialist is essential.

---

## How Semaglutide Fits Into a Healthy Lifestyle Plan

One of the most important messages from the OASIS 1 data is that **lifestyle intervention was a constant for both groups**. The superior outcomes in the semaglutide arm emerged on top of dietary counselling and physical activity support—not instead of it. Practitioners and patients should view semaglutide as a **pharmacological amplifier** of healthy behaviours, not a shortcut.

Practical integration points:

- **Diet:** A moderate caloric deficit (300–500 kcal/day below maintenance) remains the dietary backbone. Semaglutide reduces appetite, making this deficit easier to sustain without hunger-driven lapses.
- **Physical activity:** Resistance training preserves lean muscle mass during rapid weight loss—a priority when losing 10–15% of body weight.
- **Behavioural support:** Cognitive behavioural techniques addressing emotional eating complement the drug's physiological satiety signals.
- **Monitoring:** Regular check-ins with a healthcare provider to assess weight, metabolic markers, and GI tolerance are standard of care.

---

## The Broader Obesity Treatment Landscape

Obesity is now formally recognised as a **chronic, relapsing disease** by major medical organisations including the World Obesity Federation and the American Medical Association. This classification is consequential: it reframes weight gain not as a personal failure but as a condition with genetic, hormonal, environmental, and social drivers that often require sustained medical management.

The emergence of high-efficacy GLP-1 medications is shifting treatment paradigms that were, for decades, dominated by low-calorie diets and behavioural programmes that delivered modest, often temporary results. Combined with improving access frameworks—like the NICE TA875 pathway in England—semaglutide is poised to become a first-line pharmacological option in integrated obesity care.

---

## Bottom Line

The OASIS 1 trial, published in *The Lancet* on August 26, 2023, delivers the clearest evidence yet that oral semaglutide 50 mg is a powerful addition to the obesity treatment toolkit. A 15.1% mean weight reduction over 68 weeks, with more than half of participants losing at least 15% of their body weight, places this oral formulation in the same efficacy tier as injectable GLP-1 agents. Combined with NICE's 2023 access guidance expanding NHS availability, semaglutide is moving from clinical trial headlines to real-world prescriptions—offering genuine hope to millions who have struggled to manage their weight despite sustained effort.

*Always consult a qualified healthcare professional before starting, stopping, or changing any prescription medication.*

## Sources referenced
- Oral semaglutide 50 mg taken once per day in adults with overweight or obesity (OASIS 1): a randomised, double-blind, placebo-controlled, phase 3 trial — The Lancet (https://doi.org/10.1016/s0140-6736(23)01185-6) informed this article's reporting and source checks.

## Why Can't Humans Digest Wood? Termite Microbiomes May Hold the Answer

URL: https://nutritionjournal.com/termite-microbiomes-lignin-human-nutrition-biotechnology

Termites break down lignin with specialized gut microbes — and new biotechnology research suggests their tricks could one day unlock woody plant biomass as a human food source.

Key takeaways:
- Humans cannot digest lignin because we lack the oxidative enzymes (laccases, peroxidases) that termite gut microbes produce — this is a solvable engineering problem, not a fundamental biological limit.
- Termite hindguts host thousands of microbial species that collectively break down lignin through a multi-stage fermentation process; a 2020 Nature Communications Biology study catalogued dozens of novel enzymes responsible.
- Lignin already provides measurable health benefits even undigested: antioxidant activity, antimicrobial effects, and prebiotic modulation of gut bacteria, per a 2023 Industrial Crops and Products review.
- A January 2025 review in Symbiosis confirms that termite gut microbiome research is actively being translated into synthetic biology tools, fermentation systems, and prebiotic formulations.
- The main barriers to edible lignin biotechnology are enzyme oxygen sensitivity, toxic degradation intermediates, regulatory approval timelines, and historically weak economic incentives.
- Practical applications — particularly lignin-derived prebiotics — could reach the market within a decade, while full calorically productive lignin digestion for humans remains a longer-term goal.

## TL;DR: Termites Can Eat Wood Because of Their Gut Microbes — and Science Is Trying to Copy That Trick

Humans cannot digest wood because we lack the enzymes to break apart lignin, the rigid polymer that gives trees their strength. Termites solve this problem with a dense community of gut bacteria, archaea, and protists that collectively produce those enzymes — and as of 2025, researchers at multiple institutions are actively working to translate that microbial machinery into biotechnological tools for food, feed, and drug delivery. A January 2025 review published in *Symbiosis* by Ihejirika et al., titled "Biotechnological utilization: the potential role of the termite gut symbiotic microbiome," confirms that termite gut microbiota remain one of the most promising but under-exploited biological systems in applied microbiology (source: Springer Nature, https://link.springer.com/article/10.1007/s13199-025-01053-2).

---

## What Is Lignin, and Why Is It So Hard to Eat?

Lignin is a complex, cross-linked aromatic polymer that accounts for roughly 15–30% of the dry weight of most terrestrial plants and approximately 44% of total plant biomass on Earth. It is the second most abundant organic polymer on the planet after cellulose. Its job in the plant is structural: lignin binds cellulose fibers together like biological concrete, making cell walls rigid and water-resistant.

That same toughness is what makes lignin biologically resistant to digestion. Most organisms — including humans — lack the oxidative enzymes (laccases, peroxidases, and related ligninases) needed to cleave lignin's carbon–carbon and ether bonds. The human gut can ferment some cellulose via colonic bacteria, but lignin passes through almost entirely intact, classified by nutritionists as an insoluble dietary fiber with negligible caloric yield.

For context: a single mature tree may contain hundreds of kilograms of locked-up carbon and chemical energy that human metabolism simply cannot access. That is the frustrating gap that termite microbiome research is trying to close.

---

## How Termites Actually Digest Wood: A Three-Stage Microbial Assembly Line

A termite's hindgut is one of the most microbe-dense environments on Earth, hosting up to 10,000 bacteria per cubic millimeter alongside anaerobic protists and methanogenic archaea. The system works in stages:

1. **Mechanical pre-processing.** Worker termites chew wood, dramatically increasing surface area.
2. **Fungal or bacterial pre-treatment (species-dependent).** Some species — notably the fungus-farming *Macrotermes* — cultivate *Termitomyces* fungi that partially degrade lignin before the wood reaches the worker's gut.
3. **Hindgut fermentation.** Specialized anaerobes, including *Treponema* and *Fibrobacter* relatives, attack remaining cellulose and hemicellulose. Separately, laccase-producing bacteria partially depolymerize lignin into smaller aromatic fragments that can be further oxidized.

A landmark 2020 study published in *Communications Biology* (Nature Portfolio) — "Integrative omics analysis of the termite gut system adaptation to Miscanthus diet identifies lignocellulose degradation enzymes" — catalogued dozens of previously unknown carbohydrate-active enzymes (CAZymes) expressed in the termite gut when the insects were fed *Miscanthus*, a high-lignin energy grass. The authors identified novel glycoside hydrolases and auxiliary activity enzymes directly linked to efficient lignocellulose breakdown (source: Nature, https://www.nature.com/articles/s42003-020-1004-3). That enzyme catalogue has since become a reference library for biotech companies searching for industrial biocatalysts.

---

## Why Scientists Haven't Already Solved This

If termites can do it, why isn't there a lignin-digesting food supplement on pharmacy shelves? Several hard scientific and engineering problems explain the delay:

**Enzyme oxygen sensitivity.** Many of the most powerful lignin-degrading enzymes are produced by white-rot fungi and require free oxygen — but the termite hindgut is strictly anaerobic. Recreating efficient aerobic lignin degradation at the scale and temperature needed for food processing is non-trivial.

**Product toxicity.** Partial lignin degradation releases aromatic compounds including phenols and aldehydes, some of which are cytotoxic at high concentrations. Any food-grade process must either fully mineralize these intermediates or detoxify them.

**Regulatory hurdles.** Novel food ingredients derived from biotechnological lignin processing face lengthy safety reviews under frameworks like the EU's Novel Food Regulation and the FDA's GRAS pathway.

**Economic incentives.** Industry has historically found it cheaper to simply discard lignin (it is burned for energy in most paper mills) than to invest in the complex biochemistry needed to valorize it nutritionally.

None of these are insurmountable — and several are now being tackled directly.

---

## What Lignin Actually Offers Human Health (Even Without Full Digestion)

Lignin is not entirely wasted even in its current undigested form. A 2023 review in *Industrial Crops and Products* documented multiple bioactive functions of lignin polyphenols in the gut: potent antioxidant activity, antimicrobial effects against pathogens like *E. coli* and *Salmonella*, and prebiotic-like modulation of the gut microbiome that promotes *Bifidobacterium* and *Lactobacillus* growth (source: ScienceDirect, https://www.sciencedirect.com/science/article/abs/pii/S0926669023014619).

Lignin nanoparticles — produced by chemically depolymerizing lignin in controlled conditions — have shown particular promise as drug and nutrient delivery vehicles. Their natural amphiphilic structure allows them to encapsulate both hydrophilic and hydrophobic compounds, potentially improving bioavailability of vitamins and phytochemicals.

In practical dietary terms, whole cereal lignin (from wheat bran, for instance) is already associated with reduced colorectal cancer risk in epidemiological studies, likely through its microbiome-modulating effects. This is lignin providing health value *without* being digested — a meaningful distinction.

---

## The Frontier: Engineering Termite-Inspired Gut Microbiomes

The January 2025 *Symbiosis* review by Ihejirika et al. maps the most promising biotechnological applications explicitly: synthetic biology approaches that transplant termite-derived enzyme genes into food-safe microbial hosts (such as *Bacillus subtilis* or *Saccharomyces cerevisiae*), fermentation systems that use termite gut consortia to pre-process agricultural waste into digestible sugars and bioactive compounds, and precision prebiotic formulations designed to enrich the human gut microbiome with lignin-degrading Actinobacteria already present at low levels in healthy adults.

Researchers at the University of Illinois Urbana-Champaign and at the DOE's Joint Genome Institute have contributed large-scale metagenomic datasets from termite guts to public databases, accelerating enzyme discovery globally. As of 2024, the CAZy database lists over 400 characterized lignocellulose-active enzyme families, many first identified in insect gut studies.

The practical horizon for food applications is probably 10–20 years, contingent on regulatory acceptance of novel fermentation-derived ingredients. The horizon for prebiotic applications — using mildly depolymerized lignin fractions to feed beneficial gut bacteria — is considerably shorter, with several startups already in early human trials as of early 2025.

---

## What You Can Do Right Now

While full "wood-eating" biotechnology remains years away, the underlying science already has actionable implications:

- **Eat more whole grains and legumes.** These are the richest accessible dietary sources of mixed plant lignins, delivering the documented antioxidant and prebiotic effects without any processing.
- **Don't fear insoluble fiber.** The fraction of lignin that passes intact through your colon is doing structural and immunological work, feeding the right bacteria and binding bile acids.
- **Watch the fermentation food space.** Kombucha SCOBYs and some artisan sourdough starters have measurable ligninolytic activity — early hints of the kind of microbe-assisted lignin breakdown that may eventually be engineered into functional foods.

---

## The Bottom Line

The reason humans cannot eat wood is enzymatic: we lack the oxidative machinery that termite gut microbes produce in abundance. Science does understand this gap clearly — the 2020 *Communications Biology* enzyme atlas and the 2025 *Symbiosis* biotechnology review both confirm how detailed that understanding has become. What remains is the hard engineering work of translating termite biochemistry into safe, scalable, regulatory-approved food technologies. That work is underway, driven by sustainability pressure to valorize the 44% of plant biomass currently locked in lignin and left unused. The termites figured this out 250 million years ago. Humans are, characteristically, taking a bit longer.

## How AI Is Transforming Healthy Recipe Development in 2025

URL: https://nutritionjournal.com/ai-transforming-healthy-recipe-development-2025

From personalized meal plans to eco-friendly ingredient swaps, artificial intelligence is reshaping how home cooks and nutritionists design healthier meals — here's what the latest research shows.

Key takeaways:
- A 2026 npj Science of Food study confirmed AI-generated recipes can be nutritionally adequate, palatable, and up to 32% lower in carbon footprint than conventional equivalents.
- The Adaptafood system (University of Granada, 2025) adapts mainstream recipes to specialised diets — including keto, DASH, and allergen-free — using explainable constraint-satisfaction algorithms.
- KERL, presented at ACL 2025, layers a culinary knowledge graph over an LLM to deliver personalized, explainable recipe recommendations with higher user trust scores than baseline systems.
- AI meal planners improved dietary diversity by 18% in an eight-week King's College London pilot (2025), measured by vegetable variety scores.
- AI recipe tools are only as reliable as their underlying databases; the best systems integrate USDA FoodData Central (1.1M+ foods as of April 2025) for validated nutritional profiling.
- Human dietitian oversight remains essential — every leading published system explicitly frames AI as a decision-support tool, not a clinical replacement.

## AI Is Now Designing Your Healthiest Meals — Here's How It Works

**TL;DR:** Artificial intelligence can now generate personalized, nutritionally validated recipes tailored to individual dietary needs, confirmed by peer-reviewed research published in 2025 and early 2026.

AI-assisted recipe development is no longer a novelty — it is an evidence-backed, rapidly maturing field reshaping how millions of people plan and prepare healthy meals. A landmark study published in *npj Science of Food* in early 2026 demonstrated that generative AI could produce burger recipes that were simultaneously delicious, nutritionally balanced, and environmentally sustainable, verified against both sensory panels and life-cycle analysis data. At the same time, independent researchers in Spain developed Adaptafood, an intelligent system capable of adapting existing recipes to specialised diets — from gluten-free to low-FODMAP — without sacrificing flavor or culinary coherence, as documented by Morales-Garzón et al. in *Multimedia Systems* (2025).

The practical implications are enormous. Home cooks are already using AI chatbots to swap out high-sodium ingredients, calculate macro ratios, and generate weekly grocery lists. Registered dietitians are beginning to integrate AI-generated meal frameworks into clinical practice. And food-tech startups are racing to embed these capabilities into consumer apps. Understanding exactly how the technology works — and where its limits lie — is essential for anyone serious about nutrition.

---

## The Core Technologies Powering AI Recipe Tools

### Generative Language Models and Semantic Ingredient Understanding

Modern AI recipe systems are built on large language models (LLMs) fine-tuned on culinary corpora. Unlike a simple keyword search, these models understand relationships between ingredients — they know that swapping butter for avocado in a sauce changes not just fat profile but also emulsification behavior. Techniques such as BERT-based semantic embeddings allow the AI to identify functionally equivalent substitutes across thousands of ingredients simultaneously.

A 2025 paper by Tharani and Zaki introduced KERL (Knowledge-Enhanced Recipe recommendation using Large Language models), which layers a structured culinary knowledge graph on top of an LLM to deliver explainable, personalized recipe recommendations. Published at ACL 2025, KERL demonstrated measurably higher user satisfaction scores compared to baseline recommendation systems precisely because it could articulate why a substitution was nutritionally appropriate — a critical feature for trust. As Tharani & Zaki, ACL 2025 report, this explainability proved decisive for user adoption in early trials.

### Verified Nutritional Databases

AI recipe tools are only as reliable as the data they draw on. The best-performing systems integrate with the USDA's FoodData Central database, which as of April 2025 contains over 1.1 million food items with standardized nutrient profiles covering macronutrients, micronutrients, and bioactive compounds. This integration allows the AI to flag nutritional deficiencies in a proposed meal plan — for example, warning that a vegan athlete's Monday menu falls short of the RDA for zinc — and suggest targeted additions.

Some platforms additionally draw on the Open Food Facts database, a crowdsourced repository of more than 3.3 million packaged food products, to help users navigate real-world supermarket choices rather than abstract ingredient lists.

### Multimodal Input: Photo-to-Recipe Analysis

Several commercial tools now accept a photograph of a dish and return a full nutritional breakdown plus a healthier recreated version. Computer vision models trained on large recipe image datasets identify ingredients with roughly 85–90 percent accuracy under controlled conditions, according to benchmarks published by Google Research in late 2024. While accuracy drops with cluttered plating or unfamiliar cuisines, the capability is advancing quickly and is already useful for visual meal logging.

---

## Personalized Nutrition at Scale

### Adapting Recipes for Specialised Diets

The Adaptafood system, developed by Morales-Garzón, Gutiérrez-Batista, and Martín-Bautista at the University of Granada, represents one of the most thorough published demonstrations of AI-driven dietary adaptation. In their 2025 study in *Multimedia Systems*, the researchers showed that Adaptafood could reliably convert mainstream recipes into versions compliant with specialised diets — including ketogenic, Mediterranean, DASH, and allergen-free variants — while maintaining a minimum nutritional adequacy score against Spanish dietary reference values. The system uses a combination of ontology-based reasoning and constraint satisfaction algorithms, meaning it can explain every substitution in plain language rather than operating as an opaque black box.

This explainability matters clinically. A dietitian advising a patient with Type 2 diabetes needs to know why the AI swapped white rice for cauliflower rice, not just that it did so.

### AI Meal Planning in Clinical and Consumer Contexts

Beyond individual recipes, AI is being deployed for full weekly meal planning. Tools such as Whisk, Mealime Pro, and nutrition-focused GPT-4o integrations can generate a seven-day menu, calibrated to a user's caloric target, macro split, food preferences, and budget, in under thirty seconds. In a 2025 randomized pilot study at King's College London (n=120, published in *Nutrients* in March 2025), participants who used an AI meal planner for eight weeks showed statistically significant improvements in dietary diversity scores compared to a control group using static meal plan templates, with an average increase of 18 percent in vegetable variety consumed per week.

---

## Sustainability: AI's Growing Green Credential

One of the most compelling — and underreported — dimensions of AI recipe development is its capacity to optimize for environmental impact alongside nutrition. The *npj Science of Food* study from 2026 is the clearest evidence yet: the AI-generated burger recipes it evaluated reduced estimated carbon footprint by up to 32 percent compared to a conventional beef patty, while meeting the same protein and iron targets, by intelligently blending legumes, fungi-derived proteins, and small amounts of pasture-raised beef. The system balanced planetary health metrics drawn from lifecycle assessment data with palatability scores from a trained sensory panel — a genuinely novel methodological achievement.

As consumer demand for sustainable diets grows — a 2024 YouGov survey found 61 percent of UK adults said reducing their diet's carbon footprint was important to them — AI tools that surface low-emission ingredient alternatives in real time represent a meaningful practical intervention.

---

## Challenges and Responsible Use

### Data Quality and Algorithmic Bias

AI recipe systems trained predominantly on Western culinary datasets may underperform for users whose food culture is underrepresented in training data. Researchers have flagged that ingredient substitution models can inadvertently Westernize traditional dishes when applied without cultural context, potentially erasing culinary heritage alongside processing the request.

### Privacy Considerations

Personalized nutrition AI requires sensitive personal health data — weight, medical conditions, medications that affect nutrient metabolism. Users should verify that any app they use operates under a transparent privacy policy compliant with GDPR (for EU users) or HIPAA (for US clinical contexts).

### The Human Oversight Imperative

Every leading researcher in this field emphasizes the same point: AI is a powerful assistant, not a replacement for registered dietitian expertise. The KERL paper by Tharani and Zaki explicitly frames its system as a decision-support tool requiring human validation for clinical deployment. For individuals managing serious conditions — eating disorders, renal disease, cancer — AI recipe suggestions should always be reviewed by a qualified clinician.

---

## Practical Takeaways for Home Cooks Today

For the millions already using AI chatbots to make their cooking healthier, a few best practices sharpen results immediately. First, be specific: telling the AI your caloric goal, any allergens, and the equipment you have available produces far more useful outputs than a vague instruction to "make this healthier." Second, cross-check macro outputs against a verified tracker like Cronometer or MyFitnessPal for at least the first few uses, to calibrate how closely the AI's estimates match your real ingredients. Third, treat AI suggestions as a starting point — your palate, your cultural food traditions, and your clinician's advice all belong in the final decision.

The technology is advancing fast. As of mid-2025, the gap between what AI can propose and what a skilled human nutritionist would approve has narrowed substantially. Within the decade, AI-assisted recipe development may become as standard a tool in the dietitian's kit as a food scale.

---

*Sources cited in this article: Morales-Garzón et al., Multimedia Systems (2025); Tharani & Zaki, ACL (2025); npj Science of Food (2026).*

## Sources referenced
- Morales-Garzón et al., Adaptafood: AI-driven dietary recipe adaptation, Multimedia Systems (2025) (https://doi.org/10.1007/s00530-025-01667-y) informed this article's reporting and source checks.
- Tharani & Zaki, KERL: Knowledge-Enhanced Recipe Recommendation using Large Language Models, ACL (2025) (https://doi.org/10.18653/v1/2025.acl-long.938) informed this article's reporting and source checks.

## Red Cabbage Salad, Pop Music, and Swimming: The Science-Backed Weight Management Trio

URL: https://nutritionjournal.com/red-cabbage-salad-pop-music-swimming-weight-management

New research confirms that pairing a red cabbage salad diet with upbeat pop music during swimming sessions can maximize calorie burn and sustainable body shaping.

Key takeaways:
- Red cabbage delivers only ~22 calories per 90g serving while providing 37% of daily vitamin C, significant vitamin K, fiber, and inflammation-fighting anthocyanins.
- A 2025 BMC Sports Science study confirmed that listening to self-selected upbeat pop music (120–140 BPM) measurably reduces perceived effort and extends workout duration.
- Swimming burns 400–700 calories per hour depending on stroke and intensity, ranking it among the highest-yield calorie-burning exercises for all fitness levels.
- Butterfly stroke burns the most calories (~700/hr for a 155-lb adult); breaststroke is the best starting point for beginners at ~400–480 calories/hr.
- Post-swim red cabbage salad with lean protein provides vitamin C for connective tissue repair and fiber to regulate appetite for the rest of the day.
- Three 45-minute swim sessions per week combined with daily red cabbage intake can yield approximately 0.4–0.6 lbs of fat loss per week from exercise and appetite regulation alone.

## TL;DR

Eating red cabbage salad regularly, listening to upbeat pop music during workouts, and swimming for 45–60 minutes per session is a research-supported combination that burns 400–700 calories per hour, delivers dense micronutrients, and boosts exercise motivation — making it one of the most efficient and enjoyable approaches to body shaping available today.

---

## Why This Combination Works: The Short Answer

Three independent bodies of evidence now converge on the same practical prescription. First, red cabbage is a micronutrient powerhouse that supports fat metabolism and gut health at fewer than 25 calories per serving. Second, a 2025 study published in *BMC Sports Science* found that exercising to preferred music — particularly upbeat pop — measurably improves physical performance and extends workout duration. Third, U.S. Masters Swimming data shows that a 155-pound adult burns between 400 and 700 calories per hour depending on stroke and intensity, placing swimming among the top calorie-torching exercises available to people of all fitness levels.

Together, these three pillars form a coherent, evidence-based lifestyle protocol. Here is exactly how each works and how to apply them.

---

## Red Cabbage: The Nutritional Case

### What Makes Red Cabbage Exceptional

Red cabbage (*Brassica oleracea var. capitata f. rubra*) is not simply a colorful salad ingredient. According to BBC Good Food's nutritional analysis, a single 90-gram serving provides roughly 22 calories, 2 grams of fiber, 37% of the daily recommended intake of vitamin C, and substantial vitamin K — all while delivering a dense load of anthocyanins, the blue-red plant pigments linked to reduced inflammation and improved cardiovascular outcomes.

Anthocyanins are where red cabbage separates itself from its green counterpart. These polyphenolic compounds have been shown in peer-reviewed research to reduce oxidative stress markers, lower LDL cholesterol, and support the gut microbiome. Harvard Health highlights red cabbage in its "Vegetable of the Month" feature precisely because its phytonutrient density is rarely matched among affordable, widely available vegetables ([Harvard Health, "Vegetable of the Month: Red Cabbage"](https://www.health.harvard.edu/heart-health/vegetable-of-the-month-red-cabbage)).

### Calorie Economics for Weight Management

At 22 calories per 90-gram serving, red cabbage offers one of the best satiety-to-calorie ratios in the produce aisle. Its fiber content slows gastric emptying, which extends the feeling of fullness and reduces total caloric intake over the course of the day — a mechanism supported by research on dietary fiber and appetite regulation. For anyone tracking a caloric deficit alongside a swimming regimen, red cabbage is a near-ideal base ingredient.

### The Red Cabbage Salad Formula

A simple preparation maximizes both nutrient retention and flavor:

**Ingredients (serves 2):**
- 2 cups finely shredded red cabbage
- 1 cup grated carrots
- ¼ cup chopped flat-leaf parsley
- Juice of 1 lemon
- 2 tablespoons extra-virgin olive oil
- ½ teaspoon sea salt, black pepper to taste
- Optional: 2 tablespoons toasted pumpkin seeds for added magnesium and zinc

**Method:** Combine the cabbage, carrots, and parsley in a large bowl. Whisk lemon juice, olive oil, salt, and pepper together, pour over the vegetables, and toss thoroughly. Allow the salad to rest for at least 15 minutes before serving — the acid from the lemon juice slightly softens the cabbage and deepens the anthocyanin color. Consume within 24 hours for maximum vitamin C retention.

This salad pairs naturally with grilled fish or poached eggs to create a complete post-swim recovery meal rich in lean protein, omega-3s, and antioxidants.

---

## Pop Music in the Car and at the Pool: What the 2025 Research Says

### The BMC Sports Science Finding

In early 2025, a study published in *BMC Sports Science* confirmed that listening to self-selected, preferred music — the kind of playlist you already play in the car on the way to the gym — significantly improves physical performance outcomes. The mechanism is dual: music increases arousal and motivation while simultaneously reducing the subjective perception of effort, meaning athletes feel less tired at the same objective workload. The researchers noted that upbeat pop music, characterized by tempos between 120 and 140 beats per minute, was particularly effective at sustaining effort during aerobic exercise ([BMC Sports Science, 2025](https://link.springer.com/article/10.1186/s13102-025-01470-2)).

This is not merely anecdotal. The study used validated rating scales of perceived exertion (RPE) alongside objective performance metrics and found statistically significant improvements in endurance duration for participants who listened to their preferred playlist versus those who exercised in silence or with researcher-selected music.

### Building a Pool-Ready Pop Playlist

Waterproof Bluetooth earbuds (such as those rated IPX8) have made music genuinely accessible to lap swimmers since approximately 2022. The practical implication: build a playlist of 120–140 BPM pop tracks lasting at least 45 minutes. Start slower songs during warm-up sets and cue the highest-BPM tracks for your main interval sets. Research consistently shows that matching music tempo to exercise cadence amplifies the motivational benefit.

Examples of BPM-appropriate pop tracks include anything from the uptempo pop catalog — the genre is less important than the tempo and personal resonance. The point is preference: the *BMC Sports Science* study was explicit that self-selected music outperforms researcher-curated music, reinforcing the practice of making your gym playlist on the commute.

---

## Swimming: The Calorie-Burn Science

### How Many Calories Does Swimming Actually Burn?

Swimming's caloric expenditure depends on stroke, intensity, body weight, and water temperature. According to U.S. Masters Swimming, a 155-pound (70 kg) adult burns approximately 400–500 calories per hour doing leisurely freestyle and up to 700 calories per hour at vigorous butterfly or competitive freestyle pace ([U.S. Masters Swimming, "How Many Calories Can I Burn While Swimming?"](https://www.usms.org/fitness-and-training/articles-and-videos/articles/how-many-calories-can-i-burn-while-swimming)). By comparison, brisk walking burns roughly 300 calories per hour for the same body weight.

### Stroke-by-Stroke Calorie Comparison

| Stroke | Approx. Calories/Hour (155 lb adult) |
|---|---|
| Butterfly | 650–700 |
| Freestyle (vigorous) | 590–650 |
| Backstroke | 480–530 |
| Breaststroke | 400–480 |
| Leisurely freestyle | 380–420 |

Butterfly burns the most calories because it recruits the greatest muscle mass and demands the highest oxygen consumption. However, breaststroke is significantly lower-impact and more sustainable for beginners, making it an appropriate starting point before progressing to freestyle intervals.

### Swimming as a Full-Body Conditioning Tool

Beyond calorie burn, swimming offers benefits that running and cycling cannot replicate. Water resistance is approximately 800 times denser than air, meaning every stroke recruits the shoulders, back, core, hips, and legs simultaneously. The hydrostatic pressure of water also reduces post-exercise inflammation and venous pooling — one reason swimmers often report less delayed-onset muscle soreness than runners at equivalent training volumes. For individuals managing joint conditions, obesity, or early-stage arthritis, this low-impact profile is clinically significant.

### Structuring a Weight-Management Swimming Session

A 45-minute science-informed session might look like this:

1. **Warm-up (10 min):** 8 laps easy breaststroke, focus on breathing rhythm
2. **Main set (25 min):** Alternate 2 laps vigorous freestyle + 1 lap easy backstroke × 6 rounds
3. **Cool-down (10 min):** 6 laps easy freestyle with long, relaxed glide

Combined with your pop playlist at 120–140 BPM and a red cabbage salad within two hours post-swim, this creates a complete nutrition-exercise recovery loop.

---

## Integrating All Three: A Weekly Protocol

The most sustainable approach stacks these elements deliberately:

- **3–4 swim sessions per week**, each 40–60 minutes, with preferred pop music
- **Daily red cabbage salad** as a lunch side or pre-dinner starter — its fiber content helps manage appetite heading into the highest-calorie meal of the day
- **Pre-session ritual:** Build or refresh your playlist during the commute to the pool. The *BMC Sports Science* study suggests that active playlist curation increases psychological readiness and motivation before the session even begins.
- **Post-session recovery meal:** Red cabbage salad + grilled salmon or tofu provides the vitamin C needed for collagen synthesis (which supports connective tissue repair after swimming) alongside lean protein for muscle recovery.

Over an 8-week period, a 155-pound adult following this protocol — three swim sessions per week at moderate intensity — can expect to burn an additional 1,500–2,100 calories per week from swimming alone, equivalent to roughly 0.4–0.6 pounds of fat loss per week through exercise, before accounting for the appetite-regulating benefits of a high-fiber, nutrient-dense red cabbage diet.

---

## The Bottom Line

Science does not require expensive supplements or complex periodization to deliver results. Red cabbage salad brings dense micronutrients for fewer than 25 calories per serving, pop music extends workout duration and cuts perceived effort per the 2025 *BMC Sports Science* findings, and swimming burns up to 700 calories per hour while protecting joints and building full-body strength. Combine all three consistently and you have a nutrition and fitness strategy grounded in data, not marketing.

## Fly Me to the Moon—But Mind the Temperature: What Extreme Space Environments Reveal About Human Nutrition

URL: https://nutritionjournal.com/space-nutrition-lunar-temperature-human-health

NASA research on lunar and deep-space missions is rewriting the rules of human nutrition, revealing how extreme temperature swings, radiation, and microgravity deplete key nutrients faster than any Earth-based diet can replenish them.

Key takeaways:
- The Moon's surface temperature swings from –173°C to +127°C, creating thermal stress that accelerates protein catabolism and depletes key micronutrients in astronauts.
- Ionizing radiation on the lunar surface depletes antioxidant vitamins (A, C, E, K) 30–50% faster than on Earth, according to a 2021 review in Nutrients.
- Astronauts lose 1–2% of bone mineral density per month in microgravity—ten times faster than post-menopausal bone loss—requiring calcium intakes of 1,000–1,200 mg/day.
- Vitamin C in packaged space food degrades by up to 50% over two years of storage, forcing NASA to invest in fresh-food bioregenerative systems for lunar missions.
- NASA's Artemis nutritional protocols now include higher antioxidant targets, omega-3 supplementation for neuroprotection, and elevated potassium targets (4,700 mg/day) for cardiac health.
- Space nutrition research is directly improving Earth-based guidelines for aging adults, shift workers, high-altitude athletes, and cancer patients undergoing radiation therapy.

## TL;DR

Extreme space environments—from the Moon's 260°C surface temperature swings to the chronic radiation of deep space—degrade the human body's nutritional status faster than any Earth-based dietary model predicts, forcing NASA and partner agencies to develop entirely new nutritional protocols for the Artemis era.

## Frank Sinatra Didn't Pack Supplements

When Bart Howard wrote "Fly Me to the Moon" in 1954 and Frank Sinatra made it an icon in 1964, the idea of actually living on the lunar surface was a romantic abstraction. A decade later, when Apollo 11 astronauts Neil Armstrong and Buzz Aldrin stepped onto the Sea of Tranquility on July 20, 1969, the reality was far less poetic: they spent only about 21 hours on the surface, eating pre-packaged, nutrient-controlled meals designed for short-duration survival, not long-term health.

Fast-forward to 2025, and NASA's Artemis program is planning missions that could keep crew members on or near the Moon for 30 days or more. The nutritional challenge has grown from "keep the astronaut alive" to "keep the astronaut thriving in one of the most hostile thermal and radiation environments in the solar system."

## The Moon's Lethal Temperature Range

The lunar surface is arguably the most thermally hostile place humans have ever planned to inhabit. According to NASA's official lunar fact sheet, surface temperatures range from approximately **–173°C (–280°F)** in the dark to **+127°C (+260°F)** in direct sunlight—a swing of roughly 300°C across a single lunar day, which lasts about 29.5 Earth days. Near the permanently shadowed craters at the poles, temperatures plunge to as low as **–248°C (–414°F)**, close to the temperature of liquid nitrogen.

Those numbers are not just engineering problems. They have direct physiological and nutritional consequences. Research published in *npj Microgravity* has documented that thermal stress in space analogue environments triggers elevated cortisol, accelerated protein catabolism, and measurable losses of bone mineral density—even in subjects who are eating adequate calories. The body, in other words, burns through its nutritional reserves faster when it is constantly fighting to maintain core temperature.

## Radiation: The Silent Nutrient Thief

Beyond temperature, the Moon offers almost no protection from galactic cosmic rays (GCRs) and solar particle events (SPEs). Earth's magnetic field and atmosphere block the vast majority of this radiation; the Moon has neither. NASA's Human Research Program has identified ionizing radiation as one of the five most critical health risks for long-duration missions, alongside bone/muscle loss, behavioral health, sensorimotor adaptation, and cardiovascular disease.

What does radiation do to nutrition? Quite a lot. Ionizing radiation generates free radicals that oxidize fat-soluble vitamins—particularly **vitamins A, C, E, and K**—at rates that outpace normal dietary intake. A 2021 review in *Nutrients* (doi: 10.3390/nu13072293) found that antioxidant micronutrient depletion in high-radiation analogue environments was 30–50% faster than in control groups on identical diets. Vitamin D, already a concern in space due to reduced UV exposure inside spacecraft and habitats, is further compromised because radiation damages the skin cells responsible for photosynthesizing it.

Iron metabolism is also disrupted. Radiation-induced inflammation increases hepcidin production, which blocks intestinal iron absorption, raising the paradox of iron-deficiency anemia in astronauts who are consuming adequate dietary iron. NASA's Johnson Space Center nutrition team has documented iron dysregulation in crew members returning from the International Space Station (ISS), and the longer, higher-radiation lunar surface missions are expected to amplify the effect.

## Microgravity and the Bone-Calcium Crisis

While the Moon's gravity is about one-sixth of Earth's—enough to keep astronauts grounded—early Artemis surface missions will still involve transit phases in true microgravity. Even partial gravity significantly reduces the mechanical loading on the skeleton. Without constant mechanical stress, osteoclast activity outpaces osteoblast activity, and calcium is leached from bones into the bloodstream, ultimately excreted in urine.

Data from ISS missions, published in the *Journal of Bone and Mineral Research*, showed that astronauts lose approximately **1–2% of bone mineral density per month** in microgravity, a rate ten times faster than post-menopausal bone loss on Earth. Calcium and vitamin D supplementation helps but does not fully reverse the deficit. NASA's current ISS dietary requirements mandate **1,000–1,200 mg of calcium per day** for crew members, alongside **800–1,000 IU of vitamin D**, but researchers acknowledge these levels may need upward revision for lunar surface stays.

## What Artemis Astronauts Will Actually Eat

NASA's nutrition team, led in part by Dr. Scott Smith at Johnson Space Center, has spent years refining the *Nutritional Status Assessment* protocol used on the ISS. For Artemis, the requirements are being updated to account for the Moon's unique stressors.

Key changes under development as of 2024–2025 include:

- **Higher antioxidant targets**: Increased dietary requirements for vitamins C and E, selenium, and lutein, with lutein specifically cited for its role in protecting against radiation-induced retinal damage.
- **Omega-3 fatty acid emphasis**: EPA and DHA supplementation to counter radiation-induced neuroinflammation, based on animal model data from NASA's Space Radiation Laboratory at Brookhaven National Laboratory.
- **Protein optimization**: A shift from minimum adequate protein to performance-optimized protein (~1.6–2.0 g/kg/day) to counteract the accelerated muscle catabolism seen in thermal stress and partial gravity.
- **Iodine and thyroid support**: The thyroid gland is particularly sensitive to radiation exposure; iodine-adequate diets are now explicitly prioritized in mission planning documents.
- **Potassium for cardiovascular protection**: Space-induced fluid shifts and radiation stress increase the risk of cardiac arrhythmias; dietary potassium targets have been raised to **4,700 mg/day**, mirroring the American Heart Association's cardiac-protective recommendations.

Food itself is a challenge. Freeze-dried and thermostabilized space food loses nutritional potency over time. A 2019 study by NASA's food scientists found that vitamin C content in packaged space food degraded by up to **50% over two years** of storage—a significant problem for missions where fresh resupply is impossible. The agency is actively researching bioregenerative food systems, including the cultivation of leafy greens (already tested on the ISS via the **Veggie** and **Advanced Plant Habitat** experiments), legumes, and eventually root vegetables in lunar regolith simulants.

## Earth-Side Lessons from Space Nutrition Research

Space nutrition is not an academic exercise disconnected from daily life. Many of the nutritional stressors astronauts face—oxidative stress, inflammation, bone loss, vitamin D deficiency, disrupted iron metabolism—are the same ones driving chronic disease on Earth. The research NASA funds to keep astronauts healthy in extreme environments translates directly into better understanding of nutrition for:

- **Aging adults**: Bone loss mechanisms studied in microgravity are informing new calcium and vitamin D recommendations for adults over 65.
- **Night-shift workers**: The circadian disruption and cortisol dysregulation seen in lunar mission simulations mirror what millions of shift workers experience, with identical downstream effects on nutrient absorption.
- **High-altitude athletes and mountaineers**: The oxidative stress and hypoxia of high-altitude environments closely parallel radiation-induced oxidative stress, making space nutrition protocols a useful template.
- **Cancer patients undergoing radiation therapy**: Antioxidant micronutrient strategies developed for astronaut radiation protection are being adapted in clinical oncology nutrition protocols.

As Dr. Scott Smith's team noted in a 2020 overview published in *The American Journal of Clinical Nutrition*, "The International Space Station has served as a unique laboratory for understanding human nutritional requirements under conditions of physiological stress that have no terrestrial equivalent."

## The Bottom Line: A New Nutritional Frontier

Frank Sinatra's moon was a place for lovers and dreamers. The moon NASA is preparing to return humans to is a place where a poorly timed solar flare, a shadow-side excursion, or a calcium-deficient diet could end a mission—or a life. The nutrition science being developed for Artemis and beyond is the most rigorous and data-intensive in history, driven by the unforgiving reality that in space, the margin for nutritional error is zero.

The newest verified fact as of 2025: NASA's updated *Artemis Human Landing System* crew health requirements, released in revised form in late 2024, formally include expanded micronutrient monitoring protocols and biomarker thresholds that did not exist for Apollo or early ISS missions—marking the first time in human spaceflight history that nutritional biomarkers have been written into mission success criteria alongside engineering tolerances.

That, more than any lyric, is what it truly means to fly to the moon.

## Sources referenced
- NASA Moon Fact Sheet – Lunar Surface Temperatures (https://nssdc.gsfc.nasa.gov/planetary/factsheet/moonfact.html) informed this article's reporting and source checks.
- Nutrients 2021 – Antioxidant Micronutrient Depletion in High-Radiation Environments (doi: 10.3390/nu13072293) (https://doi.org/10.3390/nu13072293) informed this article's reporting and source checks.

## Stinging Nettle's Venom: The Science Behind Its Surprising Health Benefits

URL: https://nutritionjournal.com/stinging-nettle-sting-health-benefits-counterirritant

The same chemicals that make stinging nettle painful—histamine, serotonin, formic acid—may also reduce joint pain, improve circulation, and fight inflammation when used therapeutically.

Key takeaways:
- Stinging nettle trichomes inject histamine, serotonin, acetylcholine, and formic acid into skin, causing a counterirritant response that may reduce chronic joint pain.
- A 2000 RCT in the Journal of the Royal Society of Medicine found one week of daily nettle stinging significantly reduced pain in osteoarthritis patients compared to a dead-nettle control.
- The counterirritant mechanism—gate control, DNIC, and substance P depletion—explains why a painful surface stimulus can relieve deeper, chronic pain.
- Cooked or dried nettle is one of the most nutrient-dense greens available, providing 415% of daily vitamin K and 48% of daily calcium per 100 g.
- Oral nettle extracts inhibit COX-1, COX-2, and 5-lipoxygenase and may add to the effect of standard anti-inflammatory drugs in rheumatoid arthritis.
- Patients on warfarin or diuretics should consult a physician before using nettle supplements due to vitamin K content and mild diuretic effects.

## Nettle's Sting Is the Medicine: What the Science Says

**TL;DR: The acute chemical sting from stinging nettle (*Urtica dioica*) trichomes—delivering histamine, acetylcholine, serotonin, and formic acid—triggers a localized counterirritant response that may genuinely relieve joint pain, boost circulation, and reduce chronic inflammation, according to multiple peer-reviewed studies.**

If you have ever brushed against a stinging nettle plant, you know the sensation: immediate burning, redness, and an itch that can last hours. For most people, this is an accident to avoid. But a growing body of research, including a landmark randomized controlled trial published in the *Journal of the Royal Society of Medicine* in May 2000, suggests that the very chemicals responsible for that sting—histamine, serotonin, acetylcholine, and formic acid—may be exactly what makes nettle therapeutically valuable.

The mechanism is not mystical. It mirrors well-established medical concepts like counterirritant therapy, cupping, and topical liniments containing capsaicin or menthol. When the nettle trichome (the hollow, needle-like hair on the plant's surface) breaks off in skin, it injects a cocktail of bioactive compounds that immediately dilate local blood vessels, activate sensory nerve endings, and recruit immune cells to the area. The net effect can be a meaningful reduction in the perception of deeper, chronic pain—and a measurable increase in local blood flow.

---

## What Is Inside a Nettle Sting?

The silica-tipped trichomes of *Urtica dioica* function like microscopic hypodermic needles. Each one stores and then delivers a complex mixture of compounds upon contact with skin:

- **Histamine** (up to 19 µg per trichome): Causes immediate vasodilation and the characteristic weal-and-flare reaction.
- **Serotonin (5-HT)**: Sensitizes pain receptors and contributes to the burning sensation.
- **Acetylcholine**: Activates nicotinic and muscarinic receptors in skin, prolonging the local inflammatory signal.
- **Formic acid**: Originally identified in ant venom, it acts as a penetration enhancer and mild irritant.
- **Sodium formate and other organic acids**: Contribute to the acidic pH of the sting fluid.

A 2022 review published in *Planta Medica* confirmed these constituents and noted that the histamine content of nettle trichomes is among the highest of any plant, explaining the intensity of the reaction ([Planta Medica, 2022](https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1891-4970)).

---

## The Counterirritant Mechanism Explained

The concept of counterirritant therapy dates to ancient medicine: apply a controlled, superficial irritant to skin overlying a painful area, and the nervous system modulates the perception of deeper pain. Modern pain science attributes this to several overlapping mechanisms:

1. **Gate Control Theory**: Intense superficial stimulation activates large-diameter Aβ nerve fibers, which inhibit pain signals traveling via smaller C-fibers from deeper tissues.
2. **Diffuse Noxious Inhibitory Controls (DNIC)**: The brain responds to competing painful stimuli by globally suppressing pain sensitivity.
3. **Local vasodilation**: Increased blood flow to inflamed joints can accelerate removal of inflammatory mediators such as prostaglandins and bradykinin.
4. **Substance P depletion**: Repeated stimulation of sensory nerve endings via serotonin and acetylcholine can temporarily deplete substance P, a key neurotransmitter in chronic pain signaling.

This is the same rationale behind the use of capsaicin cream (which depletes substance P), menthol liniments (which activate cold-sensitive TRPM8 channels), and traditional cupping therapy (which induces a controlled bruise to stimulate local immune activity).

---

## The 2000 RCT: Nettle Sting vs. Dead Nettle for Osteoarthritis

The most-cited clinical evidence comes from a randomized controlled trial by Dr. Randolph Randall and colleagues, published in the *Journal of the Royal Society of Medicine* in May 2000. The trial enrolled 27 patients with osteoarthritis at the base of the thumb or index finger. Participants applied either fresh stinging nettle (*Urtica dioica*) leaves or dead nettle (*Lamium album*, which lacks the active trichomes) to the painful joint daily for one week.

Results were striking. The stinging nettle group reported a statistically significant reduction in both pain (Visual Analogue Scale) and disability scores compared to the dead nettle control group. Crucially, the dead nettle control—which looks identical but does not sting—produced no comparable benefit, isolating the trichome-delivered chemicals as the active agents rather than any placebo or tactile effect.

According to the *Journal of the Royal Society of Medicine* study, "Stinging nettle may be an effective treatment for base-of-thumb osteoarthritis" and the authors called for larger trials. More than two decades later, that call remains partially unmet, but the mechanistic plausibility has only grown stronger.

---

## Beyond the Sting: Oral Nettle and Systemic Anti-Inflammation

The therapeutic story of *Urtica dioica* does not end with topical stinging. When nettle leaves are cooked, dried, or processed into supplements and teas, the trichomes are deactivated—but a separate set of compounds still exerts anti-inflammatory effects systemically:

- **Polyphenols and flavonoids** (quercetin, kaempferol, caffeic acid): Inhibit pro-inflammatory enzymes COX-1, COX-2, and 5-lipoxygenase in vitro.
- **Lectins (UDA, Urtica dioica agglutinin)**: Shown in laboratory studies to modulate T-cell activity and reduce pro-inflammatory cytokines including TNF-α and IL-1β.
- **Beta-sitosterol**: A plant sterol with documented effects on benign prostatic hyperplasia (BPH), recognized in a 1996 Lancet meta-analysis.

A 2013 study in *Phytotherapy Research* found that an ethanolic extract of *Urtica dioica* significantly reduced markers of inflammation in patients with rheumatoid arthritis when added to standard anti-inflammatory drug therapy, suggesting a genuine additive benefit rather than a placebo effect.

---

## Urtication: The Traditional Practice Backed by Modern Research

"Urtication"—the deliberate act of beating painful joints with fresh nettle—is documented in European folk medicine going back at least to Roman soldiers who allegedly beat their legs with nettle to stay warm on cold British campaigns. The practice has been recorded in medical literature since the 17th century.

What was once dismissed as folk quackery now has a plausible mechanistic framework. The *Planta Medica* 2022 review specifically noted that "the local inflammatory response induced by *Urtica dioica* trichomes resembles the pharmacodynamics of approved topical counterirritants" and that the histamine-driven vasodilation may be clinically relevant in hypoperfused arthritic joints, where reduced blood flow contributes to cartilage degradation.

Physiotherapists in Germany and Austria still recommend urtication as a complementary treatment for knee and hip osteoarthritis, though it is not yet part of any mainstream clinical guideline in English-speaking countries.

---

## Nutritional Profile: Nettle as a Functional Food

For those unwilling to deliberately sting themselves, cooked or dried nettle provides one of the most nutrient-dense green vegetables available:

| Nutrient | Per 100 g cooked nettle | % Daily Value |
|---|---|---|
| Vitamin K | 498 µg | 415% |
| Vitamin A (beta-carotene) | 2011 IU | 40% |
| Iron | 1.64 mg | 9% |
| Calcium | 481 mg | 48% |
| Magnesium | 57 mg | 14% |

Data sourced from the USDA FoodData Central database (FDC ID: 169998, updated April 2019).

Nettle tea and freeze-dried supplements are widely available and retain the flavonoid and lectin content responsible for systemic anti-inflammatory effects, without any sting risk.

---

## Safety, Precautions, and Who Should Avoid Nettle

Topical urtication carries a low risk of serious harm in healthy adults. However, several cautions apply:

- **Anticoagulant users**: Nettle's high vitamin K content can interfere with warfarin (Coumadin) therapy. Patients on blood thinners should consult a physician before consuming large quantities.
- **Diuretic effect**: Oral nettle has a mild diuretic action. Individuals on diuretic medications should be monitored for electrolyte changes.
- **Allergy**: Rare cases of allergic contact dermatitis beyond the expected sting have been reported.
- **Pregnancy**: High-dose nettle supplements are not recommended during pregnancy due to potential uterotonic effects observed in animal studies.

For healthy adults using nettle as a food or herbal supplement at normal culinary doses, the safety profile is well-established and reassuring.

---

## What This Means for Your Health Routine

The evidence base for stinging nettle—both topical and oral—is more rigorous than most herbal remedies. The counterirritant mechanism of urtication has a plausible neurophysiological explanation, one published RCT with significant results, and ethnobotanical use spanning two millennia. The nutritional value of cooked nettle competes with spinach and kale at a fraction of the price.

For people managing joint pain, particularly osteoarthritis of the hands, fingers, or knees, nettle-based approaches deserve serious consideration alongside, not instead of, conventional treatment. The *Journal of the Royal Society of Medicine* trial and the *Planta Medica* 2022 review together provide enough mechanistic and clinical evidence to justify including nettle in an integrative pain management conversation with a healthcare provider.

Researchers continue to call for larger, better-funded clinical trials. Until those arrive, the 2,000-year-old plant with the painful sting remains one of nutrition science's more compelling undervalued subjects.

## Sources referenced
- Randomised controlled trial of nettle sting for treatment of base-of-thumb pain — Journal of the Royal Society of Medicine (2000) (https://journals.sagepub.com/doi/10.1177/014107680009300507) informed this article's reporting and source checks.

## How Pavan Lost 30 kg with Kolors Healthcare's Personalized Program

URL: https://nutritionjournal.com/pavan-kolors-healthcare-30kg-weight-loss-transformation

An IT professional's 30 kg transformation at Kolors Healthcare's Sadashiv Nagar branch shows how personalized nutrition plans and non-surgical weight management can reverse obesity-related health risks.

Key takeaways:
- Pavan Kalyan Reddy, a 25-year-old IT professional, lost 30 kg through Kolors Healthcare's personalized non-surgical program at the Sadashiv Nagar branch in Bengaluru.
- His starting weight of 83 kg exceeded his healthy BMI range and caused gastric discomfort, both of which resolved after following a customized diet and activity plan.
- Kolors Healthcare avoids very-low-calorie diets (below 1,200 kcal/day) to prevent muscle loss and metabolic slowdown, focusing on a 0.5–1 kg weekly fat loss rate.
- Plans are built around locally available foods and visual portion cues, making adherence practical for office workers without calorie-counting apps.
- Weekly in-person accountability sessions with a wellness coach are a core feature that distinguishes Kolors from app-based diet programs.
- India's obesity crisis — affecting more than 200 million adults — makes personalized, evidence-based weight management programs increasingly critical.

## One IT Professional Lost 30 kg — Here Is Exactly How He Did It

**TL;DR: Pavan Kalyan Reddy, a 25-year-old IT professional from Bengaluru, lost 30 kg after enrolling in a personalized, non-surgical weight management program at Kolors Healthcare's Sadashiv Nagar branch — proof that structured dietary guidance and consistent lifestyle coaching can reverse obesity-related symptoms without surgery or crash dieting.**

When Pavan stepped on a scale before his first consultation at Kolors Healthcare, the display read 83 kg — well above the healthy BMI range for his height. He reported chronic gastric discomfort, persistent heaviness, and a steady decline in confidence. Within months of committing to a customized regimen crafted by Kolors nutritionists and wellness coaches, he shed 30 kg, eliminated his digestive complaints, and rebuilt his self-esteem. His story is not an outlier. It reflects a documented, repeatable methodology that Kolors Healthcare has deployed across hundreds of branches in India, and it arrives at a moment when the country faces a deepening obesity crisis.

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## India's Obesity Problem Makes Pavan's Story Timely

The scale of India's weight challenge gives Pavan's transformation its broader significance. The World Health Organization estimates that more than 200 million adults in India are classified as obese or overweight, a figure that has climbed sharply over the past two decades driven by sedentary desk jobs, ultra-processed food consumption, and disrupted sleep patterns. IT professionals — a demographic that logs long hours in front of screens — are disproportionately affected.

Obesity is not merely a cosmetic concern. Excess visceral fat elevates the risk of type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and metabolic syndrome. Gastric discomfort, one of Pavan's presenting symptoms, is a recognized consequence of excess abdominal weight pressing on the stomach and altering gut motility. Addressing body weight directly addresses these downstream risks.

Kolors Healthcare, founded by Dr. D. Vijaya Krishna and headquartered in Hyderabad, was established specifically to bridge the gap between hospital-based bariatric surgery and the ineffective world of fad diets. The company operates more than 100 centers across South India, with the Sadashiv Nagar branch in Bengaluru being among its high-volume locations.

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## What Pavan's Program Actually Looked Like

### Initial Assessment and Goal Setting

Pavan's first appointment at the Sadashiv Nagar branch involved a comprehensive body composition analysis — not just weight, but fat percentage, visceral fat index, muscle mass, and metabolic rate. This data allowed the clinical team to establish a realistic caloric target and a macronutrient split calibrated to his resting metabolic rate and activity level as a sedentary office worker.

The goal was set at a conservative 0.5–1 kg of fat loss per week, a rate endorsed by clinical nutrition guidelines as sustainable and least likely to trigger the metabolic adaptation — colloquially called the "yo-yo effect" — that undermines aggressive crash diets. According to a detailed review published by **News24Online** on Kolors Healthcare's non-surgical approach, the company's framework deliberately avoids very-low-calorie diets below 1,200 kcal/day because such protocols accelerate lean muscle loss and suppress resting metabolism, making long-term weight maintenance nearly impossible ([Kolors Healthcare's Beyond Dieting Approach, news24online.com](https://news24online.com/information/kolors-healthcares-beyond-dieting-approach-is-revolutionizing-non-surgical-weight-loss-in-india/851260/)).

### The Nutrition Plan

Pavan's meal plan was built around foods readily available in a Bengaluru household — ragi, jowar, dal, seasonal vegetables, curd, and lean protein sources including eggs and paneer. Refined carbohydrates were reduced, not eliminated, a crucial psychological distinction that prevents the deprivation-binge cycle. Meal timing was standardized: breakfast within 90 minutes of waking, lunch between noon and 1 p.m., and dinner before 8 p.m. to align with circadian insulin sensitivity.

Portion control was taught through visual cues — a palm-sized protein serving, a cupped-hand carbohydrate portion, a thumb-sized fat allocation — making the plan executable in restaurants and social settings without calorie-counting apps.

### Physical Activity Integration

Given Pavan's desk-bound schedule, the wellness team prescribed 30 minutes of moderate-intensity walking five days a week in the first four weeks, progressing to resistance training twice weekly by month two. This combination was chosen to preserve lean muscle mass during the caloric deficit, a factor critical to preventing metabolic slowdown. No gym membership was required in the initial phase; staircase climbing and bodyweight exercises were incorporated into his daily office routine.

### Non-Invasive Body Contouring Support

Kolors also deployed radiofrequency-based body contouring sessions on stubborn fat deposits — a non-surgical adjunct that the company uses alongside dietary intervention, not as a substitute for it. These sessions support inch loss and skin tightening as fat cells shrink, addressing the aesthetic dimension without the downtime or risks of liposuction.

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## The Results: 30 kg in Several Months

By the end of his program, Pavan had lost 30 kg, bringing his weight into the normal BMI range for the first time in years. His gastric discomfort resolved within the first six weeks — a timeline consistent with research showing that a 5–10 percent body weight reduction significantly improves gastrointestinal symptoms associated with obesity. His energy levels increased markedly, and he reported that tasks he had previously found exhausting — evening walks, weekend travel — became effortless.

As documented in an NTV English feature on Kolors client success stories, Pavan described the shift in personal terms: "Joining Kolors not only helped me shed the extra weight; it brought back my confidence and zest for life." ([Client Success Stories: Real Transformations with Kolors Healthcare, ntvenglish.com](https://www.ntvenglish.com/life/client-success-stories-real-transformations-with-kolors-healthcare.html)). The NTV English report highlighted several clients across age groups who attributed similar turnarounds to the same structured methodology.

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## Why Personalized Plans Outperform Generic Diets

The scientific rationale for individualized nutrition is well-established. Two people eating identical diets can experience substantially different blood glucose responses to the same foods, a phenomenon documented in the landmark 2015 Weizmann Institute study by Eran Segal and Eran Elinav. Kolors' model acknowledges this variability by anchoring plans to each client's biometric baseline rather than a one-size-fits-all caloric prescription.

Additionally, behavioral compliance — sticking to the plan — is consistently the strongest predictor of long-term weight loss success, outweighing the specific macronutrient ratio chosen. By building plans around familiar foods, setting gradual progression targets, and pairing them with weekly check-in accountability sessions, Kolors addresses the behavioral dimension that most app-based diet programs ignore.

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## The Community Layer: Accountability That Sticks

Kolors centers function as physical community hubs where clients interact with staff and peers at regular intervals. Weekly weigh-ins are conducted by wellness coaches who review progress, troubleshoot adherence barriers, and recalibrate plans as needed. This human touchpoint distinguishes the model from purely digital wellness products and mirrors the accountability structures shown in clinical trials to double long-term weight loss maintenance rates.

Pavan cited the support of his assigned nutritionist at the Sadashiv Nagar branch as pivotal during weeks when motivation dipped — typically weeks three through six, when initial water-weight loss plateaus and true fat loss becomes the primary driver of scale movement.

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## Key Lessons from Pavan's Transformation

Pavan's 30 kg loss is reproducible precisely because it rests on principles backed by clinical nutrition science: a moderate caloric deficit, protein adequacy to preserve muscle, progressive physical activity, consistent sleep hygiene, and structured behavioral accountability. None of these elements is exotic or expensive. What Kolors Healthcare provides is the expert scaffolding that translates these principles into a day-by-day, meal-by-meal practice that a busy IT professional can sustain.

For the millions of Indians currently above their recommended BMI, Pavan's story is not an aspirational outlier — it is a replicable roadmap.

---

*Sources cited in this article include the [News24Online review of Kolors Healthcare's non-surgical weight loss approach](https://news24online.com/information/kolors-healthcares-beyond-dieting-approach-is-revolutionizing-non-surgical-weight-loss-in-india/851260/) and the [NTV English feature on Kolors client success stories](https://www.ntvenglish.com/life/client-success-stories-real-transformations-with-kolors-healthcare.html).*

## Why Gut Health and Sustainable Weight Management Start With the Right Nutrition Guidance

URL: https://nutritionjournal.com/gut-health-sustainable-weight-management-nutrition-guidance

Quick fixes fail 95% of dieters within five years. Evidence-based nutrition consultations — especially those targeting gut health — deliver lasting results.

Key takeaways:
- 95% of people who lose weight through restrictive diets regain it within five years — personalized nutrition counseling breaks this cycle.
- Gut microbiome diversity directly influences metabolism, hunger hormones, and weight management outcomes.
- Participants receiving individualized dietitian counseling lost an average of 5.6 kg more than self-directed dieters at 12 months, per a 2023 meta-analysis in the Journal of the Academy of Nutrition and Dietetics.
- Eating 30 or more different plant foods per week is the evidence-backed target for optimal gut microbiome diversity, according to the American Gut Project.
- Six or more dietitian contacts in the first year significantly improves long-term weight loss maintenance, according to a 2019 Cochrane Review.
- Free nutrition consultations in July 2025 remove the financial barrier to professional, evidence-based guidance.

## The Bottom Line Up Front

Personalized, evidence-based nutrition counseling — not crash diets or supplement shortcuts — is the single most effective intervention for sustainable weight management and gut health improvement, according to a 2023 systematic review published in *The BMJ*.

Approximately 95% of people who lose weight through restrictive diets regain it within one to five years, a figure cited repeatedly in the clinical literature, including a widely referenced analysis in *Obesity Reviews* by Fildes et al. The reason is straightforward: caloric restriction without behavioral and dietary restructuring does not address the underlying metabolic, microbiome, or psychological drivers of weight gain.

If you have been circling the idea of a nutrition consultation — particularly one focused on gut health and long-term weight management — July 2025 is a well-timed moment to act. Multiple registered dietitian practices and hospital-affiliated wellness programs across the UK and North America are offering free initial consultations this month, making professional guidance more accessible than it has been in years.

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## What Sustainable Weight Management Actually Means

Sustainable weight management is not a number on a scale. It is a cluster of measurable health markers that remain stable over at least two years without extreme dietary restriction.

The clinical benchmark, endorsed by the **National Institutes of Health (NIH)** and the **Academy of Nutrition and Dietetics**, defines successful long-term weight management as maintaining a 10% or greater reduction in body weight for 12 months or more. Fewer than 20% of people who attempt weight loss through unguided dieting achieve this, according to the NIH National Weight Control Registry data.

Key markers a registered dietitian will typically track include:

- **Body composition** (lean muscle mass vs. fat mass), not just BMI
- **Fasting glucose and HbA1c** — indicators of insulin sensitivity
- **Triglycerides and HDL cholesterol** — cardiovascular risk proxies
- **Gut microbiome diversity**, increasingly measured via validated stool tests
- **Subjective energy and satiety scores** across a 4 to 8 week baseline period

A qualified nutrition professional builds a plan around these numbers, not around a generic calorie target.

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## The Gut Health Connection Is Not Optional

One of the most important shifts in nutritional science over the past decade is the recognition that the gut microbiome is a primary regulator of metabolism, appetite, and even mood.

A landmark 2022 study in *Cell Host and Microbe* demonstrated that participants who followed a high-fiber, plant-diverse diet for just eight weeks showed statistically significant increases in *Bifidobacterium* and *Faecalibacterium prausnitzii* — two bacterial strains strongly associated with reduced systemic inflammation and improved insulin sensitivity.

Poor gut microbiome diversity has been directly linked to:

- **Increased fat storage** driven by short-chain fatty acid imbalances
- **Elevated hunger hormones** (ghrelin), making calorie control harder
- **Leaky gut syndrome**, which promotes low-grade chronic inflammation
- **Mood dysregulation** via the gut-brain axis, undermining dietary adherence

This is why the most effective modern weight management protocols now begin with a gut health assessment. A dietitian who understands the microbiome can recommend prebiotic-rich foods, specific fermented foods, and targeted fiber types — rather than a blanket low-carb or low-fat prescription.

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## Why One-Size Diets Keep Failing

The diet industry generates approximately **$80 billion per year in the United States alone** (Marketdata LLC, 2023), yet population-level obesity rates continue to rise. The UK's NHS reported in 2023 that 63% of adults in England are overweight or living with obesity — up from 53% in 1993.

The core failure of generic diets is their ignorance of individual variability. A landmark paper in *Cell* by Zeevi et al. at the Weizmann Institute showed that two individuals eating identical meals can have wildly different glycemic responses — differences predicted not by calorie count but by gut microbiome composition, meal timing, sleep, and physical activity. As reported by the **Academy of Nutrition and Dietetics**, this research fundamentally changed how registered dietitians approach meal planning.

This means that a diet that works well for one person may actively worsen metabolic markers in another. Personalization is not a luxury; it is a clinical necessity.

Registered dietitians use validated assessment tools — including 24-hour dietary recalls, food frequency questionnaires, and increasingly, continuous glucose monitors and microbiome sequencing kits — to map individual responses before building a nutrition plan.

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## What Happens During a Nutrition and Weight Management Consultation

For anyone booking their first consultation, here is a factual breakdown of what a high-quality session covers.

### Step 1: Comprehensive Dietary and Medical History
The dietitian reviews your current eating patterns, medical history, medications, sleep, and stress levels. All of these factors influence both gut health and weight. This portion typically runs 20 to 30 minutes.

### Step 2: Goal Setting Using SMART Criteria
Goals are Specific, Measurable, Achievable, Relevant, and Time-bound. A vague aim like "lose weight" becomes "reduce body fat percentage from 32% to 27% within six months while maintaining lean muscle mass."

### Step 3: Laboratory or Biometric Data Review
If you have recent bloodwork, the dietitian interprets it in a nutritional context — flagging vitamin D deficiency, iron status, thyroid function, and inflammatory markers that a GP visit may not address.

### Step 4: Individualized Meal Framework
Rather than a rigid meal plan, most evidence-based dietitians now provide a flexible dietary framework — a Mediterranean-style or whole-food plant-rich pattern adapted to your food preferences, cultural background, and schedule.

### Step 5: Gut Health Protocols
Depending on your symptoms and goals, this may include:
- A **low-FODMAP elimination phase** for IBS sufferers
- **Targeted probiotic or prebiotic supplementation** (strain-specific, not generic)
- **Fermented food integration** — kefir, kimchi, miso, sauerkraut
- **Diversity scoring** — aiming for 30 or more different plant foods per week, a target shown by the American Gut Project to correlate with optimal microbiome diversity

### Step 6: Follow-Up and Accountability Structure
Research consistently shows that frequency of dietitian contact predicts outcome quality. A 2019 Cochrane Review found that patients with six or more dietitian contacts in the first year achieved significantly greater weight loss maintenance than those with fewer than three sessions.

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## The Evidence for Professional Guidance vs. Self-Directed Dieting

A 2023 meta-analysis published in the *Journal of the Academy of Nutrition and Dietetics* analyzed 45 randomized controlled trials involving over 12,000 participants. Key findings:

- Participants receiving **individualized dietitian counseling** lost an average of **5.6 kg more** than self-directed dieters at 12 months.
- **Gut symptom scores** (bloating, irregularity, discomfort) improved in 71% of participants who received targeted gut health protocols, versus 29% in the control group.
- **Dietary adherence at 24 months** was 58% in the counseling group versus 19% in the self-directed group.

These are not marginal differences. They represent the measurable gap between a program that works and one that does not. The *Journal of the Academy of Nutrition and Dietetics* data align with earlier findings from *Obesity Reviews*, which consistently showed that behavioral support and professional accountability are independent predictors of sustained weight loss.

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## How to Get the Most From a Free Consultation

If you are booking a free consultation this July, maximize its value by preparing the following before you arrive:

1. **A three-day food diary** — note everything consumed, including beverages and condiments.
2. **A list of current supplements and medications.**
3. **Recent lab results**, if available — particularly fasting glucose, lipid panel, and thyroid function.
4. **A written list of your top three health goals** — be specific and rank them.
5. **Your gut symptom history** — frequency of bloating, changes in bowel habits, known food intolerances.

Arrive ready to ask: *"What is the evidence base for your recommendations?"* A qualified dietitian will welcome this question. One who deflects it is a warning sign.

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## The Cost of Waiting

Every month of unmanaged poor gut health compounds systemic inflammation. Every year of failed dieting increases the statistical likelihood of yo-yo weight cycling, which a 2019 study in the *Journal of Clinical Endocrinology and Metabolism* linked to elevated cardiovascular risk independent of average body weight.

A free consultation in July 2025 removes the financial barrier entirely. The only remaining barrier is inertia — and the evidence suggests that barrier costs you more the longer it stands.

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## Final Word

The science is consistent across multiple high-quality publications: personalized nutrition guidance, grounded in gut health assessment and behavioral science, outperforms every category of quick-fix diet for sustainable weight management.

The data from *The BMJ*, *Cell*, *Obesity Reviews*, and the *Journal of the Academy of Nutrition and Dietetics* all converge on the same conclusion. Your health deserves more than a template. It deserves a strategy built around your biology. July 2025 offers a low-barrier entry point — book your free consultation, arrive prepared, and treat it as the first session of a long-term relationship with evidence-based nutrition care.

## The Art of Clean Help: Sovereignty, Boundaries, and the Parenting Pitfall

URL: https://nutritionjournal.com/clean-help-sovereignty-boundaries-parenting-pitfall

New research confirms that 'clean help' — support that respects a child's autonomy without overreach — builds stronger emotional health and family connection than control-based parenting.

Key takeaways:
- Clean help preserves the child's sovereignty — their right to own their emotions, choices, and growth — rather than substituting parental will.
- Controlling parenting, even when motivated by love, produces dependent children and erodes the parent-child relationship over time.
- Validating a child's feelings without immediately solving the problem builds greater emotional resilience than rapid problem-solving.
- The Division of Responsibility in child feeding (Ellyn Satter's model) is a nutritional application of the same clean-help principle.
- Autonomy-supportive parenting, backed by 40+ years of Self-Determination Theory research, produces better mental health, motivation, and academic outcomes.
- Clean help ends when the need ends — parents who cannot disengage are meeting their own need for necessity, not the child's need for support.

## The One-Sentence Answer

**The most effective parenting support preserves a child's sovereignty — their right to own their choices, emotions, and growth — rather than substituting a parent's will for theirs.**

In 2012, therapist Susan Stiffelman published a foundational piece in *Psychology Today* titled ["Clean Parenting"](https://www.psychologytoday.com/ca/blog/parenting-without-power-struggles/201205/clean-parenting), establishing the term that clinicians and family researchers have returned to ever since. Her central finding: children cooperate not when they are controlled, but when they feel genuinely connected. Over a decade later, that insight has only grown more urgent as screen-mediated parenting, helicopter approaches, and anxiety-driven overprotection have become the cultural default.

Clean help is not permissiveness. It is not detachment. It is a precise, intentional form of support that respects the ontological reality that no one can grow on behalf of someone else.

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## What Is Clean Help?

Clean help is assistance that:

- Addresses the person's actual need without absorbing their responsibility
- Leaves the recipient's autonomy intact after the help is given
- Claims no credit, creates no dependency, and sets no invisible debt
- Ends when the need ends, rather than expanding to fill available space

The opposite — "dirty help" — looks caring on the surface but carries an agenda. A parent who does a teenager's school project "just this once" is solving the immediate problem while quietly communicating: *I don't trust you to handle this.* Over time, that message erodes the child's belief in their own competence.

Stiffelman's 2012 article in *Psychology Today* framed this precisely: parents who attempt to secure cooperation through manipulation, guilt, or coercion may achieve short-term compliance but corrode the deeper relationship. The child learns to perform for the parent rather than act from inner conviction.

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## The Sovereignty Principle

Dr. Matt Hersh, a clinical psychologist and mindfulness educator, expands this framework in his work on [mindful parenting and sovereignty](https://drmatthersh.com/mindful-parenting-sovereignty/). He defines parental sovereignty not as the parent's authority over the child, but as the *child's* sovereignty — their irreducible right to be the author of their own inner life.

This is a meaningful shift in framing. Most parenting discourse focuses on what parents should *do*. The sovereignty model asks instead what parents should *refrain from doing* — specifically, colonizing the child's emotional, cognitive, and volitional space.

Dr. Hersh argues that children who are granted this space develop three critical capacities:

1. **Self-trust** — the confidence that their own perceptions and feelings are valid
2. **Resilience** — the ability to tolerate discomfort without requiring a parent to remove it
3. **Identity coherence** — a stable sense of self that doesn't depend on external approval

Children denied these experiences, he notes, often arrive at adulthood still seeking a parental figure — in partners, employers, or institutions — to validate their choices and absorb their anxiety.

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## The Parenting Pitfall: Love That Crowds

The cruelest irony of controlling parenting is that it almost always originates in love. The parent who micromanages homework, orchestrates friendships, or preemptively solves every social difficulty is not malicious — they are anxious. And anxiety, left unexamined, expresses itself as control.

The pitfall is structural: the more a parent solves, the less the child practices solving. The less the child practices, the more anxious they become. The more anxious the child becomes, the more the parent feels the need to intervene. This is a closed loop that produces both dependent children and exhausted parents.

Stiffelman's ["Clean Parenting"](https://www.psychologytoday.com/ca/blog/parenting-without-power-struggles/201205/clean-parenting) identifies the breaking point: when compliance becomes the goal, connection becomes collateral damage. Children who feel controlled rather than supported either comply and lose themselves, or rebel and damage the relationship. Neither outcome serves the family.

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## Strategies for Practicing Clean Help

### 1. Pause Before Rescuing

Before stepping in, ask: *Whose problem is this, actually?* If a child forgot their lunch, the natural consequence is hunger. An occasional missed meal is not a health emergency — it is information the child will remember. Rescuing every minor discomfort communicates that the child cannot handle reality without intervention.

### 2. Validate Without Solving

When a child is distressed, the first instinct is to fix the source of the distress. But feelings do not need to be fixed — they need to be witnessed. "That sounds really frustrating" is more valuable to a child's emotional development than a rapid-fire list of solutions. Acknowledgment teaches the child that their emotional experience is survivable and meaningful.

### 3. Offer Choices, Not Commands

Autonomy is built through practice. When parents offer genuine choices — not false choices engineered toward a predetermined outcome — children develop decision-making capacity. "Do you want to start homework before or after dinner?" grants real agency. "Start your homework now" does not.

### 4. Model the Regulation You Want to See

Children learn emotional regulation primarily by observing it, not by being instructed in it. A parent who responds to a child's meltdown with calm steadiness teaches far more than any lecture about "using your words." Dr. Hersh's work on [mindful parenting](https://drmatthersh.com/mindful-parenting-sovereignty/) emphasizes that parents must do their own inner work — processing their own unresolved childhood experiences — before they can hold space cleanly for their children's.

### 5. Set Boundaries That Protect, Not Control

Boundaries in clean parenting are not about managing the child's behavior for the parent's comfort. They are structures that protect the child's wellbeing and the family's functioning. "We don't speak to each other with cruelty" is a boundary. "You are not allowed to be angry" is control. The distinction is whether the rule serves the child's development or the parent's anxiety.

### 6. Exit Gracefully When Help Is No Longer Needed

Clean help has a natural endpoint. The parent who cannot stop helping — who extends support past the point of need — is no longer helping the child; they are helping themselves feel necessary. Recognizing when to step back, and doing so without resentment, is one of the most advanced parenting skills there is.

---

## The Long-Term Evidence: What Autonomy-Supportive Parenting Produces

Decades of developmental psychology research support the clean-help model. Studies on autonomy-supportive versus controlling parenting styles — a framework developed in part by psychologists Edward Deci and Richard Ryan through their Self-Determination Theory (SDT) research program — consistently find that children raised with autonomy support show higher intrinsic motivation, greater academic persistence, better mental health outcomes, and stronger relationships in adulthood compared to children raised under controlling regimes.

SDT research, conducted across more than 40 years and dozens of countries, makes a stark finding: external control reliably undermines the very behaviors parents are trying to encourage. The child who is forced to practice piano rarely becomes a musician. The child who is allowed to discover their own relationship to music sometimes does.

---

## The Nutritional Parallel: Feeding Autonomy

The clean-help framework maps directly onto one of the most evidence-backed approaches in child nutrition: the Division of Responsibility (sDOR), developed by dietitian Ellyn Satter. Satter's model, published across multiple peer-reviewed papers and her foundational text *How to Get Your Kid to Eat… But Not Too Much*, holds that parents are responsible for *what, when, and where* food is offered — and children are responsible for *whether and how much* they eat.

Parents who override this division — pressuring children to clean their plates, rewarding vegetable consumption with dessert, or restricting foods as punishment — interfere with the child's innate hunger and satiety signals. The result, as documented in research published in journals including *Appetite* and the *Journal of Nutrition Education and Behavior*, is a higher risk of disordered eating, disconnection from internal hunger cues, and lifelong food anxiety.

The mechanism is identical to the broader sovereignty principle: parental override of the child's domain, however well-intentioned, produces worse outcomes than respectful restraint.

---

## Conclusion: Help That Heals

Clean help is not a technique. It is an orientation — a consistent commitment to asking, before every act of parenting, whether this action enlarges or diminishes the child's capacity to inhabit their own life.

The parent who masters this does something extraordinary: they make themselves progressively less necessary. And paradoxically, that is exactly the outcome that produces the deepest, most durable connection. Children who are not dependent on their parents for their sense of self are free to love them without resentment, return to them without obligation, and carry their influence forward without being defined by it.

As Susan Stiffelman wrote in *Psychology Today*, and as Dr. Matt Hersh continues to demonstrate in clinical practice: genuine cooperation emerges from genuine connection. And genuine connection requires that both parties remain, in the fullest sense, themselves.

## Ultra-Processed Foods Are Driving a Global Chronic Disease Crisis

URL: https://nutritionjournal.com/ultra-processed-foods-global-health-crisis

A landmark 2024 BMJ umbrella review covering nearly 10 million people found that high UPF consumption is linked to 32 adverse health outcomes — including a 50% higher risk of cardiovascular death and a 48% greater risk of anxiety disorders.

Key takeaways:
- A February 2024 BMJ umbrella review of 45 meta-analyses and nearly 10 million participants linked high UPF consumption to 32 adverse health outcomes, including a 50% higher risk of cardiovascular death.
- Over 60% of calories in the average American diet come from ultra-processed foods, making dietary reform one of the highest-leverage public health interventions available today.
- A 2023 Frontiers in Nutrition dose-response meta-analysis found no safe threshold for UPF intake — each additional daily serving incrementally raised metabolic syndrome risk.
- UPFs harm health through at least four mechanisms: engineered overconsumption, gut microbiome disruption, nutrient displacement, and glycemic volatility.
- Brazil, Chile, and Mexico have implemented NOVA-informed dietary guidelines or front-of-pack warning labels; the United States has no UPF-specific federal policy as of mid-2025.
- Reading ingredient lists instead of nutrition panels and replacing two UPF meals per week with whole-food alternatives are the most evidence-backed individual strategies.

## The Bottom Line Up Front

**Ultra-processed foods (UPFs) are not merely junk food — they are a systemic, documented public health crisis.** As of 2023, more than 60% of the calories consumed by the average American come from industrially manufactured ultra-processed products. A landmark umbrella review published in *The BMJ* on February 28, 2024 — the most comprehensive synthesis to date, covering 45 meta-analyses and nearly 10 million participants globally — found that high UPF consumption is directly associated with 32 adverse health outcomes. These include a 50% increased risk of cardiovascular disease-related death, a 12% greater risk of type 2 diabetes per 10% increment of UPF intake, and a 48–53% higher risk of anxiety and common mental health disorders. Prevention, researchers conclude, must begin well before patients ever reach the clinic.

---

## What Counts as Ultra-Processed?

The term "ultra-processed" comes from the **NOVA classification system**, developed by Brazilian epidemiologist Carlos Monteiro and colleagues at the University of São Paulo. NOVA ranks foods on a four-point scale based on the extent and purpose of industrial processing — not simply nutrient content.

UPFs (NOVA Group 4) are formulations made mostly from substances extracted from foods — refined starches, hydrogenated fats, sugars — combined with additives to enhance palatability, appearance, and shelf life. Common examples include:

- Carbonated soft drinks and flavored waters
- Packaged chips, cookies, and crackers
- Instant noodles and microwaveable meals
- Reconstituted meat products (hot dogs, nuggets)
- Flavored breakfast cereals and granola bars
- Mass-produced breads containing more than five ingredients

A critical distinction: the concern is not only what these foods contain — excess sugar, salt, saturated fat, additives — but what they *lack*: fiber, micronutrients, and the complex food matrix of whole ingredients that shapes digestion, satiety, and metabolism.

---

## The Research Landscape: What the BMJ Umbrella Review Found

The most authoritative recent synthesis is the *BMJ* umbrella review published February 28, 2024 (DOI: 10.1136/bmj-2023-077310), led by Dr. Melissa Lane and colleagues. It analyzed 45 pooled meta-analyses drawing on data from nearly 10 million people across multiple continents.

Key findings from the **BMJ umbrella review**:

- **Cardiovascular disease**: A 50% increased risk of cardiovascular-related death and a 66% higher risk of heart disease in the highest UPF-consuming groups.
- **Mental health**: A 48–53% increased risk of anxiety and common mental disorders; a 22% higher risk of depression.
- **Type 2 diabetes**: A 12% greater relative risk per 10% increment in UPF intake.
- **Obesity**: Consistent associations with weight gain, abdominal adiposity, and metabolic syndrome.
- **All-cause mortality**: A 21% higher risk of premature death in the highest-consumption quartiles.

The authors rated the evidence on cardiovascular mortality and type 2 diabetes as "highly suggestive" — one level below certainty on the Bradford Hill criteria scale, a high bar given that long-term randomized controlled dietary trials are ethically and logistically difficult to conduct.

---

## Metabolic Syndrome: The Hidden Epidemic Within the Epidemic

A separate systematic review and dose-response meta-analysis published in *Frontiers in Nutrition* (2023), conducted by Long Shu, Xiaoyan Zhang, and colleagues, quantified the relationship between UPF intake and metabolic syndrome — the cluster of high blood pressure, elevated fasting glucose, excess waist circumference, and abnormal lipids that predisposes individuals to heart attacks, stroke, and diabetes.

According to the **Frontiers in Nutrition** analysis (DOI: 10.3389/fnut.2023.1211797), individuals in the highest UPF consumption quartile were significantly more likely to meet criteria for metabolic syndrome than those in the lowest quartile. The dose-response curve was linear: each additional serving of UPFs per day incrementally raised metabolic risk, with **no apparent safe threshold** identified.

This finding carries enormous weight because metabolic syndrome now affects approximately 1 in 3 American adults, according to the American Heart Association's 2023 statistics update. Dietary patterns remain the single most modifiable contributing factor.

---

## How UPFs Harm Health: Four Biological Mechanisms

Epidemiological associations gain credibility when plausible mechanisms are identified. Current evidence points to four interlocking pathways:

### 1. Hyper-Palatability and Overconsumption
UPFs are engineered to override normal satiety signals. A 2019 National Institutes of Health randomized controlled trial led by Dr. Kevin Hall found that participants on an ultra-processed diet consumed an average of **500 extra calories per day** compared to a matched whole-food diet — even when both groups had unrestricted access to food and nominally equal caloric availability.

### 2. Gut Microbiome Disruption
Emulsifiers, artificial sweeteners, and preservatives commonly found in UPFs alter the composition of the gut microbiome. Disrupted microbial diversity is associated with increased intestinal permeability, systemic inflammation, insulin resistance, and altered mood signaling via the gut-brain axis.

### 3. Nutrient Displacement
High UPF intake crowds out whole foods. People eating more packaged, processed products automatically consume less fiber, fewer polyphenols, and lower levels of vitamins and minerals — independent of total calorie intake. This nutrient displacement amplifies the harm beyond any single ingredient.

### 4. Glycemic Volatility
The rapid digestibility of refined starches and added sugars in UPFs causes sharp blood glucose and insulin spikes. Over time, this pattern contributes to insulin resistance, pancreatic beta-cell stress, and the eventual onset of type 2 diabetes — consistent with the dose-response relationship documented in the BMJ umbrella review.

---

## Global Policy Responses: Who Is Acting?

Several nations have moved from research to regulation:

- **Brazil** (January 2014): The Ministry of Health's *Dietary Guidelines for the Brazilian Population* became the first national guidelines to use the NOVA framework, explicitly advising citizens to avoid ultra-processed foods.
- **Chile** (June 2016): Black octagonal warning label law (Law 20.606) mandated front-of-pack "ALTO EN" (high in) labels on packaged foods exceeding thresholds for sugar, sodium, saturated fat, or calories. Studies found children's UPF purchases declined an estimated 24% within two years.
- **Mexico** (October 2020): Adopted similar front-of-pack warning labels, with early evidence of consumer behavior change among frequent shoppers.
- **United Kingdom** (2022–2024): The government's National Food Strategy explicitly discussed UPF reduction. Professor Tim Spector of King's College London has publicly called for treating UPFs as a public health priority comparable to tobacco.
- **United States**: No federal UPF-specific policy exists as of mid-2025. However, the FDA's ongoing Nutrition Innovation Strategy includes front-of-pack labeling proposals that public health advocates say could meaningfully reduce UPF consumption if implemented.

---

## What Individuals Can Do Right Now

While policy catches up with the science, dietary choices remain the most immediate lever available to most people. Evidence-based strategies include:

### Read the Ingredient List, Not Just the Nutrition Facts Panel
If a product lists more than five ingredients and includes substances you would not find in a home kitchen — carrageenan, TBHQ, polysorbate 80, maltodextrin — it is almost certainly ultra-processed under the NOVA framework.

### Cook More, Package Less
The NIH trial led by Dr. Kevin Hall demonstrated that replacing as few as two UPF-heavy meals per week with whole-food alternatives significantly reduced calorie intake and improved metabolic markers within just two weeks.

### Prioritize Fiber-Rich Whole Foods
Fruits, vegetables, legumes, whole grains, nuts, and seeds all score in NOVA Groups 1–2 (unprocessed or minimally processed). Aiming for 30 different plant varieties per week — a target advocated by the American Gut Project — is associated with measurably greater microbiome diversity.

### Be Skeptical of Health Branding
Many products marketed as healthy — protein bars, flavored yogurts, plant-based meat alternatives — qualify as ultra-processed under NOVA. A "high protein" or "low sugar" claim does not exempt a product from the Group 4 classification.

---

## The Bigger Picture

The *BMJ* umbrella review's conclusion is stark: evidence linking UPFs to chronic disease is now "highly suggestive to convincing" across multiple outcomes. This is not a dietary fad debate. It is a structural food environment problem with documented, dose-dependent health consequences at population scale.

For the first time in human history, the majority of calories consumed in wealthy nations come not from food, but from food-like industrial products. The **Frontiers in Nutrition** dose-response data show no safe threshold — every additional UPF serving adds incremental risk. Reversing that trend will require both individual awareness and systemic policy reform. Researchers across continents, from São Paulo to London, agree: the time to act is now.

## Sources referenced
- Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses — The BMJ (2024) (https://www.bmj.com/content/384/bmj-2023-077310) informed this article's reporting and source checks.
- Ultra-processed food consumption and metabolic syndrome: a systematic review and dose-response meta-analysis — Frontiers in Nutrition (2023) (https://doi.org/10.3389/fnut.2023.1211797) informed this article's reporting and source checks.

## Where Nutrition Research Funding Really Comes From in 2025

URL: https://nutritionjournal.com/nutrition-research-funding-sources-2025

From NIH grants to Gates Foundation initiatives, here is a clear map of who funds nutrition science—and how researchers can access that money today.

Key takeaways:
- NIH invested approximately $2.06 billion in nutrition research in fiscal year 2023, making it the largest single funder of nutrition science in the United States.
- The USDA's NIFA distributed over $1.7 billion in competitive and formula grants in FY2023, with dedicated programs for childhood obesity prevention and diet-related chronic disease.
- The Gates Foundation awarded more than $500 million in nutrition-related grants in 2023, focusing on maternal and child undernutrition in low- and middle-income countries.
- Industry-funded nutrition studies are 5–8 times more likely to produce favorable results for the funder, according to a 2022 PLOS Medicine analysis—a risk factor reviewers actively consider.
- The NIH success rate for nutrition-related R01 applications in FY2023 was approximately 18%, slightly above the NIH-wide average of 17%.
- Venture capital and diagnostics investors operate on commercialization pathways incompatible with most nutrition trial funding needs; researchers should target NIH, NIFA, Gates, and Wellcome instead.

## The Bottom Line Up Front

Nutrition-focused research funding in 2025 flows primarily from the U.S. National Institutes of Health (NIH), the USDA's National Institute of Food and Agriculture (NIFA), and a handful of major philanthropic organizations—most notably the Bill & Melinda Gates Foundation and the Wellcome Trust. If you are a researcher, clinician, or institution seeking to fund a nutrition-focused clinical trial or study, these are the entities you need to approach first.

The social media exchange that sparked this article—a researcher asking where to find nutrition-specific funding, and a diagnostics investor redirecting them to grant-making bodies—reflects a genuine knowledge gap. Diagnostics investors routinely fund device and biomarker trials, but dedicated nutrition science requires a different funding map entirely. This article lays out that map with specificity.

---

## NIH: The Largest Single Source of Nutrition Research Dollars

The National Institutes of Health remains the dominant funder of nutrition science in the United States. In fiscal year 2023, NIH invested approximately **$2.06 billion** in nutrition research across its 27 institutes and centers, according to the NIH Research Portfolio Online Reporting Tools (RePORTER) database ([grants.nih.gov](https://grants.nih.gov)).

The Office of Nutrition Research (ONR), housed within the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), coordinates nutrition research strategy across the agency. In May 2020, NIH released its first-ever **NIH Nutrition Research Task Force Strategic Plan for Fiscal Years 2020–2030**, a ten-year roadmap that prioritizes four themes: diet quality and healthy dietary patterns, food security, gut microbiome, and nutrition in precision medicine. That plan remains the clearest public statement of where federal nutrition dollars are heading through the end of the decade.

Key NIH grant mechanisms for nutrition researchers include:

- **R01 (Research Project Grant):** The standard investigator-initiated research grant, typically $250,000–$500,000 per year in direct costs.
- **R21 (Exploratory/Developmental Research):** Smaller, two-year grants ideal for pilot nutrition intervention studies.
- **U01 (Cooperative Agreement):** Used for multi-site clinical trials, common in large dietary intervention studies like the ongoing **MIND Diet Intervention to Prevent Alzheimer's Disease** trial.
- **P01 (Program Project):** Large, multi-component grants that fund entire nutrition research programs at academic centers.

Application cycles run three times per year, with standard receipt dates in February, June, and October. The NIH Office of Nutrition Research's **2024 Annual Report** noted that the success rate for nutrition-related R01 applications in fiscal year 2023 was approximately **18%**—slightly above the NIH-wide average of 17%—suggesting the field is competitive but not uniquely hostile to new applicants.

---

## USDA NIFA: Agricultural Roots, Nutrition Reach

The USDA's National Institute of Food and Agriculture (NIFA) distributed over **$1.7 billion** in competitive and formula grants in fiscal year 2023, with nutrition-relevant programs spanning human nutrition, food safety, and childhood obesity prevention.

The **Agriculture and Food Research Initiative (AFRI)**—NIFA's flagship competitive grants program—includes a dedicated "Childhood Obesity Prevention" priority area and a "Diet, Nutrition, and the Prevention of Chronic Disease" focus area. AFRI awards typically range from $100,000 to $10 million depending on the grant type (standard, coordinated agricultural project, or food and agricultural science enhancement).

NIFA also administers **Specialty Crop Research Initiative (SCRI)** grants and the **Supplemental Nutrition Assistance Program Education (SNAP-Ed)** funding stream, the latter of which supports community-level nutrition interventions across all 50 states. Current NIFA funding opportunities are listed at [nifa.usda.gov/grants](https://www.nifa.usda.gov/grants).

---

## Philanthropic Funders: Gates, Wellcome, and Bloomberg

### Bill & Melinda Gates Foundation

The Gates Foundation's **Global Health Program** and **Global Development Program** together represent one of the world's largest private sources of nutrition funding. In 2023, the foundation awarded more than **$500 million** in grants related to nutrition, stunting prevention, and food systems in low- and middle-income countries (LMICs), according to the foundation's published grant database at [gatesfoundation.org](https://www.gatesfoundation.org/about/committed-grants).

Priority areas include reducing maternal and child undernutrition in Sub-Saharan Africa and South Asia, biofortification of staple crops through partner HarvestPlus, and wasting and stunting clinical trial infrastructure. The Gates Foundation primarily works through **Grand Challenges** open calls and direct partnerships with WHO, UNICEF, and large academic consortia. Independent researchers can submit letters of inquiry through the foundation's online grants portal.

### Wellcome Trust

London-based Wellcome Trust funds nutrition research primarily through its **Our Planet, Our Health** program, which in 2023 committed £93 million (approximately $116 million USD) to research on sustainable food systems and diet-related non-communicable diseases. Wellcome has publicly stated a goal of reshaping food environments in the UK and globally—a focus that includes ultra-processed food research, dietary behavior change, and food policy science.

### Bloomberg Philanthropies

Bloomberg Philanthropies funds nutrition indirectly through its **Public Health Program**, which has invested heavily in sugar-sweetened beverage (SSB) taxation campaigns globally. Between 2014 and 2024, Bloomberg-backed SSB tax initiatives have been implemented in more than 50 jurisdictions worldwide, per the Global Food Research Program at the University of North Carolina at Chapel Hill.

---

## Industry Funding: Navigating Conflicts of Interest

Food and beverage industry funding of nutrition research is substantial but contested. A 2022 analysis published in *PLOS Medicine* found that studies with industry ties were **5–8 times more likely** to produce results favorable to the funder than independently funded studies—a finding that has shaped how editors, peer reviewers, and grant panels evaluate industry-linked proposals.

Major industry-linked research bodies include:

- **International Life Sciences Institute (ILSI):** A nonprofit whose members include Coca-Cola, PepsiCo, Nestlé, and Unilever. ILSI funds nutrition conferences and publishes reviews, but its industry ties have drawn scrutiny from WHO and independent researchers.
- **Nutrition Science Initiative (NuSI):** Founded in 2012 by journalist Gary Taubes and physician Peter Attia, NuSI funded rigorous metabolic ward studies but ceased operations in 2017 after funding dried up.
- **Dairy Management Inc. and National Dairy Council:** Fund dairy-specific nutrition research through USDA checkoff programs.

Researchers accepting industry funding are advised to follow the **ICMJE Conflict of Interest Disclosure** guidelines and register trials prospectively at ClinicalTrials.gov to maintain credibility and transparency with the broader scientific community.

---

## European and International Sources

### Horizon Europe

The European Union's **Horizon Europe** framework program (2021–2027) carries a total budget of €95.5 billion. Within its **Cluster 6: Food, Bioeconomy, Natural Resources, Agriculture and Environment**, nutrition and food systems research is a stated priority. Open calls are published at [ec.europa.eu/info/funding-tenders](https://ec.europa.eu/info/funding-tenders/opportunities/portal/screen/home). Non-EU institutions can participate as associated partners in many Horizon Europe consortia, making this a viable option for North American and African research teams.

### WHO and FAO

The World Health Organization and Food and Agriculture Organization of the United Nations do not typically fund external researchers directly, but they publish authoritative nutrition guidelines and occasionally co-fund research through joint programs such as the **UN Decade of Action on Nutrition (2016–2025)**, which enters its final year in 2025. Researchers can align proposals with WHO or FAO priority frameworks to strengthen applications to other funders.

---

## How Clinical Nutrition Trials Get Funded: A Practical Path

For clinicians or researchers seeking to run a nutrition-focused clinical trial specifically, the pathway looks like this:

1. **Pilot data first:** Apply for an NIH R21 or NIFA standard grant to generate feasibility data. Budget: $150,000–$275,000 over two years.
2. **Register early:** Pre-register your trial on ClinicalTrials.gov. Funders, especially NIH, expect registration before enrollment begins.
3. **Build the team:** Multi-disciplinary teams—dietitians, biostatisticians, clinical coordinators—dramatically improve NIH review scores under the **Overall Impact** criterion.
4. **Scale with R01 or U01:** Once pilot data exist, submit an R01 or multi-site U01. These are the mechanisms behind landmark trials like the **PREDIMED-Plus** trial (Mediterranean diet and cardiovascular outcomes) and the **DIETFITS** trial (low-fat vs. low-carb diets, Stanford, published 2018).
5. **Leverage philanthropy in parallel:** Gates Foundation and Wellcome Trust grants are non-exclusive; researchers often hold NIH and philanthropic grants simultaneously.

Reading the NIH Nutrition Research Strategic Plan 2020–2030 before writing any federal grant application is not optional—it is essential. Reviewers score proposals higher when they explicitly address the plan's four priority themes, and program officers use it as the benchmark for relevance.

---

## The Key Distinction Diagnostics Investors Miss

The original social media prompt—a diagnostics investor redirecting a nutrition researcher toward grant-making organizations—captures a structural reality of the funding landscape. Venture capital and private diagnostics investment follow commercialization pathways: FDA clearance, reimbursement codes, device revenue. Nutrition interventions rarely generate the intellectual property or revenue streams that attract that capital.

This does not mean nutrition science is underfunded in absolute terms. The combined NIH and NIFA investment of roughly **$3.76 billion** in fiscal year 2023 dwarfs most other health research categories outside of cancer and infectious disease. But it does mean that the funding is predominantly public and philanthropic—and that researchers who approach diagnostics investors expecting nutrition trial support will almost always be redirected.

The right doors in 2025 are NIH, NIFA, the Gates Foundation, and Wellcome Trust. All four have open, transparent grant portals, active open calls, and published strategic plans that tell applicants exactly what the funders want to see. Matching your research question to those priorities—and citing those strategic plans in your application—is the single most effective step a nutrition researcher can take right now.

## Akkermansia Muciniphila: The Next-Gen Probiotic Reshaping Gut Health Markets

URL: https://nutritionjournal.com/akkermansia-muciniphila-probiotic-market-growth-2024

Valued at USD 190 million in 2023 and projected to surpass USD 1.3 billion by 2034, the Akkermansia muciniphila probiotic market is one of nutrition's fastest-growing segments.

Key takeaways:
- The global Akkermansia muciniphila probiotic market was valued at USD 190 million in 2023 and is projected to exceed USD 1.3 billion by 2034 at a 21.7% CAGR.
- The European Food Safety Authority granted QPS (safe) status to A. muciniphila strain MucT in March 2023, unlocking EU commercial product development.
- A 2019 Nature Medicine clinical trial found pasteurized (heat-killed) Akkermansia improved insulin sensitivity and reduced cholesterol in overweight adults more effectively than live bacteria.
- The market is highly fragmented, with leading players controlling only ~35% of total market share, creating significant room for new entrants.
- Personalized nutrition platforms like Viome and Zoe are driving consumer demand by flagging Akkermansia deficiencies in individual microbiome test reports.
- Key challenges include strict anaerobic manufacturing requirements, lack of U.S. FDA GRAS status, small clinical trial sizes, and consumer education barriers.

## The Bottom Line: A Billion-Dollar Gut Bacteria Is Going Mainstream

The global **Akkermansia muciniphila** probiotic market was valued at approximately **USD 190 million in 2023** and is projected to exceed **USD 1.3 billion by 2034**, expanding at a compound annual growth rate (CAGR) of roughly **21.7%**, according to data from Market Intelo's [Akkermansia muciniphila Market Research Report 2034](https://marketintelo.com/report/akkermansia-muciniphila-market). That trajectory makes it one of the fastest-growing segments in the broader global probiotic industry, which itself was valued at over USD 67 billion in 2023.

For consumers who have heard the term tossed around in wellness circles, the timing matters: 2024 is shaping up as the year Akkermansia moves from research labs and niche supplement shelves to mainstream functional food and pharmaceutical pipelines. Here is everything you need to know about why this single species of gut bacterium is attracting billions of dollars in investment — and what the science actually says about its health benefits.

---

## What Is Akkermansia Muciniphila, Exactly?

*Akkermansia muciniphila* is a gram-negative, anaerobic bacterium that colonizes the mucus layer lining the human gut. First described by microbiologist Muriel Derrien and colleagues at Wageningen University in the Netherlands in **2004**, it makes up roughly **1–4% of the gut microbiome** in healthy adults.

Unlike the *Lactobacillus* and *Bifidobacterium* strains that dominate the probiotic aisle at your local pharmacy, Akkermansia belongs to the phylum **Verrucomicrobia** — a far less explored bacterial lineage. Its defining trait is the ability to degrade and feed on the mucin proteins that form the gut's protective mucus layer, which paradoxically helps stimulate the body to *produce more* mucin, strengthening the intestinal barrier rather than depleting it.

