{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:08:35Z","timestamp":1787314115709,"version":"build-2736575974"},"reference-count":56,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"US National Institutes of Health\/National Institute on Minority Health and Health Disparities","award":["K23 MD016230"],"award-info":[{"award-number":["K23 MD016230"]}]},{"name":"Mayo Clinic Center for Clinical and Translational Science","award":["UL1 TR02377-07"],"award-info":[{"award-number":["UL1 TR02377-07"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Poor diet is the leading preventable risk factor for death worldwide, associated with over 10 million premature deaths and USD 8 trillion related costs every year. Artificial intelligence or AI is rapidly emerging as the most historically disruptive, innovatively dynamic, rapidly scaled, cost-efficient, and economically productive technology (which is increasingly providing transformative countermeasures to these negative health trends, especially in low- and middle-income countries (LMICs) and underserved communities which bear the greatest burden from them). Yet widespread confusion persists among healthcare systems and policymakers on how to best identify, integrate, and evolve the safe, trusted, effective, affordable, and equitable AI solutions that are right for their communities, especially in public health nutrition. We therefore provide here the first known global, comprehensive, and actionable narrative review of the state of the art of AI-accelerated nutrition assessment and healthy eating for healthcare systems, generated by the first automated end-to-end empirical index for responsible health AI readiness and maturity: the Responsible Health AI readiness and Maturity Index (RHAMI). The index is built and the analysis and review conducted by a multi-national team spanning the Global North and South, consisting of front-line clinicians, ethicists, engineers, executives, administrators, public health practitioners, and policymakers. RHAMI analysis identified the top-performing healthcare systems and their nutrition AI, along with leading use cases including multimodal edge AI nutrition assessments as ambient intelligence, the strategic scaling of practical embedded precision nutrition platforms, and sovereign swarm agentic AI social networks for sustainable healthy diets. This index-based review is meant to facilitate standardized, continuous, automated, and real-time multi-disciplinary and multi-dimensional strategic planning, implementation, and optimization of AI capabilities and functionalities worldwide, aligned with healthcare systems\u2019 strategic objectives, practical constraints, and local cultural values. The ultimate strategic objectives of the RHAMI\u2019s application for AI-accelerated public health nutrition are to improve population health, financial efficiency, and societal equity through the global cooperation of the public and private sectors stretching across the Global North and South.<\/jats:p>","DOI":"10.3390\/nu18010038","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:30:18Z","timestamp":1766489418000},"page":"38","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Responsible Health AI Readiness and Maturity Index (RHAMI): Applications for a Global Narrative Review of Leading AI Use Cases in Public Health Nutrition"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7671-1886","authenticated-orcid":false,"given":"Dominique J.","family":"Monlezun","sequence":"first","affiliation":[{"name":"Faculty of Bioethics, Universidad An\u00e1huac M\u00e9xico, Mexico City 52786, Mexico"},{"name":"Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA"},{"name":"Center for Responsible AI & Global Health, Global System Analytics & Structures, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Marshall","sequence":"additional","affiliation":[{"name":"Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6139-5412","authenticated-orcid":false,"given":"Lillian","family":"Omutoko","sequence":"additional","affiliation":[{"name":"Department of Educational Management, University of Nairobi, Nairobi 00200, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9877-4466","authenticated-orcid":false,"given":"Patience","family":"Oduor","sequence":"additional","affiliation":[{"name":"Africa Bioethics Network, Kigali 00502, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0170-2771","authenticated-orcid":false,"given":"Donald","family":"Kokonya","sequence":"additional","affiliation":[{"name":"School of Medicine, Masinde Muliro University of Science and Technology, Kakamega 190-50100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Rayel","sequence":"additional","affiliation":[{"name":"College of Science, Bicol University, Legazpi City 4500, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Sotomayor","sequence":"additional","affiliation":[{"name":"Pellegrino Center for Clinical Bioethics, Georgetown University, Washington, DC 20007, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleg","family":"Sinyavskiy","sequence":"additional","affiliation":[{"name":"Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Aksamit","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7034-4923","authenticated-orcid":false,"given":"Keir","family":"MacKay","sequence":"additional","affiliation":[{"name":"Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0721-3285","authenticated-orcid":false,"given":"David","family":"Grindem","sequence":"additional","affiliation":[{"name":"Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4771-2906","authenticated-orcid":false,"given":"Dhairya","family":"Jarsania","sequence":"additional","affiliation":[{"name":"Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Souaid","sequence":"additional","affiliation":[{"name":"Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9090-0966","authenticated-orcid":false,"given":"Alberto","family":"Garcia","sequence":"additional","affiliation":[{"name":"School of Bioethics, Ateneo Pontificio Regina Apostolorum, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-726X","authenticated-orcid":false,"given":"Colleen","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Honors College, University of Houston, Houston 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8817-4579","authenticated-orcid":false,"given":"Cezar","family":"Iliescu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, UT MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7858-1317","authenticated-orcid":false,"given":"Sagar B.","family":"Dugani","sequence":"additional","affiliation":[{"name":"Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ines","family":"Girault","sequence":"additional","affiliation":[{"name":"Faculty of Bioethics, Universidad An\u00e1huac M\u00e9xico, Mexico City 52786, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Elizabeth","family":"De Los R\u00edos Uriarte","sequence":"additional","affiliation":[{"name":"Faculty of Bioethics, Universidad An\u00e1huac M\u00e9xico, Mexico City 52786, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandan","family":"Anavekar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mayo Clinic, Rochester, MN 55905, 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