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Nutritional epidemiology aims to link dietary exposures to chronic disease, but the instruments for evaluating dietary intake are inaccurate. One way to identify unreliable data and the sources of errors is to compare estimated intakes with the total energy expenditure (TEE). In this study, we used the International Atomic Energy Agency Doubly Labeled Water Database to derive a predictive equation for TEE using 6,497 measures of TEE in individuals aged 4 to 96 years. The resultant regression equation predicts expected TEE from easily acquired variables, such as body weight, age and sex, with 95% predictive limits that can be used to screen for misreporting by participants in dietary studies. We applied the equation to two large datasets (National Diet and Nutrition Survey and National Health and Nutrition Examination Survey) and found that the level of misreporting was >50%. The macronutrient composition from dietary reports in these studies was systematically biased as the level of misreporting increased, leading to potentially spurious associations between diet components and body mass index.

Objective: To assess maternal energy intake and energy demand during childbirth, to understand the current status of energy management during childbirth, and to provide reference for midwives to manage childbirth. Methods: Thirty-seven deliveries in a tertiary hospital were selected for observational study to compare the energy intake and energy demand of the mothers, and the mothers with energy intake greater than the energy demand were divided into the energy standard group and the mothers with energy intake less than the energy demand were divided into the energy non-standard group. Energy intake is measured by the mother's diet and fluid rehydration, finally, it will be converted into energy. Daily energy demand = energy coefficient * ideal body weight, the daily energy demand was converted into the actual energy demand by the duration of childbirth. Finally, the effects of energy during childbirth on the outcome of pregnancy were tracked and analyzed. Results: There were 19 cases of patients in the energy-attainment group and 18 cases of patients in the energy-unattainment group, energy intake (4517.35 ± 1689.90) KJ and energy demand (3149.00 ± 1294.41) KJ in the energy-attainment group, and energy intake (3117.54 ± 1671.11) kJ and energy demand (4704.66 ± 1941.31) in the energy-unattainment group. kJ. The total duration of childbirth in the energy-attainment group was (512.21 ± 185.67) min, and the total duration of childbirth in the energy-unattainment group was (765.44 ± 315.83) min, and the comparison of the two groups suggests that the total duration of childbirth in the energy-attainment group was less than that in the energy-unattainment group, and the difference was statistically significant (T = -2.953, p < 0.05); three cases of postpartum hemorrhage occurred in the energy-unattainment group, and two cases of neonatal hypoglycemia, and the difference between the two groups was not statistically significant. Conclusion: Mothers in childbirth generally have energy substandard situation, energy substandard affects the progress of childbirth, so midwives can encourage mothers to carry out the appropriate kinds of food in different stages of childbirth, to ensure that the energy intake is sufficient. [ABSTRACT FROM AUTHOR]