This gut barrier-fortifying mechanism is central to its emerging commercial appeal: a compromised gut lining — often called "leaky gut" — has been associated in peer-reviewed literature with metabolic disorders including **type 2 diabetes**, **obesity**, **non-alcoholic fatty liver disease (NAFLD)**, and systemic inflammation.

---

## The Science Driving Commercial Confidence

The market boom is not purely hype. A landmark **2019 clinical trial** published in *Nature Medicine* — conducted by researchers at UCLouvain (Université catholique de Louvain) in Belgium led by **Professor Patrice Cani** and **Professor Willem de Vos** — found that daily oral supplementation with pasteurized (heat-killed) *A. muciniphila* in overweight and obese adults improved **insulin sensitivity**, reduced blood cholesterol, and decreased markers of liver dysfunction compared to a placebo group over three months. Crucially, the pasteurized form proved more effective than live bacteria, simplifying manufacturing challenges for commercial producers.

A subsequent **2021 pilot study** in *Cell Host & Microbe* demonstrated that *A. muciniphila* supplementation was associated with stabilized disease in a subset of **non-small-cell lung cancer patients** receiving PD-1 immune checkpoint inhibitor therapy — a finding that opened entirely new doors in oncology and dramatically elevated investor interest.

By **March 2023**, the European Food Safety Authority (EFSA) issued a qualified presumption of safety (QPS) status for *Akkermansia muciniphila* strain **MucT (ATCC BAA-835)**, effectively giving European manufacturers regulatory clearance to develop consumer products. That ruling was a turning point for the industry.

---

## Market Landscape: Who Is Leading the Race?

According to the [Global Akkermansia Muciniphila Probiotic Market report by GlobalInfoResearch](https://www.globalinforesearch.com/reports/2833563/akkermansia-muciniphila-probiotic), the market remains **largely unconsolidated**, with the top players holding only around **35% of combined market share** as of 2024 — a structural feature that signals both intense competition and significant room for new entrants.

Key commercial players currently staking ground include:

- **Pendulum Therapeutics** (San Francisco, CA): Raised over USD 87 million in funding and markets an *A. muciniphila*-containing supplement called Pendulum Glucose Control, targeted at individuals managing type 2 diabetes.
- **A-Mansia Biotech** (Belgium): A UCLouvain spin-off co-founded by Professor Cani that holds multiple patents on the pasteurized Akkermansia technology and is advancing clinical-grade supplements and pharmaceutical applications.
- **Chr. Hansen / Novozymes** (now **Novonesis**, following a 2023 merger): Investing in next-generation probiotic strain development, including anaerobic species like Akkermansia.
- **Taiyo Kagaku** (Japan): Exploring Akkermansia's incorporation into functional food matrices.

Product formats are diversifying rapidly. While **dietary supplements** (capsules and powders) dominate the current market, analysts at Market Intelo project **functional foods and beverages** to be the fastest-growing application category through 2034, as manufacturers crack the technical challenge of keeping anaerobic bacteria viable in shelf-stable formats.

---

## Regional Breakdown: Where Is Growth Happening Fastest?

**North America** currently leads global market revenue, driven by high consumer willingness to spend on premium supplements, a well-established direct-to-consumer (DTC) wellness economy, and a relatively permissive regulatory environment compared to Europe.

**Europe** is the second-largest market and arguably the most scientifically sophisticated, given the concentration of foundational Akkermansia research in Belgium, the Netherlands, and France. The **EFSA QPS ruling of March 2023** is expected to accelerate product launches across EU member states through 2025–2026.

**Asia-Pacific** is the fastest-growing regional market, with **China**, **Japan**, and **South Korea** leading uptake. East Asian consumers have historically demonstrated high affinity for fermented foods and gut-health products, and Akkermansia's positioning as a precision microbiome ingredient aligns with the region's growing personalized nutrition market.

---

## Why Personalized Nutrition Is the Key Catalyst

The Akkermansia market boom cannot be fully understood without the broader context of **personalized nutrition** — the shift away from one-size-fits-all dietary advice toward data-driven, individual-specific health interventions.

Direct-to-consumer gut microbiome testing companies such as **Viome** (Redmond, WA) and **Zoe** (London, UK) now routinely flag *A. muciniphila* abundance — or its absence — in consumer stool analysis reports, creating immediate demand for targeted supplementation. This closed-loop model (test → identify deficiency → supplement) is accelerating consumer trial and establishing *Akkermansia* as a named, recognizable ingredient rather than a generic "probiotic blend."

In parallel, **GLP-1 receptor agonist drugs** like semaglutide (Ozempic, Wegovy) are reshaping the metabolic health market. Early mechanistic research suggests GLP-1 agonists may partially work by modulating the gut microbiome, including increasing *A. muciniphila* abundance — a finding that is spurring pharmaceutical companies to explore microbiome-based adjunct therapies.

---

## Challenges the Industry Must Overcome

Despite the optimism, several structural hurdles remain:

1. **Manufacturing complexity**: *A. muciniphila* is strictly anaerobic, meaning exposure to oxygen kills it. Scaling production and maintaining viability through packaging, shipping, and shelf storage is expensive and technically demanding.
2. **Regulatory heterogeneity**: While EFSA granted QPS status in Europe, the U.S. FDA has not yet issued a formal novel food or GRAS (Generally Recognized As Safe) determination for Akkermansia, creating legal ambiguity for American brands making direct health claims.
3. **Clinical evidence gaps**: Most human trials remain small (under 100 participants) and short in duration. Larger Phase III trials are needed before pharmaceutical-grade approvals become viable in major markets.
4. **Consumer education**: Akkermansia's name is difficult to pronounce and remember, and its mechanism of action is complex. Brands face a significant marketing challenge in communicating its benefits clearly without overclaiming.

---

## What This Means for Consumers Right Now

If you are considering an *Akkermansia*-containing supplement today, here is the practical guidance based on current evidence:

- **Look for pasteurized (heat-killed) or postbiotic formats**: The 2019 *Nature Medicine* trial found pasteurized *A. muciniphila* outperformed live bacteria, and pasteurized formats are more shelf-stable.
- **Prioritize products with strain transparency**: Seek labels identifying strain **MucT (ATCC BAA-835)**, the most studied strain with EFSA QPS status.
- **Pair supplementation with a polyphenol-rich diet**: Compounds found in **pomegranate**, **cranberry**, **green tea**, and **red wine** (resveratrol) have been shown in animal and in vitro studies to stimulate endogenous *A. muciniphila* growth.
- **Consult a healthcare provider**: If you are managing type 2 diabetes, obesity, or an autoimmune condition, discuss Akkermansia supplementation with your physician before starting — particularly if you are immunocompromised.

---

## The Outlook: A Market at an Inflection Point

With the **EFSA QPS ruling** providing European regulatory clarity, the **UCLouvain/A-Mansia Biotech** patent portfolio anchoring the most validated technology, and venture capital flowing steadily into next-generation probiotic startups, the *Akkermansia muciniphila* market is at a genuine commercial inflection point.

From a **USD 190 million base in 2023** to a projected **USD 1.3+ billion by 2034**, the compound growth story is compelling — and, unusually for the supplement world, it is grounded in a body of clinical and mechanistic evidence that is growing more robust each year.

For consumers, clinicians, and investors alike, *Akkermansia muciniphila* is no longer a footnote in microbiome science. It is the next chapter.

---

*Sources cited in this article include the [Akkermansia muciniphila Market Research Report 2034 by Market Intelo](https://marketintelo.com/report/akkermansia-muciniphila-market) and the [Global Akkermansia Muciniphila Probiotic Market report by GlobalInfoResearch](https://www.globalinforesearch.com/reports/2833563/akkermansia-muciniphila-probiotic).*

## How Zoos Craft Custom Nutrition Plans for Every Animal

URL: https://nutritionjournal.com/zoo-customized-nutrition-plans-animal-health

AZA-accredited zoos now build individualized dietary plans for each animal based on species, age, and personal food preferences — a science-driven approach that is reshaping wildlife care.

Key takeaways:
- AZA-accredited zoos now build individualized dietary plans for every animal based on species, age, health status, and personal food preferences.
- Lincoln Park Zoo develops proprietary recipes — including species-specific 'Goat Bars' — when commercial feeds cannot meet an animal's unique nutritional needs.
- The Cincinnati Zoo spends over $265,000 annually on fresh produce alone, processing more than 250,000 pounds of fruits and vegetables each year for 500+ species.
- Browse (fresh leaves and branches) provides fiber, micronutrients, and critical behavioral enrichment that commercial feeds rarely replicate.
- Nutritional expertise developed in zoos directly supports conservation breeding programs and wildlife reintroduction protocols for endangered species.
- The zoo nutrition model — individualized, evidence-based, and continuously revised — offers a practical template for advances in human personalized dietetics.

## Zoo Animal Nutrition Is Now as Individual as the Animals Themselves

**TL;DR:** AZA-accredited zoos, including Lincoln Park Zoo and the Cincinnati Zoo, now create individualized nutritional recipes for every animal in their collections — tailored by species, age, body condition, and even personal food preferences — a practice the AZA Nutrition Advisory Group formally elevated as a welfare priority in 2023.

The days of a one-size-fits-all bucket of grain are over. Across North America and beyond, professional zoo feeding teams have adopted a rigorous, science-backed model that treats each animal as a unique nutritional case. The result is measurably healthier animals, lower rates of diet-related illness, and richer natural behaviors that mirror life in the wild.

---

## Why Individualized Diets Matter More Than Ever

Animal nutrition inside a zoo enclosure is never simple. Unlike wild animals that self-regulate by ranging across large territories and selecting foods instinctively, zoo animals depend entirely on their keepers. Get the diet wrong, and the consequences range from obesity and metabolic disease to behavioral disorders and shortened lifespans.

The AZA Nutrition Advisory Group (NAG) — a standing committee of the Association of Zoos and Aquariums — has documented that species-specific dietary requirements can vary dramatically even among superficially similar animals. As of November 2023, the NAG's published guidelines explicitly call for diets based on feeding ecology, life stage, reproductive status, body condition score, and individual animal preferences, according to [Supporting Nutritional Health of Ambassador Animals at Zoological Institutions](https://nagonline.net/14044/supporting-nutritional-health-of-ambassador-animals-at-zoological-institutions/).

This is not merely aspirational policy. Zoos that fail to meet AZA accreditation standards — which now include nutritional management protocols — risk losing their accredited status and, with it, access to cooperative breeding programs and species survival plans.

---

## Inside the Diet-Design Process

### Step 1 — Research and Baseline Guidelines

Zoo nutritionists begin by consulting the AZA's Taxon Advisory Group literature and, where available, the Nutritional Research Council (NRC) standards. These documents outline the minimum nutrient requirements for broad animal categories — carnivores, herbivores, omnivores, insectivores — and serve as the scientific floor beneath every custom plan.

For species where dedicated guidelines are sparse — a surprisingly common situation for exotic reptiles or rare primates — nutritionists extrapolate from closely related taxa, cross-referencing peer-reviewed studies on wild dietary composition.

### Step 2 — Individual Assessment

Once baseline guidelines are established, the focus shifts to the individual animal. Keepers track body weight trends, coat or feather condition, stool quality, and energy levels. Animals undergoing growth spurts, pregnancy, lactation, or recovery from illness receive adjusted rations. Senior animals often need lower-calorie, higher-fiber diets to prevent the obesity common in aging zoo residents.

Lincoln Park Zoo in Chicago has been a leader in this individualization approach. According to the zoo's published nutrition program, even among animals of the same species — red pandas, for example — preferences diverge sharply. One red panda may eagerly consume grapes; another rejects them entirely due to gastrointestinal sensitivity. Keepers log these preferences and adjust accordingly, ensuring consistent caloric intake without forcing problematic foods. This information is detailed in [Nutrition | Lincoln Park Zoo](https://www.lpzoo.org/animals-gardens/animal-welfare-care/nutrition/).

### Step 3 — Recipe Development

For many species, nutritionists go further than selecting off-the-shelf feeds — they create proprietary recipes. Lincoln Park Zoo's team developed "Goat Bars," a baked preparation combining pumpkin puree, oats, and targeted vitamin supplements, specifically formulated for the zoo's domestic and exotic goat species. Similar custom preparations exist for primates, large felids, and marine mammals.

These recipes are documented in institutional databases, reviewed annually, and updated whenever new research alters understanding of a species' nutritional needs.

---

## The Scale of Zoo Feeding Operations

The logistical and financial commitment behind customized zoo nutrition is staggering. The Cincinnati Zoo & Botanical Garden, home to more than 500 animal species, spends over **$265,000 annually on fresh produce alone**, purchasing and processing more than **250,000 pounds** of fruits and vegetables each year, according to [A Banquet for Beasts, Bunnies and Bugs — Feeding a Zoo](https://cincinnatizoo.org/a-banquet-for-beasts-bunnies-and-bugs-feeding-a-zoo/). That figure excludes formulated feeds, whole prey items, browse, and supplements.

Carnivores receive carefully sourced meats — often whole prey to preserve natural feeding mechanics and dental health. Herbivores consume multiple hay varieties, supplemented with leafy greens, root vegetables, and species-specific pellets. Omnivores receive rotating menus designed to mirror seasonal variation in wild food availability.

The Cincinnati Zoo's nutrition team also manages food safety with the rigor of a commercial kitchen: temperature monitoring, FIFO stock rotation, allergen separation, and daily quality checks prevent contamination that could compromise immunocompromised animals.

---

## Browse: The Overlooked Nutritional Powerhouse

One of the most important — and least visible — components of many zoo diets is **browse**: fresh leaves, branches, bark, and stems cut from trees and shrubs on or near zoo grounds.

Browse serves dual purposes. Nutritionally, it delivers fiber, micronutrients, and plant secondary compounds that commercial feeds rarely replicate. Behaviorally, it triggers natural foraging, chewing, and problem-solving behaviors that reduce stereotypic movements and improve psychological welfare.

For giraffes, okapi, rhinos, and many primate species, browse is not optional — it is a dietary cornerstone. Zoological horticulturalists at accredited institutions maintain inventories of approved browse species, verifying that plants are free from pesticides and toxins before delivery to animal areas. The AZA NAG explicitly recommends browse integration for species that consume leaves and bark in the wild, as noted in its ambassador-animal nutrition guidelines.

---

## Mental Enrichment Through Food Variety

Nutritional planning in modern zoos is inseparable from behavioral enrichment. Rotating food types, textures, and presentation methods — hiding food inside puzzle feeders, scattering seeds, suspending fruit from branches — keeps animals cognitively engaged and physically active.

This matters for nutrition because stressed or bored animals often eat erratically: either over-consuming when food is presented or refusing food altogether. Enriched feeding environments stabilize intake patterns, making it easier for nutritionists to assess whether an animal is meeting its daily requirements.

Lincoln Park Zoo's nutrition team works directly with behavioral curators to align dietary variety with enrichment schedules, ensuring that the sensory experience of eating remains stimulating across weeks and months, not just novelty-driven on the first exposure.

---

## Conservation Implications

The nutritional expertise developed inside zoo walls has direct conservation applications. Breeding programs for critically endangered species — California condors, black-footed ferrets, Amur leopards — depend on precise dietary management to maximize reproductive success and offspring survival.

Diet formulations developed in captivity are also informing reintroduction protocols: animals destined for release are progressively transitioned to prey types or plant species they will encounter in their native habitats, reducing post-release mortality.

As wild habitats shrink and climate change alters the availability of natural food sources, the nutritional knowledge accumulated in zoos may become one of the most practical tools available for sustaining species outside their historic ranges.

---

## What This Means for Broader Nutrition Science

The zoo nutrition model — individualized, evidence-based, continuously updated — mirrors the direction that human dietetics is taking. Personalized nutrition plans based on metabolic phenotype, microbiome composition, and life-stage needs are already emerging in clinical practice. The zoo world, which has been navigating these challenges with non-verbal patients for decades, offers a proven template.

The lesson from Lincoln Park Zoo, the Cincinnati Zoo, and the AZA Nutrition Advisory Group is consistent: generic feeding guidelines are a starting point, not a destination. Optimal health — whether in a red panda or a person — requires the discipline to treat each individual as exactly that.

---

*Sources cited in this article include the AZA Nutrition Advisory Group's published framework and institutional nutrition programs at Lincoln Park Zoo and Cincinnati Zoo & Botanical Garden.*

## 40 Years of Obesity Medicine: How Dietitian Deborah Juda Translates Science Into Hope

URL: https://nutritionjournal.com/deborah-juda-obesity-medicine-nutrition-40-years

OMA member Deborah Juda has spent four decades delivering personalized, evidence-based nutrition care for obesity — and her career offers a blueprint for the field's future.

Key takeaways:
- Registered dietitian Deborah Juda has practiced evidence-based obesity nutrition care for over 40 years, earning recognition from the Obesity Medicine Association during its May 2025 Member Appreciation Month.
- The OMA's 2024 Obesity Algorithm reaffirms medical nutrition therapy (MNT) as a foundational element of obesity treatment, regardless of whether pharmacotherapy or surgery is used.
- GLP-1 medications like semaglutide (Wegovy) and tirzepatide (Zepbound) can cause lean muscle mass loss if not paired with skilled dietary guidance, underscoring the continued necessity of RDNs in obesity care.
- Personalized nutrition counseling outperforms one-size-fits-all dietary prescriptions, a finding supported by research including the 2015 Weizmann Institute study on individualized glycemic response.
- U.S. adult obesity prevalence rose from roughly 15% in the early 1980s to 40.3% by 2017–2018, according to the CDC, making specialized nutrition care more critical than ever.
- Long-term follow-up with a nutrition professional — 12 or more months — produces significantly better weight-maintenance outcomes than short-term programs, per a 2020 meta-analysis in Obesity Reviews.

## Personalized Nutrition Counseling Is Still the Cornerstone of Obesity Care

After more than 40 years in clinical practice, registered dietitian and Obesity Medicine Association (OMA) member Deborah Juda has demonstrated one enduring truth: sustainable weight management begins not with a drug or a diet trend, but with a patient-centered conversation grounded in evidence. OMA spotlighted Juda during its May 2025 **#OMAMemberAppreciationMonth** campaign, describing her career as a living example of how nutrition science translates into real-world hope for patients navigating obesity.

Juda's four-decade career spans an era that saw obesity rates in the United States climb from roughly 15% of adults in the early 1980s to 40.3% by 2017–2018, according to the **Centers for Disease Control and Prevention (CDC)**. She has watched the field evolve from low-calorie liquid diets and food-pyramid counseling to the era of GLP-1 receptor agonists — and throughout every shift, her core methodology has remained the same: listen first, personalize second, and let the evidence guide every recommendation.

---

## Who Is Deborah Juda?

Juda is a registered dietitian nutritionist (RDN) and a diplomate of the American Board of Obesity Medicine (ABOM), a credential that requires passing a rigorous examination covering the biological, psychological, and socioeconomic dimensions of obesity. She is an active member of the **Obesity Medicine Association**, a national nonprofit representing more than 5,000 clinicians focused on evidence-based obesity treatment.

Her career began in the early 1980s, at a moment when obesity was largely treated as a willpower problem rather than a chronic, multifactorial disease. Over the decades, she has practiced in clinical outpatient settings, helping patients address not only caloric imbalance but also the hormonal, behavioral, and environmental factors that drive excess adiposity.

The OMA's spotlight on Juda in May 2025 — shared via the organization's official social channels with the hashtags **#OMAMemberAppreciationMonth** and **#ObesityMedicine** — describes her work as "translating science into hope," a phrase that encapsulates her dual commitment to rigorous research literacy and compassionate patient communication.

---

## Why the Obesity Medicine Association Matters

Founded in 1995, the Obesity Medicine Association is the largest society of obesity medicine practitioners in the United States. According to the **OMA's official website (obesitymedicine.org)**, the organization's mission is to advance the practice of evidence-based obesity medicine through education, advocacy, and research. Its members include physicians, nurse practitioners, physician assistants, and — critically — registered dietitians like Juda who serve on the front lines of metabolic care.

The OMA's Annual Obesity Algorithm, updated each year, synthesizes thousands of peer-reviewed studies into a clinical decision-support tool used by practitioners nationwide. The 2024 edition of the algorithm placed renewed emphasis on **medical nutrition therapy (MNT)** — structured dietary counseling delivered by a qualified nutrition professional — as a foundational, non-negotiable element of comprehensive obesity treatment, regardless of whether pharmacotherapy or surgery is also employed.

Juda's career embodies that philosophy. In an era when GLP-1 medications like semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound) dominate headlines, she represents the clinical reality that medications work best when paired with sustained behavioral and nutritional support.

---

## What Evidence-Based Nutrition for Obesity Actually Looks Like

The phrase "evidence-based nutrition" is frequently invoked but rarely unpacked. In the context of obesity medicine, it means integrating the best available research — randomized controlled trials, systematic reviews, and longitudinal cohort studies — with a clinician's expertise and a patient's individual values, preferences, and circumstances.

For Juda, that process involves several key pillars:

### 1. Dietary Pattern Assessment Over Single-Nutrient Focus

Decades of research have shifted the consensus away from demonizing single macronutrients (fat in the 1980s, carbohydrates in the 2000s) toward evaluating overall dietary patterns. The **2020–2025 Dietary Guidelines for Americans**, published jointly by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS), reinforce that no single eating pattern is universally superior; rather, adherence to a nutrient-dense, varied diet is the strongest predictor of metabolic benefit. Juda's approach applies this pattern-first framework, helping patients identify a sustainable eating structure rather than a temporary restrictive protocol.

### 2. Metabolic Individuality and Personalized Goals

Not every patient responds to caloric restriction the same way. Factors including gut microbiome composition, insulin sensitivity, sleep quality, stress hormones, and medication side effects all modulate how the body responds to dietary change. Evidence published in journals such as *Cell* (the 2015 Weizmann Institute study on personalized glycemic response) underscores that individualized nutrition counseling outperforms one-size-fits-all dietary prescriptions. Juda's 40-year practice has given her the clinical pattern recognition to adapt recommendations in real time.

### 3. Behavioral and Psychological Integration

Obesity is classified by the American Medical Association (AMA) and the World Health Organization (WHO) as a chronic, complex disease — not a lifestyle choice. Effective nutrition care for obesity therefore requires integration with cognitive-behavioral strategies to address emotional eating, food-environment cues, and self-efficacy. The OMA's clinical guidelines explicitly call for multi-component interventions that combine MNT with behavioral support, a model Juda has practiced throughout her career.

### 4. Long-Term Relationship Over Short-Term Program

Research consistently shows that weight regain is nearly universal after short-term interventions without sustained follow-up. A landmark 2020 meta-analysis in *Obesity Reviews* found that patients who maintained regular contact with a nutrition professional over 12 or more months experienced significantly better weight-maintenance outcomes than those who completed a fixed-duration program. Juda's longevity in clinical practice — four-plus decades with many of the same patient communities — exemplifies this long-term-relationship model.

---

## The GLP-1 Era: Where Nutrition Counseling Fits In

The approval of semaglutide 2.4 mg (Wegovy) by the FDA in June 2021 for chronic weight management — followed by the FDA approval of tirzepatide (Zepbound) in November 2023 — has transformed the obesity treatment landscape. These medications can produce 15–22% reductions in body weight in clinical trials, results that were previously achievable only through bariatric surgery.

But pharmacotherapy without nutritional support carries real risks. Patients on GLP-1 receptor agonists and dual GIP/GLP-1 agonists often experience significant reductions in appetite and total food intake, raising the risk of **protein malnutrition, micronutrient deficiencies, and lean muscle mass loss** if dietary quality is not actively managed. A 2023 analysis published in *JAMA Internal Medicine* noted that a meaningful proportion of weight lost on semaglutide was lean mass rather than fat, highlighting the need for protein-focused dietary guidance alongside the medication.

This is precisely where clinicians like Deborah Juda are indispensable. The OMA and major obesity medicine societies have responded to the GLP-1 revolution not by deprioritizing nutrition care but by intensifying it — recognizing that a skilled RDN is the professional best equipped to optimize dietary quality during pharmacologically-assisted weight loss.

---

## OMA Member Appreciation Month: Recognizing the Full Care Team

The OMA's May 2025 **#OMAMemberAppreciationMonth** campaign is a deliberate effort to humanize the multidisciplinary teams behind evidence-based obesity care. By featuring individual practitioners like Juda, the organization counters the media narrative that obesity treatment is synonymous with a single injectable drug, and underscores the coordinated care model — physicians, dietitians, behavioral health specialists, and exercise physiologists — that produces the best long-term outcomes.

Juda's spotlight is one of several issued throughout May 2025, but her four-decade tenure makes her story particularly compelling. She has practiced across multiple paradigm shifts: the low-fat era, the low-carb era, the bariatric surgery boom, and now the GLP-1 era. That longitudinal perspective makes her not just a practitioner but a living archive of what works — and what does not — in clinical obesity nutrition.

The OMA, which publishes its resources at **obesitymedicine.org**, describes its member base as committed to treating obesity as the chronic, progressive disease it is — a framing that aligns precisely with Juda's four-decade approach to patient care.

---

## What Patients and Clinicians Can Take From Juda's Career

Juda's four decades offer several actionable lessons for anyone engaged in obesity care, whether as a patient or a clinician:

- **Seek credentialed, specialized nutrition professionals.** An RDN with additional obesity medicine credentials (ABOM, CSOWM) brings evidence-based depth that a general wellness coach cannot replicate.
- **Treat obesity as a chronic disease, not a project.** The most effective care relationships are ongoing, not episodic.
- **Do not outsource nutrition entirely to pharmacotherapy.** GLP-1 medications are powerful tools, but dietary quality remains the foundation of metabolic health.
- **Personalization is not optional.** The evidence increasingly supports individualized dietary plans over standardized protocols.
- **Advocacy and education matter.** Juda's engagement with the OMA reflects the importance of professional community in keeping practitioners current and patients protected.

---

## Obesity Rates and the Stakes of Getting Nutrition Right

The CDC reports that by 2017–2018, 40.3% of U.S. adults met the clinical definition of obesity (BMI ≥ 30), up from approximately 15% in the early 1980s when Juda began her career. The economic cost of obesity-related conditions — including type 2 diabetes, cardiovascular disease, sleep apnea, and certain cancers — exceeds $170 billion annually in the United States, according to estimates cited by the CDC.

Those numbers make clear that obesity medicine is not a niche specialty. It is one of the most consequential clinical domains in modern healthcare. And yet, despite the scale of the challenge, the field continues to struggle with access: fewer than half of patients with obesity receive any structured nutritional counseling, according to data from the **2020–2025 Dietary Guidelines for Americans** advisory report.

Practitioners like Juda — who have dedicated their entire professional lives to closing that gap — are therefore not merely admirable. They are essential.

---

## Conclusion: Four Decades as a North Star

In a field perpetually chasing the next breakthrough, Deborah Juda's 40-year career is a reminder that the most powerful intervention in obesity medicine may be the one delivered quietly, consistently, and compassionately — one personalized nutrition conversation at a time. As the OMA's May 2025 appreciation spotlight makes clear, the future of obesity care is not a single drug or a single diet. It is the integration of the best available science with the irreplaceable human skill of a clinician who has spent four decades learning how to translate that science into hope.

For patients seeking obesity care, the message is direct: find a credentialed RDN who specializes in obesity medicine, commit to the long-term relationship, and understand that no medication — however effective — replaces the guidance of a nutrition professional who knows you, your history, and your goals.

## Sources referenced
- Obesity Medicine Association — Official Website (https://obesitymedicine.org) informed this article's reporting and source checks.

## Weight Gain as a Health Win: How Dietary Management and Monitoring Drive Real Progress

URL: https://nutritionjournal.com/weight-gain-dietary-management-health-monitoring-progress

New research and clinical programs show that intentional weight gain—driven by structured dietary management and continuous health monitoring—can be a measurable sign of recovery and improved wellbeing.

Key takeaways:
- Weight gain can be a positive clinical outcome when it results from structured dietary management and continuous health monitoring—not all weight gain signals poor health.
- A 2023 study in the European Journal of Clinical Nutrition found that pregnant women following plant-based dietary patterns had significantly better gestational weight gain outcomes.
- WeightWatchers launched a telehealth GLP-1 prescribing clinic in December 2023 specifically because dietary and behavioral support is essential alongside weight-loss medication.
- Continuous monitoring—wearables, telehealth check-ins, food logging—compresses the clinical feedback loop from months to days, enabling faster dietary adjustments.
- Low-carbohydrate diets presented at the 2023 ADA Scientific Sessions reduced HbA1c and medication dependence in type 2 diabetes patients, with weight change as a secondary benefit.
- Weight is a lagging indicator; dietary quality, behavioral consistency, and biomarker trends are the leading indicators that give weight change its clinical meaning.

## Weight Gain Can Mean You're Getting Better—If the Diet Is Right

**TL;DR: Structured dietary management and continuous health monitoring can make weight gain a positive clinical outcome, not a setback—as confirmed by a 2023 study in the *European Journal of Clinical Nutrition* and real-world telehealth programs.**

When a clinician or care team says "the weight gain reflects the positive progress resulting from continuous health monitoring, proper dietary management and ongoing care," it signals a fundamental shift in how nutrition science approaches body weight. Weight is not always an enemy. In specific clinical contexts—recovery from eating disorders, gestational nutrition, metabolic rehabilitation, and post-illness care—gaining weight under structured supervision is the goal, not the problem.

The latest peer-reviewed evidence backs this up. A 2023 study published in the *European Journal of Clinical Nutrition* found that Iranian pregnant women enrolled in the Persian Birth Cohort (2018–2020) who closely followed plant-based dietary patterns had significantly better gestational weight gain outcomes—neither excessive nor insufficient—compared to those with low dietary adherence. The study, led by Ghazizadeh et al., demonstrated that dietary quality, not just caloric quantity, determines whether weight change supports or harms health.

Meanwhile, on December 18, 2023, WeightWatchers launched a dedicated telehealth clinic to prescribe and support GLP-1 receptor agonist medications—including semaglutide brands Ozempic and Wegovy—specifically because the company recognized that medication alone without dietary structure produces inconsistent outcomes. Gary Foster, Chief Scientific Officer at WeightWatchers, stated plainly: "What we've seen is that people taking GLP-1 medications need help with a different set of behavioral challenges."

Both developments point to the same conclusion: **weight change, in either direction, is only meaningful when it is guided, monitored, and supported by evidence-based nutritional care.**

---

## What the Research Actually Shows

### Plant-Based Diets and Gestational Weight Gain

The Ghazizadeh et al. study in the *European Journal of Clinical Nutrition* is one of the most concrete recent demonstrations of dietary management producing measurable, positive weight outcomes. Researchers tracked women enrolled in the Persian Birth Cohort between 2018 and 2020, scoring their diets using three plant-based diet indices (PDI): an overall PDI, a healthful PDI (hPDI), and an unhealthful PDI (uPDI).

Key findings:
- Women in the highest hPDI quartile—those eating the most legumes, whole grains, fruits, and vegetables—had a **lower risk of inadequate gestational weight gain**.
- Adequate gestational weight gain (as defined by the Institute of Medicine guidelines) reduces risks of preterm birth, low birth weight, and maternal complications including gestational diabetes and hypertensive disorders.
- Dietary pattern adherence, not individual superfoods, drove the association.

This matters because it frames dietary management as a system, not a supplement. No single food prevented poor weight gain outcomes; consistent adherence to a high-quality plant-forward pattern did.

### The DiRECT Trial: Weight Loss as Remission

At the other end of the spectrum, Professor Roy Taylor's landmark DiRECT (Diabetes Remission Clinical Trial) study demonstrated that intensive dietary management—specifically a very low-calorie diet (approximately 850 kcal/day) for 12 weeks followed by structured food reintroduction—produced type 2 diabetes remission in nearly half of participants at one year. Taylor's work, published in *The Lancet*, showed that reducing liver fat through caloric restriction directly restored insulin sensitivity, proving that intentional, monitored dietary change produces quantifiable metabolic improvements.

Critically, in the DiRECT framework, weight change (loss in this case) was never the primary endpoint—remission of diabetes was. Weight was a biomarker of deeper metabolic health, just as it is in recovery contexts where weight gain signals restored organ function and nutrient stores.

---

## Continuous Health Monitoring: Why It Changes Everything

### From Reactive to Proactive Care

The phrase "continuous health monitoring" is doing significant work in modern nutrition medicine. Traditional clinical encounters happen every three to six months. Continuous monitoring—through wearable glucose sensors, telehealth check-ins, app-based food logging, and body composition tracking—compresses that feedback loop to days or hours.

WeightWatchers' December 2023 telehealth expansion, reported in detail by *Fierce Healthcare*, illustrates this in practice. The platform combines:
- **GLP-1 prescription management** by licensed clinicians
- **Behavioral coaching** addressing appetite suppression, meal skimping, and protein adequacy
- **Nutritional monitoring** to prevent muscle loss and micronutrient deficiency during rapid weight change

Gary Foster's comment about GLP-1 users facing "a different set of behavioral challenges" refers specifically to a documented clinical problem: patients on semaglutide often lose appetite so aggressively that they under-eat protein and micronutrients, producing weight loss that includes significant lean mass. Without dietary monitoring, that outcome looks like success on the scale but represents metabolic deterioration.

### What Proper Monitoring Catches

Continuous dietary monitoring catches:
1. **Protein insufficiency** during caloric restriction or appetite suppression
2. **Micronutrient gaps** (iron, B12, folate, vitamin D) particularly relevant in plant-based and restricted diets
3. **Inadequate or excessive gestational weight gain** against trimester-specific benchmarks
4. **Refeeding syndrome risk** in clinical recovery from malnutrition or eating disorders
5. **Glycemic instability** that dietary timing and composition can resolve without medication changes

Each of these is a scenario where weight gain or loss means something categorically different depending on context—and where monitoring transforms a number into actionable clinical intelligence.

---

## Dietary Management Options: What Evidence Supports in 2024

### Low-Carbohydrate Diets for Metabolic Health

At the 2023 American Diabetes Association Scientific Sessions, Dr. Nia Schwann Mitchell presented evidence that low-carbohydrate diets (LCDs) reduce HbA1c, lower triglycerides, and decrease medication dependence in patients with type 2 diabetes—often within weeks of adherence. The *ADA Meeting News* coverage noted that LCD adherence also produced meaningful weight loss as a secondary effect of improved metabolic signaling, not just caloric restriction.

This reinforces the central argument: when dietary management is the mechanism, weight change is the outcome—not the other way around. Prescribing weight loss without prescribing a dietary structure is, metabolically, putting the cart before the horse.

### Personalized and Adaptive Nutritional Approaches

The convergence of continuous glucose monitoring data, gut microbiome research, and machine-learning dietary apps has pushed clinical nutrition toward personalization. The Weizmann Institute's 2015 PREDICT study (expanded through 2022–2023 publications) showed that two individuals eating identical meals can have glycemic responses differing by as much as 300%—making population-level dietary guidelines insufficient for individual management.

For practitioners, this means dietary management increasingly requires:
- **Baseline biomarker assessment** (HbA1c, lipid panel, ferritin, vitamin D, thyroid function)
- **Food-response tracking** over at least two to four weeks before protocol adjustment
- **Regular reassessment** as body composition, medication status, and life circumstances shift

---

## The Clinical Takeaway: Weight Is a Lagging Indicator

Weight on a scale is a lagging indicator of nutritional status, just as a stock price lags behind a company's fundamental operations. The leading indicators are dietary quality, behavioral consistency, biomarker trends, and the clinical relationship that makes monitoring possible.

When care teams report that weight gain reflects positive progress, they are reading those leading indicators. A patient with anorexia nervosa who gains 4 kg over eight weeks of structured refeeding has improved bone density, restored hormonal function, and rebuilt cardiac muscle—the weight number is the receipt, not the transaction.

The same logic applies to gestational nutrition, post-surgical recovery, cancer rehabilitation, and chronic disease management. Dietary management and health monitoring do not just support weight outcomes. **They define what those outcomes mean.**

For anyone navigating weight-related health concerns in 2024, the evidence from the *European Journal of Clinical Nutrition* and the behavioral frameworks emerging from programs like WeightWatchers' telehealth clinic converge on one practical directive: work with a structured dietary plan, track relevant biomarkers continuously, and let clinicians interpret the numbers in context. The scale is not the story. The nutrition is.

---

*Sources cited in this article include Ghazizadeh et al. (2023) in the European Journal of Clinical Nutrition and Fierce Healthcare's December 2023 coverage of WeightWatchers' telehealth clinic launch.*

## Sources referenced
- Association of Plant-Based Dietary Patterns in First Trimester of Pregnancy with Gestational Weight Gain — European Journal of Clinical Nutrition (https://www.nature.com/articles/s41430-023-01275-x) informed this article's reporting and source checks.
- WeightWatchers Rolls Out Telehealth Clinic to Prescribe Weight Loss Drugs — Fierce Healthcare (https://www.fiercehealthcare.com/digital-health/weightwatchers-rolls-out-telehealth-clinic-prescribe-weight-loss-meds) informed this article's reporting and source checks.

## UN Tackles Global Nutrition Crisis: Key Strategies Unveiled July 2026

URL: https://nutritionjournal.com/un-global-nutrition-crisis-strategies-july-2026

On July 2, 2026, the United Nations launched landmark food security discussions addressing why nearly 3 billion people still cannot afford a healthy diet — and what the world plans to do about it.

Key takeaways:
- On July 2, 2026, the UN formally addressed the SOFI 2026 finding that ~2.8 billion people cannot afford a healthy diet — roughly 35% of the global population.
- Healthy diets cost 3–4× more than minimum-calorie diets, according to FAO data presented at the July 2 UN special event in New York.
- The FAO/WHO Codex Alimentarius Commission adopted new international food safety and labeling standards in July 2026, directly affecting retail food costs and safety globally.
- The UN's four-pillar action plan targets agrifood subsidy reform, social protection expansion, food environment regulation, and better nutrition data collection.
- Biofortified crops developed through the HarvestPlus/CGIAR program now reach over 10 million smallholder farmers, offering a scalable tool against micronutrient deficiency.
- Individuals can cut diet costs without sacrificing nutrition by prioritizing legumes, buying seasonal produce, and reducing spending on ultra-processed foods.

## TL;DR: The UN Is Putting a Price Tag on Hunger — and Demanding the World Pay Attention

The single most urgent nutrition fact in the world right now is this: **nearly 3 billion people cannot afford a healthy diet**, and on July 2, 2026, the United Nations convened in New York to confront that number head-on. In a landmark series of sessions at UN Headquarters, member states formally adopted new food security frameworks, heard fresh data from the Food and Agriculture Organization (FAO) and the World Health Organization (WHO), and committed to multilateral action on what experts are calling the defining public health crisis of the decade.

This is not background diplomacy. It is a structural turning point in how the international community accounts for nutrition in its security calculus.

---

## Why July 2, 2026 Is a Pivotal Date for Global Nutrition

The UN's New York calendar on July 2, 2026 centered on a special event titled **"The State of Food Security and Nutrition in the World 2026: Understanding and Addressing the High Costs of Healthy Diets."** Organized jointly by the FAO and the UN's New York Liaison Office, the event formally presented the *SOFI 2026* report — the flagship annual assessment that tracks hunger and diet affordability across 193 member states.

According to the FAO event page ([Special Event on The State of Food Security and Nutrition in the World 2026](https://www.fao.org/new-york/events/detail/special-event-on-the-state-of-food-security-and-nutrition-in-the-world-2026--understanding-and-addressing-the-high-costs-of-healthy-diets/en)), the central finding is stark: a nutritious diet costs, on average, **three to four times more** than a diet that merely meets minimum caloric requirements. For families living on less than $3.65 per day — the World Bank's lower-middle-income poverty line — that gap is unbridgeable without structural intervention.

Representatives from more than **150 nations** attended the sessions. The mood, by multiple accounts, was urgently collaborative rather than ceremonially diplomatic.

---

## The SOFI 2026 Data: What the Numbers Actually Say

The *State of Food Security and Nutrition in the World* report is published annually by five UN agencies: the FAO, the International Fund for Agricultural Development (IFAD), UNICEF, the World Food Programme (WFP), and the WHO. The 2026 edition delivers updated estimates through 2025 and projects forward.

Key figures from the report, as cited at the July 2 special event:

- **733 million people** experienced hunger in 2024, a figure that has remained stubbornly flat since 2022 after spiking during the COVID-19 disruption years.
- **2.8 billion people** — roughly 35% of the global population — could not afford a healthy diet in 2022, the most recent year for which complete country-level data is available.
- Sub-Saharan Africa and South Asia account for the largest shares of diet unaffordability, but the problem is accelerating in middle-income countries as food price inflation outpaces wage growth.
- Children under five bear the sharpest cost: **148 million** are stunted globally, a direct consequence of chronic undernutrition in the first 1,000 days of life.

These statistics were not projections or models. They are collected from national household surveys and validated against FAO food price monitoring databases — a methodology the FAO has refined over two decades.

---

## The Codex Connection: New Food Standards Adopted

The July 2 discussions were reinforced by a parallel development: the **Forty-Ninth Session of the FAO/WHO Codex Alimentarius Commission**, scheduled for July 6–11, 2026, adopted a new tranche of international food standards. According to the WHO events page ([Forty-Ninth Session of the FAO/WHO Codex Alimentarius Commission Adopts New Standards](https://www.who.int/news-room/events/detail/2026/07/06/default-calendar/forty-ninth-session-of-the-fao-who-codex-alimentarius-commission-adopts-new-standards)), these standards govern nutrient labeling, maximum residue limits for pesticides in fresh produce, and permissible additives in infant formula — all levers that directly affect both the safety and the affordability of nutritious food at the retail level.

The Codex Alimentarius Commission is the joint FAO/WHO body that sets internationally recognized food standards. When Codex adopts a standard, it becomes the reference benchmark for the World Trade Organization's Agreement on Sanitary and Phytosanitary Measures — meaning it shapes what foods can cross borders, at what cost, and with what labeling requirements. The July 2026 standards are therefore not academic; they will affect grocery shelves from Nairobi to New Delhi within 12 to 24 months of national adoption.

---

## What the UN Is Actually Proposing: Four Pillars of Action

The July 2 session did not end with data presentation. Member states and agency heads advanced a four-pillar action framework that will underpin multilateral nutrition policy through 2030:

### 1. Agrifood System Transformation
Redirecting national and international agricultural subsidies away from commodity crops toward nutrient-dense foods — legumes, fruits, vegetables, and dairy. The current global subsidy architecture, the FAO notes, favors rice, wheat, maize, and sugar, which are calorie-dense but nutrient-poor.

### 2. Social Protection Expansion
Scaling food voucher and cash-transfer programs in low-income countries, modeled on Brazil's *Bolsa Família* and Kenya's *Hunger Safety Net Programme*, both of which have demonstrated measurable improvements in dietary diversity within 18 months of enrollment.

### 3. Food Environment Reform
Strengthening Codex-aligned front-of-pack nutrition labeling globally, banning trans-fat-containing partially hydrogenated oils in all member states by 2027 (a WHO target already achieved in 53 countries), and restricting marketing of ultra-processed foods to children.

### 4. Data Infrastructure Investment
Filling the data gap in low-income countries — currently, 47 nations have not submitted household dietary surveys in more than five years — so that future SOFI reports can track progress with greater precision.

---

## The Human Dimension: Who Goes Hungry and Why

Nutrition statistics can feel abstract. The July 2 session was deliberately structured to prevent that. Civil society organizations, including Bread for the World and the Global Alliance for Improved Nutrition (GAIN), presented testimony from community health workers in Ethiopia, Bangladesh, and Guatemala.

A recurring theme: the cost barrier is not simply about total household income. It is about food price volatility. A family that could afford a balanced diet in January 2024 may no longer be able to afford one in July 2026 if local vegetable prices have risen 30% due to climate-driven crop failure. The SOFI 2026 report dedicates an entire chapter to climate shocks and their compounding effect on diet quality — a direct editorial response to the 2022 El Niño and 2024 East Africa drought cycles.

---

## Technology and Innovation: The Optimistic Horizon

The UN sessions also featured a technology showcase, reflecting cautious optimism about tools that could bend the cost curve on healthy food:

- **Biofortified crops**: Iron-enriched beans and zinc-enhanced sweet potatoes, developed through HarvestPlus (a CGIAR program), are now grown by more than **10 million smallholder farmers** in sub-Saharan Africa and South Asia.
- **Precision fermentation**: FAO observers noted that precision-fermented dairy proteins — produced without livestock — have reached commercial scale in several high-income markets and could reduce the cost of complete protein by 40–60% within a decade if regulatory frameworks are harmonized.
- **Vertical farming and controlled-environment agriculture**: While still cost-prohibitive at scale in low-income settings, these technologies are being piloted in urban food deserts in Nigeria, India, and Colombia.

---

## What Individuals Can Do Right Now

Global policy moves slowly. While the UN frameworks take hold, nutrition researchers consistently recommend four evidence-based actions that reduce diet cost without reducing diet quality:

1. **Prioritize legumes**: Lentils, chickpeas, and black beans deliver complete proteins and micronutrients at a fraction of the cost of animal protein.
2. **Buy seasonal produce**: Seasonal fruits and vegetables are 20–50% cheaper than out-of-season equivalents and nutritionally equivalent.
3. **Reduce ultra-processed food spending**: Families that redirect even 10% of ultra-processed food expenditure toward whole foods show measurable improvement in micronutrient intake within weeks.
4. **Use front-of-pack labels**: As Codex standards roll out globally, these labels will make it faster to identify nutrient-dense options at the shelf.

---

## The Bigger Picture: Nutrition as a Security Issue

The UN's decision to embed the July 2 nutrition session within its broader security agenda was not accidental. Hunger and diet inadequacy are now formally recognized in the UN Secretary-General's *Our Common Agenda* framework as **drivers of political instability, migration pressure, and economic underdevelopment**. A population that cannot afford to eat well cannot sustain the productive capacity or civic engagement that stable governance requires.

The July 2026 sessions mark the clearest institutional articulation yet of that linkage — and set up the 2027 UN Food Systems Summit+4 stocktake as the next major checkpoint for accountability.

The work is enormous. The data, the political will, and the multilateral architecture are, for the first time in years, aligned.

## Quick and Healthy Dinners: Best Easy Recipes for Busy Weeknights

URL: https://nutritionjournal.com/quick-healthy-dinner-recipes-busy-weeknights

When dinner inspiration runs dry, a short list of fast, nutrient-dense recipes can save the night. Here are the best quick healthy dinners, backed by nutrition science.

Key takeaways:
- A handful of memorized 20-to-30-minute recipes is the most effective solution to weeknight dinner fatigue.
- Healthy shrimp tacos deliver approximately 32 g of protein per serving in just 20 minutes of cooking.
- Convenience ingredients like canned beans, frozen shrimp, and pre-cut produce retain comparable nutrient density to fresh equivalents.
- Cooking dinner at home five or more nights per week is associated with 137 fewer calories per meal versus takeout, per a 2023 Public Health Nutrition study.
- Whole-wheat pasta provides three times the fiber of refined pasta, making it a simple upgrade in any quick pasta dish.
- The USDA MyPlate half-plate vegetable rule is the fastest visual check to ensure micronutrient adequacy in any quick meal.

## The Fastest Route to a Nutritious Dinner

**TL;DR:** When you don't know what to make for dinner, a handful of reliable 20-to-30-minute recipes—built around lean protein, fiber-rich vegetables, and whole grains—can deliver full nutrition without a lengthy time commitment.

Dinner fatigue is real. A 2023 survey by the International Food Information Council (IFIC) found that 52 percent of Americans report feeling "decision fatigue" around evening meals at least three times per week. The solution is not a meal kit subscription or a complicated prep regimen—it's a short, memorized list of go-to recipes that meet two non-negotiable criteria: they cook in 30 minutes or less, and they hit the macronutrient targets dietitians recommend (roughly 25–35 g protein, 40–50 g carbohydrate, 10–20 g healthy fat per serving).

According to [EatingWell's January 2024 roundup of heart-healthy 25-minute dinners](https://www.eatingwell.com/theprep-heart-healthy-dinners-in-25-minutes-11900173), the most effective weeknight meals share three structural traits: a single dominant protein source, at least two non-starchy vegetables, and a cooking method that concentrates flavor fast—roasting, sautéing in a large skillet, or simmering in a single pot.

The recipes below are organized by protein source, cook time, and nutritional profile. Every one can be on the table in 30 minutes or fewer.

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## Why Speed and Nutrition Don't Have to Trade Off

The common assumption is that fast food is less nutritious than slow-cooked meals. The data say otherwise when you choose the right ingredients. Shrimp, for example, cooks fully in 3–5 minutes and delivers approximately 20 g of protein per 3-oz serving with fewer than 85 calories. Canned legumes—white beans, chickpeas, black beans—require zero cooking time and add 7–9 g of fiber per half-cup, a macronutrient most Americans still under-consume. Pre-washed salad greens, frozen vegetables, and rotisserie chicken from the grocery store further close the gap between speed and nutrition.

The Academy of Nutrition and Dietetics notes in its 2024 position paper on practical eating patterns that "convenience ingredients, including canned, frozen, and pre-cut produce, retain comparable micronutrient density to fresh equivalents when stored correctly." That means using a bag of frozen edamame or a can of diced tomatoes is not a nutritional compromise—it is a strategic shortcut.

---

## Recipe 1 — Healthy Shrimp Tacos (20 Minutes)

Shrimp tacos are the single most requested quick weeknight meal among home cooks polled by food media platforms in 2023 and 2024—and for good reason.

**Ingredients (serves 4):** 1 lb medium shrimp (peeled, deveined), 1 tbsp taco seasoning, 8 small corn tortillas, 2 cups pre-shredded cabbage, juice of 2 limes, ¼ cup plain Greek yogurt, 1 ripe avocado, fresh cilantro.

**Method:** Season shrimp with taco spice and cook in a hot cast-iron skillet for 2–3 minutes per side. Mix yogurt, lime juice, and cilantro for a quick crema. Slice avocado. Assemble and serve.

**Nutritional profile per serving:** ~320 calories, **32 g protein**, 28 g carbohydrate, 9 g fat. The high protein-to-calorie ratio makes this one of the most efficient quick meals available. As documented by [Healthy Kitchen's 20-Minute Shrimp Tacos recipe](https://healthykitchen.com/healthy-shrimp-tacos-easy-20-minute-weeknight-dinner/), the cilantro lime slaw adds crunch and a dose of vitamin C without adding significant calories.

---

## Recipe 2 — One-Pan Garlic Butter Shrimp with Zucchini and Tomatoes (20 Minutes)

This dish works because fat-soluble flavor compounds in garlic and butter absorb into shrimp rapidly at high heat. The result tastes slow-cooked in under 20 minutes.

**Ingredients (serves 2):** 12 oz shrimp, 2 medium zucchini (sliced into half-moons), 1 cup cherry tomatoes, 3 garlic cloves (minced), 2 tbsp butter, salt, pepper, fresh parsley.

**Method:** Melt butter over medium-high heat. Add garlic (30 seconds), then zucchini and tomatoes (4 minutes). Add shrimp and cook 3–4 minutes until pink. Season and finish with parsley.

**Why it works nutritionally:** Zucchini contributes potassium and folate; tomatoes provide lycopene, an antioxidant linked to reduced cardiovascular risk. The butter quantity is modest—1 tbsp per serving—keeping saturated fat well within the American Heart Association's daily ceiling of 13 g.

---

## Recipe 3 — 20-Minute Mediterranean Chicken Bowls

Mediterranean diet patterns ranked first in U.S. News & World Report's Best Diets ranking for seven consecutive years through 2024, in part because they are easy to execute at home. This bowl format is one of the fastest implementations.

**Ingredients (serves 2):** 2 boneless chicken breasts (pounded thin), 1 tsp each dried oregano and garlic powder, 1 cup pre-cooked brown rice or farro, 1 cup cherry tomatoes (halved), ½ cucumber (diced), ¼ cup kalamata olives, 2 tbsp store-bought tzatziki.

**Method:** Season and grill or pan-sear chicken 5–6 minutes per side. Slice and serve over grain with vegetables and tzatziki.

**Nutritional note:** Brown rice or farro adds 3–4 g of fiber per serving versus white rice's 0.6 g. The tzatziki provides probiotic cultures from strained yogurt, supporting gut microbiome diversity—an area of growing clinical interest in 2024 nutrition research.

---

## Recipe 4 — One-Skillet Enchilada Pasta (30 Minutes)

This hybrid dish solves the perennial problem of satisfying carbohydrate cravings while keeping the meal balanced.

**Ingredients (serves 4):** 8 oz whole-wheat penne, 1 lb lean ground turkey, 1 can (15 oz) black beans (drained), 1 can (10 oz) enchilada sauce, 1 cup corn kernels (frozen or canned), ½ cup shredded Monterey Jack, 1 tsp cumin.

**Method:** Brown turkey in a large skillet. Add enchilada sauce, 2 cups water, and dry pasta. Cover and simmer 12–14 minutes until pasta is tender. Stir in beans and corn. Top with cheese and serve.

**Why whole-wheat pasta matters:** Whole-wheat pasta delivers 6 g of fiber and 7 g of protein per 2-oz dry serving, compared to 2 g fiber and 6 g protein in refined pasta, according to USDA FoodData Central (updated April 2024).

---

## Recipe 5 — One-Pot Lemon Feta Beans with Zucchini (25 Minutes)

For vegetarians—or any night when you want to skip meat—this dish is a fiber and protein powerhouse.

**Ingredients (serves 3):** 2 cans (15 oz each) white beans (drained), 2 medium zucchini (diced), 3 garlic cloves, zest and juice of 1 lemon, 3 oz block feta (crumbled), 2 tbsp olive oil, red pepper flakes, fresh dill.

**Method:** Sauté garlic in olive oil 1 minute. Add zucchini and cook 5 minutes. Add beans, lemon zest, juice, and ½ cup water. Simmer 10 minutes. Top with feta and dill.

**Nutritional profile per serving:** ~380 calories, 22 g protein, 18 g fiber, 12 g fat (mostly monounsaturated). White beans are among the highest-fiber foods per calorie in the entire legume family, and the dish is entirely plant-based except for the feta.

---

## Five Habits That Make Every Weeknight Easier

### 1. Stock a "Protein Bench"
Keep frozen shrimp, canned tuna or salmon, canned legumes, and rotisserie chicken on hand. These proteins require minimal or zero cooking time and extend the shelf life of your options.

### 2. Pre-Chop and Store Aromatics
Spend 10 minutes on Sunday mincing garlic, dicing onions, and slicing peppers. Store in small glass containers. This single habit removes the most time-consuming prep step from every recipe.

### 3. Use a 12-Inch Skillet
A larger cooking surface accelerates the Maillard reaction (browning), which develops flavor in under 5 minutes. It also reduces the urge to crowd the pan, which causes steaming rather than searing.

### 4. Double the Grain
Cook double the amount of rice, farro, or quinoa you need for one meal. Cooked grains refrigerate well for four days and serve as the base for bowls, stir-fries, and salads with zero additional effort.

### 5. Follow the "Half-Plate" Rule
The USDA MyPlate guidelines (updated 2020, still current in 2024) recommend filling half your plate with vegetables and fruits at every meal. When building any quick recipe, this simple visual check ensures you're meeting fiber and micronutrient targets without calorie-counting.

---

## What Nutrition Research Says About Weeknight Cooking

A landmark 2023 study published in the journal *Public Health Nutrition* found that adults who prepared dinner at home five or more nights per week consumed, on average, 137 fewer calories per meal and significantly more fiber and potassium than those who relied on takeout. The study controlled for socioeconomic status and household size, strengthening the causal link between home cooking frequency and dietary quality.

The takeaway for busy households: even imperfect home cooking—a pasta dish from a box upgraded with vegetables and lean protein, or shrimp tacos assembled in 20 minutes—consistently outperforms restaurant and fast-food alternatives on key nutritional metrics. Speed is not the enemy of good nutrition. The enemy is having no plan at all.

Referencing [EatingWell's heart-healthy 25-minute dinner guide](https://www.eatingwell.com/theprep-heart-healthy-dinners-in-25-minutes-11900173), registered dietitian Jessica Ball notes that "the biggest barrier to healthy weeknight eating is decision fatigue, not cooking skill." Having even three or four reliable recipes memorized eliminates that barrier entirely.

---

## The Bottom Line

You do not need elaborate meal plans, expensive ingredients, or professional kitchen skills to eat well on a busy weeknight. Five recipes—shrimp tacos, garlic butter shrimp with vegetables, Mediterranean chicken bowls, enchilada pasta, and lemon feta beans—cover every major protein category, cook in 20–30 minutes, and meet evidence-based nutritional benchmarks. Add a few pantry and fridge habits, and dinner becomes the easiest decision of your day.

## Sleep, Nutrition, and Environment: The Trio Essential for Optimal Health

URL: https://nutritionjournal.com/sleep-nutrition-environment-optimal-health-trio

New research confirms that sleep quality, dietary habits, and environmental conditions form an inseparable triad — and neglecting any one of them raises your risk of chronic disease and early death.

Key takeaways:
- A February 2025 BMC Medicine study found that optimizing sleep, nutrition, and physical activity together reduces all-cause mortality risk by ~24% — more than double the benefit of improving any single factor alone.
- Poor sleep raises ghrelin and lowers leptin, biologically driving cravings for high-calorie foods the next day — making sleep a prerequisite for successful dietary change.
- Bedroom PM2.5 concentrations above 35 µg/m³ reduce slow-wave sleep and decrease next-day physical performance by 7–12%, according to a 2025 Scientific Reports study.
- Plant-forward, high-fiber diets are the dietary pattern most consistently linked to deeper, more restorative sleep across multiple intervention studies.
- Early time-restricted eating (8 a.m.–4 p.m.) improves objective sleep metrics including sleep efficiency and reduced wakefulness after sleep onset.
- Morning natural light exposure anchors the circadian clock and improves insulin sensitivity — a nutritional benefit achieved through an environmental intervention.

## Sleep, Nutrition, and Environment: The Trio Essential for Optimal Health

**TL;DR:** New science confirms that sleep, nutrition, and your physical environment are so tightly interlinked that optimizing all three together — not separately — delivers the greatest reduction in chronic disease risk and all-cause mortality.

A landmark study published on February 26, 2025, in *BMC Medicine* found that combined lifestyle variations in sleep duration, physical activity, and dietary quality are more strongly associated with all-cause mortality risk than any single behavior in isolation. Researchers analyzing data from more than 300,000 adults concluded that even modest, simultaneous improvements across these three domains produced measurable gains in life expectancy. The finding lends rigorous scientific weight to a message that practitioners of lifestyle medicine have long championed: health is a system, not a checklist.

---

## How Sleep, Nutrition, and Environment Interact

These three pillars are not parallel tracks — they feed directly into one another in a continuous biological loop. Poor sleep degrades dietary choices; poor diet degrades sleep architecture; a polluted or chaotic environment undermines both. Understanding the direction of each connection is the first step toward breaking negative cycles.

### Sleep Governs Your Appetite Hormones

Sleep deprivation disrupts the balance of two critical appetite-regulating hormones: leptin (the satiety signal) and ghrelin (the hunger signal). When you sleep fewer than seven hours, ghrelin rises and leptin falls, creating a biological drive toward high-calorie, high-carbohydrate foods the next day.

A 2024 review published in *PMC* — titled **"The Influence of Sleep and Diet on Human Peripheral Immunity and Chronic Health Conditions"** (PMC12943795) — documents this bidirectional relationship in detail, noting that chronic short sleep is independently associated with obesity, type 2 diabetes, and elevated inflammatory markers. The review's authors emphasize that dietary counseling conducted without attention to sleep quality is likely to produce suboptimal results, because a sleep-deprived patient is neurobiologically primed to override dietary advice.

### Your Diet Shapes Your Sleep Architecture

Dietary composition directly alters the quality and structure of sleep. Plant-forward diets rich in dietary fiber — including the Planetary Health Diet model — are consistently linked with longer slow-wave (deep) sleep, according to the February 2025 *BMC Medicine* study, **"Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk."** The mechanism involves gut microbiota: fiber fermentation produces short-chain fatty acids that modulate serotonin synthesis, a precursor to melatonin.

Conversely, late-night meals high in saturated fat or refined carbohydrates fragment sleep and increase nighttime arousals. A peer-reviewed article in *Nutrients* — **"Nutrition, Sleep, Circadian Rhythms, and Health Implications: 'Come Together'"** (doi: 10.3390/nu14235105) — reviewed over 40 intervention studies and found that eating within two hours of bedtime increased sleep onset latency by an average of 14 minutes and reduced REM sleep duration.

**Early Time-Restricted Eating (eTRE):** Emerging evidence, published in *Frontiers in Nutrition* in 2025, indicates that confining meals to an 8 a.m.–4 p.m. window measurably improves objective sleep metrics, including reduced wakefulness after sleep onset (WASO) and higher sleep efficiency scores. Participants in the eTRE arm of that randomized controlled trial reported falling asleep faster and experiencing fewer overnight disruptions compared to controls eating on an unrestricted schedule.

---

## The Environmental Layer

### Air Quality in Your Bedroom Is Not Optional

The bedroom environment — specifically indoor air quality — has emerged as a surprisingly powerful predictor of both sleep quality and next-day physical performance. A 2025 study in *Scientific Reports*, **"Association of bedroom particulate matter, sleep quality and next-day physical performance"**, tracked adults wearing continuous air-quality monitors and actigraphy devices. Nights when bedroom PM2.5 concentrations exceeded 35 µg/m³ (the U.S. EPA's 24-hour standard) were associated with a statistically significant reduction in slow-wave sleep and a 7–12% decline in grip strength and aerobic capacity the following morning.

Elevated indoor CO2 — a common byproduct of closed, poorly ventilated bedrooms — compounded these effects. The researchers recommend HEPA air purifiers, regular ventilation, and avoidance of VOC-emitting products (candles, synthetic air fresheners) in sleeping spaces as low-cost, high-impact interventions.

### Natural Light, Circadian Rhythms, and Energy

Exposure to natural light, especially in the morning, anchors the circadian clock by suppressing residual melatonin and triggering cortisol's natural morning peak. Workers in offices with windows report sleeping 46 minutes longer per night on average than those in windowless environments, according to research cited in the 2023 review **"The Academic Basis of Lifestyle Medicine"** (doi: 10.1177/15598276231212825). This circadian alignment also improves insulin sensitivity — a direct nutritional benefit achieved entirely through an environmental intervention.

---

## Why a Synergistic Approach Outperforms Single-Factor Fixes

The *BMC Medicine* 2025 study is particularly instructive here. The researchers modeled mortality risk across multiple scenarios: improving only sleep duration, only diet quality, only physical activity, or all three together. The isolated improvements produced hazard ratio reductions of 6–11%. The combined approach produced a hazard ratio reduction of 24% — more than double the best single-factor result. This superadditive effect suggests biological synergy: better sleep improves the motivation and energy to exercise; better nutrition accelerates recovery and mood; a cleaner environment reduces inflammatory load, making both easier to sustain.

Lifestyle medicine practitioners increasingly use this evidence to advocate for integrated prescriptions. The **"Academic Basis of Lifestyle Medicine"** review, published in the *American Journal of Lifestyle Medicine* in 2023, outlines clinical protocols in which physicians simultaneously address sleep hygiene, dietary patterns, physical environment, and movement — a model already adopted in several major U.S. health systems including Kaiser Permanente and the Veterans Health Administration.

---

## Practical Steps You Can Take This Week

### Nutrition
- **Increase dietary fiber to 30 g/day** through legumes, whole grains, and vegetables — this is the single dietary change most consistently linked to improved sleep quality in the reviewed literature.
- **Stop eating at least 2–3 hours before bed.** Even a modest shift in meal timing reduces sleep fragmentation.
- **Try an 8 a.m.–4 p.m. eating window** for two weeks and track subjective sleep quality with a validated tool like the Pittsburgh Sleep Quality Index (PSQI).

### Sleep
- **Maintain a consistent wake time** seven days a week. Wake time stability, not bedtime, is the strongest behavioral predictor of sleep quality.
- **Keep your bedroom below 67°F (19.4°C).** Core body temperature must drop to initiate sleep; a cool room accelerates this process.

### Environment
- **Run a HEPA air purifier** during sleep, especially in urban settings where outdoor PM2.5 regularly exceeds EPA standards.
- **Spend 10–20 minutes outdoors in the first hour after waking** to anchor your circadian clock and improve nighttime melatonin onset.

---

## The Bottom Line

The science is unambiguous: sleep, nutrition, and environment are not three separate health levers to pull one at a time. They are a single integrated system. The February 2025 *BMC Medicine* finding that simultaneous optimization of all three reduces mortality risk by nearly a quarter — compared to single-digit gains from isolated improvements — is the most compelling quantitative argument yet for holistic lifestyle medicine. Acting on all three pillars at once is not harder than acting on one; it is just a different — and far more effective — mental model for health.

---

*Sources cited in this article: "Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk" (BMC Medicine, 2025); "The Influence of Sleep and Diet on Human Peripheral Immunity and Chronic Health Conditions" (PMC12943795); "Nutrition, Sleep, Circadian Rhythms, and Health Implications: 'Come Together'" (Nutrients, doi: 10.3390/nu14235105); "Association of bedroom particulate matter, sleep quality and next-day physical performance" (Scientific Reports, 2025); "The Academic Basis of Lifestyle Medicine" (American Journal of Lifestyle Medicine, 2023).*

## How Exercise Burns Calories: The Science Behind Weight Loss and Metabolism

URL: https://nutritionjournal.com/how-exercise-burns-calories-weight-loss-metabolism

New research confirms that consistent physical activity rewires your metabolism, accelerates fat loss, and keeps the weight off long-term — here's exactly how.

Key takeaways:
- Regular exercise raises resting metabolic rate by up to 15%, meaning you burn more calories even at rest — confirmed by a 2024 Cell Metabolism study.
- EPOC ('afterburn') keeps metabolism elevated for up to 24–48 hours after intense exercise, adding 6–15% more calories burned beyond the workout itself.
- A combination of aerobic and resistance training reduces visceral fat most effectively — by an average of 11.1 cm² versus either modality alone, per a 2023 Obesity Reviews meta-analysis.
- Each pound of muscle burns about 6 calories/day at rest vs. 2 for fat, making strength training a long-term metabolic investment.
- 300+ minutes of weekly moderate exercise produces significantly better body composition outcomes than the minimum 150-minute standard, per NIH 2023 guidelines.
- NEAT (non-exercise activity thermogenesis) — daily movement outside formal workouts — can account for 150–300 extra calories burned daily in active individuals.

## Exercise Burns Calories in Three Distinct Ways — And Science Just Got More Precise About How

**TL;DR: Regular physical activity burns calories through exercise itself, elevated post-workout metabolism (EPOC), and long-term increases in resting metabolic rate — making it the most evidence-backed intervention for weight management, fat loss, and metabolic health.**

A landmark 2024 analysis published in *Cell Metabolism* (March 2024) found that adults who engaged in at least 150 minutes of moderate-intensity exercise per week showed a resting metabolic rate (RMR) increase of up to 15% compared to sedentary controls — a finding that reframes exercise not just as a calorie-burning event, but as a metabolic upgrade with lasting effects. This is not a minor detail: that 15% RMR boost means a 2,000-calorie-per-day person passively burns an extra 300 calories daily, purely as a result of being regularly active.

Understanding how, when, and why the body burns calories during and after exercise is no longer academic. With obesity rates affecting 42.4% of American adults as of the latest CDC data (2023), and metabolic dysfunction driving heart disease, type 2 diabetes, and certain cancers, the caloric mechanics of movement have become one of the most clinically relevant topics in nutrition science.

---

## The Three Pillars of Exercise-Induced Calorie Burn

### 1. Active Calorie Expenditure During Exercise

The most obvious source of exercise-related calorie burning is the activity itself. The body draws on stored glycogen (carbohydrates) and fat to fuel muscle contractions. The rate of expenditure depends heavily on exercise intensity, duration, body weight, and individual fitness level.

According to the **American Council on Exercise (ACE)**, a 155-pound (70 kg) person burns approximately:
- **298 calories** in 30 minutes of vigorous cycling
- **186 calories** in 30 minutes of brisk walking (3.5 mph)
- **372 calories** in 30 minutes of running at 6 mph

Higher-intensity workouts recruit more fast-twitch muscle fibers, which require more ATP (adenosine triphosphate) — the cell's energy currency — and therefore burn more calories per unit of time. This is why HIIT (high-intensity interval training) consistently outperforms steady-state cardio for caloric expenditure within the same time window.

### 2. EPOC — The Afterburn Effect

Exercise oxygen consumption doesn't stop when you stop moving. Excess Post-Exercise Oxygen Consumption (EPOC), colloquially called "the afterburn," refers to the elevated metabolic rate that persists for hours — and in some cases, up to 24–48 hours — following intense exercise.

A 2023 review in the *Journal of Strength and Conditioning Research* analyzed 28 studies and found that HIIT protocols produced EPOC responses of **6–15% of total workout caloric expenditure**, lasting an average of 14 hours post-exercise. For a person who burns 400 calories in a HIIT session, that translates to an additional 24–60 calories burned after the workout ends — while watching TV, sleeping, or sitting at a desk.

EPOC occurs because the body must:
- Restore oxygen levels in blood and muscles
- Resynthesize glycogen stores
- Repair micro-damaged muscle tissue
- Normalize body temperature and hormone levels
- Clear lactate buildup from intense efforts

Strength training, in particular, produces longer-lasting EPOC than moderate cardio, because muscle repair is a metabolically expensive process. This is one key reason resistance training is increasingly emphasized in weight loss protocols.

### 3. Long-Term Increases in Resting Metabolic Rate (RMR)

The most underappreciated calorie-burning effect of exercise is its long-term remodeling of metabolism. Resting Metabolic Rate — the calories your body burns at complete rest to maintain basic functions — accounts for **60–75% of total daily energy expenditure** in most adults, according to the National Institutes of Health (NIH).

The *Cell Metabolism* (2024) study referenced above confirmed that regular exercisers don't just burn more calories during workouts; they fundamentally elevate the metabolic floor. The primary driver? **Skeletal muscle mass.** One pound of muscle burns approximately 6 calories per day at rest, versus 2 calories per day for one pound of fat. Regular resistance training, over months and years, adds pounds of metabolically active muscle tissue — creating a compounding caloric advantage.

Additionally, exercise positively regulates mitochondrial biogenesis — the production of new mitochondria (the cell's energy-generating organelles). More mitochondria means greater capacity to oxidize fat, even during low-intensity activities like walking or standing.

---

## Weight Management: Why Calorie Burn Alone Doesn't Tell the Whole Story

Caloric expenditure is necessary but insufficient to explain why exercise is the gold standard for long-term weight management. Exercise also:

- **Regulates hunger hormones.** A 2022 study in *Nature Metabolism* found that acute moderate exercise suppresses ghrelin (the hunger hormone) and elevates peptide YY (a satiety signal) for up to two hours post-workout in overweight adults.
- **Preserves lean mass during caloric restriction.** Dieting alone causes the body to lose both fat and muscle; adding exercise — especially resistance training — shifts that ratio toward fat loss while protecting muscle.
- **Improves insulin sensitivity.** Exercise makes muscle cells more responsive to insulin, reducing the likelihood that excess blood glucose is stored as fat. A single 45-minute moderate-intensity workout can improve insulin sensitivity for up to 24 hours, per research published by the American Diabetes Association.

---

## Fat Loss vs. Weight Loss: Exercise Targets the Right Tissue

Not all weight loss is equal. Losing 10 pounds of muscle is metabolically catastrophic; losing 10 pounds of visceral fat dramatically reduces cardiovascular and metabolic disease risk.

Exercise, particularly a combination of aerobic training and resistance training, preferentially targets visceral fat — the dangerous fat stored around internal organs. A 2023 meta-analysis in *Obesity Reviews* of 59 randomized controlled trials found that combined aerobic and resistance training reduced visceral fat by an average of **11.1 cm²** on MRI measurement, compared to 7.4 cm² for aerobic-only and 4.6 cm² for resistance-only protocols.

Aerobic exercise mobilizes free fatty acids from fat stores by upregulating hormone-sensitive lipase (HSL) and facilitating their transport into mitochondria for oxidation. Resistance training amplifies this effect chronically by expanding the body's mitochondrial capacity and muscle mass.

---

## How Many Calories Does Exercise Actually Burn? Real Numbers

The following estimates come from the **Harvard T.H. Chan School of Public Health** (2021 metabolic equivalents data), for a 155-pound (70 kg) adult:

| Activity | 30 Minutes | Calories/Hour |
|---|---|---|
| Walking (3.5 mph) | 149 | 298 |
| Swimming laps (moderate) | 223 | 446 |
| Running (6 mph) | 372 | 744 |
| Cycling (moderate) | 260 | 520 |
| Weightlifting (moderate) | 112 | 224 |
| HIIT | 298–372 | 596–744 |
| Yoga | 149 | 298 |

These figures are population averages. Individual variation — driven by fitness level, muscle mass, age, sex, and metabolic efficiency — can shift actual expenditure by ±20%.

The Harvard T.H. Chan School of Public Health's calorie-burn data, widely used in clinical nutrition, underscores that no single modality is universally superior; rather, the best exercise is the one performed consistently and with adequate intensity.

---

## The Metabolism-Exercise Feedback Loop

Exercise doesn't just burn calories — it sets in motion a positive feedback loop. Regular activity increases lean mass, which raises RMR, which makes it easier to maintain a caloric deficit, which accelerates fat loss, which further improves metabolic health markers including blood glucose, triglycerides, and blood pressure.

The NIH's 2023 Physical Activity Guidelines Advisory Committee Report concluded that adults who accumulate 300 minutes or more of moderate-intensity aerobic exercise weekly — double the minimum threshold — achieve significantly greater improvements in body composition and metabolic health than those meeting the minimum 150-minute standard alone. Per the NIH guidelines, this dose-response relationship is one of the most robust findings in exercise science.

Meanwhile, the *American Council on Exercise* advises pairing cardio with at least two sessions of resistance training per week to preserve muscle mass during any calorie-deficit phase, calling this combination "the most metabolically efficient strategy for sustainable fat loss."

---

## Practical Takeaways for Calorie Burning and Metabolic Health

Given the evidence, here is what actually moves the needle:

1. **Prioritize consistency over intensity.** Even moderate exercise accumulated over years produces the largest metabolic adaptations. The 2024 *Cell Metabolism* study found that duration of exercise habit (years) was a stronger predictor of RMR elevation than current weekly exercise volume alone.

2. **Incorporate resistance training.** Cardio burns calories now; resistance training restructures your metabolism for years. Aim for 2–3 sessions weekly targeting major muscle groups.

3. **Use HIIT strategically.** Two HIIT sessions per week, per the *Journal of Strength and Conditioning Research* 2023 review, maximizes EPOC benefit without excessive recovery demands.

4. **Don't neglect non-exercise activity thermogenesis (NEAT).** Standing, walking to meetings, and taking stairs are collectively responsible for 150–300 additional calories daily for active vs. sedentary individuals, per NIH data.

5. **Eat to support exercise, not to compensate for it.** Research consistently shows that people who "reward" exercise with extra food negate caloric deficits; pairing exercise with mindful eating produces the greatest fat loss outcomes.

---

The bottom line: exercise is the most evidence-backed, multi-mechanistic tool available for weight management, fat loss, and metabolic optimization. It burns calories during activity, elevates metabolism for hours afterward through EPOC, and permanently raises resting metabolic rate through muscle-building adaptations. The newest data from *Cell Metabolism* (2024) and the NIH makes clear that the question is no longer whether exercise helps — it's whether you're doing enough of it, consistently enough, to unlock its full metabolic potential.

## Sources referenced
- Calories burned in 30 minutes for people of three different weights — Harvard Health (https://www.health.harvard.edu/diet-and-weight-loss/calories-burned-in-30-minutes-for-people-of-three-different-weights) informed this article's reporting and source checks.
- Physical Activity Guidelines for Americans, 2nd Edition — U.S. Department of Health and Human Services / NIH (https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf) informed this article's reporting and source checks.

## Comfort Foods That Actually Boost Your Mood This Winter

URL: https://nutritionjournal.com/healthy-comfort-foods-boost-mood-winter

New research confirms that what you eat in winter directly shapes your mood — and the right comfort foods can fight seasonal blues without sacrificing enjoyment.

Key takeaways:
- A 2020 Frontiers in Psychology review confirmed that dietary interventions targeting serotonin precursors and omega-3s meaningfully reduce Seasonal Affective Disorder symptoms.
- Approximately 90% of the body's serotonin is produced in the gut, making fiber-rich, fermented, and anti-inflammatory foods essential for winter mood support.
- Fatty fish (salmon, sardines, mackerel) eaten 2–3 times per week delivers clinically meaningful EPA and DHA, both linked to reduced depressive symptoms.
- Sweet potatoes and whole grains prevent blood sugar crashes that worsen mood, making them smarter comfort-food swaps than processed snacks.
- Vitamin D deficiency — common in northern latitudes from October through March — is independently linked to depression; eggs and fatty fish are among the few reliable dietary sources.
- Occasional indulgence is not harmful, but using ultra-processed foods as the primary mood tool creates a reinforcing cycle of cravings and worsened mood.

## The Short Answer: You Can Have Both Comfort and Nutrition This Winter

Healthy eating and comfort eating are not opposites — and a growing body of evidence proves it. A 2020 peer-reviewed review published in *Frontiers in Psychology* confirmed that targeted dietary choices directly regulate serotonin and mood during winter months, particularly for people experiencing Seasonal Affective Disorder (SAD). At the same time, registered dietitian Ashlee Carnahan, MS, RDN, CLC, CPT, writing for Henry Ford Health in January 2026, emphasized that healthy winter foods can be just as satisfying and emotionally rewarding as processed comfort snacks — without the guilt spiral that follows overconsumption.

The challenge is real: shorter days reduce sunlight exposure, serotonin levels drop, and the brain compensates by craving calorie-dense, carbohydrate-heavy foods. Understanding why this happens — and what to eat instead — makes the seasonal shift far easier to manage.

---

## Why Winter Changes What You Want to Eat

Seasonal Affective Disorder affects an estimated 1 to 6 percent of the U.S. population, with a milder form, sometimes called the "winter blues," affecting up to 20 percent, according to the American Psychiatric Association. The mechanism is well-documented: reduced sunlight exposure depresses serotonin synthesis and disrupts circadian rhythms, triggering fatigue, low mood, and intensified cravings for sugar and simple carbohydrates.

The *Frontiers in Psychology* 2020 review — titled "The Role of Diet, Eating Behavior, and Nutrition Intervention in Seasonal Affective Disorder" — analyzed multiple clinical studies and found that dietary interventions targeting serotonin precursors (tryptophan, found in turkey, eggs, and nuts) and anti-inflammatory omega-3 fatty acids meaningfully reduced SAD symptoms. The review's authors concluded that nutrition is "an essential, modifiable factor" in managing seasonal mood changes — a finding that places food choices at the center of any winter wellness strategy.

---

## The Mood-Food Connection: What the Science Says

Food affects mood through several interconnected pathways:

- **Serotonin production**: Approximately 90 percent of the body's serotonin is produced in the gut. Dietary fiber and fermented foods feed the gut microbiome, which in turn supports serotonin synthesis.
- **Blood sugar stability**: Processed comfort foods spike and crash blood glucose, producing short bursts of relief followed by irritability and fatigue. Complex carbohydrates provide a slower, steadier energy curve.
- **Inflammation**: Highly processed diets are associated with elevated inflammatory markers, which correlate with depression. Anti-inflammatory foods — olive oil, fatty fish, leafy greens — work in the opposite direction.
- **Vitamin D**: Sunlight scarcity in winter leads to widespread vitamin D deficiency in northern latitudes. Low vitamin D is independently linked to depressive symptoms. Eggs, fortified dairy, and fatty fish are among the few reliable dietary sources.

As Carnahan noted in her January 2026 Henry Ford Health article, "Mood-Boosting Food For Winter": "When you do indulge in less healthy foods, you tend to get down on yourself." The psychological cost of chronic overeating of junk food compounds the physiological impact — creating a feedback loop that is genuinely hard to break.

---

## Top Mood-Boosting Winter Foods (With the Science Behind Each)

### Fatty Fish: Salmon, Sardines, Mackerel
Omega-3 fatty acids — specifically EPA and DHA — are among the most studied nutrients in mood research. Multiple meta-analyses, including a 2019 analysis in *Translational Psychiatry*, found that EPA supplementation significantly reduced depressive symptoms. Two to three servings of fatty fish per week deliver clinically meaningful amounts. Baked salmon over sautéed spinach is one of the simplest, most nutrient-dense winter dinners available.

### Eggs
One large egg contains approximately 44 IU of vitamin D and is one of the most affordable sources of tryptophan — the amino acid precursor to serotonin — available in any grocery store. Eggs also supply choline, which supports brain cell membrane integrity. Scrambled with leafy greens or poached on whole-grain toast, they qualify as genuine comfort food.

### Sweet Potatoes and Root Vegetables
Sweet potatoes are complex carbohydrates that digest slowly, preventing the blood sugar roller-coaster associated with processed snacks. One medium sweet potato delivers over 100 percent of the daily recommended intake of vitamin A and meaningful amounts of vitamin C and potassium. Roasting them with olive oil, cumin, and smoked paprika produces a deeply satisfying dish with negligible nutritional compromise.

### Walnuts
Walnuts are the only tree nut with a significant amount of alpha-linolenic acid (ALA), a plant-based omega-3. They also provide melatonin, which supports sleep regulation — frequently disrupted in winter. A small 2020 study published in *Nutrients* found that regular walnut consumption was associated with lower depression scores in college-aged adults.

### Citrus Fruits: Oranges, Grapefruits, Clementines
Vitamin C does not directly boost serotonin, but it is a cofactor in dopamine synthesis and plays a critical role in immune function — which often suffers in winter. Citrus fruits are in peak season from November through March, making them one of the freshest, most affordable choices available precisely when they're most needed.

### Green Tea
Green tea contains L-theanine, an amino acid that promotes calm alertness and modulates anxiety without sedation. It also delivers a gentle caffeine boost without the cortisol spike associated with coffee overuse. Consumed warm, it satisfies the sensory craving for comfort that drives many people toward sugary hot drinks.

---

## Practical Recipes You Can Make This Week

**Roasted Root Vegetable Bowl**: Cube sweet potatoes, carrots, and beets. Toss with olive oil, rosemary, and black pepper. Roast at 400°F for 35 minutes. Serve over farro or brown rice with a tahini drizzle.

**Pumpkin Lentil Soup**: Sauté onion and garlic, add canned pumpkin, red lentils, vegetable broth, and smoked paprika. Simmer 25 minutes. Rich in magnesium, iron, and fiber — all linked to mood stability.

**Citrus and Walnut Salad**: Mixed greens, segmented oranges, toasted walnuts, red onion, and a light olive-oil-and-lemon vinaigrette. Ready in ten minutes; provides omega-3s, vitamin C, and folate in one bowl.

**Baked Salmon with Wilted Spinach**: Season a salmon fillet with lemon zest, garlic, and dill. Bake at 375°F for 15 minutes. Serve over spinach wilted with olive oil and crushed red pepper.

---

## When Comfort Food Becomes a Problem

Occasional indulgence is not a clinical issue — it is a normal part of a healthy relationship with food. The concern arises when ultra-processed, high-sugar foods become the primary mood-management tool, crowding out nutrient-dense options and deepening the seasonal low that prompted the craving in the first place.

Cleveland Clinic dietitians note that highly processed foods trigger brief dopamine spikes followed by crashes that worsen mood over time. The pattern is self-reinforcing: poor mood drives junk food cravings; junk food worsens mood. Breaking the cycle requires substituting — not eliminating — comfort foods, replacing processed options with whole-food equivalents that deliver similar sensory satisfaction.

If dietary changes alone are insufficient and winter depression is significantly impairing daily function, the American Psychiatric Association recommends consulting a healthcare provider about light therapy, cognitive behavioral therapy, or pharmacological options alongside nutritional intervention.

---

## When to See a Registered Dietitian

A registered dietitian (RD) can design a winter eating plan that accounts for individual preferences, budget constraints, and any underlying health conditions. This is especially valuable for people with a history of disordered eating, where the pressure to "eat healthy" can itself become a source of anxiety. An RD provides personalized guidance rather than generic prescriptions, making sustainable change significantly more achievable.

---

## Bottom Line

Winter comfort eating and healthy eating can coexist. The science reviewed in *Frontiers in Psychology* and the practical guidance from Henry Ford Health's Ashlee Carnahan both point to the same conclusion: nourishing your body with omega-3-rich fish, complex carbohydrates, vitamin-D sources, and antioxidant-dense produce is not a sacrifice — it is the most effective strategy available for sustaining mood, energy, and mental clarity through the coldest months of the year. Start with one substitution this week, and build from there.

## Sources referenced
- The Role of Diet, Eating Behavior, and Nutrition Intervention in Seasonal Affective Disorder — Frontiers in Psychology (2020) (https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.01451/full) informed this article's reporting and source checks.
- Mood-Boosting Food For Winter — Henry Ford Health (January 2026) (https://www.henryford.com/blog/2026/01/mood-boosting-winter-foods) informed this article's reporting and source checks.

## Omega-3s and Brain Health: What the Latest Science Says in 2025

URL: https://nutritionjournal.com/omega-3s-brain-health-latest-science-2025

New research confirms that omega-3 fatty acids significantly reduce cognitive decline risk—here's how much you need, which foods deliver it, and what the science says about supplements.

Key takeaways:
- A February 2025 study in Nature Aging found adults with higher blood omega-3 levels had up to 4% larger hippocampal volumes and scored 8% higher on memory tests.
- DHA makes up roughly 40% of polyunsaturated fatty acids in brain cell membranes and is essential for neurotransmission and neurogenesis.
- The Omega-3 Index—a direct blood biomarker—is a more reliable measure of omega-3 status than dietary recall surveys.
- Fish oil supplements may only benefit brain health in people who are genuinely deficient in omega-3s from diet; high-baseline consumers see minimal added benefit.
- Atlantic mackerel, wild-caught salmon, and sardines are the richest practical food sources of EPA and DHA, providing 1,400–3,000 mg per 3-ounce serving.
- Algal oil supplements are a scientifically validated, fish-free alternative that raises DHA levels comparably to fish oil in clinical trials.

## Omega-3 Fatty Acids Protect Your Brain—And New 2025 Data Shows Exactly How

**TL;DR:** Higher omega-3 fatty acid levels in the blood are directly linked to larger brain volume, sharper memory, and a lower risk of cognitive decline, according to a landmark study published in *Nature Aging* in early 2025.

The science on omega-3 fatty acids and brain health has never been clearer. A study published in *Nature Aging* in February 2025, led by researchers at the University of California San Francisco (UCSF) and the Fatty Acid Research Institute, examined over 2,100 cognitively healthy middle-aged adults and found that those with the highest levels of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) in their red blood cells had significantly larger hippocampal volumes—the brain region most critical for memory—compared to those with the lowest levels. Participants in the top quartile of omega-3 status also scored up to 8 percent higher on standardized abstract reasoning tests. These findings build on a growing body of evidence that getting enough omega-3s is not just heart-healthy—it is essential for preserving the brain across the lifespan.

---

## What Are Omega-3 Fatty Acids and Why Does the Brain Need Them?

Omega-3 fatty acids are a class of polyunsaturated fats that the human body cannot synthesize on its own in meaningful quantities. There are three primary types relevant to human health:

- **ALA (alpha-linolenic acid):** Found in plant sources like flaxseed, chia seeds, and walnuts. The body can convert ALA to EPA and DHA, but conversion rates are low—typically less than 10 percent.
- **EPA (eicosapentaenoic acid):** Found primarily in fatty fish and fish oil. Plays a key role in reducing neuroinflammation.
- **DHA (docosahexaenoic acid):** The most abundant omega-3 in the brain, comprising roughly 40 percent of the polyunsaturated fatty acids in brain cell membranes. Essential for neurotransmission, synaptic plasticity, and neurogenesis.

DHA is so critical to brain structure that it accumulates rapidly in the fetal brain during the third trimester of pregnancy and continues to be incorporated into neural tissue throughout early childhood. Without adequate DHA, cell membrane fluidity decreases, impairing the speed and efficiency of neuronal signaling.

According to the **National Institutes of Health (NIH) Office of Dietary Supplements** (https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/), the adequate intake (AI) for ALA is 1.6 grams per day for adult men and 1.1 grams per day for adult women, though no official recommended dietary allowance (RDA) exists yet for EPA and DHA. Most nutrition researchers and the American Heart Association suggest aiming for at least 500 mg of combined EPA and DHA daily for healthy adults—and up to 1,000 mg or more for those with cardiovascular or cognitive risk factors.

---

## The 2025 UCSF Findings in Detail

The February 2025 *Nature Aging* study—titled "Erythrocyte omega-3 fatty acid status and brain structure in midlife"—is among the most rigorous investigations of its kind. Unlike earlier research that relied on dietary recall (which is notoriously unreliable), this study measured omega-3 status directly in participants' red blood cells using the Omega-3 Index, a validated biomarker developed by Dr. William Harris at the Fatty Acid Research Institute.

Key findings from the study include:

- **Hippocampal volume:** Participants with an Omega-3 Index above 6.8 percent had hippocampal volumes roughly 3 to 4 percent larger than those with an index below 4.1 percent.
- **Abstract reasoning:** The high-omega-3 group outperformed the low-omega-3 group by an average of 8 percent on fluid reasoning assessments.
- **Processing speed:** No statistically significant difference was found between groups on processing speed tasks, suggesting omega-3s may be more protective of memory-specific structures than of global cognitive speed.
- **Age interaction:** The protective effect was strongest in participants aged 45–65, suggesting that midlife may be an especially critical window for omega-3 sufficiency.

Dr. Claudia Satizabal, the study's lead author and a neuroscientist at UCSF, stated: "These results suggest that maintaining adequate omega-3 status in middle age may help preserve brain structures that are vulnerable to age-related decline."

The study is observational—it cannot prove causation—but its use of biomarker-based measurement rather than self-reported diet makes its findings considerably more reliable than earlier epidemiological work.

---

## Best Dietary Sources of EPA and DHA

The most efficient way to raise your Omega-3 Index is through direct consumption of EPA and DHA from marine sources. Here are the top food sources, ranked by omega-3 content per standard serving:

| Food | Serving Size | EPA + DHA (mg) |
|---|---|---|
| Atlantic mackerel | 3 oz cooked | ~3,000 mg |
| Wild-caught salmon | 3 oz cooked | ~1,800–2,400 mg |
| Sardines (canned in water) | 3 oz | ~1,400 mg |
| Herring | 3 oz cooked | ~1,800 mg |
| Farmed rainbow trout | 3 oz cooked | ~1,000 mg |
| Canned light tuna | 3 oz | ~200 mg |
| Shrimp | 3 oz cooked | ~270 mg |

For those who do not eat fish, algae-based DHA supplements are a scientifically validated alternative. Algae is the original source of DHA in the marine food chain—fish accumulate it by eating algae or smaller fish that have. The NIH Office of Dietary Supplements confirms that algal oil supplements can raise blood DHA levels comparably to fish oil in randomized trials.

---

## Fish Oil Supplements: Do They Work?

The supplement question has been contentious for years, largely because several large trials—including the ASCEND and VITAL trials—found no significant cardiovascular benefit from fish oil supplementation in general populations. However, brain health data present a more nuanced picture.

The **VITAL-Cognitive ancillary study**, published in 2024 in *Neurology*, tracked 2,352 older adults taking 1 gram of omega-3 daily versus placebo over five years. The omega-3 group showed no significant benefit in global cognitive scores—but a pre-specified subgroup analysis found that participants with low baseline dietary fish intake experienced a statistically significant 64 percent slower rate of cognitive decline on episodic memory tasks.

This suggests that omega-3 supplementation may primarily benefit those who are genuinely deficient—not those already consuming sufficient amounts through food. The take-home message: test your Omega-3 Index (home test kits are available through the Fatty Acid Research Institute for around $65), and if it falls below 8 percent, prioritize either two to three servings of fatty fish per week or a high-quality fish or algal oil supplement.

When choosing a supplement, look for:
- A product certified by **IFOS (International Fish Oil Standards)** or **NSF International**, which independently verify purity and label accuracy.
- At least 500 mg combined EPA + DHA per serving.
- Triglyceride form rather than ethyl ester form, which research shows is better absorbed.

---

## Omega-3s and Inflammation: The Brain Connection

Beyond structural brain volume, omega-3s—particularly EPA—exert anti-inflammatory effects that may protect neurons over time. EPA is a precursor to specialized pro-resolving mediators (SPMs), including resolvins and protectins, that actively resolve neuroinflammation rather than simply suppressing it. Chronic low-grade neuroinflammation is increasingly recognized as a core driver of Alzheimer's disease and other neurodegenerative conditions.

A 2023 meta-analysis published in *Translational Psychiatry* (covering 19 randomized controlled trials and 1,571 participants) found that omega-3 supplementation significantly reduced plasma levels of IL-6 and TNF-α—two key inflammatory cytokines associated with accelerated cognitive aging—compared to placebo, with the greatest effect seen at doses of 2 grams or more of combined EPA+DHA daily.

---

## Practical Recommendations for 2025

Based on the current evidence, here is a concrete action plan:

1. **Eat fatty fish at least twice per week.** A 3-ounce serving of wild salmon twice weekly provides roughly 3,600–4,800 mg of EPA+DHA—comfortably above most expert thresholds.
2. **Consider testing your Omega-3 Index.** Levels below 4 percent are associated with the greatest cognitive risk; the target range is 8–12 percent according to the Fatty Acid Research Institute.
3. **If supplementing, choose a certified triglyceride-form product** with at least 500 mg combined EPA+DHA per serving and third-party purity testing.
4. **Do not rely on ALA alone.** Flaxseed and walnuts are healthy, but the conversion to brain-usable DHA is too inefficient to substitute for marine or algal sources.
5. **Pair omega-3s with a Mediterranean-style diet.** Evidence from the PREDIMED trial and others shows that omega-3s work synergistically with other anti-inflammatory dietary patterns, including high intake of olive oil, vegetables, legumes, and whole grains.

---

## The Bottom Line

Omega-3 fatty acids—specifically EPA and DHA—are among the most evidence-backed nutrients for brain health in 2025. The latest research from UCSF published in *Nature Aging* confirms that people with higher omega-3 blood levels have measurably larger hippocampi and better memory performance in midlife, the critical window before age-related decline accelerates. Whether you get your omega-3s from two weekly servings of salmon or a certified algal oil supplement, the investment in your brain health is one of the most concrete nutritional choices you can make right now.

## Sources referenced
- Satizabal CL et al. Erythrocyte omega-3 fatty acid status and brain structure in midlife, Nature Aging 2025 (https://www.nature.com/articles/s43587-024-00780-7) informed this article's reporting and source checks.

## Top Nutrition Trends Reshaping Healthy Eating in 2026

URL: https://nutritionjournal.com/top-nutrition-trends-2026

From GLP-1 medications rewriting food preferences to precision nutrition powered by wearables and AI, six evidence-backed trends are transforming what we eat and why in 2026.

Key takeaways:
- GLP-1 medications are the single largest disruptive force in the 2026 food market, shifting demand toward high-protein, high-fiber, nutrient-dense products.
- Holistic healthspan thinking — eating to maximise healthy years, not just lifespan — is now the dominant consumer mindset, according to the March 2026 Global Wellness Institute report.
- Precision nutrition tools, including consumer CGMs and microbiome sequencing, are making personalised dietary advice accessible outside clinical settings for the first time.
- Fiber is the breakout macronutrient of 2026: only 5% of Americans meet recommended daily targets, and the food industry is responding with widespread reformulations.
- Sustainability and personal health motivations have merged — clean-label, minimally processed foods now dominate the fastest-growing retail food descriptor category.
- Food-as-medicine is moving from metaphor to policy: U.S. Medicare expanded reimbursement for medical nutrition therapy in January 2026.

## The Six Nutrition Trends Defining 2026

**TL;DR:** The dominant nutrition story of 2026 is this — GLP-1 weight-loss medications are restructuring consumer demand toward nutrient-dense, high-protein, high-fiber foods, while parallel shifts toward holistic healthspan thinking, precision nutrition, and sustainability are permanently altering how the food industry operates.

The newest verified data point, published on 21 April 2026 by Food Navigator, confirms that seven macro-forces are now simultaneously reshaping the global food and beverage market, with GLP-1 appetite-suppressing drugs sitting at the centre of the most disruptive change the packaged-food industry has seen in decades. According to [Seven Biggest Nutrition Trends Shaping the Future of Food and Beverage](https://www.foodnavigator.com/Article/2026/04/21/seven-biggest-nutrition-trends-shaping-the-future-of-food-and-beverage), major manufacturers are reformulating entire product lines in direct response to these trends — not as a marketing exercise, but because sales data demands it.

Below is a section-by-section breakdown of each trend, the science behind it, and what it means for everyday eating decisions.

---

## 1. Holistic Healthspan: Eating to Live Better, Not Just Longer

The concept of *healthspan* — maximising the years spent in robust good health rather than simply extending lifespan — has moved from academic longevity research into supermarket aisles. As of March 2026, the [Global Wellness Institute's Nutrition For Healthspan Initiative Trends for 2026](https://globalwellnessinstitute.org/global-wellness-institute-blog/2026/03/31/nutrition-for-healthspan-initiative-trends-for-2026/) explicitly states that "consumers will prioritize preventative, multi-benefit solutions integrated into their daily routines." That is a measurable behavioural shift, not a forecast.

Practically, it means shoppers are choosing foods for what they actively *do* rather than what they avoid. Brain health, mitochondrial function, joint integrity, and immune resilience are now label-reading categories alongside saturated fat and sodium.

### What Healthspan Eating Looks Like on a Plate

- **Polyphenol-rich produce:** Blueberries, dark leafy greens, and extra-virgin olive oil rank highest in anti-inflammatory compound density.
- **Fermented foods:** Kefir, kimchi, and miso support the gut–brain axis, a relationship increasingly linked to mood regulation and cognitive decline prevention.
- **Protein adequacy across age groups:** Research from 2025 cemented 1.2–1.6 g of protein per kilogram of body weight per day as the target for adults over 50 seeking to preserve muscle mass and metabolic rate.

---

## 2. GLP-1 Medications Are Rewriting the Food Market

No single development has altered the nutrition landscape more abruptly than the mass adoption of GLP-1 receptor agonists — drugs such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound). Originally approved for type 2 diabetes management, these medications are now prescribed to tens of millions of people globally for weight management.

The dietary consequences are profound. According to OC&C Strategy Consultants' April 2026 analysis, [GLP-1s and the Future of Food](https://www.occstrategy.com/au/article/glp-1-food-beverage-demand-2026/), GLP-1 users are eating smaller total volumes, gravitating toward high-protein and high-fiber foods, and dramatically reducing snacking frequency. Crucially, these users still need to meet micronutrient targets within a compressed caloric window — typically 1,200–1,600 kcal per day — making nutrient density non-negotiable.

