The Responsible Health AI Readiness and Maturity Index (RHAMI): Applications for a Global Narrative Review of Leading AI Use Cases in Public Health Nutrition
Monlezun D.J. Marshall G. Omutoko L. Oduor P. Kokonya D. Rayel J. Sotomayor C. Sinyavskiy O. Aksamit T. MacKay K. Grindem D. Jarsania D. Souaid T. Garcia A. Gallagher C. Iliescu C. Dugani S.B. Girault M.I. De Los Ríos Uriarte M.E. Anavekar N.
January 2026Multidisciplinary Digital Publishing Institute (MDPI)
Nutrients
2026#18Issue 1
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’ strategic objectives, practical constraints, and local cultural values. The ultimate strategic objectives of the RHAMI’s 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.
artificial intelligence , edge AI , ethics , human rights , low- and middle-income countries , precision nutrition , public health nutrition , responsible AI , swarm AI
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Faculty of Bioethics, Universidad Anáhuac México, Mexico City, 52786, Mexico
Division of Hospital Internal Medicine, Mayo Clinic, Rochester, 55905, MN, United States
Center for Responsible AI & Global Health, Global System Analytics & Structures, New Orleans, 70112, LA, United States
Department of Educational Management, University of Nairobi, Nairobi, 00200, Kenya
Africa Bioethics Network, Kigali, 00502, Rwanda
School of Medicine, Masinde Muliro University of Science and Technology, Kakamega, 190-50100, Kenya
College of Science, Bicol University, Legazpi City, 4500, Philippines
Pellegrino Center for Clinical Bioethics, Georgetown University, Washington, 20007, DC, United States
Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, 050012, Kazakhstan
Division of Pulmonary Medicine and Critical Care Medicine, Mayo Clinic, Rochester, 55905, MN, United States
School of Bioethics, Ateneo Pontificio Regina Apostolorum, Rome, 00163, Italy
Honors College, University of Houston, Houston, 77204, United States
Department of Cardiology, UT MD Anderson Cancer Center, Houston, 77030, TX, United States
Department of Cardiology, Mayo Clinic, Rochester, 55905, MN, United States
Faculty of Bioethics
Division of Hospital Internal Medicine
Center for Responsible AI & Global Health
Department of Educational Management
Africa Bioethics Network
School of Medicine
College of Science
Pellegrino Center for Clinical Bioethics
Department of Public Health
Division of Pulmonary Medicine and Critical Care Medicine
School of Bioethics
Honors College
Department of Cardiology
Department of Cardiology
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