Background/Objectives: Xylitol, a natural low-caloric bulk sweetener, is increasingly used as a sugar alternative due to its low-glycemic and low-insulinemic properties. The aim was to investigate the effect of orally administered xylitol, sucrose, and acesulfame potassium (ace-K) on energy intake during a subsequent ad libitum test meal. Methods: In this randomized, controlled, double-blind, crossover trial (ClinicalTrials.gov NCT05671965, 20 December 2022), we included 20 healthy participants with normal body weight. Over four study visits, participants consumed an oral preload containing 33.5 g xylitol, 33.5 g sucrose, or 0.1675 g ace-K dissolved in 300 mL water, or 300 mL pure water as control. Participants were provided with an ad libitum test meal 15 min after the preload consumption, and both energy intake and total energy intake (= preload + ad libitum test meal) were assessed. Blood samples were collected to quantify cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), glucose, and insulin concentrations. Results: Total energy intake was lower in response to xylitol and ace-K compared to sucrose (pTukey < 0.03), with no differences between xylitol and ace-K or water. Plasma CCK concentrations were higher in response to xylitol compared to sucrose, ace-K, and water (pHolm < 0.01), whereas GLP-1 concentrations did not differ between the preloads. Plasma glucose and insulin concentrations were lower in response to xylitol compared to sucrose (pHolm < 0.01), but xylitol led to an increase in insulin compared to ace-K and water (pHolm < 0.01). Conclusions: The consumption of oral preloads sweetened with xylitol or ace-K prior to an ad libitum test meal result in a lower total energy intake compared to a preload with sucrose. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aimed to investigate the levels of emotional, restrained, and external eating behaviors (EBs) among adults, categorize them, and analyze their energy and nutrient intake. Methods: A self-reported survey was administered to 522 Korean adults aged 19–64 years to evaluate their emotional, restrained, and external EBs. They were categorized into five types: Non-specific (NS), Emotional (Emo), Restrained (Res), External (Ext), and Combined (Com) EB types. Subsequently, energy intake, intake ratios and levels, and vitamin and mineral intakes were compared after adjusting for sex and age. Results: The Ext type participants consumed energy and an average of 3003.01 kcal per day, while those with Res type consumed 2415.77 kcal. Notably, both the Ext and Com types had higher proportions of excessive energy intake, while the NS and Res types displayed higher proportions of insufficient energy intake. The Emo type yielded a high ratio of lipid intake, while the Com type exhibited high ratios of both lipid and protein intakes. Furthermore, the Res type demonstrated lower vitamin E, niacin, and potassium intakes than the other types. Conclusions: Since the Ext type suggests excessive energy intake, and the Res type suggest intake of vitamin E, niacin, and potassium, identifying EB types provides a novel perspective for nutritional improvement strategies. [ABSTRACT FROM AUTHOR]

Background/Objectives: Persons with multiple sclerosis (MS) are interested in diet as a second-line approach for disease management. This study examined potential variables that correlate with inaccuracy of self-reported energy intake (EI) in adults with MS. Methods: Twenty-eight participants completed two assessment appointments within a 14-day period that included a standard doubly labeled water (DLW) protocol for estimating total energy expenditure (TEE). The participants reported their EI using the Automated Self-Administered 24 h (ASA24) Dietary Assessment Tool. The primary variables of interest for explaining the discrepancy between TEE and ASA24 EI (i.e., inaccuracy) included cognition (processing speed, visuospatial memory, and verbal memory), hydration status (total body water), and device-measured physical activity. Pearson's correlations assessed the association between absolute and percent inaccuracy in reporting of EI with outcomes of interest, followed by linear regression analyses for identifying independent correlates. Results: California Verbal Learning Test—Second Edition (CVLT-II) z-scores and light physical activity (LPA) were significantly associated with mean absolute difference in EI (r = –0.53 and r = 0.46, respectively). CVLT-II z-scores and LPA were the only variables significantly associated with mean percent difference in EI (r = –0.48 and r = 0.42, respectively). The regression analyses indicated that both CVLT-II and LPA significantly explained variance in mean absolute difference in EI, and only CVLT-II explained variance for percent difference in EI. Conclusions: The results from this study indicate that verbal learning and memory and LPA are associated with inaccuracy of self-reported EI in adults with MS. This may guide timely research identifying appropriate protocols for assessment of diet in MS. [ABSTRACT FROM AUTHOR]

Background: New approaches for the management of obesity, a worldwide problem and a major determinant of disability and mortality, are needed. Mastication influences appetite and satiety mechanisms via actual food or sham feeding. However, the effect of mastication of chewing gum, a type of sham feeding, on appetite regulation has not yet been elucidated. Objectives: Our aim was to evaluate the influence of chewing gum on appetite regulation, satiety, energy intake, and weight loss via randomized controlled Trials. Methods: This study was conducted in accordance with the 2020 PRISMA guidelines, and the protocol was registered in PROSPERO (CRD42023432699). Electronic databases MEDLINE®/PubMed, Scopus, and Cochrane Central Register of Controlled Trials were searched from July 2023 to September 2024. The quality of each included study was assessed using the Cochrane risk of bias tool, RoB 2. Results: A total of eight articles with nine RCTs were included in this systematic review. Seven out of nine RCTs evaluated appetite regulation. Five out of seven RCTs reported a significant suppressing effect of hunger, three out of five RCTs reported a significant reduction in desire to eat, and three out of four reported a significant reduction in the desire to eat a sweet snack, all of them compared to the control group. However, the effects on satiety, energy intake, and weight loss are not conclusive. Conclusions: Chewing gum could be a promising non-pharmacological tool for obesity management through appetite regulation; however, further research, with sustained RCTs evaluating the sustained effects of gum chewing on appetite and weight management, is needed. [ABSTRACT FROM AUTHOR]