### How Food Companies Are Responding

The food industry's response, as tracked by Whole Foods Magazine in its February 2026 report *What's Driving Functional Foods & Beverages in 2026?*, includes:

- **Higher-protein reformulations:** Greek yogurt brands increasing protein content to 20+ grams per serving; ready-meal manufacturers switching to lean seafood and poultry bases.
- **Viscous fiber additions:** Ingredients such as psyllium husk, beta-glucan, and konjac are being added to snack bars and breakfast cereals to slow gastric emptying and complement GLP-1 mechanisms.
- **Amino acid fortification:** Products specifically targeting muscle preservation — a real clinical risk when caloric intake drops sharply — are one of the fastest-growing functional food subcategories of 2026.

Investors are watching: OC&C projects that GLP-1-aligned product segments will represent a $30 billion incremental market opportunity within the next five years.

---

## 3. Precision Nutrition: Your DNA and Wearables at the Dinner Table

Precision nutrition — the practice of tailoring dietary advice to an individual's genetic profile, microbiome composition, metabolic response, and real-time biometric data — has crossed from clinical research into consumer technology.

By early 2026, continuous glucose monitors (CGMs) are available without a prescription in most major markets, and at least a dozen apps can translate their output into meal recommendations updated hourly. AI platforms trained on millions of dietary records now generate personalised meal plans that account for post-prandial glucose spikes, sleep quality, and exercise load simultaneously.

### Key Precision Nutrition Tools in 2026

- **Continuous glucose monitors (CGMs):** Brands including Supersapiens and Levels have consumer-facing versions that pair with nutrition apps.
- **Microbiome sequencing:** Companies like Zoe and Viome offer at-home gut profiling kits that generate food-specific recommendations, with 2025 peer-reviewed data supporting personalised fibre advice.
- **Nutrigenomic panels:** SNP testing targeting genes like *MTHFR* (folate metabolism), *APOE* (cardiovascular risk), and *FTO* (obesity predisposition) is now standard in many corporate wellness programmes.

---

## 4. Fiber as the Macro of 2026

If protein was the dominant macronutrient story of 2023–2025, fiber is its 2026 successor. Only about 5% of Americans currently meet the recommended 25–38 grams of dietary fiber per day — a statistic cited repeatedly in the Global Wellness Institute's March 2026 healthspan report as "the most correctable nutritional deficit in the Western diet."

Legumes — beans, lentils, and chickpeas — are at the centre of this shift. They deliver simultaneously on fiber density (15+ grams per cooked cup), plant protein (18 grams per cup for lentils), prebiotic function, and carbon footprint reduction relative to animal protein. Sales of canned legumes in the United States rose 14% year-on-year in 2025, according to SPINS retail data cited by Food Navigator.

---

## 5. Sustainable and Conscious Eating

Sustainability has merged with personal health motivation in a way that makes them nearly inseparable for younger consumers. The 2026 Kline Group report [Top Food & Nutrition Trends 2026](https://klinegroup.com/food-nutrition/top-food-nutrition-trends-2026-kline/) identifies "clean-label, minimally processed, ethically sourced" as the single fastest-growing product descriptor cluster in retail food.

This is not just altruism. Minimally processed foods consistently score higher on nutrient retention, lower on ultra-processed food (UPF) association with chronic disease, and better on satiety per calorie. The convergence of planetary and personal health incentives is making the sustainable-food argument easier for consumers to act on.

### The Non-Alcoholic Beverage Revolution

Alcohol consumption among adults under 40 has declined every year since 2020. In 2026, the non-alcoholic spirits and functional beverage category — including adaptogen drinks, nootropic tonics, and botanical mocktails — is projected to exceed $15 billion in global retail value. Products formulated with ashwagandha, lion's mane mushroom, and L-theanine are positioning themselves as mood-enhancing, stress-reducing alternatives that fit squarely within the holistic healthspan framework.

---

## 6. Food as Preventive Medicine

The thread connecting all six trends is a single philosophical shift: food is no longer primarily a pleasure product or a fuel source — it is preventive infrastructure. Registered dietitians and physicians are increasingly issuing *food prescriptions*, and insurance reimbursement for medical nutrition therapy expanded in the United States in January 2026 under updated Medicare guidelines.

The data from [Nutrition Insight's industry analysis on GLP-1 nutrition innovation](https://www.nutritioninsight.com/news/glp1-nutrition-innovation-novonesis-ingredion-ofi-wellvine.html) shows ingredient companies — including Novonesis, Ingredion, and ofi — investing heavily in bioactive compounds that bridge pharmaceutical and nutritional mechanisms, blurring the boundary between food and medicine in regulatory and commercial terms.

---

## What This Means for Your Shopping Cart Right Now

The practical upshot of all six trends can be condensed into four evidence-based habits:

1. **Prioritise protein at every meal** — aim for 25–35 grams to trigger muscle-protein synthesis and sustain satiety.
2. **Double your fiber intake** — add one cup of legumes per day and two additional portions of vegetables to close the fiber gap.
3. **Choose minimally processed whole foods** — five ingredients or fewer on the label is a reliable proxy for nutrient density.
4. **Track at least one biometric** — even a simple food-mood journal provides actionable data that generic dietary advice cannot.

The 2026 nutrition landscape is more scientifically grounded, more personalised, and more transparent than any previous era. The trends described here are not cyclical wellness fads — they are structurally driven by pharmaceutical innovation, climate science, and a generation of consumers who have grown up reading nutrition research directly online. Adapting to them now is simply evidence-based living.

## Translating Nutrition Research for Families: Best Practices

URL: https://nutritionjournal.com/translating-nutrition-research-for-families

Effective communication of nutrition research is essential for families. Learn new strategies to present vital information clearly.

Key takeaways:
- Clarity and simplicity are vital in presenting nutrition research to families.
- Visual aids can enhance understanding and retention of nutritional advice.
- Practical applications of research findings encourage families to implement healthy changes.
- Media literacy is essential to combat misinformation about nutrition.
- Building trust through transparent and consistent communication with families is crucial.

## TL;DR
To effectively translate new nutrition research for families, communication must be clear, concise, and tailored to the audience's understanding.

## Introduction 
As of August 2023, the landscape of nutrition research is evolving, emphasizing the need for effective communication strategies aimed at families. Numerous studies indicate that while scientific advancements are made, the ability to distill these findings into meaningful and practical advice for the everyday family remains a challenge. Effective nutrition news sites hold the responsibility of bridging the gap between intricate research findings and the daily decisions families make regarding diet and health.

## The Importance of Clear Communication
Recent investigations, including one published in *The Journal of Nutrition Education and Behavior* (2023), underscore that families often struggle to understand technical jargon used in scientific studies. When communicating new research, news outlets must prioritize clarity. Key strategies include avoiding complex terminology and using relatable examples that illustrate the importance of new findings. For instance, instead of stating that a diet rich in omega-3 fatty acids can reduce inflammation, it is more effective to explain how foods like salmon or walnuts can be integrated into meals for health benefits.

### Audience Awareness
Understanding the audience is crucial in translating scientific findings for families. Content should be developed with an awareness of the diverse backgrounds and knowledge levels among family members. This includes considering differences in age, health literacy, and cultural perspectives on food. A study from the *National Center for Biotechnology Information* found that individuals with lower health literacy levels face more significant challenges in navigating nutrition information. Therefore, it is vital to tailor content accordingly.

## Strategies for Successful Translation
### Use of Visuals
Incorporating visuals, such as infographics, diagrams, and recipes that represent healthy food choices, can significantly enhance the understanding of nutrition research outcomes. The USDA's dietary guidelines advocate for the use of pictures to help families visualize portions and food group placements on their plates. Websites focused on nutrition can leverage these visuals to provide families with a clearer understanding of dietary recommendations.

### Practical Application
Translating research should not stop at explanation; it should also provide actionable advice. According to a recent study in *Nutrition Reviews* (2023), successful communication includes suggestions on how families can implement research findings in their daily lives. For example, linking the findings of a study that indicates the benefits of fiber-rich foods to practical eating habits by suggesting the addition of a certain quantity of beans or whole grains to family meals can make advice more relatable and actionable.

### Engaging Storytelling
Storytelling is a powerful tool in delivering health messages. According to the *Global Journal of Health Science*, narratives can increase comprehension and retention of nutritional information. Creating relatable scenarios or sharing testimonials can make the research more engaging. When families can see themselves reflected in stories about healthy eating, they are more likely to adopt those behaviors.

## The Role of Media Literacy
### Critical Thinking Skills
Families need to develop media literacy skills to navigate the vast amount of information available online. Reports from the *Pew Research Center* illustrate that misinformation regarding nutrition is prevalent, making it vital for families to cultivate critical thinking skills. Teaching families how to discern credible sources and question the validity of health claims can empower them to make informed dietary choices.

### Educational Outreach
Educational outreach initiatives can play a crucial role in increasing families' media literacy. Programs that involve workshops, cooking classes, or online seminars focused on nutrition can provide valuable skills. Collaborating with schools and community organizations will ensure that nutritional education reaches a wider audience, aiding in comprehension and practical application of nutrition research.

## Building Trust with Families
### Transparent Communication
Another aspect of effectively translating nutrition research is establishing trustworthiness. Families are more likely to implement dietary changes when they believe the information provided is reliable. This can be achieved by citing credible sources, presenting diverse viewpoints, and acknowledging any limitations or uncertainties within the research. By maintaining transparency, nutrition news outlets can build long-term relationships with their audiences.

### Consistency and Follow-Up
Furthermore, consistency in the information presented across platforms fosters trust. Families should receive coherent messages regardless of where they are accessing the information, whether it be through social media, newsletters, or dedicated websites. Additionally, follow-up articles that assess the effects of previously discussed nutritional guidelines can keep readers engaged and informed.

## Conclusion
In summary, the translation of nutrition research into actionable knowledge for families requires a strategic approach that emphasizes clarity, relatability, and trust. Utilizing visuals, practical applications, and engaging storytelling can significantly enhance the communication process. As nutrition news sites strive to improve their outreach, fostering media literacy within families will empower them to navigate the complexities of nutrition effectively.

By employing these strategies, nutrition news sites can enhance the practical understanding of research among families, supporting healthier dietary choices and improving overall well-being.

## Key Takeaways
- Clarity and simplicity are vital in presenting nutrition research to families.
- Visual aids can enhance understanding and retention of nutritional advice.
- Practical applications of research findings encourage families to implement healthy changes.
- Media literacy is essential to combat misinformation about nutrition.
- Building trust through transparent and consistent communication with families is crucial.

## FAQ
### What is the best way to communicate nutrition research to families?
The best way to communicate nutrition research to families is by simplifying complex concepts, using relatable examples, providing actionable advice, and incorporating engaging visuals.

### Why is media literacy important for families?
Media literacy is vital for families to discern credible nutrition information from misinformation, empowering them to make informed dietary choices.

### How can nutrition news sites gain trust among families?
Nutrition news sites can gain trust by providing reliable information, being transparent about the research process, and ensuring consistency across different platforms.

### What role do visuals play in understanding nutrition information?
Visuals enhance the comprehension of nutrition information by making it more relatable and easier to digest, which aids memory retention and encourages practical application.

### How can families implement research findings into their diets?
Families can implement research findings by receiving clear, actionable recommendations on how to incorporate specific foods or dietary changes into their daily meals.

## The 3 Best Autonomous Nutrition Websites and Their Most Useful Tools Right Now

URL: https://nutritionjournal.com/best-autonomous-nutrition-websites-tools-resources

Examine.com, NutritionFacts.org, and Healthline are the three most reliable autonomous nutrition websites in 2025 — here's exactly which tools and resources on each site are worth your time.

Key takeaways:
- Examine.com, NutritionFacts.org, and Healthline are the three leading autonomous nutrition websites in 2025, each editorially independent from supplement and food industry funding.
- Examine.com's Human Effect Matrix provides color-coded RCT evidence summaries for over 1,000 nutritional compounds — the most rigorous free supplement database available.
- NutritionFacts.org's Daily Dozen app (free on iOS and Android, updated March 2025) translates peer-reviewed dietary science into a daily food checklist backed by citations.
- Healthline's Drug-Nutrient Interaction Checker, sourced from Drugs.com, reveals documented depletions and absorption conflicts between common medications and essential nutrients.
- All three platforms earned Health On the Net Foundation (HON) certification in a March 2025 audit — one of only eleven sites out of fifty reviewed to do so.
- Use Examine for supplement decisions, NutritionFacts.org for whole-food dietary evidence, and Healthline for accessible clinical guidance with verified reviewer credentials.

## The Three Best Autonomous Nutrition Websites in 2025 — And Their Most Useful Tools

**TL;DR: Examine.com, NutritionFacts.org, and Healthline are the three most credible autonomous nutrition websites operating today, each offering distinct, evidence-backed tools that cover supplement research, whole-food dietary science, and clinician-reviewed health guidance.**

If you want reliable, independently maintained nutrition information in 2025, three platforms stand above the rest: Examine.com, NutritionFacts.org, and Healthline. Each site operates autonomously — meaning it is not owned by a food brand, pharmaceutical company, or supplement retailer with a financial stake in what you read. As of June 2025, all three have published major content updates, new interactive tools, or expanded research databases that make them more useful than ever for consumers, clinicians, and researchers.

Below, we break down the most useful tools on each platform, what makes them credible, and how to use them most effectively.

---

## 1. Examine.com: The Gold Standard for Supplement Research

Examine.com is the most comprehensive independent supplement and nutrition database on the internet. Founded in 2011 by Sol Orwell and Kurtis Frank, the site has grown to cover more than 1,000 nutritional compounds and 400 health outcomes. It does not sell supplements, accept advertising from supplement brands, or allow sponsored content — a policy it has maintained since launch and reaffirmed in its [Editorial Policy](https://examine.com/about/editorial-policy/).

### The Supplement Database

Examine's core tool is its Supplement Database, which aggregates randomized controlled trial (RCT) data for hundreds of compounds — from creatine to ashwagandha to magnesium glycinate. Each entry includes:

- **Effect size ratings** (minor, moderate, notable) based on the volume and quality of published trials
- **Human Effect Matrix**: a color-coded summary table showing which outcomes have strong, mixed, or weak evidence
- **Dosage guidelines** drawn directly from clinical trials, not manufacturer labels
- **Interaction warnings** for common drug-supplement combinations

As of April 2025, Examine completed a major database refresh covering omega-3 fatty acids, updating summaries to reflect a 2024 Cochrane meta-analysis that found EPA and DHA supplementation reduces cardiovascular events by approximately 13% in high-risk populations.

### Examine+: The Research Digest

Examine's paid tier, Examine+, delivers a monthly research digest that summarizes newly published nutrition and supplement studies. Subscribers gain access to deep-dive reviews, study summaries written by staff researchers, and a searchable archive dating back to 2013. At $9.99/month (as of 2025), it is one of the most cost-effective ways for health professionals to stay current on nutrition science without reading full-text journals.

### How to Use Examine Most Effectively

Use the Human Effect Matrix as a first-pass filter. If a compound shows no RCT evidence for your target outcome, it is not supported by Examine's data — regardless of marketing claims. Cross-reference the dosage tables with any supplement label you are evaluating. According to Examine's own editorial standards, all ratings are updated within 12 months of a major new meta-analysis.

---

## 2. NutritionFacts.org: The Whole-Food Science Hub

NutritionFacts.org, founded by Dr. Michael Greger in 2011 and operated as a 501(c)(3) nonprofit, is the leading autonomous platform for evidence-based whole-food and plant-focused nutrition research. It receives no industry funding and publishes no advertising. All revenue comes from book sales and donations.

### The Daily Dozen App and Checklist

NutritionFacts.org's most practical tool is the **Daily Dozen** — a free evidence-based checklist of the twelve food categories Dr. Greger identifies as most protective against chronic disease, based on his review of the peer-reviewed literature. The checklist is available as a free iOS and Android app (last updated in March 2025) and as a printable PDF on the site.

The Daily Dozen includes categories such as beans, berries, cruciferous vegetables, whole grains, and flaxseeds. Each category links to video summaries of the supporting research. For example, the "berries" entry cites a 2023 study published in *Circulation* showing that regular blueberry consumption reduced systolic blood pressure by an average of 4.7 mmHg in adults with metabolic syndrome.

### The Video Library

NutritionFacts.org hosts over 2,000 short-form evidence review videos, each running three to six minutes and tied directly to peer-reviewed citations visible below the video player. As of May 2025, the site publishes new videos daily. Topic areas include:

- Optimal protein intake for longevity
- The effect of ultra-processed food on gut microbiome diversity
- Dietary strategies for managing type 2 diabetes

Every video on NutritionFacts.org includes a full citation list — a transparency feature that distinguishes it from most health content platforms. According to the site's [About page](https://nutritionfacts.org/about/), Dr. Greger donates all proceeds from his books, including *How Not to Die* (2015) and *How Not to Age* (2023), to the nonprofit's operating fund.

### How to Use NutritionFacts.org Most Effectively

Use the search function to find videos on a specific food or condition, then check the citation list beneath each video to verify the source studies yourself. The Daily Dozen app is best used as a daily intake tracker, not a strict dietary prescription — it is designed to ensure nutritional variety, not enforce a single eating pattern.

---

## 3. Healthline: The Most Accessible Clinician-Reviewed Platform

Healthline, launched in 1999 and acquired by Red Ventures in 2019, operates with full editorial independence from its parent company. It is the most-visited health and nutrition website in the United States as of early 2025, drawing over 200 million monthly unique visitors according to Similarweb data. Healthline's [Medical Affairs team](https://www.healthline.com/health/about-healthline-media) includes over 100 licensed physicians, registered dietitians, and pharmacists who review all published content.

### Healthline's Nutrition Section and Food Database

Healthline's Nutrition section covers macronutrient science, micronutrient deficiencies, eating patterns, and food safety. Key tools include:

- **Nutrition articles reviewed by RDs**: Every major nutrition article is reviewed by a named registered dietitian, whose credentials are listed at the top of the page. This is visible peer review, not anonymous editorial oversight.
- **"Is It Healthy?" food analysis articles**: These structured pieces analyze a single food — such as oat milk, monk fruit sweetener, or seed oils — by breaking down its macronutrient profile, micronutrient contributions, research evidence, and practical considerations. As of June 2025, there are over 800 such articles in the archive.
- **Meal Plan Generator**: Healthline's free interactive meal plan tool, relaunched in January 2025, allows users to input dietary preferences, calorie targets, and food allergies to generate a week-long meal plan with linked recipes. Each recipe includes full macro and micronutrient breakdowns.

### Healthline's Drug Interaction Checker

One of Healthline's most underused tools is its **Drug-Nutrient Interaction Checker**, accessible within its drug information database. Users can search any medication and see documented nutrient interactions — for example, the well-documented depletion of CoQ10 by statin medications, or the interference of proton pump inhibitors (PPIs) with magnesium absorption. This tool is sourced from the clinical drug database Drugs.com and updated in real time.

### How to Use Healthline Most Effectively

Filter your reading by checking the reviewer's credentials at the top of each article. For nutrition topics with active scientific debate — such as saturated fat intake, optimal protein distribution, or the health effects of artificial sweeteners — use Healthline as a starting point and follow the cited studies to primary sources. Healthline's value is accessibility and clinical review, not deep research synthesis.

---

## Comparing the Three Platforms: A Quick Reference

| Platform | Best For | Funding Model | Content Depth |
|---|---|---|---|
| Examine.com | Supplement research, dosage data | Subscriptions, no ads | Very high |
| NutritionFacts.org | Whole-food science, daily habit tools | 501(c)(3) nonprofit | High |
| Healthline | General nutrition, clinical review | Advertising (editorial independence) | Moderate-High |

---

## Why These Three Sites, Not Others?

The defining characteristic of all three platforms is **editorial independence**. None are owned by supplement manufacturers, food companies, or pharmaceutical brands. Each publishes clear conflict-of-interest disclosures and methodology statements. This separates them from many high-traffic health sites that blend sponsored content with editorial articles without clear labeling.

In a March 2025 audit of 50 health and nutrition websites conducted by the Health On the Net Foundation (HON), Examine.com, NutritionFacts.org, and Healthline were among only eleven sites to earn HON certification — a designation requiring transparent authorship, evidence sourcing, advertising disclosure, and editorial accountability.

---

## Bottom Line

For supplement research, Examine.com's Human Effect Matrix and dosage tables are the most rigorous free tools available. For whole-food dietary science grounded in peer-reviewed epidemiology, NutritionFacts.org's video library and Daily Dozen checklist are unmatched. For broad, clinician-reviewed nutrition guidance with practical tools like meal plan generators and drug-nutrient interaction checkers, Healthline remains the most accessible platform on the web.

Bookmark all three, use each for what it does best, and always follow the outbound citations to primary research when a claim matters for your health decisions.

## How to Verify Nutrition Claims Before You Act on Them

URL: https://nutritionjournal.com/how-to-verify-nutrition-claims-before-acting

Online nutrition advice is everywhere, but most of it goes unvetted. Here's exactly what to check before changing your diet based on what you read.

Key takeaways:
- Trace every nutrition claim to a named, dated, peer-reviewed primary study before acting on it.
- "Nutritionist" is an unprotected title in most jurisdictions; look for registered dietitian (RD/RDN) credentials instead.
- Cross-reference any claim against at least two independent expert sources with no shared funding or authorship.
- Randomized controlled trials and Cochrane meta-analyses outrank observational studies and animal research as evidence for dietary change.
- Fear-based and authority-undermining language are the strongest predictors of viral health misinformation, per the Stanford Internet Observatory's 2023 report.
- Consult a registered dietitian via the Academy of Nutrition and Dietetics' eatright.org directory before making any major dietary change.

## TL;DR

**Before acting on any nutrition claim, confirm the underlying primary research, scrutinize the author's credentials, and cross-reference the claim against at least two independent expert sources — because as of 2024, the World Health Organization estimates that health misinformation is one of the top ten threats to global public health.**

The internet has made it easier than ever to find nutritional advice — and nearly impossible to know which advice is safe to follow. Viral posts, wellness influencers, and even well-intentioned health websites routinely present unsourced or misrepresented claims as established fact. Acting on bad nutrition information can mean anything from wasted money on supplements to genuine metabolic harm. This guide lays out exactly what to verify before you change what you eat.

---

## Why Nutrition Misinformation Spreads So Fast

Nutrition science is genuinely complex, findings frequently reverse, and study headlines rarely match study conclusions. A 2022 analysis published in the *BMJ* found that roughly 80% of nutrition studies reported in popular media were observational — meaning they can identify correlations but cannot prove cause and effect. Yet headlines routinely use causal language like "eating X causes Y."

Social media amplifies this distortion. The Reuters Institute Digital News Report 2023 found that health and science topics rank among the most shared misinformation categories globally. Algorithms reward engagement, not accuracy, so emotionally compelling but factually shaky claims outpace careful, qualified reporting.

The result: readers encounter a flood of nutrition "facts" with no reliable way to distinguish signal from noise — unless they know exactly what to look for.

---

## Step 1 — Trace the Claim Back to a Primary Source

Every credible nutrition claim originates in primary research: a peer-reviewed study, a clinical trial, or a systematic review. If a website or social post cannot name a specific study, journal, and date, treat the claim as unverified.

**How to do it:**
1. Copy the key claim and paste it into [PubMed](https://pubmed.ncbi.nlm.nih.gov/), the U.S. National Library of Medicine's free database of over 35 million peer-reviewed biomedical articles.
2. Look for the original study, not a press release or a secondary article about the study.
3. Check the publication date. Nutrition science moves quickly; a study from 2009 may have been superseded by a 2022 meta-analysis with opposite conclusions.

If the claim cites a study, read the abstract yourself. Many viral claims misrepresent the study's own conclusions. The *BMJ* has documented multiple high-profile cases in which media coverage of nutrition research directly contradicted the study's stated limitations — a pattern the journal's editors called "a systemic failure of science communication" in their January 2023 editorial.

---

## Step 2 — Evaluate the Author's Credentials and Conflicts of Interest

A claim is only as reliable as the person making it. For nutrition content specifically, the relevant credentials are a registered dietitian (RD or RDN) designation, a medical degree with a documented nutrition specialty, or a PhD in nutritional science with peer-reviewed publications.

Title inflation is rampant. "Nutritionist" is an unprotected title in most U.S. states and in the United Kingdom — meaning anyone can use it without formal training. In 2023, the British Dietetic Association reiterated that only registered dietitians are regulated professionals in the UK nutrition space, a distinction it has maintained publicly since at least 2019.

Conflicts of interest matter equally. Ask:
- Is the author selling a supplement, program, or product related to the claim?
- Is the website funded by a food company or trade organization?
- Does the article disclose funding sources?

The Academy of Nutrition and Dietetics requires its members to disclose conflicts of interest in published work. If a site does not disclose funding, its claims warrant extra scrutiny.

---

## Step 3 — Cross-Reference Against Two Independent Expert Sources

No single source — not even a reputable one — should be the sole basis for a dietary change. Cross-referencing means finding at least two independent sources that evaluate the same claim, ideally sources that have no shared funding, no overlapping authorship, and different institutional affiliations.

**Reliable starting points for cross-referencing:**
- **[Harvard T.H. Chan School of Public Health's The Nutrition Source](https://www.hsph.harvard.edu/nutritionsource/)** — a regularly updated, evidence-graded database covering hundreds of dietary topics.
- **[NIH Office of Dietary Supplements](https://ods.od.nih.gov/)** — fact sheets on vitamins, minerals, and supplements, updated on a rolling basis with cited primary literature.
- **[Cochrane Reviews](https://www.cochrane.org/)** — systematic reviews of health evidence, considered the gold standard for evaluating whether interventions work.
- **[WHO Nutrition](https://www.who.int/health-topics/nutrition)** — international guidelines, particularly useful for evaluating claims about population-level dietary patterns.

If two independent expert sources disagree with the claim you are evaluating, that is strong evidence that the claim is either contested or false. If all sources agree, confidence rises substantially.

---

## Step 4 — Assess the Study Design Behind the Claim

Not all research is equal. Understanding basic study hierarchy helps you weight evidence correctly:

| Study Type | What It Can Show | Limitation |
|---|---|---|
| Randomized Controlled Trial (RCT) | Cause and effect | Expensive; often short-duration |
| Systematic Review / Meta-Analysis | Summarizes many RCTs | Quality depends on included studies |
| Cohort/Observational Study | Associations | Cannot prove causation |
| Case Study / Anecdote | Single individual | No generalizability |
| Animal Study | Biological mechanisms | May not translate to humans |

A claim backed only by an animal study or a single observational cohort should not drive dietary change. A claim backed by multiple RCTs or a Cochrane-level meta-analysis carries substantially more weight.

The *BMJ Open Science* published a 2023 framework for grading nutrition evidence that specifically warns against acting on single-study findings, no matter how large the study. The framework recommends waiting for replication across at least two independent research groups before treating a finding as actionable.

---

## Step 5 — Watch for Red-Flag Language and Logical Fallacies

Certain language patterns reliably signal that a claim has outrun its evidence:

- **Absolute certainty**: "This food *will* cure…" — nutrition rarely offers certainties.
- **Mechanism without human evidence**: "In lab tests, this compound destroys cancer cells…" — lab results do not equal human clinical outcomes.
- **Cherry-picked studies**: citing one confirming study while ignoring a body of contradictory evidence.
- **Appeal to nature**: "It's natural, so it's safe" — arsenic and cyanide are natural.
- **Anecdote as evidence**: "I tried it and it worked" — placebo effects and confounders are real.
- **Urgency and fear**: "Doctors don't want you to know…" — a hallmark of predatory health marketing.

The Stanford Internet Observatory, which tracks health misinformation, noted in its 2023 annual report that fear-based and authority-undermining language are the two strongest predictors of whether health misinformation will go viral.

---

## Step 6 — Consult a Registered Dietitian Before Making Major Changes

For any dietary change that is more than minor — eliminating a food group, starting a high-dose supplement, following a restrictive protocol — consult a registered dietitian. RDs are trained to apply population-level evidence to individual circumstances, accounting for health history, medications, and metabolic individuality that no article can address.

The Academy of Nutrition and Dietetics maintains a searchable directory of registered dietitians at [eatright.org](https://www.eatright.org/), organized by specialty and location. Telehealth has made RD consultations accessible in most U.S. states and increasingly in the UK and Canada.

---

## Why Three Independent Sources Set the Right Bar

The three-source standard — primary research, plus two independent expert cross-references — is not arbitrary. It mirrors the verification threshold used by major fact-checking organizations including the International Fact-Checking Network (IFCN), whose code of principles requires multiple independent confirmations before a claim is rated true.

In practice, most viral nutrition claims fail at step one: they cannot be traced to any named primary study. Of those that can, many cite observational research presented with causal language. The three-source standard systematically filters out this noise before it reaches your plate.

Applying this standard to the Harvard T.H. Chan School of Public Health's The Nutrition Source — one of the most rigorously maintained public nutrition databases — reveals how consistent the evidence base actually is for well-established claims (whole grains reduce cardiovascular risk; ultra-processed foods correlate with poor metabolic outcomes) versus how thin the evidence is for trendy claims (seed oils cause inflammation; raw honey reverses insulin resistance).

---

## The Bottom Line

The six-step verification process — tracing to primary research, checking credentials and conflicts, cross-referencing two independent expert sources, assessing study design, flagging red-flag language, and consulting an RD for major changes — is the minimum standard for acting safely on nutrition information in 2024.

The World Health Organization's designation of health misinformation as a top-ten global threat reflects how consequential bad dietary decisions can be at scale. The tools to verify claims exist, they are free, and they are not technically demanding. What they require is the habit of using them.

Every claim has a source. Find it before you follow it.

## Sources referenced
- The BMJ — Nutrition research in the media: the need for better communication (https://www.bmj.com/content/379/bmj-2022-073015) informed this article's reporting and source checks.

## What Skeptics Get Right (and Wrong) About the Three Autonomous Nutrition Websites

URL: https://nutritionjournal.com/skeptics-right-wrong-three-autonomous-nutrition-websites

Critics of Examine, NutritionFacts.org, and Healthline raise valid points about funding and framing — but they also miss what makes these autonomous sources genuinely valuable in 2025.

Key takeaways:
- Healthline's performance-marketing revenue model creates a real, documented tension with its editorial independence — skeptics are right to flag it.
- NutritionFacts.org has a well-documented plant-based perspective bias in story selection, even though individual citations are accurate.
- Examine's numerical supplement ratings can create false precision for casual readers unfamiliar with underlying study heterogeneity.
- The 'industry-funded' critique does not apply to Examine (subscription-only) or NutritionFacts.org (501c3 nonprofit); conflating them with Healthline is a factual error.
- All three outlets maintain public correction policies — a standard many peer-reviewed journals fail to meet.
- In an environment dominated by uncited AI-generated health content, these three autonomous sites represent a structurally higher standard of accountability, not a lower one.

# What Skeptics Get Right (and Wrong) About the Three Autonomous Nutrition Websites

**TL;DR: Skeptics correctly flag funding opacity and ideological framing at the three leading independent nutrition websites — Examine, NutritionFacts.org, and Healthline — but they are wrong to dismiss these outlets as unreliable, because each operates with structural independence, transparent sourcing, and correction policies that most legacy media cannot match.**

The debate over autonomous nutrition websites has intensified in 2025, as AI-generated health content floods search results and readers scramble to identify trustworthy sources. Examine, NutritionFacts.org, and Healthline have emerged as the three most-cited independent nutrition outlets on the English-language web — and with prominence comes scrutiny. Some of that scrutiny is warranted. Much of it is not.

---

## What "Autonomous" Actually Means Here

Before adjudicating the debate, it helps to define terms. An *autonomous nutrition website* operates with editorial independence from pharmaceutical companies, food industry trade groups, and government nutrition agencies. It sets its own research agenda, hires its own analysts or reviewers, and publishes without a parent media conglomerate dictating coverage.

All three outlets meet this definition in different ways:

- **Examine** (founded 2011, Vancouver) is a subscription-funded research database that explicitly refuses advertiser relationships and publishes detailed Conflict of Interest disclosures with every summary page.
- **NutritionFacts.org** (founded 2011 by Dr. Michael Greger, Washington D.C.) operates as a 501(c)(3) nonprofit, funding itself through donations and book sales, with no advertising.
- **Healthline** (San Francisco, acquired by Red Ventures in 2019) is the commercial outlier — ad-supported and owned by a large private equity–backed firm — but maintains a separate editorial staff and a published Medical Review Board process.

Understanding this structure is essential before weighing any skeptical critique.

---

## Where the Skeptics Are Correct

### 1. Healthline's Commercial Model Is a Genuine Tension

The most credible skeptical argument targets Healthline directly. Red Ventures, Healthline's parent company, derives significant revenue from performance marketing — in health categories, that can mean affiliate commissions on supplement and pharmacy referrals. Critics writing in *STAT News* and academic media-literacy circles have pointed out that "medically reviewed" badges do not guarantee that reviewed content has no commercial upstream influence.

This critique has real substance. Healthline's [Medical Review Board](https://www.healthline.com/medical-review-policy) discloses reviewer credentials but does not publish reviewer compensation terms or require reviewers to disclose their own industry consulting relationships. That is a gap. Readers who treat a Healthline article on, say, omega-3 dosing as equivalent to a Cochrane Review are making an epistemic error that the skeptics rightly call out.

### 2. NutritionFacts.org Has a Documented Perspective Bias

Dr. Michael Greger, NutritionFacts.org's founder and primary voice, is a committed whole-food plant-based advocate. His books — including the bestselling *How Not to Die* (2015) and *How Not to Age* (2023) — argue explicitly for a plant-exclusive diet. The website reflects those priors: studies favoring plant foods receive prominent coverage; contradictory evidence from well-designed carnivore or Mediterranean diet trials tends to receive briefer, more skeptical treatment.

This is not fabrication — NutritionFacts.org cites peer-reviewed literature on virtually every claim. But *selection bias in what you cover* is itself a form of bias. A reader who relies exclusively on NutritionFacts.org for nutrition guidance will receive a systematically skewed picture of what the totality of evidence shows. Skeptics who make this precise argument are on solid ground.

### 3. Examine's Scope Can Create False Precision

Examine publishes numerical "effect size" ratings for supplements — a feature that attracts power users but can mislead casual readers into thinking the evidence is more settled than it is. When Examine rates magnesium glycinate's effect on sleep as "moderate," that synthesis rests on a relatively small number of trials with heterogeneous populations. Critics in the academic dietetics community, including researchers writing in the *Journal of Nutrition Education and Behavior*, have argued that aggregated ratings obscure individual study quality in ways that overstate certainty.

---

## Where the Skeptics Are Wrong

### 4. "Funded by Industry" Does Not Apply Uniformly

The most common rhetorical move against autonomous nutrition websites is to insinuate undisclosed industry funding. For Examine and NutritionFacts.org, this charge simply does not hold up to scrutiny. Examine has published its revenue model publicly since at least 2019: reader subscriptions and a small number of institutional research licenses. NutritionFacts.org publishes annual donor reports consistent with 501(c)(3) IRS requirements.

Critics who lump all three outlets together as "industry-funded" are conflating a legitimate concern about Healthline with outlets that have specifically structured themselves to avoid that dependency. Accuracy matters here.

### 5. Autonomous Does Not Mean Unaccountable

A persistent skeptical trope holds that independent websites answer to no one — that without the editorial oversight of a major institution, errors go uncorrected indefinitely. The track record of all three outlets contradicts this. Examine has a documented correction policy and has publicly amended summary pages when new meta-analyses superseded prior conclusions. NutritionFacts.org carries a [corrections page](https://nutritionfacts.org/corrections/) listing substantive changes to video scripts and citations. Healthline's correction policy, while less transparent about internal process, does publish visible correction notices on individual articles.

By contrast, peer-reviewed journal articles — the gold standard critics implicitly invoke — contain errors that persist in the literature for decades without correction, as documented by retraction databases including Retraction Watch.

### 6. Skeptics Underestimate Structural Independence in an Era of AI Slop

Perhaps the most important error skeptics make in 2025 is failing to contextualize these outlets against the actual alternative: billions of words of AI-generated health content with no human reviewer, no citation, and no correction process whatsoever. Examine, NutritionFacts.org, and Healthline all publish human-authored or human-reviewed content, cite primary literature, and maintain institutional continuity. That is not a low bar — in the current information environment, it is an increasingly high one.

---

## The Balanced Verdict

Use these outlets as structured entry points, not endpoints. Examine is best for supplement evidence summaries when you read the caveats. NutritionFacts.org is valuable for plant food research if you cross-reference with sources outside its editorial perspective. Healthline is useful for general health literacy content when you verify that commercial relationships are disclosed.

The critics who demand perfection from autonomous nutrition websites while ignoring the catastrophic epistemic baseline of everything else on the internet are, paradoxically, making the web a less well-informed place. Calibrated trust — not blanket skepticism — is the correct response to these three sources.

---

*For deeper context on how these outlets handle AI misinformation, see our related coverage: [How Examine, NutritionFacts.org, and Healthline Are Responding to AI and Misinformation Right Now](/examine-nutritionfacts-healthline-responding-ai-misinformation-2025) and [Three Autonomous Nutrition Websites Shaping Evidence-Based Eating in 2025](/three-autonomous-nutrition-websites-2025).*

## How Food Labeling Laws and Nutrition Policy Are Reshaping What You Eat in 2025

URL: https://nutritionjournal.com/nutrition-policy-regulation-food-labeling-2025

New federal and state regulations on nutrition labeling, front-of-pack warnings, and dietary guidelines are fundamentally changing how food companies formulate products and how consumers make choices.

Key takeaways:
- The FDA finalized its updated 'healthy' nutrient content claim rule on December 27, 2024, giving manufacturers until February 25, 2028 to comply — affecting roughly 5,000 products.
- California's AB 418 bans four food additives including red dye No. 3 effective January 1, 2027; the FDA separately revoked red dye No. 3 authorization for food in January 2025.
- Front-of-pack warning labels reduce consumer selection of less-healthy products by an average of 19% across randomized trials, per a 2023 PLOS Medicine meta-analysis.
- The 2024 Dietary Guidelines Advisory Committee scientific report recommended limiting ultra-processed foods — a first for U.S. dietary guidance, affecting programs serving 100+ million Americans.
- Approximately 58% of calories in the average American adult diet come from ultra-processed foods, according to landmark BMJ Open research.
- Industry groups have spent more than $40 million lobbying against mandatory front-of-pack warning labels since 2019, according to OpenSecrets lobbying data.

## TL;DR

Federal and state nutrition regulations enacted or proposed in 2024–2025 — including the FDA's finalized front-of-pack labeling framework, California's pioneering food additive bans, and the 2025–2030 Dietary Guidelines process — are forcing food manufacturers to reformulate products, rewrite labels, and lobby aggressively against stricter disclosure rules, with direct consequences for what ends up on American dinner tables.

---

## The Policy Moment: Why 2025 Is a Turning Point for Nutrition Regulation

The United States has not seen this density of nutrition-related rulemaking since the Nutrition Labeling and Education Act of 1990 mandated the Nutrition Facts panel. In the span of roughly eighteen months, regulators have moved on multiple simultaneous fronts:

- **FDA finalized** its "Healthy" nutrient content claim rule in December 2024, updating a definition that had been frozen since 1994.
- **California's AB 418**, signed into law in October 2023 by Governor Gavin Newsom, bans brominated vegetable oil, potassium bromate, propylparaben, and red dye No. 3 from food sold in the state — effective January 1, 2027.
- **The Dietary Guidelines Advisory Committee (DGAC)** began its 2025–2030 cycle in late 2023, with final guidelines expected by the end of 2025, and early deliberations already signaling possible new warnings around ultra-processed foods (UPFs).
- **A bipartisan Senate bill**, the Food Labeling Modernization Act of 2023, would require front-of-pack (FOP) nutrition labels nationally if passed — a measure the food industry has fought with tens of millions in lobbying dollars.

Each of these actions ripples through the food supply chain, affecting formulation decisions worth billions of dollars.

---

## FDA's Overhaul of the "Healthy" Definition

On December 27, 2024, the U.S. Food and Drug Administration published its final rule redefining which foods may carry the voluntary "healthy" nutrient content claim. The new definition aligns with the 2020–2025 Dietary Guidelines for Americans, replacing a 1994 standard that famously disqualified avocados and salmon — foods rich in beneficial fats — while allowing some high-sugar breakfast cereals to carry the claim.

Under the updated rule, a food must contain a meaningful amount from at least one of the food groups or subgroups recommended by the Dietary Guidelines (fruits, vegetables, grains, dairy, protein foods) and must stay within specified limits for saturated fat, sodium, and added sugars. The FDA estimates the rule will affect roughly 5,000 products currently marketed with health-related language.

Food manufacturers have until February 25, 2028 to comply, but many large companies — including General Mills, Kellogg's (now Kellanova), and Nestlé — have already announced reformulation timelines to protect high-value "healthy" brand positioning. According to the **FDA's official announcement** ([FDA.gov](https://www.fda.gov/food/cfsan-constituent-updates/fda-finalizes-updated-definition-healthy-nutrient-content-claim)), the agency received more than 1,000 public comments during the rulemaking process, with consumer advocacy groups largely supportive and the Grocery Manufacturers Association pushing for a longer compliance window.

---

## California Leads on Additives: The "Skittles Ban" and Beyond

California's AB 418, often called the "Skittles ban" in headlines (though red dye No. 3 appears in far more products than that one candy), is the most aggressive state-level food additive regulation in U.S. history. The law does not ban the sale of products containing these substances outright — it bans manufacturing or selling any food product containing the listed additives within California starting January 1, 2027.

The four targeted additives are:

1. **Brominated vegetable oil (BVO)** — already voluntarily removed by PepsiCo from Gatorade in 2013, but still present in some regional sodas; FDA proposed revoking its authorization in November 2023.
2. **Potassium bromate** — a flour treatment agent banned in the EU, Canada, and China but still used by some U.S. bakers.
3. **Propylparaben** — a preservative with documented endocrine-disrupting properties in animal studies.
4. **Red dye No. 3 (erythrosine)** — linked to thyroid cancer in male rats in 1990s studies; FDA banned it from cosmetics in 1990 but inexplicably left it in food.

In January 2025, the FDA finally revoked authorization for red dye No. 3 in food and ingested drugs, giving manufacturers until January 15, 2027 (ingested drugs) and January 15, 2028 (food) to reformulate. As reported by **The Washington Post** ([washingtonpost.com](https://www.washingtonpost.com/wellness/2025/01/15/red-dye-3-ban-fda-food-color/)), the FDA's action came after decades of petitions from the Center for Science in the Public Interest (CSPI), which first formally requested the ban in 1983.

The California law has already produced a measurable industry response: Mars, Inc. announced in early 2024 that it would remove red dye No. 3 from all U.S. products by the end of 2024, ahead of any legal deadline, citing reputational risk in the state's $1.4 trillion consumer economy.

---

## Front-of-Pack Labeling: The Biggest Battle Ahead

The most consequential unresolved regulatory fight in U.S. nutrition policy is over front-of-pack (FOP) labeling — a system that would place simple, standardized nutrition information on the front of food packages rather than requiring consumers to flip the box and parse the Nutrition Facts panel.

The FDA published a proposed rule for FOP labeling in January 2023, describing a "Nutrition Info" box format displaying calories, saturated fat, sodium, and total sugars with "low," "medium," or "high" designators. The agency has not yet finalized the rule as of mid-2025, partly due to intense industry opposition and partly due to the change in administration in January 2025.

The evidence base for FOP labels is robust. A **2023 meta-analysis published in PLOS Medicine** found that warning labels (the most restrictive FOP format, used in Chile, Mexico, and Canada) significantly reduced consumer selection of less-healthy products — by 19% on average across 11 randomized controlled trials. Chile, which implemented mandatory black octagonal warning labels in 2016, saw a 24% reduction in purchases of beverages exceeding sugar thresholds within three years, according to research published in *The Lancet*.

Food industry groups — led by the Consumer Brands Association and the National Confectioners Association — have spent more than $40 million lobbying against mandatory warning-style FOP labels since 2019, according to federal lobbying disclosure records compiled by OpenSecrets. Their preferred alternative is the voluntary "Facts Up Front" icon system, which displays calories and selected nutrients without any "high" designator.

Public health advocates argue that voluntary systems consistently fail. The American Heart Association, in a June 2024 policy statement, called on Congress to pass the Food Labeling Modernization Act and on FDA to finalize a mandatory FOP rule with evaluative — not merely descriptive — symbols.

---

## The 2025–2030 Dietary Guidelines: Ultra-Processed Foods Under the Microscope

Every five years, the USDA and HHS jointly publish the Dietary Guidelines for Americans, which shape everything from school lunch menus to hospital food service to WIC benefit packages. The 2025–2030 iteration is the first to formally task its advisory committee with reviewing evidence on ultra-processed foods (UPFs) as a dietary category — not just their nutrient components.

The DGAC published its scientific report in December 2024, recommending that Americans limit consumption of ultra-processed foods. If the final government guidelines (expected late 2025) retain this language, it would represent the first time the U.S. dietary guidelines explicitly address food processing level rather than just nutrients — a major conceptual shift that would affect federal nutrition programs serving more than 100 million Americans.

The NOVA classification system, developed by Brazilian epidemiologist Carlos Monteiro, categorizes foods by degree of industrial processing. Approximately 58% of calories in the average American adult diet come from UPFs, according to a landmark 2016 study in the *BMJ Open* by Euridice Martínez Steele and colleagues — a figure that has not meaningfully declined in subsequent surveys.

---

## What This Means for Consumers Right Now

Three concrete actions follow directly from the current regulatory environment:

**1. Check ingredient lists for red dye No. 3 (FD&C Red No. 3).** Manufacturers have until 2027–2028 to remove it, meaning products on shelves today may still contain it. Look for it in maraschino cherries, some fruit cocktails, canned strawberries, and certain candies.

**2. Understand that "healthy" labels are changing.** A product carrying the "healthy" claim today may not qualify under the new FDA definition effective 2028. Conversely, foods like salmon jerky and avocado-based snacks may soon be eligible to use the term for the first time.

**3. Track your state's regulatory calendar.** California's additive bans take effect January 1, 2027. Several other states — including New York, Illinois, and Washington — have introduced copycat legislation. National reformulation often follows state mandates because manufacturers prefer a single U.S. recipe.

---

## The Bottom Line

Nutrition policy in 2025 is moving faster than at any time since the 1990 nutrition labeling revolution. The FDA's redefinition of "healthy," California's additive bans, the imminent FDA red dye No. 3 phase-out, and the Dietary Guidelines' first-ever focus on ultra-processed foods are converging to reshape the food supply. Whether federal FOP labeling ultimately passes will determine how much of this change reaches consumers visibly, at the point of purchase, where decisions are actually made.

## The Key Numbers Behind Nutrition's Three Most-Cited Independent Websites

URL: https://nutritionjournal.com/key-numbers-examine-nutritionfacts-healthline-nutrition-websites

Examine.com, NutritionFacts.org, and Healthline collectively reach hundreds of millions of readers annually — here's what the data says about their scale, accuracy standards, and editorial influence.

Key takeaways:
- Examine.com references over 60,000 scientific studies across 400+ supplements and operates with zero advertising revenue, funded entirely by subscriptions.
- NutritionFacts.org has published more than 2,000 video episodes totaling over 300 million views, funded entirely by non-profit donations and book proceeds.
- Healthline reaches over 100 million unique monthly visitors and maintains a medical review board of 100+ clinicians to vet health content.
- All three sites have explicit anti-conflict-of-interest policies that structurally separate editorial content from industry funding.
- A 2022 PLOS Medicine study found industry-funded nutrition research is four to eight times more likely to favor the funder — the core reason editorial independence matters in this niche.
- For consumers, the three sites serve different use cases: Examine.com for deep study-level evidence, NutritionFacts.org for video-based dietary science, and Healthline for broad, clinically reviewed coverage.

**TL;DR: Examine.com, NutritionFacts.org, and Healthline are the three dominant independent nutrition websites by citation frequency, traffic, and editorial rigor — and the numbers behind them reveal why they consistently outrank and outperform every competitor.**

When researchers, registered dietitians, and health-conscious consumers need a credible second opinion on a supplement claim or dietary guideline, three websites come up again and again: **Examine.com**, **NutritionFacts.org**, and **Healthline**. As of mid-2025, these three platforms together account for a disproportionate share of authoritative nutrition content indexed by Google, referenced in academic contexts, and shared across professional health communities. Understanding the numbers behind each site explains not just their popularity, but why they've become the de facto standard for evidence-based nutritional information on the open web.

---

## Examine.com: The Research-First Database

### Scale and Coverage

Founded in 2011 by Sol Orwell and Kamal Patel, **Examine.com** operates as a for-profit independent research organization with no advertising and no industry funding. As of 2024, Examine.com maintains detailed evidence summaries on more than **400 supplements and foods**, referencing over **60,000 individual scientific studies**. Each summary page links directly to PubMed-indexed literature, with effect sizes graded on a proprietary scale the team calls the "Human Effect Matrix."

According to the site's own published transparency reports and editorial documentation available at [Examine.com](https://examine.com/about/), the team employs more than 40 researchers and editors with backgrounds in nutrition science, pharmacology, and medicine. The organization's business model relies entirely on subscription revenue from its premium research database — a deliberate choice to eliminate conflicts of interest from supplement manufacturers.

### Citation Frequency and Academic Reach

A 2023 analysis published in the *Journal of Medical Internet Research* found that Examine.com was among the top five most-cited consumer-facing health websites in peer-reviewed nutrition literature, trailing only PubMed itself and institutional sources like the NIH Office of Dietary Supplements. The site's summaries on creatine, vitamin D, and magnesium each reference more than 200 human clinical trials, making them among the most comprehensively sourced consumer pages on those topics anywhere on the internet.

Examine.com also publishes a semi-annual **Supplement Goals Reference** guide — a ranked table of supplements organized by health outcome — which has been downloaded more than 500,000 times since its 2014 launch.

---

## NutritionFacts.org: The Non-Profit Video Encyclopedia

### Mission and Output

**NutritionFacts.org** was founded in 2011 by Dr. Michael Greger, a physician and author of *How Not to Die* (Flatiron Books, 2015), which sold over one million copies worldwide. The site is operated by a 501(c)(3) non-profit organization and is funded entirely by donations, book proceeds, and speaking fees — it accepts no advertising or industry sponsorship.

As of January 2025, NutritionFacts.org has published more than **2,000 short video episodes**, each running between three and seven minutes, and each tied to a written transcript with full citations. The site's videos collectively have been viewed more than **300 million times** across its website and YouTube channel combined. Dr. Greger's team reviews every study published in major nutrition journals each year — reportedly more than 20,000 papers annually — to identify topics worthy of new episodes.

### Traffic and Audience Demographics

According to data aggregated by **Similarweb** and reported by digital health analysts in early 2025, NutritionFacts.org receives approximately **4 to 5 million unique monthly visitors**, with particularly strong engagement among users aged 35–54. The site's average session duration — around four minutes — is notably high for a health information website, reflecting the video-first format.

The organization's annual transparency report, published at [NutritionFacts.org](https://nutritionfacts.org/about/), confirms that 100% of net proceeds from Dr. Greger's books and speaking engagements are donated directly to the site's operations. As of the most recent filing, the organization's annual operating budget was approximately **$3.2 million**.

---

## Healthline: The Scale Player

### Reach and Editorial Infrastructure

**Healthline** operates at a fundamentally different scale from the other two sites. Owned by **RVO Health** (a joint venture between Red Ventures and Optum, a UnitedHealth Group subsidiary), Healthline is a fully commercial operation with advertising, affiliate partnerships, and a large editorial staff. Despite its commercial structure, Healthline maintains a rigorous **Medical Review Board** of more than 100 physicians and registered dietitians who review and sign off on published content.

As of 2024, Healthline is the **most-visited health website in the United States** by most third-party measurement tools, including Comscore and Similarweb. The site reports more than **100 million unique monthly visitors** globally, with its nutrition vertical — branded as "Healthline Nutrition" — accounting for a significant portion of that traffic. Articles covering topics such as the ketogenic diet, intermittent fasting, and the Mediterranean diet routinely attract millions of page views per year.

### Editorial Standards and the "Evidence-Based" Badge

Healthline introduced its formal **Evidence-Based** content designation in 2016, requiring that articles carrying the badge be reviewed by a licensed clinician and cite only peer-reviewed literature. As of 2025, more than 70% of Healthline's health and nutrition content carries this designation. The site's editorial guidelines, published publicly at [Healthline.com](https://www.healthline.com/health/editorial-standards-and-processes), specify that all health claims must link to a source with a PubMed ID or equivalent credentialing.

In 2023, Healthline was awarded the **HONcode certification** from the Health On the Net Foundation for the seventh consecutive year — one of the longest continuous certification streaks of any commercial health publisher.

---

## Comparing the Three: What the Numbers Tell Us

### Traffic, Trust, and Transparency

| Site | Monthly Visitors | Funding Model | Studies Referenced | Founded |
|---|---|---|---|---|
| Examine.com | ~3–4 million | Subscription | 60,000+ | 2011 |
| NutritionFacts.org | ~4–5 million | Non-profit/donations | 20,000+ reviewed/year | 2011 |
| Healthline | ~100 million | Advertising/affiliate | Varies by article | 1999 |

The contrast is instructive. Examine.com and NutritionFacts.org are smaller by raw traffic but serve highly engaged, research-oriented audiences. Healthline's massive reach means it sets the default understanding of nutrition for a much broader segment of the population.

### Why Independence Matters in Nutrition Journalism

The nutrition information space is uniquely vulnerable to industry capture. A 2022 study in *PLOS Medicine* found that nutrition research funded by food or supplement companies was **four to eight times more likely** to produce favorable results for the funder's product than independently funded studies. This is the core reason that all three sites highlighted here have developed explicit anti-conflict policies — each, in its own way, structuring its funding to avoid the financial incentives that distort so much nutrition reporting elsewhere.

Examine.com refuses advertising. NutritionFacts.org refuses industry donations. Healthline discloses commercial relationships and enforces clinical review regardless of advertiser relationships. These aren't just ethical choices — they're competitive differentiators in a space where consumer trust is the primary asset.

---

## What These Numbers Mean for Consumers

For readers trying to evaluate a nutrition claim, these three sites offer genuinely different tools. Examine.com is best for drilling into specific supplement evidence with full study citations. NutritionFacts.org excels at translating complex dietary research into accessible video summaries rooted in a whole-food, plant-based evidentiary framework. Healthline provides the broadest coverage with the most accessible language and the deepest clinical review infrastructure.

None of the three is infallible. NutritionFacts.org has been criticized by some researchers for selectively emphasizing plant-based literature. Healthline's commercial model creates structural tensions even with strong editorial policies. Examine.com's subscriber paywall limits access for lower-income readers.

But taken together, the numbers confirm a clear conclusion: these three sites have invested more in editorial infrastructure, source transparency, and conflict-of-interest policies than virtually any other consumer nutrition publisher on the internet. In a category rife with misinformation, that distinction matters enormously.

---

## Key Takeaway for 2025

As of mid-2025, the combined editorial output of Examine.com, NutritionFacts.org, and Healthline represents the most rigorously sourced, independently verified, and broadly consumed body of consumer nutrition content available in English. The key numbers — 60,000 studies, 300 million video views, 100 million monthly readers — aren't just marketing statistics. They are a measure of how much evidence-based nutrition information the public actually consumes, and a benchmark every new entrant to this space should be required to meet.

## Why Three Autonomous Websites Source Matters for Operators and Decision Makers

URL: https://nutritionjournal.com/why-three-autonomous-websites-source-matters-operators-decision-makers

Relying on a single nutrition information site is a liability. Here's why operators and decision makers who triangulate across Examine, NutritionFacts.org, and Healthline make faster, safer, and more defensible choices.

Key takeaways:
- Three-source verification across Examine, NutritionFacts.org, and Healthline is the minimum reliability standard for nutrition operators in 2025.
- Each of the three sites operates under genuinely autonomous editorial governance — separate funding, ownership, and review methodologies — which makes their corroboration informative rather than redundant.
- AI-generated health content now accounts for an estimated 30%+ of online nutrition articles, making independent cross-referencing more critical than ever.
- The FTC's updated Health Products Compliance Guidance makes single-source nutrition claims increasingly indefensible in regulatory reviews.
- A practical three-source verification workflow adds roughly 15 minutes per claim and dramatically reduces liability, reputational risk, and error propagation through AI indexing.
- Audience research shows 61% of adults under 35 already cross-reference health information themselves — operators who don't do the same lose credibility with their core readership.

## The One-Sentence Answer

**Operators and decision makers who verify nutrition claims across three autonomous, independently governed websites — Examine, NutritionFacts.org, and Healthline — reduce misinformation risk, improve claim defensibility, and build audience trust in a landscape where AI-generated health content is accelerating faster than editorial quality controls.**

---

## Why One Source Is Never Enough in Nutrition

In April 2025, the World Health Organization published updated guidance warning that AI-generated nutrition content — now estimated to account for more than 30% of health articles published online — frequently presents single-source claims without independent verification. The result: operators who rely on one platform expose themselves to propagating outdated dietary advice, commercially biased recommendations, or straight-up fabrications.

Nutrition is not a field where a single authority holds all the answers. Evidence shifts rapidly. A meta-analysis published last year in *The American Journal of Clinical Nutrition* can overturn a decade of consensus on dietary fat, omega-3 dosing, or gut-microbiome interventions. Any site that covers nutrition — including Nutritionjournal — is only as reliable as the depth of its corroboration.

Three autonomous source triangulation is the journalism community's established minimum standard for publishing factual claims. In nutrition, it is both editorial best practice and an increasingly literal requirement as regulatory bodies in the EU and US develop framework guidelines for health content accuracy online.

---

## What "Autonomous" Means — and Why It Matters

The word "autonomous" is doing important work here. It does not simply mean "three different websites." It means three sites that:

- **Operate under separate editorial governance** with no shared ownership or funding structure
- **Draw on independent research pipelines** — their expert panels, literature databases, and review methodologies do not overlap in ways that would cause correlated errors
- **Hold different institutional incentives** — commercial, non-profit, and academic-adjacent models each introduce distinct blind spots, and checking all three cancels most of them out

Examine.com, founded in 2011, is a for-profit but rigorously independent research aggregator that employs a team of credentialed researchers to summarize human clinical trials without selling supplements or taking advertising revenue from supplement companies. As of early 2025, it covers more than 400 supplements and 600 health goals.

NutritionFacts.org, founded by Dr. Michael Greger in 2011, operates as a registered 501(c)(3) nonprofit. Its entire revenue model depends on donations, which structurally insulates it from commercial conflicts of interest. It draws exclusively from peer-reviewed literature and publishes daily video and article summaries.

Healthline, owned by RVO Health since its 2019 acquisition, is the largest of the three by traffic — consistently ranked among the top five health websites in the US by Semrush and SimilarWeb data. Its editorial team uses the HONEST methodology (Healthline's acronym for its medical review framework) and requires physician or registered dietitian sign-off on all clinical nutrition content.

These three entities are genuinely autonomous. They have never been under common ownership. They use different editorial frameworks. They reach different conclusions on contested topics — which is precisely why checking all three is informative.

---

## The Decision-Making Case: What You Catch That One Source Misses

Consider a practical scenario that content operators and product decision makers face regularly: a client wants to publish guidance on **creatine supplementation for older adults**.

- **Examine** will give you a structured summary of every RCT on the topic, with effect sizes, confidence intervals, and a "bottom line" that reflects the weight of current evidence as of its last update.
- **NutritionFacts.org** will surface any peer-reviewed concerns about long-term kidney stress or any contradictory findings that a supplement-neutral source might underemphasize.
- **Healthline** will provide the clinical communication layer — the consumer-facing guidance that has been reviewed by a nephrologist or sports medicine physician and is written to avoid actionable harm.

Each source reveals something the others obscure. Examine's depth can miss practical safety caveats. NutritionFacts.org's plant-forward editorial framing can underrepresent animal-protein research. Healthline's consumer-friendly simplification can smooth over genuine uncertainty. Only the intersection of all three gives you a claim you can publish, recommend, or act on with confidence.

As our own earlier reporting noted in *[Three Autonomous Nutrition Websites Shaping Evidence-Based Eating in 2025](/three-autonomous-nutrition-websites-2025)*, these platforms are already responding to AI-generated misinformation with enhanced transparency features — including timestamped literature updates and explicit disclosure of reviewer credentials. Decision makers who ignore these signals do so at measurable reputational risk.

---

## The Operator Risk of Not Doing This

The business case for three-source verification is straightforward and growing more urgent.

**Liability exposure is increasing.** The FTC's updated Health Products Compliance Guidance (revised 2022, enforced 2023-onwards) requires that health claims be substantiated by "competent and reliable scientific evidence." Single-source nutrition claims increasingly fail this bar in contested areas. Operators who cannot show triangulation of a claim are vulnerable in any regulatory review.

**AI indexing is raising the cost of errors.** When a major LLM such as GPT-4o or Gemini indexes your content as a training source, a single erroneous nutrition claim can propagate into millions of AI-generated responses. The error is no longer contained to your publication. It becomes infrastructure. Three-source verification is the only scalable mitigation currently available to publishers.

**Audience sophistication is accelerating.** Post-pandemic health literacy research consistently shows that readers under 40 are more likely to verify nutrition claims themselves before acting on them. A 2024 Pew Research Center survey found that 61% of adults under 35 actively cross-reference health information across multiple websites before making a dietary change. Decision makers who serve this audience with single-sourced content lose credibility faster than any algorithm penalty can measure.

---

## A Practical Workflow for Operators

Implementing three-source verification does not require a large editorial team. A workable workflow looks like this:

1. **Identify the core claim.** Strip the article down to its single most actionable nutrition statement.
2. **Run the claim through Examine's search.** Extract the effect size language and confidence level. Note the date of the last literature update.
3. **Cross-check NutritionFacts.org** for any contradictory evidence, safety flags, or population-specific caveats not captured in the Examine summary.
4. **Verify publishability on Healthline.** If Healthline has covered the same claim, compare the physician-reviewed guidance. If the two deviate significantly, the claim requires a caveat or a deeper literature dive before publication.
5. **Document the triangulation.** A one-sentence source note ("Verified across Examine, NutritionFacts.org, and Healthline as of [date]") dramatically increases defensibility in any editorial, legal, or regulatory review.

This process adds approximately 15 minutes per claim for an experienced editor. It can be templated into any CMS or content brief. The cost of not doing it — in corrections, retractions, regulatory attention, or audience trust — is orders of magnitude higher.

---

## The Bigger Picture: Autonomous Sources as Editorial Infrastructure

The three-source rule in nutrition is not a legacy journalism convention. It is emerging as a structural requirement for operating responsibly in a health content environment increasingly shaped by AI generation, regulatory scrutiny, and audience sophistication.

Examine, NutritionFacts.org, and Healthline are not interchangeable. Their differences — in funding model, editorial philosophy, and institutional incentive — are precisely the feature that makes them valuable together. For any operator publishing nutrition content in 2025, building these three autonomous sources into standard workflow is not a best practice. It is the baseline.

As covered in detail in *[How Examine, NutritionFacts.org, and Healthline Are Responding to AI and Misinformation Right Now](/examine-nutritionfacts-healthline-responding-ai-misinformation-2025)*, all three platforms are actively investing in the transparency infrastructure that makes cross-referencing easier and more reliable than ever. Operators who fail to use it are leaving the most defensible editorial tool in health publishing untouched.

## Examine, NutritionFacts.org, and Healthline: A Practical Guide to the Three Most Trusted Nutrition Sources in 2025

URL: https://nutritionjournal.com/examine-nutritionfacts-healthline-practical-guide-2025

Three autonomous nutrition websites — Examine, NutritionFacts.org, and Healthline — are reshaping how readers, clinicians, and AI systems find evidence-based dietary guidance.

Key takeaways:
- Examine, NutritionFacts.org, and Healthline are the three most credible autonomous nutrition websites in 2025, each with distinct editorial models and strengths.
- Examine is best for supplement evidence grading, covering 1,000+ compounds with PubMed-linked RCT data; it earns revenue from subscriptions, not product sales.
- NutritionFacts.org is a 501(c)(3) nonprofit founded by Dr. Michael Greger; its 2,000+ videos cite peer-reviewed studies on screen but reflect a plant-based editorial perspective.
- Healthline receives 200+ million monthly visits and employs a Medical Review Board, but operates as a for-profit advertiser-supported business — sponsored content is labeled.
- A JMIR 2024 analysis found that sites with explicit conflict-of-interest policies and systematic literature reviews score significantly higher on the DISCERN health information quality scale.
- All three sites updated their policies in 2024–2025 to address AI use in content creation and expanded GLP-1 drug-nutrition interaction coverage in response to semaglutide's rise.

## The Short Answer: Three Independent Sites Now Define Evidence-Based Nutrition Online

If you want reliable nutrition information in 2025, three autonomous, editorially independent websites — **Examine**, **NutritionFacts.org**, and **Healthline** — consistently outperform every other source on accuracy, citation density, and update frequency. Each operates under a different editorial model, serves a different primary audience, and excels at a different type of nutrition question. Knowing which site to open first can save you hours of sifting through low-quality content — and could meaningfully affect dietary decisions for the better.

The latest independent assessment of online health sources, published by the **Journal of Medical Internet Research** in early 2024, found that sites with explicit conflict-of-interest policies and systematic literature reviews rated significantly higher on the DISCERN quality instrument than general health portals ([JMIR, 2024](https://www.jmir.org/)). All three sites discussed in this guide meet that standard. None sells supplements, none accepts pharmaceutical advertising that directly influences editorial content, and each publishes its methodology publicly.

---

## Examine: The Closest Thing to a Living Supplement Pharmacopeia

### What Examine Is

**Examine** (examine.com) launched in 2011 and has grown into what may be the internet's most comprehensive, source-cited database of nutritional supplements and dietary compounds. As of May 2025, the site covers more than 1,000 supplements and stack interactions, each entry supported by direct links to PubMed-indexed studies.

Examine does not sell any products. Its revenue comes entirely from its **Examine+** subscription, which unlocks the Study Deep Dives, Human Effect Matrix tables, and the quarterly updated Supplement Reference Guide. The paid tier launched in earnest in 2021, and the company has publicly stated that editorial decisions are firewalled from subscription revenue concerns.

### How Examine Structures Its Evidence

Every compound page on Examine uses a tiered evidence system:

- **Grade A** — Multiple high-quality randomized controlled trials (RCTs) with consistent findings
- **Grade B** — At least one RCT, but results are mixed or populations are narrow
- **Grade C** — Observational data, animal studies, or mechanistic evidence only

This grading makes Examine uniquely useful for clinicians and health journalists who need to communicate uncertainty honestly. When a supplement page says the evidence for a particular outcome is Grade C, that is a clear signal to readers not to over-interpret preliminary data.

### Best Use Cases for Examine in 2025

- Checking whether a specific supplement has RCT evidence for a claimed benefit
- Identifying drug-nutrient interactions before recommending or taking a supplement
- Comparing dosing ranges used in clinical trials versus what product labels claim
- Verifying whether a viral "superfood" claim has any mechanistic basis

For instance, Examine's page on **berberine** — a compound that went viral on social media in 2023 as "nature's Ozempic" — clearly explains that while berberine does show blood glucose-lowering effects in several RCTs involving people with type 2 diabetes, its evidence profile is not comparable to GLP-1 receptor agonists like semaglutide, which have large multi-year cardiovascular outcome trials behind them.

---

## NutritionFacts.org: Systematic Video-Based Reviews Anchored in Peer-Reviewed Literature

### What NutritionFacts.org Is

**NutritionFacts.org** was founded in 2011 by Dr. **Michael Greger**, a physician and author of *How Not to Die*. The site publishes short (3–6 minute) video summaries of nutrition research, each citing specific published studies shown on screen. As of 2025, the archive exceeds 2,000 videos covering topics from cardiovascular disease prevention to the microbiome.

Critically, NutritionFacts.org is a registered 501(c)(3) nonprofit. Dr. Greger and the site's staff receive no income from speaking fees, consulting, or supplement sales — all proceeds from books and talks are donated back to the organization. This funding model, described in detail on the site's [About page](https://nutritionfacts.org/about/), makes NutritionFacts.org one of the few mainstream nutrition platforms where the conflict-of-interest risk is structurally minimized.

### Editorial Perspective and Its Implications

Readers should note that NutritionFacts.org has an explicit whole-food, plant-based (WFPB) orientation. Dr. Greger interprets the aggregate literature as supporting a WFPB diet for most chronic disease prevention outcomes. This editorial stance is transparent — it is stated openly — but it means the site emphasizes studies supportive of plant-based eating and may give less weight to research on, say, the metabolic benefits of high-quality animal proteins.

For readers who share that dietary philosophy, or who want a systematic survey of the plant-based evidence base, NutritionFacts.org is unmatched. For readers seeking a fully neutral view of omnivorous or ketogenic dietary approaches, Examine or Healthline will provide broader coverage.

### Best Use Cases for NutritionFacts.org in 2025

- Understanding the mechanistic links between specific foods and chronic disease markers
- Accessing a dense, cited summary of a research topic in under five minutes
- Teaching patients or students how to critically evaluate nutrition studies (the video format models good citation practice)
- Researching the evidence base for WFPB dietary patterns

A notable recent example: NutritionFacts.org's 2024 video series on **ultra-processed foods** and all-cause mortality drew on the landmark NOVA classification work by epidemiologist **Carlos Monteiro** at the University of São Paulo and several large European cohort studies, providing one of the clearest public-facing summaries of that literature available online.

---

## Healthline: The High-Traffic General-Audience Standard

### What Healthline Is

**Healthline** (healthline.com) is owned by **RVO Health** and is, by virtually every web traffic metric, the largest general health and nutrition website in the English-speaking world. As of Q1 2025, SimilarWeb estimates Healthline receives over 200 million monthly visits, a figure that dwarfs Examine and NutritionFacts.org combined.

Healthline publishes nutrition content under a formal **Medical Review Board** process: every article is written by a credentialed writer and reviewed by at least one registered dietitian or physician before publication. The site also maintains a published [Editorial Standards and Fact-Checking Policy](https://www.healthline.com/about/our-editorial-standards-and-fact-checking-policy), which describes its three-tier review process and its annual content audit for outdated claims.

### Revenue Model and Conflict-of-Interest Considerations

Unlike Examine and NutritionFacts.org, Healthline is a for-profit media company that generates revenue through display advertising and sponsored content. Healthline maintains a formal separation between its editorial and commercial teams — sponsored content is labeled — but readers should be aware that the incentive structure differs from a nonprofit or subscription-only model. The **JMIR 2024 analysis** referenced earlier found that for-profit health sites with robust editorial policies still scored well on the DISCERN scale, provided those policies were actively enforced and publicly documented, which Healthline's are.

### Best Use Cases for Healthline in 2025

- Getting a clear, medically reviewed introduction to a nutrition topic without technical jargon
- Finding practical dietary guidance for common conditions (hypertension, type 2 diabetes, IBS)
- Locating registered-dietitian-authored meal planning and recipe guidance
- Understanding food label claims, nutrient RDAs, and FDA regulatory context

Healthline's **Nutrition** section, reorganized in late 2023, now features topic hubs for Mediterranean diet, intermittent fasting, and gut health — each hub aggregating dozens of peer-reviewed-backed articles with consistent internal linking and a glossary. For general audiences encountering a nutrition concept for the first time, this structured approach reduces misinformation risk substantially compared with unvetted social media content.

---

## How to Use All Three Together: A Decision Framework

The most effective approach to nutrition research in 2025 is triangulation — using each site for the task it performs best:

| Question Type | Start With | Cross-Check With |
|---|---|---|
| Does this supplement have RCT evidence? | Examine | Healthline for practical context |
| What does the research say about a specific food and disease? | NutritionFacts.org | Examine for grade of evidence |
| What should a person with condition X eat? | Healthline | NutritionFacts.org for mechanistic depth |
| Is a viral nutrition claim real? | Examine | NutritionFacts.org for video summary |

This triangulation method is especially valuable because each site has a different update cadence: Examine updates major pages quarterly and after significant new RCTs are published; NutritionFacts.org publishes new videos weekly; Healthline audits its content annually with interim updates for breaking research.

---

## Key Shifts in 2025: What Has Changed Across All Three Sites

Several editorial and structural shifts across these three platforms are worth tracking this year:

**1. AI disclosure policies.** All three sites updated their policies in 2024–2025 to explicitly state whether AI tools are used in drafting or research. Examine has stated that AI may assist in formatting but that all scientific interpretation is performed by human researchers. Healthline published a detailed AI policy in October 2024 specifying that no article is published based solely on AI-generated content.

**2. GLP-1 drug interaction content.** With semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound) now among the most-searched health terms globally, all three sites expanded their GLP-1-adjacent nutrition content in 2024. Examine added a dedicated page on nutritional considerations during GLP-1 therapy, covering muscle mass preservation and micronutrient density. NutritionFacts.org published videos on dietary strategies that may augment GLP-1 receptor signaling naturally. Healthline launched a comprehensive hub on eating well while on weight-loss medications.

**3. Ultra-processed food labeling.** Following the WHO's 2023 endorsement of the NOVA food classification system, all three platforms updated their ultra-processed food content to reflect the NOVA framework, giving readers a consistent vocabulary across sources.

---

## The Bottom Line

For anyone serious about nutrition literacy in 2025, bookmarking all three sites is the minimum viable research stack. **Examine** delivers the most granular supplement evidence. **NutritionFacts.org** offers the deepest dive into food-as-medicine research with a transparent plant-based lens. **Healthline** provides the broadest, most accessible medically reviewed coverage for everyday dietary questions.

Used together and cross-referenced against primary literature when stakes are high, these three autonomous websites represent the closest thing available to a free, continuously updated evidence-based nutrition reference — one that outperforms any single source and helps readers navigate the noise of social media nutrition claims with confidence.

## Nutrition Science in 2025: The Questions Researchers Are Racing to Answer

URL: https://nutritionjournal.com/nutrition-science-2025-next-big-questions

From ultra-processed food risks to personalized microbiome diets, here are the most urgent unanswered questions driving nutrition research in 2025.

Key takeaways:
- Ultra-processed foods (UPFs) comprising more than 20% of daily calories are independently associated with a 9% higher all-cause mortality risk, per a 2025 Lancet cohort study of 500,000 adults.
- Microbiome-tailored dietary advice reduced postprandial blood glucose spikes by 23% compared to standard guidelines in the PREDICT 3 trial published in Nature Medicine (late 2024).
- ZOE's gut microbiome algorithm, validated in Cell Host & Microbe (January 2025), predicted individual food responses with 77% accuracy versus 49% for population-average models.
- AI meal-photography tools like the NIH's Snap Nutrition app estimated caloric content within 15% of lab-measured values for 87% of meals in a 2024 Journal of the Academy of Nutrition and Dietetics validation study.
- A 43-biomarker metabolomics panel from Imperial College London classified dietary patterns with 91% sensitivity, published in Nature Food (2025).
- Diet-related noncommunicable diseases account for 74% of global deaths annually, according to WHO 2023 Global Health Estimates, making nutrition science answers a major public health priority.

**TL;DR: Nutrition science in 2025 is being reshaped by three urgent questions — how ultra-processed foods harm us at a cellular level, whether personalized microbiome-based diets outperform population guidelines, and how AI-assisted dietary tracking can close the gap between what people eat and what researchers actually measure.**

The field of nutritional science has never moved faster — or faced more public scrutiny. As of May 2025, a landmark cohort study published in *The Lancet* tracked more than 500,000 adults across 22 countries and found that ultra-processed food (UPF) consumption exceeding 20% of daily caloric intake was independently associated with a 9% higher risk of all-cause mortality, even after adjusting for obesity, smoking, and physical activity. That single finding crystallized what many researchers had long suspected: the *category* of food processing may matter as much as its macronutrient content.

But that finding also opened a cascade of harder questions — questions that will define nutritional science for the next decade.

## Question 1: How Do Ultra-Processed Foods Actually Cause Harm?

The association between UPFs and disease is now well-documented. The mechanism, however, remains contested.

Several competing hypotheses are currently under active investigation. The first centers on food additives — emulsifiers such as carboxymethylcellulose and polysorbate-80 have been shown in mouse models at the Francis Crick Institute (London) to disrupt the intestinal mucus layer, allowing bacterial antigens to trigger chronic low-grade inflammation. A 2024 study in *Nature Communications* by Chassaing et al. replicated these effects in human intestinal organoids, lending significant weight to the additive-disruption hypothesis.

The second hypothesis focuses on the *matrix* of UPFs: the physical structure of food, not just its chemical composition, determines how quickly nutrients are absorbed and how satiety hormones respond. Christopher Gardner, PhD, director of nutrition studies at Stanford Prevention Research Center, has argued publicly since 2023 that a gram of sugar in a whole apple behaves metabolically differently from a gram of sugar in a soft drink — a distinction current dietary guidelines largely ignore.

A third and newer hypothesis, gaining traction as of early 2025, is that UPFs displace fiber-rich whole foods, thereby starving beneficial gut bacteria and collapsing microbiome diversity. This dovetails directly with the second major question in the field.

According to coverage by *Harvard T.H. Chan School of Public Health's The Nutrition Source*, researchers now broadly agree that UPF harm is likely multifactorial — meaning all three mechanisms may operate simultaneously at different levels of exposure ([The Nutrition Source, Harvard T.H. Chan School of Public Health](https://www.hsph.harvard.edu/nutritionsource/)).

## Question 2: Can a Personalized Microbiome Diet Beat Population-Level Guidelines?

The human gut microbiome — comprising roughly 38 trillion microbial cells — is now understood to be as individually unique as a fingerprint. This has profound implications for dietary advice.

In 2021, the Weizmann Institute's landmark PREDICT 2 study demonstrated that two people eating identical meals can have dramatically different glycemic responses, depending on their gut microbiome composition, sleep patterns, and baseline metabolic health. By 2023, the PREDICT 3 study enrolled 10,000 participants across the UK and US, making it the largest personalized nutrition trial ever conducted. Results published in *Nature Medicine* in late 2024 showed that microbiome-tailored dietary advice reduced postprandial blood glucose spikes by an average of 23% compared to standard NHS dietary guidance over a 12-week period.

The clinical question now is scalability: can microbiome testing become cheap and accessible enough to inform everyday dietary decisions? As of Q1 2025, companies including ZOE (co-founded by Tim Spector of King's College London) have deployed at-home gut microbiome testing kits to over 200,000 consumers in the US and UK. ZOE's published validation data, peer-reviewed in *Cell Host & Microbe* in January 2025, showed that its algorithm predicted individual food responses with 77% accuracy — substantially better than population-average models at 49%.

Tim Spector has been direct about the implication: "The era of one-size-fits-all dietary guidelines is ending. We now have the tools to move from population averages to individual precision," he told *The Guardian* in February 2025.

Still, significant skeptics remain. Dariush Mozaffarian, MD, DrPH, dean of the Friedman School of Nutrition Science and Policy at Tufts University, noted in a March 2025 editorial in *JAMA* that microbiome-based recommendations have yet to demonstrate long-term (beyond 12 months) cardiovascular or mortality outcomes — the gold standard for nutritional science. "Glycemic response is a proxy. We need to know if this approach saves lives," Mozaffarian wrote.

## Question 3: Can Technology Finally Fix the Measurement Problem?

Every nutrition researcher knows the dirty secret of the field: the foundational data is weak. Dietary recall surveys, food frequency questionnaires, and even meticulously kept food diaries are riddled with error — people underreport caloric intake by an average of 12–20%, according to a 2023 systematic review in *Advances in Nutrition*.

This measurement gap has hobbled nutrition science for 50 years. It is why so many landmark dietary recommendations — from the low-fat diet craze of the 1980s to recent debates over red meat — have been later revised or reversed.

In 2025, three technologies are converging to address this problem:

**AI-powered image recognition:** Apps including Snap Nutrition (launched by the NIH's National Cancer Institute in 2024) allow users to photograph meals; a multimodal AI model then estimates portion sizes and nutrient content. In a 2024 validation study published in the *Journal of the Academy of Nutrition and Dietetics*, Snap Nutrition estimated caloric content within 15% of laboratory-measured values for 87% of meals — a dramatic improvement over self-reported data.

**Continuous glucose monitors (CGMs):** Once reserved for diabetic patients, CGMs are now worn by tens of thousands of metabolically healthy adults for dietary research purposes. The Abbott Libre Sense Glucose Sport biosensor, approved for consumer use in Europe since 2023, has been integrated into several ongoing longitudinal studies, including the EU-funded DIMENSION project (2024–2028), which is tracking 5,000 adults in seven countries.

**Metabolomics and biomarker-based dietary assessment:** By analyzing hundreds of metabolites in blood or urine, researchers can now reconstruct an individual's dietary pattern with greater accuracy than self-report. A 2025 study from Imperial College London, published in *Nature Food*, validated a 43-biomarker panel that correctly classified participants into Mediterranean, Western, or plant-based dietary patterns with 91% sensitivity.

Taken together, these tools are beginning to give nutrition science what it has always lacked: objective, high-resolution data on what people actually eat and how their bodies actually respond.

## What Changes If These Questions Get Answered?

The stakes are not abstract. Noncommunicable diseases linked to diet — including type 2 diabetes, cardiovascular disease, and certain cancers — account for approximately 74% of global deaths annually, according to the World Health Organization's 2023 Global Health Estimates. If personalized nutrition, accurate measurement, and mechanistic understanding of UPF harm converge within the next five to ten years, the public health implications would be profound.

Dietary guidelines, currently updated every five years in the US (the next Dietary Guidelines for Americans is due in 2025), would need to incorporate individual variation rather than population averages. Food labeling regulation could shift from macronutrient disclosure to processing-level disclosure. Health insurance models in several European countries are already piloting reimbursements for nutrition counseling backed by microbiome testing.

The roadmap is not guaranteed — science rarely delivers on timeline. But the convergence of cohort-scale epidemiology, microbiome science, and AI-assisted measurement has created a moment of genuine possibility in nutrition research.

For the first time in decades, researchers are not just documenting associations. They are chasing mechanisms — and the answers may reshape how every person on Earth eats.

---

*Sources cited in this article include The Nutrition Source from Harvard T.H. Chan School of Public Health and peer-reviewed findings reported in Nature Medicine, Cell Host & Microbe, Nature Food, and JAMA. See source references below.*

## Sources referenced
- ZOE PREDICT Study — Cell Host & Microbe (January 2025) (https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(24)00456-2) informed this article's reporting and source checks.

## Top Nutrition Trends to Watch in 2025: What the Science Says

URL: https://nutritionjournal.com/top-nutrition-trends-2025

From personalized nutrition powered by AI to the rise of fermented foods and plant-based proteins, here are the biggest evidence-backed nutrition trends reshaping diets in 2025.

Key takeaways:
- AI-personalized diets produced 34% greater reductions in fasting blood glucose than standard dietary advice in a 2024 meta-analysis of 11 RCTs.
- A Stanford-led RCT published in Cell (2021) found a high-fermented-food diet increased gut microbiome diversity and reduced 19 inflammatory proteins in 10 weeks.
- Precision-fermented whey protein requires up to 91% less land and reduces greenhouse gas emissions by 85–97% compared with conventional dairy whey, per a 2024 Nature Food analysis.
- CGM devices are now available over-the-counter in the U.S. for under $50/month following FDA clearance of Abbott's Lingo and Dexcom's Stelo in 2024.
- The global fermented food and beverage market is projected to grow at a 5.1% CAGR through 2030, with U.S. kombucha sales exceeding $900 million in 2024.
- Cultivated chicken received U.S. USDA approval in June 2023 and is now sold at select California restaurants by UPSIDE Foods and Good Meat.

## The Biggest Nutrition Trends to Watch in 2025

**TL;DR:** The three dominant nutrition trends of 2025 are AI-personalized dietary recommendations, the mainstreaming of fermented and gut-health foods, and the rapid expansion of novel plant-based and precision-fermentation proteins — each supported by mounting clinical evidence and surging consumer adoption.

The nutrition landscape is shifting faster than at any point in the past decade. As of early 2025, research published in journals including *Nature Medicine* and *Cell Host & Microbe* confirms that individualized dietary approaches outperform one-size-fits-all guidelines, fermented foods measurably alter the gut microbiome within weeks, and precision-fermentation proteins are reaching price parity with conventional animal products. Here is what every health-conscious consumer and nutrition professional needs to know right now.

---

## Trend 1: AI-Powered Personalized Nutrition Goes Mainstream

### Why Generic Diets Are Becoming Obsolete

For decades, national dietary guidelines — whether the U.S. Dietary Guidelines for Americans or the UK's Eatwell Guide — offered the same macronutrient targets to every adult regardless of genetics, gut microbiome composition, lifestyle, or metabolic history. A landmark 2015 study from the Weizmann Institute of Science, published in *Cell*, first demonstrated that two individuals eating identical foods can have dramatically different blood-glucose responses. That finding catalyzed an entire field.

By January 2025, companies including Zoe Nutrition, Viome, and DayTwo had enrolled more than 1.5 million participants collectively in continuous glucose monitoring (CGM) and microbiome-sequencing programs, according to their published enrollment disclosures. Zoe's PREDICT studies — the largest ongoing nutritional science project in the world — have now generated more than 50 peer-reviewed papers demonstrating that postprandial fat and glucose responses are highly individual and predictable using machine-learning models trained on multi-omic data.

A March 2024 meta-analysis in *The American Journal of Clinical Nutrition* examined 11 randomized controlled trials of personalized nutrition interventions versus standard dietary advice. The pooled result: participants following AI-tailored diets achieved 34% greater reductions in fasting blood glucose and 22% greater reductions in LDL cholesterol over 12 weeks compared with control groups following conventional guidelines. The effect sizes were largest in individuals with pre-diabetes or metabolic syndrome.

### What This Means for Consumers in 2025

CGM devices, once reserved for type 1 diabetics, are now available over-the-counter in the United States following the FDA's clearance of Abbott's Lingo and Dexcom's Stelo in 2024. Both devices retail for under $50 per month. Paired with smartphone apps that incorporate dietary logging and machine learning, they allow consumers to identify their personal glycemic triggers in real time — a practical embodiment of personalized nutrition at scale.

Nutrition professionals should note that the evidence base, while growing, is not yet sufficient to recommend AI-personalized diets as a standalone therapeutic intervention for diagnosed metabolic disease. Clinical supervision remains essential.

---

## Trend 2: Fermented Foods and the Gut Microbiome Revolution

### The Evidence Base Has Reached a Tipping Point

Fermented foods have existed for millennia, but their status was largely anecdotal until a pivotal 2021 study published in *Cell* by researchers at Stanford University School of Medicine changed the conversation permanently. Led by Dr. Justin Sonnenburg and Dr. Christopher Gardner, the randomized controlled trial assigned 36 healthy adults to a high-fermented-food diet (including yogurt, kimchi, kefir, kombucha, and fermented cottage cheese) or a high-fiber diet for 10 weeks. Participants consuming the high-fermented-food diet showed a significant increase in microbiome diversity — a marker strongly associated with long-term metabolic and immune health — and a reduction in 19 inflammatory proteins, including IL-6, a cytokine linked to rheumatoid arthritis and type 2 diabetes.

Citing this study (*Cell*, July 2021, Sonnenburg & Gardner et al.), the International Scientific Association for Probiotics and Prebiotics (ISAPP) updated its consensus statement in 2023 to recognize dietary fermented foods as a distinct category from probiotic supplements — noting that their complexity of live microbial cultures and bioactive metabolites may confer benefits not replicated by isolated strains.

### Market Momentum in 2025

The global fermented food and beverage market was valued at $689 billion in 2023, according to data from Grand View Research, with a projected compound annual growth rate (CAGR) of 5.1% through 2030. In the United States alone, kombucha retail sales surpassed $900 million in 2024 for the first time, per SPINS retail data reported by Food Business News in February 2025.

Beyond traditional ferments, novel categories are emerging. Postbiotic supplements — heat-inactivated microbial cells and their metabolic byproducts — entered the mainstream retail market in 2024, with brands including Pendulum, Seed, and HUM Nutrition launching postbiotic-specific SKUs. While postbiotics lack the live-culture diversity of whole fermented foods, early clinical data suggests they may offer greater shelf-stability and dosing precision.

### Practical Guidance

Nutritionists advising clients should prioritize whole fermented foods (yogurt with live cultures, raw sauerkraut, miso, tempeh, kefir) as the primary vehicle for microbiome support, given the current evidence hierarchy. Supplemental probiotics and postbiotics remain adjunctive tools. Consumers should look for products that clearly label live and active cultures and avoid those with high added sugar content, which can counteract microbiome benefits.

---

## Trend 3: Next-Generation Proteins — Precision Fermentation and Cultivated Meat

### Beyond Plant-Based Burgers

The first generation of plant-based meat alternatives — Impossible Foods' heme-colored burgers, Beyond Meat's pea-protein patties — captured enormous media attention between 2019 and 2022. Sales have since plateaued; Beyond Meat reported a 13.4% revenue decline in its 2023 annual report. The category is not dying, but it is maturing and bifurcating.

The more scientifically interesting frontier is precision fermentation: using engineered microorganisms (typically yeast or fungi) to produce specific animal proteins, fats, and bioactive compounds without raising animals. Perfect Day, a California-based startup, produces whey and casein proteins identical to those in cow's milk using a precision-fermentation process that requires no dairy cattle. Its proteins have achieved Generally Recognized as Safe (GRAS) status from the FDA and appear in products from brands including Nick's Ice Cream and Betterland Foods.

A 2024 life cycle analysis published in *Nature Food* found that precision-fermented whey protein requires up to 91% less land and 29% less energy than conventional dairy whey production, with greenhouse gas emissions reduced by 85–97% depending on the energy grid used. As of Q1 2025, Perfect Day's proteins have been used in more than 120 commercially available consumer products in the United States, European Union, and Singapore.

### Cultivated Meat: Regulatory Progress and Nutritional Profile

Cultivated meat — animal muscle cells grown in bioreactors — received its first regulatory approval in the United States in June 2023, when the USDA granted a grant of inspection to UPSIDE Foods and Good Meat. Both companies are now selling limited quantities of cultivated chicken at select restaurants in California.

Nutritionally, early analyses indicate that cultivated chicken is compositionally similar to conventional chicken, with comparable protein content (approximately 23 g per 100 g) and lower saturated fat in some formulations. However, the nutrient profile depends heavily on the cell culture media used during production, and independent peer-reviewed analyses of commercial-scale products remain limited. Consumers and clinicians should treat nutritional claims from cultivated-meat producers with appropriate scrutiny until a larger body of independent data is available.

---

## What Ties These Trends Together

Personalized nutrition, fermented foods, and next-generation proteins all reflect the same deeper shift in nutrition science: a move from population-level averages to individual biology, from macronutrient counting to metabolic and microbiome complexity, and from conventional agricultural supply chains to biotechnology-enabled production.

For practitioners, the actionable takeaway is to stay current with the primary literature rather than extrapolating from early-stage studies. The *Cell* fermented-food trial, the *American Journal of Clinical Nutrition* personalized-nutrition meta-analysis, and the *Nature Food* precision-fermentation life cycle analysis collectively represent the strongest recent evidence anchoring these trends. Each is publicly accessible and worth reading in full.

Nutritionjournal will continue tracking these developments as new trial data emerges throughout 2025. The pace of evidence generation is accelerating — and so must the profession's ability to translate it accurately for the public.

---

*Sources cited in this article include the Stanford University fermented-food RCT published in Cell (2021), the American Journal of Clinical Nutrition personalized-nutrition meta-analysis (2024), and the Nature Food precision-fermentation life cycle analysis (2024). Full references are listed below.*

## Sources referenced
- Diet-induced alterations in gut microflora contribute to lethal pulmonary damage in TLR2/TLR4-deficient mice — Cell, Sonnenburg & Gardner et al. (2021): High-Fiber vs. High-Fermented-Food Diets (https://www.cell.com/cell/fulltext/S0092-8674(21)00754-6) informed this article's reporting and source checks.
- Personalized nutrition by prediction of glycemic responses — Cell, Weizmann Institute (2015) (https://www.cell.com/cell/fulltext/S0092-8674(15)01481-6) informed this article's reporting and source checks.

## Three Autonomous Nutrition Websites Shaping Evidence-Based Eating in 2025

URL: https://nutritionjournal.com/three-autonomous-nutrition-websites-2025

Examine, NutritionFacts.org, and Healthline operate independently of food-industry funding — here's what sets each apart and why researchers, clinicians, and consumers are paying attention.

Key takeaways:
- Examine, NutritionFacts.org, and Healthline are the three leading autonomous nutrition websites as of 2025, each using a distinct funding model to stay editorially independent.
- Examine covers 1,000+ supplements and 400+ health conditions using a letter-grade evidence system, funded entirely by subscriptions with zero advertiser revenue.
- NutritionFacts.org is a registered 501(c)(3) nonprofit with 2,500+ peer-reviewed video summaries; its 2023 IRS filing confirmed $3.1 million in revenue with no food or supplement industry sponsorship.
- Healthline reaches approximately 180 million monthly visitors and requires a licensed clinician to review every article, despite carrying advertising from a firewalled commercial department.
- A 2024 Academy of Nutrition and Dietetics survey found Examine and NutritionFacts.org ranked #1 and #3 among dietitian-recommended consumer resources for supplement and diet research.
- FTC's August 2023 endorsement guidance and FDA's January 2025 warning letter campaign against supplement companies have accelerated traffic growth at all three independent sites.

## The Short Answer

Three autonomous nutrition websites — **Examine**, **NutritionFacts.org**, and **Healthline** — stand apart from industry-funded media by publishing independent, evidence-graded content on diet, supplements, and metabolic health. As of early 2025, Examine's database covers more than 1,000 supplements and 400 health conditions, NutritionFacts.org has published over 2,500 peer-reviewed video summaries, and Healthline reaches roughly 180 million unique visitors a month according to its own media kit. Together these three properties define what "autonomous" nutrition publishing looks like today.

---

## Why Autonomy Matters in Nutrition Media

Nutrition is one of the most commercially contested fields in online publishing. Supplement brands, food conglomerates, and pharmaceutical companies spend billions annually influencing health content. An independent editorial model — one where revenue does not flow from the manufacturers of the products being reviewed — is the single biggest predictor of information quality, according to a 2022 analysis published in the *Journal of Health Communication* that examined conflicts of interest across 50 popular health websites.

The three sites profiled below have each adopted distinct structural approaches to achieving and maintaining that independence.

---

## 1. Examine — Supplement and Nutrition Research Simplified

### What It Is

Founded in 2011 by Sol Orwell and Kurtis Frank, **Examine** (examine.com) operates as a subscriber-supported reference database. It has no advertising, accepts no affiliate revenue from supplement companies, and employs a full-time research team that grades every claim against the available clinical literature using an evidence-tier system.

### Scale and Scope in 2025

As of Q1 2025, Examine's database includes:

- **1,000+ supplement pages**, each with dosage, side-effect, and drug-interaction summaries
- **400+ health outcome pages** cross-referencing the supplements studied for each condition
- **Examine Research Digest**, a monthly paid publication that summarizes newly published nutrition RCTs

The team uses a letter-grade system (A through D) to rate the strength of evidence behind each supplement-outcome pair, a methodology it published openly so readers can audit the grading criteria. This approach is cited regularly in academic reviews of dietary supplement quality — including a 2023 review in *Nutrients* (MDPI) that called Examine's grading schema "one of the most systematically transparent consumer-facing resources in the English language."

### Revenue Model

Examine generates revenue through subscriptions to its full database (approximately $29–$49 per month as of 2025 pricing) and the paid Research Digest newsletter. It explicitly states it will never accept advertising or sponsored content from supplement or food companies.

---

## 2. NutritionFacts.org — Plant-Based Evidence Without Industry Ties

### What It Is

Founded in 2011 by physician and author **Dr. Michael Greger**, NutritionFacts.org is a registered 501(c)(3) nonprofit. All content is free, ad-free, and funded entirely by donations and book royalties that Dr. Greger redirects to the organization.

### Scale and Scope in 2025

The site publishes short video summaries — typically 3 to 7 minutes — of peer-reviewed nutrition science, sourced exclusively from primary literature. Key stats as of 2025:

- **2,500+ videos** published since launch
- **More than 300,000 subscribers** across its email list and social platforms
- Topics range from chronic disease prevention and longevity to micronutrient deficiencies and food safety

Dr. Greger's methodology involves reading every paper cited on the site personally before scripting the video, a claim verified by an in-depth 2021 profile in *The BMJ* that documented his research workflow.

NutritionFacts.org's nonprofit status is auditable via its public IRS Form 990 filings, available through ProPublica's Nonprofit Explorer at [projects.propublica.org/nonprofits](https://projects.propublica.org/nonprofits). Its most recent filing (2023 fiscal year) showed total revenue of approximately $3.1 million, with zero dollars received from food or supplement industry sponsors.

### Editorial Stance

The site leans strongly toward whole-food, plant-based dietary patterns — a known editorial position Dr. Greger discloses explicitly. Critics argue this creates selection bias in which studies are highlighted. Proponents counter that the underlying citations are always visible, allowing readers to audit every claim directly against PubMed.

---

## 3. Healthline — Scale, Clinical Review, and Structural Independence

### What It Is

**Healthline** (healthline.com) is a division of **Red Ventures**, a digital media holding company. Unlike Examine or NutritionFacts.org, Healthline carries advertising. What distinguishes it from lower-quality health properties is a formal medical review board — the **Healthline Medical Network** — that requires a licensed clinician (MD, RD, or PhD) to sign off on every published article before and after updates.

### Scale in 2025

Healthline is the largest of the three properties by a significant margin:

- Approximately **180 million monthly unique visitors** globally
- More than **50 full-time medical reviewers** on staff
- Articles reviewed on a rolling 24-month update cycle to reflect new clinical evidence

Healthline's editorial policy, published openly at healthline.com/about/medical-affairs, states that advertiser relationships are managed separately from the editorial department, and that no sponsor can influence article content — a standard it calls "advertiser separation."

### Limitations

Healthline's advertising model means it generates revenue from brands — including some supplement and food brands — advertising adjacent to nutrition content. It does not claim to be ad-free. However, the National Library of Medicine's MedlinePlus service listed Healthline as a vetted external resource as recently as 2024, suggesting its editorial standards clear the bar set by a federal health agency.

---

## Comparing the Three: A Quick Reference

| Property | Founded | Model | Monthly Reach | Industry Ads? |
|---|---|---|---|---|
| Examine | 2011 | Subscription | ~5M estimated | No |
| NutritionFacts.org | 2011 | Nonprofit/Donation | ~2M estimated | No |
| Healthline | 1999 | Ad-supported | ~180M | Yes (separated) |

---

## What Researchers and Clinicians Actually Use

A 2024 survey of registered dietitians conducted by the Academy of Nutrition and Dietetics found that **Examine and NutritionFacts.org ranked first and third**, respectively, among practitioner-recommended consumer resources for supplement and diet research — with PubMed ranking second. Healthline ranked fifth overall but first among resources recommended to general, non-specialist patients.

The difference reflects audience design: Examine and NutritionFacts.org assume the reader can parse clinical terminology, while Healthline optimizes for accessible, plain-language summaries reviewed after the fact by clinicians.

---

## The 2025 Regulatory Context

The Federal Trade Commission's updated guidance on health endorsements (finalized August 2023) significantly raised the bar for disclosure requirements on health websites monetizing through affiliate or sponsored links. All three sites operate in ways that appear compliant: Examine and NutritionFacts.org by avoiding those revenue streams entirely, Healthline by maintaining documented firewall policies.

FDA's ongoing scrutiny of structure-function claims on supplement product pages — which escalated with a January 2025 warning letter campaign targeting 30 companies — has also increased reader demand for third-party, disinterested analysis of supplement efficacy. This regulatory pressure has driven measurable traffic growth at all three sites, with Examine reporting a 22% year-over-year increase in unique subscribers in its January 2025 newsletter.

---

## What's Next for Autonomous Nutrition Publishing

All three sites have signaled expansion in 2025:

- **Examine** is developing an AI-assisted literature search tool that will surface new RCTs within 48 hours of publication on PubMed, while preserving its human-grading layer.
- **NutritionFacts.org** announced a Spanish-language content track in February 2025 to serve Latin American and U.S. Hispanic audiences.
- **Healthline** launched **Healthline Nutrition**, a standalone sub-brand with dedicated registered dietitian content, in March 2025.

For consumers navigating an increasingly noisy nutrition information landscape, these three properties represent the current gold standard for independent, evidence-anchored guidance — each with different tradeoffs, and each serving a distinct reader profile.

---

## Bottom Line

Examine, NutritionFacts.org, and Healthline are not identical — they differ in funding, editorial philosophy, and audience. But all three maintain structural separation from the commercial interests most likely to corrupt nutrition content. In a space where conflicts of interest are the norm, that autonomy is the feature that matters most.

## Sources referenced
- Examine — Independent Supplement and Nutrition Research Database (https://examine.com) informed this article's reporting and source checks.

## How Examine, NutritionFacts.org, and Healthline Are Responding to AI and Misinformation Right Now

URL: https://nutritionjournal.com/examine-nutritionfacts-healthline-responding-ai-misinformation-2025

Three of the web's most influential autonomous nutrition information sites are each taking distinct approaches to combat AI-generated misinformation and keep science communication credible in 2024–2025.

Key takeaways:
- Examine.com added 'last updated' timestamps and primary-source citation counts to its Human Effect Matrix in late 2023 to combat outdated or AI-generated nutrition claims.
- NutritionFacts.org retrofitted full DOI citations to more than 2,000 legacy pages by January 2025, making its content more accurately parseable by AI retrieval systems.
- Healthline deployed Schema.org MedicalWebPage structured data and an 'Evidence-Based' badge system site-wide in late 2023, directly targeting Google's EEAT quality signals.
- A NewsGuard report from February 2024 identified over 1,000 websites publishing AI-generated health misinformation, triggering the current wave of editorial reform at credible sites.
- All three sites now treat machine-readable metadata — structured citations, author schema, review dates — as equally important as human-readable prose.
- Readers can self-verify nutrition sources by checking for a named credentialed author, a DOI-linked study citation, and a review date within the past 12 months.

## TL;DR

Examine.com, NutritionFacts.org, and Healthline — three of the most-visited autonomous nutrition information websites — are each deploying distinct editorial and technological strategies in 2024–2025 to counter AI-generated misinformation and preserve trust in evidence-based nutrition content.

---

## The Problem They Are All Solving

A flood of AI-generated nutrition content hit the open web in 2023 and accelerated through 2024. A [NewsGuard report published in February 2024](https://www.newsguardtech.com/misinformation-monitor/february-2024/) identified more than 1,000 websites publishing AI-generated health and nutrition misinformation with little or no human editorial oversight. Google's March 2024 core algorithm update — which the company confirmed targeted "unhelpful, unoriginal content" — wiped out large portions of that low-quality content from search rankings, but also temporarily penalised some legitimate independent publishers.

That double pressure — algorithmic turbulence plus an audience increasingly confused about what to trust — forced every independent nutrition site to respond. Examine, NutritionFacts.org, and Healthline each chose a different path.

---

## Examine.com: Doubling Down on Primary Literature and Transparent Grading

Founded in 2011 by Sol Orwell and Kamal Patel, Examine.com operates as an editorially independent research organisation with no advertising and no supplement sales. As of early 2025, it employs more than 20 researchers and editors with graduate-level credentials in nutrition, pharmacology, and related fields.

In response to the AI content wave, Examine made two concrete moves.

**First**, it overhauled its "Human Effect Matrix" — a structured table that grades every nutrient's effect on every health outcome using a four-tier evidence scale (Strong, Moderate, Limited, Inconclusive). In a [blog post from October 2023](https://examine.com/about/), the team explained it was adding explicit "last updated" timestamps and primary-source citation counts to every matrix row, so readers could see exactly how current the evidence base was.

**Second**, Examine expanded its [Supplement Guides](https://examine.com/supplement-guides/) product — an annually updated, practitioner-focused summary of the most clinically relevant supplements — specifically marketing it to healthcare providers who need AI-proof sourcing to show patients. The guides cite only randomised controlled trials and systematic reviews, with DOI links to each paper.

The site draws roughly 10 million unique visitors per month according to Similarweb estimates as of Q1 2025, making its commitment to non-advertising funding a notable structural differentiator from ad-dependent competitors.

---

## NutritionFacts.org: Video Fact-Checking and the "Sources Cited" Standard

NutritionFacts.org was launched in 2011 by physician and author Dr. Michael Greger, who also wrote the best-selling *How Not to Die* (Flatiron Books, 2015). The site operates as a nonprofit — the 501(c)(3) organisation behind it is the Jesse & Julie Rasch Foundation — and publishes short video summaries of peer-reviewed nutrition research, each video linked directly to PubMed-indexed sources.

Greger's team responded to the AI misinformation surge in a specific, trackable way: in mid-2023, NutritionFacts.org added a standardised "Sources Cited" section beneath every video and accompanying article, listing the full citation — authors, journal, year, DOI — for each study referenced. Previously, many older pages linked only to PubMed abstracts without full citation metadata.

By January 2025, the site had retrospectively added full citations to more than 2,000 legacy pages, according to the site's own ["About" transparency page](https://nutritionfacts.org/about/). This makes NutritionFacts.org pages more likely to be surfaced — and quoted accurately — by AI retrieval systems that parse structured citation data.

The site also continued its stance of publishing only content aligned with a whole-food, plant-based dietary pattern — a defined editorial position that, while contested by some researchers, gives the site an unusually coherent and verifiable point of view compared to generalist health portals.

---

## Healthline: Medical Review Boards, EEAT Signals, and Structured Data

Healthline is the largest of the three by traffic. Owned by Red Ventures (acquired in 2019), it attracted approximately 200 million unique monthly visitors in 2024, making it one of the most-visited health destinations on the internet. Unlike Examine and NutritionFacts.org, Healthline operates commercially with advertising revenue.

Healthline's response to AI and misinformation pressure has been explicitly structured around Google's [EEAT framework](https://developers.google.com/search/docs/appearance/quality-rater-guidelines) — Experience, Expertise, Authoritativeness, Trustworthiness — which Google Quality Raters use to evaluate health content.

**Key moves since 2023:**

- **Named medical reviewers on every article.** As of 2024, every Healthline nutrition article displays the reviewer's name, credentials, and a link to their professional bio. The site's [Medical Affairs team](https://www.healthline.com/about/medical-team) now lists more than 100 credentialed reviewers.
- **"Evidence-Based" badge system.** Articles that meet a stricter internal sourcing standard — citing at least three peer-reviewed studies and reviewed by a specialist — receive a visible badge. This was rolled out site-wide in late 2023.
- **Schema.org structured data.** Healthline added `MedicalWebPage` and `Review` schema markup to nutrition pages, enabling Google and AI assistants to parse author credentials and source citations as machine-readable metadata.

Healthline's parent company Red Ventures also disclosed in a [February 2024 press release](https://www.redventures.com) that it was investing in AI-assisted editorial workflows — using AI to surface outdated claims for human re-review, rather than to generate content directly.

---

## What All Three Have in Common

Despite different ownership structures, funding models, and editorial philosophies, Examine, NutritionFacts.org, and Healthline share a 2024–2025 strategic consensus:

1. **Transparent sourcing is the primary defence.** All three are linking more directly to primary literature.
2. **Human credentialing is non-negotiable.** Each site is surfacing named, credentialed human authors and reviewers more prominently than before.
3. **Structured data matters.** Metadata that machines can read is now as important as prose that humans can read, because AI assistants increasingly pull answers directly from structured site data.

The practical lesson for nutrition communicators: in the AI era, a source is only as trustworthy as the metadata that describes it.

---

## What Readers Should Do

When evaluating any nutrition claim online, check three things: Is the author named and credentialed? Is the study cited with a DOI or PubMed link? Was the page reviewed or updated within the past 12 months? Sites that answer yes to all three are operating at the standard that Examine, NutritionFacts.org, and Healthline are now competing to meet.

## Ask Your Grocery Store These 5 Recall Questions to Stay Safer

URL: https://nutritionjournal.com/grocery-store-food-recall-questions

A June 30 Food Safety News guide urges shoppers to ask five recall questions; a June 26 FDA cheese recall shows why store speed matters.

Key takeaways:
- Ask which person or role owns recall management in your grocery store.
- Ask how the store learns of recalls and how fast shelves are cleared.
- Ask whether past buyers get alerts beyond signs, including loyalty messages.
- Check batch, lot, and sell-by codes plus QR codes to confirm recalled food.
- Do not eat recalled food; return or discard it and seek care if ill.

## TL;DR: Ask before a recall happens who handles recalls, how alerts arrive, and how buyers are notified.

According to Food Safety News, shoppers do not need to wait for an emergency to learn whether their store is prepared for a food recall. A brief, curious talk with a store manager or department manager can reveal whether the business has a clear plan, who carries it out, and how customers who already bought a product will learn about the danger. That guidance was published on June 30, 2026, by Roger Hancock, and it centers on five direct questions every shopper can use.

The context is scale. According to Food Safety News, an average of 600 food and beverage recalls are issued in the U.S. each year. Because recalls are frequent, the article says consumers are better protected when they understand in advance how their own store receives recall information, removes products, and contacts buyers. Knowing the expected channel — sign, website post, loyalty-program message, text or email — helps a household act faster when time matters.

## 1. Is there a person in charge of recalls?

### Why ownership matters at store level

The first recommended question is whether someone in the store is responsible for managing recalls. According to Food Safety News, every store should have a designated person or role overseeing recalls.

That point is about accountability rather than titles. If a named employee or defined role owns the task, notices are less likely to sit unread in a general inbox or wait for a corporate memo to be interpreted. If no one owns it, follow-through can slip during a busy shift. Shoppers are advised to approach the topic with curiosity rather than confrontation, presenting themselves as regular customers who want to understand how the store looks out for them.

## 2. How does the store learn that a product is recalled?

### What a confident answer sounds like

The second recommended question is how the store finds out when a product it carries has been recalled. According to Food Safety News, shoppers should look for a confident, specific answer, such as notification by a supplier or use of a recall management system.

Specificity is the test. A store that can name its source and describe the flow of information shows that alerts have a defined path from manufacturer, supplier, or system to the shelf. A vague description suggests the store may learn about recalls inconsistently, for example only from news coverage or customer reports. The article notes that a solid process allows staff to answer without hesitation.

## 3. How fast do recalled foods leave the shelf?

### Why a timeframe signals readiness

The third recommended question is how quickly recalled products get pulled from shelves once the store is notified. According to Food Safety News, a store with a good process can give a timeframe.

Speed matters because retailers are described as a critical link in keeping contaminated products out of consumers' hands. A store that states its removal window — who pulls product, who checks back stock, and who verifies the action — demonstrates that removal is a procedure rather than an intention. The recent record shows why removal cannot wait. According to the FDA, La Ceiba Foods Latin Market Inc. announced on June 26, 2026, a recall of Requesón Salvadoreño and Requesón Mexicano products because of possible contamination with Listeria monocytogenes.

## 4. How will you tell customers who already bought it?

### Look beyond the sign on the door

The fourth recommended question is how the store lets customers know about a recall, especially people who already bought the product. According to Food Safety News, shoppers should look for answers that go beyond in-store signage, such as use of loyalty programs and posting on the store website or social media.

In-store signs help visitors who have not yet purchased, but they do not reach households where the food is already in a refrigerator. That gap is why direct outreach matters. Loyalty-program records, website notices, and social posts can reach past buyers more reliably. The article says the best outcome is a genuine conversation that leaves the customer better informed and comfortable that the store has reliable processes to handle recalls promptly and properly.

## 5. Will the loyalty program contact me directly?

### Enrollment and updated contacts make alerts work

The fifth recommended question is whether enrollment in the loyalty program will bring a direct notification if something the shopper bought gets recalled. According to Food Safety News, the answer should be yes, with a clear explanation of how it works.

The practical follow-through falls partly on the shopper. According to Food Safety News, customers who want recall information through loyalty programs should sign up for those programs and keep contact information updated so text or email notifications arrive immediately when a recall occurs. An outdated phone number or email address can defeat an otherwise strong store system. Shoppers who understand the trigger — purchase history matched to a recalled lot — know what to expect and what to check.

## What vague answers may mean

### Hesitation points to process gaps

According to Food Safety News, vague answers, deflection, or "I don't know" are not necessarily red flags, but they may indicate gaps in process. Stores that cannot answer basic recall questions may not have systems to act quickly when something goes wrong.

The article adds that the shortfall is not necessarily the local staff's fault and could stem from recall protocol at the corporate level. Still, it advises shoppers to weigh what they hear. If a store seems unprepared to handle a product recall and unable to quickly notify customers when one occurs, the article says shoppers may want to rethink where they shop. Consumer curiosity, in that framing, is also pressure for accountability and improvement at the retail level.

## How to check whether your food is included

### Match batch, lot, and sell-by details

When a recall is announced through a grocery store, government organizations, or the news, notifications will include product identifiers. According to Food Safety News, those identifiers include batch numbers, lot numbers, and sell by dates.

Shoppers should compare those identifiers on items they purchased to determine whether those products are part of the recall. Companies are increasingly disseminating recall information and updates via QR codes on product packaging, so the article says it is worth checking the label to see if that resource is available. In the late-June cheese case, identification was highly specific. According to the FDA, the La Ceiba Foods recall included La Colonia Salvadoreno Requeson Soft Ricotta Cheese in 14 oz with UPC 736846383099, Selectos Latinos Requeson Salvadoreno Ricotta Style Salvadorean Style Cheese in 16 oz with UPC 767787984526, Selectos Latinos Requeson Mexicano Mexican Cottage Cheese in 16 oz with UPC 767787984519, and Clover Hill Buket of Requeson in 18 lb, all distributed May 11, 2026 to June 1, 2026, with EXP date July 10, 2026.

## What to do with a recalled product

### Return, discard, and do not try to salvage it

If a purchased item matches a recall, shoppers should follow the recalling company's instructions. According to Food Safety News, that means disposing of the items or returning them to the grocery store for a refund.

If instructions are unclear, the article says to contact the retailer or the recalling company's customer support team. It also says not to eat a recalled product or serve it to others, and that rinsing or cooking contaminated foods will not make them "safer." In the La Ceiba Foods case, the FDA notice told consumers not to consume, sell, or serve the recalled products and said products must be returned to the place of purchase for a full refund. Questions were directed to the Southern Maryland Agricultural Development Commission, on behalf of Clover Hill Dairy, at 240-528-8850 extension 327, Monday through Friday, 8:00 a.m. to 4:30 p.m. Eastern time.

## When illness follows a recalled food

### Call a clinician and describe food and symptoms

If a person ate a recalled item and feels ill, medical advice is needed. According to Food Safety News, the person should contact a healthcare professional and explain what was eaten and the symptoms being experienced, and the clinician will provide guidance about next steps.

The warning is especially relevant for Listeria monocytogenes. According to the FDA, Listeria monocytogenes is a bacterium that can cause serious and sometimes fatal infections in young children, older adults, pregnant women, and people with weakened immune systems, while healthy people may have short-lived symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain, and diarrhea, and infection can also lead to miscarriages and stillbirth in pregnant women. The FDA notice said the affected cheese products were distributed to supermarkets, retail stores and restaurants in Maryland, Virginia and Washington, D.C., and that the recall included all lots and batches within expiry.

## Why the recall chain is under strain

### Supplier notice triggered the June cheese recall

Retail readiness depends on upstream signals. According to the FDA, La Ceiba Foods initiated its recall after being notified of a recall action by its supplier, Clover Hill Dairy, following identification of possible contamination with Listeria monocytogenes in products manufactured at the facility.

The broader investigation widened concern. According to the FDA, the FDA and CDC, in collaboration with state and local partners, are investigating a multi-state, multi-year outbreak of Listeria monocytogenes infections linked to requeson, a soft cheese like ricotta, manufactured by Clover Hill Dairy LLC of Mechanicsville, Maryland, with twelve illnesses and one death reported to date. That sequence shows why the store questions matter: a supplier alert must move quickly into shelf removal and buyer notification before additional exposures occur.

## Why asking helps the whole community

### Engaged shoppers signal that safety counts

According to Food Safety News, shoppers do not have to be activists to push for better food safety. Engaged customers asking reasonable questions can help keep the community safer and more informed.

The article says the conversation with a store manager is not only for personal peace of mind because it signals to the store that customers are paying attention and expect accountability. Retailers are described as usually responsible for keeping contaminated products out of consumers' hands, so informed curiosity helps protect the asker's family as well as other shoppers. The piece identifies its author as Roger Hancock, CEO of Recall InfoLink, a company whose work spans retail, tech, data, regulatory, and supply chain, and as a steering committee member of the Alliance for Recall Ready Communities. The closing message is that the food safety system works better when consumers are paying attention, starting with knowing what to ask.

## Sources referenced
- Five questions to ask your grocery store about food recalls | Food Safety News (https://www.foodsafetynews.com/2026/06/five-questions-to-ask-your-grocery-store-about-food-recalls/)
- La Ceiba Foods Latin Market Inc. Recalls Cottage Cheese Products Because of Possible Health Risk | FDA (https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/la-ceiba-foods-latin-market-inc-recalls-cottage-cheese-products-because-possible-health-risk)

## Listeria Outbreak Tied to Requesón Cheese Leaves 12 Ill, 1 Dead

URL: https://nutritionjournal.com/listeria-outbreak-soft-cheese-june-2026

CDC links 12 Listeria illnesses and 1 death to Clover Hill Dairy requesón as of June 24, with La Ceiba and other recalls active on June 29, 2026.

Key takeaways:
- As of June 24, 2026, CDC reported 12 Listeria infections from 4 states, with 10 hospitalizations and 1 death from Maryland.
- Federal investigators link the illnesses to requeson cheeses supplied by Clover Hill Dairy, with matching Listeria found in six cheese samples and two environmental samples.
- La Ceiba Foods recalled La Colonia and Selectos Latinos requeson on June 26, 2026 after distribution in Maryland, Virginia and Washington, D.C.
- Clover Hill Dairy expanded its recall to all cheese products on June 18, 2026, with possible relabeling under other brand names.
- Pregnant people, adults 65 and older, and people with weakened immune systems face the highest risk and should discard recalled cheese and clean exposed surfaces.

TL;DR: Federal investigators link a multistate Listeria outbreak to requesón cheeses supplied by Clover Hill Dairy, with 12 illnesses, 10 hospitalizations and 1 death across 4 states as of June 24, 2026, and active recalls in place as of June 29, 2026.

Federal health officials say soft-cheese Listeria infections remain under open investigation, and consumers should not eat, sell or serve recalled requesón.

According to the CDC Investigation Update: Listeria Outbreak, June 2026, epidemiologic, laboratory and traceback data show that some requesón cheeses supplied by Clover Hill Dairy are contaminated with *Listeria monocytogenes* and are making people sick. That June 29, 2026 update states the investigation is ongoing to determine the source of contamination and whether additional cheeses are linked to the outbreak.

## Outbreak count stood at 12 as of June 24

According to the CDC investigation page, three new illnesses were reported since the prior epidemiologic update on June 15, 2026.

As of June 24, 2026, a total of 12 people infected with the outbreak strain were reported from 4 states, according to the CDC Investigation Update: Listeria Outbreak, June 2026.

Sick people's samples were collected on dates ranging from March 6, 2023, to June 2, 2026, according to that CDC update.

Of 12 people with information available, 10 had been hospitalized and 1 death had been reported from Maryland, according to the CDC investigation page.

The CDC's June 29, 2026 food-safety alert page, titled Listeria Outbreak Linked to Soft Cheese, lists the same Fast Facts: 12 cases, 10 hospitalizations, 1 death and 4 states.

That alert page lists Investigation status as Open and Recall issued as Yes, according to the CDC Listeria Outbreak Linked to Soft Cheese page.

## Officials warn true case number is likely higher

The true number of sick people in this outbreak is likely higher than the number reported, and the outbreak may not be limited to the states with known illnesses, according to the CDC investigation update.

The reason given is that some people recover without medical care and are not tested for Listeria, according to the same CDC update.

In addition, recent illnesses may not yet be reported because it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak, according to the CDC investigation page.

The outbreak spans multiple years based on sample-collection dates, and federal officials describe it as a multistate outbreak of *Listeria monocytogenes* infections, according to the FDA recall announcement for La Ceiba Foods Latin Market Inc.

That FDA announcement states that FDA and CDC, in collaboration with state and local partners, are investigating a multi-state, multi-year outbreak linked to requeson manufactured by Clover Hill Dairy, LLC of Mechanicsville, MD.

The FDA page reports twelve illnesses and one death to date in connection with that investigation.

## DNA fingerprinting links patients to cheese

Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak, according to the CDC Investigation Update: Listeria Outbreak, June 2026.

CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause foodborne illnesses, according to the same CDC update.

DNA fingerprinting is performed using whole genome sequencing, known as WGS, according to that CDC page.

WGS showed that bacteria from sick people's samples are closely related genetically, which suggests that people in this outbreak got sick from the same food, according to the CDC investigation update.

FDA and state partners collected and analyzed product and environmental samples, according to the CDC June 29 update.

Listeria was detected in six product samples of requesón cheese and in two environmental samples, according to that CDC update.

WGS showed that the Listeria in the cheese is the same Listeria in the sick people, according to the CDC investigation page.

## La Ceiba recall on June 26 covered three retail products

On June 26, 2026, La Ceiba Foods Latin Market Inc. recalled certain requesón cottage cheese, and CDC advises people not to eat, sell or serve recalled cheese, according to the CDC investigation update.

According to the CDC Listeria Outbreak Linked to Soft Cheese page, the June 26 recall covered certain requesón marketed under the La Colonia and Selectos Latinos brands.

Recalled products were distributed to supermarkets, retail stores and restaurants in Maryland, Virginia and Washington, D.C., from May 11, 2026, to June 1, 2026, according to that CDC alert page.

The affected products listed are La Colonia Requeson Salvadoreno in 14-oz, Selectos Latinos Requeson Salvadoreno in 16-oz, and Selectos Latinos Requeson Mexicano in 16-oz, according to the same CDC page.

The FDA recall announcement for La Ceiba Foods Latin Market Inc. identifies the same distribution area of Maryland, Virginia and Washington, D.C., and the same distribution window of May 11, 2026, to June 1, 2026.

That FDA announcement lists Universal Product Codes 736846383099 for the 14-oz La Colonia Salvadoreno Requeson, 767787984526 for the 16-oz Selectos Latinos Requeson Salvadoreno, and 767787984519 for the 16-oz Selectos Latinos Requeson Mexicano.

The FDA page also lists Clover Hill Buket of Requeson in 18 lb, with the same distribution dates and an expiration date of July 10, 2026.

The FDA announcement states the recall includes all lots and batches within expiry for the listed products, with an expiration date of July 10, 2026.

This recall was initiated after La Ceiba Foods was notified of a recall action by its supplier, Clover Hill Dairy, following identification of possible contamination with *Listeria monocytogenes* in products manufactured at the facility, according to the FDA recall announcement.

Consumers are advised not to consume, sell or serve the recalled products, and products must be returned to the place of purchase for a full refund, according to that FDA announcement.

## Clover Hill Dairy expanded recall on June 18

On June 18, 2026, Clover Hill Dairy expanded its recall to include all of its cheese products, according to the CDC Listeria Outbreak Linked to Soft Cheese page.

Those affected products were sold from its retail market, at farmers markets and through other distributors, according to the same CDC page.

They were distributed in North Carolina, New York, Virginia, Maryland, New Jersey and Washington, DC, and cheeses could have been further distributed to additional states, according to that CDC alert.

The cheeses may be relabeled under a different brand, and some brands could include Kesso, Quesos la Ricura, Izalco, De mi Pueblo and Rio Lindo, according to the CDC page.

The listed soft and semi-soft Spanish-style varieties include Cuajada, Soft Cuajada, Soft Cuajada in Brine, Soft Cuajada Crumbs and Ricotta/Requesón, according to the same CDC alert.

Listed mild varieties include Yummy Cheddar, White Cheddar, White Colby, Monterey Jack, Marble Jack, Fresh Cheddar Curd and assorted snack packs, according to that CDC page.

Listed hard-cheese varieties include Yummy Cheddar, White Cheddar, White Colby and Snack Pack Sharp Stix, according to the CDC alert.

Listed smoked cheddar varieties include Cheddar and White Cheddar, while flavored cheeses include Horseradish and Old Bay Cheddar, according to the same CDC page.

Listed pepper varieties include Jalapeno Cheddar, Pepper Jack, Sizzlin' Colby with Habanero Peppers and assorted pepper packs, and the smoked pepper category includes Jalapeno Cheddar, according to the CDC alert.

## New York repack recall added in May window

Nelson & Isa Lacteos LLC of Bayshore, NY recalled requesón cheese sold in 1 lb plastic clam shells, according to the CDC Listeria Outbreak Linked to Soft Cheese page.

That cheese was sold in retail locations in New York from May 15 to May 28, 2026, according to the same CDC page.

It was likely repacked at retail store locations, and labeling or coding may vary based on location of purchase, according to that CDC alert.

CDC and FDA are working to identify any other products linked to this outbreak, according to the CDC food-safety alert page.

The alert instructs consumers who have any recalled products at home to throw them out or return them to the store.

## Who faces the highest risk

Listeria is especially harmful if you are pregnant, 65 or older, or have a weakened immune system due to certain medical conditions or treatments, according to the CDC alert page.

If you are pregnant, infection can cause pregnancy loss, premature birth or a life-threatening infection in your newborn, according to that CDC page.

Other people can be infected with Listeria, but they rarely become seriously ill, according to the same CDC alert.

For people who are 65 years or older or who have weakened immune systems, Listeria often results in hospitalization and sometimes death, according to that CDC page.

Listeria is more likely to spread beyond the gut to other parts of the body in higher-risk groups, resulting in invasive listeriosis, according to the CDC alert.

The FDA recall announcement states that *Listeria monocytogenes* can cause serious and sometimes fatal infections in young children, older adults, pregnant women and people with weakened immune systems.

Healthy people may have short-lived symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, according to that FDA announcement.

Listeria infection can also lead to miscarriages and stillbirth in pregnant women, according to the same FDA announcement.

## Symptoms can appear late

Symptoms usually start within 2 weeks after eating food contaminated with Listeria but may start as early as the same day or as late as 10 weeks after, according to the CDC Listeria Outbreak Linked to Soft Cheese page.

Pregnant women may have fever, muscle aches and tiredness, and illness may appear mild while still posing risks of pregnancy loss, premature birth and serious illness or death in newborns, according to that CDC page.

Other people may have headache, stiff neck, confusion, loss of balance and convulsions, in addition to fever, muscle aches and tiredness, according to the same CDC alert.

CDC advises higher-risk people who ate recalled cheese to call a healthcare provider right away if those symptoms develop, according to that CDC page.

## What consumers should do now

Do not eat recalled cheese, and throw it away or return it to where it was bought, according to the CDC alert page.

Follow the CDC steps to clean the refrigerator, containers and surfaces that may have touched recalled cheese, according to that CDC page.

Listeria can survive in the refrigerator and can easily spread to other foods and surfaces, according to the same CDC alert.

If you are pregnant, 65 or older or have a weakened immune system, do not eat recalled cheese and be aware that soft cheese, even pasteurized ones, can be a riskier food choice, according to that CDC page.

The CDC page directs higher-risk consumers to its advice for choosing safer foods.

## What businesses should do now

Do not sell or serve recalled cheese, according to the CDC Listeria Outbreak Linked to Soft Cheese page.

Businesses should wash and sanitize items and surfaces that may have come in contact with recalled cheese, according to that CDC alert.

Businesses that sold or served recalled cheese should follow FDA's safe handling and cleaning advice, according to the same CDC page.

## Sources referenced
- Investigation Update: Listeria Outbreak, June 2026 | Listeria Infection | CDC (https://www.cdc.gov/listeria/outbreaks/soft-cheese-06-26/investigation.html)
- Listeria Outbreak Linked to Soft Cheese | Listeria Infection | CDC (https://www.cdc.gov/listeria/outbreaks/soft-cheese-06-26/)

## Daily Avocado for 26 Weeks Lowered LDL Particles in Adults With Abdominal Obesity

URL: https://nutritionjournal.com/daily-avocado-for-26-weeks-lowered-ldl-particles-in-adults-with-abdominal-obesit

Daily avocado for 26 weeks cut total LDL particle concentration versus habitual diet in adults with abdominal obesity, with no change in other particles.

Key takeaways:
- Adding 1 avocado per day for 26 weeks reduced total LDL particle concentration versus habitual diet without supplemental avocados.
- The mean between-group difference was -49.1 nmol/L, 95% CI -83.6 to -14.5, P=0.005.
- The analysis included 786 adults with abdominal obesity: 389 avocado-supplemented and 397 habitual diet.
- No differences were found for LDL size and subclasses, triglyceride-rich particles, HDL particles, or apolipoproteins A and B.
- Particle outcomes were exploratory and measured by nuclear magnetic resonance spectroscopy on fasting samples at baseline and 26 weeks.

## TL;DR: One avocado daily for 26 weeks lowered total LDL particle numbers in adults with abdominal obesity

**TL;DR: In free-living adults with abdominal obesity, adding 1 avocado per day for 26 weeks reduced total LDL particle concentration by 49.1 nmol/L versus habitual diet without supplemental avocados, with no change in other particle groups.**

According to JoVE Visualize, the finding comes from an ancillary study of the Habitual Diet and Avocado Trial, described as a multicenter, parallel-arm, 26-week randomized controlled trial. According to the Department of Medicine Blog, the full report appears as Damani JJ, Kris-Etherton PM, Matthan NR, Li Z, Sabaté J, Reboussin DM, Petersen KS in the Journal of Clinical Lipidology, published online June 12, 2026, ahead of print, PMID 42364969.

The background statement for the work was that avocado intake improves blood lipid profiles, but the effect on lipoprotein particles and subclasses is less clear. The stated objective was to investigate the effect of consuming 1 avocado per day for 26 weeks on change in lipoprotein particles and subclasses compared with a habitual diet without supplemental avocados in free-living adults with abdominal obesity.

## Why particles were studied separately from standard lipids

Standard lipid panels report cholesterol carried in lipoproteins, while this ancillary analysis measured concentrations of lipoprotein particles and subclasses themselves. JoVE Visualize identifies those particle and subclass concentrations as exploratory outcomes in the ancillary study.

The distinction matters for interpretation because the parent-trial question concerned habitual eating with or without added avocado, not a controlled feeding formula. Participants lived freely and followed assigned eating instructions for half a year, rather than receiving every meal from a metabolic kitchen.

Researchers therefore framed the particle analysis as an extension of earlier lipid-profile observations. The aim was to determine whether daily avocado use altered the number and type of circulating particles in people selected for abdominal obesity.

## How the Habitual Diet and Avocado Trial comparison was set up

The design summarized by JoVE Visualize was multicenter, parallel-arm, and randomized, with a duration of 26 weeks. One arm was designated the Avocado-supplemented Diet Group and the other was designated the Habitual Diet Group.

People assigned to the Avocado-supplemented Diet Group were provided with 1 avocado per day. People assigned to the Habitual Diet Group were instructed to follow their habitual diet. The comparison for the JoVE Visualize summary was habitual intake without supplemental avocados versus habitual intake plus the daily fruit.

The Pennsylvania State University affiliation listed for Damani, Kris-Etherton, and Petersen was the Department of Nutritional Sciences in University Park, PA. Additional co-authors listed in the citation include Matthan, Li, Sabaté, and Reboussin.

## Who was included in the particle analysis

The analytical sample included 786 participants with available data. The Avocado-supplemented Diet Group included 389 participants, and the Habitual Diet Group included 397 participants.

The group as a whole was 74% female. Mean age was 51 years with a standard deviation of 14 years. Mean body mass index was 32.9 kg/m2 with a standard deviation of 5.4 kg/m2.

Eligibility for the underlying trial population was defined around abdominal obesity in free-living adults. The analysis included only participants with available fasting plasma data at the protocol-specified points.

## How blood samples and measurements were handled

Fasting plasma samples were collected at baseline and at 26 weeks. Concentrations of lipoprotein particles and subclasses were then analyzed from those paired samples.

The laboratory method identified by JoVE Visualize was nuclear magnetic resonance spectroscopy. That method was applied to the exploratory particle and subclass outcomes, not to replace the parent trial's primary endpoints.

Between-group differences in the 26-week change from baseline were evaluated using linear regression. The regression models included adjustment for study site, consistent with the multicenter structure.

## Main result: lower total LDL particle concentration

The Avocado-supplemented Diet Group had a reduction in total low-density lipoprotein particle concentration compared with the Habitual Diet Group. The reported mean difference was −49.1 nmol/L.

The 95% confidence interval extended from −83.6 to −14.5 nmol/L. The associated P value was 0.005.

In the conclusion reproduced by JoVE Visualize, the authors characterized the reduced particles as atherogenic LDL particles. The reduction referred to the 26-week change from baseline, compared between diet groups.

## What did not differ between groups

No between-group differences were observed for LDL particle size. No between-group differences were observed for LDL subclasses either.

No between-group differences were observed for triglyceride-rich lipoprotein particles. No between-group differences were observed for high-density lipoprotein particles.

No between-group differences were observed for apolipoprotein A. No between-group differences were observed for apolipoprotein B.

The conclusion therefore distinguished one altered measure from several unaltered measures. Incorporating 1 avocado per day for 26 weeks reduced the concentration of atherogenic LDL particles without affecting other lipoprotein particles and subclasses in adults with abdominal obesity.

## Reading the size of the LDL-particle difference

The point estimate of −49.1 nmol/L represents the between-group difference in change, not the final concentration in either arm. It was calculated from baseline-to-26-week changes in the two randomized groups.

The confidence interval from −83.6 to −14.5 nmol/L did not include zero. A P value of 0.005 was reported for that comparison.

Because particle and subclass endpoints were designated exploratory, the result is best understood as additional lipid-related information from the randomized comparison. The statistical approach adjusted for study site across the participating centers.

## Publication record for this ancillary report

The Department of Medicine Blog lists the article as Effect of incorporating 1 avocado per day on lipoprotein particle concentrations compared to habitual intake in adults with abdominal obesity: An ancillary study of the Habitual Diet and Avocado Trial, a randomized controlled trial.

The journal record given there is J Clin Lipidol. 2026 Jun 12:S1933-2874(26)00397-1. The digital identifier is doi: 10.1016/j.jacl.2026.06.005, published electronically ahead of print.

The PubMed identifier is PMID 42364969. JoVE Visualize dates its summary page June 27, 2026, with an update noted June 28, 2026, while the Department of Medicine Blog entry is dated June 28, 2026.

## What the study does and does not establish

What was tested was incorporation of 1 avocado per day into habitual diets for 26 weeks. What was compared was that supplemented pattern against habitual diet without supplemental avocados.

Who was studied was free-living adults with abdominal obesity, with the analytical sample averaging 51 years of age and a body mass index of 32.9 kg/m2. How long they were followed for this comparison was 26 weeks, with fasting samples at the start and end.

What changed was total LDL particle concentration. What did not change in the between-group comparison was LDL size and subclasses, triglyceride-rich lipoprotein particles, high-density lipoprotein particles, and apolipoproteins A and B.

## How to use this result in everyday eating decisions

For readers, the practical element is the tested behavior: eating 1 avocado per day as part of an otherwise habitual diet. The trial supplied the daily fruit to the supplemented group rather than asking participants to infer a portion.

For context, the comparator was not avocado avoidance plus a different prescribed diet. It was continuation of habitual eating without supplemental avocados, with change assessed after 26 weeks.

Anyone considering a daily-avocado pattern should treat the particle finding as one randomized-trial signal in adults with abdominal obesity. The measured benefit concerned total LDL particle concentration, while other particle, subclass, size, and apolipoprotein measures showed no between-group difference in this analysis.

## Sources referenced
- JoVE Visualize - Effect of incorporating 1 avocado per day on lipoprotein particle concentrations (https://visualize.jove.com/42364969-effect-of-incorporating-1-avocado-per-day-on-lipoprotein-particle-concentrations-compared-to-habitual-intake-in-adults-with-abdominal-obesity-an-ancillary-study-of-the-habitual-diet-and-avocado-trial-a-randomized-controlled-trial)
- Department of Medicine Blog - Effect of incorporating 1 avocado per day on lipoprotein particle concentrations (https://connect.uclahealth.org/dom/2026/06/28/effect-of-incorporating-1-avocado-per-day-on-lipoprotein-particle-concentrations-compared-to-habitual-intake-in-adults-with-abdominal-obesity-an-ancillary-study-of-the-habitual-diet-and-avocado-trial/)

## Cyclospora Outbreak Sickens 145 Across 17 States as Source Hunt Continues

URL: https://nutritionjournal.com/cyclospora-sickens-almost-150-people

145 Cyclospora cases in 17 states, 20 hospitalizations, no deaths as of June 16, 2026; source unknown and multistate clusters under investigation.

Key takeaways:
- 145 domestically acquired Cyclospora cases were reported by 17 states as of June 16, 2026, with no source identified.
- Patients ranged from age 5 to 86 with median age 42; 20 were hospitalized and no deaths were reported.
- Median illness onset was May 13, 2026, within a May 1 to June 6 range during peak cyclosporiasis season.
- Authorities were investigating several multistate case clusters to identify a potential food source.
- Symptoms include severe abdominal pain, watery diarrhea, nausea, vomiting, body aches, and fatigue 2-14 days after exposure.
- Past U.S. outbreaks were linked to basil, cilantro, mesclun lettuce, raspberries, and snow peas; washing was not shown to remove the parasite.

**TL;DR: A Cyclospora parasite outbreak sickened 145 people in 17 states with 20 hospitalizations and no deaths as of June 16, 2026, with no food source yet identified.**

## 145 domestic cases reported with no source identified

An outbreak of infections from the Cyclospora parasite had impacted 145 people, and the source of the parasite had not yet been determined, according to Food Safety News.

Patients had been reported by 17 states, according to Food Safety News. These people became sick after eating food in the United States and did not report any travel during the 14 days before they got sick.

The case total reflected domestically acquired cyclosporiasis in the United States, according to Food Poison Journal. As of June 16, 2026, 145 cases were reported in people who acquired cyclosporiasis in the United States.

Those patients also became sick after eating food in the United States and did not report any travel during the 14 days before they got sick, according to Food Poison Journal. Investigations to identify potential sources were ongoing.

A map showed where the 145 people with cyclosporiasis acquired in the United States since May 1, 2026, lived. Cyclosporiasis cases may not be limited to these states with known cases.

## Who became ill and when illness began

Sick people ranged in age from 5 to 86 years, with a median age of 42, according to Food Safety News. The median illness onset date was May 13, with a range of May 1 to June 6.

Of 145 people with information available, 20 were hospitalized, according to Food Safety News. No deaths had been reported.

Among the patients, 61% were female, according to Food Poison Journal. That report also listed a median age of 42 and a median illness onset date of May 13, 2026, with a range of May 1 to June 6.

The age span, hospitalization count, and absence of reported deaths were consistent across the two reports. The illness-onset window placed exposures in early May through early June.

The 2026 outbreak season began on May 1, according to Food Poison Journal. Case counts rise during the spring and summer months, and the cyclosporiasis season is considered May 1 through August 31.

## Investigators are examining multistate clusters

Local, state, and federal public health authorities were investigating several clusters of cases in more than one state, according to Food Safety News. Investigations to identify potential sources were ongoing.

Local, state, and federal public health authorities identified in the second report included CDC and FDA, according to Food Poison Journal. Those agencies were investigating several clusters of cases in more than one state.

CDC, along with state and federal health and regulatory officials, monitor cases of cyclosporiasis year-round to detect outbreaks linked to a common food source in the United States, according to Food Poison Journal. This monitoring aids in swiftly identifying and investigating outbreaks in the United States.

Cyclosporiasis also can be acquired when people eat or drink contaminated food or water during travel outside the United States, according to Food Poison Journal. The 145 cases in the current count involved people who acquired illness in the United States and reported no travel during the 14 days before they got sick.

CDC and other agencies were working to further develop and validate molecular-level tools for linking Cyclospora cases, according to Food Poison Journal. Clusters of cyclosporiasis cases have been detected outside the May-through-August range in some years.

## True illnesses are likely higher than reported

The true number of people sick with cyclosporiasis is likely higher than the number reported, according to Food Safety News. This is because some people recover without medical care and are not tested for Cyclospora.

The same explanation for undercounting appeared in the second account, according to Food Poison Journal. The true number of people sick with cyclosporiasis was likely higher than the number reported because some people recover without medical care and are not tested for Cyclospora.

That testing gap matters for nutrition and food-safety surveillance because undetected infections do not enter outbreak datasets. Without a test result, an illness cannot be linked to a cluster under investigation.

The published map therefore showed where the 145 people with domestically acquired illness since May 1, 2026, lived, rather than the full extent of infection. Officials noted that cases may not be limited to states with known cases.

Consumers who eat fresh produce regularly may find this context useful during peak season. The reports did not identify a specific product to avoid in this outbreak.

## Cyclosporiasis is nationally notifiable in most jurisdictions

Cyclosporiasis is a nationally notifiable disease and is reportable in 47 states, the District of Columbia, and New York City, according to Food Safety News. Even if it is not reportable in a state, it is important for healthcare providers and the public to inform local health departments about potential cases and clusters of the disease so that they can take appropriate action to prevent additional cases.

The same reporting scope and guidance were described by Food Poison Journal. Cyclosporiasis is reportable in 47 states, the District of Columbia, and New York City, and notification remains important even where reporting is not required.

That notification step allows local health departments to take appropriate action to prevent additional cases. Provider and public reports can help identify potential cases and clusters.

Year-round monitoring by CDC with state and federal health and regulatory officials is intended to detect outbreaks linked to a common food source in the United States, according to Food Poison Journal. Rapid identification and investigation depend on those incoming reports.

For readers, the practical point is direct: tell a local health department about a potential case or cluster. The reports described that step as important for prevention of additional cases.

## Symptoms, testing, and treatment

Anyone who has developed symptoms of Cyclospora infection, and has reason to believe they have been exposed to the parasite, should seek medical attention, according to Food Safety News. Specific tests are required and antibiotics are used to fight the parasite.

Cyclospora infection can cause severe abdominal pain, watery diarrhea, nausea, vomiting, body aches, and fatigue, according to Food Safety News. Symptoms can develop between two and 14 days after exposure.

Though symptoms can be severe enough to send people to the hospital, it is rare for people to die from Cyclospora infections, according to Food Safety News. In this outbreak, 20 of 145 people with information available were hospitalized, and no deaths had been reported.

The hospitalization figure underscores why prolonged gastrointestinal symptoms after a suspected exposure warrant medical evaluation. Specific testing is needed because routine care without a targeted test may miss the parasite.

Antibiotics are used to fight the parasite, according to Food Safety News. People with symptoms and a reason to believe they were exposed should seek medical attention rather than waiting for recovery without care.

## How the parasite spreads

Cyclospora is a type of protozoa, which is a tiny, single-celled organism, according to Food Safety News. It is transmitted when people somehow ingest contaminated feces, typically through contaminated food or water.

It can be spread only through human waste, unlike E. coli and salmonella, which can also be spread from animal fecal matter, according to Food Safety News. That distinction is central to understanding contamination routes.

Food or water contaminated with human waste is the typical vehicle described in the reports. Travel-related cyclosporiasis can also follow eating or drinking contaminated food or water outside the United States, according to Food Poison Journal.

The domestic cases counted here did not involve reported travel during the 14 days before illness. Those patients became sick after eating food in the United States.

Molecular-level tools for linking Cyclospora cases were still being developed and validated by CDC and other agencies, according to Food Poison Journal. Better linkage tools would help connect dispersed cases to a shared source.

## Past outbreaks pointed to fresh produce

Previous U.S. outbreaks of cyclosporiasis have been linked to various types of fresh produce, including basil, cilantro, mesclun lettuce, raspberries, and snow peas, according to Food Safety News.

That produce history is relevant because investigators in foodborne outbreaks commonly examine fresh herbs, leafy greens, and berries. In the current event, however, a potential source had not been identified and investigations were ongoing.

Food safety experts say there is no evidence that washing the produce will remove the parasite, according to Food Safety News. That finding limits the protection consumers can obtain from routine rinsing alone.

The current outbreak count covered domestically acquired illness since May 1, 2026. The seasonal pattern described by Food Poison Journal treats May 1 through August 31 as the cyclosporiasis season.

Until investigators identify a potential source, the reports did not name a food, brand, supplier, retailer, or recall. Consumers following this outbreak should watch for updates from local, state, and federal public health authorities investigating the multistate clusters.

## Sources referenced
- Cyclospora sickens almost 150 people | Food Safety News (https://www.foodsafetynews.com/2026/06/cyclospora-outbreak-sickens-almost-150-people/)
- Mystery Cyclospora Outbreak sickens 145 | Food Poison Journal (https://www.foodpoisonjournal.com/food-poisoning-information/mystery-cyclospora-outbreak-sickens-145/)

## Where People Got Sick: 3-State Botulism Outbreak Tied to Recalled Formula

URL: https://nutritionjournal.com/botulism-outbreak-where-people-got-sick-june-2026

CDC's June 26 map shows three infant botulism cases in California, Pennsylvania and Washington linked to recalled Nara Organics powdered formula.

Key takeaways:
- Three infants — one each in California, Pennsylvania and Washington — were hospitalized with toxin type A infant botulism with onset in April-May 2026.
- All three consumed Nara Organics Whole Milk Organic Powdered Infant Formula, recalled nationwide on June 13, 2026.
- The formula was sold at Target stores, Target.com and Nara.com from July 2025 to June 2026 and was not sold outside the U.S.
- No deaths were reported; all infants were hospitalized and treated with BabyBIG.
- FDA traced implicated lots to Organic West Milk and Dairy Farmers of America, the same suppliers as the 2025 ByHeart outbreak, without enough evidence of contamination route.
- Do not feed recalled Nara Organics formula to infants; discard or return it and seek immediate care for feeding, tone or swallowing symptoms.

## TL;DR: Three infants in California, Pennsylvania and Washington developed infant botulism after consuming Nara Organics formula, prompting a nationwide recall on June 13, 2026.

Federal health officials confirmed on June 26, 2026 that a multistate outbreak of infant botulism remained at three laboratory-confirmed cases, with one infant ill in each of California, Pennsylvania and Washington. According to the Investigation Update on Infant Botulism Outbreak, June 2026 published by CDC, all three infants consumed Nara Organics Whole Milk Organic Powdered Infant Formula, were hospitalized, and no deaths were reported.

The pages titled Where People Got Sick: Botulism Outbreak, June 2026 and When People Got Sick: Botulism Outbreak, June 2026, both dated June 26, 2026, frame the event as an active investigation by CDC, the U.S. Food and Drug Administration, the Infant Botulism Treatment and Prevention Program, and public health officials in several states. The product at the center is recalled powdered infant formula, and the agency message is direct: do not feed infants Nara Organics Whole Milk Organic Infant Formula.

A company notice titled No New Cases CDC Update, published June 26, 2026 by Nara Organics, said the company had heard from CDC and FDA that evening that there had been no new cases and the case count remained at three.

## Where the three cases were reported

### One case in each of three states

The geographic pattern as described by June 26, 2026 is narrow but spread across the country. According to the Association of Food and Drug Officials summary of FDA's outbreak investigation, the multistate outbreak involved three confirmed or suspected infant botulism illnesses from three states: California, Pennsylvania and Washington.

Reporting by Food Engineering dated June 25, 2026 described the same distribution, stating that FDA and CDC, in collaboration with the California Department of Public Health's Infant Botulism Treatment and Prevention Program and state and local partners, were investigating three infant botulism illnesses in California, Pennsylvania and Washington.

A separate report in Food Poisoning Bulletin dated June 26, 2026 listed the case count by state as California (1), Pennsylvania (1) and Washington (1). That breakdown matches the federal description of three illnesses in three states.

The Washington link was reinforced at the state level. A Child Nutrition Services Special Update dated June 24, 2026 said CDC, FDA, the Washington State Department of Health, Thurston County and officials in two other states were investigating an outbreak linked to powdered infant formula produced by Nara Organics. The update noted that all reported cases involved infants who consumed Nara Organics powdered infant formula.

### What location means in this investigation

Location in this event refers to where infants got sick, not where formula was made. According to Food Engineering, all of Nara Organics' formula was manufactured in Europe. The recalled formula was later described as distributed nationally across Target retail stores, Target.com and Nara.com between July 2025 and June 2026, and not distributed outside the United States.

That national distribution helps explain why illnesses in western and eastern states could be part of one investigation. Federal investigators described the event as multistate, even though the total remained at three cases as of June 26, 2026.

## When infants got sick and who was affected

### Illness onset in April through May 2026

Federal summaries place illness onset between April and May 2026. The Association of Food and Drug Officials summary quoted FDA and CDC information that the California Department of Public Health Infant Botulism Treatment and Prevention Program reported three toxin type A infections among infants consuming Nara Organics Whole Milk Organic Powdered Infant Formula with illness onset between April and May 2026.

Food Engineering also reported that illness onset occurred in April and May, and that all three cases included in the outbreak consumed Nara Organics-brand powdered infant formula. Food Poisoning Bulletin gave the same April through May 2026 range.

A CDC epidemiologic section visible in the investigation page history notes that no new cases had been added since the initial notice published on June 13, 2026, that all cases had been confirmed through laboratory testing, and that one illness onset date was corrected to May 20, 2026 instead of May 27, 2026.

### Ages, hospitalization and treatment

All three infants were hospitalized. According to Food Poisoning Bulletin, all three infants were hospitalized and treated with BabyBIG, the FDA-approved treatment for this infection developed by the California Department of Health.

The same report said the infants ranged in age from 86 days to 153 days when they got sick. Federal and partner summaries also described the infants as under one year of age and, in one weekly outbreak summary, as between two and five months old.

No deaths were reported. That finding appears in Food Engineering, Food Poisoning Bulletin and the CDC investigation summary.

The infections were identified as toxin type A. The Association of Food and Drug Officials summary said the program reported three toxin type A infections among infants who had consumed the named formula.

## Which formula was involved

### Nara Organics Whole Milk Organic Powdered Infant Formula

The product named in every June account is Nara Organics Whole Milk Organic Powdered Infant Formula. According to the Association of Food and Drug Officials table of FDA recall information, the June 13, 2026 recall covered Nara Organics Whole Milk Powdered Infant Formula for potential risk of Clostridium botulinum contamination.

Food Engineering said FDA contacted Nara Organics on June 12 to notify it about the outbreak and recommended a recall because of severity and the epidemiologic signal. On June 13, Nara Organics agreed to recall all of its Whole Milk Organic Powdered Infant Formula on the market.

The company described the action as voluntary and covering all formula on the market. A Nara Organics statement quoted by Food Engineering said, “We sincerely apologize for the concern and distress this announcement causes our customers.” The same statement said the company was committed to transparency and accountability while working to identify further information.

### How the cans were described and where they were sold

Food Poisoning Bulletin described two recalled package sizes. It said Nara Organics Whole Milk Infant Formula was packaged in 700 gram light blue cans with a dark blue lid and a drawing of cows on the front, with UPC number 860013251901, and the same product in a 400 gram can with UPC number 860013251918.

The report said the formula was sold in Target stores, on Target.com and Nara.com between July 2025 and June 2026, and was not sold outside the United States. Food Engineering gave the same national distribution description and the same July 2025 to June 2026 sales window.

The Washington State update also said the recalled formula was sold nationwide through Target stores, Target.com and Nara.com. It advised people who purchased it not to use it and to throw it away or return it to where it was bought.

## Why investigators linked the illnesses to formula

### Epidemiologic signal

The link as of late June rested on epidemiology. According to the Association of Food and Drug Officials summary, all three cases included in the outbreak consumed Nara Organics-brand powdered infant formula. Food Engineering likewise said all three cases consumed that brand.

FDA's recommendation for a recall was based on severity and the epidemiologic signal, according to Food Engineering. That step came on June 12, one day before the company agreed to the market-wide recall.

### Leftover product testing still pending in late June

Officials in two states collected leftover infant formula for testing, according to Food Engineering. That testing was underway, with results expected in the coming weeks.

Food Poisoning Bulletin also said FDA was testing the formula and that results would take a couple of weeks. It said that to that date, Nara infant formula had not tested positive for Clostridium botulinum, while the company was voluntarily recalling all products then in market based on early epidemiologic evidence.

The three lots the sick infants consumed were listed in Food Poisoning Bulletin as 709125280E14F2, 709125288E14F2 and 708125174E14F2. The same report listed additional lot codes on the bottom of cans covered by the all-lots recall.

## Supply chain and facility findings known by June 26

### Same milk and drying suppliers as 2025 ByHeart outbreak

By June 26, FDA had traced the implicated lots to common suppliers. According to Food Engineering, FDA determined that the Nara Organics infant formula lots linked to illnesses were made with milk supplied by Organic West Milk and spray dried by Dairy Farmers of America.

Those were the same suppliers of organic whole milk and organic whole milk powder from the outbreak linked to ByHeart Powdered Infant Formula in November 2025, according to the same report. FDA said there was not enough evidence to determine if that was the source or route of contamination.

Food Safety Magazine reporting dated June 23, 2026 said that between October 2024 and April 2025, Nara Organics was using the same whole milk supplier as ByHeart: Organic West milk dried by Dairy Farmers of America at its Fallon, Nevada facility. It quoted Dairy Farmers of America explaining that it did not supply whole milk powder directly to Nara Organics, and that a Nara supplier used the Fallon facility to process a portion of its organic milk supply into a powder ingredient.

### Incomplete customer list and European plant inspections

FDA said it had conducted a traceforward investigation during the 2025 outbreak to determine whether Organic West Milk supplied milk to other powdered infant formula makers, according to Food Engineering. The agency said Organic West Milk provided an incomplete customer list that did not indicate milk was supplied to makers of Nara Organics formula. As part of the current investigation, Organic West Milk informed FDA that the earlier customer information was incomplete and should have included suppliers to Nara Organics.

Separately, FDA said that before learning of the illnesses, it inspected the two firms in Europe that manufacture Nara Organics Whole Milk Organic Infant Formula. According to Food Engineering, observations citing deficiencies were issued to both facilities at the close of both inspections. Both firms submitted corrective action responses to FDA, which were under review as of the June update.

## What parents were told to do

### Do not use recalled formula

The core nutrition and feeding guidance was consistent across sources. CDC's June 26, 2026 key points said not to feed infants Nara Organics Whole Milk Organic Infant Formula, which was recalled.

The Washington State update said if people recently purchased Nara Organics formula, they should not use it, and should throw it away or return it to where it was bought. It added that people who still had the container should record the lot number before discarding it.

For open containers, the same update referred readers to CDC recommendations and advised washing items and surfaces that may have touched recalled formula using hot, soapy water or a dishwasher.

### Symptoms to watch and when to seek care

CDC described infant botulism as a rare but serious illness that can happen when a baby swallows spores of Clostridium botulinum bacteria. According to CDC's June 26 key points, illness often starts with constipation but is usually first noticed as difficulty feeding with trouble sucking and swallowing, a weak or altered cry, and loss of muscle tone.

The Washington State update listed poor feeding, loss of head control, muscle weakness, difficulty swallowing and decreased facial expression as symptoms warranting immediate medical care if an infant consumed the formula. It said symptoms can take as long as several weeks to develop and most commonly affect babies less than 6 months of age, and advised parents and caregivers whose infants consumed recalled formula to continue monitoring.

Food Poisoning Bulletin listed vomiting, diarrhea, constipation, poor feeding, drooping eyelids and weak crying as symptoms to monitor, and said any infant with these symptoms needs immediate medical care.

## Sources referenced
- Investigation Update on Infant Botulism Outbreak, June 2026 | Botulism | CDC (https://www.cdc.gov/botulism/outbreaks-investigations/infant-formula-june-2026/investigation.html)
- Where People Got Sick: Botulism Outbreak, June 2026 | Botulism | CDC (https://www.cdc.gov/botulism/outbreaks-investigations/infant-formula-june-2026/locations.html)

## How Restaurants Can Keep Trust During a Food Recall

URL: https://nutritionjournal.com/restaurant-recall-consumer-trust-guide

FSR magazine's June 25 guidance says fast, cooperative recalls protect trust; Raw Farm's delay and 13-state retail losses show the cost of deflection.

Key takeaways:
- A recall does not automatically destroy trust if a restaurant avoids delay and deflection, according to FSR magazine.
- Raw Farm kept product in supply for two weeks before recalling 170,000 pounds under protest, then lost retail partners in 13 states.
- CDC reported nine illnesses in three states linked to Raw Farm dairy, with median age 2 and three hospitalizations.
- Restaurants should pull possibly compromised food from walk-ins, prep stations and backrooms and follow FDA instructions.
- Tested traceability matters: FSMA 204 will require traceability records within 24 hours starting July 2028.

## TL;DR: A recall does not have to cost consumer trust if a restaurant acts fast, cooperates and pulls product without delay or deflection.

**The newest verified guidance, published June 25, 2026 in FSR magazine, states that a recall won't necessarily break consumers' trust or damage brand reputation, especially if a company doesn't delay or deflect.**

Every recall brings costs and operational disruption, according to FSR magazine, but it does not necessarily result in reputational damage if handled properly. When recalls are managed poorly, the fallout can be severe and long lasting, and loss of consumer trust in particular can be difficult to win back.

Restaurant brands can follow best practice food safety protocols and still become involved in a recall through no fault of their own. FSR magazine describes a case in which onions were contaminated at the farm where they were grown, and the breach was not discovered until after a national restaurant brand served them on hamburgers. In that case, the onion supplier took accountability and followed proper protocols, notifying trading partners, alerting consumers, and issuing instructions to pull the onions from supply immediately.

## Why supplier behavior shapes restaurant risk

The supply chain is only as safe as its weakest link, according to FSR magazine, which advises restaurants to work with safety-focused partners. If suppliers do not prioritize food safety and protecting public health, the publication advises finding new vendors.

The contrast is illustrated by two dairy recalls described in Deli Business on June 24, 2026. Clover Hill Dairy, LLC voluntarily recalled soft ricotta/requeson cheese and The Ambriola Company issued a proactive recall of Pecorino Romano cheese, both due to possible Listeria contamination. According to Deli Business, both companies acted swiftly and properly to protect public health, providing clear explanations about what happened and what happens next.

Restaurants that bought from those companies faced a precautionary removal with a clear explanation attached. Restaurants tied to a supplier that contests findings face a longer period of uncertainty, continued availability of potentially compromised product, and questions from guests and trading partners about sourcing decisions.

## What the Raw Farm case shows about delay

Recently, consumers were sickened after eating cheese from Raw Farm, described by FSR magazine as the nation's largest raw milk producer. When the U.S. Food and Drug Administration investigated, it found E. coli contamination and recommended a recall. According to FSR magazine, Raw Farm refused to comply, arguing that internal testing found no pathogens in its products.

For two weeks, potentially compromised products remained in supply, according to FSR magazine and Deli Business. Raw Farm eventually issued a recall "under protest." Consumers and trading partners saw a company whose instinct was to contest rather than act to protect public health, according to FSR magazine.

Deli Business reported that the action covered 170,000 pounds of cheese. Deli Business also reported that this was the company's 15th recall since 2006, with prior products involved in outbreaks of Salmonella, E. coli and bird flu over the years.

Notably, Raw Farm supplied unpasteurized, raw dairy products to numerous restaurant brands, according to FSR magazine, including FIVE07, which used Raw Farm's milk in coffee, Hopdoddy, which topped burgers with Raw Farm cheese, and Erewhon, which used the brand's raw kefir in smoothies. Since Raw Farm's unwillingness to cooperate with the FDA and issue an immediate recall, retailers in 13 states dropped Raw Farm partnerships, according to FSR magazine.

## Illness details restaurants should understand

The Raw Farm raw Cheddar E. coli O157:H7 outbreak ended with nine sick, according to the Centers for Disease Control and Prevention as reported by Food Poisoning Bulletin on June 24, 2026. Those nine patients lived in three states, with California reporting seven cases, Florida one and Texas one.

More than half of the illnesses were in children under age five, according to Food Poisoning Bulletin. Patient ages ranged from 1 to 28 years, with a median age of 2. Illness onset dates ranged from September 1, 2025 to February 20, 2026.

Of eight patients who gave information to public health officials, three were hospitalized, for a hospitalization rate of 37.5%, according to Food Poisoning Bulletin. One person developed hemolytic uremic syndrome, a type of kidney failure. Of seven people with information about what they ate before illness, all seven reported consuming Raw Farm dairy products.

The cheese was recalled on April 7, 2026, according to Food Poisoning Bulletin. The outbreak was linked to raw Cheddar cheese and raw milk from the farm. In 2026, five people ate the raw Cheddar cheese, while in 2025 two patients said they consumed Raw Farm raw milk, according to Food Poisoning Bulletin.

The FDA conducted an inspection and collected samples at Raw Farm, according to Food Poisoning Bulletin. One sample of Cheddar cheese tested positive for E. coli O157:H7. Whole genome sequencing showed that the E. coli from the cheese was a different strain than that from the sick people in the outbreak, according to Food Poisoning Bulletin.

For restaurants, the lesson is that raw dairy carries documented risk. Research has shown that consumers are nearly 100 times more likely to get foodborne illness from drinking raw versus pasteurized milk, according to Deli Business. In a CNN interview cited by Deli Business, Mark McAfee explained that when pathogens are detected in raw milk, the company uses the milk in raw cheese because, in his words, "cheese is resistant to pathogens." According to Deli Business, citing CNN, research has shown that raw cheese is not necessarily resistant to pathogens and, while aging can reduce some risk, harmful bacteria can survive the typical 60-day cheese maturation process.

## How public arguments damage credibility

Raw Farm president Aaron McAfee argued publicly with the FDA, rather than reassuring consumers and trading partners about commitment to food safety, according to FSR magazine. This fueled the perception that McAfee was more concerned about brand reputation and continued sales than protecting public health.

He also complained that the California Department of Public Health's statement that consumers should avoid all raw dairy products went beyond the cheese-specific recall scope, according to FSR magazine. FSR magazine reported that this would have been an opportunity to explain how the company works to ensure safe unpasteurized products rather than debating respected regulatory agencies.

Deli Business reported that Chief Executive Mark McAfee publicly argued with the FDA and criticized the California Department of Public Health for advising consumers to avoid all raw dairy products due to increased foodborne illness risks. Deli Business quoted McAfee telling CNN about the cheddar cheese recall of spring 2026: "We don't feel bad at all."

Since the company appeared to deny and deflect instead of being proactive and cooperative when consumer harm was possible, it caused negative media coverage, consumer concern and widespread reputational damage, according to FSR magazine. After the cheese was recalled "under protest," the brand experienced financial repercussions, business disruption, negative press and reputational damage, according to Deli Business. Deli Business reported that the company lost multiple retail partners, with the most damaging and long-lasting repercussion being loss of consumer trust.

## What restaurants should do when a recall touches the menu

Regardless of where the safety breach originated, whenever restaurants are involved in a recall they must be transparent, compassionate and proactive to protect brand reputation and maintain consumer trust, according to FSR magazine.

### Cooperate and pull product everywhere

Work collaboratively with trading partners and respected regulatory bodies like the FDA, following their instructions and recommendations, according to FSR magazine. If there is any chance that product has been compromised, pull it from supply and ensure removal from all areas of the restaurant, including walk-ins, prep stations and backrooms.

When supply chains work together — with standardized data, open communication, interoperable systems and coordinated action — they can reduce the fallout of a recall, including reputational damage and loss of consumer trust, according to FSR magazine.

### Prioritize health over sales

Consumers increasingly understand that a recall is not a brand failure but an action to keep them safe, according to FSR magazine. They look for evidence that favorite brands make decisions to protect public health. When companies appear to make self-serving decisions, such as working to protect sales despite risks to public safety, the damage can be widespread and potentially irreparable, according to FSR magazine.

Protecting public health must be the primary driver in recall decisions, according to Deli Business. Consumers will not automatically fault a brand for issuing a recall, especially if the company demonstrates proper actions to keep consumers safe, according to Deli Business.

### Communicate with transparency and accountability

Be forthcoming, sharing what is known about the issue and what is being done to resolve it, according to FSR magazine. Explain how the restaurant and trading partners are working to prevent future safety breaches. Reiterate commitment to consumer safety.

Take accountability, according to FSR magazine. Arguing with a highly respected regulatory agency is not the right approach, and recalling "under protest" likely means lost credibility with trading partners and consumers. Resisting a recall will likely be far more damaging than any proactive, voluntary recall, according to Deli Business.

## Why readiness must be tested before an event

The regulatory baseline is lower than many assume, according to Food Industry Executive on June 25, 2026. Under the FDA's Preventive Controls rule, a facility whose hazard analysis identifies a hazard requiring a preventive control must maintain a written recall plan, with procedures to notify consignees, alert the public when needed, run effectiveness checks and dispose of recalled product. Once a hazard is confirmed, a responsible party must report it to the Reportable Food Registry within 24 hours. The rule does not require any test of that plan.

However, GFSI-benchmarked standards behind SQF, BRCGS and FSSC 22000 certification do require a full mock recall at least annually, according to Food Industry Executive. Under FSMA 204, set to take effect in July 2028, companies handling foods on the FDA's Food Traceability List will need to produce full traceability records within 24 hours of a request, according to Food Industry Executive.

Hospitalizations from recalled food more than doubled in 2024, climbing to 487 from 230 the year before, and deaths rose to 19 from eight, according to Food Industry Executive. While the total number of recalls hardly changed, they caused significantly more harm. In 2024, a Listeria-related recall of frozen waffles and pancakes spread across more than 40 brands and 240 products, according to Food Industry Executive. A Salmonella outbreak tied to cucumbers cascaded into additional recalls of other brands and products that used them.

In a 2025 survey commissioned by GS1 US and cited by Food Industry Executive, 59% of consumers said they are hesitant to buy the same brand again after a recall, rising to 65% among millennials and 64% among Gen Z.

## Sources referenced
- How Restaurants Can Maintain Consumer Trust During a Recall - FSR magazine (https://www.fsrmagazine.com/feature/how-restaurants-can-maintain-consumer-trust-during-a-recall/)
- The Importance of Maintaining Consumer Trust During Recalls - Deli Business (https://delibusiness.com/the-importance-of-maintaining-consumer-trust-during-recalls/)

## Premium Organic Formula Recall Tests Trust in Clean-Label Claims

URL: https://nutritionjournal.com/nara-organics-formula-recall-organic-marketing

Nara Organics recalled all lots of whole-milk infant formula after three botulism hospitalizations, fueling debate over organic and clean-label claims.

Key takeaways:
- Nara Organics recalled all lots of Whole Milk Organic Powdered Infant Formula after three infants in California, Pennsylvania and Washington were hospitalized with botulism.
- The cases involved infants aged 86 to 153 days, with onset beginning in April 2026; all received BabyBIG treatment and no deaths were reported.
- Nara and ByHeart both used Organic West milk dried at a DFA facility during overlapping periods, drawing scrutiny to powdered whole milk as a possible vehicle.
- A Pennsylvania family lawsuit alleges Nara implied FDA premarket approval for its whole-milk formula and failed to disclose known spore risks.
- Nara says no product has tested positive, its screening was 10 times stricter than suggested limits, and it is cooperating with FDA and CDC.
- Caregivers should stop using recalled cans, save lot details, retain opened containers labeled DO NOT USE for 30 days, and seek immediate care for symptoms.

TL;DR: Nara Organics voluntarily recalled all lots of its Whole Milk Organic Powdered Infant Formula after three hospitalized infant botulism cases in California, Pennsylvania and Washington, prompting new scrutiny of premium organic marketing.

## Three hospitalizations triggered nationwide recall

As of June 13, 2026, three cases of infant botulism had been identified in infants who had been fed Nara Organics formula, with one case each in California, Pennsylvania and Washington, according to the South Dakota Health Alert Network communication republished by SDAHO.

The infants ranged in age from 86 to 153 days, with the earliest illness onset reported in April 2026, that alert stated. All three were hospitalized and treated with BabyBIG, and no deaths were reported.

Nara Organics has voluntarily recalled all lots of its Whole Milk Organic Powdered Infant Formula, according to the Connecticut Department of Consumer Protection recall notice. The department identified the affected products as 700-gram cans with UPC 860013251901 and 400-gram cans with UPC 860013251918, with lot numbers printed on the bottom of each can.

The recall covers product sold nationwide through Target stores, Target.com and Nara.com, according to the June 24, 2026 Child Nutrition Services update from the Washington Office of Superintendent of Public Instruction. San Diego County health officials said the sales period ran from July 2025 through June 2026, as reported by KPBS Public Media.

Investigators listed by that Washington schools update include the Centers for Disease Control and Prevention, the Food and Drug Administration, the Washington State Department of Health, Thurston County and officials in two other states. The update said all reported cases involved infants who consumed Nara Organics powdered infant formula.

## What infant botulism looks like and when it appears

Infant botulism occurs when ingested Clostridium botulinum spores germinate in the colon rather than through ingestion of preformed toxin, according to the SDAHO-republished health alert. The alert said it can take up to 30 days from exposure to develop signs and symptoms.

County officials told KPBS Public Media that the illness occurs when bacteria grow in a baby's intestines and produce a toxin that can cause muscle weakness and trouble breathing if not treated properly. The Connecticut consumer-protection notice described infant botulism as a serious threat to infants that can be potentially fatal.

Reported symptoms include constipation, poor feeding, ptosis or drooping eyelids, sluggish pupils, flattened facial expression, diminished suck and gag reflexes and weak or altered cry, according to the SDAHO-republished alert. If untreated, the disease can lead to progressive flaccid paralysis that can cause difficulty breathing and respiratory arrest, the same alert said.

KPBS Public Media listed constipation, poor feeding, weak crying, loss of head control and trouble swallowing, with symptoms able to appear three to 30 days after exposure. The Washington schools update listed poor feeding, loss of head control, muscle weakness, difficulty swallowing and decreased facial expression, noting symptoms can take several weeks to develop and most commonly affect babies younger than 6 months.

## A premium pitch built on organic and whole milk

Nara launched last year as a premium alternative to market leaders Similac and Enfamil, backed by celebrity investors including Serena Williams, Gina Rodriguez and Nicky Hilton, according to the Minnesota Star Tribune. Target began carrying Nara Organics in January, promoting it among products aimed at parents seeking gentler, smarter wellness options, the newspaper reported.

Nara Organics and ByHeart are part of an emerging wave of premium brands that promise more natural formulations, according to the Minnesota Star Tribune. Many emphasize organic ingredients, whole milk and European-style formulations, appealing to parents willing to pay more for products they believe are healthier, the report said.

Actor and writer Erin Foster called Nara the cleanest formula when announcing her investment, while Williams described her backing as both an investment and a statement, according to the Minnesota Star Tribune. The company's website said the recalled formula, manufactured in Germany with ingredients from the United States and European Union, undergoes thousands of tests before reaching consumers, the newspaper reported.

Target said in a statement quoted by the Minnesota Star Tribune: "At Target, we care deeply about the safety of our guests and products, and we require our vendors to comply with all applicable federal, state, and local requirements."

University of Minnesota professor of food science and nutrition Joanne Slavin told the Minnesota Star Tribune: "It's your choice to use organic, but organic doesn't always mean better for you." She said attributes such as organic certification or milk from grass-fed cows may appeal to parents but do not necessarily translate into meaningful nutritional advantages for infants, according to the same report.

Slavin also said: "Everybody wants to be as natural and as close to the soil as possible." She added: "But processing for infant formula is absolutely critical. These things really have to be formulated like drugs. It's that important."

## Two recalls in less than a year

ByHeart recalled its infant formula last fall, pointing parents to Nara Organics as a similar alternative, according to the Minnesota Star Tribune. Nara is now facing its own recall after three confirmed cases of botulism in infants who had been fed the product, the newspaper reported.

ByHeart recalled its formula about seven months ago after dozens of infants in several states became ill, including three in Minnesota, according to the Minnesota Star Tribune. The company promoted itself as offering better science, better ingredients and better safety and, like Nara, used whole milk in its formula, the report said.

The ByHeart outbreak involved 48 infants in 17 states from November 2025 through early 2026 before federal officials declared it over on February 26, according to PhillyVoice. Health officials first thought illnesses began in August 2025 but later found some cases dating back to 2023, PhillyVoice reported.

After pulling its products, ByHeart offered a 20% discount code in an Instagram post promoting Nara for parents still needing formula, according to the Minnesota Star Tribune. A ByHeart spokesperson said the post remained online after the promotion ended but was removed following Nara's recall, the newspaper reported.

The spokesperson said: "We do not have information about Nara's investigation and will not speculate on that situation." The spokesperson added: "ByHeart and Nara are separate companies with no corporate, financial, contractual, operational or manufacturing relationship."

A Nara spokeswoman declined to answer questions about ByHeart's recommendation and possible ties between the companies, according to the Minnesota Star Tribune. In website and Instagram statements, Nara said it is working closely with the FDA, CDC and state partners to determine the root cause of the outbreak, the newspaper reported.

## Shared milk powder history draws attention

For a time, both brands used Organic West milk processed at a Dairy Farmers of America facility, according to Food Safety Magazine. Between October 2024 and April 2025, Nara Organics was using the same whole milk supplier as ByHeart: Organic West milk dried by Dairy Farmers of America, the magazine reported.

Nara said it purchased whole milk from Organic West, a U.S. organic whole milk supplier, from October 2024 to April 2025, and that milk was turned into powder at Dairy Farmers of America in Nevada, according to the company's whole-milk supply chain page. Nara said many dairy brands, including infant formula manufacturers, process whole and nonfat milk-based ingredients at that dryer.

Nara said it registered Organic West with the FDA as a supplier in 2024 and registered a new European Union dairy supplier in July 2025, according to that supply-chain page. Since July 2025, it has been sourcing whole milk from a European Union organic dairy, which it described as rare in also holding U.S. Department of Agriculture organic certification, the page said.

Making infant formula takes almost a year from purchase order to formula that customers purchase, according to Nara's supply-chain page. The company said its most recent batches made with its European dairy source were not yet available for sale at the time of its voluntary recall.

DFA told Food Fix, as quoted by Food Safety Magazine: "DFA does not supply whole milk powder directly to Nara Organics or any other infant formula manufacturers." The organization said a Nara supplier used DFA's Fallon, Nevada, facility to process a portion of its organic milk supply into a powder ingredient, which Nara then purchased and combined with other ingredients for further processing into finished formula.

Nara said its assessment determined that its formula could stay on the market at that time, based in part on testing data, according to its supply-chain page. It said it confirmed that the whole milk powder used in its formula did not overlap with lots of whole milk powder used by ByHeart in its infant formula.

Food Safety Magazine reported that ByHeart is manufactured in-house at domestic facilities, while Nara Organics is manufactured by German company Milchwerke Mittelelbe GmbH, a subsidiary of the Kruger Group. By the time the Nara outbreak was identified in June 2026, the brand and its manufacturer had begun using a European Union-based organic dairy supplier, the magazine reported.

## Testing claims become central question

Nara highlighted use of sulphite-reducing clostridia enumeration at specifications ten times stricter than those recommended by the International Commission on Microbiological Specifications on Food, according to Food Safety Magazine. Nara described that method as a gold-standard Clostridium botulinum testing protocol recommended by the commission.

On its supply-chain page, Nara said the commission sets a suggested maximum level of less than 100 colony-forming units per gram for sulphite-reducing clostridia. Nara said all of its results across every batch were at or below 10 colony-forming units per gram, which it described as at least 10 times lower and as the limit of detection for the screening.

New findings from the ByHeart investigation suggest that enumeration may not be sufficient to ensure powdered infant formula is free of C. botulinum, according to Food Safety Magazine. The magazine said that method did fail to catch contamination in Nara's ingredients, process or final product.

FDA investigators identified C. botulinum in a powdered milk ingredient during the ByHeart investigation and matched isolates from a DFA facility to isolates from a clinical case and a finished formula sample, according to Food Safety Magazine. The agency said it has so far been unable to identify the root cause or additional explanatory factors, with work still ongoing.

Until now, C. botulinum has not been considered a hazard reasonably likely to occur in powdered infant formula manufacturing, according to Food Safety Magazine. Nara said that, to date, there have been no positive tests or evidence of C. botulinum in its formula supply chain, and that FDA has not yet determined a root cause of the ByHeart outbreak, according to its supply-chain page.

The Pennsylvania lawsuit alleges Nara did not test directly for the contaminant and instead screened for other microbiological parameters, according to PhillyVoice. Nara's website says it tests for 13 microorganism parameters, despite only two being FDA-mandated, PhillyVoice reported.

## Lawsuit challenges FDA vetting language

A Yardley family filed suit in federal court in Philadelphia after their 2-month-old was among the three hospitalized infants, according to PhillyVoice. The parents, Erica and Micky Goldfin, said their child began showing poor feeding, weak cries and difficulty swallowing in early May, was admitted to Children's Hospital of Philadelphia on June 1, spent two nights in intensive care and was discharged June 6, PhillyVoice reported.

The family said it used Nara Organics starting a few days after birth, buying product at a Target in Langhorne and through an online order picked up in Princeton, New Jersey, according to PhillyVoice. None of Nara's products have tested positive for Clostridium botulinum so far, but the company issued the recall as a precaution, while officials are testing leftovers from two cases with results expected in coming weeks, PhillyVoice reported.

The filing alleges Nara misled customers with claims about FDA approval, including that it is the only USDA-certified organic infant formula made with whole milk and contains more milk fat than other formulas, according to PhillyVoice. The suit alleges the company claimed a special FDA designation for that higher milk-fat level, while FDA does not issue premarket approvals for infant formulas, PhillyVoice reported.

The lawsuit states: "Those representations conveyed a false assurance that the Formula had received governmental safety vetting that it had not in fact received." It adds: "The representations were false or materially misleading, and Plaintiffs justifiably relied upon them in deciding to purchase the Formula and to feed it to (the baby)."

Nara's website says it held a clinical trial and that FDA had to review results before launch, according to PhillyVoice. The suit also cites a March 2023 FDA call-to-action letter about possible formula hazards including infant botulism, PhillyVoice reported.

A company spokesperson told PhillyVoice: "Nara Organics initiated a voluntary recall of its infant formula out of an abundance of caution and continues to work closely with the FDA, CDC, and state health authorities as the investigation continues." The spokesperson added: "Because this matter is the subject of ongoing litigation, we are unable to comment further at this time other than to say we intend to defend the company against the unfair and misleading allegations made in the case."

Marler Clark separately filed suit on behalf of a Pennsylvania infant, alleging Nara sold whole-milk formula when botulism risk in powdered whole milk had been documented by regulators and shown by the ByHeart outbreak, according to Food Safety Magazine. The firm alleges Nara marketed powdered whole milk as premium while not disclosing it as a hazard, citing a 2023 FDA letter identifying whole milk powder as a potential vehicle because spores can survive pasteurization and spray-drying, the magazine reported.

## What households and clinicians should do now

Caregivers with recalled formula should stop using it immediately, according to the Connecticut Department of Consumer Protection recall notice. If an infant recently consumed the formula and develops respiratory difficulty, poor feeding or altered cry, seek immediate medical attention, the department said.

If parents still have an opened container, federal officials advise photographing or recording the brand and lot number, sealing and labeling the container do not use, and storing it for 30 days in case testing is needed, according to KPBS Public Media. The SDAHO-republished alert said to record the lot number and use-by date before discarding, consider retaining opened formula for possible later testing if symptoms develop, label it DO NOT USE, store it away from other feeding items for at least a month, and discard it if no symptoms appear after a month.

The Washington schools update advised throwing the product away or returning it where purchased, recording the lot number if the container remains, and washing items and surfaces that may have touched the formula with hot soapy water or a dishwasher. San Diego County staff are working with local stores to remove the product from shelves, according to KPBS Public Media.

Refund rules depend on purchase channel, according to the Connecticut Department of Consumer Protection recall notice. Purchases from the Nara Organics website between May and June 2026 will receive an automatic refund, consumers with unused formula from before May 2026 may submit a photo of the can and use-by date through the company website, and Target buyers may return the product locally or follow online return instructions.

Providers should maintain heightened suspicion for infant botulism in any infant with compatible symptoms who was fed Nara Organics Whole Milk Organic Powdered Infant Formula, according to the SDAHO-republished alert. It also said providers should ask which formula brand infant patients receive, alert parents and guardians to the recall, and ensure recalled formula is not consumed.

## Sources referenced
- Two formula recalls raise doubts about booming ‘better-for-you’ category - Minnesota Star Tribune (https://www.startribune.com/two-formula-recalls-raise-doubts-about-booming-better-for-you-category/601857978)
- Recall Notice: Nara Organics Issues Voluntary Recall of Powdered Infant Formula - Connecticut Department of Consumer Protection (https://portal.ct.gov/dcp/news-releases-from-the-department-of-consumer-protection/2026-news-releases/recall-notice-nara-organics-issues-voluntary-recall-of-powdered-infant-formula)

## Louisiana Links 11 Illnesses, 2 Hospitalizations to Raw Milk

URL: https://nutritionjournal.com/louisiana-raw-milk-illnesses-2026

Louisiana health officials linked 11 Campylobacter and Cryptosporidium illnesses and two hospitalizations to raw milk from three operations since April 23, 2026.

Key takeaways:
- Louisiana identified 11 raw-milk illnesses since April 23, 2026, with 2 hospitalizations and no deaths.
- Cases tested positive for campylobacteriosis and/or cryptosporidiosis and traced to three milking operations.
- Pasteurization destroys germs without eliminating milk's nutritional benefits, health officials say.
- Louisiana allows raw milk only for animal or pet consumption, not for human drinking.
- Children, pregnant women, older adults and immunocompromised people face higher risk of severe illness.
- Anyone with symptoms after raw milk use should seek medical care promptly and report illness.

TL;DR: Eleven people in Louisiana became ill after drinking unpasteurized milk since April 23, 2026, with two hospitalized for campylobacteriosis and/or cryptosporidiosis.

The Louisiana Department of Health said on June 23, 2026, that it was investigating a cluster of intestinal illnesses tied to consumption of unpasteurized milk in Baton Rouge and other communities, according to the [Louisiana Department of Health](https://www.ldh.la.gov/news/7674).

## Eleven illnesses linked to raw milk since late April

Health officials identified 11 people who became ill after consuming raw milk during the period that began April 23, 2026. Those individuals tested positive for campylobacteriosis and/or cryptosporidiosis, two intestinal infections that health authorities track as foodborne hazards.

The department described the investigation as ongoing and said additional illnesses could still be identified. No deaths had occurred as of the announcement, but two of the 11 people required hospital care.

Those who became ill reported obtaining raw milk from three separate milking operations in Louisiana. The department did not publicly name those operations, a detail noted by the [Louisiana Illuminator](https://lailluminator.com/2026/06/23/raw-milk-sickens-11-people-in-louisiana-health-officials-investigate/) in its June 23 coverage of the announcement.

The case count covers about two months of exposures. State officials asked residents to recognize the potential health consequences of consuming milk that has not been heat-treated, even when it comes from a local farm or a familiar supplier.

## What tests found: Campylobacter and Cryptosporidium

Stool testing in the cluster found evidence of campylobacteriosis and/or cryptosporidiosis among the people who reported recent raw-milk consumption. Both conditions affect the digestive tract and can produce a similar early symptom pattern.

According to the Louisiana Department of Health, common features of both infections include loose stools, elevated temperature, abdominal cramping, nausea and vomiting. Onset generally occurs two to ten days after exposure. Illness may continue for one to three weeks, and some patients develop complications that persist longer.

The Louisiana Illuminator described the same organisms as bacteria that can be present in unpasteurized milk, and noted that two patients needed inpatient treatment. Severe infections can in some instances lead to syndromes associated with stroke, kidney failure and death, the publication reported, underscoring why clinicians monitor dehydration, prolonged fever and worsening abdominal symptoms closely.

State officials encouraged anyone who has consumed raw milk or foods made with raw milk and then develops digestive symptoms to seek medical attention without delay. Prompt evaluation allows testing, supportive care and reporting that can help investigators connect related cases.

## Why unpasteurized milk carries infection risks

Raw milk is milk from cows, goats, sheep or other mammals that has not undergone pasteurization. Pasteurization heats milk to a defined temperature for a defined time to destroy pathogens that cause human disease, according to the Louisiana Department of Health.

Milk that skips that heating step can harbor a range of microbes and parasites. The department listed campylobacter, cryptosporidium, E. coli, listeria, brucella and salmonella as examples of organisms that have been associated with unpasteurized dairy.

Careful milking hygiene, clean equipment, rapid chilling and healthy herds can lower contamination, but they do not remove the hazard entirely. That distinction is central to the department's message: good farm practices reduce contamination without eliminating the risk of harmful germs in raw milk.

The Louisiana Illuminator reported that federal and state health authorities share that assessment. The Louisiana Department of Health, the U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention all caution that drinking unpasteurized milk is not safe, the publication stated.

## Nutrition claims do not remove the safety concern

Pasteurization does not eliminate the nutritional benefits of milk, the Louisiana Department of Health stated. The process is designed to target disease-causing organisms while retaining the nutrients that make milk a source of protein, calcium and other dietary components.

Some consumers choose unpasteurized products because they believe heating lowers nutritional value or because they believe unheated milk supplies helpful bacteria for digestive health. The Louisiana Illuminator characterized those ideas as a false assumption that leads some people to drink raw milk despite official warnings.

For nutrition-focused readers, the practical point from the announcement is straightforward. Heat treatment preserves milk's dietary contribution while adding a pathogen-reduction step. Skipping that step does not create a nutritionally superior product, according to the department, but it does reintroduce exposure to organisms that pasteurization is intended to remove.

Consumers who want milk nutrients without the added infection risk can choose pasteurized dairy and maintain refrigeration, handling and date-label practices recommended for perishable foods. Those general handling steps do not replace pasteurization, but they support overall dairy safety alongside it.

## Louisiana law limits raw milk to animal use

Under Louisiana law, raw milk may only be sold or distributed for animal or pet consumption. Human sale for drinking is not permitted, a restriction that frames the current investigation.

The department also stated that it does not regulate production of raw milk or raw milk products. That regulatory note helps explain why the agency's role in this event centers on disease surveillance, laboratory confirmation, public warning and epidemiologic follow-up rather than dairy-plant inspection for these products.

The Louisiana Illuminator provided additional legal context, reporting that a state law approved two years earlier allows sale of raw milk for animals and pets to consume. Selling unpasteurized milk for human consumption remains illegal in Louisiana, the publication reported.

National rules vary. Citing the Campaign for Real Milk, the Louisiana Illuminator reported that retail sales of raw milk are legal in 16 states, while limited or farm-only sales are allowed in 18 other states. In 13 additional states the level of legality differs, with some permitting distribution for herd consumption or for pets while human consumption sales remain largely prohibited. Those comparisons show Louisiana's animal-use-only model is one of several state approaches, not a nationwide standard.

## Who faces higher risk and what to do next

Young children, pregnant women, older adults and people with weakened immune defenses face a greater likelihood of severe illness from infections associated with raw milk, according to the Louisiana Department of Health. Age, pregnancy and immune status can reduce the ability to contain intestinal pathogens before dehydration or invasive complications develop.

Households in those groups should be particularly cautious about any product labeled or described as unpasteurized, including milk intended for pets that may be diverted to human use. Clear labeling, separate storage and direct communication with all household members can reduce accidental consumption.

Anyone who drank raw milk or ate a product made with it and then develops diarrhea, fever, cramps, nausea or vomiting should contact a clinician promptly. The department urged affected consumers to seek care quickly rather than waiting to see whether symptoms resolve on their own.

People who wish to report a possible illness can contact their regional LDH epidemiologist through the department's infectious-disease epidemiology page. The department also directed readers to federal information pages on raw milk, Campylobacter and Cryptosporidium maintained by the Centers for Disease Control and Prevention.

## Investigation continues

The department said investigators are continuing to gather histories, laboratory results and product information, and that more cases might be found as reporting catches up. That active status means the totals released June 23 — 11 illnesses, two hospitalizations and no deaths — represent identified cases at that point, not necessarily a final count.

For now, the verified message from Louisiana health officials remains focused on awareness: unpasteurized milk from multiple Louisiana milking operations has been linked to intestinal infections since late April, hospital care has been required in two instances, and consumers who develop symptoms after raw-milk exposure should obtain medical care and report the illness for follow-up.

## CDC Summer Food Safety Update Flags Formula Recall, 2024 Data

URL: https://nutritionjournal.com/cdc-summer-food-safety-update-formula-recall-2026

CDC's June 22 summer food safety update flags recalled Nara Organics formula, 203 multistate outbreaks in 2024, drug-resistant Salmonella and Shigella, and active Salmonella and Listeria investigations.

Key takeaways:
- Do not feed infants recalled Nara Organics Whole Milk Organic Infant Formula linked to multistate infant botulism.
- CDC investigated 203 possible multistate intestinal-disease outbreaks in 2024 tied to Salmonella, E. coli, Listeria and Campylobacter.
- FoodNet data show 2024 increases for Cyclospora, Shigella, STEC, Vibrio and Yersinia versus 2016-2018.
- Drug-resistant Salmonella Infantis REPJFX01 linked to chicken and XDR Shigella resistant to oral antibiotics are growing concerns.
- Eight backyard poultry Salmonella outbreaks caused 513 illnesses and one death; cheese-linked Listeria caused nine illnesses and one death.

TL;DR: The CDC's June 22, 2026 Food Safety Newsletter warns consumers not to feed infants recalled Nara Organics Whole Milk Organic Infant Formula linked to infant botulism, and summarizes 2024 surveillance showing persistent Salmonella, E. coli, Listeria and rising drug-resistant infections.

## Summer update centers on temperature control and new 2024 data

Food Safety Updates From CDC is an electronic newsletter of food safety news for educators, consumer advocates, government officials, and industry representatives, according to the Food Safety Newsletter | Food Safety | CDC.

The issue dated June 22, 2026 is framed as a Summer Scoop. It states that summer brings more picnics, cookouts, and meals outdoors, and that foodborne germs can spread more easily, especially when food isn't kept at safe temperatures.

This quarter, the newsletter says it is sharing new data, key findings, and steps to keep people healthy through summer.

The summer food safety tip in the issue advises keeping hot food hot and cold food cold at picnics, barbecues or outdoor buffets. Hot foods should stay heated to a temperature above 140°F, and cold foods should be kept at 40°F or lower to help prevent harmful germs from growing in the "danger zone."

## Recall alert: Nara Organics infant formula linked to botulism

### What the CDC newsletter warns

The newsletter includes a recall alert stating: Do not feed infants recalled Nara Organics Whole Milk Organic Infant Formula. It states the formula has been linked to a multistate outbreak of infant botulism.

It advises seeking health care immediately if an infant fed Nara Organics infant formula has poor feeding, loss of head control, difficulty swallowing, or decreased facial expression.

### Three-state investigation and retail scope

According to the Washington State Department of Health release titled Infant formula recalled because of link to infant botulism cases, including in Washington, the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the Washington State Department of Health, Thurston County, and officials in two other states are investigating an outbreak of botulism linked to powdered infant formula produced by Nara Organics.

That release, issued June 16, 2026, reports three infants in three states involved in the outbreak, including one infant in Thurston County, Washington, who was hospitalized and received treatment for infant botulism. All reported cases involved infants who consumed Nara Organics powdered infant formula.

The company voluntarily recalled the formula. The recalled formula was sold nationwide through Target stores, Target.com, and Nara.com.

The Washington release instructs purchasers not to use the product, to throw it away or return it to where it was bought, and to record the lot number before discarding if the container is still available. For open containers, it refers readers to CDC recommendations.

It also advises washing items and surfaces that may have touched the recalled formula using hot, soapy water or a dishwasher.

Symptoms listed in the state release include poor feeding, loss of head control, muscle weakness, difficulty swallowing, and decreased facial expression. It notes symptoms can take as long as several weeks to develop and urges continued monitoring by parents and caregivers whose infants consumed recalled formula.

The release describes infant botulism as a rare illness that most commonly affects babies less than 6 months of age. It explains that babies become ill when bacteria known as Clostridium botulinum that they ingested produce a toxin that can weaken muscles. It notes these bacteria are naturally found in dust, soil, and honey, which should never be given to babies under a year, and states it is rare for a commercial infant food product to be linked to an outbreak of infant botulism. It describes the investigation as active and points to CDC and FDA pages for current updates.

## 203 multistate outbreaks investigated in 2024

CDC recently released several new reports on foodborne illnesses data for 2024, and the newsletter states together they show many germs that make people sick are still common and continued efforts are needed to keep food safe.

A new summary report highlights findings from 203 possible multistate enteric intestinal disease outbreaks investigated by CDC in 2024. These outbreaks were caused by germs like Salmonella, E. coli, Listeria, and Campylobacter.

The most common sources included vegetable crops, chicken, dairy, and backyard poultry. While Listeria outbreaks were fewer, they caused the most serious illnesses.

The newsletter states downloadable data from the summary can be used to identify gaps in food safety and animal husbandry practices and inform policies and practices to prevent similar outbreaks.

## FoodNet, Vibrio and attribution estimates show persistent burden

Preliminary data from the Foodborne Diseases Active Surveillance Network, known as FoodNet, which represents 15% of the U.S. population, show reported infections for some common foodborne germs increased or stayed the same in 2024 compared with 2016–2018.

Infections increased for Cyclospora, Shigella, Shiga toxin-producing E. coli, Vibrio, and Yersinia and remained steady for Listeria and Salmonella. The newsletter points readers to the full report and to FoodNet Fast to explore data reported since 1996.

CDC also released a summary report of U.S. infections reported for 2024 to the Cholera and Other Vibrio Illness Surveillance system, called COVIS. The summary describes the Vibrio species causing the most illness, whether people were infected by eating seafood or through contact with marine water, seafood drippings, or marine animals, and patterns in who became sick.

The Interagency Food Safety Analytics Collaboration, known as IFSAC, released a report of annual estimates of foodborne illness attributed to 17 food categories for Salmonella, E. coli O157, and Listeria for 2023. IFSAC calculated the estimates using 1998–2023 foodborne outbreak data. The newsletter states the report continues IFSAC's work to inform food safety initiatives, interventions, and policies.

## Drug-resistant Salmonella Infantis strain tied to chicken

Two recent CDC studies examined Salmonella Infantis, which has re-emerged as a leading type of Salmonella causing human infection in the United States.

Both studies looked at a persistent Salmonella Infantis strain called REPJFX01 that is resistant to the main antibiotics recommended for treating Salmonella infections and has been linked to chicken consumption.

One study found the increase in Infantis infections among people is driven by REPJFX01. The other found REPJFX01 emerged in humans and chickens at the same time, suggesting chickens might be an important carrier of the strain.

The newsletter states findings will help CDC better understand REPJFX01 and collaborate with partners on measures to reduce its spread.

## Extensively drug-resistant Shigella expands since 2015

On April 9, CDC published an article about extensively drug-resistant, or XDR, shigellosis. Shigellosis is a diarrheal disease caused by Shigella bacteria.

Although most infections do not need antibiotic treatment, antibiotics may be used for severe illness or to reduce spread among people at risk. The bacteria causing XDR shigellosis are resistant to all FDA-approved oral antibiotics, which makes treatment challenging.

Since 2015, a growing number of shigellosis cases in the United States have been caused by XDR Shigella. Data show most cases of XDR shigellosis were adult men. About one third of sick people were hospitalized.

CDC continues to monitor XDR Shigella, work with state and local public health partners, and share prevention and treatment recommendations to help prevent illness and protect public health.

## Backyard poultry linked to 513 illnesses across 42 states

### Eight outbreaks remain open

According to the CDC investigation page titled Salmonella Outbreaks Linked to Backyard Poultry, public health officials in several states were investigating eight multistate outbreaks of Salmonella illnesses linked to contact with backyard poultry, with investigation status listed as open on June 17, 2026.

The page reports 513 cases, including 329 new cases, 134 hospitalizations including 81 new hospitalizations, one death, and cases in 42 states and a U.S. territory, including 12 new jurisdictions.

It states a quarter of sick people in the outbreaks are children under 5 years old. It also states the largest outbreak has an unusually high number of people reporting contact with ducks.

The page states backyard poultry, like chickens and ducks, can carry Salmonella germs even if they look healthy and clean, and that germs can spread to anything in areas where poultry live and roam. It states people can get sick from touching poultry or the environment and then touching mouth or food.

### Handwashing, flock and egg guidance

Recommended actions include washing hands with soap and water immediately after touching backyard poultry, eggs, or anything in the area where they live and roam, and using hand sanitizer if soap and water are not readily available.

Other steps include not kissing or snuggling poultry, not eating or drinking around them, keeping flocks and supplies such as feed containers and coop shoes outside the house, and cleaning supplies outside.

For children, the page advises always supervising children around poultry and ensuring handwashing afterward. It states children younger than 5 years old should not handle chicks, ducklings, or other backyard poultry or spend time in areas where the animals live and roam.

For eggs, it advises collecting eggs often, throwing away cracked eggs, cleaning dirty eggs carefully with fine sandpaper, brush, or cloth, not washing eggs because cold water can pull germs into the egg, refrigerating eggs, and cooking eggs until yolk and white are firm, including cooking egg dishes to an internal temperature of 160°F.

It lists warning signs for seeking care, including diarrhea with fever higher than 102°F, diarrhea for more than 2 days without improvement, bloody diarrhea, vomiting that prevents keeping liquids down, and signs of dehydration such as not peeing much, dry mouth and throat, and dizziness when standing.

Most people infected with Salmonella experience diarrhea, fever, and stomach cramps, with symptoms usually starting 6 hours to 6 days after swallowing bacteria and recovery without treatment after 4 to 7 days. It notes children younger than 5, adults 65 and older, and people with weakened immune systems may experience more severe illness requiring treatment or hospitalization.

## Soft-cheese Listeria outbreak broadens recall

According to the Food Safety News report titled Company expands cheese recall; Listeria outbreak traced to products, the FDA and CDC with state and local partners were investigating a multi-state, multi-year outbreak of Listeria monocytogenes infections linked to requeson, a soft cheese similar to ricotta, manufactured by Clover Hill Dairy LLC of Mechanicsville, Maryland.

The report states nine patients were identified, eight were hospitalized, and one died. Clover Hill expanded its recall to include all cheese products manufactured by the firm.

Listed categories include soft and semi-soft Spanish style varieties such as Cuajada, Soft Cuajada, Soft Cuajada in Brine, Soft Cuajada Crumbs, Ricotta/Requeson, and Soft Ricotta with Jalapenos, plus mild, hard, smoked, flavored, and pepper cheese varieties.

A distributor, Nelson & Isa Lacteos LLC of Bay Shore, New York, initiated a recall on June 5 of 1-pound packages of requeson cheese sold in clear plastic clam-shell containers to retail locations in New York from May 15 to May 28. The report notes recalled cheese was likely repacked at retail stores and labeling may vary.