Although the energy stored in the lean tissue (LT) and adipose tissue (AT) is well known, the energy required to synthesise these tissues is obscure. Theoretically, the energy at the point at which ΔLT/Δ body weight (BW) reaches 100 % on a regression line, which indicates the relationship between ΔLT/ΔBW and the energy required for BW gain, is considered to be the energy expended to synthesise LT. Therefore, we investigated this relationship in rats. Rats were fed diets with different ratios of protein, fat and carbohydrates because their ΔLT/ΔBW values were expected to be different. Six-week-old male Sprague-Dawley rats had ad libitum access to normal (N, n 6), high-fat (HF, n 7) or high-protein (HP, n 8) diets for 4 weeks. The ΔLT/ΔBW was 0·77 in the N, 0·70 in the HF and 0·87 in the HP groups, respectively. The average energy required to gain BW was 8·8 kJ/g in the N group, 7·0 kJ/g in the HF group and 11·3 kJ/g in the HP group. We observed a positive correlation between ΔLT/ΔBW and energy required for BW gain. The regression line demonstrated that the energy expended to synthesise LT was 13·9 kJ/g and AT was −7·9 kJ/g. Therefore, combined with the energy stored in LT, the energy required to accumulate LT is approximately 19 kJ/g, whereas the energy to accumulate AT could not be elucidated. [ABSTRACT FROM AUTHOR]

Background/Objectives: As an endurance multi-sport race, triathlon places significant energy demands on athletes during performance and training. Insufficient energy intake from food can lead to low energy availability (LEA) and Relative Energy Deficiency in Sport (RED-S). We aimed to measure symptoms related to LEA, examine the risk of RED-S, and find how diet relates to the risk of RED-S in highly trained female amateur triathletes. Methods: Our sample was 20 top-performing female triathletes competing in Quarter Ironman (IM), Half IM, IM, or Double IM triathlons for 5.5 ± 2.5 y who were during the preparatory phase of training (training load 11 ± 3.76 h/week, a single workout 84 ± 25 min). Triathletes completed 3-day food diaries, training diaries, and the Low Energy Availability in Females Questionnaire (LEAF-Q). Exercise energy expenditure was estimated using wrist-worn activity trackers. To examine dietary patterns related to the first signs of LEA, predating RED-S, we created two groups: the L-LEA group (LEAF-Q score 0–5, no symptoms related to LEA, low risk of RED-S, n = 10) and the H-LEA group (LEAF-Q ≥ 6, at least one LEA-related symptom, high risk of RED-S, n = 10). Results: The risk of RED-S was prevalent in 30% of female triathletes, and 50% showed at least one symptom related to LEA. Macronutrient intake was similar in all participants, but triathletes from the H-LEA group tended to eat more plant-sourced protein and fiber. They consumed less saturated fatty acids but ingested more significant amounts of n-6 polyunsaturated fatty acids (PUFAn6). Conclusions: We conclude that foods higher in plant proteins, fiber, and PUFAn6 might predispose female triathletes to LEA by reducing the diet's energy density. [ABSTRACT FROM AUTHOR]

Objective: In treating obesity, energy intake control is essential to avoid exceeding energy expenditure. However, excessive restriction of energy intake often leads to resting energy expenditure (REE) reduction, increasing hunger and making weight loss difficult. This study aimed to investigate whether providing nutritional guidance that considers energy expenditure based on the regular evaluation of REE and physical activity could effectively reduce body weight (BW) in patients with obesity. Methods: A single-arm, prospective interventional study was conducted on 20 patients with obesity (body mass index ≥ 25 kg/m2) at the Nagoya University Hospital for 24 weeks. REE and physical activity were regularly assessed, and the recommended energy intake was adjusted based on the values. The primary outcome was the change in BW, and the secondary outcomes included changes in REE and hunger ratings, which were assessed using a visual analog scale. Results: Eighteen participants completed the study, demonstrating a significant reduction in BW after 24 weeks (−5.34 ± 6.76%, p < 0.0001). No significant changes were observed in REE or hunger ratings. No adverse events were reported throughout the study period. Conclusions: Guidance on energy intake based on REE and physical activity was effective for reducing BW in patients with obesity without decreasing REE or increasing hunger. This approach may reduce the burden on patients with obesity while losing BW. [ABSTRACT FROM AUTHOR]

According to the Indonesia Nutrition Status Survey 2022, Central Java highest stunting rate is in Brebes District. In Brebes Regency, the prevalence of stunting increased by 2.8% between 2021 and 2022. The goal of the study was to investigate the risk factors for stunting in toddlers in the Kersana Public Health Center area between the age of 24 and 59 months. This study employed a quantitative approach using a case-control design. Purposive sampling was used to create a sample set of 90. There are two variables in this study, namely the dependent variable (stunting) and the independent variables (family income, mother and father education, immunization, LBW, PBL, birth spacing, mother SEZ status during pregnancy, environmental sanitation, energy and protein intake, IMD, exclusive breastfeeding, complementary feeding, history of diarrhea and respiratory tract infections). The binary logistic regression test on multivariate analysis and the chi-square test were utilized in the bivariate analysis test. The study findings indicated that the following variables were linked to the incidence of stunting: immunization status (p-value=0.000), family income (p-value=0.000), environmental sanitation (p-value=0.000), history of diarrhea (p-value=0.030), early breastfeeding initiation history (p-value=0.006), history of exclusive breastfeeding (p-value=0.003), history of complementary feeding (p-value=0.000), energy intake (p-value=0.000), and protein intake (p-value= 0.001). According to the research, immunization status and energy intake are the two risk variables that have the most significant effects on stunting in children between the ages of 24 and 59 months. [ABSTRACT FROM AUTHOR]

Background: The global rise in obesity has been significantly influenced by shifts in dietary habits that have been exacerbated by external factors such as the COVID-19 pandemic. This study aims to analyze the trends in Romanian dietary habits from 2015 to 2023, focusing on the impact of the COVID-19 pandemic and the role of socio-economic factors, seasonality, and cultural practices. Methods: For dietary habits, we used nationally representative data from the Romanian Household Budget Survey provided by the Romanian National Institute of Statistics. The survey includes 30,000 households annually. From the same provider, we downloaded data about potential drivers of food consumption, such as income, the consumer price index, and the unemployment rate. The analysis mixes descriptive statistics and panel data analysis. Among the main drivers, the econometric models include seasonality and regional factors, ensuring a comprehensive understanding of the changes in dietary behavior. Results: During the COVID-19 pandemic, daily calorie consumption increased to over 3000 calories per person, representing a 20% increase compared to the pre-pandemic period. Post-pandemic, food consumption remains elevated, averaging 2500–2600 calories per person daily. The pandemic also led to a shift in dietary composition, with significant changes. Thus, we mark an increase in fat (p < 0.001) and carbohydrate intake (p < 0.01) and a decrease in protein intake (p < 0.001). Beyond the presence of health disruptors, we confirm the significant impact of income (p < 0.001) and seasonality (p < 0.001). Other factors like unemployment, the consumer price index, and hidden regional factors have a minor role. Conclusions: The COVID-19 pandemic has had a lasting impact on Romanian dietary habits, reinforcing unhealthy eating patterns that were already prevalent. The sustained increase in calorie consumption, particularly of nutrient-poor, energy-dense foods, poses a significant public health challenge. The study also highlights significant seasonal variations, with a marked increase in food intake during the last quarter of the year, driven by cultural and religious traditions. These findings underscore the need for targeted public health interventions and policies that address economic factors and cultural and regional influences to promote healthier dietary behaviors in Romania. [ABSTRACT FROM AUTHOR]