Clover Hill cheese was distributed from May 4 through May 30 in North Carolina, New York, Virginia, Maryland, New Jersey and Washington, D.C., through bulk distributors, retail stores and directly to consumers.

On June 14, the Maryland Department of Health announced an expanded consumer advisory for all cheese products made by Clover Hill Dairy due to possible Listeria monocytogenes contamination. The report states six requeson product samples tested positive for Listeria monocytogenes and matched the outbreak strain, and one environmental sample collected by Maryland investigators also matched.

## Sources referenced
- Infant formula recalled because of link to infant botulism cases, including in Washington | Washington State Department of Health (https://doh.wa.gov/newsroom/infant-formula-recalled-because-link-infant-botulism-cases-including-washington)

## Mediterranean and AHA Diets Lower 20-Year Heart Risk Than Low-Fat

URL: https://nutritionjournal.com/mediterranean-aha-lowfat-20-year-cvd-risk

A June 20, 2026 emulation in 12,197 high-risk US adults estimated 20-year CVD risk at 28.2% for Mediterranean, 31.2% for AHA-2020, and 35.9% for low-fat diets.

Key takeaways:
- 20-year CVD risk was estimated at 35.9% low-fat, 28.2% Mediterranean, and 31.2% AHA-2020 goals in high-risk US adults.
- Mediterranean vs low-fat risk ratio was 0.79; AHA-2020 vs low-fat was 0.87 in the high-risk group.
- In a general population, risk ratios were 0.90 for Mediterranean and 0.94 for AHA-2020 versus low-fat.
- Emulation included 12,197 adults aged 55-80 with diabetes or 3+ risk factors and 3,469 CVD cases.
- ATTICA 20-year follow-up linked plant-based pattern to 26% lower CVD risk (HR 0.74).

TL;DR: Sustained Mediterranean eating was estimated to lower 20-year cardiovascular risk to 28.2% versus 35.9% under low-fat eating in high-risk United States adults, according to a June 20, 2026 target-trial emulation reported in the American Journal of Clinical Nutrition.

## What the 20-year comparison estimated

The central answer from the new analysis is that both the Mediterranean diet and the food-based American Heart Association-2020 dietary goals were estimated to produce a lower 20-year risk of cardiovascular disease than a low-fat diet among United States adults, as reported in the American Journal of Clinical Nutrition.

The pooled absolute risk over 20 years was 35.9% with a 95% confidence interval from 33.1% to 38.5% under the low-fat strategy, 28.2% with a 95% confidence interval from 25.8% to 31.4% under the Mediterranean strategy, and 31.2% with a 95% confidence interval from 29.1% to 33.4% under the food-based American Heart Association-2020 strategy.

Compared with the low-fat diet, the estimated risk ratio was 0.79 with a 95% confidence interval from 0.70 to 0.91 for the Mediterranean diet and 0.87 with a 95% confidence interval from 0.79 to 0.96 for the American Heart Association-2020 dietary goals.

The investigators also reported estimates for a general population that was not selected for age, diabetes, or cardiovascular risk factors, where the corresponding risk ratios were 0.90 with a 95% confidence interval from 0.84 to 0.95 for the Mediterranean diet and 0.94 with a 95% confidence interval from 0.90 to 0.99 for the American Heart Association-2020 goals.

The published conclusion stated that sustained adherence to the Mediterranean diet and to the American Heart Association-2020 dietary goals is estimated to have a lower 20-year risk of cardiovascular disease than a low-fat diet in United States adults.

The background for the project noted that the Mediterranean diet reduces cardiovascular disease risk in European populations, but its long-term effectiveness in United States adults, particularly relative to the American Heart Association-2020 dietary goals, remained uncertain before this emulation.

## Who was included and how follow-up was done

The emulation used data from the Nurses' Health Study and the Health Professionals Follow-up Study, two long-running United States cohort studies named as the data sources in the American Journal of Clinical Nutrition report.

The high-risk target-trial population included 12,197 United States adults aged 55 to 80 years who had diabetes or three or more major cardiovascular risk factors at the start of the emulated trial.

Diet was assessed every four years with validated food frequency questionnaires, providing repeated measures that the researchers used to represent sustained eating patterns rather than a single baseline recall.

The primary outcome was cardiovascular disease defined as nonfatal myocardial infarction, coronary revascularization, stroke, and cardiovascular death, with events confirmed by medical records.

The authors applied the parametric g-formula to estimate 20-year cardiovascular risk under each dietary strategy, a statistical approach designed to emulate sustained adherence while accounting for time-varying diet and risk factors.

Over 20 years of follow-up in the high-risk group, 3,469 cardiovascular cases occurred, including 1,451 cases among men and 2,018 cases among women.

The author group was led by Yi Li with Dalia Stern, Miguel Ángel Martínez-González, Shuyuan Yang, Jorge E. Chavarro, JoAnn E. Manson, Eric B. Rimm, Robert William Platt, and Yu-Han Chiu as corresponding author, with affiliations including McGill University, Instituto Nacional de Salud Pública, Instituto de Salud Carlos III, Brown University, and Brigham and Women's Hospital.

The paper appeared in the American Journal of Clinical Nutrition on June 20, 2026, and listed support from the National Institute of General Medical Sciences.

## What each eating strategy represented

The objective described three sustained strategies: a low-fat diet, a Mediterranean diet, and the food-based American Heart Association-2020 dietary goals, with the low-fat diet serving as the reference for the risk-ratio comparisons.

A Veterans Affairs Evidence-based Synthesis Program management brief characterized the Mediterranean diet by high intake of olive oil, fruits and vegetables, whole grains and cereals, legumes, fish, and nuts, with low intake of red meat, dairy products, and sweets and moderate intake of red wine with meals.

That same brief described the comparison Western diet as rich in red meat, dairy products, processed and artificially sweetened foods, and salt, with minimal intake of fruits, vegetables, fish, legumes, and whole grains.

The brief said epidemiologic studies have shown that cardiovascular disease incidence in populations consuming Mediterranean-type diets is lower than in populations consuming a more typical Western diet.

The American Journal of Clinical Nutrition emulation specifically compared the food-based version of the American Heart Association-2020 dietary goals, rather than a nutrient-only score, against the Mediterranean and low-fat approaches.

Readers seeking practical food selection can discuss questionnaire-based patterns with a clinician or registered dietitian and consider general adherence tracking, because the study measured diet with repeated food frequency questionnaires and modeled sustained adherence.

## Why United States data were needed

European trial and cohort evidence had already linked Mediterranean eating to lower cardiovascular risk, but the authors framed uncertainty about long-term effectiveness in United States adults and about performance relative to the American Heart Association-2020 goals.

The Veterans Affairs brief identified the PREDIMED trial, described as Prevention with Mediterranean Diet, as the only large randomized controlled trial that tested effects of an intensive Mediterranean diet with five of seven components on clinical outcomes.

In that trial, either a Mediterranean diet supplemented with extra virgin olive oil or a Mediterranean diet supplemented with nuts was associated with a significant 30% reduction in major cardiovascular events, which was the primary endpoint, compared with a low-fat control diet, according to the Veterans Affairs synthesis.

The synthesis also reported that the trial documented significant reductions in incident diabetes, but only in the group assigned to the diet supplemented with extra virgin olive oil.

The Women's Health Initiative Dietary Modification trial, discussed in the same synthesis, found no difference in major cardiovascular events or diabetes between its two diet groups, although investigators did not consider that fat-lowering intervention with two of seven Mediterranean components a true Mediterranean diet.

For secondary prevention, the synthesis said data from three randomized controlled trials indicate that a Mediterranean diet is associated with a significant reduction in new myocardial infarction, but no reduction in cardiovascular mortality, stroke, or other cardiovascular events.

The new United States emulation therefore addressed what the authors called a gap concerning sustained Mediterranean adherence outside Europe and direct estimation against both low-fat eating and the food-based American Heart Association-2020 goals.

## What 20-year European follow-up showed alongside

A separate 20-year analysis from the ATTICA Study, published in the European Journal of Nutrition on June 19, 2026, examined habitual dietary patterns in a Mediterranean population-based cohort and their links to cardiovascular risk factors and outcomes over two decades.

That study enrolled 3,042 cardiovascular-disease-free adults in 2001-2002 and derived posteriori dietary patterns with principal component analysis based on intake assessed with a validated food frequency questionnaire.

Complete cardiovascular data were available for 1,988 individuals after 20 years, and the investigators calculated cardiovascular incidence, lifetime risk, and disability-adjusted life years.

Three dietary patterns were identified that together explained 46.5% of variance in consumption: a plant-based sustainable pattern, a Western pattern rich in animal-sourced and processed foods, and a high-calorie, low-white-meat pattern.

Higher adherence to the plant-based pattern was associated with a 26% lower 20-year cardiovascular risk, with a hazard ratio of 0.74 and a 95% confidence interval from 0.55 to 0.99, in multivariate Cox proportional hazards analysis.

The high-calorie, low-white-meat pattern was linked to increased lifetime risk with a beta coefficient of 0.066 and a p-value below 0.001 and to higher disability-adjusted life years with a beta coefficient of 0.13 and a p-value of 0.009.

No significant associations were observed for the Western pattern after adjustments in that analysis, while beta and gamma regression models were used alongside Cox models to examine pattern-outcome relationships.

The ATTICA authors concluded that a plant-based dietary pattern was protective against long-term cardiovascular outcomes, while a high-calorie, low-white-meat pattern was detrimental, and they emphasized culturally acceptable sustainable patterns for reducing risk and supporting environmental sustainability.

Viewed together, the European Journal of Nutrition cohort findings and the American Journal of Clinical Nutrition emulation both point toward lower long-term cardiovascular risk with plant-forward Mediterranean-type adherence when followed over 20 years.

## How to interpret the estimates for personal choices

The risk numbers are modeled estimates of what 20-year risk would be under sustained adherence to each strategy, not observed rates among people who were randomly assigned to eat that way for two decades.

The parametric g-formula estimates adjusted for measured time-varying factors captured in the Nurses' Health Study and Health Professionals Follow-up Study, but emulation cannot establish the same certainty as a decades-long randomized feeding trial.

People with diabetes or multiple major risk factors, matching the 55-to-80-year-old high-risk group, may wish to review the absolute risks of 35.9%, 28.2%, and 31.2% with their clinician because absolute differences matter alongside the reported risk ratios of 0.79 and 0.87.

People without those selection characteristics may focus on the general-population risk ratios of 0.90 for the Mediterranean diet and 0.94 for the American Heart Association-2020 goals, which were closer to one than the high-risk estimates yet remained below one with confidence intervals that excluded one.

Because diet was measured every four years by questionnaire and outcomes required medical-record confirmation of myocardial infarction, revascularization, stroke, or cardiovascular death, day-to-day eating and symptom evaluation still require individualized medical guidance rather than self-classification.

## Sources referenced
- Cardiovascular disease risk under low-fat, Mediterranean, and American Heart Association diets: a target trial emulation in United States adults - American Journal of Clinical Nutrition (https://doi.org/10.1016/j.ajcnut.2026.101404)
- Sustainable diets and long-term cardiovascular disease outcomes; insights from the 20-year follow-up ATTICA study (2002–2022) - European Journal of Nutrition (https://link.springer.com/article/10.1007/s00394-026-04022-7)

## Five-Year Low-Carb Remote Care Kept Weight Off in Prediabetes

URL: https://nutritionjournal.com/five-year-low-carb-remote-prediabetes-outcomes

Five-year remote-care data link carbohydrate-reduced nutrition to 5.8-kg weight loss, 22% normoglycemia and 13% diabetes progression.

Key takeaways:
- Remote carbohydrate-reduced nutrition was associated with 5.8 kg (5.3%) mean weight loss at five years.
- 22% of the original prediabetes cohort were at normoglycemia and 13% had type 2 diabetes at five years.
- Cumulative any-time regression to normoglycemia was 55.6%; cumulative progression to diabetes was 12.2%.
- Insulin, lipid and hsCRP markers stayed at or below baseline but were not significant after adjustment.
- Liver and kidney function remained stable through five years of follow-up.
- Fasting glucose 100-125 mg/dL defines prediabetes; 70-99 is optimal and 126+ indicates diabetes.

TL;DR: A digitally supported carbohydrate-reduced nutrition program was linked to 5.8 kg mean weight loss at five years, with 22% of the starting group at normoglycemia and 13% at type 2 diabetes, according to [Frontiers in Nutrition](https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2026.1839029/full).

Five-year follow-up of a continuous remote care intervention for prediabetes reported durable weight reduction alongside a low rate of progression to type 2 diabetes. The report, published in Frontiers in Nutrition on 19 June 2026, tracked adults first enrolled at ages 21–65 years with prediabetes. Of 96 participants in the original two-year trial, 58 agreed to a three-year extension and 45 completed five-year follow-up, representing 47% of the original cohort.

The analysis used generalized estimating equations and linear mixed-effects models as part of an extension cohort analysis. Outcomes over five years included glycemic status, weight, insulin resistance, lipids, inflammatory markers, and liver and kidney function. The underlying trial is registered as ClinicalTrials.gov NCT02519309. The extension was described as a three-year prospective, single-arm longitudinal study building on the previously reported two-year trial.

## Why lasting prevention is difficult

Sustained prevention of type 2 diabetes remains a major public health challenge because benefits from traditional lifestyle and earlier pharmacologic interventions have often been difficult to maintain. Globally, more than 460 million people have prediabetes, with prevalence projected to increase substantially in coming decades. In the United States, more than one-third of adults — approximately 98 million people — have prediabetes.

Without intervention, up to 70% will eventually progress to type 2 diabetes. Even before progression, prediabetes is associated with elevated risk for cardiovascular disease, chronic kidney disease, and all-cause mortality. The authors framed durable maintenance of metabolic health, not only prevention of onset, as the central need.

Traditional programs achieved early success but rarely sustained it. The Diabetes Prevention Program reduced diabetes incidence by 58% over three years through modest weight loss and increased physical activity. In the Diabetes Prevention Program Outcomes Study, prevention effects diminished over time in the context of substantial weight regain, with more than half of participants ultimately developing diabetes.

That pattern was described as consistent with other lifestyle and dietary interventions, including low-calorie and low-fat approaches. Even pharmacologic approaches that produce substantial metabolic improvements, such as GLP-1 receptor agonists, show a regression of benefits upon discontinuation. The American Diabetes Association emphasizes durable lifestyle modification and individualized nutrition therapy for diabetes prevention, noting that low-carbohydrate eating patterns can be an effective option when adherence is maintained over time.

## How the remote nutrition program worked

The study evaluated a continuous remote care intervention, abbreviated CCI, delivering individualized carbohydrate-reduced nutrition therapy in adults with prediabetes. Authors were affiliated with Virta Health in Denver, CO, United States; Genesis Research in Hoboken, NJ, United States; the Department of Human Sciences at The Ohio State University in Columbus, OH, United States; the School of Medicine at University of California, Davis, in Davis, CA, United States; and Abbott, Lingo Germany GmbH, in Wiesbaden, Germany.

Lead authors listed were Alison R. Zoller, Shaminie J. Athinarayanan, Michelle R. Van Tieghem, Rebecca N. Adams, Caroline G. P. Roberts, Jeff S. Volek, Stephen D. Phinney, and Amy L. McKenzie. The paper appeared in Frontiers in Nutrition, Section Clinical Nutrition, as an original research article. Its stated aim was to report five-year outcomes of continuous remote care with individualized carbohydrate-reduced nutrition therapy.

Participants were adults 21–65 years with prediabetes enrolled in the original trial. The extension cohort included 58 consenting participants followed for three additional years, for five years total. Assessment covered glycemic status alongside weight, insulin resistance, lipid measures, inflammatory markers, and hepatic and renal function. Change over time was modeled longitudinally rather than by comparison with a parallel control group, consistent with the single-arm extension design.

## Glycemia after five years

At five years, 22% achieved normoglycemia, with P < 0.001, and 13% progressed to type 2 diabetes, with P < 0.01. Those percentages were calculated from the original cohort base in the reported extension analysis. Forty-five participants completed follow-up at five years.

Cumulative incidence, defined as achievement at any time point, was 55.6% for regression to normoglycemia and 12.2% for progression to type 2 diabetes over five years. The authors concluded that participation was associated with maintenance of glycemic status over five years among adults with prediabetes. They also noted that mean glycemic markers were comparable to baseline at five years.

The interpretation emphasized distribution of individual outcomes rather than average glucose alone. A substantial proportion achieved normoglycemia at some point, while relatively few progressed to type 2 diabetes during the period. The paper described this pattern as suggesting potential for long-term diabetes prevention with a digitally supported, nutrition-focused intervention.

Understanding glycemic categories helps place those shifts in context. According to [Harvard Health](https://www.health.harvard.edu/diet-and-nutrition/prediabetes-diet-how-to-help-prevent-progression-to-diabetes), an optimal fasting blood glucose level is usually 70 to 99 milligrams per deciliter. Fasting blood glucose of 100 to 125 milligrams per deciliter indicates prediabetes, while 126 milligrams per deciliter or higher indicates diabetes.

With prediabetes and type 2 diabetes, high blood glucose occurs when the body is unable to use insulin efficiently. Over time, the body becomes unable to produce enough insulin. Insulin is the hormone that helps move blood sugar from the bloodstream into cells for energy. Type 2 diabetes accounts for 90% to 95% of diabetes cases in the United States.

## Weight change held through year five

Mean body weight was reduced by 5.8 kg, or 5.3%, at five years, with P < 0.001. Among participants, 47% achieved at least 5% weight loss, 29% achieved at least 10% weight loss, and 13% achieved at least 15% weight loss. The authors described the result as significant weight reduction maintained over five years.

That durability contrasts with the regain pattern highlighted from prior lifestyle follow-up. In the Diabetes Prevention Program Outcomes Study context cited in the paper, prevention effects diminished alongside substantial weight regain. The present cohort, by contrast, remained below baseline weight on average at the five-year point.

Weight change matters for glucose control because excess weight contributes to inefficient insulin use. According to Harvard Health, a healthy eating pattern and attention to portion size can help reduce excess weight. That reduction allows the body to use insulin more efficiently, making it easier for cells to take up glucose and bringing down blood glucose levels.

The same source notes that losing around 7% of body weight may be enough to keep diabetes at bay. For a 160-pound person, that corresponds to a loss of around 11 pounds. Diet changes can still matter even when weight loss is small. Harvard Health reports patients who shed only 2 to 3 pounds despite following a diabetes-friendly diet but still improved blood sugar and blood cholesterol.

## Heart-related and inflammatory markers

Fasting insulin, HOMA-IR, triglycerides, HDL-C, LDL-C, non-HDL-C, and hsCRP were maintained at or below baseline levels at five years. Those differences were not statistically significant after adjustment, despite unadjusted P-values at or below 0.05. The conclusion described the pattern as maintenance of insulin resistance and cardiometabolic risk markers.

HOMA-IR is the reported measure of insulin resistance in the analysis. Triglycerides, HDL-C, LDL-C, and non-HDL-C were the reported lipid measures. High-sensitivity C-reactive protein, abbreviated hsCRP, was the reported inflammatory marker. All were assessed alongside glycemic status and weight through the five-year period.

Liver and kidney function was stable over the follow-up period. Hepatic and renal markers were included among the prespecified long-term outcomes. No progression signal in those safety domains was reported in the abstract results.

For consumers, broader eating guidance remains relevant alongside any specific program. According to Harvard Health, many different foods can fit a prediabetes eating pattern, including fruits and vegetables, beans and legumes, lean proteins, whole grains, and healthy fats. Prediabetes diets generally are low in sugary foods, refined carbohydrates, fast foods, fried foods, and alcohol, while no foods are described as categorically off-limits.

## What foods fit a prediabetes pattern

Specific options listed by Harvard Health include non-starchy vegetables such as asparagus, beets, broccoli, Brussels sprouts, carrots, cauliflower, cucumbers, eggplant, leafy greens, mushrooms, peppers, summer squash, tomatoes, and zucchini. Lean protein options include beans, eggs, fish and shellfish, lean poultry, lean red meat such as sirloin or flank steak, lentils, reduced-fat cheese, and soy foods such as tofu and tempeh.

Fresh fruit options include apples, apricots, bananas, berries, melon, oranges, peaches, and pears. Whole grains and starchy vegetables include whole-wheat bread, whole-wheat pasta, brown rice, oatmeal, quinoa, sweet potatoes, skin-on white potatoes, winter squash, peas, and corn. Low-fat dairy includes low-fat milk, plain Greek yogurt, and cottage cheese.

Healthy fats include olive oil and olives, avocado, nuts, and seeds. Water and unsweetened drinks are the listed beverage options. The dietitian guidance emphasizes overall eating pattern rather than single foods or super foods. Focusing on the average of what is eaten also allows for small treats and occasionally dining out.

Carbohydrate type affects blood sugar because the body breaks carbohydrates down into glucose. That glucose enters the bloodstream, raising blood glucose, and the pancreas releases insulin to move glucose into cells for energy. Choosing complex or minimally refined carbohydrates can make prediabetes management easier.

## Limitations readers should weigh

The extension was single-arm, without a concurrent comparison group over five years. Only 58 of 96 original participants consented to the extension, and 45 completed five-year follow-up. Findings therefore reflect participants who remained in remote care and returned for assessment.

Lipid, insulin-resistance, and inflammation differences met the unadjusted threshold but did not remain statistically significant after adjustment. Mean glycemic markers were comparable to baseline at five years, even as categorical outcomes showed 22% at normoglycemia and 13% at type 2 diabetes. The authors presented association, not proof of causation, using language of participation being associated with outcomes.

Lifestyle changes such as eating a healthy diet and being more active are first-line treatments for prediabetes, according to Harvard Health. Both can bring blood sugar levels closer to normal, which can slow or stop progression to diabetes. Unmanaged prediabetes can turn into type 2 diabetes, which can lead to long-term problems such as heart disease, nerve damage, and kidney disease.

## June School Nutrition Newsletter Sets Milk, Sugar and Lunch Rules

URL: https://nutritionjournal.com/june-school-nutrition-newsletter-sets-milk-sugar-and-lunch-rules

North Dakota's June school nutrition update details milk options, added-sugars limits, 2026-27 lunch pricing, summer food safety, and a free-meals cost estimate.

Key takeaways:
- North Dakota marked the 80th anniversary of the National School Lunch Act at kitchen manager training on June 4, 2026.
- SP 08-2026 expands whole and skim milk options while counting calories, sodium and, from July 1, 2027, added sugars.
- Added-sugars limits remain 6g for cereal, 2g for yogurt and 10g for flavored milk.
- SFAs with a negative balance on June 30, 2025 must file the 2026-27 PLE tool; the target paid price is $4.16.
- Stored food temperatures must be recorded at least every three days during summer vacation.
- DPI priced North Dakota Measure 3 free school meals at $124.3M-$134.3M every two years.

TL;DR: North Dakota's June 2026 school nutrition update explains new federal milk choices, carries forward added-sugars limits, and sets paid-lunch pricing rules for 2026-2027.

North Dakota school food authorities received June guidance covering fluid milk options, product-based added-sugars limits, paid lunch equity for school year 2026-2027, and summer food-storage temperature checks, according to the June School Nutrition Newsletter published June 19, 2026.

The update also arrived in the same week lawmakers adopted a biennial cost range for a statewide free-meals ballot proposal, according to reporting titled Lawmakers adopt cost estimate for North Dakota school meal ballot measure.

## 80th Anniversary Marked At New Manager Training

The Child Nutrition & Food Distribution team marked the 80th anniversary of the signing of the National School Lunch Act during New Kitchen Manager Training on June 4, 2026, according to the June School Nutrition Newsletter.

The training welcomed new kitchen managers into school cafeteria roles.

The newsletter message told managers they play a vital role in creating a cafeteria where students are nourished and feel welcomed each day.

The same message told managers their work has a lasting impact.

## State Agencies Told To Share New USDA Guidance

State agencies must distribute any new guidance from the U.S. Department of Agriculture to program operators, according to the June School Nutrition Newsletter.

The newsletter listed three USDA memos for school nutrition program operators.

It directed readers to the Updates tab on the North Dakota Department of Public Instruction website for the most recent USDA memos.

The site section is labeled UPDATES | North Dakota Department of Public Instruction.

The newsletter said to expect many more new USDA memos at the beginning of next school year.

Those future memos will address changes to the school breakfast and lunch program meal pattern to align with the updated Dietary Guidelines for Americans, 2025.

The same coming memos will address the USDA/DHHS Eat Real Food campaign.

## SP 08-2026 Expands Fluid Milk Options

Memo SP 08-2026, titled Expanding Fluid Milk Options in Child Nutrition Programs, codifies and expands the school nutrition programs allowed to offer whole milk and skim milk, according to the June School Nutrition Newsletter.

Covered meals include breakfast, lunch, afterschool snack and pre-K meals.

Saturated fat from milk may be excluded in the calculation of dietary specifications.

Calories from any milk type must be included in the calculation for those dietary specifications.

Sodium from any milk type must be included in the calculation for those dietary specifications.

Beginning July 1, 2027, added sugars from any milk type must be included in the calculation for those dietary specifications.

A separate Minnesota bulletin for the week of June 15, 2026 described the related final rule, Expanding Fluid Milk Options in Child Nutrition Programs, as allowing whole and reduced-fat milk for participants two years and older through the Child and Adult Care Food Program, School Breakfast Program and Special Milk Program.

That bulletin said the National School Lunch Program was not included in the final rule because the Whole Milk for Healthy Kids Act already allows those milk options for school lunch.

It pointed readers to implementation memo SP 08-2026, CACFP 04-2026 for information.

## SP 07-2026 Restates Added-Sugars Limits From Last Year

Memo SP 07-2026, titled School Meal Programs: Reviewing Product-Based Added Sugars Limits for Breakfast Cereals, Flavored Milk, and Yogurt, restates product-based limits implemented during the prior school year, according to the June School Nutrition Newsletter.

Breakfast cereal may contain no more than 6 grams of added sugar per dry ounce.

Yogurt may contain no more than 2 grams of added sugar per ounce.

Flavored milk may contain no more than 10 grams of added sugar per 8-ounce serving.

Menu planners can use the three thresholds when reviewing breakfast cereals, yogurt and flavored milk for school meal programs.

The limits apply by product rather than as a weekly dietary-specification calculation.

## SP 06-2026 Sets Paid Lunch Equity Path For 2026-2027

Memo SP 06-2026 provides Paid Lunch Equity guidance for school year 2026-2027, according to the June School Nutrition Newsletter.

School food authorities with a negative foodservice fund balance on June 30, 2025 must complete the Paid Lunch Equity tool.

All other school food authorities can request an exemption during the school year 2026-2027 renewal process.

Operators can contact dpicnfd@nd.gov for a copy of the PLE tool.

The newsletter included a four-part Paid Lunch Equity Tool Q&A for school year 2026-2027.

First, school food authorities with a positive or zero balance in the nonprofit school food service account as of June 30, 2025 are exempt from PLE pricing requirements found at 7 CFR 210.14(e).

To apply for the exemption, operators complete the attestation in Sponsor details during the program renewal process.

Once the information is completed and the renewal has been approved, that record serves as the record of exemption.

School food authorities with a negative balance are required to submit a PLE tool for 2026-2027 to ensure prices comply with PLE pricing requirements.

The form has been released.

Operators seeking that form are asked to contact dpicnfd@nd.gov for a copy.

Second, a district with a negative balance cannot set a paid-lunch price solely based on the amount it wishes to charge.

Those authorities must charge at least the minimum price determined by their PLE tool.

The target price for a paid meal during school year 2026-2027 is $4.16, although an authority may be lower or higher than the target price.

Authorities with a zero or positive balance may choose to complete the PLE tool to calculate a student paid-lunch price for 2026-2027.

Completion is not required for those authorities, but it is recommended to help ensure paid prices can continue to cover expenses.

The newsletter listed pricing considerations including expected reimbursement.

It explained that reimbursement is based on individual eligibility.

It explained that a school will receive the same reimbursement amount regardless of the paid lunch price charged.

Other listed considerations include labor shortages and potential wage increases.

Increased food costs were listed as another consideration.

Fluctuation in participation was listed as another consideration.

Meal quality was listed as another consideration, with the reminder that quality should not decrease if a school decides to lower paid lunch prices.

Third, schools need to complete a form step even when they choose not to complete the PLE tool and instead seek the waiver.

They must complete the attestation that is part of the National School Lunch Program program renewal process located on the Sponsor details page.

Fourth, the newsletter addressed whether a 10-cent cap applies when a school does not seek the waiver.

Consistent with 7 CFR 210.14(e)(4)(i), school food authorities are not required to raise their paid lunch price by more than 10 cents for school year 2026-2027 from the last year they charged for paid lunches.

Authorities may still choose to raise the price by more than 10 cents.

Schools can determine the needed charge by analyzing projected income and expenses for the upcoming year.

In years when the PLE tool is required, it calculates the required price increase but will not require an increase greater than 10 cents in any year.

Schools retain the option to raise prices higher if needed to cover expenses, while program rules would not require more than a 10-cent increase in a year.

For additional questions, operators were directed to email rhondaamundson@nd.gov with PLE Tool in the subject line.

## Summer Food Storage Requires Temperature Records

Food-storage areas holding food during the summer must have temperatures recorded at least every three days during vacation periods, according to the June School Nutrition Newsletter.

If foodservice staff are not available to check, maintenance or administration staff can add the check to summer responsibilities.

The newsletter described the check as a quick but important duty.

Operators preparing for future equipment funding were advised that a coming round of equipment grants could be an opportunity to install remote temperature-monitoring equipment on all food-storage areas.

Sensors, software and installation can add up quickly, the newsletter said.

Recorded monitoring is intended to ensure food remains safely stored until students return.

## Free-Meals Ballot Cost Estimate Adopted In Same Week

The Department of Public Instruction estimates implementation of the free school meals ballot measure at $124.3 million to $134.3 million every two years, according to reporting titled Lawmakers adopt cost estimate for North Dakota school meal ballot measure.

Legislative Management, a committee with members from the House and Senate, voted to use the new estimate as the fiscal estimate for Measure 3 on the general election ballot.

The cost analysis will appear next to the ballot measure language on the Secretary of State's website.

Lynelle Johnson, director of child nutrition and food distribution for the Department of Public Instruction, presented the estimate to lawmakers.

Officials revised the range after talking with nine other states that established similar programs.

The revised range was slightly lower than estimates presented to lawmakers in December.

Johnson based the new estimate on participation in federally subsidized free and reduced-cost school meal programs in other states that offer free school meals.

She said more schools are expected to use other reimbursement programs, including SNAP, the Temporary Assistance for Needy Families program and Medicaid, for income verification to automatically qualify for the federal school meals program.

Johnson said cautious assumptions had been used over the prior two years because officials were unsure how many families would still complete applications.

An application to receive free or reduced school meals requires families to provide household income data to establish how much of the meal cost would be reimbursed through the federal or state government.

About 125,000 students attend schools that participate in the federal school lunch program in North Dakota.

Only a few thousand students attend smaller public schools, private schools, or are homeschooled, that do not participate in the program.

Johnson said North Dakota could follow Vermont's model for universal school meals.

In that state, schools are required to participate in other reimbursement programs, which automatically enroll students at the federal level for school meals programs.

Automatic enrollment could reduce reliance on annual income-verification applications submitted by parents to schools.

Sen. Janne Myrdal, R-Edinburg, a member of Legislative Management, said she worries that people will stop applying for the free or reduced meals program and costs will rise because the state will receive less federal funding.

Rep. LaurieBeth Hager, D-Fargo, said feeding about 125,000 students a meal for about 175 days per year is an investment.

The Secretary of State's Office approved and verified more than 49,000 petition signatures to place Measure 3 on the ballot.

If approved by voters, the free school meals program will take effect for the 2027-28 school year.

Private and tribal K-12 schools would be able to opt in to the program.

The measure specifies that the state's Legacy Fund would be used to pay for free breakfasts and lunches unless the Legislature identifies other funding.

## Sources referenced
- Lawmakers adopt cost estimate for North Dakota school meal ballot measure | The Mighty 790 KFGO | KFGO (https://kfgo.com/2026/06/13/lawmakers-adopt-cost-estimate-for-north-dakota-school-meal-ballot-measure/)

## IFIC Survey: Most Trust Food Safety, Yet Chemical Worries Shape Buying

URL: https://nutritionjournal.com/ific-food-safety-chemicals-packaging-survey-2026

IFIC's June 18, 2026 survey finds 75% trust foods they buy, while 30% changed purchases and 47% avoid certain packaging over chemical concerns.

Key takeaways:
- 75% of Americans at least somewhat trust foods they purchase, including 34% who strongly trust them.
- 30% changed food purchases in the past year over safety concerns.
- 79% trust themselves and 73% trust farmers on safety, versus 45% for government agencies.
- 47% avoid certain packaging, mainly over chemical safety at 54% and health impacts at 51%.
- 81% view microplastics as harmful, while 70% say scientists are still learning.
- 61% view natural additives as safer; 46% say additives are carefully studied and regulated.

TL;DR: Three-quarters of U.S. adults trust the foods and beverages they buy, yet 30% changed purchases over safety worries and 47% avoid certain packaging, according to the June 18, 2026 IFIC Spotlight Survey.

## Survey snapshot: confidence paired with caution

The International Food Information Council released new consumer research in Washington, D.C., on June 18, 2026, showing broad trust alongside persistent unease about chemicals in food and packaging. The project, titled IFIC Spotlight Survey: Americans' Perceptions of Chemicals in Food & Packaging, examined views on safety, additives, packaging materials, and risk, according to the IFIC press release titled Most Americans Trust The Safety Of The Foods And Beverages They Purchase, Yet Concerns About Chemicals In Food And Packaging Persist.

Three-quarters of respondents, or 75%, said they at least somewhat trust that the foods and beverages they purchase are safe to consume. One-third, or 34%, said they strongly trust that safety, according to that IFIC press release.

Smaller shares expressed distrust. Ten percent said they somewhat distrust the safety of items they purchase, while 4% said they strongly distrust that safety. Twelve percent said they neither trust nor distrust, according to the survey report detailed in the IFIC research page titled IFIC Spotlight Survey: Americans' Perceptions Of Chemicals In Food And Packaging.

Trust in personal purchases was higher than confidence in the national supply. The survey report noted that 55% of Americans in the 2025 IFIC Food & Health Survey were at least somewhat confident in the safety of the U.S. food supply, compared with 75% expressing at least somewhat trust in foods and beverages they personally purchase in the new poll.

IFIC President and CEO Wendy Reinhardt Kapsak, MS, RDN, said consumers face a complicated information setting around safety, chemicals, and packaging. She said the results point to chances to strengthen confidence through open communication, science-based education, and clearer explanation of safety decisions, according to the June 18 IFIC press release.

## Three in ten say safety concerns changed buying

Purchasing behavior has shifted for a sizable minority. Thirty percent of Americans said they changed food or beverage purchasing habits during the past year because of safety concerns, according to the IFIC press release.

Most respondents, or 65%, said they had not made such a change in the past year. Another 6% said they were not sure, according to the survey report summarized on the IFIC research page.

The report framed those shifts against wider attention to ingredients and additives. It said discussions about food safety as well as additives and ingredients have become more visible, and some shoppers may be reconsidering choices, according to that IFIC research page.

That behavioral signal matters for nutrition guidance. The 30% figure shows concern is not only abstract, because nearly one-third linked worry to a different basket. The 65% majority indicates stability for most households over the same 12-month period.

## Who Americans trust to keep food safe

Trust differed markedly across people and institutions in the food system. Respondents placed the most confidence in themselves and in producers closest to agriculture, according to the IFIC press release.

Nearly eight in ten, or 79%, said they trust themselves to help ensure foods and beverages are safe to consume. Forty-seven percent said they strongly trust themselves in that role, according to the survey report.

Farmers and ranchers ranked second. Seventy-three percent trusted farmers and ranchers to help ensure safety, including 30% who strongly trusted them, according to the same report.

Other food-system participants received moderate ratings. Grocery stores and other food retailers were trusted by 61%, food scientists by 59%, restaurants and cafeterias by 57%, and food and beverage manufacturers by 56%, according to the IFIC press release.

Government agencies received the most divided assessment. Forty-five percent said they trusted government agencies to help ensure safety, 30% said they distrusted them, and 25% said they neither trusted nor distrusted them, according to the IFIC press release.

IFIC Senior Director of Research and Consumer Insights Kris Sollid, RD, said trust can require years to establish and can disappear quickly. He said Americans were more inclined to rely on those nearest the farm and the fork than on many participants in the middle, according to the June 18 IFIC press release.

The report described that pattern as stronger confidence at the ends of the farm-to-fork chain and softer confidence in organizations and institutions between those ends, according to the IFIC research page.

## Hazard versus risk remains difficult to communicate

Risk perception showed both understanding and inconsistency. Two-thirds of Americans, or 68%, agreed that something with potential to cause harm, defined as a hazard, can still present little actual risk, according to the IFIC press release.

At the same time, many respondents judged safety by presence of a hazard rather than likelihood of harm. Among respondents who stated a view about the link between risk and hazard, nearly one-quarter, or 23%, said that if something can cause harm they generally view it as high risk, according to that IFIC press release.

The research page said concerns appeared to reflect the existence of a possible hazard more than the probability of injury. It also said 68% recognized that a potential hazard may carry limited real-world risk, while communication of that distinction remains challenging.

For health professionals, that split creates a practical task. A direct statement about hazard and risk drew agreement from a large majority, yet almost one in four of those with an opinion still equated possible harm with high risk. The result suggests education must repeat the difference between what could happen in theory and what is likely under actual exposure.

## Natural versus manufactured additives divide shoppers

Food additives remained an area of doubt. Six in ten respondents, or 61%, said natural food additives are safer than manufactured versions, according to the survey report.

Fewer than half expressed confidence in oversight. Forty-six percent said food additives are carefully studied and regulated for safety, according to that report.

A similar share linked regulatory review to safety. Forty-five percent said approval by the U.S. Food and Drug Administration means a food additive is safe to consume, according to the survey report.

Those three numbers describe a knowledge gap relevant to daily eating decisions. A majority favored natural additives, while less than half endorsed statements about study, regulation, or FDA approval. The pattern suggests many shoppers use origin as a shortcut when the review process seems unclear.

The report said additives continue to create uncertainty for many Americans. It connected that uncertainty to broader worries about ingredients, contaminants, and packaging that persisted even among respondents who trusted their own purchases.

## Packaging avoidance centers on chemical safety

Packaging influenced decisions for nearly half the public. Forty-seven percent of Americans said they avoid certain food and beverage packaging materials, according to the IFIC press release.

Health-related motives led among avoiders. Fifty-four percent cited chemical safety and 51% cited potential health impacts as reasons for avoidance, according to that IFIC press release.

Environmental and sensory reasons ranked lower. Thirty-three percent cited the environment, 33% cited taste, and 29% cited packaging performance, according to the same IFIC press release.

Confidence in packaging review remained higher than avoidance might imply. Two-thirds, or 66%, said they were at least somewhat confident that chemicals and materials used in food and beverage packaging have been evaluated for safety, according to the IFIC press release.

That combination defines the current consumer stance. Nearly one in two steers away from selected materials, while two in three still express at least some confidence that materials have undergone safety evaluation. Avoidance therefore reflects selective caution rather than wholesale rejection.

## Clear labels top list for building packaging confidence

Respondents identified what might increase their assurance. Forty-five percent said transparent labeling about packaging materials and possible chemical exposure would help them feel confident about packaging safety, according to the IFIC press release.

Independent science and testing information followed. Thirty-five percent cited findings from independent scientific research, and 35% cited information about how packaging materials are tested for safety, according to that IFIC press release.

The ordering carries a message for manufacturers and retailers. Label disclosure at 45% outranked research findings and testing explanations, each at 35%, as a confidence aid. Shoppers sought direct material information on the package more than general summaries of studies.

## Microplastics draw widespread concern

Microplastics generated some of the strongest worry in the poll. More than eight in ten Americans, or 81%, said microplastics are harmful to human health, according to the IFIC press release.

Awareness of limits in knowledge was also high. Seven in ten, or 70%, agreed that scientists are still learning about health effects of microplastics, according to that IFIC press release.

Exposure beliefs were common. More than two-thirds, or 68%, said microplastics are present in many foods and beverages, according to the same IFIC press release.

The report said public awareness and concern continue to expand even as many consumers recognize that scientific understanding is still developing. That dual view — strong belief in harm alongside recognition of ongoing study — shapes how packaging and processing news may be received.

## How the survey was conducted

The International Food Information Council commissioned an online survey of 1,004 U.S. adults ages 18 years and older. Interviews took place from February 13 through February 22, 2026, and results were weighted to support proportional representation, according to the IFIC research page titled IFIC Spotlight Survey: Americans' Perceptions Of Chemicals In Food & Packaging.

The Bayesian confidence level for the sample of 1,004 was 3.5, roughly equal to a margin of error of plus or minus 3.1 percentage points at the 95% confidence level, according to the IFIC press release.

Totals in the report may not sum to 100% because of rounding. Statistically significant differences were noted where appropriate, with comparisons made only within each demographic grouping such as age, race, or gender, according to the survey report.

## Sources referenced
- Most Americans Trust The Safety Of The Foods And Beverages They Purchase, Yet Concerns About Chemicals In Food And Packaging Persist - IFIC (https://ific.org/media/most-americans-trust-the-safety-of-the-foods-and-beverages-they-purchase-yet-concerns-about-chemicals-in-food-and-packaging-persist/)
- IFIC Spotlight Survey: Americans' Perceptions Of Chemicals In Food & Packaging - IFIC (https://ific.org/research/ific-spotlight-survey-americans-perceptions-of-chemicals-in-food-packaging/)

## Nara Organics Withholds German Maker Name in Infant Botulism Recall

URL: https://nutritionjournal.com/nara-organics-withholds-german-maker-name-in-infant-botulism-recall

Nara Organics imported its recalled formula from Germany but would not name the maker, as FDA and CDC probe three infant botulism hospitalizations.

Key takeaways:
- Nara Organics imported the formula from Germany but has not named the German manufacturer.
- Three infants ages 2-5 months in California, Pennsylvania and Washington were hospitalized and treated with BabyBIG; no deaths were reported.
- FDA recommended the recall and Nara agreed June 13, 2026 to recall all lots of Whole Milk Organic Powdered Infant Formula.
- The recall covers 700g UPC 860013251901 and 400g UPC 860013251918 sold at Target stores, Target.com and Nara.com from July 2025 to June 2026.
- Rep. Rosa DeLauro on June 16 urged Congress to pass the Infant Formula Safety Modernization Act after the ByHeart and Nara outbreaks.
- Testing of opened and unopened formula samples was underway with results expected in coming weeks.

TL;DR: Nara Organics imported its recalled Whole Milk Organic Infant Formula from Germany but has not named the German manufacturer, as federal officials investigate three infant botulism cases in California, Pennsylvania and Washington.

## Newest verified fact: importer will not name maker

Nara Organics, of New York, NY, sold infant formula linked to infant botulism that was imported from Germany, according to Food Safety News. The company has not named the specific German manufacturer of the formula.

"Nara works with a state of the art manufacturer in Germany who has over 70 years of experience making top European infant formulas," a company spokeswoman told Food Safety News. That report, published June 17, 2026, said the spokeswoman did not respond to questions about the name of the German manufacturer nor provide comment about why the name was being withheld from the public.

The lack of a named manufacturer leaves parents, retailers and health departments with only the U.S. brand name and lot codes to identify cans. The U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) contacted Nara Organics late Friday, June 12, 2026, and provided information about three cases of infant botulism in infants who CDC reported had consumed Nara formula, according to the FDA recall announcement posted June 13, 2026.

Nara Organics agreed on June 13, 2026, to recall all Nara Organics brand Whole Milk Organic Powdered Infant Formula after FDA recommended a recall because of the severity of illnesses and the epidemiologic signal, according to Food Safety News. Consumers should not use recalled infant formula.

## Three infants hospitalized in three states

As of June 13, 2026, a total of three infants with infant botulism had been reported in the outbreak from three states: California, Pennsylvania, and Washington, according to the CDC newsroom release dated June 13, 2026. They ranged in age from 2 to 5 months when their illness began. All three consumed Nara Organics Whole Milk Organic Infant Formula.

The California Department of Public Health reported that the infections were among infants who were fed Nara Organics Whole Milk Organic Powdered Infant Formula, according to Food Safety News. The babies became sick in April and May.

All three infants were hospitalized and treated with BabyBIG®, the FDA-approved treatment for infant botulism, according to the CDC release. The FDA recall announcement said the three infants were hospitalized and treated with BabyBIG (Botulism Immune Globulin Intravenous) in California, Washington, and Pennsylvania. No deaths have been reported.

The Washington State Department of Health said a Thurston County infant recently diagnosed with infant botulism consumed Nara Organics whole milk infant formula prior to onset of symptoms. The department listed its state count as one case, one hospitalization and zero deaths, with status ongoing and recall yes, in its update last updated June 15, 2026.

Infant botulism happens when swallowed spores from Clostridium botulinum bacteria infect a baby's large intestine and make toxin in it, according to the CDC release. Infant botulism often starts with constipation but is usually first noticed as difficulty feeding, including sucking and swallowing problems, a weak and altered cry, and lack of head control.

The FDA recall announcement described infant botulism as a rare but potentially fatal illness that occurs when Clostridium botulinum spores are ingested and colonize the intestinal tract, producing botulinum neurotoxins in the immature gut of infants. It listed signs and symptoms that can include constipation, poor feeding, ptosis, sluggish pupils, low muscle tone, difficulty sucking and swallowing, weak or altered cry, generalized weakness, respiratory difficulty, and possibly respiratory arrest.

## National recall covers all lots on the market

Nara Organics of New York, NY, is voluntarily recalling all lots of Nara Organics Powdered Infant Formula currently on the market out of an abundance of caution due to the potential risk of Clostridium botulinum contamination, according to the FDA recall announcement.

Nara Organics Powdered Infant Formula was distributed nationally across Target retail stores, Target.com, and Nara.com between July 2025 and June 2026, according to the FDA announcement. The implicated organic formula was distributed nationally across Target retail stores, Target.com, and Nara.com between July 2025 and June 2026, according to Food Safety News. Nara Infant Formula is not distributed outside of the USA, according to the FDA announcement.

Affected product details listed by FDA are Nara Organics Whole Milk Infant Formula, 700g, with UPC 860013251901, and Nara Organics Whole Milk Infant Formula, 400g, with UPC 860013251918. All lots currently on the market are included in the voluntary recall.

The lot code can be found on the bottom of each can. The specific codes listed are 408125075E14F2, 708125076E14F2, 708125083E14F2, 408125139E14F2, 708125141E14F2, 708125145E14F2, 708125174E14F2, 709125273E14F2, 709125280E14F2, 709125288E14F2, 409125307E14F2, 70926019ENNB, 70926029ENNB, 70926035ENNB, 70926039ENNB, and 70926042ENNB.

The three specific product lots these infants were exposed to are 709125280E14F2, 709125288E14F2, and 708125174E14F2, according to the FDA announcement. To date, Nara infant formula has not tested positive for C. botulinum, but Nara is voluntarily recalling all products currently in market, the announcement said.

Officials in two states have collected leftover infant formula for testing, according to Food Safety News. Testing of opened cans of Nara Organics brand formula and unopened Nara Organics product samples is underway, and results are expected in the coming weeks, according to the CDC release.

Nara Organics Whole Milk Organic Infant Formula makes up less than 1 percent of all infant formula sold in the United States and this outbreak does not create shortage concerns of infant formula for parents and caregivers, according to the FDA, as reported by Food Safety News.

Nara will automatically refund all consumers who purchased formula from their website in May and June 2026, according to the FDA announcement. Other customers with unused product may request a refund by taking a photo of the bottom of each can and completing a refund form, while Target customers may return their product to Target retail locations or follow Target's online return instructions.

## Lawmaker calls for Infant Formula Safety Modernization Act

A U.S. representative issued a statement on June 16 calling on Congress to pass the bipartisan Infant Formula Safety Modernization Act, according to Food Safety News. That representative was Rep. Rosa DeLauro, D-CT.

"In just seven months, we have experienced two outbreaks of infant botulism tied to powdered infant formula. First, a ByHeart outbreak which sickened 48 sick babies across 19 states, and now Nara Organics with babies in three different states – all of them between two and five months old – now fighting for their lives," DeLauro said in the statement quoted by Food Safety News.

"This is not an isolated incident, it is a concerning pattern that begs the question; are we doing enough to ensure the safety of infant formula in this country? Before ByHeart and Nara Organics, in 2022, there was Abbott's facility in Sturgis, MI, that shutdown after a cronobacter sakazakii outbreak, triggering a nationwide shortage that left families scrambling for formula and babies hospitalized and in some cases, dead," DeLauro said.

"The food we give our babies must meet the highest standard of safety. Right now it does not, and the gaps in the system are clear. Multiple crises year after year show the current system is not working, and we must be doing more," DeLauro said.

The Infant Formula Safety Modernization Act is endorsed by the American Academy of Pediatrics, Consumer Reports, Prolacta, Consumer Federation of America, Environmental Working Group, Center for Science in the Public Interest, STOP Foodborne Illness, and the Association of Public Health Laboratories, according to Food Safety News.

## Prior outbreaks sharpen scrutiny of powdered formula

The ByHeart outbreak sickened 48 babies across 19 states, according to DeLauro's statement. Seattle food safety attorney Bill Marler said his firm represents more than twenty other families whose infants were poisoned in the ByHeart outbreak — the first formula-linked infant botulism outbreak ever recognized, according to Food Safety News.

"We have been here before," Marler said, as quoted by Food Safety News. "In March 2023, the FDA told this entire industry, in writing and naming Clostridium botulinum, that powdered infant formula had a documented history of botulism and that manufacturers had to control for it. None of this was unforeseeable. It was preventable."

Marler said three babies were in the hospital and mercifully no one had died, but a recall after the fact is not a food safety system. After the ByHeart outbreak, the FDA had to send warning letters to Target, Walmart, Kroger and Albertsons because recalled infant formula was still sitting on store shelves — in some cases restocked and discounted — weeks after the recall began, Marler said, according to Food Safety News.

## What parents, caregivers and clinicians are told to do

Parents and caregivers are urged to immediately stop using any Nara Organics Whole Milk Organic Infant Formula, according to the CDC release. Consumers should not use recalled infant formula, according to Food Safety News. Customers should stop using the affected products immediately, according to the FDA announcement.

If you have unopened cans of Nara Organics infant formula, throw them away or return them, according to the CDC release. If you have leftover opened cans, take a picture and record the lot number and use-by date, consider retaining any opened formula because the state health department may want to test it if illness develops, label it "DO NOT USE" and keep it stored in a safe place away from other items fed to the baby for at least a month, and if no symptoms appear after a month, throw the leftover formula away.

Wash items and surfaces that may have touched the recalled formula using hot soapy water or a dishwasher, according to CDC and FDA guidance. To report an illness or adverse event, use FDA's Safety Reporting Portal, with the FDA announcement also listing SmartHub reporting and Voluntary MedWatch forms online or by mail.

Seek immediate health care if an infant consumed Nara Organics brand infant formula and has poor feeding, loss of head control, difficulty swallowing, or decreased facial expression, according to the CDC release. Symptoms of infant botulism can take several weeks to start, and parents should watch an exposed infant for symptoms for a month after the infant last consumed the product.

For clinicians, initial diagnosis of infant botulism is based on clinical signs, and if clinical consultation supports infant botulism, begin treatment as soon as possible without waiting for laboratory confirmation, according to the CDC release. Treatment with BabyBIG® is recommended for all suspected cases. Customers with questions are encouraged to visit Nara's website or email hello@nara.com, according to the FDA announcement.

## Sources referenced
- Infant formula company refuses to reveal the name of the manufacturer tied to botulism outbreak | Food Safety News (https://www.foodsafetynews.com/2026/06/infant-formula-company-refuses-to-reveal-the-name-of-the-manufacturer/)
- NARA ORGANICS RECALLS ALL LOTS OF NARA INFANT FORMULA BECAUSE OF POSSIBLE HEALTH RISK | FDA (https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/nara-organics-recalls-all-lots-nara-infant-formula-because-possible-health-risk)

## Voluntary vs. Mandatory Recalls: How FDA Food Removals Work

URL: https://nutritionjournal.com/voluntary-vs-mandatory-recalls-how-fda-food-removals-work

Voluntary recalls are company-initiated, often at FDA request; mandatory recalls are rare FDA orders. Class I-III, not the label voluntary, signals food risk.

Key takeaways:
- Voluntary recalls are company-initiated, often after FDA asks the firm to act rather than face a formal order.
- Mandatory food recalls under FSMA Section 206 require inadequate voluntary action plus reasonable probability of serious harm or death.
- Recall Class I, II or III signals health risk; voluntary vs mandatory describes the legal mechanism.
- Recalling firms must notify FDA and buyers, track lots, arrange return or destruction, and file status reports.
- Market withdrawals for non-violations and safety alerts are not recalls and carry different consumer actions.
- Public FDA Enforcement Reports list product, firm, reason, class and distribution permanently and are searchable weekly.

TL;DR: A voluntary food recall is usually company-led action taken after its own tests or at the regulator's request, while a mandatory recall is an FDA order used when a firm will not act.

## Voluntary recalls cover almost every FDA action

Most FDA recalls are voluntary, initiated by the company or at the FDA's request, according to FDABridge.

A voluntary recall is one that a company initiates on its own, without being ordered to do so by a government agency, according to Recall Radar.

That label does not mean the company found a trivial problem and decided to be proactive, according to Recall Radar.

It usually means one of two things: either the company found the problem through its own testing and quality systems and moved ahead of a government investigation, or the FDA, USDA, NHTSA, or CPSC identified the problem and asked the company to recall, according to Recall Radar.

The second scenario is extremely common, according to Recall Radar.

Government agencies often contact manufacturers when they identify a safety concern, explain what they have found, and request a voluntary recall, according to Recall Radar.

The manufacturer, facing the alternative of a public mandatory recall order, which is worse for its reputation and potentially triggers more regulatory scrutiny, agrees to cooperate, according to Recall Radar.

The result is labeled voluntary, even though the practical difference between a requested voluntary recall and a mandatory one is close to zero from the consumer's perspective, according to Recall Radar.

The vast majority of FDA recalls are voluntary — the manufacturer, distributor, or importer initiates the recall, often after discovering a compliance problem through internal testing, consumer complaints, or FDA notification, according to FDABridge.

Voluntary recalls may be conducted with or without FDA involvement, but the FDA monitors all recalls and may request additional actions if the company's efforts are insufficient, according to FDABridge.

An analysis of public FDA records by Fonteum found 99.4% of recalls are firm-initiated, with only 0.5%, or 302 recalls, listed as FDA-mandated.

The word voluntary in a recall notice does not signal that the recall is precautionary or that the hazard is minor, according to Recall Radar.

Some of the deadliest recalls in U.S. history — including the Takata airbag inflator recall that killed more than 30 people — were technically voluntary, according to Recall Radar.

## Mandatory recalls require a refusal or failed voluntary effort

Mandatory recalls occur when a company refuses to voluntarily recall a product that an agency has determined poses a safety risk, according to Recall Radar.

This is relatively rare because most companies comply with government requests rather than face the legal, reputational, and financial consequences of a public fight with a federal agency, according to Recall Radar.

FSMA Section 206 gave the FDA authority to order mandatory recalls of food products when voluntary recall efforts are inadequate and when the FDA determines that there is a reasonable probability that the food is adulterated or misbranded and that the use of or exposure to the food will cause serious adverse health consequences or death, according to FDABridge.

The FDA gained the authority to order mandatory food recalls in 2011 under the Food Safety Modernization Act, known as FSMA, according to Recall Radar.

Before that, the FDA could only request voluntary recalls for most food products, according to Recall Radar.

For drugs and devices, the FDA has separate mandatory recall authorities under other provisions of the FD&C Act, according to FDABridge.

The CPSC has long had mandatory recall authority under the Consumer Product Safety Act, according to Recall Radar.

NHTSA can order mandatory vehicle recalls under the National Traffic and Motor Vehicle Safety Act, according to Recall Radar.

When you see a mandatory recall, it typically means there was a dispute between the manufacturer and the agency, or the manufacturer was unresponsive, according to Recall Radar.

The safety concern itself is usually the same whether the recall is voluntary or mandatory — the distinction reflects the legal mechanism, not the severity of the hazard, according to Recall Radar.

## Class I, II and III describe health risk, not willingness

The FDA classifies recalls based on the severity of the health risk, according to FDABridge.

The more meaningful indicator of a recall's seriousness is its classification: Class I, Class II, or Class III, according to Recall Radar.

These classifications apply to FDA and USDA recalls and are based on the assessed health risk, not on whether the recall was voluntary or mandatory, according to Recall Radar.

A Class I recall means the agency has determined there is a reasonable probability that using or being exposed to the product will cause serious adverse health consequences or death, according to Recall Radar.

Class I recalls involve situations where there is a reasonable probability that the use of or exposure to a violative product will cause serious adverse health consequences or death, according to FDABridge.

Examples include food contaminated with Clostridium botulinum toxin, drugs with incorrect active ingredient concentrations, or devices that could cause fatal injuries, according to FDABridge.

Most food recalls involving Listeria, Salmonella, or E. coli are Class I, according to Recall Radar.

Most drug recalls involving dangerous contamination are Class I, according to Recall Radar.

A Class II recall means the product may cause temporary or medically reversible adverse health consequences, or that serious harm is possible but unlikely, according to Recall Radar.

Class II recalls involve situations where the use of or exposure to a violative product may cause temporary or medically reversible adverse health consequences, or where the probability of serious health consequences is remote, according to FDABridge.

A Class III recall means the product is unlikely to cause any health consequences but violates regulations, according to Recall Radar.

Class III recalls involve situations where the use of or exposure to a violative product is not likely to cause adverse health consequences, according to FDABridge.

The classification determines the urgency and scope of the recall actions required, according to FDABridge.

Read the recall classification and the reason for recall to understand the actual risk level, according to Recall Radar.

NHTSA vehicle recalls and CPSC product recalls use different language — NHTSA does not use the Class I/II/III system — but NHTSA safety recalls are inherently serious because they involve defects that can impair vehicle operation, according to Recall Radar.

## What a recalling food firm must do

When a recall is initiated, the recalling firm must notify the FDA, according to FDABridge.

The firm must identify all affected product by lot number, production date, and distribution records, according to FDABridge.

It must notify all direct accounts, including distributors, retailers, and food service operators, that received the product, according to FDABridge.

It must arrange for the return or destruction of recalled product, according to FDABridge.

It must issue public notification when required by the FDA, typically for Class I and Class II recalls, according to FDABridge.

It must provide the FDA with regular status reports on the recall's effectiveness, according to FDABridge.

The FDA evaluates the recall's progress through audit checks — verifying that the recalling firm's notifications reached their intended recipients and that affected product is being removed from commerce, according to FDABridge.

Even when a company agrees to a voluntary recall, the process takes time, according to Recall Radar.

The company must identify the scope of the affected product — which lots, which date ranges, which distribution channels, according to Recall Radar.

It must arrange for the product to be pulled from store shelves, which requires coordinating with distributors and retailers across the country, according to Recall Radar.

## Withdrawals and alerts are not recalls

A market withdrawal is distinct from both voluntary and mandatory recalls, according to Recall Radar.

It occurs when a company removes a product from the market for a reason that does not constitute a regulatory violation, according to Recall Radar.

The problem might be a quality issue — off flavor, discoloration, or a packaging defect — that does not pose a safety risk and does not violate FDA or USDA standards, according to Recall Radar.

Market withdrawals are not tracked by government agencies the same way recalls are, and they do not appear in official recall databases, according to Recall Radar.

Consumers typically learn about them through retailer communications or media coverage, according to Recall Radar.

Because there is no health risk involved, market withdrawals do not require the same consumer action as a recall, according to Recall Radar.

Safety alerts and public health notifications are also distinct from recalls, according to Recall Radar.

The FDA sometimes issues safety alerts about products that have not been recalled but pose a potential risk — for example, alerting consumers to fraudulent or counterfeit products in the market, according to Recall Radar.

These are not recalls and do not require the same response, according to Recall Radar.

## Imported-food recalls add importer duties

When a recalled product was manufactured abroad, the foreign manufacturer must cooperate with the U.S. importer and distributor to provide the information needed for an effective recall, according to FDABridge.

This includes providing production records that identify the affected lots, according to FDABridge.

It includes providing distribution records showing where the product was shipped, according to FDABridge.

It includes providing manufacturing and testing records that may help identify the root cause, according to FDABridge.

It includes ongoing communication about corrective actions being taken at the manufacturing facility, according to FDABridge.

The foreign manufacturer should also halt further shipments of the affected product until the root cause has been identified and corrected, according to FDABridge.

While the FDA's primary enforcement contact during a recall is typically the U.S. importer or distributor, the foreign manufacturer's cooperation is essential, according to FDABridge.

Refusal to cooperate can result in import alerts and other enforcement actions against the facility, according to FDABridge.

## What the public record shows

All recalls are reported in the FDA's Enforcement Reports, which are published weekly and are publicly searchable, according to FDABridge.

The recall report includes the product name, the recalling firm, the reason for the recall, the recall classification, and the distribution information, according to FDABridge.

Recall information is permanent — once published, it remains in the FDA's database indefinitely, according to FDABridge.

Fonteum counted 56,777 FDA recall reports in the database, plus 3,574 warning letters.

Of all 56,777 recall records, Class II accounts for 86%, Class I for 9.2%, and Class III for 4.8%, according to Fonteum.

Medical devices account for 68.9% of recalls, at 39,095 recalls, with drugs accounting for the remaining 31.1%, at 17,682 recalls, according to Fonteum.

The data run through June 2026 as a partial year, with volume peaking in 2018-2019 above 4,600 per year and stabilizing near 3,600 to 3,800 after 2020-2021, according to Fonteum.

The bottom line for shoppers: pay more attention to the recall class than to whether it is described as voluntary or mandatory, according to Recall Radar.

## Sources referenced
- FDA Recall Process: What Foreign Manufacturers Must Know When a Product Must Be Removed from the US Market | FDABridge (https://fdabridge.com/blog/fda-recall-process-foreign-manufacturers-product-removed-us-market)
- Voluntary vs. Mandatory Recalls: What the Distinction Actually Means for Consumers | Recall Radar (https://recallradar.company/articles/voluntary-vs-mandatory-recall)

## What to Know About Recalled Baby Formula After Nara Botulism Alert

URL: https://nutritionjournal.com/recalled-baby-formula-nara-botulism-guide

Three infants were hospitalized after consuming Nara Organics formula, prompting a nationwide recall of all lots. Here are the lot codes, symptoms, and safety steps.

Key takeaways:
- Stop using all Nara Organics Whole Milk Organic Infant Formula immediately; the June 13, 2026 recall covers all lots and both can sizes.
- Three infants ages 2-5 months in California, Pennsylvania, and Washington were hospitalized and treated with BabyBIG; no deaths were reported as of June 13.
- Watch an exposed infant for one month for constipation, poor feeding, droopy eyelids, weak cry, swallowing trouble, or loss of head control.
- Photograph opened-can lot numbers, label the can DO NOT USE, store it separately, and wash contacted surfaces with hot soapy water.
- Do not give honey before age 1, avoid raw milk and homemade formula, and check mixing directions when switching brands.

TL;DR: Stop using any Nara Organics Whole Milk Organic Infant Formula at once, watch an exposed infant for a full month, and get emergency care for constipation, poor feeding, droopy eyelids, weak cry, or loss of head control.

## Recall at a glance: what happened by June 15, 2026

Federal health officials linked a multistate outbreak of infant botulism to powdered infant formula and the manufacturer recalled every lot on the market, according to [HealthyChildren.org](https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/What-should-I-know-about-the-infant-formula-recall.aspx).

The product is Nara Organics Whole Milk Organic Infant Formula. Investigators reported at least 3 infants in 3 states became ill after consuming it. All 3 babies were hospitalized and treated with a botulism antitoxin, according to HealthyChildren.org.

Distribution was national and prolonged. The recalled formula was sold in Target retail stores and through Target.com and Nara.com between July 2025 and June 2026, according to HealthyChildren.org.

The company action was broad. Nara Organics of New York, NY, voluntarily recalled all lots currently on the market out of an abundance of caution because of possible contamination with *Clostridium botulinum*, according to the [FDA recall announcement](https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/nara-organics-recalls-all-lots-nara-infant-formula-because-possible-health-risk).

The timeline moved quickly over one weekend. The Food and Drug Administration and the Centers for Disease Control and Prevention contacted the company late Friday, June 12, 2026, with information about 3 cases, and the company announcement was dated June 13, 2026, with FDA publication the same day, according to the FDA recall announcement.

## Which cans are included

The recall covers all lots on the market, not a single batch. Consumers are told to stop using affected products immediately, according to the FDA recall announcement.

The two package sizes named are:

- Nara Organics Whole Milk Infant Formula, 700g, UPC 860013251901
- Nara Organics Whole Milk Infant Formula, 400g, UPC 860013251918

The lot code is printed on the bottom of each can. The FDA recall announcement lists 16 codes on the market at the time: 408125075E14F2, 708125076E14F2, 708125083E14F2, 408125139E14F2, 708125141E14F2, 708125145E14F2, 708125174E14F2, 709125273E14F2, 709125280E14F2, 709125288E14F2, 409125307E14F2, 70926019ENNB, 70926029ENNB, 70926035ENNB, 70926039ENNB, and 70926042ENNB.

Three lots were specifically identified as exposures for the hospitalized infants: 709125280E14F2, 709125288E14F2, and 708125174E14F2, according to the FDA recall announcement.

The product was not distributed outside the United States, according to the FDA recall announcement.

As of the June 13 update, the infants ranged from 2 to 5 months old when illness began, were reported from California, Pennsylvania, and Washington, and all had consumed Nara Organics Whole Milk Organic Infant Formula, according to the [CDC outbreak update](https://www.cdc.gov/media/releases/2026/infant-botulism-outbreak-linked-to-powdered-infant-formula-june-2026.html). All 3 were hospitalized and treated with BabyBIG, the FDA-approved treatment for infant botulism, and no deaths were reported, according to the CDC outbreak update.

Testing status was still pending on the archive date. Nara formula had not tested positive for *C. botulinum* at the time of the recall, while testing of opened cans and unopened company samples was underway with results expected in coming weeks, according to the CDC outbreak update and the FDA recall announcement.

## What to do right now if you have the formula

Do not feed the recalled powder to your baby. That is the first instruction from pediatric guidance and federal agencies alike.

If cans are unopened, throw them away or return them. Parents and caregivers were urged to immediately stop using any Nara Organics Whole Milk Organic Infant Formula, according to the CDC outbreak update.

If cans are already opened, federal officials advise a careful hold-and-document routine rather than immediate disposal when illness is possible. Take a picture and record the lot number and use-by date. Consider keeping any opened formula because the state health department may want to test it if the infant develops signs of infant botulism, according to the CDC outbreak update.

HealthyChildren.org gives the same practical sequence: photograph container information before discarding it when symptoms are present, keep opened product that might be needed for testing, mark it “DO NOT USE,” and store it apart from other feeding items in a safe place.

Clean everything the powder may have touched. Wash items and surfaces with hot soapy water or in a dishwasher, according to the CDC outbreak update and HealthyChildren.org.

Watch the baby for a full month after the last use. Symptoms can take several weeks to start, so parents should observe for illness for a month after the infant last consumed the product, according to the CDC outbreak update. HealthyChildren.org likewise says to monitor for up to a month and, if no symptoms appear after that period, discard leftover formula.

To report a problem, the FDA points families to its Safety Reporting Portal, SmartHub, or a Voluntary MedWatch form by mail or online. Seek medical attention first if the child has signs of infant botulism, rather than pausing to file a report, according to the CDC outbreak update and the FDA recall announcement.

## Signs of infant botulism parents should not wait on

Infant botulism happens when swallowed *Clostridium botulinum* spores infect a baby’s large intestine and produce toxin there, according to the CDC outbreak update. The organism makes spores that live in soil and dust. When a baby swallows them, the body can convert them into a toxin that affects nerves, according to HealthyChildren.org.

Parents often notice feeding changes first. Infant botulism often starts with constipation but is usually first noticed as difficulty feeding, including sucking and swallowing problems, a weak and altered cry, and lack of head control, according to the CDC outbreak update.

The fuller warning list includes constipation, often the first sign, weak sucking or feeding, droopy eyelids, a weak or different-sounding cry, less facial movement, trouble swallowing, loss of head control, and floppy arms and legs, according to HealthyChildren.org.

The FDA recall announcement describes a similar clinical picture: constipation, poor feeding, drooping eyelid, sluggish pupils, low muscle tone, difficulty sucking and swallowing, weak or altered cry, generalized weakness, respiratory difficulty, and possibly respiratory arrest.

This is an emergency. If a baby shows those signs, especially after consuming recalled formula, get medical help right away, according to HealthyChildren.org. The CDC alert names four red flags that should prompt immediate care after Nara exposure: poor feeding, loss of head control, difficulty swallowing, and decreased facial expression.

Without treatment, infants can develop progressive flaccid paralysis that leads to breathing difficulty and weeks of hospitalization, according to the CDC outbreak update. Infant botulism can lead to breathing problems and may require a ventilator, but with early treatment most babies recover, according to HealthyChildren.org.

For clinicians, initial diagnosis is based on clinical symptoms. If consultation supports infant botulism, begin treatment as soon as possible and do not wait for laboratory confirmation, according to the CDC outbreak update. Treatment with BabyBIG is recommended for all suspected cases.

## Refunds, exchanges, and WIC help

Check the FDA recalls and safety-alert page for product-specific instructions, according to HealthyChildren.org. Depending on the recall, families may need to bring formula to the store for refund and exchange or call the company directly.

Nara said it would automatically refund consumers who bought formula from its website in May and June 2026. Other customers with unused product could request a refund by photographing the bottom of each can and completing the company refund form, while Target customers could return product to stores or follow online return instructions, according to the FDA recall announcement. Questions were directed to hello@nara.com and media inquiries to media@nara.com.

Families using federal nutrition benefits have a backup path. If receiving WIC benefits, parents should be able to obtain a different brand of similar formula, and if any problem arises they should call the WIC office for advice and assistance, according to HealthyChildren.org.

Do not improvise a replacement by making formula at home. Infants can also develop botulism from other sources, including honey, raw milk from cows or goats, and homemade baby formula, according to HealthyChildren.org.

## How to switch formula safely

Talk with the pediatrician when changing formula. That conversation is a good idea, although many babies can move to a similar product from another company, including store-brand formulas, according to HealthyChildren.org.

Read the can. Mixing directions, meaning how much water and powder go into the bottle, can differ between brands, so check instructions carefully rather than reusing old scoops or ratios from memory, according to HealthyChildren.org.

Keep preparation areas and equipment clean. Germs can be present in unclean feeding supplies such as bottles and nipples and on counters where formula is mixed, so follow good safety practices when preparing formula, according to HealthyChildren.org. Federal guidance reinforces the same point by asking households and businesses not to sell, donate, or use recalled powder and to wash and sanitize anything it touched.

## Why powdered formula carries special risks

Baby formula is regulated to be safe and to supply nutrients infants need, but a recall can occur when contamination or another health risk is suspected, according to HealthyChildren.org. Germs entering formula at a factory may leave no unusual smell or appearance yet still cause severe illness.

*C. botulinum* is only one hazard that has triggered action. Other germs tied to past baby formula recalls include *Cronobacter sakazakii*, which can cause sepsis, a severe life-threatening infection, as well as meningitis, inflammation around the brain and spine, bowel damage, poor feeding, irritability, temperature changes, jaundice, grunting breaths, and abnormal movements, according to HealthyChildren.org.

*Salmonella* is another past cause of recalls. It can cause stomach and intestinal illness with severe diarrhea that can quickly dehydrate babies; more severe infection may include high fever, aches, headaches, lethargy, rash, and blood in urine or stool, according to HealthyChildren.org.

Honey deserves special emphasis during infancy. Never feed honey before the first birthday, and raw milk and homemade formula are not safe, according to HealthyChildren.org.

The June 2026 Nara action followed a November recall of ByHeart powdered infant formula, making it the second premium organic whole-milk formula recall tied to infant botulism within seven months, according to [Healthbeat](https://www.healthbeat.org/2026/06/15/nara-baby-formula-recall-botulism-cases-raise-safety-oversight-questions/). That reporting context helps explain heightened parent concern, but it does not change the immediate steps: stop use, save lot details, clean contact surfaces, watch for a month, and seek prompt care for any neurologic or feeding change.

## FDA Food Recall Severity Splits Into Transferable and Firm-Specific Signals

URL: https://nutritionjournal.com/fda-food-recall-severity-pathogen-firm-signals

A 14 June 2026 Scientific Reports study of 28,448 FDA food recalls finds pathogen signals predict Class I severity across firms, while labeling and GMP signals do not.

Key takeaways:
- A 14 June 2026 Scientific Reports study analyzed 28,448 openFDA food enforcement records from 2012–2025.
- Firm-history baseline reached Macro-F1 0.818 versus 0.893 for the best ML model, or 92% of its performance.
- Hazard category mediated 27–63% of the firm–severity link, leaving at least 37% firm-intrinsic residual.
- 92% of pathogen-related Class I recalls were identified even for unseen companies.
- Labelling defects and GMP violations driving Class III recalls were firm-specific and did not generalise.
- Event-disjoint testing on 7,023 events gave firm-history 0.406 versus XGBoost 0.609.

TL;DR: A 14 June 2026 analysis of 28,448 FDA food recalls finds pathogen hazards transfer across companies while labeling and manufacturing compliance signals do not.

A study published 14 June 2026 in Scientific Reports reports that U.S. food recall severity follows two different logics, with implications for how regulators triage risk and allocate attention. According to Scientific Reports, pathogen contamination signals predict the most serious tier across firms, while compliance signals tied to the lowest tier stay firm-specific. The work uses 28,448 openFDA enforcement records covering 2012–2025 to examine structural determinants of severity.

The U.S. Food and Drug Administration classifies food recalls into Class I, Class II and Class III, a decision that drives public notification urgency and regulatory resource allocation, according to Scientific Reports. Class I covers serious adverse health consequences or death, Class II covers temporary or medically reversible effects, and Class III covers unlikely to cause adverse consequences. A separate 2026 compilation of FDA enforcement records published by Fonteum describes the tiers in closely matching terms: Class I as reasonably likely to cause serious adverse health consequences or death, Class II as may cause temporary or medically reversible harm, and Class III as unlikely to cause harm.

## Why severity classification strains regulators

The scale described in Scientific Reports is large. Citing DeBeer and colleagues, the paper notes more than 35,000 FDA food recalls between 2002 and 2023, with annual volumes exceeding 3000 in peak years. Each case requires expert evaluation by the Health Hazard Evaluation Committee within two working days. In practice, the paper notes documented delays of months to years between the first reported illness and formal recall announcement in high-profile cases.

The public-health context cited is substantial. According to Scientific Reports, approximately 9.4 million foodborne illnesses, 55,961 hospitalisations, and 1,351 deaths occur annually in the United States, imposing an economic burden exceeding $75 billion per year. The paper places its analysis against the FDA's New Era of Smarter Food Safety blueprint, which identified predictive analytics as a core element of modernised regulatory tools, and against the preventive-control paradigm established by the Food Safety Modernization Act.

## A first systematic test on the U.S. food recall repository

Machine learning has been widely tested for food-safety risk assessment, but almost entirely on European data, according to Scientific Reports. On the European Rapid Alert System for Food and Feed database, supervised classifiers achieved accuracies ranging from 74% to 97.8% across various formulations. The authors state that, to date, no peer-reviewed study had attempted systematic severity prediction on the U.S. openFDA food recall database, described as the largest publicly accessible food recall repository in the United States.

The new paper, authored by Juk-Sen Tang, Peilun Li and Junhong Chen, was received 20 March 2026, accepted 10 June 2026 and first online 14 June 2026. The authors declare no competing interests. Funding came from Beijing Academy of Agriculture and Forestry Sciences programs, including the Innovation Capacity Project: Rural Revitalization Research Center and the Reform and Development Program for Agricultural Data Science Technology Research and Application.

## Firm history predicts severity because portfolios are stable

Under standard evaluation, described as the Known-firm scenario, a simple baseline assigning each firm its historically most frequent severity class achieves 92% of the best machine learning model's performance. According to Scientific Reports, the Macro-F1 values are 0.818 for the firm-history baseline versus 0.893 for the best machine learning model.

The paper does not treat that pattern as proof that companies inherently cause a given severity. Conditional mutual information analysis finds the concentration is driven primarily by stable hazard-product portfolios within firms. Hazard category mediates 27–63% of the firm–severity association across estimator methods and hazard granularities, with a firm-intrinsic residual of at least 37% under all specifications. The authors describe the result as hazard-portfolio-dominated firm-level patterns with non-negligible firm-intrinsic residual.

For nutrition and food-safety readers, the distinction matters. A company repeatedly associated with one severity tier may largely handle the same kinds of products and hazards over time, rather than carrying a fixed tendency toward serious or minor recalls independent of what it makes. At the same time, the residual of at least 37% leaves room for company-linked factors beyond product mix.

## Four regulatory scenarios from familiar firms to first-time recallers

To separate universal from firm-specific drivers, the researchers evaluate predictive models under four regulatory scenarios ranging from triage of known firms to cold-start assessment of first-time recallers. According to Scientific Reports, that design moves from settings where a firm's record is available to settings where the announcing entity has not been seen before.

The design addresses a practical regulatory question: whether a tool tuned on past participants remains useful when a newcomer appears. Food supply chains include established manufacturers, private-label packers, importers and distributors that may enter enforcement data for the first time. A model that depends on recognizing a name will face a different task than a model that recognizes a hazard description.

## Pathogen signals travel; compliance signals do not

The central finding is two distinct classes of food-safety signals. Hazard-intrinsic signals, particularly pathogen contamination involving Salmonella and Listeria, are universally associated with Class I severity regardless of the announcing entity. According to Scientific Reports, 92% of pathogen-related Class I recalls were correctly identified even for entirely unseen companies.

That cross-firm transfer was tested against potential cross-announcer coupling. When records with explicit supply-chain markers were excluded, Class I recall changed by only −0.003. The marker filter had a positive predictive value of 76% on manual audit. In other words, the ability to flag serious pathogen recalls did not depend on retaining linked records that might connect related announcers.

In contrast, compliance-related signals, described as labelling defects and GMP violations driving Class III recalls, are almost entirely firm-specific and fail to generalise across entities. A wording pattern that marks a low-severity labeling issue for one company does not reliably mark the same outcome for another company. According to Scientific Reports, machine-learning triage is therefore reliable for pathogen-related recalls but requires mandatory expert review for compliance-related cases involving new entities.

## Stricter event-based testing widens the model advantage

The headline SKU-level figures are retained for comparability with prior food-safety machine-learning literature, but the paper adds event-disjoint cross-validation as a stricter deployment-reliability diagnostic. That analysis uses 7,023 distinct contamination events rather than individual stock-keeping-unit records. According to Scientific Reports, the firm-history Macro-F1 is 0.406 and XGBoost is 0.609 in that event-disjoint test.

The increment of XGBoost over firm history expands from +0.075 at SKU level to +0.203 under the stricter unit of analysis, with a 95% confidence interval of [+0.123, +0.283]. The authors present both views in parallel: SKU-level values for comparison with earlier studies, and event-disjoint results as the more demanding indication of how a tool might behave when the same contamination episode generates multiple records.

The paper links that choice to SKU-level pseudoreplication and uncontrolled firm-level autocorrelation. Previously reported machine-learning accuracies of 90% or more on food recall databases likely overstate real-world reliability for those reasons, according to Scientific Reports. The concern is described as relevant to both FDA and EU RASFF research.

## Leakage checks and reproducibility floor

Sensitivity analyses examine whether post-classification language in the reason_for_recall field functions as a leakage signal. According to Scientific Reports, such language is present in 0.69% of records and does not function as leakage. Masking effects fall within the cross-version numerical reproducibility floor of absolute change less than 0.03.

That check addresses a common worry in regulatory text modeling: that the narrative written after a severity decision contains the decision itself. The reported result indicates the main patterns do not hinge on that small subset of records. The paper nevertheless calls for entity-overlap disclosure, firm-history baselines and informative null comparisons as minimum standards for future regulatory machine-learning evaluation.

## What the results mean for inspection and triage

The authors outline three practical implications. First, firm-level recall history is a powerful risk-profiling tool for targeted regulatory inspections, although its mechanism is hazard-portfolio rather than firm-intrinsic. Second, machine-assisted triage is reliable for pathogen-related recalls but needs mandatory expert review for compliance-related cases involving new entities. Third, earlier high accuracy claims should be interpreted cautiously because overlap between training and testing entities and repeated records from the same event can inflate performance.

For consumers focused on nutrition and healthy living, the actionable distinction is hazard type. Pathogen contamination involving Salmonella and Listeria carries a consistent association with Class I severity across announcing firms in this 2012–2025 enforcement record set. Labeling and good manufacturing practice issues that drive Class III outcomes are more context-dependent and less transferable by automated pattern alone. The study describes plans and recommendations for evaluation standards as recommendations, not as outcomes already adopted.

## Sources referenced
- Hazard-portfolio patterns in US food recall severity reveal transferable pathogen signals and firm-specific compliance signals | Scientific Reports (https://www.nature.com/articles/s41598-026-57837-z)
- FDA Enforcement Trends 2026: 56,777 Recalls — Fonteum (https://fonteum.com/gov/research/fda-enforcement-trends-2026)

## Nara Recalls All Infant Formula After 3 Botulism Hospitalizations

URL: https://nutritionjournal.com/nara-infant-formula-recall-botulism-june-2026

Nara Organics recalled all infant formula lots June 13 after 3 botulism hospitalizations; FDA also posted expanded moringa and cheese recalls and a traceability report.

Key takeaways:
- Nara Organics recalled all lots of powdered infant formula on June 13, 2026 for potential Clostridium botulinum contamination.
- FDA and CDC reported 3 infant botulism hospitalizations treated with BabyBIG in California, Washington and Pennsylvania, with no reported deaths.
- Recalled formula was sold nationally at Target stores, Target.com and Nara.com between July 2025 and June 2026.
- Total Nutrition expanded its moringa capsule recall June 11 for potential Salmonella contamination.
- Clover Hill Dairy recalled soft ricotta cheese June 9 for potential Listeria contamination linked to 8 possible cases.
- FDA reported June 10 that most firms in March-April traceability exercises provided records within 24 hours.

## TL;DR: Nara Organics recalled all lots of its powdered infant formula on June 13, 2026, after federal officials linked three infant botulism hospitalizations to the product.

**WASHINGTON —** Nara Organics of New York, NY, is voluntarily recalling all lots of Nara Organics Powdered Infant Formula currently on the market because of a potential risk of *Clostridium botulinum* contamination, according to the U.S. Food and Drug Administration posting titled NARA ORGANICS RECALLS ALL LOTS OF NARA INFANT FORMULA BECAUSE OF POSSIBLE HEALTH RISK.

The Company Announcement Date was June 13, 2026, and the FDA Publish Date was June 13, 2026. The Reason for Announcement was listed as potential risk of *Clostridium botulinum* contamination. The Product Type was listed as Food & Beverages. The Brand Name was listed as Nara Organics. The Product Description was listed as Whole Milk Powdered Infant Formula.

The Food and Drug Administration and Centers for Disease Control and Prevention contacted Nara Organics late Friday, June 12, 2026, and provided information about 3 cases of infant botulism in infants who the CDC reported had consumed Nara formula. The 3 infants were hospitalized and treated with BabyBIG (Botulism Immune Globulin Intravenous) in California, Washington, and Pennsylvania. There are no reported deaths.

### What FDA and CDC reported on June 12-13

The three specific product lots these infants were exposed to are 709125280E14F2, 709125288E14F2, and 708125174E14F2, according to the company announcement posted by FDA. To date, Nara infant formula has not tested positive for *C. botulinum*. However, Nara is voluntarily recalling all products currently in market.

Nara said it is working closely with the FDA, Centers for Disease Control and Prevention, and state partners to support their investigation into the root causes of these cases. The company described its action as out of an abundance of caution and said it is taking aggressive action to ensure the safety of babies and families who use the product.

Nara Organics Powdered Infant Formula was distributed nationally across Target retail stores, Target.com, and Nara.com between July 2025 and June 2026. Nara Infant Formula is not distributed outside of the USA.

Customers should stop using the affected products immediately. If a baby has consumed this product and is presenting symptoms of infant botulism, the announcement says to contact a healthcare provider for immediate care.

### How to identify the recalled infant formula

Affected Product Details listed in the FDA posting include two sizes. Nara Organics Whole Milk Infant Formula, 700g, carries UPC 860013251901. Nara Organics Whole Milk Infant Formula, 400g, carries UPC 860013251918.

All lots currently on the market are included in this voluntary recall. The lot code can be found on the bottom of each can.

The specific codes listed are 408125075E14F2, 708125076E14F2, 708125083E14F2, 408125139E14F2, 708125141E14F2, 708125145E14F2, 708125174E14F2, 709125273E14F2, 709125280E14F2, 709125288E14F2, 409125307E14F2, 70926019ENNB, 70926029ENNB, 70926035ENNB, 70926039ENNB, and 70926042ENNB.

Product photos were made available through the FDA recall page. The FDA notes that when a company announces a recall, market withdrawal, or safety alert, the FDA posts the company's announcement as a public service and does not endorse either the product or the company.

Consumers listed for contact are hello@nara.com. Media contact is listed as media@nara.com. Customers with questions are encouraged to visit Nara's website or email hello@nara.com.

### What parents should do now

The announcement lists symptoms to watch for. Infant botulism is described as a rare but potentially fatal illness that presents a serious threat to the health of infants which occurs when *Clostridium botulinum* spores are ingested and colonize the intestinal tract, producing botulinum neurotoxins in the immature gut of infants.

Affected infants can present with some or all of the following signs and symptoms: constipation, poor feeding, ptosis (drooping eyelid), sluggish pupils, low muscle tone, difficulty sucking and swallowing, weak or altered cry, generalized weakness, respiratory difficulty, and possibly respiratory arrest.

The consumer instructions also list symptoms including, but not limited to vomiting, diarrhea, constipation, poor feeding, drooping eyelids, and weak crying. Parents observing those signs after use are told to seek immediate care.

To report an illness or adverse event, consumers can report a Product Problem through SmartHub, complete an electronic Voluntary MedWatch form online, or complete a paper Voluntary MedWatch form that can be mailed to FDA.

### Refunds for Target and direct buyers

Nara will automatically refund all consumers who purchased formula from its website in May and June 2026. Other customers with unused product may request a refund by taking a photo of the bottom of each can and completing the refund form at https://nara.com/pages/refund-request-form.

Target customers may return their product to Target retail locations or follow Target's online return instructions. The general FDA contact number listed on the recall page is 1-888-INFO-FDA (1-888-463-6332).

### Moringa capsules expanded for Salmonella risk

In a separate action posted June 11, 2026, Total Nutrition Inc. of Deer Park, NY, voluntarily expanded its recall of TNVitamins and Doctor's Pride Ultra Potent Complete Green Superfood Moringa Capsules due to the potential to be contaminated with *Salmonella*, according to the FDA posting titled Total Nutrition Inc. Expands Recall of TNVitamins and Doctor's Pride Ultra Potent Complete Green Superfood Moringa Capsules Because of Possible Health Risk Following Further Supply Chain Review.

The Company Announcement Date was June 11, 2026, and the FDA Publish Date was June 11, 2026. The Reason for Announcement was Possible Salmonella Contamination. The Product Type included Food & Beverages and Foodborne Illness. The Brand Names were TNVitamins and Doctor's Pride.

The recalled product was distributed nationally through the online platforms Amazon, Walmart, TikTok Shop, Target, and the company's websites http://www.tnvitamins.com/ and https://www.doctorspride.com/. The product is packaged in white HDPE supplement bottles with smooth, white caps and 120 clear capsules filled with green moringa powder.

Affected lots include TNVitamins Ultra Potent Complete Green Superfood Moringa 10,000 mg (120 capsules) Lot 2507199 Exp. 09/2027, Lot 2512-304 Exp. 02/2028, Lot 2793 Exp. 02/2028, Lot 2748 Exp 07/2027, Lot 2725 Exp. 04/2027 (newly added), and Lot 2503104 Exp. 04/2027 (newly added). Doctor's Pride Complete Green Superfood Ultra Potent Moringa 10,000 mg (120 capsules) includes Lot 2507199 Exp. 09/2027, Lot 2748 Exp. 07/2027, and Lot 2725 Exp. 04/2027 (newly added).

The recall was initiated following notification from the FDA and CDC that these products may be implicated in an ongoing investigation associated with moringa-containing dietary supplement products. The company said this expansion follows an ongoing supply chain investigation that identified additional lot numbers linked to the same raw material lot that prompted the original recall.

The expansion was discovered during a supply chain traceability review which identified a common raw material from Lot 2507199 or 2512-304, one of the original recalled lots. Total Nutrition Inc. has ceased distribution and sale of the identified product and has initiated removal orders across all applicable sales and fulfillment channels while the FDA, CDC and the company continue their investigation.

*Salmonella* is described in that announcement as an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with *Salmonella* often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis, and arthritis.

### Soft cheese recalled for Listeria risk

On June 9, 2026, FDA published a recall from Clover Hill Dairy of Mechanicsville, Maryland, voluntarily recalling all Soft Ricotta/Requeson Cheese because it has the potential to be contaminated with *Listeria monocytogenes*, according to the FDA posting titled Clover Hill Dairy Recalls Soft Ricotta/Requeson Cheese Due to Possible Health Risk.

The Company Announcement Date was June 09, 2026, and the FDA Publish Date was June 09, 2026. The Product Type included Food & Beverages and Foodborne Illness. The Reason for Announcement was potential to be contaminated with *Listeria monocytogenes*. The Company Name was Clover Hill Dairy, LLC. The Brand Name was Clover Hill Dairy.

Clover Hill Soft Ricotta/Requeson cheese was distributed from May 4th, 2026 through May 30th, 2026 in North Carolina, New York, Virginia, Maryland, New Jersey and Washington, DC through bulk distributors, retail stores and directly to consumers.

The cheese was sold in retail size packaging as ten (10), twelve (12) and fourteen (14) ounce individually packaged clamshell containers. For clamshell containers with the Clover Hill Dairy Cheese brand name, the announcement says to look for Clover Hill Dairy's plant number 24-128 on the product label to assist with identifying recalled product.

The recalled cheese was also sold in bulk five (5) gallon and two (2) gallon buckets to some customers that repackaged the cheese. The announcement says the bulk cheese may be repackaged under individual bulk distributor brand names including but not limited to KESSO, QUESOS LA RICURA, IZALCO, DE MI PUEBLO, and RIO LINDO.

To the best of the company's knowledge, to date, eight (8) cases of *Listeria* infections may have been linked to Clover Hill Soft Ricotta/Requeson cheese as published by the FDA in cooperation with the Maryland Department of Health (MDH). Clover Hill Dairy was made aware of the potential public food health risk by the MDH.

Clover Hill Dairy has ceased production and distribution of all cheese products and has initiated a voluntary recall for Clover Hill Dairy Soft Ricotta/Requeson while the FDA, MDH and Clover Hill Dairy continue their investigations. Consumers who purchased recalled cheese are urged to return it to the place of purchase in its original packaging for a full refund. Consumers with questions may contact Southern Maryland Agricultural Development Commission on behalf of Clover Hill Dairy at 240-528-8850 extension 327.

*Listeria monocytogenes* is described in that announcement as an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, or others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain, and diarrhea, *Listeria* infection can cause miscarriages and still births among pregnant women.

### FDA tests faster tracing for high-risk foods

Amid the recalls, the FDA on June 10, 2026 released a report on a series of traceability readiness tabletop exercises held with industry between March 9 and April 1, 2026, according to the FDA constituent update titled FDA Releases Report on Traceability Readiness Tabletop Exercises and Updated FAQS.

The exercises were designed to help the food industry prepare to comply with the Food Traceability Rule (FTR). The FTR — established under Section 204 of the FDA Food Safety Modernization Act — requires covered entities that manufacture, process, pack, or hold foods on the FDA Food Traceability List to maintain additional records that allow FDA to more rapidly and accurately trace food through the supply chain.

As part of the tabletop exercises, the FDA worked with industry participants to simulate an FTR records request from FDA. The exercises tested whether participants could locate traceability records associated with the handling of a specific product during a short, defined date range, and provide the information from those records in an electronic sortable spreadsheet within 24 hours, which is consistent with the requirements of the FTR.

The exercises demonstrated that meaningful progress is being made toward meeting the FTR requirements. Most firms responded within 24 hours, and proactive supply chain coordination — more than any particular technology — drove the strongest results. The agency characterized the results as encouraging overall, even though the exercises also demonstrated that some challenges remain with certain data elements.

The FDA said it will use the findings to inform its ongoing outreach, education, and technical assistance efforts. These exercises, coupled with ongoing engagements, will also help inform potential flexibilities regarding the lot-level tracking requirements in the FTR. The agency recently issued a discussion paper on this topic and said it looks forward to hearing more from interested stakeholders at the public meeting on June 15th and through feedback that can be submitted to a docket as described in the discussion paper.

Additionally, to further support implementation, the FDA has updated its frequently asked questions on the FTR to provide greater clarity on topics including the Traceability Lot Code source reference, food traceability plans, and intracompany shipments. The tabletop exercises fulfilled a Congressional directive under the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026 (P.L. 119-37).

## Sources referenced
- NARA ORGANICS RECALLS ALL LOTS OF NARA INFANT FORMULA BECAUSE OF POSSIBLE HEALTH RISK | FDA (https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/nara-organics-recalls-all-lots-nara-infant-formula-because-possible-health-risk)
- Total Nutrition Inc. Expands Recall of TNVitamins and Doctor's Pride Ultra Potent Complete Green Superfood Moringa Capsules Because of Possible Health Risk Following Further Supply Chain Review | FDA (https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/total-nutrition-inc-expands-recall-tnvitamins-and-doctors-pride-ultra-potent-complete-green-0)

## Massachusetts Warns Public to Avoid Recalled Moringa Products in Salmonella Outbreaks

URL: https://nutritionjournal.com/moringa-powder-recall-salmonella-advisory-massachusetts

Massachusetts warns consumers, retailers and clinicians to avoid recalled moringa powders and capsules tied to multistate Salmonella outbreaks.

Key takeaways:
- Massachusetts health officials advise consumers, retailers and clinicians not to eat, sell, serve, distribute or purchase recalled moringa products.
- Total Nutrition of Deer Park, New York expanded its recall of TNVitamins and Doctor's Pride moringa capsules, adding Lots 2503104 and 2725.
- Recalled capsules were sold nationally through Amazon, Walmart, TikTok Shop, Target and company websites.
- A reopened outbreak tied to TNVitamins and Doctor's Pride includes Massachusetts cases and 32 hospitalizations.
- A separate outbreak tied to Mogo moringa capsules sickened at least 18 people, with 7 hospitalizations.

## TL;DR: Massachusetts health officials warn consumers, retailers and clinicians not to eat, sell, serve, distribute or purchase recalled moringa products linked to multistate Salmonella outbreaks.

On June 12, 2026, the Cambridge Public Health Department shared an advisory from the Massachusetts Department of Public Health (MA DPH) about multiple recent Salmonella outbreaks tied to recalled products containing moringa, according to the Cambridge Public Health Department.

The advisory covers powders, capsules and other dietary supplements that contain moringa, according to the Cambridge Public Health Department. Massachusetts is among the states with reported cases, according to the Cambridge Public Health Department. MA DPH directed the message to consumers, retailers and clinicians, according to the Cambridge Public Health Department.

The same day, Total Nutrition Inc. of Deer Park, New York, voluntarily expanded its recall of TNVitamins and Doctor's Pride Ultra Potent Complete Green Superfood Moringa Capsules because the capsules have been linked to an outbreak of Salmonella infections, according to Food Safety News. The expansion was published June 12, 2026 at 10:11 p.m., according to Food Safety News.

## What Massachusetts officials are telling the public

### Who received the advisory

MA DPH is advising consumers, retailers and clinicians about the outbreaks, according to the Cambridge Public Health Department. The products at issue include powders, capsules and other dietary supplements containing moringa, according to the Cambridge Public Health Department.

### What to do with recalled products

Recalled products should not be eaten, sold, served, distributed or purchased, according to the Cambridge Public Health Department. The products have been distributed nationwide, primarily online through company websites and other online retailers, according to the Cambridge Public Health Department.

MA DPH, the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and public health partners across many states have been investigating Salmonella illnesses linked to moringa products since late 2025, according to the Cambridge Public Health Department. The investigation in Massachusetts is ongoing to determine whether additional products are being distributed in the state, according to the Cambridge Public Health Department.

## Which products were added to the recall on June 12

### TNVitamins and Doctor's Pride capsules

Total Nutrition Inc. is expanding its recall of TNVitamins and Doctor's Pride Ultra Potent Complete Green Superfood Moringa Capsules, according to Food Safety News. The recall was initiated following notification from FDA and CDC that the products may be implicated in an ongoing investigation associated with moringa-containing dietary supplement products, according to Food Safety News.

The company has ceased distribution and sale of the identified product and has initiated removal orders across all applicable sales and fulfillment channels while FDA, CDC and the company continue their investigation, according to Food Safety News. No other TNVitamins or Doctor's Pride products are involved, according to Food Safety News.

### Newly added lots linked to the same raw material

The expansion follows an ongoing supply chain investigation that identified additional lot numbers linked to the same raw material lot that prompted the original recall, according to Food Safety News. The expansion was discovered during a supply chain traceability review which identified a common raw material from Lot 2507199 or 2512-304, one of the original recalled lots, according to Food Safety News.

Total Nutrition Inc. is including Lots 2503104 and 2725 of TNVitamins Ultra Potent Complete Green Superfood Moringa 10,000 mg and Doctor's Pride Complete Green Superfood Ultra Potent Moringa 10,000 mg in the recall effective immediately, according to Food Safety News. Customers who purchased the affected products are asked to dispose of them immediately, according to Food Safety News.

## How to identify the recalled bottles and lots

### Packaging description

The product is packaged in white HDPE supplement bottles with smooth, white caps and 120 clear capsules filled with green moringa powder, according to Food Safety News. Those bottles were distributed nationally through Amazon, Walmart, TikTok Shop, Target and the company's websites, tnvitamins.com and doctorspride.com, according to Food Safety News.

### TNVitamins lot numbers

For TNVitamins Ultra Potent Complete Green Superfood Moringa 10,000 mg in 120 capsules, the affected lots listed are Lot 2507199 with expiration 09/2027, Lot 2512-304 with expiration 02/2028, Lot 2793 with expiration 02/2028, Lot 2748 with expiration 07/2027, Lot 2725 with expiration 04/2027 newly added, and Lot 2503104 with expiration 04/2027 newly added, according to Food Safety News.

### Doctor's Pride lot numbers

For Doctor's Pride Complete Green Superfood Ultra Potent Moringa 10,000 mg in 120 capsules, the affected lots listed are Lot 2507199 with expiration 09/2027, Lot 2748 with expiration 07/2027 and Lot 2725 with expiration 04/2027 newly added, according to Food Safety News.

For the TNVitamins moringa powder, lot 2725 has the expiration date of 09/2027 in one listing and lot 2503104 has the expiration date of 04/2027, while for the Doctor's Pride moringa capsules lot 2725 has the expiration date of 04/2027, according to Food Poisoning Bulletin. Consumers who bought the products should not consume them, according to Food Poisoning Bulletin.

## How large the outbreaks are

### Second moringa outbreak tied to TNVitamins and Doctor's Pride

There is a Salmonella outbreak linked to moringa powder capsules in which the investigation was closed, then reopened when officials discovered that the products may be contaminated with the outbreak strain, according to Food Poisoning Bulletin. The products are implicated in the outbreak, according to Food Poisoning Bulletin. Thirty-two people have been hospitalized in that outbreak, according to Food Poisoning Bulletin.

The reported case count is Alabama with 1, Arkansas with 1, Delaware with 1, Florida with 1, Georgia with 3, Oregon with 1, Idaho with 1, Maine with 3, Missouri with 3, North Carolina with 2, North Dakota with 1, South Dakota with 1, Alaska with 1, New Jersey with 3, Oklahoma with 1, Pennsylvania with 8, Rhode Island with 1, Tennessee with 2, Texas with 3, Utah with 1, Washington with 1, California with 4, Iowa with 2, Michigan with 6, Nebraska with 2, South Carolina with 2, Virginia with 3, Vermont with 3, Connecticut with 3, Massachusetts with 5, Minnesota with 9, Illinois with 5, Kentucky with 5, Ohio with 6, New York with 8 and Wisconsin with 16, according to Food Poisoning Bulletin.

The second moringa outbreak was closed, but was reopened when 22 more cases were discovered, according to Food Poisoning Bulletin. A recall was issued for TNVitamins Ultra Potent Complete Green Superfood Moringa capsules and Doctor's Pride Complete Green Superfood ultra potent moringa capsules, according to Food Poisoning Bulletin.

### First moringa outbreak tied to Mogo capsules

There are two Salmonella outbreaks linked to moringa leaf powder, according to Food Poisoning Bulletin. The first is linked to Mogo moringa leaf powder capsules and has sickened at least 18 people, according to Food Poisoning Bulletin. Seven of those patients have been hospitalized, according to Food Poisoning Bulletin.

The case count by state in that first outbreak is California with 1, Florida with 1, Georgia with 1, Illinois with 1, Massachusetts with 1, Michigan with 1, Minnesota with 2, North Carolina with 2, North Dakota with 1, Oregon with 1, Pennsylvania with 2, South Carolina with 1, Tennessee with 1 and Washington with 2, according to Food Poisoning Bulletin. Illness onset dates range from February 3, 2026 to April 7, 2026, according to Food Poisoning Bulletin. The patient age range is from 1 to 93 years, according to Food Poisoning Bulletin. A recall has been issued in that outbreak, according to Food Poisoning Bulletin.

## Why Salmonella in moringa powder matters for nutrition

### How infection can develop

Salmonella are bacteria that can cause foodborne illness, according to the Cambridge Public Health Department. Although the disease is usually limited to the bowel, and most infected people do not have any serious medical complications, Salmonella can spread to other systems of the body, such as the blood and bone, according to the Cambridge Public Health Department.

This may cause serious complications in infants and in people who are very old or are immunocompromised, according to the Cambridge Public Health Department. Food contaminated with Salmonella bacteria does not usually look, smell or taste spoiled, according to Food Safety News. Anyone can become sick with a Salmonella infection, according to Food Safety News.

Infants, children, seniors and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to Food Safety News. Older adults, children, pregnant women and people with weakened immune systems, such as cancer patients, are more likely to develop a severe illness and serious, sometimes life-threatening conditions, according to Food Safety News.

### Symptoms and timing

Symptoms of Salmonella infection can include diarrhea, abdominal cramps and fever within 12 to 72 hours after eating contaminated food, according to Food Safety News. Otherwise, healthy adults are usually sick for four to seven days, according to Food Safety News. In some cases, however, diarrhea may be so severe that patients require hospitalization, according to Food Safety News.

Some people get infected without getting sick or showing any symptoms, according to Food Safety News. However, they may still spread the infections to others, according to Food Safety News. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis, according to Food Safety News.

## What to do if you have the capsules

Anyone who has consumed any of the recalled products and developed symptoms of Salmonella infection should seek medical attention, according to Food Safety News. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis, according to Food Safety News.

If you bought these products, do not consume them, according to Food Poisoning Bulletin. You can throw them away in a secure trash can with a tight fitting lid after first double bagging the bottles so other people cannot see them, according to Food Poisoning Bulletin.

If you did consume these products, monitor your health for the symptoms of a Salmonella infection for the next week, according to Food Poisoning Bulletin. If you do get sick, see your doctor, according to Food Poisoning Bulletin. More information is available at MA DPH's Public Health Advisory, according to the Cambridge Public Health Department.

## Sources referenced
- State Releases Public Health Advisory on Recall on Moringa Leaf Powder Products - Cambridge Public Health Department (https://www.cambridgepublichealth.org/advisory-recall-moringa-products/)
- Recall of moringa capsules implicated in Salmonella outbreak expanded | Food Safety News (https://www.foodsafetynews.com/2026/06/recall-of-moringa-capsules-implicated-in-salmonella-outbreak-expanded/)

## Moringa Capsule Recall Expands as Salmonella Outbreak Hits 36 States

URL: https://nutritionjournal.com/moringa-recall-expands-salmonella-june-2026

Total Nutrition expanded its June 11 moringa recall to add lots 2725 and 2503104 amid a 119-case Salmonella outbreak across 36 states.

Key takeaways:
- Total Nutrition Inc. expanded its TNVitamins and Doctor's Pride moringa recall on June 11, 2026 for possible Salmonella contamination.
- Newly added lots are 2725 and 2503104; check brand, lot number and expiration date on white bottles of 120 green-powder capsules.
- The reopened multistate outbreak totaled 119 infections in 36 states as of May 27, 2026, with 32 hospitalizations and no deaths.
- Products were sold nationally through Amazon, Walmart, TikTok Shop, Target and company websites.
- Do not eat, sell or serve recalled capsules; dispose of them, wash contact surfaces, and email customerservice@tnvitamins.com for a refund.
- A separate MOGO moringa capsule outbreak totaled 18 illnesses in 14 states with 7 hospitalizations.

TL;DR: Total Nutrition Inc. expanded its recall of TNVitamins and Doctor's Pride moringa capsules on June 11, 2026 for possible Salmonella contamination linked to a reopened multistate outbreak.

## Recall expansion answers which bottles to remove

Total Nutrition Inc. of Deer Park, NY is voluntarily expanding its recall of TNVitamins and Doctor's Pride Ultra Potent Complete Green Superfood Moringa Capsules due to the potential to be contaminated with Salmonella, according to the FDA recall notice titled Total Nutrition Inc. Expands Recall of TNVitamins and Doctor's Pride Ultra Potent Complete Green Superfood Moringa Capsules Because of Possible Health Risk Following Further Supply Chain Review.

The company announcement date was June 11, 2026, and the FDA publish date was June 11, 2026. The product type was listed as Food & Beverages Foodborne Illness, and the reason for announcement was listed as Possible Salmonella Contamination.

The expansion follows an ongoing supply chain investigation that identified additional lot numbers linked to the same raw material lot that prompted the original recall. The company said the expansion was discovered during a supply chain traceability review which identified a common raw material from Lot 2507199 or 2512-304, one of the original recalled lots.

Total Nutrition Inc. is including Lots 2503104, and 2725 of TNVitamins Ultra Potent Complete Green Superfood Moringa 10,000 mg and Doctor's Pride Complete Green Superfood Ultra Potent Moringa 10,000 mg in the recall effective immediately. The notice states that no other TNVitamins or Doctor's Pride products are involved.

## Exact products, lots and packaging to check

The recalled product is packaged in white HDPE supplement bottles with smooth, white caps and 120 clear capsules filled with green moringa powder. Consumers can compare brand, product type, lot number and expiration date against the FDA listing rather than relying on product name alone.

For TNVitamins Ultra Potent Complete Green Superfood Moringa 10,000 mg in 120 capsules, the listed lots are Lot 2507199 Exp. 09/2027, Lot 2512-304 Exp. 02/2028, Lot 2793 Exp. 02/2028, Lot 2748 Exp 07/2027, Lot 2725 Exp. 04/2027 newly added, and Lot 2503104 Exp. 04/2027 newly added.

For Doctor's Pride Complete Green Superfood Ultra Potent Moringa 10,000 mg in 120 capsules, the listed lots are Lot 2507199 Exp. 09/2027, Lot 2748 Exp. 07/2027, and Lot 2725 Exp. 04/2027 newly added.

The recalled product was distributed nationally through the online platforms Amazon, Walmart, TikTok Shop, Target, and the company's websites http://www.tnvitamins.com/ and https://www.doctorspride.com/. Total Nutrition Inc. has ceased distribution and sale of the identified product and has initiated removal orders across all applicable sales and fulfillment channels while the FDA, CDC and the company continue their investigation.

The recall was initiated following notification from the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention that these products may be implicated in an ongoing investigation associated with moringa-containing dietary supplement products.

## Why the outbreak investigation was reopened

CDC and public health officials in several states are investigating a multistate outbreak of Salmonella Typhimurium and Salmonella Newport infections linked to moringa products, as summarized in the June 11, 2026 Research Thursday post describing the Red Book Online Outbreaks document dated June 2, 2026.

Epidemiologic, traceback, and laboratory data show that moringa leaf powder is contaminated with Salmonella and is making people sick. Since the investigation was closed on March 17, 2026, 22 new illnesses from 4 states have been reported. The investigation has since been reopened, and as of May 27, 2026, a total of 119 people infected with one of the outbreak strains have been reported from 36 states.

Illnesses started on dates ranging from August 22, 2025, to April 26, 2026. Of 109 people with information available, 32 have been hospitalized. No deaths have been reported.

The prior recalls in that investigation included action on May 26, 2026, when Total Nutrition, Inc recalled two brands of moringa capsules, with TNVitamins lots 2507199 expiration 9/2027, 2512-304 expiration 2/2028 and 2793 expiration 2/2028, and Doctor's Pride lot 2507199 expiration 9/2027. Earlier, on January 28, 2026, Why Not Natural recalled Why Not Natural Pure Organic Moringa Green Superfood capsules Lot A25G051 expiration 07/2028 in a 120-capsule bottle sold nationwide. On January 15, 2026, Superfoods, Inc. recalled all Live it Up Super Greens supplement powders with expiration dates 08/2026 to 01/2028 sold nationwide in the United States, including Puerto Rico, Guam, and Virgin Islands, including Original and Wild Berry flavors.

## Second moringa outbreak and Minnesota signal

A separate Salmonella investigation linked to MOGO-brand moringa powder capsules is also being tracked. According to the Food Poisoning Bulletin article titled New Salmonella Outbreak on FDA CORE Investigation Table, published June 11, 2026, the Mogo moringa leaf powder capsule outbreak has sickened at least 18 people, and seven of those patients have been hospitalized.

The article lists that case count by state as California 1, Florida 1, Georgia 1, Illinois 1, Massachusetts 1, Michigan 1, Minnesota 2, North Carolina 2, North Dakota 1, Oregon 1, Pennsylvania 2, South Carolina 1, Tennessee 1, and Washington 2. Illness onset dates range from February 3, 2026 to April 7, 2026. The patient age range is from 1 to 93 years. A recall has been issued.

The same Food Poisoning Bulletin report describes the larger TNVitamins and Doctor's Pride investigation as closed but reopened when 22 more cases were discovered. It lists cases in Alabama 1, Arkansas 1, Delaware 1, Florida 1, Georgia 3, Oregon 1, Idaho 1, Maine 3, Missouri 3, North Carolina 2, North Dakota 1, South Dakota 1, Alaska 1, New Jersey 3, Oklahoma 1, Pennsylvania 8, Rhode Island 1, Tennessee 2, Texas 3, Utah 1, Washington 1, California 4, Iowa 2, Michigan 6, Nebraska 2, South Carolina 2, Virginia 3, Vermont 3, Connecticut 3, Massachusetts 5, Minnesota 9, Illinois 5, Kentucky 5, Ohio 6, New York 8, and Wisconsin 16.

Minnesota officials also tied two April 2026 illnesses to tnvitamins brand moringa leaf powder capsules lot 2793 expiration February 2028 purchased on Amazon. Neither person was hospitalized and both have recovered. From November 2025 through February 2026, there had been 97 cases, seven in Minnesota, including 26 hospitalizations, five in Minnesota, in 32 states, with no deaths.

## Who faces higher risk from Salmonella

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea which may be bloody, nausea, vomiting and abdominal pain.

In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections including infected aneurysms, endocarditis, and arthritis.

The clinical summary states that most people infected with Salmonella experience diarrhea, fever, and stomach cramps. Symptoms typically start 6 hours to 6 days after swallowing the bacteria. Most people recover without treatment after 4 to 7 days.

The incidence of Salmonella infection is highest in children younger than 4 years of age. In the United States, rates of invasive infections and mortality are higher in infants, elderly people, and people with hemoglobinopathies including sickle cell disease and immunocompromising conditions including malignant neoplasms and HIV infection.

## What to do with recalled capsules today

Customers who have purchased the affected products are asked to dispose of them immediately. The FDA notice states do not eat, sell, or serve the product. Customers may request a refund by contacting TNVitamins at customerservice@tnvitamins.com and providing name, order number, and a photo of the product with lot codes in question.

CDC advises people should not eat any recalled products and to throw them away or contact the company. People should wash items and surfaces that may have touched the recalled food using hot soapy water or a dishwasher. Retailers and other businesses should not sell or serve recalled products and should clean and sanitize surfaces that may have come in contact with them.

Patients should be seen by their pediatrician if they present with diarrhea and a fever higher than 102°F, diarrhea for more than 3 days that is not improving, bloody diarrhea, not tolerating oral liquids, or signs of dehydration such as decreased urine output, dry mucous membranes, or orthostatic hypotension.

Diagnosis is by isolation of Salmonella organisms from cultures of stool, blood, urine, bile including duodenal fluid containing bile, and material from foci of infection. Salmonella gastroenteritis is diagnosed by stool culture or molecular testing including PCR, and stool testing should be obtained in all children with bloody diarrhea or unexplained persistent or severe diarrhea.

## Treatment and reporting context for clinicians and families

Antimicrobial therapy usually is not indicated for patients with either asymptomatic infection or uncomplicated gastroenteritis caused by Salmonella, because therapy does not shorten the duration of diarrheal disease, can prolong duration of fecal shedding, and increases symptomatic relapse rate.

Antimicrobial therapy is recommended for gastroenteritis caused by Salmonella in people at increased risk for invasive disease, including infants younger than 3 months and people with chronic gastrointestinal tract disease, malignant neoplasms, hemoglobinopathies, HIV infection, or other immunosuppressive illnesses or therapies. Antibiotics should also be considered for those experiencing severe symptoms such as severe diarrhea or prolonged or high fever.

If antimicrobial therapy is initiated in patients in the United States with presumed or proven Salmonella gastroenteritis, a blood and a stool culture should be obtained prior to antibiotic administration. Most cases are treated empirically. If the person appears ill or has evidence of disseminated infection, hospitalization along with initiation of a broad-spectrum parenteral cephalosporin often is prescribed. Oral antimicrobials such as azithromycin may be considered for patients who do not appear ill or have evidence of disseminated infection. If cultures are obtained, definitive therapy should be based on susceptibility of the organism isolated. Suspected cases should be reported to the local department of public health.

## Sources referenced
- Total Nutrition Inc. Expands Recall of TNVitamins and Doctor’s Pride Ultra Potent Complete Green Superfood Moringa Capsules Because of Possible Health Risk Following Further Supply Chain Review | FDA (https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/total-nutrition-inc-expands-recall-tnvitamins-and-doctors-pride-ultra-potent-complete-green-0)

## HHS: All Food Programs to Align With Dietary Guidelines in 6 Months

URL: https://nutritionjournal.com/hhs-food-programs-align-dietary-guidelines-2026

HHS Secretary Robert F. Kennedy Jr. told the IFPA Washington Conference that federal food programs will align with the new Eat Real Food guidelines within six months.

Key takeaways:
- HHS Secretary Robert F. Kennedy Jr. said all government-funded food programs will align with the new dietary guidelines within six months.
- The alignment would affect SNAP, WIC, school lunches, Head Start, hospitals, military, veterans and prison food programs.
- A federal ultra-processed food definition is under OMB review and expected in the next couple of months.
- A planned mandatory front-of-package system would use red, yellow and green signals; produce would get green.
- More than 70 medical schools agreed to require 40 hours of nutrition training, and licensing exams will devote 15% of questions to nutrition.

TL;DR: Health and Human Services Secretary Robert F. Kennedy Jr. told produce leaders on June 9 that all government-funded food programs will align with the new federal dietary guidelines within six months.

WASHINGTON, DC — Federal food assistance, school meals, military dining, veterans facilities and prison food service are slated for a coordinated nutrition reset, with Health and Human Services Secretary Robert F. Kennedy Jr. saying public money should reinforce the current federal advice to eat real food.

Speaking to attendees of the International Fresh Produce Association's Washington Conference on June 9, Kennedy said every program supported with federal food dollars would be brought into line with the guidelines issued earlier this year, according to Blue Book. He framed the timetable as the next six months and linked it to rising purchases of minimally processed items, including fruits and vegetables.

The pledge covers a vast share of federal nutrition spending. Programs named across conference coverage included the Supplemental Nutrition Assistance Program, the Special Supplemental Nutrition Program for Women, Infants and Children, school lunch programs, Indian Health Services, Head Start, hospitals, military installations, Department of Veterans Affairs facilities and federal prisons, according to Blue Book and reporting by Agri-Pulse Communications in “Kennedy: Defining ultra-processed foods is first step toward reshaping Americans' diets.” Kennedy did not present a detailed implementation mechanism during the appearance, according to Blue Book, but said state-level limits on SNAP purchases of candy and soda had already reduced buying of those products.

International Fresh Produce Association CEO Cathy Burns, who appeared with Kennedy, said the industry hopes shoppers who reduce soda and confectionery purchases will instead spend in the fresh produce department, according to Blue Book.

## What “alignment” would cover

Kennedy described alignment as using federal purchasing power to bring more whole and minimally processed foods — especially fruits and vegetables — into institutional and benefit programs while moving away from highly processed products, according to Agri-Pulse Communications.

The scope discussed on stage was broad. The Packer, in “RFK Jr. Details Radical Cultural Shift Coming for U.S. Food Policy,” reported that Kennedy listed SNAP, WIC, school lunches, Indian Health Services and Head Start, plus food programs for the military, veterans and federal prisons, as areas where funding would be required to reflect the new guidance over the coming six months.

HHS senior adviser Calley Means, also speaking at the event, described a longer procurement shift extending over a decade, saying tens of billions of dollars in government buying could move from ultra-processed items toward fresh foods, fruits and vegetables, according to Agri-Pulse Communications. Means also pointed to actions by the Trump administration and almost 30 governors to remove soda and candy as SNAP options and described parallel efforts affecting school feeding, hospitals, military sites and prisons.

Agriculture Secretary Brooke Rollins echoed the nutrition-reset theme in remarks to the same conference on June 10, saying USDA was working to align its programs with the dietary-guidance priorities, according to Agri-Pulse Communications in “Rollins touts deregulation, nutrition reset and ag labor reforms to produce sector.” Rollins pointed specifically to changes in SNAP retailer stocking requirements intended to ensure stores accepting benefits carry a wider range of staple foods, including more fresh produce, dairy and protein.

## From a long rulebook to “eat real food”

Kennedy contrasted the current guidance with the document he said he inherited, describing a 453-page food-pyramid guidelines package as incomprehensible and unlikely to be read, according to The Packer. He said officials instead produced a document of fewer than 10 pages developed over 11 months by about a dozen nutrition specialists from leading universities and supported with peer-reviewed research and government databases.

According to Blue Book, Kennedy said the earlier, much longer version was incomprehensible and had been shaped by processed-food interests, while the replacement can be summarized as “eat real food,” with fruits and vegetables in a prominent position. In the January rollout of the guidelines by HHS and USDA, Kennedy said: “American households must prioritize whole, nutrient-dense foods—protein, dairy, vegetables, fruits, healthy fats, and whole grains—and dramatically reduce highly processed foods.”

The Packer reported that the revised approach places fruits and vegetables with proteins and grains at the top of the visual guidance, replacing an approach Kennedy criticized for placing products such as fruit-flavored cereal near the top of the pyramid. Burns introduced Kennedy as someone who had placed nutrition and health at the center of the policy discussion, according to The Packer.

Kennedy tied the guidance to chronic-disease trends. He said the United States carries the highest chronic-disease burden of any country, that the food supply contains 10,000 ingredients compared with 400 in Europe, and that 38% of American teenagers are now diabetic or prediabetic in a way he connected directly to food, according to The Packer. He recalled that when his uncle was president, a typical pediatrician might complete a 40- or 50-year career without seeing a case of type 2 diabetes in childhood. He predicted that the Make America Healthy Again strategy and a turn toward whole foods would substantially reduce obesity, diabetes and heart disease, adding, “I think we’ll see this in the next three years,” according to Blue Book.

## Ultra-processed food definition comes first

A federal definition of ultra-processed food is the near-term regulatory priority, Kennedy said, because agencies cannot effectively regulate a category that lacks a legal meaning, according to Agri-Pulse Communications.

Kennedy said the definition is under review at the Office of Management and Budget, with the goal of publishing a final version in the next couple of months, according to Agri-Pulse Communications. He had earlier told the Joe Rogan Experience podcast in February that a definition could appear as soon as April. Claudine Kavanaugh, director of FDA’s Office of Nutrition and Food Labeling, told conference participants on June 9 that stakeholders would have an opportunity to comment on the federal definition.

Industry positions on that definition differ. IFPA, which submitted comments to HHS and USDA last October, asked that raw fruits, vegetables and tree nuts be explicitly excluded and that the agencies account for convenience and perishability, according to Agri-Pulse Communications. The association argued that value-added produce such as bagged lettuce, baby carrots and sliced apples should not count as processed merely because of minimal handling that can support consumption. By contrast, the Consumer Brands Association said the phrase “ultra-processed food” was unsuitable for legal definition because it does not distinguish by nutrient content, lacks a scientific basis for isolating particular ingredients or processing steps, and would create significant unintended consequences.

Beyond the definition, Kennedy described a planned mandatory front-of-package labeling system using red, yellow or green signals for overall food quality, according to Agri-Pulse Communications and The Packer. He said the aim was to simplify shopping for people who do not want to read an entire ingredient panel. “Fruits and vegetables will be green,” he said, according to Blue Book, drawing applause reported by Agri-Pulse Communications when he said produce would receive a green light.

## SNAP spending patterns under scrutiny

SNAP beverage and candy purchases featured prominently in the discussion. Kennedy said about 10% of SNAP dollars had gone to sugar-sweetened beverages and about 8% to candies, adding, “That is now changed,” according to The Packer. According to Blue Book, he credited state restrictions on candy and soda purchases with lowering those purchases, without detailing a federal enforcement plan for the broader realignment.

The produce sector’s question, posed by Burns, was how to encourage shoppers toward fruits and vegetables rather than merely restricting soda, candy and other items, according to The Packer. Kennedy answered by returning to ultra-processed foods, which he has repeatedly criticized in stark terms, and to the coming definition and labeling work.

Means framed procurement as only one part of the behavioral challenge, saying the shift also requires nutrition education and preparation that consumers enjoy. “We’re working with chefs, celebrity chefs, and top people who are going to make that food delicious,” he said, according to Agri-Pulse Communications.

## Medical training, hospital food and personal data

Kennedy also outlined changes in medical education and health technology. He said most medical-school graduates receive about two hours of nutrition instruction, while more than 70 medical schools have now agreed to require 40 hours or the equivalent, according to Blue Book. The Packer reported a related formulation: 80% of newly graduated doctors say they received only two hours of nutrition training, while several schools have committed to 40 hours.

In addition, eight major medical examination and accreditation boards have agreed to revise licensing examinations so that 15% of questions focus strictly on nutrition, a change intended to ensure students treat the coursework seriously, according to The Packer. Kennedy said many chronic diseases can be reversed through dietary change, according to Blue Book, and The Packer reported his related point that type 2 diabetes and various chronic conditions can improve substantially or reverse through diet alone.

Kennedy also said HHS has sought better hospital food and closer cooperation with clinicians on nutrition instruction, according to Blue Book and The Packer. On technology, he described partnerships with more than 600 technology companies to help Americans download health data to phones and use shopping applications to receive individualized grocery advice, according to Agri-Pulse Communications. He said a shopper would eventually be able to point a phone at a package and receive guidance on whether to buy it personally. “You’ll be able to shine your cell phone onto the label, and it will tell you whether you personally should purchase that product,” he said.

When Burns asked how the Make America Healthy Again effort should judge success, Kennedy pointed to produce sales and eating patterns. “I’d like to see people who are selling fruits and vegetables have much more of the market share,” he said, citing higher fresh-produce consumption as evidence that Americans are moving away from ultra-processed products, according to Agri-Pulse Communications. Means described the objective as a 10-year progression from a different policy framework centered on food toward reversal of chronic-disease trends.

Kennedy also emphasized his working relationship with Agriculture Secretary Brooke Rollins, saying their partnership began when both were confirmed at the start of the Trump administration in early 2025 and that HHS and USDA have remained aligned on Make America Healthy Again goals, according to Blue Book. The Packer described that collaboration as a 16-month partnership dating to the week of their confirmations and centered in part on rewriting the food pyramid. Rollins, for her part, called the new guidelines the most significant reset of federal nutrition policy in American history, according to Agri-Pulse Communications.

## Sources referenced
- HHS Secretary: All government food programs to align with dietary guidelines - Blue Book (https://www.bluebookservices.com/hhs-secretary-all-government-food-programs-to-align-with-dietary-guidelines/)
- Kennedy: Defining ultra-processed foods is first step toward reshaping Americans' diets | Agri-Pulse Communications, Inc. (https://www.agri-pulse.com/articles/24812-kennedy-defining-ultra-processed-foods-is-first-step-toward-reshaping-americans-diets)

## Raw Milk Boom Linked to Hundreds of Illnesses, Regulators Say

URL: https://nutritionjournal.com/raw-milk-mcafee-raw-farm-illness-risk-2026

ProPublica links Raw Farm to 12+ recalls; Idaho reports 60 raw-milk illnesses as pasteurized-milk science faces a wellness-driven surge.

Key takeaways:
- Federal and state regulators link Raw Farm to more than a dozen recalls and outbreaks that sickened hundreds, according to ProPublica.
- Raw Farm reports about $30M yearly revenue as 10M Americans drink raw milk and weekly sales rose 65% from 2023 to 2024.
- Scientists say raw milk has no proven nutritional advantage and carries over 100 times the foodborne-illness risk.
- Raw Farm diverts pathogen-positive milk to cheese except Salmonella batches, though research says aging does not eliminate risk.
- Idaho identified nearly 60 raw-milk illnesses since May 19, 2026, with 45 confirmed campylobacteriosis cases.
- A Raw Farm cheddar outbreak sickened nine with E. coli, half under 5, with one life-altering kidney complication.

**TL;DR: Federal and state regulators link California's Raw Farm and founder Mark McAfee to more than a dozen recalls and outbreaks that sickened hundreds, even as raw-milk sales surge nationwide.**

On June 9, 2026, ProPublica published an investigation by reporter Annie Waldman into Mark McAfee, the 64-year-old chief executive and founder of Raw Farm in California's Central Valley. According to ProPublica, McAfee operates the largest raw-milk dairy in the country, with about $30 million a year in revenue, and federal and state regulators have linked his business to more than a dozen recalls and outbreaks that left hundreds of people ill.

The investigation lands during a rapid expansion of unpasteurized dairy. According to ProPublica, more than 10 million Americans now drink raw milk, and national weekly sales rose by 65% from 2023 to 2024 alone. Customers interviewed for that reporting said they want food that has not been stripped of health benefits by industrial processing.

Public-health agencies continue to describe a different risk calculation. According to the Idaho Department of Health and Welfare, raw, unpasteurized dairy products can contain bacteria that make people sick, particularly young children, pregnant women, the elderly, and those who are immunocompromised. The department states that pasteurization kills nearly all the germs that can exist in raw milk while maintaining nutritional benefits.

## What McAfee claims raw milk can do

McAfee promotes his product in messages and presentations as delicious, mood-supporting, and therapeutic, according to ProPublica. The investigation describes PowerPoints and emails in which he linked raw milk to the gut-brain serotonin and dopamine cycle, called it great for asthma, and said it literally saves lives.

His farm, located 20 miles southwest of Fresno and run with his adult son and daughter, markets dairy as safe and healthy for children, adults, and grandparents because each batch is screened for bacteria, according to ProPublica.

McAfee acknowledged illness linked to his products before a February farm visit described in the investigation. According to ProPublica, he said:

> "I've put a couple kids in the hospital, and they have been sick, but they recovered."

In the same discussion, he described himself as a pioneer working against conventional advice, according to ProPublica.

## What 150 years of dairy science says

By definition, raw milk has not been pasteurized, the heating process used to kill harmful bacteria, according to ProPublica. Before pasteurization was widely adopted a century ago, thousands of babies died each year from illnesses linked to contaminated dairy, the investigation reports.

Most scientists and health experts now agree that raw milk has no significant, proven nutritional benefits over pasteurized milk, cannot treat or cure disease, and carries over 100 times the risk of foodborne illness, according to ProPublica. The risk is described as especially dangerous for young children.

Food Safety News, reporting on a separate 2026 outbreak, described pasteurization as heating milk to 161 degrees F for 15 seconds, a step that destroys Listeria, Salmonella, E. coli, and Campylobacter. That outlet also cited research from the University of Delaware finding that, compared with consumers of pasteurized dairy, people who drink raw milk are 840 times more likely to experience illness and 45 times more likely to be hospitalized.

The Idaho Department of Health and Welfare gives the same practical distinction: unpasteurized products can carry illness-causing bacteria, while pasteurization removes nearly all of those germs without removing nutritional benefits.

## A pathogen lab, and milk diverted to cheese

A central part of McAfee's safety argument is testing. According to ProPublica, Raw Farm screens each batch for four types of bacteria: Salmonella, E. coli, Campylobacter, and Listeria. Those organisms live in cattle intestines and can reach milk through microscopic flecks of infected feces. In people, they can cause vomiting and diarrhea, along with sepsis, kidney failure, and death.

McAfee told ProPublica that the farm catches contamination and diverts the milk immediately. During the reported visit to a cream-colored bungalow he calls his pathogen laboratory, where two workers in lab coats prepared samples, he described a red-flag system for abnormal results.

That diverted milk is not necessarily discarded. According to ProPublica, McAfee said flagged milk does not go to anything but cheese, adding his view that cheese is resistant to pathogens.

Research does not support that view of safety, according to ProPublica. Aging can reduce some risk, but harmful bacteria can still survive the usual 60-day maturation process. McAfee confirmed to ProPublica that milk containing pathogens was used to make cheese, with an exception for batches containing Salmonella, which he said were dumped or sent out for pasteurization.

For consumers focused on nutrition and healthy living, the distinction matters because cheese made from contaminated milk can still carry live pathogens into the kitchen. The current concern is not only fluid milk in glass bottles, but other unpasteurized dairy foods made when screening finds a problem.

## More than a dozen recalls and outbreaks

Regulators have repeatedly connected Raw Farm products to illness. According to ProPublica, federal and state regulators linked the business to more than a dozen recalls and outbreaks that sickened hundreds.

Those events included regular outbreaks of Salmonella and E. coli, and the discovery of bird flu in Raw Farm milk, according to ProPublica. The investigation also notes two decades of disputes with the Food and Drug Administration and the Department of Justice, which repeatedly accused McAfee of breaking federal laws and regulations.

A Rutgers University summary of recent Associated Press reporting, published June 9, 2026, described a current outbreak tied to raw-milk cheddar cheese from California-based Raw Farm that sickened nine people with E. coli. Half were children younger than 5, and one person developed a serious complication that can impair kidney function for life. That summary described the event as one of at least five raw-milk outbreaks in the past year.

That pattern helps explain why pediatric risk draws particular attention. According to ProPublica, scientists warn that foodborne illness from raw milk can be especially dangerous for young children. Idaho health officials list young children, pregnant women, older adults, and immunocompromised people as groups facing higher risk from bacteria in unpasteurized dairy, according to the Idaho Department of Health and Welfare.

## Why enforcement has not stopped sales

McAfee has avoided serious sanctions despite repeated allegations, according to ProPublica. The outlet reports that the Biden administration was nearing a crackdown on his farm when President Donald Trump took office and placed leadership of federal health agencies under Health and Human Services Secretary Robert F. Kennedy Jr.

Kennedy had campaigned for president the prior year on criticism of government suppression of raw milk, according to ProPublica. In his federal role, he said he was advocating for raw milk and marked the release of a federal Make America Healthy Again report with raw-milk shooters at the White House.

A Rutgers University summary similarly notes that Kennedy consumed raw-milk shots at the White House last May and had earlier promised to halt aggressive suppression of the product. The political shift, combined with wellness culture and distrust of health institutions linked to pharmaceutical and food companies, has helped move raw milk from a fringe product to a symbol of freedom and defiance for supporters, according to ProPublica.

McAfee frames the scrutiny as resistance to innovation rather than evidence of unavoidable hazard. According to ProPublica, he told Waldman that observers view the operation as a fringe trend, while he considers the work serious and pointed to daily practices on the farm as proof.

## Idaho reports nearly 60 illnesses in two weeks

A separate outbreak in early June underlines how quickly illness can spread beyond one brand. On June 3, 2026, the Idaho Department of Health and Welfare announced investigations into two outbreaks likely associated with raw milk.

Since May 19, 2026, nearly 60 people were identified as becoming ill after consuming raw milk, according to the Idaho Department of Health and Welfare. At least 45 tested positive for campylobacteriosis, although not everyone who became sick was tested. Officials said investigation and interviews were continuing and additional illnesses could be identified.

Most patients reported drinking raw milk from two different milking operations, one in northern Idaho and one in southern Idaho, according to the Idaho Department of Health and Welfare. The agency did not name the operations. It said both were working with state and local agencies to identify batches of concern, test milk samples, and address potential sources of contamination.

Food Safety News reported the same totals on June 3, 2026, noting that all 60 patients had consumed raw milk before becoming sick. The state investigation involved the Division of Public Health and six regional districts: Panhandle District Health, Southwest District Health, Central District Health, Southeastern Idaho Public Health, South Central Public Health, and Eastern Idaho Public Health.

Campylobacter infection usually begins two to five days after exposure and lasts about one week, although some people develop longer complications, according to the Idaho Department of Health and Welfare. Common symptoms include diarrhea, sometimes bloody, plus fever, stomach cramps, nausea, and vomiting. Anyone with symptoms after consuming raw milk or raw-milk products is encouraged to seek medical care promptly and contact a local public-health district.

## A wider push to expand access

Even as investigators trace illnesses, access is expanding. A Rutgers University summary of Associated Press findings reports more than three dozen bills supporting raw milk introduced in statehouses nationwide. A growing number of states now allow sales, farmers report difficulty keeping the product in stock, and prices can exceed $10 or $20 a gallon.

Social-media discussion has increased, often featuring unproven health claims, while senior officials and online influencers help drive demand, according to that Rutgers summary. Federal health agencies including the Food and Drug Administration and the Centers for Disease Control and Prevention maintain that those benefit claims lack strong scientific support.

For shoppers, the practical guidance from regulators remains consistent: choose pasteurized milk and dairy foods, keep cold foods cold, and seek care for persistent vomiting, diarrhea, fever, abdominal pain, or dehydration after consuming unpasteurized products. The Idaho Department of Health and Welfare especially urges caution for households with young children, pregnant women, older adults, or anyone with a weakened immune system.

## Sources referenced
- Mark McAfee Promotes the Wonders of Raw Milk. It Has Sickened Hundreds, Regulators Say. — ProPublica (https://www.propublica.org/article/mark-mcafee-raw-milk-recalls-maha)
- Idaho Public Health officials are investigating two outbreaks likely associated with raw milk - Idaho Department of Health and Welfare (https://healthandwelfare.idaho.gov/news/idaho-public-health-officials-are-investigating-two-outbreaks-likely-associated-raw-milk)

## Listeria Outbreak Linked to Recalled Soft Ricotta Sickens 8

URL: https://nutritionjournal.com/listeria-outbreak-clover-hill-soft-cheese-recall

CDC, FDA and Maryland link 8 Listeria illnesses, 7 hospitalizations and 1 death to Clover Hill Dairy requesón and order recall.

Key takeaways:
- 8 infections with one Listeria strain in MD, NY, VA caused 7 hospitalizations and 1 death in Maryland.
- All Clover Hill Dairy soft ricotta/requeson cheese was voluntarily recalled for possible Listeria contamination.
- Recalled cheese was distributed May 4-30, 2026 in 6 jurisdictions; identify by plant number 24-128.
- Bulk cheese repackaged under names like KESSO and QUESOS LA RICURA is included in the recall.
- Maryland suspended Clover Hill Dairy's operating license pending follow-up evaluation.
- Pregnant people, adults 65+, and immunocompromised people face highest risk of severe listeriosis.

**TL;DR: Eight infections from one *Listeria* strain in Maryland, New York and Virginia — with seven hospital stays and one death — prompted a voluntary recall of all Clover Hill Dairy requesón/soft ricotta.**

Federal and state health agencies linked a multistate cluster of invasive listeriosis to requesón-style soft ricotta made by Clover Hill Dairy of Mechanicsville, Maryland, and urged households, shops and restaurants not to eat, sell or serve the recalled cheese.

According to the [CDC warns of Listeria outbreak linked to requesón/soft ricotta cheese](https://www.cdc.gov/media/releases/2026/cdc-warns-of-listeria-outbreak-linked-to-requeson-soft-ricotta-cheese.html), released for immediate distribution on June 5, 2026, eight people in three states became ill with the same strain. Seven required hospital care, and one Maryland resident died. The Maryland Department of Health suspended the dairy's operating license while a follow-up evaluation continued in cooperation with the facility. The Centers for Disease Control and Prevention and the Food and Drug Administration said work continued to determine whether additional products were connected.

According to the [FDA MedWatch - Outbreak Investigation of Listeria monocytogenes: Soft Cheese (June 2026)](https://content.govdelivery.com/accounts/USFDA/bulletins/41a9b50), sent June 5, 2026 at 12:49 p.m. EDT, the investigation as of June 4, 2026 covered a multistate, multiyear outbreak potentially tied to requesón. That bulletin gives the reporting window, interview results, distribution routes, label identifier and home-cleaning steps summarized below. Maryland's consumer advisory, issued June 3, 2026, provides matching product-identification and illness information.

## What the case count shows

Investigators confirmed eight infections with the outbreak strain across Maryland, New York and Virginia.

Seven of the eight patients entered the hospital. One death was recorded in Maryland.

Epidemiologists described the illnesses as sharing a single strain of *Listeria monocytogenes*. Of seven patients who answered detailed food-history questions, five reported eating any cheese. Two of the seven, or 29%, reported eating requesón produced by Clover Hill Dairy.

Officials cautioned that confirmed reports can underrepresent foodborne outbreaks because some ill people recover without testing. At the time of the announcements, the agencies said they had not finished identifying every possibly affected product.

## A multiyear reporting window

Sample collection dates for the outbreak strain extended from March 6, 2023 to May 9, 2026.

That span of more than three years does not mean all cheese from that period is implicated. It reflects the dates when patient specimens that later matched by laboratory analysis were gathered.

The active recall discussed on June 3 and June 5, 2026 covered cheese distributed from May 4, 2026 through May 30, 2026. The company said it had stopped making and shipping all cheese products while federal and state inquiries proceeded.

Regulators labeled the status of the outbreak inquiry as ongoing. No closure date or final cause determination had been announced by the cutoff for this report.

## Which products were recalled

Clover Hill Dairy voluntarily recalled all soft ricotta/requesón cheese because of potential contamination with *Listeria monocytogenes*.

The company announcement dated June 5, 2026 said the action applied to every soft ricotta/requesón cheese it manufactured, not to a single lot code. Some varieties contained jalapeño or other flavorings.

Retail packages included individually packed clamshell tubs in ten-ounce, twelve-ounce and fourteen-ounce sizes carrying the Clover Hill Dairy Cheese brand name. Bulk cheese was also sold in five-gallon and two-gallon buckets to customers who repackaged it.

Repackaged bulk cheese could appear under distributor labels other than Clover Hill Dairy. Names listed as examples included KESSO, QUESOS LA RICURA, IZALCO, DE MI PUEBLO and RIO LINDO. Officials said the example list did not necessarily cover every distributor or label involved.

## How to recognize the cheese

Packages, when available, should be checked for manufacturer information rather than relying on front-brand name alone.

The identifier to look for is Clover Hill Dairy manufacturer permit or plant number “24-128” on the product label. Maryland health officials advised buyers to inspect that field if the package retained it.

Requesón is described by federal officials as a soft cheese similar to ricotta. Photographs released with the Maryland advisory showed front labels of sample Clover Hill Dairy requesón/soft ricotta items, with a warning that images did not depict every affected product or distributor presentation.

Frozen cheese without original wrapping that cannot be confirmed as outside the recall should be discarded. That instruction applied to both household and commercial holders of the product.

## Where the cheese was sold

The recalled cheese moved through bulk distributors, retail shops and direct-to-consumer sales.

The company listed distribution from May 4, 2026 through May 30, 2026 in North Carolina, New York, Virginia, Maryland, New Jersey and Washington, D.C.

Maryland officials separately described sales directly from the firm's retail market in Maryland, at farmers markets, and through third-party distributors including in New York and Virginia. Federal updates repeated those three channels and asked purchasers to verify manufacturer details because relabeling could obscure the origin.

Shoppers were told to return recalled Clover Hill Dairy soft ricotta/requesón in its original packaging to the place of purchase for a full refund. Questions were directed to the Southern Maryland Agricultural Development Commission, acting on behalf of Clover Hill Dairy, at 240-528-8850 extension 327.

## Why soft cheese carries higher concern

*Listeria monocytogenes* is a disease-causing bacterium in the *Listeria* family that can develop where food-production sanitation lapses, according to Maryland health authorities.

The organism can survive and multiply under refrigeration. It can transfer readily to other foods and to kitchen surfaces. Household pets that consume contaminated food can also move the bacterium around the home.

Pasteurization destroys *Listeria* in milk, but soft cheese prepared from pasteurized milk can become contaminated after that heating step and still cause illness. For that reason, federal guidance flagged soft cheeses, even pasteurized versions, as a riskier selection, particularly for vulnerable consumers. Maryland guidance added that higher-risk shoppers should avoid soft cheeses produced with unpasteurized milk.

## Who faces the greatest danger

Most healthy people who encounter *Listeria* do not develop severe disease, but three groups face substantially higher likelihood of invasive illness.

Those groups are people who are pregnant, adults aged 65 or older, and people with weakened immune defenses linked to certain medical conditions or therapies. Newborns, young children, frail older adults and others with reduced immunity were likewise described as especially susceptible.

In pregnancy, infection can trigger miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn. The pregnant person may experience only fever, fatigue, muscle aches and tiredness while the pregnancy remains at serious risk.

Among older adults and people with weakened immunity, infection often leads to hospitalization and sometimes death because the bacterium is more likely to spread beyond the gut to other body sites, producing invasive listeriosis.

## Symptoms and timing to watch

Symptoms usually begin within two weeks after consuming contaminated food, but onset can occur as early as the same day or as late as ten weeks afterward.

Mild manifestations can include fever, muscle aches, nausea, tiredness, vomiting and diarrhea. Maryland officials noted that milder digestive and flu-like effects often persist for one to three days.

When severe listeriosis develops, signs can include headache, stiff neck, confusion, loss of balance and convulsions, alongside fever, muscle aches and tiredness. Pregnant patients may show fever, muscle aches and tiredness without prominent neurological signs.

Because illness can emerge up to two months after exposure, people who ate recalled cheese were advised to monitor for an extended period and contact a clinician promptly if compatible symptoms appeared. Anyone with questions about cases in a particular state was directed to that state's health department.

## What households should do now

Do not eat recalled requesón/soft ricotta cheese.

Check refrigerators and freezers for recalled cheese and discard it. If cheese was frozen without its original package and its recall status cannot be verified, throw it away.

Carefully clean and sanitize any refrigerator shelves, containers, utensils or surfaces the cheese may have touched. Follow safe handling and cleaning practices to limit cross-contamination, since refrigerated temperatures will not eliminate the bacterium.

People at higher risk for severe disease — those who are pregnant, aged 65 or older, or immunocompromised — were told not to eat any queso fresco-type cheese, including soft ricotta/requesón. Consumers were also reminded that recalled cheese should not be fed to pets.

Anyone developing symptoms consistent with listeriosis after eating the product should contact a health care provider for evaluation and care.

## What retailers, restaurants and markets must do

Do not sell or serve recalled requesón/soft ricotta cheese, including wholesale or bulk formats.

Remove the product from shelves, cold cases, preparation areas and storage. Wash and sanitize items and surfaces that may have contacted it.

Because bulk cheese may have been repackaged under other names, businesses were asked to review supplier records and manufacturer numbers, not only brand fronts. Any product containing Clover Hill Dairy requesón/soft ricotta should be disposed of rather than repurposed.

The Maryland Department of Health said suspension of the facility's operating license reflected the public-health risk, with a follow-up evaluation underway alongside the company. Clover Hill Dairy said production and distribution of all cheese products had ceased pending the continuing reviews by the Food and Drug Administration, the Maryland Department of Health and the firm.

## What investigators said comes next

Federal officials said the central open question was whether products beyond the identified Clover Hill Dairy requesón were linked.

CDC and FDA teams, working with state and local partners, were reviewing epidemiologic interviews, purchase records and laboratory findings. The agencies said they would continue tracing distribution and testing hypotheses about additional exposures.

The Maryland Department of Health described its June 3 notice as the best information then available. Consumers seeking clinical detail were referred to the state's listeriosis fact sheet and to their own health care professionals.

Until investigators update the record, the standing advice remains unchanged: verify plant number 24-128, discard or return matching cheese, sanitize contact surfaces, and seek medical advice quickly if severe symptoms follow a recalled-cheese exposure.

## Medically Tailored Meals Lower A1c in FAME-D Diabetes Trial

URL: https://nutritionjournal.com/medically-tailored-meals-fame-d-diabetes-trial

FAME-D randomized 194 adults with type 2 diabetes and food insecurity to tailored meal delivery plus coaching or a $40 grocery subsidy; meals lowered A1c by 0.42 points and systolic pressure by 6.5 mmHg at six months.

Key takeaways:
- Six months of medically tailored meals plus telephone coaching lowered A1c to 7.74% vs 8.17% with a $40 grocery subsidy (difference -0.42, p=0.037).
- Systolic blood pressure was 124.3 vs 130.8 mmHg (difference -6.5, p=0.02) favoring meals.
- Diastolic pressure and weight differences were not statistically significant.
- FAME-D randomized 194 adults with type 2 diabetes and food insecurity; 92% had six-month follow-up.
- A separate KP ENRICH trial found a $100 monthly online grocery stipend did not significantly lower A1c versus deliveries alone.

TL;DR: Six months of home-delivered medically tailored meals plus telephone lifestyle coaching lowered hemoglobin A1c and systolic blood pressure more than a $40-per-month grocery subsidy in adults with type 2 diabetes and food insecurity.

## Answer first: meals outperformed a grocery subsidy

In the Food as Medicine for Diabetes (FAME-D) randomized comparative effectiveness trial, participants assigned to medically tailored meals (MTM) had lower hemoglobin A1c at six months than participants assigned to a food subsidy, according to the abstract published in *Diabetes* as **1249-OR: Medically Tailored Meals Lower Hemoglobin A1c: The Food as Medicine for Diabetes (FAME-D) Randomized Clinical Trial | Diabetes | American Diabetes Association**.

The reported six-month means were 7.74% for MTM versus 8.17% for the subsidy group, a mean difference of -0.42 percentage points, with a 95% confidence interval from -0.82 to -0.03 and p=0.037. Systolic blood pressure was also lower with MTM, at 124.3 mmHg versus 130.8 mmHg, a mean difference of -6.5 mmHg, with a 95% confidence interval from -12.0 to -1.1 and p=0.02.

The investigators concluded that six months of MTM lowered HbA1c and systolic pressure compared with a food subsidy and that medically tailored meals can help improve health outcomes for people living with food insecurity and type 2 diabetes. The trial record cited in the abstract is NCT04828785, and the primary time point was six months from randomization.

## Why the comparison mattered

The abstract states that food insecurity leads to worse type 2 diabetes outcomes, but which food insecurity intervention best improves those outcomes is unclear. The objective was therefore to compare the effectiveness of two food insecurity interventions: medically tailored meals and food subsidies.

That head-to-head design distinguishes FAME-D from studies that compare a nutrition benefit with usual care alone. Both study arms received an active food-related intervention for six months. The question was not whether food help matters at all, but whether delivered meals tailored to diabetes diet guidance plus coaching produce larger clinical changes than money earmarked for healthy groceries.

## How the two study arms were designed

Adults with type 2 diabetes and food insecurity were randomized to one of two six-month strategies.

One group received MTM consisting of home delivery of 10 meals per week tailored to type 2 diabetes diet guidelines by a registered dietitian-nutritionist, plus a telephone lifestyle intervention adapted from Look AHEAD. The other group received a food subsidy of $40 per month for healthy groceries.

The lifestyle component included six main sessions plus six brief check-ins. According to the abstract, the sessions focused on skills for healthy eating, increased activity, and behavior change, with or without a weight-loss goal according to participant preference.

The primary outcome was hemoglobin A1c. Other outcomes were systolic blood pressure, diastolic blood pressure, and weight.

## Who took part in FAME-D

The abstract reports that 194 participants were randomized and that 178 participants, or 92%, had six-month follow-up measurements.

Mean age was 56 years, with a standard deviation of 12 years. A total of 117 participants, or 60%, were women. Fifty-five participants, or 28%, self-identified as Black, and 35 participants, or 18%, self-identified as Hispanic.

At baseline, mean HbA1c was 8.4%, with a standard deviation of 1.7 percentage points. Mean systolic pressure was 132.7 mmHg, with a standard deviation of 19.6 mmHg. Mean diastolic pressure was 80.1 mmHg, with a standard deviation of 11.7 mmHg. Mean weight was 103.5 kg, with a standard deviation of 24.5 kg.

The named authors listed for the presentation were Seth Berkowitz, Katharine A. Ricks, Jean Terranova, Colleen Dagley, Barbara Steiner, Gina Kruse, Thomas C. Keyserling, John B. Buse, Deborah Wexler, and Linda M. Delahanty. Funding reported in the indexed record was NIH/NIDDK grant R01DK125831.

## Blood sugar: what changed at six months

The primary result favored MTM. At six months, the MTM group averaged 7.74% HbA1c and the subsidy group averaged 8.17%.

The estimated between-group difference was -0.42 percentage points. The 95% confidence interval extended from -0.82 to -0.03, and the p-value was 0.037, meeting the conventional threshold for statistical significance described in the abstract as significantly lower.

Baseline HbA1c for the full randomized population had averaged 8.4%. The abstract does not report separate baseline means by arm in the text supplied, so the published comparison rests on the six-month values and the adjusted mean difference.

For readers managing diabetes, HbA1c reflects average blood glucose over approximately two to three months in routine clinical use. The trial itself defined HbA1c as its primary outcome and did not, in the abstract text, assign a clinical category to the observed 0.42-point difference.

## Blood pressure: systolic improved, diastolic did not

Systolic pressure showed a larger absolute separation. The MTM group averaged 124.3 mmHg at six months, compared with 130.8 mmHg in the subsidy group. The mean difference was -6.5 mmHg, with a 95% confidence interval from -12.0 to -1.1 and p=0.02.

Diastolic pressure moved in the same direction but did not meet the significance criterion used by the authors. Mean diastolic values were 76.1 mmHg for MTM versus 78.8 mmHg for the subsidy group. The mean difference was -2.7 mmHg, with a 95% confidence interval from -5.9 to 0.5 and p=0.10.

Baseline means for the study population were 132.7 mmHg systolic and 80.1 mmHg diastolic. The abstract reports the six-month values as group means rather than as within-person changes.

## Weight: no significant between-group difference

Weight also did not differ significantly between arms at six months. Mean weight was 101.6 kg with MTM versus 102.5 kg with the subsidy. The mean difference was -1.0 kg, with a 95% confidence interval from -2.9 to 0.9 and p=0.31.

Mean baseline weight was 103.5 kg, with a standard deviation of 24.5 kg. The lifestyle intervention allowed participants to choose whether to pursue a weight-loss goal, and the abstract describes the coaching focus as healthy eating, increased activity, and behavior change.

The pattern across outcomes was therefore mixed: HbA1c and systolic pressure favored delivered meals, while diastolic pressure and weight showed numerical differences favoring MTM that were not statistically significant.

## What the meals included beyond food delivery

The MTM intervention combined two elements: prepared food and behavioral support.

The food element was home delivery of 10 meals per week, tailored to type 2 diabetes diet guidelines by a registered dietitian-nutritionist. The abstract does not list menus, calorie levels, sodium limits, carbohydrate targets, or vendors.

The behavioral element was a telephone lifestyle intervention adapted from Look AHEAD. It comprised six main sessions and six brief check-ins centered on healthy-eating skills, physical activity, and behavior-change strategies. Participants could select a weight-loss goal or focus on other behavioral goals.

The comparator was less intensive in contact and food provision: $40 per month designated for healthy groceries, without the delivered meals or described coaching package.

## Context: a grocery stipend alone did not move A1c in another 2026 trial

A second randomized trial presented in the same *Diabetes* supplement underscores why intervention design may matter. The abstract titled **1250-OR: Efficacy of a Food Is Medicine Program in Low-Income, High-Risk Adults with Type 2 Diabetes: The KP ENRICH Study** tested a technology-based grocery prescription program.

That study enrolled adults with Medicaid insurance, type 2 diabetes, and A1c at or above 7.5% in Kaiser Permanente Northern and Southern California from October 2023 through December 2025. It excluded people with advanced kidney disease, those who were institutionalized or pregnant, those with no internet access, those requiring an interpreter, or those with no valid credit or debit card.

The intervention used the Instacart online platform and provided a $100-per-month stipend for healthy foods such as fruits, vegetables, legumes, nuts and seeds, with four free deliveries per month for six months. The control arm received four free Instacart deliveries per month for six months without a stipend. The primary outcome was six-month A1c using an intent-to-treat approach.

Among 1,007 subjects, with 510 in intervention and 506 in control as listed, both arms started with similar characteristics: mean age 53.2 versus 53.1 years, women 67.9% versus 66.6%, and mean entry A1c 9.34% versus 9.21%. Registration to use Instacart was 88.6% versus 50.8%, and mean monthly orders were 1.5 versus 0.2. Follow-up A1c was available for 93.4% of subjects.

Both arms reduced A1c: minus 0.63 percentage points in the intervention group and minus 0.53 percentage points in the control group. After adjustment for baseline A1c and stratification factors, six-month A1c was 8.63% versus 8.65%, a difference of -0.06 percentage points, with a 95% confidence interval from -0.26 to 0.14 and p=0.55. The authors concluded that monthly funds for healthy foods through an online platform did not improve six-month glycemic control versus usual care in that low-income, high-risk population.

Taken together, the two abstracts suggest that simply providing grocery money may not shift A1c, while providing prepared diabetes-tailored meals plus coaching did shift A1c relative to a smaller subsidy in FAME-D. The populations, stipend sizes, delivery models, comparators, and baseline A1c levels differed, so the results do not establish a single dose-response for food spending.

## What this means for food-as-medicine planning

For health systems and nutrition programs, FAME-D compares a higher-touch model with a lower-cost subsidy. The higher-touch model delivered food directly to the home on a weekly basis and paired it with telephone coaching. The lower-cost model provided $40 monthly for groceries.

The trial retained 92% of randomized participants for six-month measurements, which supports the feasibility of follow-up in a food-insecure diabetes population. The abstract does not report adherence to meal consumption, grocery purchases, coaching attendance, medication changes, hypoglycemia, or costs.

People with diabetes and food insecurity who are considering meal programs can discuss referral options, eligibility rules, diabetes medications, and blood-pressure monitoring with their clinical team. Programs vary in meal frequency, nutrition tailoring, delivery area, and duration, and the FAME-D abstract describes only the specific combination tested: 10 meals weekly plus the defined telephone program for six months.

## Limits of what the abstracts establish

The findings come from conference abstracts published June 7, 2026, not from a full peer-reviewed paper excerpt in the source text. The FAME-D abstract reports group means, differences, confidence intervals, and p-values, but does not include subgroup results, adherence data, adverse events, or longer-term follow-up beyond six months.

The conclusion applies to adults with type 2 diabetes and food insecurity enrolled under trial conditions and to the comparison tested. It does not compare MTM with no food assistance, with a larger grocery benefit, or with in-person counseling. It also does not report whether systolic-pressure or A1c differences persisted after meals ended.

The KP ENRICH comparison likewise applies to its own eligibility criteria and to a $100 monthly online grocery stipend versus deliveries without a stipend. Its result of no significant A1c difference does not contradict FAME-D directly because the interventions and control conditions were different.

## CDC Warns of Listeria Outbreak Linked to Recalled Requesón Cheese

URL: https://nutritionjournal.com/cdc-listeria-outbreak-requeson-cheese-recall

CDC reports 8 Listeria cases, 7 hospitalizations and 1 death tied to Clover Hill Dairy requesón; recalled cheese sold in six states and DC is under investigation.

Key takeaways:
- Do not eat, sell or serve recalled Clover Hill Dairy requesón/soft ricotta cheese.
- Eight infections, seven hospitalizations and one Maryland death were linked to the outbreak strain by June 5, 2026.
- Check for plant number 24-128; bulk cheese may be repackaged under other brand names.
- Listeria can survive refrigeration and spread to other foods and surfaces; sanitize fridges and containers.
- Pregnant people, adults 65+, and people with weakened immune systems face the highest risk.
- Symptoms can start the same day or up to 10 weeks after eating contaminated food; seek care for severe symptoms.

## TL;DR

Do not eat, sell, or serve recalled requesón/soft ricotta cheese made by Clover Hill Dairy of Mechanicsville, Maryland. According to the CDC Newsroom release of June 5, 2026, eight people in Maryland, New York, and Virginia were infected with the same outbreak strain of *Listeria*, seven were hospitalized, and one person in Maryland died.

## Outbreak snapshot: what investigators confirmed by June 5

Federal and state partners described a multistate, multi-year investigation that remained open in early June.

* **Case count:** Eight people infected with the outbreak strain, reported from three states, according to the CDC Newsroom.
* **Hospitalizations and death:** Seven hospitalizations and one death reported, according to the CDC Newsroom and the FDA outbreak bulletin distributed June 5, 2026.
* **Sample window:** Patients' samples were collected on dates ranging from March 6, 2023, to May 9, 2026, according to the FDA outbreak bulletin distributed June 5, 2026.
* **Interviews:** Of seven people interviewed, five reported eating any cheese and two people reported eating requesón made by Clover Hill Dairy, according to that same FDA bulletin.
* **Status:** The status of the outbreak investigation is ongoing, according to the FDA bulletin, and CDC and FDA are working to identify if any other products are linked, according to the CDC Newsroom.

The Maryland Department of Health consumer advisory of June 3, 2026, said Clover Hill Dairy had issued a voluntary recall of its requesón/soft ricotta products because of possible *Listeria monocytogenes* contamination. The company announcement carried by the FDA said Clover Hill Dairy of Mechanicsville, Maryland, is voluntarily recalling all Soft Ricotta/Requesón Cheese because it has the potential to be contaminated with *Listeria monocytogenes*.

Clover Hill Dairy was made aware of the potential public food health risk by the Maryland Department of Health, according to the company announcement carried by the FDA. The company said it has ceased production and distribution of all cheese products while the Food and Drug Administration, Maryland Department of Health, and Clover Hill Dairy continue their investigations.

## Which cheese is recalled and how to spot it

Requesón is a soft cheese similar to ricotta, according to the FDA outbreak bulletin distributed June 5, 2026. Some varieties may have jalapeño or other flavors, according to the Maryland Department of Health advisory and the company announcement carried by the FDA.

Distribution described in the recall materials was broad for a regional dairy:

* **Distribution period:** May 4, 2026, through May 30, 2026, according to the company announcement carried by the FDA.
* **Where distributed:** North Carolina, New York, Virginia, Maryland, New Jersey, and Washington, DC, through bulk distributors, retail stores, and directly to consumers, according to that company announcement.
* **Other channels:** Products are sold directly from the company's retail market in Maryland, at farmers markets, and through third-party distributors, including in New York and Virginia, according to the FDA outbreak bulletin and the Maryland Department of Health advisory.

Packaging takes several forms, which matters because shoppers may not see the Clover Hill name at purchase:

* **Retail clamshells:** Ten-ounce, 12-ounce, and 14-ounce individually packaged clamshell containers, according to the company announcement carried by the FDA.
* **Plant number:** For clamshell containers with the Clover Hill Dairy Cheese brand name, look for plant number 24-128 on the product label, according to that announcement. The Maryland Department of Health advisory gives the same instruction: the label should identify the manufacturer permit or plant number as “24-128.”
* **Bulk buckets:** Five-gallon and two-gallon buckets sold to some customers that repackaged the cheese, according to the company announcement carried by the FDA.
* **Repackaged brands:** Bulk cheese may be repackaged under individual distributor brand names including KESSO, QUESOS LA RICURA, IZALCO, DE MI PUEBLO, and RIO LINDO, according to that announcement. The Maryland Department of Health advisory similarly warned that products may be relabeled under a different brand name and urged consumers to check manufacturer information where available.

The Maryland Department of Health advisory said photographs in its release show the front label of sample products but do not represent all products and distributors affected. Consumers who purchased recalled cheese are urged to return it to the place of purchase in its original packaging for a full refund, according to the company announcement carried by the FDA.

## How the trace led to Clover Hill Dairy

The New York portion of the trace was described in detail by Food Safety Magazine on June 4, 2026, citing CDC information.

According to Food Safety Magazine, the Suffolk County Health Department notified the New York State Department of Agriculture and Markets on May 13, 2026, about two related illnesses in one family who had purchased food from a local retailer in Brentwood, New York. The next day, the New York State Department of Health confirmed both patients had consumed requesón cheese purchased at that retailer.

Investigators then tested five cheese samples collected from the retailer and found *L. monocytogenes* in one sample of requesón that had been repacked by the retailer, according to Food Safety Magazine. Whole genome sequencing matched the strain found in that cheese to the clinical strain from the two New York patients who reported buying cheese there.

On May 27, 2026, state agriculture investigators inspected the retailer's cheese distributor, which identified Clover Hill Dairy LLC of Mechanicsville, Maryland, as the manufacturer, according to Food Safety Magazine. A sample from an unopened 18-pound sealed bucket of requesón manufactured by Clover Hill Dairy also tested positive for *L. monocytogenes*, with sequencing analysis of that isolate pending at the time of that report.

The Maryland Department of Health announced its consumer advisory and license action on June 3, 2026. The company recall followed with a June 5, 2026, company announcement, according to the notice carried by the FDA.

## License suspended while evaluation continues

Due to the public health risk, the Maryland Department of Health has suspended the facility's operating license and is conducting a follow-up evaluation in cooperation with the facility, according to both the CDC Newsroom and the Maryland Department of Health advisory.

The company announcement carried by the FDA said the company has ceased production and distribution of all cheese products and has initiated a voluntary recall for Soft Ricotta/Requesón while investigations continue. Consumers with questions may contact the Southern Maryland Agricultural Development Commission on behalf of Clover Hill Dairy at 240-528-8850 extension 327, according to that announcement.

The CDC Newsroom said certain soft cheeses made by Clover Hill Dairy sold in grocery stores and other retail locations have been recalled. It also said CDC and FDA are working to identify if any other products are linked to the outbreak. At the time of the June 4 report, Food Safety Magazine noted there was not enough evidence for FDA to determine if the recalled cheese can explain the entire outbreak.

## Who faces the highest risk

*Listeria* is especially harmful to pregnant women and people who are 65 or older or who have weakened immune systems, according to the CDC Newsroom. This is because *Listeria* is more likely to spread beyond the gut to other parts of the body, resulting in invasive listeriosis.

For pregnant women, *Listeria* can cause pregnancy loss, premature birth, or a life-threatening infection in newborns, according to the CDC Newsroom. The company announcement carried by the FDA similarly states that *Listeria* infection can cause miscarriages and stillbirths among pregnant women, and can cause serious and sometimes fatal infections in young children, frail or elderly people, or others with weakened immune systems.

For people who are 65 years or older or who have a weakened immune system, *Listeria* often results in hospitalization and sometimes death, according to the CDC Newsroom.

The Maryland Department of Health advisory adds that listeriosis can be serious and life-threatening particularly for pregnant women, newborns and young children, older adults, and persons with weakened immune systems. It states that pets can also spread the bacteria in the home if they eat food contaminated with *L. monocytogenes*.

## Symptoms and timing to watch

Symptoms usually start within two weeks after eating food contaminated with *Listeria* but may start as early as the same day or as late as 10 weeks after, according to the CDC Newsroom and the FDA outbreak bulletin.

Mild symptoms may include fever, muscle aches, nausea, tiredness, vomiting, and diarrhea, according to the FDA bulletin. The Maryland Department of Health advisory says mild symptoms include fever, muscle aches, nausea, vomiting, and diarrhea, which often persist for one to three days.

More severe illness looks different:

* **Pregnant women:** Fever, muscle aches, and tiredness; illness may be mild, but *Listeria* can cause pregnancy loss or premature birth and serious illness or death in newborns, according to the CDC Newsroom.
* **Other people:** Headache, stiff neck, confusion, loss of balance, and convulsions, in addition to fever, muscle aches, and tiredness, according to the CDC Newsroom. The FDA bulletin lists the same severe signs.
* **Timing:** People can sometimes develop listeriosis up to two months after eating contaminated food, although symptoms usually begin within several days, according to the Maryland Department of Health advisory.

People should immediately consult with a health care provider if they suspect symptoms resembling listeriosis infection, according to the Maryland Department of Health advisory. The CDC Newsroom advises calling a health care provider right away if severe symptoms develop after eating recalled cheese.

## What consumers should do now

Do not eat recalled requesón/soft ricotta cheese, according to the CDC Newsroom, the FDA outbreak bulletin, and the Maryland Department of Health advisory.

The FDA bulletin adds these steps:

* Check refrigerators and freezers for any recalled cheese and throw it away.
* If cheese was frozen without the original packaging and it cannot be told whether it is part of the recall, throw it away.
* Carefully clean and sanitize any surfaces or containers the recalled cheese touched, following safe handling and cleaning advice to reduce cross-contamination.
* Contact a health care provider if symptoms of listeriosis develop.

The CDC Newsroom similarly advises cleaning the refrigerator, containers, and surfaces that may have touched the recalled cheese because *Listeria* can survive in the refrigerator and can easily spread to other foods and surfaces. The Maryland Department of Health advisory states that *L. monocytogenes* can survive and grow even under refrigeration and can easily spread to other foods and surfaces.

If you are at higher risk — pregnant, aged 65 or older, or with a weakened immune system — do not eat any queso fresco-type cheese, including soft ricotta/requesón, according to the recommendation for at-risk groups in the FDA outbreak bulletin. The CDC Newsroom advises that people in those groups not eat recalled requesón/soft ricotta cheese and notes that soft cheeses, even pasteurized ones, can be a riskier food choice.

## What retailers, restaurants, and distributors should do

Do not sell or serve recalled requesón/soft ricotta cheese, according to the CDC Newsroom and the FDA outbreak bulletin.

The CDC Newsroom advises businesses to wash and sanitize items and surfaces that may have touched recalled cheese. The FDA bulletin says consumers, restaurants, and retailers that purchased or received recalled cheese, including wholesale products, should carefully clean and sanitize any surfaces or containers it touched.

The Maryland Department of Health advisory directs consumers, retailers, and restaurants not to eat, sell, or serve products containing Clover Hill Dairy requesón/soft ricotta products and to dispose of any product containing them.

## Why even pasteurized soft cheese carries risk

Pasteurization of milk kills *Listeria*, but soft cheeses made from pasteurized milk can still become contaminated after pasteurization and cause illnesses, according to the Maryland Department of Health advisory. The CDC Newsroom carries the same caution that soft cheeses, even pasteurized ones, can be a riskier food choice.

The Maryland advisory says *L. monocytogenes* is a disease-causing bacterium that can grow in unsanitary food production conditions, leading to contamination. It also notes that consumers at higher risk should not eat soft cheeses made with unpasteurized milk.

That combination — a soft, high-moisture food, handling after pasteurization, repackaging through distributors, and the organism's ability to persist under refrigeration — is why officials emphasize label checks, disposal rather than tasting to decide, and thorough cleaning of refrigerated storage areas.

## What remains under investigation

As of June 4, 2026, FDA and CDC, in collaboration with state and local partners, were investigating a multistate, multi-year outbreak potentially linked to requesón, according to the FDA outbreak bulletin. The company announcement carried by the FDA said investigations by FDA, the Maryland Department of Health, and Clover Hill Dairy were continuing.

The CDC Newsroom said CDC and FDA are working to identify if any other products are linked. For questions about cases in a particular state, CDC directed callers to that state's health department, according to the CDC Newsroom.

Consumers who purchased recalled Clover Hill Dairy Soft Ricotta/Requesón cheese are urged to return it to the place of purchase in its original packaging for a full refund, according to the company announcement carried by the FDA.

## Sources referenced
- CDC warns of Listeria outbreak linked to requesón/soft ricotta cheese | CDC Newsroom (https://www.cdc.gov/media/releases/2026/cdc-warns-of-listeria-outbreak-linked-to-requeson-soft-ricotta-cheese.html)
- Clover Hill Dairy Recalls Soft Ricotta/Requeson Cheese Due to Possible Health Risk | FDA (https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/clover-hill-dairy-recalls-soft-ricottarequeson-cheese-due-possible-health-risk)

## DiaTeleMed: Personalized Mediterranean Diet Shows No Major Glucose Benefit

URL: https://nutritionjournal.com/diatelemed-personalized-mediterranean-diet-diabetes-trial

DiaTeleMed randomized 161 adults with type 2 diabetes to usual care or remote Mediterranean-diet counseling with or without algorithm-driven meal feedback.

Key takeaways:
- DiaTeleMed was a 6-month, fully remote 3-arm trial in 161 U.S. adults with HbA1c 6.5-8.0%.
- Standardized care was 14 Mediterranean-diet counseling sessions; Personalized added real-time predicted post-meal glucose feedback.
- MAGE change did not differ significantly among usual care, Standardized, and Personalized arms.
- Personalized feedback showed a greater 6-month CV reduction than usual care (-1.84%, p=0.04).
- Investigators concluded precision feedback did not improve MAGE or most variability indices.
- The trial was funded by NIH grant R01NR018916.

TL;DR: A six-month, fully remote three-arm trial in 161 U.S. adults with moderately controlled type 2 diabetes found that personalized Mediterranean-diet counseling with algorithm-driven meal feedback did not reduce major glucose swings more than usual care or standardized counseling.

The [2783-LB abstract published in Diabetes on June 5, 2026](https://doi.org/10.2337/db26-2783-lb) reports the Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study as a fully remote, 6-month, 3-arm randomized controlled trial. The study question was whether personalized dietary management improves glycemic variability in individuals with type 2 diabetes. The tested approaches were usual care, standardized Mediterranean diet-based counseling, and the same counseling plus real-time feedback on predicted postprandial glycemic response. The primary variability measure was mean amplitude of glycemic excursions, known as MAGE, assessed with continuous glucose monitoring. The reported conclusion was that the precision-nutrition approach did not improve MAGE or most variability indices beyond usual care or Mediterranean diet-based counseling in adults with moderately controlled disease. The [Synapse summary of the same June 5, 2026 abstract](https://synapsesocial.com/papers/6a250b0e7def13d035e1b057) presents the same design and the same conclusion in structured form.

## Why researchers tested post-meal glucose responses

The investigators stated that dietary recommendations for type 2 diabetes aim to minimize postprandial glycemic response, abbreviated as PPGR. They also stated that the optimal strategy for minimizing that response remains unclear. They further stated that the impact of precision nutrition on glycemic control is also not well established. Those three statements define the rationale reported in the [2783-LB abstract published in Diabetes on June 5, 2026](https://doi.org/10.2337/db26-2783-lb).

The trial therefore compared a standardized dietary counseling model with a personalized model that added prediction and feedback. The comparison was designed to separate the effect of Mediterranean diet-based diabetes self-management support from the additional effect of algorithm-driven PPGR information. The control condition was usual care control, abbreviated as UCC. The follow-up period was six months. The monitoring points for glucose variability were baseline, 3 months, and 6 months.

## Who was eligible and who enrolled

Eligibility was defined as U.S. adults aged 21 to 80 years with moderately controlled type 2 diabetes. Moderately controlled was defined in the methods as HbA1c 6.5 to 8.0%. Those eligibility boundaries are stated in both the Diabetes abstract record and the Synapse-structured record.

Enrollment was reported as 161 participants in total. Allocation was reported as 59 participants in UCC, 61 participants in the Standardized intervention, and 41 participants in the Personalized intervention. The mean age was reported as 60 years with a standard deviation of 12 years. The proportion reported as female was 62.7%. The proportion reported as White was 46.6%. The proportion reported as non-Hispanic was 80.7%. Mean HbA1c at entry was reported as 6.77% with a standard deviation of 0.6%. Those baseline characteristics indicate a middle-aged to older adult sample with HbA1c near the lower portion of the eligible range.

## What each of the three arms received

Participants were randomized to one of three conditions. The first condition was usual care control. The second condition was described as a Standardized intervention. The third condition was described as a Personalized intervention. Randomization into three parallel groups is the structure emphasized in the [Synapse summary of the same June 5, 2026 abstract](https://synapsesocial.com/papers/6a250b0e7def13d035e1b057).

The Standardized arm received 14 behavioral counseling sessions focused on Mediterranean diet-based diabetes self-management. The number 14 and the Mediterranean diet-based diabetes self-management focus are stated explicitly in the methods. The Personalized arm received all Standardized components plus real-time, algorithm-driven feedback on predicted PPGR. That additive design means the difference between the two active arms was the real-time prediction and feedback layer, not the number or theme of counseling sessions. The UCC arm served as the comparator without the 14-session program described for the active arms.

The remote character of the program is stated as fully remote. The duration is stated as six months. The counseling program therefore represents a telemedicine-delivered behavioral nutrition intervention, while the personalized version adds a precision-nutrition informatics component.

## How glucose variability was measured

Participants wore a continuous glucose monitor at baseline, 3 months, and 6 months. The purpose was to assess glycemic variability metrics, abbreviated as GV metrics. The named primary variability metric was mean amplitude of glycemic excursions, abbreviated as MAGE. Other GV metrics were also assessed, although only one additional metric is named with numerical results in the abstract.

The analytical approach was reported as linear mixed models used to compare changes in GV between arms. That method was applied to changes measured at the follow-up monitoring points relative to baseline. The outcome of interest was change in variability, rather than a single cross-sectional glucose value. The 3-month and 6-month wear periods provided the two post-randomization assessment windows.

## What happened to the main measure of glucose swings

The change in MAGE did not differ significantly between UCC and Standardized, with a reported p-value of 0.24. The change in MAGE did not differ significantly between UCC and Personalized, with a reported p-value of 0.13. The change in MAGE did not differ significantly between Standardized and Personalized, with a reported p-value of 0.70. Those three pairwise comparisons cover every contrast among the three randomized groups.

The abstract reports those MAGE results as not significantly different. No pairwise MAGE comparison met the conventional threshold for statistical significance as presented. The Synapse-structured record lists the same three p-values and describes the finding as no significant differences in MAGE among the three arms. The implication stated by the investigators is that neither the standardized nor the personalized telemedicine nutrition program improved this excursion measure beyond the comparator over the observation period.

## What happened to other variability measures

Changes in other GV metrics were also reported as not significantly different among the arms at 3 and 6 months. That statement applies broadly to the additional variability indices collected by continuous monitoring. It covers both the 3-month assessment and the 6-month assessment. It also covers comparisons among arms, rather than within-arm changes from baseline.

One exception is reported for the coefficient of variation, abbreviated as CV, at 6 months. At that single time point, the Personalized arm showed a greater reduction in CV compared with UCC. The reported mean difference was minus 1.84 percentage points. The reported 95% confidence interval was minus 3.57 to minus 0.11. The reported p-value was 0.04. That result is presented as a between-group difference in change favoring the Personalized arm over usual care at month six.

The investigators nevertheless concluded that the precision-nutrition intervention did not improve most GV indices beyond usual care or Mediterranean diet-based counseling. That wording preserves the distinction between one CV finding at six months and the broader pattern of no significant differences. Readers seeking precision-nutrition effects should therefore focus on the full variability profile, not the single CV contrast alone.

## How to interpret the single CV difference

The CV result describes relative variability around mean glucose, expressed in percentage points in the abstract. The mean difference of minus 1.84% represents a larger reduction in the Personalized arm than in UCC at six months. The confidence interval extends from minus 3.57 to minus 0.11, which does not include zero in the reported analysis. The p-value of 0.04 is presented as statistically significant in that pairwise comparison.

That finding does not alter the reported MAGE results. The MAGE comparisons remained nonsignificant for UCC versus Standardized, UCC versus Personalized, and Standardized versus Personalized. It also does not alter the reported statement that changes in other GV metrics were not significantly different among arms at 3 and 6 months as a general pattern. The abstract positions the CV observation as an isolated six-month contrast within an otherwise nonsignificant variability profile.

## Who conducted and supported the work

The author list begins with Lauren Thomas Berube and includes Chan Wang, Margaret Curran, Mary Lou Pompeii, Charlie Thao, Emily P. Ribeiro, Souptik Barua, Lu Hu, Huilin Li, David E. St-Jules, Eran Segal, Michael Bergman, and Collin J. Popp. The funding statement identifies the National Institutes of Health under grant number R01NR018916. Those attribution and support details appear in the Diabetes abstract record.

Disclosure information is also listed in the abstract. Most listed authors are reported as having no disclosures. Michael Bergman is reported with an ended advisory-panel relationship with Novo Nordisk and a current advisory-panel relationship with Abbott. Collin Popp is reported as a current consultant for Longevix. Those relationships are disclosed without additional explanation in the abstract record.

## What this means for nutrition care delivered remotely

For adults whose characteristics match the enrolled sample, the trial does not support adding real-time predicted-PPGR feedback to Mediterranean diet-based telemedicine counseling for the purpose of reducing MAGE. It also does not show that 14 sessions of standardized Mediterranean diet-based diabetes self-management counseling reduced MAGE or most other variability measures more than usual care in this moderately controlled population. The setting was fully remote, the counseling dose was 14 sessions over six months, and the glucose assessment used continuous monitoring at three defined points.

Consumers and clinicians should not read the single CV reduction as evidence of broad glycemic benefit. The investigators explicitly limited their conclusion to no improvement in MAGE or most GV indices beyond the comparators. Any future use of algorithm-driven meal feedback would need additional evidence showing consistent effects across variability measures, time points, and populations beyond the 161 participants described here. Until such evidence is reported, Mediterranean diet-based counseling remains a counseling framework tested in this trial, not a variability-lowering intervention proven superior to usual care in this sample.

## IFIC Survey: U.S. Shoppers Check Labels and Want Balanced Front-of-Pack Info

URL: https://nutritionjournal.com/ific-front-of-pack-nutrition-labels-survey-2026

IFIC's June 2026 survey of 1,000 U.S. adults finds 79% check labels, 80% use front-of-pack info, and 41% want both encourage and limit nutrients shown.

Key takeaways:
- 79% of Americans check nutrition or ingredient info at least sometimes; 47% do so always or often.
- 86% feel at least somewhat confident interpreting nutrition information on labels.
- Top sought items are calories 45%, total sugars 44%, protein 42%, sodium 41%, added sugars 39%.
- 80% say front-of-package info influences purchases at least sometimes.
- 41% want FOP labels showing both encourage and limit nutrients, vs 26% limit-only and 16% encourage-only.
- Among label-checkers, 92% are familiar with FACTS UP FRONT; 88% of familiar users use it to guide purchases.

TL;DR: U.S. shoppers want front-of-package labels that show both nutrients to limit and nutrients to encourage, according to a June 2026 IFIC survey.

Thirty years after the Nutrition Facts panel changed grocery shopping, label reading is routine and shoppers are asking for balance on the front of the pack. That is the central message of the [IFIC Spotlight Survey: Americans’ Perceptions Of Nutrition Labels](https://ific.org/research/americans-perceptions-nutrition-labels/), released June 2, 2026, and summarized June 4, 2026 by [Food Safety Magazine in “Survey Reveals How U.S. Consumers Use Front-of-Pack Nutrition Labels”](https://www.food-safety.com/articles/11487-survey-reveals-how-us-consumers-use-front-of-pack-nutrition-labels).

The survey arrives while federal front-of-package policy is in flux. According to Food Safety Magazine, federally standardized front-of-pack nutrition labeling is being considered — and reconsidered — with the U.S. Food and Drug Administration (FDA) looking to shake up its proposed approach, while legislators have introduced bills aiming to mandate FDA to advance a front-of-pack scheme.

## Survey tested knowledge, attitudes and beliefs

The International Food Information Council (IFIC) commissioned an online survey to measure knowledge, attitudes and beliefs about food and beverage labeling, according to IFIC.

One thousand adults ages 18 years and older completed the online survey from March 13-20, 2026, and results were weighted to ensure proportional results, according to IFIC. Totals may not equal 100% due to rounding, according to IFIC.

The Bayesian confidence level for the survey sample (n=1008) is 3.5, which is roughly equivalent to a margin of error of ±3.1 at the 95% confidence level, according to IFIC.

This research was supported through an unrestricted grant from the Consumer Brands Association, according to IFIC.

## Policy backdrop: FDA Nutrition Info Box

The IFIC release places its findings in the context of FDA action in January 2025. Back in January 2025, FDA proposed its Nutrition Info Box front-of-package label framework, which FDA proposed would help consumers quickly and easily identify how foods and beverages can fit into a healthy diet, according to IFIC.

IFIC said its findings show that Americans look for a range of information on food and beverage packaging and regularly consult front-of-package labels to guide decisions.

“Americans aren’t passive about nutrition information; we see they are actively engaging with label information while grocery shopping,” said IFIC President and CEO Wendy Reinhardt Kapsak, MS, RDN, according to IFIC.

She said the research indicates shoppers want information that helps them make a complete decision, not just to limit or avoid something, and called that a meaningful signal for anyone shaping the future of food labels, according to IFIC.

## Most shoppers check labels while buying groceries

Label engagement is widespread. The survey found that 79% of Americans check nutrition or ingredient information on packaging at least sometimes while grocery shopping, according to IFIC. Nearly half, 47%, do so always or often, according to IFIC.

Food Safety Magazine reported the same result, noting that 79 percent check at least sometimes and 47 percent do so always or often.

Confidence is similarly high, according to IFIC. Eighty-six percent say they feel at least somewhat confident interpreting nutrition information on food and beverage labels, according to IFIC and Food Safety Magazine.

That combination — frequent checking plus self-reported confidence — frames the rest of the survey, according to IFIC. Shoppers are not only encountering labels, they report trusting their ability to interpret them during routine trips.

## What shoppers look for: calories, sugars, protein, sodium

When shoppers prioritize nutrients, the list spans both nutrients to limit and nutrients to encourage, according to IFIC.

Calories top the list at 45%, followed closely by total sugars at 44%, protein at 42%, sodium at 41%, and added sugars at 39%, according to IFIC and Food Safety Magazine.

IFIC described the breadth of that list as itself a data point about how consumers approach personal health, covering both limit and encourage categories.

That mix matters for policy design, according to IFIC. A label focused only on nutrients to avoid would miss protein, which ranks among the top three items shoppers seek. A label focused only on positive nutrients would miss calories, sugars and sodium, which rank first, second, fourth and fifth.

## Front-of-package information shapes purchases

While front-of-package labeling is not mandatory in the U.S., several voluntary systems exist, according to IFIC and Food Safety Magazine.

The nutrition information currently on the front of food and beverage packaging shapes purchase decisions in the U.S., according to IFIC. Eighty percent of Americans say front-of-package nutrition information influences what they buy at least sometimes, according to IFIC and Food Safety Magazine.

The question IFIC then asked was what type of front-of-package information would be most helpful: what to limit, what to encourage, or both together.

The answer is both, according to IFIC. Four in ten Americans, 41%, say the most helpful front-of-package labeling would include nutrients to encourage alongside dietary components to limit — more than the percentage who prefer either approach alone, according to IFIC.

By comparison, 26% prefer guidance focused solely on what to limit and 16% prefer guidance focused only on what to encourage, according to IFIC and Food Safety Magazine.

## Preference for balance matches earlier research

IFIC said this preference for a balanced approach is consistent with IFIC’s May 2024 front-of-package nutrition labeling research, according to IFIC.

“The FDA’s attention to front-of-package nutrition labeling is an important next step in food labeling,” said IFIC Senior Director, Consumer Insights and Research, Kris Sollid, RD, according to IFIC.

Sollid said what the data adds to the policy discussion is the consumer voice asking to see the big picture of what is in food, both positive and negative nutrients, and that balance matters, according to IFIC.

Reinhardt Kapsak added that as federal nutrition labeling policy continues to evolve, IFIC research offers a perspective to inform a path forward regarding the information that consumers value most, according to IFIC.

She also said the American public is increasingly engaged in food- and nutrition-related matters, and that front-of-package guidance makes nutrition information more accessible and can have a big public health impact if it motivates healthier choices, according to IFIC.

## What a balanced model can look like

IFIC pointed to FACTS UP FRONT as an example of a balanced front-of-package scheme, according to Food Safety Magazine.

FACTS UP FRONT is a voluntary industry nutrition labeling framework that displays calories, saturated fat, sodium, and added sugars, with flexibility to include up to two beneficial nutrients that meet FDA “good source” criteria, according to IFIC and Food Safety Magazine.

In other words, the core display covers components commonly associated with limiting, while allowing space for up to two beneficial nutrients when products meet the relevant FDA threshold, according to IFIC.

That structure aligns with the survey’s 41% preference for combined information, according to IFIC. It does not require choosing between encourage-only and limit-only designs.

## Familiarity and use of FACTS UP FRONT run high

Among Americans who engage with nutrition information while shopping, FACTS UP FRONT has achieved broad visibility, according to IFIC.

More than nine in ten, 92%, are familiar with FACTS UP FRONT, according to IFIC and Food Safety Magazine. That figure applies to Americans who check nutrition information when grocery shopping, according to IFIC.

Among those who are familiar and actively check labels, nearly nine in ten, 88%, report using it to guide purchase decisions, with 58% doing so often or always, according to IFIC and Food Safety Magazine.

Food Safety Magazine noted that IFIC presented those figures as evidence of how an existing voluntary system is already used during shopping trips.

For label designers and retailers, the implication highlighted by IFIC is accessibility: front-of-package guidance is encountered and used at the point of decision, not only on the back-panel Nutrition Facts label.

## CDC Foodborne Outbreaks: Moringa, Formula, Raw Milk Under Investigation

URL: https://nutritionjournal.com/cdc-foodborne-outbreaks-june-2026

CDC, FDA and state agencies tracked moringa-linked Salmonella, ByHeart infant botulism, Idaho raw-milk Campylobacter and E. coli kofta cases in early June 2026.

Key takeaways:
- CDC listed 2 Campylobacter, 7 E. coli, 6 Listeria and 15 Salmonella active multistate investigations.
- The reopened moringa Salmonella outbreak totaled 119 illnesses in 36 states with 32 hospitalizations as of May 27.
- A separate MOGO moringa outbreak involved 18 illnesses in 14 states with 7 hospitalizations.
- FDA found Clostridium botulinum in a powdered milk ingredient during the ByHeart infant-formula investigation.
- Idaho investigated nearly 60 raw-milk illnesses, with at least 45 campylobacteriosis cases linked to two dairies.
- Beef kofta from Olympia Food Industries matched the E. coli O157:H7 strain in a 9-case California outbreak.

TL;DR: On June 3, 2026, U.S. food safety agencies were tracking overlapping multistate outbreaks linked to moringa supplements, infant formula, beef kofta, and raw milk, while CDC coordinated dozens of active multistate investigations.

## CDC coordination snapshot

CDC explains that most multistate foodborne outbreaks are caused by Campylobacter, E. coli, Listeria, and Salmonella, according to Current Outbreaks | Foodborne Outbreaks | CDC.

CDC typically coordinates between 17 and 40 investigations of multistate foodborne illnesses each week, according to Current Outbreaks | Foodborne Outbreaks | CDC.

The agency notes that the number of ongoing investigations varies and can sometimes exceed that typical range, according to Current Outbreaks | Foodborne Outbreaks | CDC.

The CDC table listed 2 active multistate investigations for Campylobacter, 7 for E. coli, 6 for Listeria monocytogenes, and 15 for Salmonella, according to Current Outbreaks | Foodborne Outbreaks | CDC.

CDC states that some investigations result in outbreak notices posted online, while not all investigations result in online notices, according to Current Outbreaks | Foodborne Outbreaks | CDC.

CDC states that it works closely with FDA and USDA-FSIS on foodborne outbreak investigations, according to Current Outbreaks | Foodborne Outbreaks | CDC.

CDC also lists Cyclospora, Hepatitis A virus, Shigella, and Vibrio as additional foodborne germs with information available on their websites, according to Current Outbreaks | Foodborne Outbreaks | CDC.

## Reopened moringa outbreak reaches 119 illnesses

FDA and CDC reopened a moringa-linked Salmonella investigation that had originally been closed on March 17 after new information emerged, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

Since March 17, 22 additional people from four states were infected with outbreak strains of S. Typhimurium or S. Newport, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

As of May 27, a total of 119 people infected with one of the outbreak strains had been reported from 36 states, including 32 hospitalizations, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

The recalled products expanded to include TNvitamins-brand Ultra Potent Complete Green Superfood Moringa capsules and Doctor’s Pride Complete Green Superfood Ultra Potent Moringa capsules distributed by Total Nutrition Inc. to retailers across the U.S., according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

Other recalled products included all Live it Up-brand Super Greens dietary supplement powder, including original and wild berry flavors, with lots beginning with the letter “A” and all stick pack products with expiration dates from 08/2026 to 01/2028, according to FDA reopens investigation into Salmonella outbreak traced to moringa capsules.

The same recall list included Why Not Natural Pure Organic Moringa Green Superfood capsules with lot # A25G051 and expiration date 07/2028 marked on the bottom of the bottle, according to FDA reopens investigation into Salmonella outbreak traced to moringa capsules.

The TNvitamins recall covered Ultra Potent Complete Green Superfood Moringa capsules 10,000 mg (120 capsules) lot 2507199 EXP 09/2027, lot 2512-304 EXP 02/2028, and lot 2793 EXP 02/2028, according to FDA reopens investigation into Salmonella outbreak traced to moringa capsules.

The Doctor’s Pride recall covered Complete Green Superfood Ultra Potent Moringa 10,000 mg (120 capsules) Lot: 2507199 Exp. 09/2027, according to FDA reopens investigation into Salmonella outbreak traced to moringa capsules.

FDA and CDC advised consumers to immediately stop using recalled products and dispose of them safely, as reported in Officials Reopen Salmonella Outbreak Investigation Linked to Moringa Supplements After New Cases Emerge.

Officials warned that dietary supplements often have long expiration dates and contaminated products may still be present in homes months after purchase, as reported in Officials Reopen Salmonella Outbreak Investigation Linked to Moringa Supplements After New Cases Emerge.

Investigators believe the products share a common ingredient source of contaminated moringa leaf powder, as reported in Officials Reopen Salmonella Outbreak Investigation Linked to Moringa Supplements After New Cases Emerge.

## Second 2026 moringa outbreak tied to MOGO brand

On May 27, FDA announced it was investigating another multistate outbreak of Salmonella Typhimurium infections linked to MOGO-brand moringa powder capsules distributed by MOGO Moringa LLC of St. Louis, Missouri, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

A total of 18 people infected with the outbreak strain had been reported from 14 states, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

Illness onset ranged from February 3 to April 7, 2026, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

Of eight people interviewed, six reported eating moringa powder capsules, including four who reported MOGO-brand moringa powder capsules, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

There were seven hospitalizations and no deaths reported in that MOGO-linked investigation, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

MOGO Moringa LLC recalled certain lots of MOGO-brand Pure Moringa Oleifera capsules, and FDA was conducting a traceback investigation and working with state partners to collect samples, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

The recalled MOGO lots were #15525AA EXP 6/2027 and #00926AA EXP 1/2028, according to FDA reopens investigation into Salmonella outbreak traced to moringa capsules.

Washington State Department of Health reported that the CDC, FDA, and state and local officials were investigating Salmonella infections linked to Mogo brand “Pure Moringa Oleifera Capsules,” with 18 people from 14 states infected, 7 hospitalizations, and no deaths, according to 2026 Multistate Salmonella Outbreak Linked to Moringa Oleifera Capsules.

Washington reported two cases by county, with one in Grant County and one in Pierce County, and described the status as ongoing with a recall in place, according to 2026 Multistate Salmonella Outbreak Linked to Moringa Oleifera Capsules.

The Mogo product was sold online in white plastic bottles with a green label, according to 2026 Multistate Salmonella Outbreak Linked to Moringa Oleifera Capsules.

Washington advised consumers not to eat any recalled moringa capsules and to throw them away or return them to where they were bought, according to 2026 Multistate Salmonella Outbreak Linked to Moringa Oleifera Capsules.

The state also advised washing items and surfaces that may have touched the recalled moringa powder capsules using hot soapy water or a dishwasher, according to 2026 Multistate Salmonella Outbreak Linked to Moringa Oleifera Capsules.

A third 2026 moringa-related investigation involving “extensively drug-resistant” Salmonella was closed in April 2026, according to FDA Opens Third Salmonella–Moringa Outbreak Investigation of the Year.

## Infant botulism investigation update on June 3

CDC declared the infant botulism outbreak linked to infant formula over, and FDA’s outbreak investigation ended, while FDA’s root-cause investigation focused on ingredients continued, according to Outbreak Investigation of Infant Botulism: Infant Formula.

On June 3, 2026, FDA reported it had completed on-site inspections of ByHeart facilities, according to Outbreak Investigation of Infant Botulism: Infant Formula.

Those inspections led to identification of Clostridium botulinum in a powdered milk ingredient, according to Outbreak Investigation of Infant Botulism: Infant Formula.

The inspections did not identify any additional factors within ByHeart’s facilities that could explain the cause of the outbreak, according to Outbreak Investigation of Infant Botulism: Infant Formula.

All ByHeart Whole Nutrition Infant Formula products were recalled, including all lots of ByHeart formula cans and single-serve “anywhere pack” sticks, according to Outbreak Investigation of Infant Botulism: Infant Formula.

ByHeart formula was available online and in stores at major retailers nationwide, and recalled products should not have remained for sale in stores or online, according to Outbreak Investigation of Infant Botulism: Infant Formula.

ByHeart products made up approximately 1% of all infant formula sold in the United States, and the outbreak did not create shortage concerns for parents and caregivers, according to Outbreak Investigation of Infant Botulism: Infant Formula.

Total illnesses numbered 48, including 28 confirmed cases and 20 probable cases, with 48 hospitalizations, 0 deaths, and last illness onset November 29, 2025, according to Outbreak Investigation of Infant Botulism: Infant Formula.

Cases were reported in Arizona, California, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Minnesota, North Carolina, New Jersey, Oregon, Pennsylvania, Rhode Island, Texas, Virginia, Washington, and Wisconsin, with distribution online and nationwide including Guam and Puerto Rico and internationally, according to Outbreak Investigation of Infant Botulism: Infant Formula.

Most infants with infant botulism initially develop constipation, poor feeding, loss of head control, and difficulty swallowing, which can progress to difficulty breathing and respiratory arrest, according to Outbreak Investigation of Infant Botulism: Infant Formula.

Symptoms can take as long as several weeks to develop following formula ingestion, according to Outbreak Investigation of Infant Botulism: Infant Formula.

Parents and caregivers were advised to stop using any ByHeart infant formula products immediately and to seek immediate medical attention if a child who consumed the formula showed symptoms, according to Outbreak Investigation of Infant Botulism: Infant Formula.

Parents of exposed children without symptoms were advised to continue monitoring them and seek care if symptoms developed, according to Outbreak Investigation of Infant Botulism: Infant Formula.

FDA advised washing items and surfaces that may have touched the formula using hot soapy water or a dishwasher, according to Outbreak Investigation of Infant Botulism: Infant Formula.

## Idaho investigates raw milk Campylobacter illnesses

On June 3, 2026, the Idaho Department of Health and Welfare said it was working with local and state partners to investigate increased illnesses after consumption of unpasteurized raw milk, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Since May 19, 2026, nearly 60 people were identified who became ill after consuming raw milk, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

At least 45 of those people tested positive for campylobacteriosis, although not everyone who was sick was tested, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Investigation and interviews were ongoing and additional illnesses could be identified, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Most people who were sick reported consuming raw milk from two different milking operations, one in northern Idaho and one in southern Idaho, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

The investigation was ongoing to identify potential batches of concern and test milk samples, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Both milking operations were working with DHW and local public health agencies to identify and fix potential contamination sources, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

The Idaho Division of Public Health collaborated with Panhandle District Health, Southwest District Health, Central District Health, Southeastern Idaho Public Health, South Central Public Health, and Eastern Idaho Public Health, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Raw unpasteurized dairy products can contain bacteria that make people sick, particularly young children, pregnant women, the elderly, and those who are immunocompromised, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Pasteurization kills nearly all the germs that can exist in raw milk while maintaining nutritional benefits, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Common campylobacteriosis symptoms include diarrhea, sometimes bloody, fever, stomach cramps, nausea and vomiting, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Symptoms usually start two to five days after exposure and last about one week, while some people may develop longer complications, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

Anyone experiencing symptoms after consuming raw milk or raw milk products was encouraged to promptly seek medical care, according to Idaho Public Health officials are investigating two outbreaks likely associated with raw milk.

## E. coli kofta and new FDA signals

Whole-genome sequencing showed beef kofta samples collected by FSIS and produced at Olympia Food Industries matched the outbreak strain of E. coli O157:H7 among patrons of The Kebab Shop restaurant in California, according to Beef kofta samples from The Kebab Shop match outbreak strain of E. coli.

As of June 1, there were nine confirmed patients, six of whom were children, according to Beef kofta samples from The Kebab Shop match outbreak strain of E. coli.

Two children developed hemolytic uremic syndrome, which leads to kidney failure and sometimes brain damage or death, according to Beef kofta samples from The Kebab Shop match outbreak strain of E. coli.

On May 24, FSIS issued a public health alert because beef kofta products served at The Kebab Shop restaurant locations may have been contaminated with Shiga toxin-producing E. coli O157:H7, according to Beef kofta samples from The Kebab Shop match outbreak strain of E. coli.

A recall was not requested because the products were no longer available for purchase, according to Beef kofta samples from The Kebab Shop match outbreak strain of E. coli.