Background Early-life food consumption patterns may affect children’s health by increasing susceptibility to developing non-communicable chronic diseases (NCDs) in adulthood. Aims To evaluate Jordanian children and adolescents’ energy and macronutrient intake and how closely they adhere to dietary recommendations. Methods This cross-sectional study used data from Jordan’s Population-based Food Consumption Survey, a household population-based study conducted in Jordan between 2021 and 2022 (561 children and adolescents 8-19 years). Dietary intake was assessed using the two non-consecutive 24-hour dietary recall methods (24-h DR). The estimated food group and nutrient intakes were compared to nutritional recommendations, including MyPlate dietary guidelines. Results The prevalence of overweight/obese individuals based on body mass index (BMI) was 44%, and the average waist-to-height ratio (WHtR) was 24.7%. Compared to MyPlate dietary guidelines, children and adolescents had a higher added sugar intake (57g/day). Also, consuming vegetables, fruits, and dairy fell short of MyPlate dietary guidelines. The total discretionary calorie intake in children and adolescents was approximately one-third of the total energy intake. Conclusion The food consumption of Jordanian children and adolescents includes high intakes of discretionary calories, with a low intake of fruits, vegetables, and dairy products. The prevalence of overweight/obesity was elevated compared to international norms.

Background Early-life food consumption patterns may affect children’s health by increasing susceptibility to developing non-communicable chronic diseases (NCDs) in adulthood. Aims To evaluate Jordanian children and adolescents’ energy and macronutrient intake and how closely they adhere to dietary recommendations. Methods This cross-sectional study used data from Jordan’s Population-based Food Consumption Survey, a household population-based study conducted in Jordan between 2021 and 2022 (561 children and adolescents 8-19 years). Dietary intake was assessed using the two non-consecutive 24-hour dietary recall methods (24-h DR). The estimated food group and nutrient intakes were compared to nutritional recommendations, including MyPlate dietary guidelines. Results The prevalence of overweight/obese individuals based on body mass index (BMI) was 44%, and the average waist-to-height ratio (WHtR) was 24.7%. Compared to MyPlate dietary guidelines, children and adolescents had a higher added sugar intake (57g/day). Also, consuming vegetables, fruits, and dairy fell short of MyPlate dietary guidelines. The total discretionary calorie intake in children and adolescents was approximately one-third of the total energy intake. Conclusion The food consumption of Jordanian children and adolescents includes high intakes of discretionary calories, with a low intake of fruits, vegetables, and dairy products. The prevalence of overweight/obesity was elevated compared to international norms.

Context: How pre-exercise meal composition influences metabolic and health responses to exercise later in the day is currently unclear., Objective: Examine the effects of substituting carbohydrate for protein at lunch on subsequent exercise metabolism, appetite, and energy intake., Methods: Twelve healthy males completed 3 trials in randomized, counterbalanced order. Following a standardized breakfast (779 ± 66 kcal; ∼08:15), participants consumed a lunch (1186 ± 140 kcal; ∼13:15) containing either 0.2 g·kg-1 carbohydrate and ∼2 g·kg-1 protein (LO-CARB), or 2 g·kg-1 carbohydrate and ∼0.4 g·kg-1 protein (HI-CARB), or they fasted (FAST). Participants later cycled at ∼60% V̇O2peak for 1 hour (∼16:15) and post-exercise ad libitum energy intake was measured (∼18:30). Substrate oxidation, subjective appetite, and plasma concentrations of glucose, insulin, nonesterified fatty acids (NEFA), peptide YY (PYY), glucagon-like peptide 1 (GLP-1), and acylated ghrelin were measured for 5 hours post-lunch., Results: Fat oxidation was greater during FAST (+11.66 ± 6.63 g) and LO-CARB (+8.00 ± 3.83 g) than HI-CARB (P < .001), with FAST greater than LO-CARB (+3.67 ± 5.07 g; P < .05). NEFA were lowest in HI-CARB and highest in FAST, with insulin demonstrating the inverse response (all P < .01). PYY and GLP-1 demonstrated a stepwise pattern, with LO-CARB greatest and FAST lowest (all P < .01). Acylated ghrelin was lower during HI-CARB and LO-CARB vs FAST (P < .01). Energy intake in LO-CARB was lower than FAST (-383 ± 233 kcal; P < .001) and HI-CARB (-313 ± 284 kcal; P < .001)., Conclusion: Substituting carbohydrate for protein in a pre-exercise lunch increased fat oxidation, suppressed subjective and hormonal appetite, and reduced post-exercise energy intake., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Background: In 2014, Mexico implemented an 8% tax on non-essential energy-dense foods (NEDFs) exceeding 275 calories per 100 g to improve dietary quality and reduce obesity prevalence. While this tax has shown promising results in reducing purchases of these items and decreasing obesity rates in children, its potential may be limited by the relatively low tax rate. We aimed to assess the potential impact of increasing the existing NEDF tax on body weight (kg), body mass index (BMI), obesity prevalence, and obesity cases in the Mexican adult population., Methods: Using data from the Mexican 2018 National Health and Nutrition Survey (ENSANUT-2018), and a microsimulation mathematical model that translates adult energy balance into body weight changes, we analyzed the potential impact on obesity over 10 years. Our final sample included 15,109 participants, representing approximately 76,221,919 adults aged 20 and older in Mexico., Results: We found that doubling the existing tax (16%) could result in an average weight reduction of 0.4 kg and a 3.2% reduction in obesity prevalence over 10 years. If the NEDF tax was quadrupled (32%), an average weight loss of 1.2 kg and an 8.8% reduction in obesity prevalence could be expected. Males, low-income individuals, and adults aged 20 to 39 years would benefit the most, showing a higher expected reduction in obesity., Conclusions: Very few examples of taxation on NEDFs exist worldwide, and Mexico has been a key example. Policymakers should consider a tax reform that increases the current NEDFs tax to achieve larger health benefits., Competing Interests: Declarations. Ethics approval and consent to participate: The study complies with the ethical principles outlined in the Declaration of Helsinki, ensuring respect for individuals, informed consent, and the ethical conduct of research involving human participants. The National Health and Nutrition Survey (ENSANUT) was reviewed and approved by the Ethics Committee of the National Institute of Public Health (INSP) in Mexico, under applicable national and international standards. All participants provided informed consent prior to their inclusion in the study, and their confidentiality and privacy were safeguarded throughout the research process. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Low energy availability (LEA) is a prevalent concern among athletes, often attributed to intentional or unintentional under-fueling behaviors. Nutritional and energy availability educational interventions are poised for successful LEA prevention, with a robust body of literature examining intervention effectiveness. Thus, this systematic review aimed to synthesize the available evidence on nutritional education interventions to address gaps in nutritional knowledge and combat LEA among athletes. Medical databases (MEDLINE, Web of Science) were systematically searched on July 11, 2023, and an updated search was conducted on July 26, 2024. Studies conducted among adult athletes who underwent nutritional education interventions with assessed effects on dietary knowledge, behaviors, and/or LEA outcomes were included. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale by two blinded assessors. Intervention methodology and primary outcomes related to nutritional interventions were extracted by a single assessor. Twelve articles were included (mean PEDro score: 5). Interventions ranged from 1 to 20 sessions, and 10- to 120-minute durations. Most studies employed in-person educational sessions on fueling and macro- and micro-nutrient intake for athletic performance. Half of included studies included LEA education. Intervention approaches were largely heterogeneous, although most programs had favorable outcomes for nutrition knowledge and fueling behaviors. Nutrition interventions appear to be beneficial for athletes in the context of LEA, though current approaches are largely heterogenous. Future research should seek to develop a translational nutritional education plan for broad application in athletes designed to increase nutritional knowledge and combat LEA., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 DeJong Lempke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Poor appetite is an important health concern in older adults. Numerous methods exist for appetite assessment, without a consensual gold standard. This study aims to compare Simplified Nutritional Appetite Questionnaire (SNAQ) and two single-item appetite questions with appetite ratings from visual analogue scales (VAS) and energy intake (EI). In 126 community-dwelling adults aged ≥65 years from the APPETITE trial, appetite was assessed using SNAQ, SNAQ 1 st item, Centre for Epidemiologic Studies-Depression scale (CES-D) 2 nd item and using VAS appetite ratings (fasting, 0, 30, 60, 120, 180 min post-breakfast, post-lunch) and EI (ad libitum lunch) in a test meal setting. Spearman correlations were calculated between SNAQ, single-items, VAS-fasting, and EI. Differences in VAS-fasting and EI between normal and poor appetite groups (based on SNAQ, single-items) were examined using Mann-Whitney-U-test. Repeated measures Generalized Linear Models were used to compare all VAS ratings across the test morning and post-breakfast response ratings with VAS-fasting as a covariate between appetite groups. SNAQ score was correlated with VAS-fasting (r=0.26, p<0.001) and EI (r=0.22, p<0.05). VAS-fasting was lower in the SNAQ-based poor appetite group (p=0.01). Time/group interaction effects (SNAQ, η p 2 =0.02; CES-D-item, η p 2 =0.02) for all VAS ratings, and group (SNAQ-item, η p 2 =0.04) and interaction effects (CES-D-item, η p 2 =0.03) for post-breakfast ratings were observed (p<0.05, respectively). SNAQ identified differences in VAS-fasting, possibly reflecting processes related to the drive to eat, while the two single-items identified appetite differences in response to a standardised breakfast. Different methods appear to capture different aspects of appetite, which should be considered when choosing an assessment method., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare., (Copyright © 2025. Published by Elsevier Ltd.)