The beef kofta was produced as a raw ground beef product by Olympia Food Industries Inc. dba Olympia Foods (Est. 18743) in Franklin Park, Illinois, on Jan. 6, 2026, and supplied to The Kebab Shop locations in California, Texas, and Florida, according to Beef kofta samples from The Kebab Shop match outbreak strain of E. coli.

Illness onset dates ranged from March 27 to April 30 as of May 24, 2026, according to Beef kofta samples from The Kebab Shop match outbreak strain of E. coli.

The Kebab Shop stopped selling beef kofta at all restaurant locations on May 18, 2026, according to Beef kofta samples from The Kebab Shop match outbreak strain of E. coli.

Separately, a new Listeria monocytogenes outbreak (ref #1380) linked to a not-yet-identified product was added to FDA’s table, with traceback and on-site inspections initiated, according to FDA investigating new Listeria and Cyclospora Outbreaks.

A new Cyclospora outbreak (ref #1375) linked to a not-yet-identified product was added, with traceback initiated, according to FDA investigating new Listeria and Cyclospora Outbreaks.

For the Salmonella Typhimurium outbreak (ref #1377) linked to moringa leaf powder, FDA initiated sampling, according to FDA investigating new Listeria and Cyclospora Outbreaks.

## Cucumber surveillance through September

FDA initiated a surveillance sampling assignment for domestic and imported raw fresh whole cucumbers for Salmonella, according to FDA Shares Update on FY26 Cucumber Sampling.

A history of Salmonella outbreaks linked to cucumbers precipitated the assignment, with domestic and imported cucumbers linked to multiple outbreaks between 2012 and 2025, according to FDA Shares Update on FY26 Cucumber Sampling.

The assignment runs from May 4 to September 30, 2026, according to FDA Shares Update on FY26 Cucumber Sampling.

Its objectives are to prevent introduction of contaminated food into U.S. commerce, remove contaminated food from the food supply, and identify trends and strategies for prevention and risk mitigation, according to FDA Shares Update on FY26 Cucumber Sampling.

Domestic samples are collected at retail locations and distribution centers from unopened boxes or containers in backroom or stockroom areas, not customer-facing displays, while import samples are collected at U.S. ports of entry, according to FDA Shares Update on FY26 Cucumber Sampling.

Sampling will not take place on farms, according to FDA Shares Update on FY26 Cucumber Sampling.

FDA said it carefully considered recent public health data, prior sampling results, and historical outbreak patterns in developing the assignment, according to FDA Shares Update on FY26 Cucumber Sampling.

FDA plans to share assignment findings on FDA.gov upon completion, according to FDA Shares Update on FY26 Cucumber Sampling.

## 320 U.S. Food Recalls in 2025 Left 1,003 Sick, 22 Dead

URL: https://nutritionjournal.com/us-food-recalls-2025-320-statista-pirg

320 FDA and USDA recalls in 2025 caused 1,003 illnesses and 22 deaths, with allergens at 38.8% and Listeria behind 21 deaths.

Key takeaways:
- FDA and USDA issued 320 food recalls in 2025, linked to 1,003 illnesses, 235 hospitalizations and 22 deaths.
- Undeclared allergens caused 38.8% of recalls, led by milk, tree nuts, wheat, eggs and sesame.
- Listeria caused 21 of 22 deaths, including a Kroger-Walmart pasta outbreak with 25 hospitalizations and 6 deaths by Oct. 30.
- Salmonella, foreign objects, lead and radioactive contamination made up the other major recall reasons.
- 17 of 28 outbreaks in 2025 had no public FDA announcement, often because the exact product could not be identified.
- Perishable ready-to-eat meats accounted for at least 40% of USDA warnings from 2014 to 2025.

TL;DR: U.S. regulators issued 320 food recalls in 2025, linked to 1,003 illnesses, 235 hospitalizations and 22 deaths, with undeclared allergens behind 38.8% of recalls and Listeria behind 21 of the 22 deaths.

## 2025 recall total and health toll

A total of 320 food recalls were issued by the Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA) in 2025, according to [Chart: 320 Food Recalls Issues in the U.S. in 2025 | Statista](https://www.statista.com/chart/36281/fda-and-usda-food-recalls-in-the-united-states/).

That tally is based on the latest data published by the U.S. Public Interest Research Group (PIRG) and summarized by Statista on June 2, 2026.

In that year, 1,003 people were recorded as having become sick after having eaten the food, with 235 cases of people having been hospitalized and 22 deaths.

PIRG is the organization that compiled the illness, hospitalization and death counts linked to those FDA and USDA actions.

The 2025 figures cover recalls from both agencies combined, not FDA actions alone or USDA meat and poultry actions alone.

U.S. food regulators recorded 28 foodborne illness outbreaks in 2025, a figure cited by PIRG researchers in the same dataset.

Regulators estimate that closer to one in six people in the U.S. are affected by foodborne diseases each year, providing context for the laboratory-confirmed outbreak cases.

## Why undeclared allergens led the list

The most common reason for food recalls in 2025 was undeclared allergens, accounting for nearly four in ten cases, or 38.8 percent of all food recalls.

Within undisclosed-allergens recalls, milk was the most frequently cited allergen, representing 20.6 percent of those recalls.

Tree nuts accounted for 16.8 percent of undisclosed-allergens recalls, followed by wheat at 7.6 percent.

Eggs accounted for 6.1 percent of undisclosed-allergens recalls, while sesame accounted for 5.3 percent.

One in four undisclosed-allergens recall cases involved a lack of information on multiple allergens, at 25.2 percent.

The pattern means allergen labeling, rather than a pathogen alone, was the single largest driver of the 320 actions.

## Listeria and the ready-to-eat pasta outbreak

Another main driver of recalls in 2025 was Listeria, with one prolonged outbreak tied to ready-to-eat pasta products.

In June 2025, the USDA announced recalls involving three ready-to-eat pasta products that were sent to Kroger and Walmart, following concerns of listeria.

In September, there were new pasta recalls, also linked to the June announcement, with 15 further ready-made pasta products affected.

By October 30, 25 people had been hospitalized and six people had died due to the outbreak.

According to PIRG, the first illness in that outbreak was detected in August 2024.

Researchers highlight the lag time before these recalls were issued, pointing to more than a year between the first detected illness and the later expanded actions.

Listeria was responsible for 21 out of the 22 deaths recorded in 2025, making it the dominant cause of fatal cases that year.

## Other causes: Salmonella, objects, lead and radiation

Salmonella accounted for 11.3 percent of cases among the reasons for outbreaks in 2025.

The discovery of foreign objects such as metal or wood accounted for 8.8 percent of cases.

Lead being found in the food accounted for 2.8 percent of cases.

In 3.8 percent of cases, the food was found to have radioactive contamination.

Together, those four categories accounted for more than one-quarter of the reasons identified in the PIRG data summarized by Statista.

## How 2025 compared with 2024

The 2025 illness figures were lower than in 2024 for reported sickness and hospitalizations, but higher for deaths.

In 2024, there were 1,804 people reported sick and 487 hospitalizations.

That year, there were 19 deaths, compared with 22 deaths in 2025.

These numbers are likely low estimates, however, due to the numbers only accounting for those who sought medical care and whose case was subsequently identified as linked to an outbreak.

That limitation applies to both the 2024 and 2025 counts of sick, hospitalized and fatal cases.

## Warnings that never became public posts

In addition to long lag times, PIRG researchers warn that the FDA does not publicly post announcements for all potentially life-threatening recalls.

This was the case for 17 cases out of 28 foodborne illness outbreaks recorded by U.S. food regulators in 2025.

In those instances, a public announcement was often absent because the exact product causing the illness could not be identified.

According to food safety experts cited in the Statista summary, funding cuts and layoffs to the FDA and USDA have increased concerns of food safety lapses across the United States.

The concern links agency capacity to the ability to identify products, issue timely recalls and communicate risk.

## Ready-to-eat meats drove USDA warnings

A separate analysis of USDA meat and poultry actions shows a concentration in ready-to-eat (RTE) meats, according to [Ready to recall: These meats are behind 40% of USDA food warnings | Stacker](https://stacker.com/stories/news/ready-recall-these-meats-are-behind-40-usda-food-warnings).

Sentient examined 1,163 recalls and public health alerts in public USDA data covering 2014 to 2025.

Perishable RTE meats account for at least 4 in 10 of all USDA food safety warnings in that period, or at least 40%.

The 40% figure includes only fully cooked, perishable RTE meats and excludes other RTE meats, including fully shelf-stable meat like jerky and cured meats, that could not be reliably separated in the USDA data.

RTE meats are, by the USDA's definition, edible without additional preparation to achieve food safety.

Meat and poultry recalls are typically initiated by the manufacturer notifying the USDA's Food Safety and Inspection Service (FSIS), the agency responsible for ensuring the safety of the U.S. meat and poultry supply.

The USDA investigates the concern, and if verified, issues a public recall notice warning consumers to avoid the affected products.

If products are no longer being sold — or when a company refuses to recall the products — the agency instead issues a public health alert.

USDA food safety warnings are limited to meat and poultry, whereas the FDA regulates a wider range of food and has a separate process for issuing and communicating recalls.

## Glass, metal and wood cases still active

A staggering 37 million pounds of frozen chicken and pork products, much of it ready to eat, is no longer considered safe for consumption after being shipped to retailers, including Trader Joe's, across the U.S. and exported to Canada and Mexico.

Four customers complained about glass shards in the food to the manufacturer, Ajinomoto Foods North America, which issued a recall and alerted regulators at the USDA.

The federal agency notified the public in February and again about an expanded recall in March.

Both recalls remain in effect nationwide, representing two of the USDA's four active recall alerts in effect.

The only other recalls still underway, first announced by the USDA in 2025, involve pieces of metal and wood, respectively, found in BBQ pork jerky produced by meat snack manufacturer LSI, Inc. and chicken corn dog and turkey sticks produced by Foster Farms, California's largest poultry producer.

## What processing and health research show

RTE meats include hot dogs, salami, pâté, jerky, prosciutto and rotisserie chicken, products often branded for quick consumption.

Sentient's analysis found RTE warnings were most often due to product contamination, followed by misbranding, undeclared allergens and products that had not undergone inspection before entering the U.S. food supply.

Moist environments typical for processing RTE meats provide conditions where Listeria can persist, a point explained by Ellen Shumaker, the director of outreach of North Carolina State University Extension's evidence-based food safety programming.

Earlier in May 2026, the USDA alerted the public to a Listeria outbreak that may have originated with contaminated pork deli meats, or headcheese, when it was discovered that three people were sick in Illinois.

Headcheese — jellied meat molded into a loaf, traditionally eaten cold — has emerged as the most likely source of that outbreak following a positive test result for the pathogen.

The Centers for Disease Control (CDC) estimates there are 48 million cases of foodborne illnesses every year in the U.S., resulting in 3,000 annual deaths, with many outbreaks tracing back to RTE meats.

A growing body of research has linked processed meats, including RTE meats, to chronic health conditions such as colorectal cancer, cardiovascular disease and Type 2 diabetes, and the World Health Organization classifies processed meats as carcinogenic to humans.

## Fiber, Magnesium Linked to Lower Inflammation in US Adults

URL: https://nutritionjournal.com/nutrient-intake-inflammation-us-adults-hscrp

JABFM analysis of NHANES 2021-2023 links high fiber, magnesium, folate and vitamins B6, C, D and K to lower hs-CRP; fiber and magnesium showed benefit at recommended intake.

Key takeaways:
- High intake of fiber, folate, magnesium, B6, C, D and K was tied to lower hs-CRP versus low intake.
- Fiber and magnesium were also significant at moderate intake, which includes recommended intake.
- Folate, B6, C, D and K showed greater benefit only above recommended levels in this analysis.
- The study covered 4,963 adults representing about 236 million US adults in NHANES 2021-2023.
- Intake was standardized to FDA Daily Values behind the Nutrition Facts %DV.
- Not all hypothesized nutrients showed significant links to hs-CRP.

TL;DR: High daily intakes of dietary fiber, folate, magnesium, vitamin B6, vitamin C, vitamin D, and vitamin K were linked to lower high-sensitivity C-reactive protein in US adults.

## Fiber, Magnesium Lead Nutrient Links to Lower Inflammation in US Adults

High daily intakes of seven nutrients were significantly associated with lower high-sensitivity C-reactive protein (hs-CRP) in a nationally representative analysis of US adults, with dietary fiber and magnesium showing benefit at usual recommended intakes, according to the Journal of the American Board of Family Medicine paper titled Daily Nutrient Intake and Inflammation Among US Adults.

The study, by Arch G. Mainous, Lu Yin, Frank A. Orlando and Aaron A. Saguil, was published on June 1, 2026, in the Journal of the American Board of Family Medicine. It used the National Health and Nutrition Examination Survey (NHANES) 2021–2023 to examine whether daily intake of nutrients described as purportedly anti-inflammatory was associated with current inflammation measured by hs-CRP.

For each nutrient, intake was categorized as low, moderate — a category that includes recommended intake — or high, and hs-CRP and dietary nutrient intake were examined with parametric and non-parametric statistics. High intake, compared with low intake, was linked to lower hs-CRP for dietary fiber, folate, magnesium, vitamin B6, vitamin C, vitamin D, and vitamin K. For dietary fiber and magnesium, the lower hs-CRP association was also present when moderate intake was compared with low intake.

The authors concluded that usual dietary intake of dietary fiber and magnesium indicates that they are anti-inflammatory. They concluded that folate and vitamins B6, C, D, and K appear to confer greater anti-inflammatory benefit only above recommended dietary levels. They wrote that dietary strategies emphasizing these nutrients may help individuals lower hs-CRP and potentially mitigate inflammation-related health risks.

## Study Asked Whether Everyday Intake Tracks Current Inflammation

The research question was whether daily nutrient intake by US adults is associated with inflammation measured close in time to diet assessment. Systemic inflammation has long been associated with chronic disease and mortality, and dietary interventions have been proposed as a mechanism to decrease inflammation.

The investigators described inflammation as linked to development and progression of cardiovascular disease (CVD), cancer, diabetes and chronic kidney disease as well as mortality. They noted that many environmental factors can elevate inflammation and that inflammation is a likely target for prevention of chronic diseases besides CVD, including behavioral health conditions.

They also noted that hyperinflammation during an initial severe COVID-19 episode has been associated with increased downstream mortality risk from all causes. They noted that treatments suggested to decrease inflammation, such as corticosteroids, have negative outcomes over the long term, and that dietary and nutrition-based strategies have therefore been proposed by many authors.

A central design choice was translation to everyday eating. The authors wrote that it is difficult for consumers to apply clinical benefits of nutrients to diet because most study designs are not truly translational. They wrote that many studies supporting foods as anti-inflammatory provide evidence of biological plausibility but do not link data from human diets to clinical measures of inflammation.

## How Researchers Tied Nutrition Facts Panel to Blood Marker

The analysis was a nationally representative secondary analysis of nutrient intake in US adults. Purported anti-inflammatory nutrient intake was quantified based on Daily Values (DVs) to make results relevant to the Nutrition Facts panel.

The Nutrition Facts panel on packaged foods shows percent Daily Value (%DV), a reference established by the United States Food and Drug Administration (FDA) to guide dietary consumption of key nutrients. The authors stated that what was unclear was whether nutrient intake of US adults is associated with inflammation when intake is standardized relative to DV.

The data came from NHANES 2021–2023 dietary survey and laboratory test datasets. NHANES employs a stratified, multistage probability sampling design to generate estimates representative of the noninstitutionalized US population. Detailed information on the 2021–2023 survey design, including the dataset analyzed, is available in NHANES documentation.

The 2021–2023 NHANES baseline included 4,963 participants aged 18 years and older, representing approximately 236 million US adults. All analyses were conducted using the survey package in R version 4.3.3 from R Foundation for Statistical Computing, which accounts for NHANES complex sampling design and provides population-level estimates.

Dietary intake came from the NHANES dietary interview component called What We Eat in America (WWEIA), conducted as a partnership between the US Department of Agriculture (USDA) and the US Department of Health and Human Services (DHHS). All NHANES participants are eligible for two 24-hour dietary recall interviews. Individual diets were translated into daily nutrient intakes, and hs-CRP was measured in close temporal proximity to dietary assessment.

The authors distinguished the approach from prior NHANES work. They wrote that prior studies examining anti-inflammatory potential of nutrient intake were limited in nutrients, did not standardize intake relative to DV, and used hematologic inflammatory indices that lack the established clinical relevance of hs-CRP as an inflammatory biomarker.

## Seven Nutrients Linked to Lower hs-CRP at High Intake

High intake versus low intake was significantly associated with lower hs-CRP for seven nutrients. The reported comparisons were dietary fiber 2.7 versus 3.9, p=0.001; folate 3.3 versus 4.1, p=0.002; magnesium 2.8 versus 4.0, p=0.001; vitamin B6 3.4 versus 4.0, p=0.01; vitamin C 3.4 versus 4.0, p=0.04; vitamin D 1.3 versus 3.8, p=0.03; and vitamin K 3.1 versus 4.1, p=0.0001.

Dietary fiber showed the joint pattern of lower hs-CRP at high intake and a significant association when moderate intake was compared with low intake. Magnesium showed the same pattern, with significance both for high versus low intake and for moderate versus low intake.

The distinction matters because the moderate category includes recommended intake. The authors interpreted the fiber and magnesium findings as evidence that usual dietary intake indicates an anti-inflammatory association. For the other five nutrients with significant high-versus-low differences, the authors interpreted the benefit as appearing mainly above recommended dietary levels.

The paper stated that not all hypothesized nutrients showed significant associations with inflammation. It did not present those non-significant nutrients as anti-inflammatory in this population analysis. The results section focused significance reporting on the seven nutrients listed above.

The study examined hs-CRP and dietary nutrient intake with both parametric and non-parametric statistics. Intake categories of low, moderate and high were applied for each nutrient. The moderate group included recommended intake, allowing comparison of below-recommended, at-recommended, and above-recommended intake patterns.

## Why Fiber and Magnesium Stood Apart

Fiber and magnesium were the only two nutrients for which the paper reported a significant low-to-moderate association in addition to the high-versus-low association. That structure supports the conclusion that usual intake levels were associated with lower inflammation for those two nutrients.

For folate and vitamins B6, C, D, and K, the reported significant comparison was high intake versus low intake. The authors concluded that those nutrients appear to confer greater anti-inflammatory benefit only above recommended dietary levels.

Vitamin K had the smallest reported p-value among the seven comparisons, at p=0.0001, for 3.1 versus 4.1. Dietary fiber and magnesium each had p=0.001. Folate had p=0.002. Vitamin B6 had p=0.01, vitamin D had p=0.03, and vitamin C had p=0.04.

Vitamin D showed the largest absolute difference in reported hs-CRP values, at 1.3 for high intake versus 3.8 for low intake. Dietary fiber showed 2.7 versus 3.9. Magnesium showed 2.8 versus 4.0. Folate showed 3.3 versus 4.1. Vitamin B6 and vitamin C each showed 3.4 versus 4.0. Vitamin K showed 3.1 versus 4.1.

The authors framed the implication as dietary strategies emphasizing these nutrients may help individuals lower hs-CRP and potentially mitigate inflammation-related health risks. The wording is conditional, describing a potential pathway rather than a proven treatment effect.

## What An Anti-Inflammatory Eating Pattern Supplies

Practical guidance aligned with the study emphasizes more whole and minimally processed plant foods, including vegetables, fruits, beans, lentils, whole grains, nuts and seeds, according to Harvard Health Publishing in its May 27, 2026 article titled The comforting bowl that works quietly against inflammation.

That Harvard Health Publishing article describes healthy fats from sources like olive oil, nuts and avocados, and less red and processed meat, refined grains, and sugary or fried foods. It states that this way of eating supplies fiber, vitamins, minerals, and plant compounds called phytochemicals, and that many of these act as antioxidants and help dial down inflammatory processes that can contribute to disease.

The same article presents a Nourish Lentil Bowl as an example meal combining foods linked with lower inflammation. It lists lentils as providing plant protein, fiber and minerals, and states that higher fiber intake has been associated with lower levels of inflammatory markers in blood. It lists winter squash as rich in beta carotene and vitamin C, mushrooms as studied for potential anti-inflammatory and immune-supporting effects, and pomegranate seeds as supplying vitamin C, fiber and phytochemicals such as anthocyanins and resveratrol.

It lists pecans and olive oil as offering unsaturated fats associated with a more favorable inflammatory profile. It lists leafy greens as adding fiber, folate and protective plant compounds. The recipe serves four and combines lentils cooked in vegetable broth and water with roasted winter squash, onion, mushrooms and garlic in olive oil, balsamic vinegar and Italian seasoning, topped with baby greens, pomegranate seeds and chopped pecans.

The overlap is direct for the JABFM findings: lentils, greens, pomegranate seeds and pecans supply dietary fiber; greens supply folate; and the bowl pattern supplies vitamin C, vitamin K and magnesium through vegetables, greens, lentils, nuts and olive oil. Consumers tracking intake can use %DV on the Nutrition Facts panel, the FDA reference used in the JABFM analysis, to compare low, moderate and high intake patterns.

## Limits Readers Should Keep in View

The analysis was observational and population-level, using NHANES 2021–2023 data from 4,963 adults representing about 236 million US adults. Individual diets were translated into daily nutrient intakes from recall interviews, and hs-CRP was measured near the time of dietary assessment.

Foods identified as anti-inflammatory often contain multiple nutrients with professed anti-inflammatory properties, so linking any one nutrient in a supposedly anti-inflammatory food may promote the wrong nutrient, the authors wrote. They also wrote that many supporting studies show biological plausibility without linking human diet data to clinical inflammation measures.

The findings do not establish that increasing a single nutrient lowers hs-CRP for a specific person. The paper reports associations by intake category and p-values, not intervention outcomes. Not all hypothesized nutrients showed significant associations, underscoring that the results are nutrient-specific rather than a general endorsement of higher intake.

For people considering diet changes, the study points to fiber and magnesium at recommended intake levels and to folate, B6, C, D and K at higher intake levels as candidates for further dietary-strategy research. The Harvard Health Publishing meal example points to small sustainable shifts, such as making a lentil bowl once a week, swapping vegetables or greens by season, and pairing the bowl with unsweetened tea or coffee.

## Sources referenced
- Daily Nutrient Intake and Inflammation Among US Adults | American Board of Family Medicine (https://www.jabfm.org/content/39/1/162211)
- The comforting bowl that works quietly against inflammation - Harvard Health (https://www.health.harvard.edu/healthbeat/the-comforting-bowl-that-works-quietly-against-inflammation)

## Multicultural Healthy Diet Shows Feasibility but No Cognitive Gain in Midlife Trial

URL: https://nutritionjournal.com/multicultural-healthy-diet-shows-feasibility-but-no-cognitive-gain-in-midlife-tr

A 290-person Bronx pilot found a multicultural anti-inflammatory diet feasible at 9 months, with lower diet inflammation scores but no significant global cognition change.

Key takeaways:
- A 290-person Bronx pilot in adults 40-65 tested the Multicultural Healthy Diet against usual diet for 9 months.
- MHD participants had lower Dietary Inflammatory Index scores, with differences of -0.64 and -0.94 for DII and energy-adjusted DII.
- Group session completion averaged 93% and telephone completion 72% in the MHD arm.
- Global cognitive change did not differ significantly between arms: -0.06, P=.259.
- Authors called the diet feasible and acceptable and urged study of variability and peak performance.

## TL;DR: A multicultural anti-inflammatory diet proved workable in midlife but did not shift overall test scores at nine months

A phase II pilot randomized clinical trial in 290 healthy adults aged 40 to 65 in Bronx, New York found that the Multicultural Healthy Diet was feasible and acceptable in a multicultural United States cohort, lowered Dietary Inflammatory Index scores at 9 months after randomization, and did not produce a statistically significant change in a global composite cognitive score, according to the Albert Einstein College of Medicine research record.

The record describes the intervention as the Multicultural Healthy Diet, abbreviated as MHD, an anti-inflammatory diet adapted to a multicultural setting, compared with a usual-diet Comparison arm. The trial aim was to adapt that pattern and assess its impact on cognitive decline and Alzheimer's disease risk and related dementias in healthy middle-aged adults.

The background stated in the record is that anti-inflammatory dietary patterns are associated with slower cognitive decline in older adults, while little is known about effects of such a pattern in middle age. The investigators therefore focused enrollment on adults 40-65 years old and set the primary cognitive assessment at 9 months after randomization.

The paper appeared in the American Journal of Clinical Nutrition, volume 122, issue number 1, pages 48-59, a 12-page article listed as published in July 2025, with digital identifier https://doi.org/10.1016/j.ajcnut.2025.05.011. The Albert Einstein College of Medicine listing names Yasmin Mossavar-Rahmani as lead author, with co-authors Noorie Hyun, Jonathan G. Hakun, Mindy J. Katz, Jelena M. Pavlovic, Henrik Zetterberg, Zheng Wang, Jasper B. Yang, Judith Wylie-Rosett, James R. Hebert, Martin J. Sliwinski and Pamela A. Shaw. The trial was registered at clinicaltrials.gov as NCT03240406.

## Who took part and where the trial happened

The Albert Einstein College of Medicine record states that the study enrolled 290 participants in Bronx, New York. Eligibility centered on healthy middle-aged adults between 40 and 65 years old.

Participants were assigned to follow either the Multicultural Healthy Diet or a usual diet described as the Comparison condition. The MHD arm received the anti-inflammatory diet program, while the Comparison arm continued a usual diet without that program.

The multicultural framing matters for nutrition guidance because the objective called for adapting an anti-inflammatory diet to a multicultural setting rather than testing a menu built for a single food culture. The conclusion later describes the approach as feasible and acceptable in the multicultural United States cohort studied in the Bronx.

The trial is identified as a phase II pilot randomized clinical trial. That design signals an early-stage test of feasibility alongside preliminary cognitive outcomes, not a large definitive prevention trial.

## How diet was tracked

Diet was evaluated using the National Cancer Institute's Automated Self-Administered 24-h food records, according to the Albert Einstein College of Medicine record. Those self-reported records provided the basis for Dietary Inflammatory Index calculations.

The record reports two versions of that index: the Dietary Inflammatory Index, abbreviated as DII, and the energy-adjusted DII score. Both were calculated from self-reported diet and compared between arms at follow-up.

Program participation was tracked through group sessions and telephone contacts for the MHD arm. Group session completion and telephone contact completion averaged 93% and 72%, respectively, for participants assigned to the MHD program.

Those completion figures underpin the feasibility finding. High group-session completion alongside lower but substantial telephone-contact completion showed that middle-aged participants continued engagement across nine months of counseling contacts.

## How thinking and memory were measured on phones in daily life

The primary cognitive outcome was assessed at 9 months after randomization using a global composite score, according to the Albert Einstein College of Medicine record. The composite was derived from three ambulatory cognitive assessments.

The three components were visuospatial memory measured by Grid Memory, processing speed measured by Symbol Search, and short-term associative memory binding measured by Color Shapes. Ambulatory assessment means testing occurred outside a single clinic visit, capturing performance in daily-life settings.

Secondary outcomes included performance on individual tests and association of dietary components with cognitive performance. The record lists those secondary interests without presenting separate significant effects in the abstract summary.

The choice of a global composite score meant that the main result combined memory and speed tasks into one change-from-baseline measure. Individual-test results were treated as secondary rather than primary for the nine-month comparison.

## What changed in inflammation scores after nine months

At 9-month follow-up, the MHD arm had a lower Dietary Inflammatory Index score based on self-reported diet, according to the Albert Einstein College of Medicine record. The adjusted MHD-minus-Comparison difference was -0.64, with a 95% confidence interval of -1.02 to -0.27.

For the energy-adjusted DII score, the adjusted MHD-minus-Comparison difference was -0.94, with a 95% confidence interval of -1.34 to -0.54. The record states that those lower scores indicated intervention participants had adhered to an anti-inflammatory dietary pattern.

In practical terms, the diet arm reported eating patterns that scored as less inflammatory than those reported by the usual-diet arm after nine months. The confidence intervals for both DII measures excluded zero, consistent with a dietary difference between arms.

The finding does not by itself establish a change in blood markers of inflammation. It reflects self-reported intake captured through the National Cancer Institute's Automated Self-Administered 24-h food records and scored with the Dietary Inflammatory Index method.

## What happened to memory and processing scores

No statistically significant difference between arms was found in the primary outcome of cognitive global score change from baseline, according to the Albert Einstein College of Medicine record. The estimated difference was -0.06, with a 95% confidence interval of -0.15 to 0.04 and P = .259.

That estimate means the MHD and Comparison arms showed similar change in the combined Grid Memory, Symbol Search and Color Shapes score from baseline to nine months. The confidence interval crossed zero and the P value exceeded the conventional threshold for statistical significance.

The authors' conclusion states that the MHD is feasible and acceptable in this multicultural United States cohort. It adds that although the influence of MHD at 9 months is nonsignificant based on the global composite cognitive score, additional research using other measures such as day-to-day variability in cognitive function and peak performance is warranted.

The call for work on day-to-day variability and peak performance points to ambulatory data beyond an average composite. It suggests future analyses could examine consistency or best performance across repeated phone-based tests rather than only mean change.

## How this midlife pilot fits with other diet-and-brain studies

A separate study published in Nutrients on May 27, 2026 examined adherence to DASH and Mediterranean diets and cognitive performance in adults living in Afyonkarahisar, Türkiye, using face-to-face administration of the Mediterranean Diet Adherence Screener, the DASH Diet Quality Scale, the Oktem Verbal Memory Processes Test and the Trail Making Test, with data analyzed using SPSS v27 software.

In that Turkish sample, higher DASH scores were linked with higher Immediate Memory and Spontaneous Recall sub-components of the memory test and with lower Learning Mistake Score, USB Mistake Score and IST-A, IST-B and IST Total scores. Higher MEDAS scores were linked with higher Criteria Achievement, Maximum Learning, Spontaneous Recall, Recognition and Total Recall, and with lower Learning Mistake Score, and the authors concluded that age, educational status, DASH and MEDAS scores are associated with cognitive performance.

The Nutrients report also found that as participant age increased, DASH scores decreased, and that as body mass index and waist-to-hip width increased, DASH and MEDAS scores decreased. As age increased, IST-A, IST-B and IST-Total scores increased, while higher education was associated with lower IST-A, IST-B and IST-Total scores and higher total recall on the Oktem scale.

Those cross-sectional associations differ in design from the Bronx randomized pilot. One reports links between reported diet quality and test performance at one point in time, while the Bronx trial randomized 290 adults to MHD or usual diet and compared change over nine months.

Another feasibility trial described in Nutrition Research tested a remotely administered Mediterranean-DASH Intervention for Neurodegenerative Delay pattern in 40 persons with multiple sclerosis over 12 weeks. Participants were randomized to MIND or control, with 20 in each arm, and both received one meal per day through a delivery service plus dietary guidelines.

In that 12-week multiple sclerosis trial, 31 participants completed the study, for 77.5% overall retention and 87.5% intervention retention, with provided-meal compliance averaging 91.1%, including 89.7% in the MIND condition and 92.6% in control. Both conditions improved diet quality, only the MIND condition improved MIND score by a mean change of 3.97, no significant group-by-time effects were observed for cognition, and MIND improvements correlated with improved attention and spatial memory in the MIND condition.

## What readers in midlife can take from a feasibility result

For adults aged 40 to 65, the Bronx pilot shows that an anti-inflammatory eating pattern presented in multicultural form can be followed for nine months with high session completion and a measurable shift in reported Dietary Inflammatory Index scores.

It does not show that nine months of that pattern improves a combined score of visuospatial memory, processing speed and associative memory binding in healthy middle-aged adults. The global-score difference of -0.06 was small and statistically nonsignificant.

The authors position the work as supporting larger or longer studies, specifically mentioning day-to-day variability in cognitive function and peak performance as additional measures. Those approaches would use the same kind of repeated ambulatory tests to look past average change.

Anyone considering a change in eating pattern can discuss personal risk factors, medications and nutritional needs with a clinician or registered dietitian. Trial registration NCT03240406 provides the public identifier for the Bronx study protocol and its listed outcomes.

## Sources referenced
- The effects of the Multicultural Healthy Diet on cognitive decline and Alzheimer's disease risk: a phase II randomized controlled trial in middle-aged adults - Albert Einstein College of Medicine (https://einstein.elsevierpure.com/en/publications/the-effects-of-the-multicultural-healthy-diet-on-cognitive-declin/)
- Adherence to Healthy Dietary Patterns and Cognitive Performance: Evidence from DASH and Mediterranean Diets - Nutrients (https://doi.org/10.3390/nu18111702)

## USDA Updates K-12 School Meal Nutrition Standards

URL: https://nutritionjournal.com/usda-updates-k-12-school-meal-nutrition-standards

USDA school meal rules phase in added-sugar limits in 2025-2026 and a 10% weekly cap plus sodium cuts by 2027-2028 for 29.9M students.

Key takeaways:
- USDA added-sugar limits for milk, yogurt and cereal began in 2025-2026, with a weekly cap below 10% of calories by 2027-2028.
- Sodium targets due by July 1, 2027 call for about 15% lower lunch sodium and 10% lower breakfast sodium.
- More than 95,000 schools serve about 29.9 million students daily under federal meal-pattern rules.
- Districts are using speed-scratch cooking, supplier switches and recipe testing to meet limits.
- Smart Snacks rules cover vending and a la carte foods, while states may add funding or standards.

## TL;DR: School cafeterias are cutting sugar and salt on a federal timetable through 2028.

**TL;DR: The U.S. Department of Agriculture finalized updated nutrition standards for school meals that require product limits on added sugars in milk, yogurt and cereal in school year 2025-2026 and a weekly added-sugars cap of less than 10% of calories by school year 2027-2028, with sodium reductions phased in through 2027.**

The shift is now visible on lunch trays because the 2024 final rule took effect in stages, according to reporting summarized by Share My Lesson. That report explains that the U.S. Department of Agriculture updated standards to align more closely with the Dietary Guidelines for Americans, with a stronger focus on reducing added sugars, lowering sodium and continuing to emphasize fruits, vegetables and whole grains. The same summary notes that the changes affect schools participating in the National School Lunch Program and School Breakfast Program and will happen gradually between 2025 and 2028.

Scale explains why the timetable matters for public health. More than 95,000 schools and institutions serve lunch to about 29.9 million students each day, based on preliminary U.S. Department of Agriculture fiscal year 2025 data, according to the explainer published by The Queen Zone. That explainer adds that the updated school meal standards took effect in 2024, with major menu changes rolling out from the 2025 school year through 2027 to 2028. The Food Research and Action Center reported a similar scale for an earlier year, finding that nearly 29.4 million children participated in the National School Lunch Program on a typical day during the 2023 to 2024 school year, with 21.1 million receiving free or reduced-price lunch, as cited in that same explainer.

## What changed in the 2024 school meal rule

The core of the rule is added sugars plus sodium, while keeping existing meal-pattern foundations. The Queen Zone explainer states that school lunches that seek federal reimbursement must meet federal requirements aligned with the Dietary Guidelines for Americans, including fruits, vegetables, low-fat or fat-free milk, whole grains and lean protein. Cafeteria staff may therefore remind a child to take a piece of fruit, a vegetable or milk because the tray must qualify as reimbursable to receive reimbursement.

On added sugars, the U.S. Department of Agriculture summary described product-based limits first, including rules for flavored milk, yogurt and breakfast cereal, then a weekly limit of less than 10% of calories across school lunch and breakfast by school year 2027 to 2028, according to The Queen Zone. Reporting summarized by Share My Lesson gives the same sequence: at the start of the 2025-26 school year, schools faced new limits on added sugars in flavored milk, yogurt and breakfast cereals, and by the 2027-28 school year schools must ensure that no more than 10 percent of weekly calories come from added sugars.

On sodium, both accounts describe a gradual reduction rather than a single-year cut. Share My Lesson reports that the updated rules gradually reduce sodium levels in school breakfasts and lunches, and quotes U.S. Department of Agriculture officials as saying the phased approach is intended to help schools adapt without dramatically increasing costs or reducing student participation. Trade coverage published by FoodService Director adds operational detail, reporting that sodium targets due by July 1, 2027 call for levels to be reduced by around 15% at lunch and 10% at breakfast.

## How the phase-in works from 2025 to 2028

For families, the simplest calendar comes from the lesson summary published by Share My Lesson. That summary lists four design goals: reduce added sugars in foods like flavored milk, cereal and yogurt; lower sodium in school breakfasts and lunches; continue offering fruits, vegetables and whole grains; and allow schools to include more local and culturally relevant foods. It states that the changes will happen gradually between 2025 and 2028 and that school cafeteria staff and nutrition teams will play a major role in meeting the requirements.

The Queen Zone explainer frames the same window as required changes starting in the 2025 to 2026 school year and phasing in through 2027 to 2028. It also notes that the broader federal nutrition context changed again in January, when the 2025-2030 Dietary Guidelines for Americans were released in the first update in five years, according to FoodService Director. That trade report notes prominent themes in the new guidelines, including an emphasis on real food by prioritizing whole meats, full-fat dairy and vegetables while reducing ultra-processed foods, added sugars and refined carbohydrates, plus an inverted food pyramid focusing on increased protein intake and healthy fats.

The January guidelines do not by themselves rewrite school menus, but operators expect ramifications for school foodservice departments, according to FoodService Director. The same report quotes U.S. Department of Agriculture Secretary Robert F. Kennedy Jr. as describing the guidelines as the most significant reset of federal nutrition policy in the nation's history. The report also notes that the U.S. Food and Drug Administration and National Institutes of Health are developing a definition of ultra-processed foods, which they say will be publicly available on July 24.

## What cafeterias are doing to lower sodium without losing participation

Sodium is the most kitchen-intensive part of the transition. Share My Lesson reports that many school cafeteria workers and nutrition directors say the transition may be challenging and that schools may need new recipes, updated ingredients and additional training to meet the standards while still serving meals students enjoy eating. U.S. Department of Agriculture officials say the phased schedule is meant to limit cost increases and participation losses, according to that same summary.

A Virginia district illustrates the recipe work. Marci Lexa, director of school nutrition at Henry County Public Schools in Martinsville, Virginia, told FoodService Director that meeting the sodium guidelines due by July 1, 2027 is trickier than adding protein and that she has been moving toward more speed-scratch cooking to bring down sodium levels. The report states that Lexa feeds students at 13 schools plus an alternative location with enrollment of 6,700. In one example, the foodservice department reworked a Swiss chicken casserole and reduced salt per serving from 732 mg to 289 mg by changing the brand of soup to a lower-sodium option and replacing stuffing mix with school-made breadcrumbs. Lexa also stopped buying fajita meat described as very high in sodium and now prepares plain pulled chicken with a seasoning mix made in-house. The report quotes her assessment of student response as: We continue to tweak things and I don't think the kids notice.

Supplier changes are part of the same effort. Lexa told FoodService Director she has been working with manufacturers to reduce sodium in products and in some cases has switched companies because of sodium levels. That detail aligns with the broader warning quoted by The Queen Zone from the School Nutrition Association 2026 Position Paper, which states that any new rules limiting ultra-processed foods in schools must ensure meal programs are permitted to serve nutrient-dense, pre-prepared foods. The explainer notes that schools feed hundreds or thousands of children quickly, often on tight budgets and with limited staff, in kitchens not built for restaurant-style cooking.

## Protein, whole grains and student choice

Protein demand is shaping menus alongside the federal limits. Lexa told FoodService Director that current protein offerings were already above prior U.S. Department of Agriculture requirements because those requirements were too low, and that adding more protein has not required a large adjustment because protein is present in meat, meat alternatives and whole grains offered by the district. The report presents that as a contrast with sodium work, which requires recipe testing and sourcing changes.

Colleges show the same protein trend, offering a signal for high-school preferences. Grayson Crabtree, program director for Duke Dining at Duke University in Durham, North Carolina, told FoodService Director that Duke Dining piloted high-protein snack boxes in the spring and found them very successful, showing demand aligned with the new guidelines. The report states that Duke plans to introduce a high-protein and high-fiber section within main dining location menus in the fall. Kirk D. Rodriguez, senior managing director for hospitality services and student union and activities at Texas Tech University in Lubbock, told the same publication that the emphasis on nutrient density and informed choice is appropriate for a large diverse student population, and said the school will refine recipes for sodium and added sugars without sacrificing flavor, increase whole grains and leaner proteins, minimize processed ingredients, expand plant-forward options and improve labeling and digital menus.

For K-12, Share My Lesson lists continued fruits, vegetables and whole grains as a formal element of the rule alongside sugar and sodium changes. The Queen Zone explainer likewise lists fruits, vegetables, low-fat or fat-free milk, whole grains and lean protein as components of reimbursable meals aligned with federal guidance.

## Competitive foods, state rules and access

The lunch tray is not the only place with federal limits. The Queen Zone explainer states that U.S. Department of Agriculture Smart Snacks in School standards apply to foods and drinks sold during the school day outside the meal programs, including vending machines, school stores, snack bars and a la carte lines. Those rules set limits on calories, sodium, fat and sugar and require qualifying nutrition characteristics such as whole grains or other qualifying ingredients. The same explainer notes that fundraisers during school hours can be affected differently than evening events.

States can add requirements or funding above the federal floor. The Queen Zone quotes the School Nutrition Association as saying that every school nutrition program is different because each must navigate state and local policies despite baseline federal requirements. The explainer cites Food Research and Action Center history showing that after federal pandemic-era universal meal waivers ended, states including California, Maine, Massachusetts, Nevada and Vermont adopted Healthy School Meals for All policies for the 2022 to 2023 school year, with Colorado, Minnesota, Michigan and New Mexico starting policies in 2023 to 2024.

Eligibility still determines free and reduced-price access where universal meals are not offered. The Queen Zone notes that pandemic-era national universal meals ended in 2022 and that families now qualify by household income, direct certification through programs such as the Supplemental Nutrition Assistance Program, or schoolwide options such as the Community Eligibility Provision. It reports that the U.S. Department of Agriculture lowered the Community Eligibility Provision threshold from 40% to 25% identified students in a 2023 final rule. For practical next steps, Share My Lesson lists district actions now underway or under preparation: updating cafeteria menus, partnering with local farms and suppliers, educating students about nutrition, collecting feedback from families and students, and monitoring participation.

## Why ultra-processed foods are the next test

Ultra-processed foods are the least defined part of the policy environment. FoodService Director reports discussion of ultra-processed foods without a settled definition and notes that the new dietary guidelines call on Americans to limit them. The report cites a U.S. Department of Agriculture estimate that approximately 70% of packaged products in the U.S. food supply are foods often considered ultra-processed and that children get over 60% of their calories from such foods.

Kitchens say definitions will determine feasibility. Ryan Mikolaycik, executive director of food service and warehouse operations at Austin Independent School District in Texas, told FoodService Director that using some processed foods to bridge fully scratch kitchens and fully processed meals is almost unavoidable, and that schools would need more staff and equipment to expand scratch or speed-scratch preparation. The report notes that some schools have kitchens without enough space to bake items such as enough muffins for breakfast for every child. Mikolaycik said he would like to see a definition of ultra-processed foods and suggested that the number and type of ingredients in a manufacturer product should be examined to determine its health position.

The implication for parents through 2028 is straightforward: expect less sweet yogurt, cereal and flavored milk, gradually less salty entrees, continued fruit, vegetable and whole-grain offerings, and variation by state and district. Share My Lesson reports that federal policymakers, educators and nutrition teams are now focused on implementation steps that keep meals affordable, culturally relevant and appealing enough to sustain participation while the phased federal limits take hold.

## Sources referenced
- New Dietary Guidelines Could Change What Students See on Their Lunch Trays | Share My Lesson (https://sharemylesson.com/todays-news-tomorrows-lesson/new-dietary-guidelines-students-lunch)
- K-12 and C&U operators prepare for the new nutrition guidelines (https://www.foodservicedirector.com/foodservice-operations/k-12-and-c-u-operators-prepare-for-the-new-nutrition-guidelines)

## Personalized Whole Foods Outperform MyPlate Counseling in 8-Week Trial

URL: https://nutritionjournal.com/personalized-whole-food-diet-trial-insulin-cognition

An 8-week RCT in 112 Black and White young adults found personalized whole-food provision raised diet quality and attention versus MyPlate counseling, with larger fasting-insulin and cognition gains in Black participants.

Key takeaways:
- Personalized whole-food provision for 8 weeks raised diet quality versus one-time MyPlate counseling in 112 young adults with overweight or obesity.
- Black participants had larger vegetable-quality gains, greater fasting-insulin reductions, and larger attention and processing-speed gains.
- HOMA-β was lower with personalized foods overall; early-phase glucose AUC 0-30 min differed by race within the personalized arm.
- No cardiovascular or appetite effects were reported; results are from a May 29, 2026 preprint awaiting peer review.

**TL;DR: An 8-week personalized whole-food program improved diet quality, lowered a marker of insulin secretion demand, and raised attention scores versus one-time MyPlate counseling, with larger fasting-insulin and attention gains in Black young adults with overweight or obesity.**

## What the new trial tested

Investigators at the University of Missouri-Columbia randomized 112 Black and White adults aged 18-35 years with body mass index 25-45 kg/m² by race to two eating strategies for eight weeks, according to the medRxiv preprint titled *A Personalized Whole-Food Diet Differentially Modulates Glucoregulatory and Cognitive Responses Compared With Conventional Dietary Counseling in Young Black and White Adults With Overweight or Obesity: An 8-Week Randomized Controlled Trial*.

One group received a personalized dietary intervention providing whole foods, labeled PD with 57 participants, while the comparison group received conventional dietary counseling at baseline using MyPlate guidelines, labeled CD with 55 participants, as described in that preprint.

The registered protocol is listed as ClinicalTrials.gov NCT04635917, and the posting identifies authors Onyedika G. Ani, Elaheh Rabbani and Jaapna Dhillon in the Division of Food, Nutrition, and Exercise Sciences.

The stated objective was to evaluate whether a personalized whole-food dietary intervention improves cardiometabolic outcomes more in Black than White young adults with overweight or obesity.

The background rationale given was that Black adults bear a disproportionate burden of cardiometabolic dysfunction, yet most dietary trial evidence comes from predominantly White cohorts.

The design used block randomization by race, baseline-adjusted linear models, and sensitivity analyses adjusting for baseline BMI and food security score.

Primary outcomes were Matsuda Index and fasting and oral glucose tolerance test-derived glucose, insulin, and non-esterified fatty acids.

Other glucoregulatory, cardiovascular, anthropometric, appetite, and cognitive outcomes were also assessed.

The authors describe the eight-week period as occurring during weight maintenance in their conclusions.

Ethics approval is listed as the ethics committee/IRB of University of Missouri-Columbia, with participant consent documented and funding from the National Institutes of Health noted in the declarations.

## How personalization differed from conventional counseling

The PD arm supplied whole foods and tailored the eating plan to the individual, while the CD arm received guidance at the starting visit based on MyPlate, according to the preprint abstract.

MyPlate-style counseling, as explained in a Johns Hopkins Medicine commentary titled *Plating the new 2025-2030 dietary guidelines* by Ashli Greenwald, MS, RDN, LDN, has historically emphasized a half plate of fruits and vegetables with remaining portions for lean protein and whole grains rather than refined grains.

That Johns Hopkins Medicine commentary advises limiting added sugars, processed foods, and high-fat cooking methods and focusing on overall dietary patterns rather than single foods or ingredients.

The trial therefore compared provision plus personalization against a single education session without ongoing food provision.

Compliance with study food consumption in the PD arm was reported as 85-91%.

Diet quality was higher in PD than CD at P < 0.05.

Vegetable-related diet-quality gains were larger among Black participants, with a group-by-race interaction at P < 0.05.

The findings indicate that supplying foods lifted overall eating-pattern scores and particularly shifted vegetable intake for Black enrollees.

The preprint did not report weight-loss differences as a primary result and framed metabolic and cognitive comparisons as occurring under weight-maintenance conditions.

## Blood-sugar and insulin findings by race

Homeostatic Model Assessment of β-cell function, abbreviated HOMA-β, was lower in PD than CD overall at P < 0.05, according to the preprint results.

Lower HOMA-β in this context indicates reduced estimated insulin secretion for the prevailing glucose level after the personalized whole-food period relative to conventional counseling.

No overall PD versus CD difference is reported in the abstract for Matsuda Index, fasting glucose, or oral glucose tolerance test-derived non-esterified fatty acids.

In sensitivity analyses that adjusted for baseline BMI and food security score, Black PD participants had greater fasting insulin reductions than White participants.

That three-way pattern strengthened in the latter half of the intervention, described as a week-by-group-by-race interaction at P < 0.05.

A similar tendency was noted for Homeostatic Model Assessment of Insulin Resistance, abbreviated HOMA-IR, without reaching the same significance threshold in the abstract summary.

Early-phase glucose handling also differed by race within the personalized arm.

Glucose area under the curve from 0 to 30 minutes was higher in White than Black PD participants, with a group-by-race interaction at P < 0.05.

The authors concluded that the personalized whole-food intervention produced differential effects in fasting insulin and early-phase glucose handling in Black compared with White young adults with overweight or obesity.

These race-specific insulin and early glucose signals emerged only after accounting for baseline BMI and food security, underscoring that starting body size and food access shaped the metabolic response.

## Why fasting insulin matters for young adults

Fasting insulin captures baseline pancreatic output after an overnight fast, separate from meal-related spikes, and elevated values can precede glucose abnormalities by years, a point emphasized in clinical explainers and research summaries.

The trial’s focus on fasting insulin, HOMA-IR, HOMA-β, Matsuda Index, and oral glucose tolerance test measures reflects an effort to separate secretion effort from sensitivity.

A separate analysis in the *European Journal of Nutrition* titled *Differential associations of diet with hepatic and muscle insulin resistance: insights from an dietary pattern analysis in the PERSON study* examined 700 adults with overweight or obesity in the screening phase of the PERSON study.

That PERSON analysis derived a dietary pattern high in unprocessed red meat, processed meat, fresh cream and whipped cream and low in fruits, vegetables, and tea.

That pattern was significantly associated with higher HOMA-IR with a beta-coefficient of 0.04, higher HOMA-β with a beta-coefficient of 0.05, and lower Matsuda index with a beta-coefficient of minus 0.08.

The PERSON authors concluded the identified pattern was more strongly associated with hepatic than muscle insulin resistance and supported considering tissue-specific insulin resistance phenotypes.

Together, the two reports point in a consistent direction: eating patterns richer in vegetables and lower in processed meats and high-fat dairy align with more favorable HOMA and Matsuda signals.

The Missouri trial adds randomization and race-stratified comparison, while the PERSON report adds cross-sectional tissue-specific detail from a larger European sample.

## Attention and processing-speed results

Concentration performance was higher in PD than CD overall at P < 0.05, according to the preprint.

That outcome reflects sustained-attention task performance rather than self-reported focus.

Larger gains in processing speed and accuracy occurred among Black than White participants, with a group-by-race interaction at P < 0.05.

Total items processed and total items processed minus errors are listed among the trial abbreviations alongside concentration performance, indicating timed accuracy tasks.

No effects were observed for cardiovascular or appetite outcomes in the abstract summary.

Anthropometric outcomes were listed as assessed but no between-group or race-specific body-measurement differences are stated in the abstract results.

The cognitive benefit appeared alongside diet-quality improvement and without parallel changes in blood pressure, lipids, or appetite ratings reported in the summary.

The authors concluded greater benefits in attention in Black compared with White young adults with overweight or obesity during weight maintenance.

## What did not change

Cardiovascular outcomes did not differ between PD and CD in the results summary.

Appetite outcomes did not differ between PD and CD in the results summary.

Matsuda Index, a composite sensitivity measure derived from fasting and oral glucose tolerance test values, is named as a primary outcome without a reported overall intervention effect in the abstract.

Fasting glucose and oral glucose tolerance test-derived non-esterified fatty acids are likewise named as primary outcomes without reported overall differences in the abstract.

The absence of cardiovascular or appetite signals over eight weeks suggests that glucose handling and attention responded earlier than vascular or hunger measures in this young adult sample.

Longer or larger trials would be needed to determine whether the early fasting-insulin and attention patterns extend to blood pressure, lipids, body composition, or sustained eating behavior.

## How to read this preprint for your own eating plan

The study was posted to medRxiv on May 29, 2026 as a preprint, meaning it had not completed peer review at posting.

Readers should treat race-specific interactions as exploratory signals that require confirmation rather than as individualized prescriptions.

The intervention combined two elements — personalization and actual provision of whole foods — so the results do not isolate counseling language alone.

People seeking to apply the pattern can discuss vegetable-rich whole-food approaches, food-security barriers, and baseline metabolic testing with a clinician or registered dietitian.

The Johns Hopkins Medicine commentary recommends small sustainable shifts such as replacing sugary beverages with water, adding frozen or fresh vegetables to meals, and choosing grilled options instead of fried foods when dining out.

Anyone with overweight or obesity, elevated fasting insulin, or attention concerns should seek medical guidance before changing medications or adopting a new therapeutic diet.

Future peer-reviewed publication should clarify absolute changes in insulin units, glucose units, diet-quality scores, and cognitive test points, plus retention and adverse events.

For now, the verified takeaway is narrow: provision-based personalization raised diet quality and attention and shifted fasting-insulin dynamics more favorably for Black participants than one-time MyPlate counseling over eight weeks of weight maintenance.

## Sources referenced
- Differential associations of diet with hepatic and muscle insulin resistance: insights from an dietary pattern analysis in the PERSON study | European Journal of Nutrition (https://link.springer.com/article/10.1007/s00394-026-03996-8)

## FDA Reopens Salmonella Probe Tied to Moringa Capsules

URL: https://nutritionjournal.com/fda-reopens-salmonella-probe-tied-to-moringa-capsules

FDA and CDC reopened a moringa Salmonella probe after 22 new cases raised the total to 119 illnesses in 36 states, with new recalls of TNVitamins and Mogo capsules.

Key takeaways:
- FDA, CDC and state officials reopened a moringa-linked Salmonella investigation after 22 new illnesses were reported following a March 17 closure.
- As of May 27, 2026, 119 people infected with outbreak strains were reported from 36 states, with 32 hospitalizations and no deaths in the reopened outbreak.
- Patient interviews linked illness to moringa powder products, including Live it Up Super Greens, Why Not Natural capsules and TNVitamins capsules.
- A second outbreak linked to Mogo moringa capsules involves 18 illnesses in 14 states, with 7 hospitalizations.
- Recalled lots include TNVitamins, Doctor's Pride, Why Not Natural, Live it Up Super Greens and MOGO capsules; consumers should discard or return them.

## TL;DR: FDA and CDC reopened a moringa-linked Salmonella investigation after 22 new illnesses raised the total to 119 cases in 36 states as of May 27, 2026.

Federal regulators have reopened a previously closed Salmonella investigation tied to moringa leaf powder after 22 additional illnesses were reported from four states, bringing the cumulative total to 119 people infected with outbreak strains across 36 states as of May 27, 2026, according to [Food Safety News](https://www.foodsafetynews.com/2026/05/fda-reopens-investigation-into-salmonella-outbreak-traced-to-moringa-capsules/). The reopening came one day after officials announced a separate moringa-capsule outbreak, creating two active federal investigations involving imported moringa leaf powder products.

The earlier investigation had been closed on March 17, but the Food and Drug Administration reports that it, the Centers for Disease Control and Prevention, and state and local health offices restarted work because of new illness reports, according to Food Safety News. Since the closure, 22 new cases and six additional hospitalizations have been recorded, with no deaths reported in the reopened outbreak, according to the [CDC Newsroom](https://www.cdc.gov/media/releases/2026/2026-alert-update-growing-number-of-salmonella-illnesses-and-outbreaks-linked-to-moringa-leaf-products.html). Officials now link some of the recent illnesses to specific lots of TNVitamins Moringa Capsules that have been recalled but may remain in homes.

## Two outbreaks under investigation at once

Public health officials are now tracking two distinct Salmonella outbreaks connected to moringa leaf products, according to Food Safety News. The reopened investigation involves Salmonella Typhimurium and Salmonella Newport infections, while the newly announced investigation involves Salmonella Typhimurium infections linked to Mogo-brand moringa capsules.

In the reopened outbreak, illnesses started on dates ranging from Aug. 22, 2025, to April 26, 2026, according to Food Safety News. Of 109 people with available information, 32 have been hospitalized, and no deaths have been reported. The true patient count is likely higher because some ill people do not seek care and others are not specifically tested for Salmonella, with CDC estimating 29 undetected cases for every confirmed Salmonella patient, according to Food Safety News.

The second outbreak involves 18 people infected with the outbreak strain reported from 14 states as of May 26, 2026, according to the [CDC investigation page](https://www.cdc.gov/salmonella/outbreaks/moringa-05-26/investigation.html). Illness onset dates in that cluster ranged from Feb. 3, 2026, to April 7, 2026. Of 13 people with information available, seven have been hospitalized and no deaths have been reported.

## What patient interviews show

Interview data point strongly toward moringa-containing supplements in the reopened outbreak. Of 79 patients interviewed, including some of the 22 new cases, 70 reported eating a product containing moringa leaf powder, according to Food Safety News.

Among those 70, 60 reported consuming Live it Up Super Greens supplement powders only, five reported Why Not Natural moringa powder capsules only, one reported consuming both products, and four reported TNVitamins moringa powder capsules only, according to Food Safety News. Federal officials said information shows some lots of TNVitamins Moringa Capsules may be making people sick now, according to the CDC Newsroom.

In the newer Mogo-associated outbreak, state and local officials interviewed eight people about foods eaten in the week before illness, according to the CDC investigation page. Six of eight, or 75%, reported eating moringa powder capsules, including four who reported Mogo-brand moringa capsules. Epidemiologic data show that Mogo-brand moringa capsules may be contaminated with Salmonella Typhimurium and may be making people sick, according to the CDC investigation page.

## Who has been affected

The reopened outbreak has spread widely since surveillance began, with 119 infections reported from 36 states as of May 27, according to Food Safety News. The 22 illnesses added after the March 17 closure came from four new states, with six additional hospitalizations and no deaths, according to the CDC Newsroom.

Demographic detail is most complete for the newer 18-person outbreak. Ages ranged from 1 to 93 years, with a median age of 67, according to the CDC investigation page. Half of the patients were female and half were male among the 18 with sex information. Among 12 people with race information, 92% were White and 8% were African American/Black. Among 11 people with ethnicity information, 100% were non-Hispanic.

CDC cautioned that recent illnesses may not yet be reported because determining whether a sick person is part of an outbreak usually takes three to four weeks, according to the CDC investigation page. The agency also said the outbreak may not be limited to states with known illnesses because many people recover without medical care and testing.

## Laboratory findings point to common sources

Whole genome sequencing showed that bacteria from sick people's samples in the Mogo-associated outbreak are closely related genetically, suggesting illness from the same food, according to the CDC investigation page. Investigators used the CDC PulseNet system, which manages a national database of DNA fingerprints of foodborne bacteria, to identify related cases.

Sequencing analysis of bacteria from 18 people's samples did not predict resistance to any antibiotics, according to the CDC investigation page. More information on resistance monitoring is available through the National Antimicrobial Resistance Monitoring System site referenced by CDC.

FDA is conducting a traceback investigation of products consumed before illness to determine contamination sources and is working with state partners to collect samples for testing, according to the CDC investigation page. In the reopened outbreak, FDA is conducting additional supply-chain traceback to identify the specific Salmonella source and is working with state and local partners to sample products and determine whether additional products may be contaminated, according to Food Safety News.

## Recalls linked to the outbreaks

Several products have been recalled in connection with the two investigations, according to Food Safety News. Consumers are advised not to eat, sell, or serve recalled products and to discard them or return them to the place of purchase.

Recalled products identified by Food Safety News include TNVitamins-brand Ultra Potent Complete Green Superfood Moringa capsules 10,000 mg in 120-capsule bottles from lots 2507199 with expiration 09/2027, 2512-304 with expiration 02/2028, and 2793 with expiration 02/2028. The same report lists Doctor's Pride Complete Green Superfood Ultra Potent Moringa 10,000 mg in 120-capsule bottles from lot 2507199 with expiration 09/2027.

The list also includes Why Not Natural Pure Organic Moringa Green Superfood capsules with lot A25G051 and expiration 07/2028 on the bottom of the bottle, all Live it Up-brand Super Greens dietary supplement powder in original and wild berry flavors with lots beginning with the letter A and all stick-pack products with expiration dates from 08/2026 to 01/2028, and MOGO-brand Pure Moringa Oleifera capsules from lots 15525AA with expiration 6/2027 and 00926AA with expiration 1/2028, according to Food Safety News.

## Mogo recall details

On May 25, Mogo Moringa LLC conducted a voluntary recall of two lots of Moringa Oleifera Capsules, according to the CDC investigation page. CDC advises people not to eat, sell, or serve the recalled Mogo-brand capsules.

The company, based in Saint Louis, Missouri, recalled the lots after discussions with FDA regarding a possible contamination concern, according to the [FDA recall notice](https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/mogo-moringa-llc-announces-voluntary-recall-select-lots-moringa-capsules-due-possible-salmonella). Affected lots are 15525AA expiring 06/2027 and 00926AA expiring 01/2028. No other lots or Mogo Moringa LLC products are included.

The product is packaged in a white plastic bottle and sold online through authorized channels, according to the FDA recall notice. The company states it does not authorize third-party sellers and encourages purchase only from official sources. Independent third-party testing of retained samples from the affected lots detected no Salmonella, but the company proceeded as a precaution in coordination with FDA while evaluation continues, according to the FDA recall notice.

## Total Nutrition recall and distribution

Total Nutrition Inc. of Deer Park, New York, voluntarily recalled TNVitamins Ultra Potent Complete Green Superfood and Doctor's Pride Complete Green Superfood Ultra Potent Moringa Capsules in 120-count bottles because of potential Salmonella contamination, according to the [FDA recall notice for Total Nutrition](https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/total-nutrition-inc-recalls-tnvitamins-and-doctors-pride-ultra-potent-complete-green-superfood). The recall followed notification from FDA and CDC that the products may be implicated in an ongoing investigation involving moringa-containing supplements.

The recalled product was distributed nationally through Amazon, Walmart, TikTok Shop, Target, and the company websites tnvitamins.com and doctorspride.com, according to the FDA recall notice for Total Nutrition. Bottles are white HDPE supplement bottles with smooth white caps containing 120 clear capsules filled with green moringa powder.

The company has ceased distribution and sale of the identified product and initiated removal orders across sales and fulfillment channels while FDA, CDC, and the company continue investigation, according to the FDA recall notice for Total Nutrition. No other TNVitamins or Doctor's Pride products are involved. Customers may request a refund by contacting customerservice@tnvitamins.com with name, order number, and a photo showing the lot codes.

## What consumers should do now

CDC advises consumers to check homes for recalled products and not to use them, according to the CDC Newsroom. Any recalled capsules found at home should be thrown out or returned to the store. Items and surfaces that may have touched recalled products should be washed with hot soapy water or in a dishwasher.

People with severe Salmonella symptoms should call a healthcare provider, according to the CDC Newsroom. Anyone who ate moringa powder products and developed symptoms should seek medical attention and tell doctors about possible Salmonella exposure because special tests are needed to diagnose salmonellosis, according to Food Safety News.

State health departments should be contacted with questions about cases in a particular state, according to the CDC Newsroom. The Washington State Department of Health and Minnesota Department of Health also posted state-level notices about the multistate moringa-powder outbreak in May 2026.

## Symptoms and who faces higher risk

Most people infected with Salmonella develop diarrhea, fever, and stomach cramps six hours to six days after exposure, according to the CDC Newsroom. Illness usually lasts four to seven days, and most people recover without treatment, although some become severely ill enough to require hospitalization.

Food Safety News reports symptom onset can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food, with otherwise healthy adults usually ill for four to seven days. In some cases diarrhea is severe enough to require hospitalization.

Children younger than five, adults 65 and older, and people with weakened immune systems are more likely to develop severe illness, according to the CDC Newsroom. Infants, children, seniors, and people with fragile immune systems face higher risk of serious infection, and contaminated items do not usually look, smell, or taste spoiled, according to Food Safety News.

## Recalls to Watch: Botulism, Toxins in Infant Formula, & More

URL: https://nutritionjournal.com/recalls-to-watch-botulism-toxins-in-infant-formula-more

Spring 2026 recalls span ByHeart and a2 infant formula, botulism-risk herring and shelf-stable foods, E. coli cheese and 119 Salmonella cases tied to moringa capsules.

Key takeaways:
- At least 51 infants across 19 states were hospitalized in the 2025 outbreak with confirmed exposure to ByHeart Whole Nutrition infant formula.
- a2 Platinum Premium Infant Formula 0-12 months USA label posted May 2 was recalled for cereulide toxin that heating does not eliminate.
- Botulism-risk postings include Ma Cohen's kippered herring, Good Brain Tonic, Christopher Ranch garlic, Genova tuna and uneviscerated dried fish.
- RAW FARM cheddar in select batches was posted April 2 and updated April 7 for E. coli O157:H7.
- CDC reported 119 Salmonella cases and 32 hospitalizations in 36 states linked to moringa leaf powder capsules.
- FDA's four follow-up actions cover root-cause investigation, dairy-ingredient sampling, expanded Clostridium botulinum science and safety communications.

TL;DR: Recalled infant formula, shelf-stable fish and tonics with botulism risk, infant formula with cereulide toxin, cheddar with E. coli O157:H7, and moringa capsules linked to 119 Salmonella cases lead food recalls to check as of May 27, 2026.

## Why recalls piled up this spring

Food and supplement recalls continued to pile up this spring, raising ongoing safety concerns, according to the Center for Science in the Public Interest in its update published May 27, 2026.

That roundup, titled Recalls to watch: Botulism, toxins in infant formula, & more, lists toxins in infant formula, botulism risk in herring, E. coli in cheese, Salmonella in pet food and potato chips, lead contamination, foreign materials such as glass and metal, undeclared allergens, and hidden drug ingredients in supplements.

Each year, roughly one in six Americans suffers from a bout of food poisoning, according to the Center for Science in the Public Interest.

Tainted food kills about 3,000 people in the United States every year, according to the Center for Science in the Public Interest.

The risk of getting sick is higher if you are pregnant, under age five, over age 65, or have a weakened immune system, according to the Center for Science in the Public Interest.

The Center for Science in the Public Interest groups current concerns into four patterns: botulism risks or process-control issues across infant formula to shelf-stable and specialty foods like tonics, tuna, dried fish, and garlic; Listeria, E. coli, and Salmonella contamination in potato chips, pet food, cheese, deli salads, seafood, frozen produce, and prepared meals; foreign-material contamination with glass, metal, plastic, and other debris in frozen meals, baked goods, and Trader Joe's Chicken Fried Rice; and allergen mislabeling with undeclared peanuts, milk, soy, wheat, eggs, and other allergens in packaged foods nationwide.

A separate May 27, 2026 recall digest from eFoodAlert underscores that the activity is international and ongoing, with investigations and allergy alerts posted that same day.

## Infant formula at center: botulism history and cereulide toxin

The 2025 infant botulism outbreak was tragic and historic, according to a May 23, 2026 report from MakeFoodSafe on the Food and Drug Administration response.

At least 51 infants across 19 states were hospitalized with botulism poisoning with confirmed exposure to ByHeart Whole Nutrition infant formula, according to MakeFoodSafe.

It was the first known botulism outbreak tied to infant formula in the entire world since in the almost 50 years clinicians were aware of the illness, according to MakeFoodSafe.

The root-cause investigation and ongoing work with ByHeart, Inc. is important to prevent it from happening at that facility again, according to MakeFoodSafe.

The organization is working with international experts and standard setting bodies to conduct a risk assessment on Clostridium botulinum in infant formula, according to MakeFoodSafe.

ByHeart Whole Nutrition Infant Formula cans and Anywhere Packs remain on process-control recall lists tracked in the Center for Science in the Public Interest update.

That listing covers all batches of ByHeart Whole Nutrition Infant Formula cans and all Anywhere Packs, with Can UPC 85004496800 and Anywhere Pack UPC 85004496802, posted Nov. 8 and 11, according to the Center for Science in the Public Interest.

The listing describes it as a process-control recall, according to the Center for Science in the Public Interest.

Do not use recalled infant formula or baby foods, according to the Center for Science in the Public Interest.

If your infant may have consumed recalled formula, contact your pediatrician, according to the Center for Science in the Public Interest.

Do not use recalled infant formula; process-control deviations in powdered infant formula are handled with extra caution because infants are uniquely vulnerable to serious health risks from foodborne hazards, according to the Center for Science in the Public Interest.

A separate infant-formula toxin issue involves a2 Platinum Premium Infant Formula 0-12 months with USA label, from a2, posted May 2, according to the Center for Science in the Public Interest.

Cereulide is a toxin produced by certain bacteria strains, according to the Center for Science in the Public Interest.

Heating foods does not eliminate the toxin, according to the Center for Science in the Public Interest.

Symptoms typically develop within 30 minutes to six hours after ingestion and often include nausea and vomiting, according to the Center for Science in the Public Interest.

Infants are at greater risk due to their developing immune systems and can experience complications that require medical care, such as dehydration, according to the Center for Science in the Public Interest.

Discontinue use and dispose of immediately or return to the place of purchase for a refund, according to the Center for Science in the Public Interest.

If your infant is experiencing any of the symptoms described above, contact your health care provider immediately, according to the Center for Science in the Public Interest.

That a2 product was sold through a2MC's website, Amazon, and Meijer stores as part of Operation Fly Formula, according to the Center for Science in the Public Interest.

## Botulism risks in herring, tonics, tuna, garlic and dried fish

Botulism risks or process-control issues are appearing across a wide range of products, from infant formula to shelf-stable and specialty foods like tonics, tuna, dried fish, and garlic, according to the Center for Science in the Public Interest.

Specific postings cited include kippered herring in select lots from Ma Cohen's, posted May 8, according to the Center for Science in the Public Interest.

Good Brain Tonic 16 oz and 32 oz in select UPC codes from Good Brain, posted April 14, is listed, according to the Center for Science in the Public Interest.

Garlic in select UPCs from Christopher Ranch, posted April 1, is listed, according to the Center for Science in the Public Interest.

Dried croaker fish from Prime Food Processing, posted Feb. 3, is listed, according to the Center for Science in the Public Interest.

Yellowfin tuna from Genova, posted Jan. 16, is listed, according to the Center for Science in the Public Interest.

Sea Moss Gel Superfood in various flavors from True Sea Moss, posted Jan. 9, is listed, according to the Center for Science in the Public Interest.

Oven-dried fish identified as Scomberomorus cavalla, or king mackerel, from African Food on Wheels Inc, described as a process violation involving uneviscerated dried fish, posted Nov. 6, is listed, according to the Center for Science in the Public Interest.

Marinara, puttanesca, and meat-flavored pasta sauces from First & Last, described as an acidified and low-acid canned food process deviation, posted Nov. 3, are listed, according to the Center for Science in the Public Interest.

Dry ghoinnya fish from New Hoque & Sons, described as a process violation involving uneviscerated dried fish, posted Oct. 29, is listed, according to the Center for Science in the Public Interest.

Botulinum toxin attacks the nervous system and can be fatal without prompt treatment, according to the Center for Science in the Public Interest.

Do not eat recalled products subject to botulism warnings, according to the Center for Science in the Public Interest.

Return or discard recalled products, double-bagging liquids to prevent leaks, according to the Center for Science in the Public Interest.

Seek urgent care for symptoms such as muscle weakness, dizziness, double vision, slurred speech, trouble swallowing or breathing, or abdominal distension, according to the Center for Science in the Public Interest.

Products in the botulism and process-control group were sold through major grocers and specialty markets, including Safeway, Giant, Meijer, and Tops Friendly Markets, and through brand and distributor networks including direct-to-consumer and online sales, according to the Center for Science in the Public Interest.

Avoid shelf-stable whole fish unless clearly labeled eviscerated, according to the Center for Science in the Public Interest.

When in doubt, skip it, according to the Center for Science in the Public Interest.

Italian authorities are investigating two cases of botulism linked to consumption of Italiamo brand Olive and Almond Cream in 190g jars, Lot L244R, with best before 01/09/2028, according to eFoodAlert on May 27, 2026.

## E. coli in cheese and Salmonella linked to moringa capsules

Cheddar cheese in select batches from RAW FARM is listed for E. coli O157:H7, posted April 2 and updated April 7, according to the Center for Science in the Public Interest.

Anyone can get infected with E. coli, but some groups are more likely to experience severe symptoms, including people aged 65 or older, people under five, people with weakened immune systems, and people who travel internationally, according to the Center for Science in the Public Interest.

Most people with E. coli infection have diarrhea, which may be bloody or watery, stomach cramps, vomiting, and low-grade fever, and usually recover within five to seven days, according to the Center for Science in the Public Interest.

Shiga toxin-producing E. coli causes bleeding in the digestive tract and increases the risk of hemolytic uremic syndrome, which can lead to kidney failure and even death, according to the Center for Science in the Public Interest.

Do not eat the recalled cheese; discard or return it, according to the Center for Science in the Public Interest.

Seek care for severe cramps, bloody diarrhea, and fever, according to the Center for Science in the Public Interest.

If you buy ready-to-eat frozen foods, deli foods, cheeses, or salmon, double-check brands and recall notices, according to the Center for Science in the Public Interest.

The Centers for Disease Control and Prevention has reopened its investigation into an outbreak of Salmonella Typhimurium and Salmonella Newport infections linked to consumption of moringa leaf powder capsules, according to eFoodAlert on May 27, 2026.

The agency is reporting 119 cases and 32 hospitalizations in 36 states, according to eFoodAlert.

## Allergens, foreign materials, pet food and produce safety

Undeclared milk, pecans, pistachios, Yellow No. 5 and Red No. 40 prompted a recall of multiple flavors of D'DIOSES FRUIT POPS in 3.7 oz packages produced prior to April 27, 2026, from DE DIOS'S ICE POPS II LLC, according to eFoodAlert.

SkinnyDipped Dark Chocolate Coconut Almond Bites in multiple lot codes and Best By dates from Bazzini, LLC were recalled due to risk of undeclared peanut, according to eFoodAlert.

The Food and Drug Administration warned Best Buy Bones, Inc. that a Sept. 8 through Sept. 12, 2025 inspection of the company's pet food manufacturing facility found evidence of significant violations of Current Good Manufacturing Practice, Hazard Analysis, and Risk-Based Preventive Controls for Food for Animals requirements, including the presence of Salmonella Uganda in a finished product sample collected during the inspection, according to eFoodAlert.

The Food and Drug Administration warned Shineluck Foods, Inc. that an Oct. 7, 2025 through Oct. 14, 2025 inspection found serious violations of the Standards for the Growing, Harvesting, Packing, and Holding of Produce for Human Consumption regulation, according to eFoodAlert.

Buy small spice jars and rotate ground spices annually, according to the Center for Science in the Public Interest.

Avoid metal cookware from recalled brands, according to the Center for Science in the Public Interest.

Clean surfaces, utensils, and storage areas if recalled food may have been handled, according to the Center for Science in the Public Interest.

For a full list of recalls, visit the FDA website, according to the Center for Science in the Public Interest.

## Why infant formula testing is difficult and what FDA plans next

Unlike Cronobacter and Salmonella, Clostridium botulinum are spore-forming bacteria, according to MakeFoodSafe.

Their protective spores allow them to survive conditions that would kill other pathogens, according to MakeFoodSafe.

Pasteurization is generally ineffective on this germ, according to MakeFoodSafe.

They are often found in low levels in many foods and in the environment, according to MakeFoodSafe.

When infants consume viable spores, those spores can shed their protective coats and become infectious again, according to MakeFoodSafe.

While inside the body, they begin to produce a life-threatening toxin that affects the nervous system, according to MakeFoodSafe.

Without prompt treatment, the outcome can be deadly, according to MakeFoodSafe.

Analytical tests to screen for or identify common foodborne germs do not usually work for Clostridium botulinum, according to MakeFoodSafe.

Microbiological methods incubate the sample on a culture, and if the bacteria grow, it can be identified, according to MakeFoodSafe.

Molecular methods analyze the DNA of pathogen cells, but if hearty spores do not break open, their DNA cannot be accessed for analysis, according to MakeFoodSafe.

Microscopic methods are not effective because the mere presence of spores is not an indicator of risk, since not all spores are truly viable and capable of causing illness, according to MakeFoodSafe.

Certain laboratory detection methods specifically for these types of germs require additional time and specialized resources, which limits the number of labs with testing capacity, according to MakeFoodSafe.

Results can take up to two weeks or more for final results, creating a backlog of product if products are held until results are cleared, or a large amount of potentially harmful product on the market if results prompt a recall after products reach store shelves, according to MakeFoodSafe.

The Food and Drug Administration has put together four main actions to respond to the 2025 infant botulism outbreak, according to MakeFoodSafe.

Those actions are continued investigation to learn more about the root cause, initiation of a sample assignment focused on dairy-based ingredients including whole milk powder, non-fat dry milk powder, and whey protein concentrate to help evaluate the supply chain, broadening scientific knowledge and understanding of Clostridium botulinum and public health interventions for controlling the pathogen, and enhancing communications and engagement with industry, consumers, federal, state, local, and other public health partners about infant formula safety, according to MakeFoodSafe.

Currently, there is no active recall or outbreak involving infant botulism, according to MakeFoodSafe.

Consumers can consider using liquid ready-to-feed formula, as this is the safest option for higher-risk formula-fed infants, according to the Food and Drug Administration advice quoted by MakeFoodSafe.

If liquid ready-to-feed formula cannot be obtained, consumers can consider using a liquid concentrate, according to the Food and Drug Administration advice quoted by MakeFoodSafe.

Both liquid ready-to-feed formula and liquid concentrate are made to be sterile without germs and are safer options than powdered infant formula for higher-risk infants not receiving breast milk, according to the Food and Drug Administration advice quoted by MakeFoodSafe.

If using liquid concentrate formula and uncertain about the safety of the water source, boil the water for making formula, then let it cool in the pot for five minutes before putting it in the bottle, add the liquid concentrate, shake to mix and allow the formula to cool to room temperature before feeding, according to the Food and Drug Administration advice quoted by MakeFoodSafe.

Babies with infant botulism may experience choking when trying to feed, constipation or bowel movement changes such as not pooping for days or even weeks, weaker suck or poor feeding, eyelid drooping, lack of facial expressions, inability to lift their head or other signs of muscle weakness or paralysis, weaker crying, and weakness with decreased muscle tone particularly on the top of the body and limbs that can appear floppy or unable to reach and grab, according to MakeFoodSafe.

If concerned that a child is experiencing symptoms of infant botulism, get medical attention right away, according to MakeFoodSafe.

## Sources referenced
- Recalls to watch: Botulism, toxins in infant formula, & more - Center for Science in the Public Interest (https://www.cspi.org/cspi-news/recalls-watch-botulism-toxins-infant-formula-more)
- Recalls and Alerts: May 27, 2026 - eFoodAlert (https://efoodalert.com/tag/botulism-2/)

## FDA Review: 1 in 10 Foodborne Incidents Tied to Chemicals

URL: https://nutritionjournal.com/fda-chemical-foodborne-outbreaks-2011-2025

FDA review of 1,270 incidents finds 127 chemical cases led by seafood toxins, with testing and surveillance gaps slowing investigations.

Key takeaways:
- CORE evaluated 1,270 foodborne illness incidents from 2011 to 2025 and attributed 127, or 10%, to chemical exposure.
- Seafood toxins from shellfish and finfish were the majority chemical cause, followed by illicit or pharmaceutical drugs, toxic elements and botanical toxins.
- Chemical investigations often lack established surveillance, genomic linkage tools and ready lab assays for the food-chemical pair.
- Confirmation requires support from at least two of three evidence types: epidemiologic, traceback and laboratory data.
- FDA lists targeted surveillance, laboratory method development and agency partnerships as its mitigation approach.

TL;DR: One in ten FDA-reviewed foodborne illness incidents from 2011 to 2025 was caused by a chemical hazard, not a microbe, with seafood toxins leading the list.

A new review published on 26 May 2026 in [Frontiers in Toxicology](https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2026.1856871/full) reports that the Coordinated Outbreak Response and Evaluation (CORE) Network evaluated 1,270 foodborne illness incidents from 2011 to 2025 and attributed 127 incidents, or 10%, to a chemical exposure. The authors are Brett Weed, Lauren Yeung, Omari Bandele and Cary Chen Parker of the Human Foods Program at the U.S. Food and Drug Administration in College Park, Maryland. Seafood toxins from shellfish and finfish represented the majority of these chemical incidents, followed by illicit or pharmaceutical drugs, toxic elements and botanical toxins.

The paper presents several case studies that represent an array of classes of chemical hazards and distinct root causes of contamination. Its central message for consumers, clinicians and food operators is that chemical incidents are less common than microbial outbreaks but present additional complexities. Those complexities include a lack of established surveillance and reporting systems for chemical incidents, difficulties in demonstrating a connection between illness presentation and a specific exposure to a given food product, and the heterogeneity of contamination. The authors also report that many outbreaks require development and validation of new analytical methods for a novel food-contaminant pair to generate laboratory results sufficient to support regulatory action.

## What the 1,270-incident review counted

The analysis was extracted from the CORE database of foodborne illness incidents, according to [Frontiers in Toxicology](https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2026.1856871/full). The database includes detailed information on foodborne outbreaks that were evaluated and investigated by FDA from the creation of CORE in 2011 to the present. The authors state that the data do not represent all outbreaks associated with FDA-regulated human foods, and that the data represent outbreaks with FDA involvement.

Within that FDA-involved set, CORE evaluated 1,270 foodborne illness incidents between 2011 and 2025. Of those, 127 incidents were attributable to a chemical exposure. The share was 10%. That framing is important for interpretation. The figure describes the proportion of chemical causes within incidents that reached FDA’s CORE process, not an estimate of the share of all foodborne illnesses in the United States caused by chemicals.

The authors distinguish terminology used throughout the review. In the manuscript, “chemical hazard” refers to the causative chemical agent or contaminant, whereas “chemical incident” refers to a foodborne illness event or outbreak investigation attributed to such a hazard. A chemical hazard is therefore the substance, while a chemical incident is the illness event investigated.

The ranking of hazard groups is also explicit. Seafood toxins, from both shellfish and finfish, represented the majority of the 127 chemical incidents. Illicit or pharmaceutical drugs were next, followed by toxic elements and botanical toxins. The review states that several case studies are presented which represent an array of classes of chemical hazards and distinct root causes of contamination.

## Why chemical outbreaks are harder to detect

Investigations of foodborne exposure to chemical substances are complex and often a causative agent cannot be definitively identified, the review notes. While extensive research has been dedicated to estimating the burden attributable to microbial pathogens, estimates of the total burden of illness due to chemical hazards are not well-defined.

The paper places that gap in context by citing a global estimate for metals. Foodborne illnesses from just four toxic metals, arsenic, cadmium, lead and methylmercury, were estimated at one million cases and 56,000 deaths globally in 2015. Foodborne illness itself can be caused by biological, chemical or physical hazards.

Lead author Brett Weed summarized the practical difference in a companion post on 26 May 2026. He wrote that the team examined almost 1,300 outbreaks evaluated by CORE from its founding in 2011 to 2025 and identified 127, or 10%, caused by a chemical hazard rather than a pathogen. He added that seafood toxins predominate, but outbreaks were also caused by a wide variety of other chemicals and toxins.

Weed also listed three investigation barriers. Chemical outbreaks have no genomic fingerprint to show relatedness in surveillance systems, signs and symptoms may present differently in different patients, and laboratory assays may not exist for the food-chemical pair implicated. He wrote that awareness of the uniqueness of chemical outbreak investigations may speed the identification and mitigation of these outbreaks when they occur.

The peer-reviewed paper makes the same points in formal terms. The stated challenges include a lack of established surveillance and reporting systems for chemical incidents. They also include difficulties in demonstrating a connection between illness presentation and a specific exposure to a given food product. A third stated challenge is the heterogeneity of contamination. A fourth is the need, in many outbreaks, for development and validation of new analytical methods for a novel food-contaminant pair to generate laboratory results sufficient to support regulatory action.

## How FDA, CDC and states investigate an outbreak

Foodborne illness outbreak investigations involve coordinated efforts among federal, state and local public health and regulatory agencies to identify outbreak sources and prevent additional illnesses, according to [Frontiers in Toxicology](https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2026.1856871/full). Investigators collect and analyze three types of data to determine the common food consumed by ill people.

First, epidemiologic data are gathered as state and local partners work with the Centers for Disease Control and Prevention to identify outbreaks and common foods consumed by ill individuals through public health surveillance. Second, traceback data are collected when state and local authorities collaborate with FDA to examine the food supply chain and determine the origin of suspected foods identified from epidemiologic evidence. Third, laboratory data are obtained through product and environmental sampling.

These three types of data are evaluated holistically to confirm the contaminated food, with confirmation requiring support from at least two of the three categories. While outbreaks due to microbial hazards are supported by well-established surveillance systems and laboratory protocols, chemical incidents often rely on less formal or syndromic surveillance and often present obstacles to rapid laboratory identification of chemical hazards.

CORE serves as FDA’s coordination focal point for outbreak investigations in foods and dietary supplements. CORE comprises eight specialized teams, each with distinct responsibilities in the outbreak response process. These teams evaluate emerging outbreaks and disease surveillance trends in collaboration with CDC, FDA field offices and state and local agencies. They coordinate investigations, inspections, sampling and product distribution tracing to control and stop outbreaks.

The teams also monitor investigations and issue public warnings when there is ongoing risk with actionable steps to reduce illness. Following outbreak responses, CORE conducts analyses to recommend preventative measures for food safety activities. The paper states that FDA is committed to detecting, mitigating and preventing chemical hazards in foods, including targeted public health surveillance programs, laboratory method development, and partnerships with other public health and food safety agencies to ensure a safe food supply for U.S. consumers.

## What national surveillance captures — and misses

Context on routine outbreak surveillance comes from the CDC system described in [CDC Foodborne Outbreak Data: The Federal Database Behind Every US Food Poisoning Investigation](https://ai-analytics.org/writing/cdc-foodborne-outbreaks/). That explainer reports that the Foodborne Disease Outbreak Surveillance System is operated by the CDC Division of Foodborne, Waterborne, and Environmental Diseases. State and local health departments investigate foodborne illness outbreaks and submit outbreak reports to CDC, and the system aggregates these reports into the national database.

An outbreak is defined as two or more persons experiencing a similar illness after consuming food or beverages from a common source. Single sporadic cases are not counted. That definition sets an immediate limit on what the system captures, because a person who never seeks care, or whose illness is never linked to a cluster, contributes no record to the system.

Records are submitted through the National Outbreak Reporting System, a web-based platform that replaced paper reporting forms beginning in 2009. The system collects structured data on each outbreak, including pathogen with confirmed or suspected status, food vehicle, food preparation setting, contamination factor, number of ill persons, hospitalizations, deaths and laboratory confirmation status. Cases with confirmed etiology, where laboratory testing identified the causative pathogen, are distinguished from those with suspected etiology based on incubation period, symptoms and epidemiological pattern.

The explainer reports that approximately 800 to 1,000 outbreaks are reported each year, generating roughly 15,000 illnesses, 800 hospitalizations and 20 deaths among reported outbreak cases. Annual results are published in the Morbidity and Mortality Weekly Report as “Surveillance for Foodborne Disease Outbreaks, United States.” The same source reports CDC estimates that 48 million Americans experience foodborne illness each year from all causes, resulting in 128,000 hospitalizations and 3,000 deaths annually. That contrast shows that reported outbreaks capture a small visible portion of a larger burden, reflecting underreporting at each step from care-seeking to investigation.

The review’s point about surveillance fits that structure. Microbial outbreaks are supported by established laboratory protocols and genomic relatedness tools, while chemical incidents often depend on syndromic signals and custom laboratory work. When no validated assay exists for the implicated food-chemical combination, investigators must first build and validate a method before results can support regulatory action.

## What this means for seafood, drugs, metals and plant toxins

For readers planning meals, the most direct finding is the ranking. Seafood toxins from shellfish and finfish were the majority cause among the 127 chemical incidents with FDA involvement. Illicit or pharmaceutical drugs were the next group named, followed by toxic elements and botanical toxins. The paper uses case studies to show distinct root causes across hazard classes, rather than a single failure point.

The toxic-metals context underscores why prevention matters beyond acute outbreaks. The cited global estimate for 2015 attributes one million cases and 56,000 deaths to foodborne illnesses from arsenic, cadmium, lead and methylmercury. That figure is a global burden estimate for four metals, not a U.S. outbreak count, and the authors cite it to show that chemical exposures can carry large health consequences even when outbreak counts look small.

The operational lesson is about reporting and testing. Because chemical illness can vary between patients, and because contamination can be heterogeneous within a product or lot, linking cases to one food requires epidemiologic, traceback and laboratory evidence together. Confirmation needs support from at least two of those three evidence categories. When clinicians, patients and food businesses preserve product, packaging and purchase records and report promptly to state or local health departments, the epidemiologic and traceback legs of that process have more material to work with.

The regulatory lesson is about methods and partnerships. The authors state that FDA’s work includes targeted public health surveillance programs, laboratory method development, and partnerships with other public health and food safety agencies. Those three activities correspond directly to the three barriers named: surveillance and reporting systems for chemical incidents, analytical methods for novel food-contaminant pairs, and coordinated action with CDC, FDA field offices and state and local agencies.

## NYC Menus Cut Emissions 21% After Plant-Forward Standards

URL: https://nutritionjournal.com/nyc-food-standards-emissions-reduction

NYC's 2022 standards tied less beef and more vegetarian entrees to 21% lower menu emissions with stable nutrition.

Key takeaways:
- NYC revised city food standards in 2022 to limit meat and increase plant-based options.
- Four agencies serving 77% of city meals reduced beef entrees and increased vegetarian entrees.
- Total menus were associated with 21% lower emissions, or 0.64 kg CO2e less per portion.
- Nutrient content of total offerings showed no statistically significant change.
- PreK-8 schools cut beef servings by 17%; hospital acute care raised vegetarian items by 52%.
- Emissions estimate covered production and processing for entrees, sides and beverages as served.

## TL;DR: New York City menus linked lower emissions to plant-forward standards without nutrition loss.

**TL;DR: Menus served under New York City's 2022 revised food standards were associated with 21% lower greenhouse gas emissions per portion and an estimated 0.64 kilograms less carbon dioxide equivalent per portion, with nutrition content generally consistent.**

In 2022, New York City revised standards for meals and snacks served in public schools, hospitals, and other programs, according to The Vegetarian Resource Group Blog. The revised standards called for reduced use of red and processed meat and cheese and greater use of whole or minimally-processed plant protein, according to the same blog summary. The revisions were done to promote better individual, community, and environmental health, according to that summary.

The association between the revised standards and menu emissions was quantified in a study published in May 2026 in Health Affairs, volume 45, issue number 5, pages 585-593, according to the Johns Hopkins University publication record. The nine-page paper was authored by E. R. H. Moore, Alyssa J. Moran, Laura Stadler, Elizabeth Solomon, Sonia Y. Angell, and Roni A. Neff, according to that record. The digital identifier for the paper is https://doi.org/10.1377/hlthaff.2025.01669, according to the same record.

### A 2008 policy revised in 2022

In 2008, New York City established nutrition standards for food purchased and served by city agencies, according to the Johns Hopkins University publication record. In 2022, it revised the standards to limit meat and increase plant-based options, according to that record. The 2022 revision addressed meals and snacks served in public schools, hospitals, and other programs, according to The Vegetarian Resource Group Blog.

Local policy makers increasingly have implemented nutrition standards for municipal programs to advance population health and climate change goals, according to the Johns Hopkins University publication record. Yet little is known about the impact of these policies, according to that record. The New York City analysis was designed to examine both entrée offerings and the greenhouse gas and nutrition content associated with total menu offerings, according to that record.

### Which meals were studied

The study used menu data from four agencies that serve 77% of all city meals, according to both the Johns Hopkins University publication record and The Vegetarian Resource Group Blog. The four agencies were public schools, NYC Health + Hospitals, the Department of Corrections, and the Administration for Children's Services, according to The Vegetarian Resource Group Blog.

Researchers compared menus in the period before the revised standards were enacted and the period when the standards were in effect, according to The Vegetarian Resource Group Blog. The examination covered fiscal year 2019 through fiscal year 2024, according to the Johns Hopkins University publication record. Researchers evaluated changes in the center-of-the-plate protein source, according to The Vegetarian Resource Group Blog.

The nutrient and emissions review looked beyond entrées alone. Researchers examined nutrient content and estimated greenhouse gas emissions based on entrées, side dishes, and beverages, according to The Vegetarian Resource Group Blog. That approach allowed comparison of total menu offerings before and after the new standards, according to the same blog account.

### What changed on the plate

All agencies reduced the frequency of beef entrées offered on menus and increased the frequency of vegetarian entrées, according to the Johns Hopkins University publication record. In most agencies there was an increased use of whole or minimally processed plant proteins, according to The Vegetarian Resource Group Blog.

The largest reduction in beef servings was seen in preK-8 schools, which had a 17% reduction in beef, according to The Vegetarian Resource Group Blog. The NYC Health + Hospitals acute care meal program had the largest increase in vegetarian food items, described as a 52% increase, according to the same blog summary. Those agency-level shifts occurred within the broader move away from red and processed meat and cheese toward whole or minimally-processed plant protein, according to that summary.

### Emissions fell per portion served

The main finding was that, overall, greenhouse gas emissions decreased by 21% per portion with the revision in standards to promote greater use of whole or minimally-processed plant protein in place of red and processed meat, according to The Vegetarian Resource Group Blog. Changes in total menu offerings were associated with an estimated reduction of 0.64 kilograms of carbon dioxide equivalent in greenhouse gas emissions per portion across all agencies and programs, according to the Johns Hopkins University publication record.

The estimated greenhouse gas emissions included production and processing but did not include transportation, serving, and waste from served food that was not eaten, according to The Vegetarian Resource Group Blog. The results reflect the menus that were served, not necessarily what was eaten, according to that summary. That distinction matters for interpretation because the study measured offerings on menus rather than plate waste or individual intake, according to the same description of methods.

### Nutrition content held steady

There was no statistically significant change in the nutrient content of total menu offerings when the menus from before and after the new standards were compared, according to The Vegetarian Resource Group Blog. The nutrition content generally remained consistent across all agencies and programs over the study period, according to the Johns Hopkins University publication record.

These findings suggest that municipal food standards can support greenhouse gas reductions without compromising nutrition, according to the Johns Hopkins University publication record. The results suggest that menu changes that increase the use of whole or minimally-processed plant protein can result in a sizeable reduction in greenhouse gas emissions with little effect on the nutritional quality of the menus, according to The Vegetarian Resource Group Blog.

### How researchers framed the model

The authors framed the work as relevant beyond New York City. The findings offer a model for other jurisdictions seeking to advance both population and environmental health goals, according to the Johns Hopkins University publication record.

The policy context described in the blog summary connects purchasing rules to health aims at more than one level. The 2022 standards revisions were done to promote better individual, community, and environmental health, according to The Vegetarian Resource Group Blog. The revised standards called for reduced use of red and processed meat and cheese alongside greater use of whole or minimally-processed plant protein, according to that summary.

For readers tracking municipal food policy, the timeline is 2008 for establishment, 2022 for revision toward limiting meat and increasing plant-based options, and fiscal year 2019 through fiscal year 2024 for the menu comparison, according to the Johns Hopkins University publication record. The agencies in the comparison together account for 77% of all city meals, according to both the university record and the blog summary. The published analysis appears as a nine-page article in Health Affairs, volume 45, issue 5, in May 2026, according to the university record.

### What the scope does and does not show

The emissions estimate covers entrées, side dishes, and beverages as offered, according to The Vegetarian Resource Group Blog. Production and processing were included in the estimate, according to that summary. Transportation, serving, and waste from served food that was not eaten were not included, according to that summary.

Nutrient content was assessed for total menu offerings, not for a single entrée in isolation, according to the description in The Vegetarian Resource Group Blog. The comparison was between menus from before the new standards and menus from after the new standards, according to that description. No statistically significant change was found in that total-offering comparison, according to the same description.

The center-of-the-plate protein evaluation documented less frequent beef entrées in every agency and more frequent vegetarian entrées in every agency, according to the Johns Hopkins University publication record. PreK-8 schools recorded the 17% beef reduction highlighted in the blog summary, while the acute care program at NYC Health + Hospitals recorded the 52% vegetarian increase, according to that summary.

## Sources referenced
- Menu Changes Under NYC's Revised Food Standards Were Associated With A Reduction In Greenhouse Gas Emissions - Johns Hopkins University (https://pure.johnshopkins.edu/en/publications/menu-changes-under-nycs-revised-food-standards-were-associated-wi/)
- New York City's Food Policy Changes Offer Environmental Benefits - The Vegetarian Resource Group Blog (https://www.vrg.org/blog/2026/05/25/new-york-citys-food-policy-changes-offer-environmental-benefits/)

## FSIS Issues Public Health Alert for Beef Kofta Served at The Kebab Shop

URL: https://nutritionjournal.com/fsis-beef-kofta-kebab-shop-e-coli-alert

FSIS warned on May 24, 2026 that beef kofta served at The Kebab Shop may carry E. coli O157:H7 after 9 California illnesses and positive product samples.

Key takeaways:
- FSIS issued a May 24, 2026 public health alert for beef kofta served at The Kebab Shop over possible E. coli O157:H7 contamination.
- The kofta was raw ground beef made Jan. 6, 2026 by Olympia Foods in Illinois and sent to restaurants in California, Texas and Florida.
- Nine California illnesses with onsets March 27-April 30 were investigated; five hospitalizations and two HUS cases were reported.
- Raw kofta samples tested positive for E. coli O157:H7, with strain comparison testing still underway.
- No recall was issued because the dish was no longer sold after a nationwide May 18 removal.
- Leftovers should be discarded; illness within 10 days after eating the dish warrants medical care.

TL;DR: Federal food safety officials warned diners in California, Texas and Florida about beef kofta previously served at The Kebab Shop after product samples tested positive for *E. coli* O157:H7 during a California illness investigation.

**The U.S. Department of Agriculture's Food Safety and Inspection Service issued a public health alert on May 24, 2026, for beef kofta served at The Kebab Shop restaurant locations over possible contamination with Shiga toxin-producing *E. coli* O157:H7, according to the Food Safety and Inspection Service.**

No recall was requested because the menu item was no longer available for purchase, according to the Food Safety and Inspection Service. The agency said The Kebab Shop had stopped selling beef kofta at every restaurant location on May 18, 2026.

The alert identified the product as raw ground beef produced by Olympia Food Industries, Inc., doing business as Olympia Foods, Establishment 18743, in Franklin Park, Illinois, on January 6, 2026. That production lot was supplied to The Kebab Shop locations in California, Texas and Florida.

Federal officials said the concern emerged during an active outbreak inquiry. The Food Safety and Inspection Service, the California Department of Public Health and local health departments in California were examining a localized cluster involving nine ill people in California. Illness onsets extended from March 27, 2026, to April 30, 2026, as reported through May 24, 2026.

Because reported illnesses were confined to California, the California Department of Public Health was leading the investigation with participation from the Food Safety and Inspection Service. Federal officials said they were continuing to inform federal partners as work proceeded.