There's more to a healthy diet than merely getting the desirable calories. At the present cross-sectional study, dietary consumption was measured using 24-hour dietary recall method. Nutrient density was evaluated using the NRF 9.3 index, which is based on nine recommended nutrients and three nutrients to limit. The link between carbohydrate, protein, fat, fiber and sugar intake at breakfast and the nutrient density in subsequent meals was evaluated using dose-response analysis. A total of 427 adults (199 men and 228 women) were included. The study found an inverse relationship between sugar intake at breakfast and nutrient density at lunch. Specifically, consuming up to 10 g of sugar at breakfast was associated with a reduction in the NRF profile, Additionally, breakfasts containing 12 g of fat were linked to the lowest nutrient density (p non-linearity < 0.001). The dose-response test showed a non-linear relationship (p non-linearity < 0.001); the intake of fiber in breakfast up to 1.5 g was associated with a steep increase in dinner NRF while higher intakes resulted in a more gradual slope of improvement (p non-linearity < 0.001). This study revealed that increment in fat and sugar intake at breakfast is associated with decrease in NRF score at lunch. Moreover, increasing fiber consumption at breakfast is associated with increasing the dinner quality. Consuming a higher quality breakfast is associated with better overall diet quality., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Running title: Nutrient density and diet quality., (© 2025. The Author(s).)

Background: Resting metabolic rate (RMR), the energy required by the body at rest, is the largest part of total daily energy expenditure. Commonly used prediction equations may overestimate RMR in adults with Down syndrome (DS). The purpose of this study was to assess the equivalency of prediction equations for estimating RMR in adults with DS., Methods: Twenty-five adults with DS (24 ± 5 years of age, 64% female) completed RMR assessments at an academic medical centre in the United States between November 2021 and July 2023. Measured RMR (kilocalories per day) was compared to estimated RMR from eight prediction equations using a null hypothesis significance (i.e., a paired t-test) and equivalence (i.e., a two one-sided test) tests. Bland-Altman plots, Pearson correlations and linear regressions were used to evaluate the bias between the measured and predicted RMR values., Results: Measured RMR in adults with DS was 1090 ± 136 kcal/day. Prediction equations overestimated RMR by 8 ± 16% (76 ± 165 kcal/day) to 45 ± 16% (488 ± 165 kcal/day) except for the Bernstein fat-free mass equation which underestimated RMR by 0.2 ± 11.5% (8 ± 123 kcal/day) and was statistically equivalent to measured RMR in our sample (p = 0.027)., Conclusions: The Bernstein fat-free mass equation offers better accuracy in adults with DS than other RMR prediction equations, but the equation needs to be evaluated in larger, more diverse samples of adults with DS., (© 2025 John Wiley & Sons Ltd and MENCAP.)