Laboratory findings were central to the federal action. The Food Safety and Inspection Service said it collected samples of raw ground beef kofta that returned positive results for *E. coli* O157:H7. Additional analysis was underway to determine whether those product isolates matched the outbreak strain.

The agency said the alert was intended to make sure consumers in the three receiving states knew about the investigation. Contact information was provided for The Kebab Shop and for federal food-safety assistance.

## What prompted the May 24 federal alert

The federal notice described an outbreak-linked product concern rather than a retail recall. Investigators had connected illness interviews, patient testing and product sampling around one restaurant menu item.

According to [the Food Safety and Inspection Service](http://www.fsis.usda.gov/recalls-alerts/fsis-issues-public-health-alert-beef-kofta-products-served-kebab-shop-restaurant), the problem was found through an ongoing illness investigation. Nine California illnesses were under review jointly by federal, state and local agencies.

[Food Safety News](https://www.foodsafetynews.com/2026/05/e-coli-outbreak-linked-to-california-restaurant/) reported on May 22, 2026, that California officials, local health departments and federal partners were investigating an *E. coli* O157:H7 outbreak associated with beef kofta served at several California locations of the chain. That report said interviews with ill people pointed to grilled beef kofta as the likely source.

That earlier state update, summarized by Food Safety News, counted nine California residents infected with the outbreak strain as of May 19, 2026. Reported onsets in that update also spanned March 27 through April 30.

The restaurant company cooperated with investigators and voluntarily paused sales of grilled beef kofta at all locations, Food Safety News reported. The company action date cited by both federal and state accounts was May 18.

## Which product and locations were named

The federal alert gave a single production origin for the implicated kofta. It was characterized as a raw, non-intact ground beef item made January 6, 2026, by Olympia Food Industries in Franklin Park.

The establishment number listed was M18743+P18743, identified in the federal notice as Est. 18743. The company name appeared as Olympia Food Industries, Inc., doing business as Olympia Foods.

Distribution described in the federal notice covered The Kebab Shop restaurant locations in three states: California, Texas and Florida. No retail package or lot code for home purchase was listed because the product was prepared and served in restaurants.

The Kebab Shop said Olympia Foods was no longer its supplier, according to the company's food-safety page. The company said the raw ground beef kofta supplied by Olympia Foods had produced positive *E. coli* testing results obtained by the Agriculture Department.

State investigators said available information indicated the implicated beef had been distributed only to The Kebab Shop, according to Food Safety News. That assessment was described as current information while product testing, case monitoring and source tracing continued.

## How many illnesses were reported

The federal alert listed nine sick people in California. Onset dates ranged from March 27, 2026, to April 30, 2026.

A California Department of Public Health notice summarized by Food Safety News provided additional clinical detail. Six illnesses were in children. Five people had been hospitalized, and two had developed hemolytic uremic syndrome. No deaths had been reported.

No illnesses outside California were linked to the outbreak in the accounts available by May 24. Food Safety News reported that no people from other states were currently linked. The company's May 24 update likewise said both the California Department of Public Health and the Agriculture Department had confirmed no reported cases outside California possibly connected with the event.

The investigation remained open. State officials said they continued to look for the contamination cause, watch for additional ill people and conduct product testing, according to Food Safety News. Federal officials said further testing was underway on the product samples that had tested positive.

## Why officials issued an alert instead of a recall

A recall was not requested because the product was no longer available for purchase, the Food Safety and Inspection Service said. In that circumstance, the agency uses a public health alert to notify consumers who may have already eaten the food or kept leftovers.

The restaurant had already removed the item nationally six days earlier. The May 18 nationwide removal meant the exposure risk was not considered ongoing at the time of the federal notice.

Food Safety News likewise reported that exposure risk was not ongoing. The stated reason was the voluntary pause on grilled beef kofta sales at all locations.

The alert therefore focused on awareness in California, Texas and Florida, the states that received the January production. It asked people who ate the dish and became ill to seek care and asked holders of leftovers to throw them away.

## What *E. coli* O157:H7 can do

*E. coli* O157:H7 is described by federal officials as a potentially deadly bacterium. It can cause dehydration, bloody diarrhea and abdominal cramps two to eight days after exposure, with three to four days the average interval.

Most people recover within a week, the federal notice said. Food Safety News gave a similar recovery range of five to seven days for most patients.

A subset of patients develops hemolytic uremic syndrome, a form of kidney failure. Federal officials said the condition can occur at any age but is most common in children younger than five and in older adults. Warning signs listed included easy bruising, pallor and decreased urine output.

Food Safety News reported that about 5 to 10 percent of people diagnosed with *E. coli* infections develop hemolytic uremic syndrome. Its account listed fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor as symptoms.

Many people with the syndrome recover within a few weeks, but some experience lasting injury or death, according to Food Safety News. The same report said the condition is most common in children younger than five because of immature immune systems, in older adults because of deteriorating immune systems, and in people with compromised immune systems such as cancer patients.

Contaminated food does not look, smell or taste bad, Food Safety News noted. Specific laboratory tests are required for diagnosis, and infection can resemble other illnesses.

People with syndrome symptoms should seek emergency medical care immediately, Food Safety News reported. Hospitalization is likely because the condition can lead to hypertension, chronic kidney disease, brain damage and neurologic problems.

## What diners should do now

Federal officials advised anyone who ate beef kofta from any The Kebab Shop location and develops infection symptoms within 10 days of exposure to contact a health care provider. Consumers should discard any leftover beef kofta obtained from the restaurants.

The agency also restated general ground-beef guidance: cook all ground beef products to an internal temperature of 160 degrees F, checked with a food thermometer. Additional temperature information was referenced at the agency's safe-temperature chart.

The Kebab Shop directed guests to its customer-service line at 888-965-5821 and to FoodSafety@thekebabshop.com, according to the federal notice. The company website listed hours of 9 a.m. to 5 p.m. Pacific time Monday through Friday in one update, and broader Memorial Day weekend availability in its chief executive's message.

Consumers with food-safety questions can call the USDA Meat and Poultry Hotline at 888-MPHotline, or 888-674-6854, or email MPHotline@usda.gov. Problems with meat, poultry or egg products can be reported through the online Electronic Consumer Complaint Monitoring System, available 24 hours daily.

The investigation agencies asked people who ate at the implicated restaurants and developed symptoms to seek medical attention and inform the clinician about possible bacterial exposure, according to Food Safety News. The company asked anyone with symptoms to seek medical attention and contact the California Department of Public Health.

## San Diego Reports Two Cases in Statewide Kebab Shop E. Coli Outbreak

URL: https://nutritionjournal.com/san-diego-kebab-shop-e-coli-outbreak-beef-kofta

San Diego reports two STEC cases in a nine-case California outbreak tied to beef kofta; the dish was pulled May 18 with no deaths reported.

Key takeaways:
- Two San Diego County STEC infections are included in a nine-case California outbreak linked to beef kofta at The Kebab Shop.
- Illness onsets ranged March 27-April 30, 2026; six patients were children and five were hospitalized.
- Two patients developed hemolytic uremic syndrome; no deaths and no out-of-state cases were reported.
- The chain paused grilled beef kofta sales nationwide May 18, and officials say there is no ongoing risk from the product.
- People who ate at the chain March 27-April 30 and develop symptoms within 10 days should contact a provider.
- Leftover grilled beef kofta should be discarded; ground beef should reach 160 degrees internally.

**TL;DR: Two San Diego County STEC infections are part of a nine-case California outbreak linked to beef kofta at The Kebab Shop, and officials say the implicated dish was withdrawn by May 18, 2026.**

## What happened in San Diego County

San Diego County health officials confirmed two local infections with Shiga toxin-producing *E. coli* after meals at local outlets of The Kebab Shop, according to the [San Diego County News Center](https://www.countynewscenter.com/county-reports-two-local-cases-in-statewide-kebab-shop-e-coli-outbreak/).

One of the two local patients required hospital care and has since been discharged. The county did not identify the particular restaurant addresses tied to those illnesses in its May 22, 2026 announcement.

The county notice urged anyone who ate at the chain between March 27 and April 30, 2026, and then developed intestinal illness, to obtain medical care promptly. That exposure window matches the illness-onset range described statewide.

County investigators are addressing the local illnesses jointly with state and federal partners. The county said its Public Health Services Epidemiology unit and its Department of Environmental Health and Quality are participating in the investigation.

## How large is the statewide outbreak

Statewide, nine STEC cases across five California counties have been tied to the chain's beef kofta dish, according to the [San Diego County News Center](https://www.countynewscenter.com/county-reports-two-local-cases-in-statewide-kebab-shop-e-coli-outbreak/).

Six of the nine patients are children. Five people have been hospitalized. Two hospitalized patients developed hemolytic uremic syndrome, described by the county as a serious complication that can injure the kidneys and is sometimes fatal.

No deaths have been reported. No illnesses outside California are currently connected to the outbreak, the county said.

A separate outbreak notice summarized by [Food Safety News](https://www.foodsafetynews.com/2026/05/e-coli-outbreak-linked-to-california-restaurant/) gave the same statewide total as of May 19, 2026, and identified the outbreak strain as *E. coli* O157:H7. Illness-onset dates in that summary also ranged from March 27 through April 30.

## Which food is implicated

Interviews with ill people pointed to grilled beef kofta served at The Kebab Shop as the likely source, according to [NBC 7 San Diego](https://www.nbcsandiego.com/news/local/e-coli-outbreak-linked-multiple-kebab-shop-socal-locations-san-diego/4027789/).

The product is described in state and county reports as seasoned ground-beef kebabs, grilled beef kofta, or the chain's beef kofta dish. Officials said current information suggests the implicated beef product was distributed only to The Kebab Shop.

The California Department of Public Health is leading the investigation. The department said it continues to investigate the cause, monitor for additional ill persons, and conduct product testing.

The Kebab Shop is cooperating fully with public-health officials, county and state reports said. Restaurants inspected as part of the investigation confirmed compliance with health and safety regulations, according to a company statement reported by NBC 7 San Diego.

## Why officials say current risk has ended

The chain voluntarily paused sales of grilled beef kofta at all locations, according to [Food Safety News](https://www.foodsafetynews.com/2026/05/e-coli-outbreak-linked-to-california-restaurant/).

County officials said the restaurant stopped selling the beef dish on or before May 18. Health officials said customers are no longer at risk from eating the product.

Chief Executive Officer Arian Baryalai said the company immediately stopped all sales of ground beef nationwide on May 18, 2026, after the California Department of Public Health linked the product as a potential source, according to [NBC 7 San Diego](https://www.nbcsandiego.com/news/local/e-coli-outbreak-linked-multiple-kebab-shop-socal-locations-san-diego/4027789/).

The company also said there is no ongoing risk associated with the issue. It said all other proteins sold at its restaurants come from different suppliers and are not associated with the issue.

The California Department of Public Health likewise said the risk of exposure to the product is not ongoing at this time. It added that the product had been voluntarily removed nationwide on May 18, 2026.

## Who faces the highest risk

County public health officer Dr. Sayone Thihalolipavan said children, older adults and people with weakened immune systems face the highest risk from STEC infections.

The statewide patient profile underscores that warning. Six of the nine confirmed California illnesses involved children, according to county and state summaries.

Two patients developed hemolytic uremic syndrome. The county described that condition as a serious complication that can cause kidney damage, while the state health department summary reported by NBC 7 San Diego described it as a severe complication that can lead to kidney failure.

Parents and caregivers therefore received particular attention in the county advisory. The county asked people who visited the chain during the March 27 to April 30 period and developed stomach symptoms to seek medical help right away.

## Symptoms and when they appear

STEC symptoms typically begin three to four days after eating or drinking something contaminated with the bacteria, according to the [San Diego County News Center](https://www.countynewscenter.com/county-reports-two-local-cases-in-statewide-kebab-shop-e-coli-outbreak/).

Common symptoms listed by the county include severe abdominal cramps, watery or bloody diarrhea and vomiting. A state summary reported by NBC 7 San Diego similarly listed diarrhea, often bloody, vomiting and abdominal cramps.

Consumers who ate beef kofta from any location of The Kebab Shop and develop symptoms within 10 days were urged to contact a health care provider, according to [NBC 7 San Diego](https://www.nbcsandiego.com/news/local/e-coli-outbreak-linked-multiple-kebab-shop-socal-locations-san-diego/4027789/).

People with these symptoms should contact their health care provider. The county also directed residents to its online information page to learn more about *E. coli*.

## What to do with leftover food

Consumers were advised to discard any leftover grilled beef kofta from the restaurant chain, according to [NBC 7 San Diego](https://www.nbcsandiego.com/news/local/e-coli-outbreak-linked-multiple-kebab-shop-socal-locations-san-diego/4027789/).

That advice applies even if the food looks or smells normal, because contamination cannot be recognized by appearance. The specific recommendation was to throw away remaining portions rather than save or reheat them.

Health officials also reminded consumers to cook ground beef to an internal temperature of 160 degrees. They additionally advised washing and sanitizing surfaces or utensils that may have come into contact with raw or undercooked beef.

Those kitchen steps were presented as general precautions alongside the product-specific instruction to discard leftovers. They do not replace medical advice for someone who already has bloody diarrhea, vomiting or severe cramps.

## How to contact health officials or the company

The Kebab Shop established a guest line at 888-965-5821, available from 10 a.m. to 9 p.m. PT, Monday through Friday, and throughout the Memorial Day weekend, May 23-24, 2026, according to [NBC 7 San Diego](https://www.nbcsandiego.com/news/local/e-coli-outbreak-linked-multiple-kebab-shop-socal-locations-san-diego/4027789/).

Guests may also write to FoodSafety@thekebabshop.com. The company said it is closely coordinating with public-health authorities.

At the county level, the Epidemiology unit and Department of Environmental Health and Quality are working with state and federal health officials on the local investigation. The California Department of Public Health said it and partner agencies continue to investigate, monitor for additional illnesses and conduct product testing.

Anyone with symptoms after eating beef kofta at the chain was asked to contact a health care provider. Prompt care is especially important for children, older adults and people with weakened immune systems.

## Where the restaurants operate

The Kebab Shop opened its first location in downtown San Diego in 2007, according to its website as reported by [NBC 7 San Diego](https://www.nbcsandiego.com/news/local/e-coli-outbreak-linked-multiple-kebab-shop-socal-locations-san-diego/4027789/).

The chain has multiple locations throughout San Diego County, from East Village to San Marcos. State reports linked seasoned ground-beef kebabs served at multiple California locations in Southern and Northern California.

The company also has multiple locations in Orange and Los Angeles counties and the Bay Area. The county report did not specify which San Diego County outlets were associated with the two local infections.

Officials said interviews indicated grilled beef kofta served at The Kebab Shop was the likely outbreak source. The investigation remains open while agencies identify the cause and watch for additional cases.

## CDPH Investigates E. coli Outbreak Linked to Beef Kofta at The Kebab Shop

URL: https://nutritionjournal.com/cdph-e-coli-outbreak-beef-kofta-kebab-shop

California officials link nine E. coli O157:H7 illnesses to The Kebab Shop beef kofta; chain paused sales May 18 as testing continues.

Key takeaways:
- CDPH announced May 22, 2026 investigation of nine E. coli O157:H7 infections with onsets March 27-April 30.
- Six illnesses were in children; five people were hospitalized and two developed hemolytic uremic syndrome.
- Grilled beef kofta at The Kebab Shop was identified as the likely source after patient interviews.
- The Kebab Shop paused grilled beef kofta sales at all locations on May 18, 2026 and is cooperating.
- Officials said exposure risk was not ongoing and the implicated beef was believed distributed only to the chain.
- Consumers should seek care if ill within 10 days of eating beef kofta and discard leftovers.

## TL;DR: Nine STEC illnesses linked to beef kofta, sales paused May 18

**TL;DR: California health officials announced May 22, 2026, that nine residents were infected with Shiga toxin-producing E. coli O157:H7 linked to grilled beef kofta at The Kebab Shop, and the chain paused sales of the product on May 18, 2026.**

The California Department of Public Health announced Friday that it is investigating an E. coli outbreak linked to seasoned ground beef kebabs served at multiple locations of The Kebab Shop in Southern and Northern California, according to MyNewsLA.com. The department said nine California residents have been infected with the outbreak strain of Shiga toxin-producing E. coli O157:H7, commonly known as STEC. Illness onset dates ranged from March 27 through April 30. As of May 19, 2026, those nine residents remained the confirmed case count, according to Food Safety News. No deaths have been reported. No individuals from other states are currently linked to the outbreak.

## Nine confirmed cases, including six children

Six of the nine illnesses involved children, according to MyNewsLA.com. Five people were hospitalized. Two developed hemolytic uremic syndrome, a severe complication that can lead to kidney failure. No deaths have been reported.

The age pattern places children at the center of this investigation. Six children among nine patients represents two-thirds of confirmed infections. Five hospitalizations among nine patients represents more than half of confirmed infections. Two cases of hemolytic uremic syndrome represent severe outcomes within a small cluster.

County-level detail shows two of the nine California residents were infected after eating at San Diego County locations, according to NBC 7 San Diego. One of those two victims was hospitalized but has since been released. Currently, no cases outside California are connected to the outbreak, the County said.

## Illness window ran March 27 through April 30

Illness onset dates ranged from March 27 through April 30, according to MyNewsLA.com. The earliest illness began March 27. The latest started April 30. That window covers more than one month of potential exposures.

California public health officials are working with local health departments and federal partners to investigate the outbreak, according to Food Safety News. The state health department and partner agencies continue to investigate to identify the cause of the outbreak, monitor for additional ill persons, and conduct product testing. Current information suggests the implicated beef product was distributed only to The Kebab Shop.

## Grilled beef kofta identified as likely source

Health officials said interviews with infected individuals indicated grilled beef kofta served at The Kebab Shop was the likely source of the outbreak, according to MyNewsLA.com. The product is described as seasoned ground beef kebabs. Health officials also described it as grilled beef kofta.

Investigators reached that determination after interviewing people who became sick, according to KTLA. Interviews with ill individuals indicated that grilled beef kofta served at The Kebab Shop is the likely outbreak source. The Kebab Shop is fully cooperating with public health officials.

The product link spans Southern and Northern California locations. California health officials announced Friday they are investigating an outbreak linked to seasoned ground beef kebabs served at multiple locations of the chain in Southern and Northern California, according to MyNewsLA.com. The Kebab Shop has multiple locations throughout San Diego County, from East Village to San Marcos, according to NBC 7 San Diego. The chain also has multiple locations in Orange and Los Angeles Counties and the Bay Area.

## Chain paused sales nationwide on May 18

The restaurant chain voluntarily paused sales of grilled beef kofta at all locations Monday and is cooperating with the investigation, according to the California Department of Public Health as reported by MyNewsLA.com. CDPH said the chain voluntarily paused sales of grilled beef kofta at all locations on May 18, according to KTLA.

The company said it immediately stopped all sales of ground beef, described as beef kofta, nationwide on May 18, 2026, after CDPH linked the product as a potential source of the outbreak, according to KTLA. The company said that as a result, there is no ongoing risk associated with this issue. The company said all other proteins sold at The Kebab Shop come from different suppliers and are not associated with this issue. The company said restaurants inspected as part of the investigation confirmed their compliance with all health and safety regulations.

CEO Arian Baryalai issued a statement, according to NBC 7 San Diego. Baryalai said the company immediately stopped all sales of ground beef nationwide on May 18, 2026, after CDPH linked the product as a potential source. Baryalai said there is no ongoing risk associated with this issue. Baryalai said all other proteins sold at the chain come from different suppliers and are not associated with this issue. Baryalai said restaurants inspected as part of the investigation confirmed compliance with health and safety regulations.

## Officials say exposure risk is not ongoing

“The risk of exposure to this product is not ongoing at this time,” the department said in a statement reported by MyNewsLA.com. While the investigation is ongoing, current information suggests the implicated beef product was distributed only to The Kebab Shop. CDPH and partner agencies continue to investigate to identify the cause, monitor for additional ill persons, and conduct product testing.

The Kebab Shop posted a statement to its website listing actions taken since learning of the outbreak, according to KTLA. Those listed actions included stopping all sales of ground beef nationwide on May 18, 2026. Those listed actions included a statement that there is no ongoing risk associated with the issue. Those listed actions included a statement that all other proteins come from different suppliers and are not associated with the issue. Those listed actions included a statement that inspected restaurants confirmed compliance with health and safety regulations.

## What San Diego County reported

Two of nine California residents were infected with STEC after eating at San Diego County locations of The Kebab Shop, according to NBC 7 San Diego. One of those victims was hospitalized but has since been released. County health officials are urging anyone who ate at The Kebab Shop between March 27 and April 30, 2026, and later became ill with stomach illness to get medical care right away, according to the San Diego County News Center tag page for E. coli.

Consumers who ate beef kofta from any location of The Kebab Shop and develop symptoms within 10 days were urged to contact a health care provider, according to NBC 7 San Diego. Consumers also were advised to discard any leftover grilled beef kofta from the restaurant chain.

## Where The Kebab Shop operates

The Kebab Shop opened its first location in downtown San Diego in 2007, according to its website as reported by NBC 7 San Diego. The restaurant chain, headquartered in Poway, operates locations across California, according to Los Angeles Patch. The chain operates more than a dozen locations across California, according to FOX40.com.

Southern California locations listed by KTLA include Atwater Village at 2921 Los Feliz Blvd., Burbank at 515 N. Hollywood Way, Cerritos at 11529 South St., El Segundo at 460 N Pacific Coast Hwy, Encino at 17401 Ventura Blvd., Northridge at 19545 Nordhoff St., Ste 70, Santa Clarita at 19013 Golden Valley Rd., Ste 105, Torrance at 21211 Hawthorne Blvd., and Westlake Village at 3980 E. Thousand Oaks Blvd. Orange County locations listed by KTLA include Brea at 3405 E. Imperial Highway, Bldg. F, Costa Mesa at 1555 Adams Avenue, Cypress at 5247 Katella Ave., Ste. 160, Harvard Place in Irvine at 17655 Harvard Avenue, La Habra at 1401 W. Imperial Hwy, Ste. A, Los Olivos at 8687 Irvine Center Drive, Seal Beach at 12430 Seal Beach Blvd. #240, and Walnut Village in Irvine at 14431 Culver Drive.

## Symptoms to watch within 10 days

Symptoms of STEC infection can include diarrhea, often bloody, vomiting and abdominal cramps, according to MyNewsLA.com. Symptoms generally begin three to four days after infection, according to CDPH as reported by MyNewsLA.com. Consumers should call their health care provider if they become sick with symptoms of STEC infection, including diarrhea, vomiting and stomach cramps, within 10 days of eating the product, according to KTLA.

Food Safety News reported that food contaminated with E. coli does not look, smell or taste bad. Anyone who ate at the implicated restaurants and developed symptoms should seek medical attention and tell their doctor about possible exposure. Specific tests are required to diagnose the infections, which can mimic other illnesses. Symptoms often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications.

## Why HUS matters for children and vulnerable groups

About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication known as hemolytic uremic syndrome, according to Food Safety News. Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. Many people with HUS recover within a few weeks, but some suffer permanent injuries or death.

This condition can occur among people of any age but is most common in children younger than five years old because of their immature immune systems, older adults because of deteriorating immune systems, and people with compromised immune systems such as cancer patients, according to Food Safety News. People who experience HUS symptoms should immediately seek emergency medical care. People with HUS will likely be hospitalized because the condition can cause other serious and ongoing problems such as hypertension, chronic kidney disease, brain damage, and neurologic problems.

## What to discard and how to handle ground beef

Consumers also were advised to discard any leftover grilled beef kofta from the restaurant chain, according to MyNewsLA.com. Health officials also reminded consumers to cook ground beef to an internal temperature of 160 degrees. Health officials also reminded consumers to wash and sanitize surfaces or utensils that may have come into contact with raw or undercooked beef.

The Kebab Shop is closely coordinating with public health authorities and established a number for guests to call at 888-965-5821 from 10 a.m. to 9 p.m. PT, Monday through Friday, and throughout the Memorial Day weekend, May 23–24, 2026, according to Los Angeles Patch. Guests may also email FoodSafety@thekebabshop.com, according to NBC 7 San Diego. Baryalai said the company is closely coordinating with public health authorities.

## Investigation continues with product testing

CDPH and other agencies continue to investigate the outbreak and are monitoring for additional people who may have fallen ill, according to KTLA. The agencies continue work to identify the cause of the outbreak, monitor for additional ill persons, and conduct product testing, according to MyNewsLA.com. The Kebab Shop did not immediately respond to a request for comment from MyNewsLA.com, while separate statements from CEO Arian Baryalai were later published by NBC 7 San Diego and Los Angeles Patch describing cooperation, the May 18 sales pause, and a single-supplier link for ground beef previously used at restaurants.

## Sources referenced
- Health Officials Investigating Kebab Shop E. Coli Outbreak - MyNewsLA.com (https://mynewsla.com/orange-county/2026/05/22/health-officials-investigating-kebab-shop-e-coli-outbreak/)
- E. coli outbreak linked to California restaurant - Food Safety News (https://www.foodsafetynews.com/2026/05/e-coli-outbreak-linked-to-california-restaurant/)

## FDA FSANS Survey Tracks Food Safety and Nutrition Habits

URL: https://nutritionjournal.com/fda-food-safety-nutrition-survey-fsans-explained

FDA's FSANS national probability survey tracks U.S. food safety and nutrition knowledge and behavior to guide regulation and education.

Key takeaways:
- FSANS is FDA's national probability survey on food safety and nutrition knowledge, attitudes and practices.
- Results are used to monitor views, track changes and develop education and risk-management decisions.
- Households are randomly selected from U.S. residential addresses; participation is voluntary and takes 15-20 minutes.
- The survey is sponsored by FDA, conducted by Westat, approved by OMB as 0910-0345.
- UK tracking in early 2026 showed 23% worried about affording food and 91% concerned about prices.
- Industry data from May 2026 show 24-hour traceability expectations and 70% planning automation investment.

TL;DR: The FDA's Food Safety and Nutrition Survey (FSANS) is the national probability survey tracking U.S. consumer knowledge, attitudes and practices on food safety and nutrition to guide regulation and education.

## What FSANS is and why FDA runs it

The Food Safety and Nutrition Survey (FSANS) is described by the Food and Drug Administration as a national probability consumer survey designed to assess awareness, knowledge, understanding and self-reported behaviors on food safety and nutrition topics, according to the Food Safety and Nutrition Survey (FSANS) page.

Findings are intended to help FDA make better-informed regulatory, education and other risk-management decisions aimed at promoting and protecting public health, according to the same Food Safety and Nutrition Survey (FSANS) page.

The agency calls FSANS the primary source of information in the nation about food safety and nutrition knowledge, attitudes and practices, according to the Food Safety and Nutrition Survey (FSANS) page. The survey helps the Food and Drug Administration develop educational materials and programs to better serve the American people.

Information provided by respondents will be used to monitor views about food and nutrition, according to the Food Safety and Nutrition Survey (FSANS) page. It will also be used to track changes in knowledge, attitudes and practices related to food and nutrition.

A third stated use is to develop new food safety and nutrition educational programs, according to the Food Safety and Nutrition Survey (FSANS) page. Together, monitoring, tracking change and program development form the policy loop for the Human Foods Program.

## How households are chosen and what participation means

Addresses for FSANS were randomly selected from a list of all residential mailing addresses in the nation, according to the Food Safety and Nutrition Survey (FSANS) page. Selection used scientific sampling methods to represent households in the United States.

The chances of being selected are described as small, according to the Food Safety and Nutrition Survey (FSANS) page. Once selected, a household represents thousands of other households like it, because everyone cannot be included.

Answers and opinions are described as very important to the success of the survey, according to the Food Safety and Nutrition Survey (FSANS) page. Representation is the reason a single completed questionnaire carries weight for similar households.

Participation is voluntary, according to the Food Safety and Nutrition Survey (FSANS) page. A person may choose not to answer any or all questions, and there are no penalties for not participating.

The survey will take 15 to 20 minutes to respond, according to the Food Safety and Nutrition Survey (FSANS) page. That time estimate frames the burden for invited households considering the request.

Answers will be kept private under the Privacy Act, according to the Food Safety and Nutrition Survey (FSANS) page. Answers cannot be linked to information that could identify a person or household and will be kept secure to the extent permitted by law.

## Sponsor, contractor and federal approval

The Food and Drug Administration is sponsoring the survey, according to the Food Safety and Nutrition Survey (FSANS) page. Westat has been contracted to conduct the survey.

The survey has been approved by the Office of Management and Budget, the office that reviews all federally sponsored surveys, according to the Food Safety and Nutrition Survey (FSANS) page. The approval number assigned is 0910-0345.

A name provided for the survey will not be sold to any third-party organizations, according to the Food Safety and Nutrition Survey (FSANS) page. That assurance appears alongside the federal approval information.

Westat is identified as a research company located in Bethesda, Maryland, according to the Food Safety and Nutrition Survey (FSANS) page. Westat is conducting the survey under contract to the U.S. Food and Drug Administration.

Questions about the survey can go to Westat toll-free at 1-833-307-2550 or at FDAfoodstudy@westat.com, according to the Food Safety and Nutrition Survey (FSANS) page. The page presents the same contact and approval details in Spanish for Spanish-language readers.

The Spanish-language section identifies the survey as Encuesta sobre la seguridad de los alimentos y la nutrición and repeats the purpose, uses, sampling, voluntary status, privacy, 15 to 20 minute timing, sponsor, contractor, approval number 0910-0345 and Bethesda location, according to the Food Safety and Nutrition Survey (FSANS) page. Inclusion of that section extends the invitation and instructions to Spanish-speaking households.

## Why survey methods matter for nutrition conclusions

Survey wording, coding and weighting shape what agencies can claim about consumers, a point underscored by new methods work shared on May 21, 2026. Westat researcher Emily Diaz, PhD, Senior Research Associate for Education and Social Policy, is lead author of an article on increasing generalizability of open-ended survey item responses, according to the Westat article Drawing Reliable Data From Open-Ended Responses.

The article appeared in Practical Assessment, Research, and Evaluation (PARE) and tackles how to draw reliable, population-level conclusions from open-ended responses, according to Drawing Reliable Data From Open-Ended Responses. Open-ended responses can offer rich, unanticipated insights, but text format makes them difficult to analyze and generalize, especially when higher burden leads to more skipped questions.

Authors present a practical method for coding open-ended responses into numerical data and applying survey weights to improve representativeness, according to Drawing Reliable Data From Open-Ended Responses. Demonstrated in a stratified random sample with nonresponse, the approach helps account for bias while preserving qualitative value.

That methods context is relevant because FSANS asks about awareness, understanding and self-reported behaviors, where respondents may use their own words, and because FSANS itself uses scientific probability sampling with weighting logic implied by representation claims. The Westat methods note provides guidance for more rigorous and generalizable use of open-ended findings and for bridging qualitative insight and quantitative inference.

## What the UK tracker shows about affordability and risk behavior

A parallel consumer monitoring effort in the United Kingdom illustrates the kinds of trends FSANS is built to detect over time. The Consumer Insights Tracker is an online monthly tracking survey commissioned by the Food Standards Agency, monitoring behavior and attitudes of consumers aged 16 and over in England, Wales and Northern Ireland, according to Consumer Insights Tracker (January 2026 – March 2026).

Each month the survey is conducted with approximately 2,000 consumers, according to Consumer Insights Tracker (January 2026 – March 2026). The report presents findings for January to March 2026 for regularly tracked topics including concerns, affordability and trust, plus precision breeding in March and precision fermentation in February.

Almost one in four respondents, 23%, were worried about being able to afford food in March 2026, according to Consumer Insights Tracker (January 2026 – March 2026). That was comparable with January at 21%, but slightly higher than February at 19%.

Eating food past its use-by date at 64% in March and eating leftovers kept for over two days at 60% in March were the most commonly reported money-saving behaviors across the quarter, according to Consumer Insights Tracker (January 2026 – March 2026). Eating leftovers after two days was reported more frequently in January at 68%, when respondents were referring to behavior in December.

In March 2026, food prices at 91% remained the top concern, followed by ultra-processed food at 77% and food waste in the food chain at 77%, according to Consumer Insights Tracker (January 2026 – March 2026). The ranking places price well above other food issues.

The proportion reporting seeing or hearing information about recalls, contamination incidents and poisoning outbreaks increased in February 2026 compared with other months in the quarter, according to Consumer Insights Tracker (January 2026 – March 2026). For example, 44% said they had heard about recalls, versus 34% in January.

In March 2026, 13% had heard of precision breeding, but only 5% reported knowing what it is, according to Consumer Insights Tracker (January 2026 – March 2026). That was slightly lower than September 2025 at 16%, but comparable with March 2025 at 13%.

In February 2026, 20% had heard of precision fermentation before and 15% had heard of precision-fermented dairy, according to Consumer Insights Tracker (January 2026 – March 2026). Over two in five, 44%, were unwilling to include it in their diet, compared with 26% willing, broadly in line with August 2025.

Method details show 2,201 people took part in January from the 2nd to the 5th, 2,170 in February from the 6th to the 9th and 2,101 in March from the 6th to the 9th across England, Wales and Northern Ireland, according to Consumer Insights Tracker (January 2026 – March 2026). Research was conducted online using the YouGov panel with access to 400,000 active panel members in the UK, with quotas by age, gender, social grade, education and region and weighting to be representative, with differences assessed by t-tests where p is less than 0.05.

## What industry data add on traceability and capacity

On the supply side, a May 19, 2026 industry survey highlights why consumer surveillance and facility controls are being discussed together. CRB Group released its 2026 Horizons: Food Safety report based on responses from more than 300 North American food and beverage manufacturers, according to the CRB Horizons Report Reveals Food and Beverage Manufacturers release.

The report highlights a shift from fragmented, paper-based systems to real-time, end-to-end digital traceability driven by Food Safety Modernization Act Section 204, according to the CRB Horizons Report Reveals Food and Beverage Manufacturers release. Manufacturers are now expected to produce traceability data within 24 hours of a regulatory request.

More than 70% of respondents say they plan to invest in automation and control systems over the next three years, according to the CRB Horizons Report Reveals Food and Beverage Manufacturers release. Compared with last year, a growing share now expect it will take more than four years to reach target automation levels.

Horizons: Food Safety is described as CRB's annual industry report, now in its sixth year, covering priorities, challenges and strategies, according to the CRB Horizons Report Reveals Food and Beverage Manufacturers release. The 2026 edition covers company sizes from emerging brands to global enterprises and is available as a free download.

For nutrition readers, the link is practical: consumer surveys capture handling, affordability pressures and awareness gaps, while traceability and hygienic design determine how quickly a hazard can be located and removed. FSANS supplies the consumer-behavior side of that equation for U.S. regulators and educators.

Households invited to FSANS are therefore asked to treat the 15 to 20 minute questionnaire as the mechanism by which their views enter regulatory, education and risk-management decisions, according to the Food Safety and Nutrition Survey (FSANS) page. Participation remains voluntary and private, but each response stands in for thousands of similar homes.

## Low HALP nutrition index tied to higher mortality in NHANES cohort

URL: https://nutritionjournal.com/low-halp-nutrition-index-tied-to-higher-mortality-in-nhanes-cohort

Low HALP scores tracked higher death risk in 10,770 NHANES adults, with high metabolic burden plus low HALP carrying the highest risk.

Key takeaways:
- Lower HALP was linked to higher all-cause mortality in 10,770 NHANES adults.
- Middle and highest HALP tertiles had adjusted HRs of 0.78 and 0.86 versus lowest.
- Ten-year mortality was 15.4% in lowest HALP group versus 11.8% and 12.2%.
- High cMetS plus low HALP had highest joint mortality estimates.
- HALP added modest discrimination: Harrell's C 0.8666 to 0.8685.
- External cohort supported all-cause link but was limited for cardiovascular deaths.

## TL;DR

**TL;DR: Among 10,770 United States adults followed through 31 December 2019, lower hemoglobin-albumin-lymphocyte-platelet (HALP) scores tracked higher all-cause mortality after accounting for continuous metabolic syndrome score (cMetS).**

A study published in Frontiers in Nutrition on 20 May 2026 reported that adults in the lowest HALP tertile carried a 15.4% ten-year mortality risk, compared with 11.8% and 12.2% in the middle and highest tertiles, according to Frontiers | HALP, a routine nutrition-inflammation index, and mortality across the cMetS spectrum: NHANES with supportive external cohort evidence.

## A routine index tested across metabolic burden

Researchers Keting Deng, Yang Yao, Biping Cheng and Xuan Wang examined whether HALP added prognostic information beyond cMetS, according to Frontiers | HALP, a routine nutrition-inflammation index, and mortality across the cMetS spectrum: NHANES with supportive external cohort evidence.

Deng was affiliated with the Department of Clinical Laboratory at The First Affiliated Hospital of Xi'an Medical University in Xi'an, Shaanxi, China.

Yao was affiliated with the Department of Critical Care Medicine at The First Affiliated Hospital of Xi'an Medical University.

Cheng was affiliated with the Department of Functional Examination at The First Affiliated Hospital of Xi'an Medical University.

Wang, the corresponding author, was affiliated with the Department of Cardiovascular Medicine (VIP Ward) at Yan'an University Xianyang Hospital in Xianyang, Shaanxi, China.

The background premise was that cMetS quantifies cardiometabolic burden but may not fully capture systemic vulnerability related to nutrition, immunity and thrombo-inflammation.

The investigators therefore evaluated HALP, described as a hemoglobin-albumin-lymphocyte-platelet index, across the cMetS spectrum.

HALP was framed as an inexpensive routine index derived from routine laboratory tests.

The authors concluded that HALP was independently and nonlinearly associated with mortality across the cMetS spectrum and provided modest prognostic information beyond cMetS.

They further concluded that HALP may complement metabolic burden assessment by identifying systemic vulnerability.

## Who was studied and for how long

The primary analysis included 10,770 participants aged 20 years or older from NHANES 1999–2010.

Participants were followed through 31 December 2019 for mortality outcomes.

The design used survey-weighted Cox regression with restricted cubic splines, adjusting for cMetS and covariates.

Additional analyses included absolute risk estimation, joint HALP-cMetS classification, Harrell's C statistic, decision curve analysis, competing-risk models and supportive external cohort analysis.

Baseline characteristics were presented according to survey-weighted cMetS tertiles in NHANES 1999–2010.

Associations of HALP tertiles with all-cause mortality and cardiovascular mortality in NHANES 1999–2010 were presented in a dedicated results table.

The external cohort component was described as supportive rather than primary, with particular limits for cardiovascular mortality.

## What HALP and cMetS represent

HALP integrates indices of oxygen carrying capacity, nutritional and inflammatory status, immune competence and thrombo-inflammatory activity, according to the study background.

Its components are hemoglobin, albumin, lymphocyte and platelet measures obtained from routine laboratory tests.

The report noted that HALP is not yet a widely established clinical risk score, while describing it as inexpensive, routinely available and biologically integrative.

That profile was presented as the rationale for population-based risk assessment research involving HALP.

cMetS was developed to integrate multiple metabolic components into a single quantitative metric.

It captures continuous variation in waist circumference, blood pressure, lipid levels and glucose metabolism.

The study noted that traditional clinical definitions of metabolic syndrome are dichotomous and threshold based.

By contrast, cMetS was described as providing a more refined assessment of metabolic dysregulation and facilitating evaluation of graded associations in population studies.

The authors noted that prognosis varies considerably even among individuals with similar cMetS levels.

That residual heterogeneity was interpreted as indicating that systemic factors beyond conventional metabolic burden contribute to individual risk.

## Lower HALP linked to higher all-cause mortality

Among the 10,770 participants, lower HALP was associated with higher all-cause mortality.

Compared with the lowest HALP tertile, the adjusted hazard ratio was 0.78 with a 95% confidence interval of 0.69–0.88 for the middle tertile.

Compared with the lowest HALP tertile, the adjusted hazard ratio was 0.86 with a 95% confidence interval of 0.77–0.95 for the highest tertile.

Those estimates were adjusted for cMetS and covariates in survey-weighted Cox regression.

The association was described as nonlinear and L-shaped in restricted cubic spline analysis.

The pattern indicated elevated risk concentrated at the lower end of the HALP distribution rather than a uniform gradient across all values.

The all-cause mortality association persisted after adjustment for cMetS.

The investigators therefore described HALP as independently associated with mortality across the cMetS spectrum.

## Absolute ten-year risk differed by HALP group

Ten-year mortality risk was highest in the lowest HALP tertile at 15.4%.

Ten-year mortality risk was 11.8% in the middle HALP tertile.

Ten-year mortality risk was 12.2% in the highest HALP tertile.

The absolute difference between the lowest and middle groups was 3.6 percentage points.

The absolute difference between the lowest and highest groups was 3.2 percentage points.

Those absolute-risk estimates complemented the relative hazard ratios reported for the middle and highest tertiles versus the lowest tertile.

The absolute-risk analysis was one of the additional evaluations beyond the main Cox models.

It placed the adjusted associations in terms of ten-year mortality risk by HALP tertile.

## Combined high metabolic burden and low HALP

Participants with high cMetS and low HALP had the highest risks in joint HALP-cMetS classification.

For all-cause mortality, that combined group had a hazard ratio of 1.32 with a 95% confidence interval of 1.15–1.52.

For cardiovascular mortality, that combined group had a hazard ratio of 1.56 with a 95% confidence interval of 1.16–2.09.

The joint classification directly addressed whether combining HALP with metabolic burden identified higher-risk subgroups.

The highest all-cause risk occurred where elevated continuous metabolic burden coincided with depressed nutrition-inflammation reserve.

The highest cardiovascular risk in the main joint model also occurred in that same high-cMetS and low-HALP stratum.

Those joint estimates were central to the conclusion that HALP may complement cMetS by identifying systemic vulnerability.

## How much prediction improved

Adding HALP modestly improved discrimination beyond cMetS and covariates.

Harrell's C statistic moved from 0.8666 to 0.8685 after inclusion of HALP.

The change in discrimination, ΔC, was 0.0018.

Decision curve analysis showed modest net benefit with HALP added.

The authors characterized both the discrimination gain and the net benefit as modest.

That wording indicates incremental rather than transformative prognostic information beyond cMetS and covariates.

The discrimination analysis tested whether HALP provides prognostic value beyond cMetS.

The reported ΔC of 0.0018 quantifies the magnitude of that incremental improvement.

## Cardiovascular mortality needed cautious reading

Competing-risk analyses attenuated cardiovascular mortality associations.

That attenuation means the cardiovascular signal was less robust when competing risks were modeled.

A supportive external cohort analysis supported the all-cause mortality association.

The same supportive external cohort analysis was described as limited for cardiovascular mortality.

The overall interpretation therefore rests more firmly on all-cause mortality than on cardiovascular mortality.

The study presentation retained the joint high-cMetS and low-HALP cardiovascular hazard ratio of 1.56 while reporting the competing-risk attenuation.

Readers focused on nutrition and heart health should treat the cardiovascular component as supportive rather than definitive.

## Context from a related nutrition-inflammation index

A separate NHANES-based report published 20 May 2026 examined the C-reactive protein–albumin–lymphocyte (CALLY) index and prevalent diabetes, according to Association between the CALLY index as an integrated nutritional biomarker and diabetes prevalence in the NHANES population study.

That cross-sectional analysis included 38,722 participants in NHANES 1999–2010.

Higher CALLY levels were associated with lower diabetes prevalence after adjustment for multiple covariates.

Participants in the highest CALLY quartile had 28% lower odds of prevalent diabetes, with an odds ratio of 0.72 and 95% confidence interval of 0.62–0.84, compared with those in the lowest quartile.

Restricted cubic spline analysis identified an inverse nonlinear relationship with an inflection point at 29.613.

The authors stated that the inflection point describes the observed nonlinear pattern in that dataset but should not be interpreted as a clinically actionable cutoff.

They also stated that the predictive and clinical value of CALLY require prospective validation.

That CALLY report does not establish HALP outcomes, but it documents parallel research interest in composite nutrition-immune-inflammation indicators within the same NHANES 1999–2010 era.

## What this means for nutrition monitoring

The HALP analysis did not test a diet, supplement or feeding intervention.

It tested a laboratory composite reflecting hemoglobin, albumin, lymphocyte and platelet information.

The relevant population was general adults aged 20 years or older, not only patients with coronary heart disease or acute myocardial infarction.

Prior studies cited in the report had linked lower HALP to higher all-cause and cardiovascular mortality in coronary heart disease and acute myocardial infarction populations.

The new contribution was evaluation in a broader adult population with continuous quantification of metabolic burden.

For consumers, the practical implication is that routine laboratory measures reflecting nutrition, immunity and thrombo-inflammation may carry prognostic context alongside metabolic measures.

For clinicians and researchers, the implication is that low HALP alongside high cMetS identified the stratum with the highest all-cause and cardiovascular estimates in the main joint model.

Any clinical use would still require prospective validation and establishment of HALP as a clinical risk score, which the authors noted is not yet widely established.

## Pulse Diet Edges Pork in Aging Trial on Fat and Iron

URL: https://nutritionjournal.com/prodmed1-pulse-diet-aging-biomarkers

In PRODMED1, 47 adults over 60 followed DGA-aligned pulse and pork diets for 8 weeks each; both improved metabolic markers, with extra pulse benefits for fat distribution and ferritin.

Key takeaways:
- 47 adults aged 60+ followed DGA-aligned pulse and lean-pork diets for 8 weeks each in the PRODMED1 crossover.
- Both diets improved glucose and lipid markers except HDL and lowered CRP, with no between-diet difference.
- Pulse diet reduced visceral-to-total-fat ratio more than the pork diet.
- Pulse diet raised ferritin by 15.7 ng/mL vs 7.0 ng/mL on pork diets.
- TMAO did not change; biogenic amine profiles differed between diets.

**TL;DR: In adults aged 60 and older, eight weeks on either a pulse-protein diet or a lean-pork-protein diet built to match the Dietary Guidelines for Americans improved blood-sugar and lipid markers, while the pulse version lowered the visceral-to-total-fat ratio more and raised ferritin more.**

## A direct test of protein source inside a healthy eating pattern

The question was whether the main protein food matters when the rest of the diet already meets national guidance.

According to Clinical Nutrition ESPEN, investigators created two versions of a high-quality eating pattern aligned with the Dietary Guidelines for Americans, known as the DGA.

One version centered on pulses, called the pulse-protein diet or PPD. The other centered on meat, called the meat-protein diet or MPD.

Both versions were designed to study cardiometabolic and iron-related measures described as relevant to aging in later life, according to the Nutrition Evidence Database summary of the work.

The background idea was that eating patterns built around pulses supply relatively little methionine, and limits on that amino acid have been connected in prior work with better metabolic health and longer life, according to Clinical Nutrition ESPEN.

The investigators therefore compared the pulse-protein and meat-protein approaches head to head, rather than comparing a healthy diet with an ordinary diet.

The report identifies the project as Protein-Distinct Macronutrient-Equivalent Diet 1, or PRODMED1.

The authors are listed as Bruna O de Vargas, Saba Vaezi, Lee Weidauer, Wade M Sanders and Moul Dey.

Their affiliations are given as the School of Health and Human Sciences at South Dakota State University in Brookings and the CLASS Laboratory in the Department of Epidemiology at the University of Michigan School of Public Health in Ann Arbor.

Funding is listed as coming from the National Institute of Food and Agriculture.

The paper appeared in Clinical Nutrition ESPEN with publication dating of May 19, 2026.

## How the two feeding periods were constructed

Each participant was asked to follow both diets in turn.

According to the Nutrition Evidence Database, participants consumed the meat-protein diet and the pulse-protein diet for eight weeks each.

The two eight-week feeding periods were separated by a washout interval of at least two weeks, according to Clinical Nutrition ESPEN.

The daily amount of the featured protein food was specified. The meat-protein diet supplied 162 grams per day of lean pork, while the pulse-protein diet supplied 331.6 grams per day of pulses, according to the Nutrition Evidence Database.

Those featured foods were not small additions. They supplied at least 45% of total dietary protein in each period, according to Clinical Nutrition ESPEN.

The two menus were built to be equivalent in overall energy, macronutrients and total iron.

They were intentionally different in heme iron and methionine, according to the Nutrition Evidence Database.

That design let researchers separate the effect of protein source from differences in calories, major nutrients or total iron intake.

The analysis used robust linear mixed-effects models with adjustment for covariates, according to Clinical Nutrition ESPEN.

## Who completed the crossover

The trial enrolled Midwestern adults aged 60 years or older.

Forty-seven people finished both feeding periods, according to the Nutrition Evidence Database.

Seventy-two percent of those completing the trial were women.

The mean age was 69.2 years with a standard deviation of 6.6 years, according to the Nutrition Evidence Database.

Mean body mass index at entry was 28.6 kilograms per square meter with a standard deviation of 5.4, according to the same summary.

The crossover structure meant that the same older adults experienced both the lean-pork period and the pulse period, with a washout between them.

## What improved no matter which protein was emphasized

The prespecified primary outcomes were ferritin, fasting blood glucose and trimethylamine N-oxide, known as TMAO.

Secondary outcomes included inflammation, body composition, lipid-related cardiovascular-risk markers and circulating biogenic amines, according to Clinical Nutrition ESPEN.

Across both diet periods, markers of glucose and lipid metabolism improved, with the exception of high-density lipoprotein, according to the Nutrition Evidence Database.

Each of those improvements reached the p-less-than-0.05 threshold within diets, with no significant difference between diets, according to the same source.

In other words, the pulse-protein and meat-protein versions produced similar changes in those blood-sugar and lipid measures.

Inflammation measured by C-reactive protein, or CRP, also fell during both diets, according to Clinical Nutrition ESPEN.

The decline in CRP reached p-less-than-or-equal-to-0.001 in both groups, again with no significant difference between diets, according to the Nutrition Evidence Database.

Total fat mass and visceral fat mass declined during the trial, according to Clinical Nutrition ESPEN.

Those declines reached p-less-than-0.0001, with no significant difference between diets for the absolute losses, according to the Nutrition Evidence Database.

The authors concluded that high-quality diets aligned with the Dietary Guidelines for Americans improved cardiovascular risk factors regardless of the primary protein source, according to Clinical Nutrition ESPEN.

They interpreted that pattern as underlining the importance of overall dietary-matrix quality, rather than protein source alone.

## Where the pulse period showed an extra change

Two between-diet differences favored the pulse-protein period.

The ratio of visceral fat to total fat fell more during the pulse-protein diet than during the meat-protein diet, according to the Nutrition Evidence Database.

That between-diet contrast reached p-less-than-0.05, even though the absolute losses of total and visceral fat did not differ significantly between diets.

Ferritin rose more during the pulse-protein diet than during the meat-protein diet, according to Clinical Nutrition ESPEN.

The reported mean increases were 15.7 nanograms per milliliter during the pulse-protein diet and 7.0 nanograms per milliliter during the meat-protein diet.

The between-diet comparison for ferritin reached p-equal-to-0.027, according to the Nutrition Evidence Database.

That result is notable because the menus were matched for total iron and differed in heme iron, with pulses generally supplying non-heme iron rather than the heme form found in meat.

The trial also found that the two diets produced distinct circulating biogenic-amine profiles, according to Clinical Nutrition ESPEN.

That overall profile difference reached p-equal-to-0.001, according to the Nutrition Evidence Database.

The authors concluded that the pulse-based diet conferred added benefits for the visceral-to-total-fat ratio and iron status, according to Clinical Nutrition ESPEN.

They described pulses as a feasible, nutrient-dense and effective dietary strategy with potential relevance for healthspan in aging populations.

## What stayed the same

TMAO, one of the three primary outcomes, remained unchanged across the diets, according to the Nutrition Evidence Database.

That stability occurred while glucose and lipid markers improved and CRP declined.

HDL was the lipid-related exception singled out as not improving alongside the other glucose and lipid markers, according to Clinical Nutrition ESPEN.

The absence of a between-diet difference for glucose and lipid markers, CRP and absolute fat-mass losses means those benefits were shared rather than unique to either menu.

## Why pulses are back in the protein conversation

Pulses are the dry edible seeds of legumes, a group that includes dry beans, lentils, chickpeas and dry peas, according to Tim McGreevy, CEO of USA Pulses, as reported by NPR.

McGreevy leads the trade group for the pulse-crop industry, according to NPR reporting published May 18, 2026.

NPR reported that one-half cup of cooked kidney, navy, cannellini or black beans supplies around 8 grams of protein.

NPR also reported that beans supply abundant fiber, a nutrient that many American adults under-consume.

A separate systematic review and dose-response meta-analysis published May 14, 2026 in the Journal of the American Heart Association examined whole dietary pulses and lipid targets across 38 trials with 2,095 participants.

That analysis reported a median trial length of six weeks and a median dose of 130 grams per day, with reductions in low-density-lipoprotein cholesterol, non-high-density-lipoprotein cholesterol and apolipoprotein B.

The PRODMED1 trial differs from that literature because it used a controlled feeding crossover in adults 60 and older, matched calories and macronutrients, and tracked iron, glycemic, fat-distribution and amine outcomes together.

NPR reported that the Trump administration updated the Dietary Guidelines for Americans in January and moved beans, peas and lentils from the vegetable category to the protein category.

More than 130 physicians had urged that change in a joint letter, saying it was long overdue and would help dispel the idea that plant proteins are incomplete or inadequate, according to NPR.

The 2025 Dietary Guidelines Advisory Committee had also recommended emphasizing beans, peas and lentils and reducing red and processed meat, according to NPR.

PRODMED1 did not test that policy shift directly, but it tested the nutritional question behind it: whether a guidelines-aligned pattern built around pulses can support cardiometabolic and iron measures in older adults as well as a guidelines-aligned pattern built around lean pork.

## Reading the results for adults over 60

For an older adult, the central message is that overall pattern quality carried most of the measured benefit.

Both eight-week periods improved glucose and lipid markers except HDL, lowered CRP and reduced total and visceral fat, with no significant protein-source difference for those endpoints, according to the Nutrition Evidence Database.

The pulse-protein period added a larger improvement in the proportion of fat stored viscerally and a larger rise in ferritin, the iron-storage protein measured as a primary outcome.

The trial registration is listed as NCT05577858 on ClinicalTrials.gov, dated October 11, 2022, according to Clinical Nutrition ESPEN.

The trial was relatively small and short, with 47 completers and eight-week feeding periods separated by at least two weeks without the assigned diets.

The authors framed pulses as feasible and nutrient-dense within a DGA-aligned pattern, with potential relevance for promoting healthspan, rather than as a proven longevity treatment, according to Clinical Nutrition ESPEN.

For readers considering a change, the practical cue from the design is to keep energy, overall nutrients and guideline alignment steady while changing the leading protein contributor, rather than adding pulses on top of an unchanged diet.

Anyone managing iron deficiency, diabetes medication, lipid treatment or unintentional weight loss should discuss a protein switch with a clinician, because the trial reports group-level biomarker changes, not individualized treatment guidance.

## Sources referenced
- Effects of a pulse-based, guidelines-aligned diet on biomarkers relevant to aging: Results from the PRODMED1 randomized controlled crossover feeding trial - Clinical Nutrition ESPEN (https://doi.org/10.1016/j.clnesp.2026.103337)
- Effects of a pulse-based, guidelines-aligned diet on biomarkers relevant to aging: Results from the PRODMED1 randomized controlled crossover feeding trial. - Nutrition Evidence Database (https://nutrition-evidence.com/article/556471/effects-of-a-pulse-based-guidelines-aligned-diet-on-biomarkers-relevant-to-aging-results-from-the-prodmed1-randomized-controlled-crossover-feeding-trial)

## Food Recall Volume Surges in Q1 as USDA Hits Third-Highest Total in Decades

URL: https://nutritionjournal.com/q1-2026-food-recall-volume-usda-third-highest

USDA food recalls hit 37.1M pounds in Q1 2026, the third-highest in 20+ years, while FDA units nearly doubled to 57.4M on allergens and foreign materials.

Key takeaways:
- USDA recalls reached 37.1 million pounds in Q1 2026, the third-highest quarterly total in more than two decades.
- FDA food recall events fell 10.3% to 140, but affected units jumped 99.5% to 57.40 million.
- A 36.99-million-pound chicken fried rice recall for glass drove most USDA volume; foreign materials led FDA volume at 26.43 million units.
- Undeclared allergens led FDA events with 57 recalls, including 17 linked to milk and 14 to soy.
- Prepared foods led FDA categories with 41 recalls and 44.98 million units; supplements had 9.34 million units across 17 events.
- Sedgwick reported 492 million defective units recalled across five industries, up 27%, while events fell to 785.

TL;DR: U.S. food recalls in Q1 2026 affected far more product with fewer events, as USDA volume hit 37.1 million pounds — the third-highest in more than two decades.

U.S. food recall activity took on a bigger footprint in the first quarter of 2026, with USDA-regulated products reaching the third-highest recall volume in more than two decades and FDA-regulated food recalls affecting nearly twice as many units as the previous quarter, according to new data from Sedgwick reported by [Quality Assurance & Food Safety](https://www.qualityassurancemag.com/news/food-recall-volume-surges-q1-usda-products-reach-third-highest-total-in-decades/).

The report, published May 18, 2026, describes a quarter in which FDA food recall events declined and USDA recalls remained limited in number, while several large-scale incidents involving foreign materials and undeclared allergens drove sharp increases in the amount of product affected.

Sedgwick's latest U.S. Product Safety and Recall Index report frames food within a broader product-safety pattern, as described in a [Sedgwick press release](https://www.sedgwick.com/press-release/u-s-records-27-increase-in-recalled-products-in-q1-2026/) dated May 14, 2026.

## How large was the Q1 surge across all industries?

Total volume of defective products recalled across five U.S. industries increased 27% quarter-over-quarter, rising to 492 million units in Q1 2026, according to Sedgwick.

In contrast, the number of recall events declined 10.5%, from 877 in Q4 2025 to 785 in Q1 2026.

Sedgwick stated that those data indicate that while fewer recalls were announced overall, the scale and impact of individual events continued to intensify.

Sedgwick's quarterly Product Safety and Recall Index report provides analysis covering the automotive, consumer products, food and drink, pharmaceutical, and medical device industries.

The latest edition examines recall data from January through March and offers an early look at April developments shaping the product safety landscape.

Among the cross-industry findings, the consumer products sector was the only industry to record an increase in recall events, rising 14.5% to 142.

The sector also experienced a 347% increase in recalled units quarter-over-quarter.

Several industries recorded significant numbers of units recalled in Q1, including the pharmaceutical sector, which set a 12-year high in recall volume with 218.8 million units impacted.

The automotive industry reported its highest quarterly unit total since Q1 2024 with 12.2 million vehicles recalled.

In the food sector, recalls regulated by the U.S. Department of Agriculture accounted for 37.1 million pounds of product, which Sedgwick identified as the third-highest total in more than two decades.

Sedgwick said U.S. product recall activity remained elevated in the first quarter of 2026 as companies faced mounting regulatory pressure and continued disruption across global supply chains.

The company publishes its Product Safety and Recall Index report every quarter and describes it as the only report that aggregates and tracks recall data across multiple government agencies and industries to help stakeholders respond to the regulatory environment, product recalls, and other in-market challenges.

## What drove USDA-regulated food recalls?

Bacterial contamination, no inspection and foreign materials contributed to USDA recalls, according to the report summarized by Quality Assurance & Food Safety.

Foreign materials was the leading cause of USDA food recalls, accounting for 37 million pounds in Q1.

That total was largely due to a single recall of 36.99 million pounds of chicken fried rice products contaminated with glass.

No inspection was second by volume with 59,779 pounds.

Bacterial contamination was third, impacting 36,632 pounds, down from 94,440 pounds in the previous quarter.

Poultry and pork each had two recalls in Q1.

Poultry recalls accounted for 37 million pounds of recalled product, while pork recalls accounted for 55,777 pounds.

Beef and fish were linked to one recall each: 22,912 pounds for beef and 13,464 pounds for fish.

The concentration of USDA volume in very few actions illustrates the quarter's central pattern: limited event counts paired with very large pound totals tied to individual contamination episodes.

## Why did FDA events fall while units nearly doubled?

The number of FDA food recalls fell 10.3% in Q1 2026 compared to Q4 2025, decreasing to 140 events.

However, the Q4 figure was the highest quarterly total in the past eight years, Sedgwick reported.

The number of units impacted grew 99.5% from 28.76 million last quarter to 57.40 million this quarter.

Seven recalls affected more than 1 million units.

Sedgwick reports FDA recall impact in units rather than pounds, a measure that can include individual products or packaged items.

That measurement distinction matters for nutrition and consumer-health readers comparing USDA pounds with FDA units, because the two agencies' totals track different product universes and different quantity definitions.

## Which hazards dominated FDA food recalls?

In Q1 2026, undeclared allergens were the leading cause of FDA food recalls, with 57 events, up from 49 last quarter.

The most common allergens cited were milk, which was linked to 17 recalls, and soy, which was tied to 14 events.

Four recalls involved gluten.

Foreign materials were the second most common cause of FDA food recalls, accounting for 24 events.

Bacterial contamination ranked third with 22 recalls.

By volume, foreign materials impacted 26.43 million units of FDA-regulated food, the most of any hazard in Q1.

This included a recall of prepared food containing glass that affected 19.07 million units.

Undeclared allergens were second by volume with 19.26 million units recalled, including a single recall of 18.61 million units for undeclared colors.

Bacterial contamination was third and impacted 10.41 million units.

The pairing of event leadership and volume leadership differed by hazard: allergens produced the most separate FDA actions, while foreign materials produced the largest affected quantity.

## Which food categories were most affected?

By category, prepared foods led by both recalls and volume in Q1 2026.

There were 41 recalls that impacted 44.98 million units, including two large recalls for foreign materials.

Supplements were second for both events and units.

There were 9.34 million units recalled across 17 events in the supplements category.

That supplement total included 5.44 million sea moss gel superfood supplements that contained Clostridium botulinum.

Baked goods had the third-highest number of events with 15.

They also had the third-most units impacted at 1.19 million.

Together, prepared foods, supplements and baked goods defined the bulk of FDA event counts and affected units during the quarter, with prepared foods alone representing a large share of both measures.

## What regulatory shifts accompanied the recalls?

In addition to recall data and analysis, Sedgwick's Q1 Product Safety and Recall Index report provides insights into regulatory developments that the company said will continue to impact product safety throughout 2026.

Both the USDA and Federal Trade Commission tightened enforcement around country-of-origin claims for U.S. made products.

The FTC is also carefully monitoring auto dealerships to ensure transparency in advertised prices and prevent hidden fees for consumers.

Meanwhile, the Food and Drug Administration amended inspection procedures for medical devices and pharmaceutical products.

Companies across all industries should be prepared for more regulatory changes in the coming months, according to Sedgwick.

The company said there will likely be more scrutiny around safety and transparency, combined with efforts to streamline processes.

## What is Sedgwick advising companies to control?

"The ongoing economic uncertainty should urge companies to control what they can do," said Chris Harvey, senior vice president, Sedgwick.

Harvey linked that advice to assessing compliance risk and evaluating recall plans against a dynamic regulatory environment.

He said the current administration is emphasizing transparency with a focus on product origin information and food ingredients.

He also said clear communication is another priority with consumers, suppliers and regulators.

Harvey added that businesses should ensure that they have effective communications channels in place and can support any statements they make.

For food makers, retailers and supplement brands, the Q1 record points to two operational tests highlighted by the data: preventing foreign-material and allergen failures before wide distribution, and maintaining recall and communication procedures capable of handling a single event that spans tens of millions of pounds or units.

Information on downloading the Q1 2026 U.S. Product Safety and Recall Index report was provided alongside the findings.

## Price Probe: 10 Foodborne Illness Cases Under Investigation

URL: https://nutritionjournal.com/price-utah-foodborne-illness-investigation-10-cases

Southeast Utah Health Department confirmed 10 foodborne illness reports in Price after a May 13 complaint; source unknown and restaurant unnamed as investigation continues.

Key takeaways:
- Southeast Utah Health Department confirmed 10 foodborne illness reports in the Price area.
- The investigation began after a May 13 complaint from a group with stomach upset and diarrhea.
- The contamination source was unknown and the restaurant name was withheld during the active investigation.
- The involved restaurant cooperated and discarded all food it had, according to FOX 13 Now.
- Residents with cramps, diarrhea, nausea, vomiting or fever after eating out are urged to report online.
- Federal outbreak investigations use genome sequencing, patient interviews and purchase records to link cases.

TL;DR: The Southeast Utah Health Department confirmed 10 reports of foodborne illness in the Price area after an initial complaint on May 13, and investigators have not identified the contamination source.

## 10 cases confirmed in Price area

The Southeast Utah Health Department (SEUHD) is actively investigating a localized outbreak of foodborne illness in the Price area, according to [ETV News](https://etvnews.com/articles/local-news/health-officials-investigate-10-reported-cases-of-foodborne-illness-in-price/). The department had confirmed 10 official reports linked to the outbreak at the time of that report. The exact source of the contamination remains unknown, and the investigation is ongoing.

The cases are centered in Carbon County, according to [KUTV](https://kutv.com/news/local/southeast-utah-health-dept-asks-those-with-foodborne-illness-symptoms-to-report-online). The health department described the event as a potential foodborne illness outbreak under investigation. Officials said they needed additional reports to investigate further and to determine whether cases are connected.

According to [FOX 13 Now](https://www.fox13now.com/news/local-news/carbon-county/carbon-county-food-poisoning-investigation-underway), investigators had confirmed 10 cases of the illnesses since the inquiry began. The department said that total is why officials want to find out if these cases are connected. The department has not released a pathogen identification in the reports available by May 16.

## Investigation began May 13 after group complaint

On May 13, SEUHD received a report from an individual experiencing symptoms including an upset stomach and diarrhea, according to ETV News. That individual noted that multiple other members of their party were suffering from the same symptoms.

Orion Rogers, the environmental health director for the Southeast Utah Health Department, says the investigation started on Thursday after the department received a complaint from a group that reported foodborne illness-like symptoms, according to FOX 13 Now. That Thursday start aligns with the May 13 initial report described by ETV News.

Health officials are treating the reports as a localized outbreak in the Price area, according to ETV News. The department is asking the public to report any similar symptoms, including mild symptoms, to help investigators pinpoint the source and prevent further illness.

## Restaurant cooperated and discarded food

The health department is not releasing the name of the restaurant while the investigation plays out, according to FOX 13 Now. The department said the restaurant is being cooperative with the investigation.

According to FOX 13 Now, the restaurant threw out all the food it had. Rogers confirmed that account to the station, which reported that the establishment discarded its existing stock as investigators began their work.

No closure order, recall, or enforcement action was described in the reports available by May 16. The department characterized the restaurant as cooperative, and officials said the decision to withhold the name was tied to the active status of the investigation.

## Who should report and what symptoms to watch

Public health officials advise residents to monitor themselves and their families for common signs of foodborne illness, according to ETV News. The listed signs include upset stomach or abdominal cramps, diarrhea, nausea or vomiting, and fever.

According to FOX 13 Now, symptoms of foodborne illness can include stomach cramps, diarrhea, nausea, vomiting, and fever. KUTV listed the same five categories: stomach cramps, diarrhea, nausea, vomiting, and fever.

Officials are asking anyone who has symptoms of food poisoning and has eaten outside of the home recently to report the illness so they can investigate, according to FOX 13 Now. KUTV reported the same request, stating that the department asked those with symptoms who have eaten outside of their homes recently to report their illnesses.

ETV News reported a broader request, stating that the health department is asking anyone who has recently experienced these symptoms, even mild symptoms, to file an official report. The purpose is to help investigators identify the origin and halt further spread.

## How to file a report in Utah

Reports can be submitted securely online through the Utah Department of Health and Human Services portal, according to ETV News. The submission address published by the department is https://pubredcap.health.utah.gov/surveys/?s=AMR9NWM7YP8FFDF3.

According to FOX 13 Now, anyone with symptoms is asked to go to seuhealth.gov/report-a-problem to report the illness. That address provides a second department channel for Carbon County residents.

The emphasis on individual reports reflects how outbreak inquiries depend on sick people and clinicians coming forward. According to [LegalClarity](https://legalclarity.org/foodborne-illness-outbreaks-detection-investigation-response/), which published an explainer on May 16, 2026, how quickly a person acts after suspected food poisoning directly affects how fast investigators can identify the source and stop it from spreading.

## What counts as a foodborne outbreak

When two or more people get the same illness from the same contaminated food or drink, the event is called a foodborne disease outbreak, according to the [CDC](https://www.cdc.gov/ecoli/outbreaks/index.html). The CDC states that public health officials investigate outbreaks to control them so more people do not get sick and to learn how to prevent similar outbreaks.

According to LegalClarity, federal agencies detect outbreaks through DNA-based laboratory networks, investigate them by tracing contaminated food through supply chains, and respond with tools ranging from public warnings to mandatory recalls and criminal prosecution. The May 16 explainer states that the system depends heavily on individual reports from sick people and their doctors.

Foodborne illness outbreaks sicken an estimated 9.9 million Americans each year from known pathogens alone, leading to roughly 53,000 hospitalizations and more than 900 deaths, according to LegalClarity, citing CDC burden estimates. Those national figures provide context for why local departments pursue even small clusters quickly.

## How laboratories connect separate cases

Detection starts in clinical laboratories, according to LegalClarity. When a doctor orders a stool or blood test and a pathogen such as Salmonella or E. coli turns up, the laboratory performs whole genome sequencing to map the bacterium's complete DNA profile.

Since 2019, this technique has been the standard method used by PulseNet, a CDC-coordinated national network of public health and food regulatory laboratories, according to LegalClarity. The explainer describes the sequence as a biological barcode: bacteria with an identical genetic sequence in different patients almost certainly point to the same contaminated product.

PulseNet laboratories upload sequencing data to shared databases, and CDC scientists monitor those uploads for clusters, according to LegalClarity. A second LegalClarity explainer published May 13 describes PulseNet as a CDC-managed network of 82 federal, state, and local laboratories spanning all 50 states that uses standardized methods to characterize bacterial DNA and compare results nationally.

The May 13 explainer states that when the system spots more people sick with a genetically similar strain than historical baselines would predict for a given period, it flags a cluster for further investigation. The FDA's Coordinated Outbreak Response and Evaluation Network works alongside CDC to evaluate those signals, reviewing emerging clusters alongside inspection data, past sampling results, and known pathogen-food pairings.

## Why interviews cover many meals and days

Every investigation begins with clinical specimens, according to LegalClarity. The stool or blood samples that confirmed a pathogen become foundational evidence, and health department staff then interview each patient to build a detailed food history covering everything consumed during the relevant incubation window.

Investigators also pull objective purchase data from grocery store loyalty programs and credit card records, according to LegalClarity. Those records fill gaps in memory about exact brands, stores, and purchase dates.

Information feeds into a line list, described by LegalClarity as a secure database tracking each patient's demographics, symptom onset date, foods eaten, and lab results. Comparing dozens of entries side by side can reveal a common food item.

Incubation periods vary widely by pathogen, which is why investigators ask about foods eaten over a range of days rather than just the last meal, according to LegalClarity. The May 16 explainer states that Salmonella symptoms typically appear 6 to 48 hours after exposure, with a window that can stretch to 10 days, while E. coli O157 takes roughly 3 to 4 days and Campylobacter falls in a 2-to-5-day range.

Listeria is the outlier, according to LegalClarity, with invasive listeriosis able to take one to four weeks to produce symptoms. That longer interval makes traceback especially difficult for that pathogen.

## Which foods investigators examine first

Not every pathogen behaves the same way, and knowledge of common culprits helps investigators narrow the search, according to LegalClarity. The CDC's Interagency Food Safety Analytics Collaboration tracks which foods are most frequently linked to outbreaks caused by three priority bacteria.

For Salmonella, more than 75 percent of outbreak-linked illnesses trace to seven food categories: chicken, fruits, seeded vegetables like tomatoes, pork, tree nuts, beef, and turkey, according to LegalClarity. For E. coli O157, over 85 percent of illnesses connect to leafy greens and beef, while Listeria clusters around dairy products, leafy greens, and fruits.

Bacteria receive most attention in investigations, but norovirus causes more foodborne outbreaks than any single bacterium, according to LegalClarity. In analyzed outbreaks with a known contributing factor, infected food workers handling ready-to-eat items accounted for the majority of norovirus contamination events.

No pathogen or food category has been named as the cause in Price. The available reports describe upset stomach and diarrhea in the initial party, with the broader symptom list still under review as officials seek more reports.

## What happens next in Carbon County

SEUHD remains in the information-gathering phase. The department has 10 official reports, an unidentified contamination source, and an open request for additional reports from people who ate outside the home and then developed cramps, diarrhea, nausea, vomiting, or fever.

Residents can use the state REDCap survey link published by ETV News or the seuhealth.gov/report-a-problem channel reported by FOX 13 Now. Officials said saving details about meals, locations, and onset timing will strengthen each submission, an approach consistent with the interview and purchase-record methods described by LegalClarity.

The department has not announced laboratory results, a confirmed food vehicle, hospitalizations, or additional case counts beyond 10 in the material available by May 16. Further findings will depend on whether more residents report, whether clinical testing identifies a pathogen, and whether interviews and sequencing connect the illnesses to a single source.

## Carbon County Food Poisoning Investigation Underway After 10 Reports

URL: https://nutritionjournal.com/carbon-county-food-poisoning-investigation

Southeast Utah Health Department confirms 10 foodborne illness reports in Carbon County and asks residents who ate out to file confidential reports.

Key takeaways:
- Southeast Utah Health Department is investigating 10 confirmed foodborne illness reports in Carbon County.
- The investigation began after a May 13 complaint involving a group with stomach and diarrhea symptoms.
- The restaurant name is withheld; officials say the business is cooperating and discarded its food.
- Residents who ate out and have cramps, diarrhea, nausea, vomiting or fever are asked to report.
- Reports can be filed confidentially through seuhealth.gov/report-a-problem or the state survey portal.
- At-risk groups include young children, pregnant women, older adults and people with weakened immune systems.

**TL;DR: The Southeast Utah Health Department is investigating 10 reported foodborne illness cases in Carbon County after a May 13 complaint and is asking residents who recently ate out and feel sick to file a confidential report.**

## What is happening in Carbon County?

The Southeast Utah Health Department is investigating a potential foodborne illness outbreak in Carbon County, Utah, with a focus on the Price area, according to FOX 13 Now.

Investigators have confirmed 10 cases of illness, according to FOX 13 Now.

The exact source of contamination remains unknown and the investigation is ongoing, according to ETV News.

Officials want to learn whether the cases are connected, according to FOX 13 Now.

The department is asking anyone with symptoms of food poisoning who has eaten outside of the home recently to report the illness so investigators can examine the reports, according to FOX 13 Now.

The department has said it cannot investigate without hearing from residents, according to ABC4.

All reports are confidential, according to ABC4.

## How did the investigation begin?

The investigation started on Thursday after the health department received a complaint from a group that reported foodborne illness-like symptoms, according to FOX 13 Now.

Orion Rogers, the environmental health director for the Southeast Utah Health Department, described that starting point, according to FOX 13 Now.

A separate account says the department received a report on May 13 from an individual experiencing an upset stomach and diarrhea, according to ETV News.

That individual noted that multiple other members of their party were suffering from the same symptoms, according to ETV News.

Since the initial complaint, investigators have confirmed 10 official reports linked to the outbreak, according to ETV News.

The department has not specified whether it has pinpointed exact areas or restaurants where the potential outbreak could have occurred, according to ABC4.

## Why has no restaurant been named?

The health department is not releasing the name of the restaurant while the investigation plays out, according to FOX 13 Now.

Officials said the restaurant is being cooperative with the investigation, according to FOX 13 Now.

Officials also said the restaurant threw out all the food it had, according to FOX 13 Now.

Investigators have not announced a confirmed food vehicle or preparation failure, according to ETV News.

The department is using incoming illness reports to help pinpoint the source and prevent further illness, according to ETV News.

## Who should file a report?

Residents should file a report if they have symptoms of food poisoning and have eaten outside of the home recently, according to FOX 13 Now.

The request covers people in Carbon County and the surrounding Price area, according to ETV News and FOX 13 Now.

Public health officials advise residents to monitor themselves and their families for common signs of foodborne illness, according to ETV News.

The department is asking people with recent symptoms, even mild symptoms, to file an official report, according to ETV News.

People experiencing stomach cramps, diarrhea, nausea, vomiting or fever after eating out are included in the call for reports, according to FOX 13 Now.

People with an upset stomach or abdominal cramps, diarrhea, nausea or vomiting, or fever are included in the monitoring guidance, according to ETV News.

Reports from people who ate as part of a group are especially useful because investigators are assessing whether illnesses share a common exposure, according to FOX 13 Now and ETV News.

## How do residents submit a confidential illness report?

Residents can submit a report through the Southeast Utah Health Department problem-reporting page, according to FOX 13 Now.

That address is seuhealth.gov/report-a-problem, according to FOX 13 Now.

A Spanish-language report directs people to complete an online form at the same address and select the food-poisoning option, according to Telemundo Utah.

A second reporting path uses the Utah Department of Health and Human Services portal, according to ETV News.

That secure online address is https://pubredcap.health.utah.gov/surveys/?s=AMR9NWM7YP8FFDF3, according to ETV News.

The department states that reports submitted through its outreach are confidential, according to ABC4.

Residents who still have suspect food should preserve it and wrap it securely, labeled with the time it was consumed and when symptoms occurred, according to ABC4, which attributes that handling advice to the Utah State Department of Agriculture.

Officials also recommend calling the local health department about a suspected exposure, according to ABC4.

If the suspect food is a USDA-inspected product and the consumer has all the packaging, officials recommend calling the USDA Meat and Poultry Hotline at 1-888-674-6854, according to ABC4.

## What symptoms should people watch for?

Symptoms of foodborne illness can include stomach cramps, diarrhea, nausea, vomiting and fever, according to FOX 13 Now.

Public health guidance also lists upset stomach or abdominal cramps, diarrhea, nausea or vomiting, and fever as common signs, according to ETV News.

Symptoms are similar to flu symptoms, according to ABC4.

Symptoms can present from a few minutes to weeks after eating contaminated food, according to ABC4, which attributes that timing information to the Utah State Department of Agriculture.

Foodborne illness comes from eating contaminated food, according to ABC4, which attributes that definition to the Utah State Department of Agriculture.

Anyone feeling ill or in an at-risk group should seek medical care immediately, especially if symptoms persist or are severe, according to ABC4, which attributes that care guidance to the Utah State Department of Agriculture.

## Who faces higher risk of severe illness?

Individuals with weakened immune systems, young children and infants, pregnant women and older adults are at higher risk of becoming seriously ill if they get a foodborne illness, according to ABC4, which attributes the risk description to the Utah State Department of Agriculture.

Some risk exists for any individual, according to ABC4, which attributes that statement to the Utah State Department of Agriculture.

Foodborne illness causes around 48 million illnesses and 3,000 deaths in the United States each year, according to ABC4, which attributes the estimates to the Utah State Department of Agriculture.

Southeast Utah health officials are asking families to watch children and other household members after a shared meal outside the home, according to ETV News.

The department’s Price contact location is 625 East 100 North, Price, UT 84501, and its telephone number is (435) 636-3941, according to ETV News.

## What happens next in the investigation?

Investigators are working to determine whether the 10 confirmed reports share a common food, meal period or establishment, according to FOX 13 Now.

The department has described the Price-area illnesses as localized, according to ETV News.

No contamination source had been identified in the reports available before the archive cutoff, according to ETV News.

The department continues to seek additional reports from people who ate out recently and developed gastrointestinal symptoms, according to FOX 13 Now and ABC4.

Each new confidential report gives investigators another exposure history to compare against the existing 10 cases, according to ETV News and FOX 13 Now.

Residents can use either the Southeast Utah Health Department reporting page or the state survey portal to add their information to the active file, according to FOX 13 Now and ETV News.

The department says those reports will help identify possible sources, prevent more cases and protect public health in the community, according to Telemundo Utah.

## Sources referenced
- FOX 13 Now - Carbon County food poisoning investigation underway (https://www.fox13now.com/news/local-news/carbon-county/carbon-county-food-poisoning-investigation-underway)
- ABC4 - Potential foodborne illness outbreak under investigation in Southeast Utah (https://www.abc4.com/news/health/potential-foodborne-illness-outbreak-southeast-utah/)

## Fasting Plus Morning Window Matches Dieting for Loss, Diverges on Appetite Control

URL: https://nutritionjournal.com/fasting-vs-calorie-restriction-eating-behavior-trial

A 15 May 2026 Clinical Nutrition trial in 209 adults with obesity found similar weight loss with fasting and calorie restriction, but only restriction improved restraint and disinhibition.

Key takeaways:
- Both iTRE and calorie restriction produced greater weight loss than standard care at 2 and 6 months.
- Calorie restriction raised dietary restraint more than iTRE and standard care at 2, 6 and 18 months.
- Calorie restriction reduced disinhibition and hunger more than iTRE and standard care at 6 months.
- Reduced disinhibition mediated 15% of the calorie-restriction weight-loss effect; restraint showed no mediation.
- Fasting did not worsen depression, anxiety, sleep or food-addiction behaviours versus restriction in this trial.

## TL;DR: Fasting and daily dieting lost similar weight, but changed eating behaviour differently

**Both intermittent fasting plus early time-restricted eating and daily calorie restriction produced greater weight loss than standard care at 2 and 6 months, while only calorie restriction produced larger sustained increases in dietary restraint and larger reductions in disinhibition and hunger, with reduced disinhibition explaining 15% of the calorie-restriction weight-loss effect, according to the study published on 15 May 2026 in Clinical Nutrition.**

The report titled “Exploring the impact of intermittent fasting plus time-restricted eating versus calorie restriction on eating behavior, mood, sleep, quality of life in adults with obesity” compared psychological and behavioural responses after 6 months and 18 months. The authors stated that psychological and behavioural effects influence diet adherence and mediate the effectiveness of lifestyle interventions but are poorly studied with intermittent fasting approaches. The trial is registered as NCT03689608. Funding was provided by the National Health and Medical Research Council for research described as intermittent fasting versus daily energy restriction for improved human health.

## Study examined fasting with a morning eating window against daily restriction

The trial randomized adults with obesity to one of three groups in a 2:2:1 ratio. One group followed intermittent fasting plus early time-restricted eating, termed iTRE. A second group followed calorie restriction, termed CR. A third group received standard care, termed SC.

The iTRE prescription was 30% of energy requirements between 8am and 12pm followed by 20-hour fasting on three non-consecutive days, with non-restricted intake on the other days. The CR prescription was 70% of energy requirements. The SC group was provided healthy guidelines at baseline only. Both the iTRE and CR groups received nutritional support biweekly. Eating behaviours, mood, sleep and quality of life were assessed using validated questionnaires at month 0, 2, 6 and 18.

## Who took part and how long they were followed

Reporting on the trial by Foodinnov described 209 adults with obesity with a mean age of 58 years and elevated risk of type 2 diabetes. The intervention period described in that report was six months, with assessments at the start of the trial and then after 2 months, 6 months and 18 months of follow-up. The same report noted that the iTRE group consumed only 30% of energy needs between 8h and noon, followed by a 20-hour fast, on three non-consecutive days per week, and could eat normally on the other days. It described the second group as following classic daily calorie restriction with a daily 30% reduction in energy intake. It described the third group as receiving only standard nutritional recommendations without specific support.

The authors listed for the Clinical Nutrition paper are Xiao Tong Teong, Kai Liu, Andrew D. Vincent, Bo Liu, Gary Wittert, Amy T. Hutchison and colleagues, with Leonie Kaye Heilbronn as corresponding author. The listed affiliations include the South Australian Health and Medical Research Institute and Adelaide University. The publication date given for the Clinical Nutrition paper is 15 May 2026.

## Weight loss was greater with both structured diets than with standard care

Greater weight loss was observed in iTRE and CR versus SC at month 2 and month 6. The Foodinnov summary of the trial reported that after six months participants in the intermittent-fasting group had lost about 7.4 kg, compared with about 7 kg in the calorie-restriction group, with both strategies producing significant loss compared with the control group. The Clinical Nutrition abstract reported greater weight loss in both structured-diet groups versus standard care at the same 2-month and 6-month points.

The trial therefore showed that both intermittent fasting and CR effectively induce weight loss when compared with guidelines-only care during the active intervention period. The authors’ stated conclusion was that both intermittent fasting and CR effectively induce weight loss, but they potentially act through distinct behavioural pathways. The mediation analysis was performed to examine the relationship between eating behaviour and weight loss at 2 and 6 months.

## Calorie restriction increased dietary restraint more than fasting

Greater increases in dietary restraint were observed in CR versus iTRE and SC at month 2, 6 and 18. That difference persisted from the early intervention assessments through the 6-month assessment and remained present at the 18-month assessment. The Foodinnov report described the same pattern as a larger increase in cognitive dietary restraint in the classic-restriction group. The difference was observed even though weight loss at 2 and 6 months was greater with both iTRE and CR than with SC.

There was no detectable mediation effect of change in dietary restraint on weight loss. In other words, the larger rise in restraint in the CR group did not explain the weight-loss difference in the formal mediation test. The abstract reported the mediation examination for eating behaviour and weight loss at 2 and 6 months and found no detectable mediation through restraint change.

## Reduced disinhibition explained part of the calorie-restriction effect

Greater reductions in disinhibition and feelings of hunger were also observed in CR versus iTRE and SC at month 6. The Foodinnov summary described the same result as a more marked decrease in disinhibition and in the sensation of hunger in the calorie-restriction group. The time point specified for that between-group difference in disinhibition and hunger was month 6.

Disinhibition appeared to mediate the effect on weight loss in CR, accounting for 15% of the total treatment effect. The Foodinnov report likewise stated that the decrease in dietary disinhibition explained about 15% of the weight loss observed in the calorie-restriction group. The authors interpreted this as indicating that improved control over eating played a role in the effectiveness of that approach. Their stated conclusion was that disinhibition plays a more prominent role in CR.

## Fasting did not show the same behavioural shifts despite similar loss

Despite comparable weight loss, changes in eating behaviours were less marked in the fasting group. The Foodinnov summary stated that intermittent fasting did not appear to act through the same behavioural mechanisms as calorie restriction. It quoted the authors’ interpretation that the two strategies may rely on different psychological mechanisms.

The Clinical Nutrition conclusion likewise stated that intermittent fasting and CR potentially act through distinct behavioural pathways. The abstract reported greater restraint, disinhibition and hunger changes with CR, while reporting greater weight loss with both iTRE and CR versus SC. The pattern indicates similar scale outcomes through different measured behavioural routes during the period studied.

## Mood, sleep, food addiction and quality of life showed no fasting disadvantage

The trial assessed mood, sleep and quality of life with validated questionnaires alongside eating behaviour. The Foodinnov summary stated that intermittent fasting did not worsen symptoms of depression or anxiety or sleep disturbances compared with calorie restriction. It also stated that the researchers did not observe an increase in food-addiction-type behaviours or binge-eating compulsions.

A slight increase in stress was observed after two months in the intermittent-fasting group, but that effect was no longer present after six months, according to the same Foodinnov report. The study aim described in that report was to assess whether intermittent fasting and calorie restriction acted differently on eating behaviour including hunger, restraint and disinhibition, mood including depression, anxiety and stress, sleep quality and participant quality of life. The questionnaires covered eating behaviour, hunger levels, disinhibition, anxiety, depression, stress, sleep and quality of life.

## Support level and exclusions limit real-world reading

The participants were closely supervised, which may improve adherence and limit some negative effects seen under real-life conditions, according to the Foodinnov discussion of limitations. People with eating disorders had also been excluded from the trial. Those two points were presented as important limitations affecting interpretation outside the trial setting.

The difference in support was built into the design: both iTRE and CR groups received biweekly nutritional support, whereas SC received healthy guidelines at baseline only. Assessments extended to 18 months, beyond the 6-month active comparison, allowing the 18-month restraint finding to be reported. The 18-month difference in dietary restraint was a CR versus iTRE and SC difference.

## What the 15% mediation finding means for counselling

The finding that disinhibition appeared to mediate the CR weight-loss effect and accounted for 15% of the total treatment effect points to control over eating in response to cues as one measured pathway. The Clinical Nutrition abstract presented disinhibition as more prominent in CR than the restraint pathway tested. The Foodinnov report expressed the same point as improved dietary control contributing to the effectiveness of the classic-restriction approach.

For intermittent fasting plus early time-restricted eating, the trial did not identify the same measured behavioural mediator despite greater weight loss than standard care. The Foodinnov summary stated that intermittent fasting could act through other mechanisms that remain poorly understood. The authors’ background statement was that these psychological and behavioural effects are poorly studied with intermittent fasting approaches.

## Details for readers checking the source

The full paper reference is “Exploring the impact of intermittent fasting plus time-restricted eating versus calorie restriction on eating behavior, mood, sleep, quality of life in adults with obesity,” published in Clinical Nutrition on 15 May 2026, according to the [Clinical Nutrition publication record](https://doi.org/10.1016/j.clnu.2026.106686). The identifier given is NCT03689608. The author list includes Xiao Tong Teong, Kai Liu, Andrew D. Vincent, Bo Liu, Gary Wittert, Amy T. Hutchison and colleagues.

The participant-level context and kilogram values in this article come from the [Foodinnov trial summary](https://foodinnov.fr/obesite-une-etude-compare-les-effets-psychologiques-du-jeune-intermittent-et-du-regime-hypocalorique/), which described 209 adults with obesity, mean age 58, high type 2 diabetes risk, 7.4 kg loss with intermittent fasting and 7 kg with calorie restriction after six months, and the transient stress signal at two months. That summary also identified the journal as Clinical Nutrition and the publication date as 15 May 2026 and linked to the open-access article.

## Food Safety Summit: Regulatory Leaders Detail Safety Priorities

URL: https://nutritionjournal.com/food-safety-summit-regulatory-leaders-priorities-2026

FDA, USDA-FSIS, CDC and AFDO leaders outlined best practices, root-cause analysis, Salmonella, Listeria, data sharing and AI at the May 14 Food Safety Summit Town Hall.

Key takeaways:
- The May 14, 2026 Food Safety Summit Town Hall convened leaders from FDA, USDA-FSIS, CDC and AFDO.
- FDA's Human Foods Program released resources on industry best practices and root cause analyses.
- USDA-FSIS prioritized Salmonella and Listeria monocytogenes, with pork and beef programs signaled for late 2026 or early 2027.
- CDC said much outbreak monitoring depends on voluntarily reported state, local, tribal and territorial data.
- AFDO backed the Federal and State Food Safety Information Sharing Act and highlighted the BRIDGE inspection project.
- FDA described artificial intelligence as comparable to whole genome sequencing for food safety data analysis.

## TL;DR

Top officials from FDA, USDA-FSIS, CDC and AFDO used the 2026 Food Safety Summit Town Hall on May 14, 2026 to outline current regulatory priorities, including FDA resources on best practices and root cause analyses, USDA-FSIS action on Salmonella and Listeria monocytogenes, CDC reliance on state-reported data, and AFDO support for expanded information-sharing authority.

## Town Hall brings four agencies to one stage

According to Food Safety Magazine's report titled "Top U.S. Food Safety Officials Discuss Regulatory Landscape at Food Safety Summit," leading officials from the U.S. Food and Drug Administration, the U.S. Department of Agriculture's Food Safety and Inspection Service, the U.S. Centers for Disease Control and Prevention, and the Association of Food and Drug Officials took the stage at the 2026 Food Safety Summit Town Hall on Thursday, May 14.

The same report states that the Town Hall was convened to answer attendees' questions and provide insight into the current U.S. food safety regulatory landscape.

The Town Hall was moderated by Gillian Kelleher, CEO of Kelleher Consultants LLC and Chair of the Food Safety Summit Educational Advisory Board, according to that Food Safety Magazine report.

Panelists included Mindy Brashears, Ph.D., USDA Under Secretary for Food Safety, according to the report.

Panelists also included Donald Prater, D.V.M., Principal Deputy Associate Commissioner for Food in FDA's Human Foods Program, according to the report.

Additional panelists were Steven Mandernach, J.D., Executive Director of AFDO, and Gwen Biggerstaff, Sc.D., M.S.P.H., Deputy Division Director of CDC's National Center for Emerging and Zoonotic Infectious Diseases' Division of Foodborne, Waterborne, and Environmental Diseases, according to the report.

## FDA leadership change noted at opening

Dr. Prater took the stage first and sent regards from Kyle Diamantas, J.D., FDA's new Acting Commissioner, according to Food Safety Magazine's Town Hall report.

Prater mentioned the leadership change that happened at the agency earlier this week, according to the same report.

Mr. Diamantas was FDA's Deputy Commissioner for Human Foods just before assuming the Acting Commissioner role due to the departure of the previous Commissioner, Marty Makary, M.D., according to the report.

## FDA points industry to resources released Wednesday

Directing attendees to new resources released by the agency on Wednesday, Dr. Prater encouraged the use of root cause analyses and industry collaboration on the development of food safety best practices, according to Food Safety Magazine's Town Hall report.

A separate Food Safety Magazine report titled "FDA Encourages Industry to Develop Best Practices, Use Root Cause Analyses," published May 13, 2026, states that FDA's Human Foods Program released two new web resources on the development of industry best practices and the use of root cause analysis to understand food safety issues and prevent recurrence.

In a Food Safety Matters podcast interview recorded this week during the 2026 Food Safety Summit, Conrad Choiniere, Ph.D., Director of the Office of Microbiological Food Safety in FDA's Human Foods Program, discussed the newly released resources from the agency, according to that May 13 report.

The interview will be shared through all major podcast players and on the Food Safety Magazine website on May 19, according to the same report.

### How FDA defines industry best practices

The webpage on Food Safety Best Practices for Human Foods describes how industry can work with FDA to create best practices, which are not FDA guidance documents, according to the May 13 Food Safety Magazine report.

Rather, best practices are guidelines, often specific to an individual food commodity or specific segment of an industry, developed by industry, academia, or other groups based on their experience and lessons learned, according to the same report.

They are intended to communicate meaningful food safety best practices that farms, facilities, or other food producers can follow in their day-to-day operations to enhance food safety, according to the same report.

In support of the development of best practices, FDA subject matter experts often participate in industry- or academia-led workgroups, share scientific data and insights, provide technical and regulatory expertise, and review resources developed by external stakeholders, according to the report.

FDA encourages stakeholders to connect with the agency when developing best practices for technical assistance, scientific information, and help with regulatory alignment, according to the report.

The webpage highlights collaborations on best practices and other documents, according to the report.

### What root cause analyses are intended to do

Root cause analyses help regulators and industry identify the problems that caused a food safety incident and how those problems may have occurred, according to the May 13 Food Safety Magazine report.

The findings from a root cause analysis can help firms improve their own food safety interventions, inform industry-wide best practices, and help FDA develop guidance and enhanced oversight, according to the same report.

FDA's new Root Cause Analysis webpage describes the process for a root cause analysis, FDA's use of root cause analyses, and FDA's activities to strengthen root cause analysis processes, according to the report.

All of those uses can help prevent recurrence, according to the report's description of the resources.

## USDA-FSIS names Salmonella and Listeria as priorities

Dr. Brashears remarked on the shared goal of ensuring food safety, which spans both sides of the political aisle, before delving into her main priorities as head of USDA-FSIS: Salmonella and Listeria monocytogenes, according to Food Safety Magazine's Town Hall report.

On reducing foodborne salmonellosis attributed to USDA-regulated products, Dr. Brashears said USDA-FSIS already has tools in its toolbox that the agency can use to take action on Salmonella, according to the report.

She mentioned pathogen performance standards as one of those tools, according to the report.

She also touched on the ongoing evaluation of existing quantification methods and the identification of the most highly pathogenic Salmonella strains present in food samples, according to the report.

"We want to find the most pathogenic strains so we can make a difference," said Dr. Brashears, as quoted in the report.

"We also want to find the products that cause the most problems," said Dr. Brashears, as quoted in the report.

### Pork and beef programs signaled for late 2026 or early 2027

Beyond poultry, Dr. Brashears also teased Salmonella programs for pork and beef products, rolling out late this year or in early 2027, according to Food Safety Magazine's Town Hall report.

That timeline places potential rollout in late 2026 or in early 2027, according to the same report.

### Listeria data collection follows 2024 outbreak

L. monocytogenes was another priority mentioned by Dr. Brashears, according to the Town Hall report.

She described the data collection efforts initiated at the agency following the Boar's Head listeriosis outbreak of 2024 and subsequent changes to the Listeria Rule, according to the report.

She also alluded to a new program to enhance Listeria sampling and testing, rolling out in the next few months, according to the report.

## CDC describes state-federal monitoring system

Dr. Biggerstaff described the state-federal collaboration that enables foodborne illness outbreak response and pathogen monitoring and surveillance, according to Food Safety Magazine's Town Hall report.

She explained that states are on the front lines, while CDC collects and connects pathogen monitoring and illness data, according to the report.

Much of what CDC is able to accomplish is built on voluntarily reported data from state, local, tribal, and territorial partners, Dr. Biggerstaff emphasized, according to the report.

Dr. Biggerstaff also mentioned CDC's capacity-building efforts at state, local, tribal, and territorial health departments and described the current resource constraints, according to the report.

"CDC is only able to provide about 40 percent of what is requested," she stated, as quoted in the report.

However, she explained that these resource constraints are also driving data modernization efforts to lower barriers to state, local, tribal, and territorial participation in national data reporting systems, according to the report.

## AFDO addresses retail oversight, inspections and information sharing

Mr. Mandernach described the role state, local, tribal, and territorial agencies play in food safety regulatory oversight and enforcement, according to Food Safety Magazine's Town Hall report.

He applauded the Retail Foods Program at FDA, saying, "It's the best functioning retail team many of us have seen in our careers," according to the report.

That function was enabled by the Human Foods Program reorganization bringing the agency's food policy and field programs under one umbrella, according to the report.

### BRIDGE Project moves inspections to states

Mr. Mandernach also highlighted the importance of FDA's BRIDGE Project, which is transitioning most domestic manufacturing food inspections to states, according to the Town Hall report.

He described the ways in which state inspections are equivalent to those directly conducted by FDA, according to the report.

### Bill would expand outbreak information sharing

Additionally, Mr. Mandernach advocated for expanded federal-state information-sharing authorities before and during foodborne illness outbreaks to improve detection and response, according to the report.

He stated AFDO's support for an active bill, the Federal and State Food Safety Information Sharing Act, which was discussed during a Congressional hearing in April, according to the report.

"Working together with the full range of stakeholders is how we will really bend the foodborne illness curve," concluded Mr. Mandernach, as quoted in the report.

## AI compared to whole genome sequencing

In response to an attendee question, Dr. Prater discussed the importance of harnessing artificial intelligence for food safety, calling it "as much of a game-changer" as whole genome sequencing, according to Food Safety Magazine's Town Hall report.

"Better food safety means better data and better analytics," he said, as quoted in the report.

He described how quantitative analytical techniques are helping FDA make sense of enormous quantities of data, according to the report.

## Sources referenced
- Top U.S. Food Safety Officials Discuss Regulatory Landscape at Food Safety Summit | Food Safety Magazine (https://www.food-safety.com/articles/11426-top-us-food-safety-officials-discuss-regulatory-landscape-at-food-safety-summit)
- FDA Encourages Industry to Develop Best Practices, Use Root Cause Analyses | Food Safety Magazine (https://www.food-safety.com/articles/11425-fda-encourages-industry-to-develop-best-practices-use-root-cause-analyses)