Background: Cardiovascular diseases are a leading cause of global mortality, with diet playing a key role in their progression. The Atherogenic Index of Plasma (AIP) is a predictive marker for cardiovascular risk, but its association with dietary intake across cardiometabolic phenotypes remains underexplored. This study investigates the relationship between dietary intake and AIP, hypothesizing that energy intake and macronutrients influence AIP and, consequently, cardiovascular risk., Methods: This cross-sectional study analyzed data from 9,515 participants aged 35-55 in the Azar cohort study. Based on Body Mass Index (BMI) and metabolic syndrome (MetS), participants were classified into four phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUHNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUHO). Dietary intake was evaluated using a semi-quantitative food frequency questionnaire (FFQ), and AIP was calculated. Adjustments were made for age, gender, socioeconomic status, and physical activity., Results: A notable difference was observed in demographic and clinical status between cardiometabolic groups of males and females. The AIP was highest in the MUHNW (0.42 for males; 0.28 for females) and lowest in the MHNW (0.05 for males; -0.05 for females, P < 0.001). There was a statistically significant difference in the mean energy intake and the percentage of energy intake from protein among the cardiometabolic phenotypes (p < 0.001). After adjusting for confounders, only weak but meaningful correlations remained for energy, carbohydrate, and protein intake in the MUHO (r = 0.048, P = 0.01; r = 0.057, P = 0.003; and r = 0.050, P = 0.01) and for carbohydrate and lipid intake in the MHO (r = 0.034, P < 0.01 and r = -0.055, P < 0.001)., Conclusion: The study found weak but meaningful correlations between energy, carbohydrate, and protein intake and AIP in the MUHO phenotype and between carbohydrate and lipid intake and AIP in the MHO phenotype. This highlights the role of energy and carbohydrates in AIP within specific subgroups. Future research should focus on the effects of macronutrient combinations on AIP and long-term dietary impacts on metabolic health instead of BMI., Competing Interests: Declarations. Consent for publication: At the beginning of the cohort study, written informed consent for publication was obtained from all participants or their legal guardians. Competing interests: The authors declare no competing interests. Ethical approval: This study was approved by the Ethical Board of the Research Council of Tabriz University of Medical Sciences (No.IR.TBZMED.REC.1402.428)., (© 2025. The Author(s).)

Objective: To determine the association between survey-based self-reported problematic low energy availability indicators (LEA-I) and race performance and intra-event medical encounters during the Boston Marathon., Methods: 1030 runners who were registered for the 2022 Boston Marathon completed an electronic survey (1-4 weeks pre-race) assessing LEA-I, training and medical history. De-identified survey data were linked to event wearable timing chips and medical encounter records. LEA-I was defined as: an elevated Eating Disorder Examination Questionnaire score, elevated Low Energy Availability (LEA) in Females Questionnaire score, LEA in Males Questionnaire with a focus on gonadal dysfunction score and/or self-report of diagnosed eating disorder/disordered eating., Results: The prevalence of LEA-I was 232/546 (42.5%) in females and 85/484 (17.6%) in males. Athletes without LEA-I (non-LEA-I) achieved significantly better race times versus those with LEA-I (accounting for demographic and anthropomorphic data, training history and marathon experience), along with better division finishing place (DFP) mean outcomes (women's DFP: 948.9±57.6 versus 1377.4±82.9, p<0.001; men's DFP: 794.6±41.0 versus 1262.4±103.3, p<0.001). Compared with non-LEA-I athletes, LEA-I athletes had 1.99-fold (95% CI: 1.15 to 3.43) increased relative risk (RR) of an intra-event medical encounter of any severity level, and a 2.86-fold increased RR (95% CI:1.31 to 6.24) of a major medical encounter., Conclusion: This is the largest study to link LEA-I to intra-event athletic performance and medical encounters. LEA-I were associated with worse race performance and increased risk of intra-event medical encounters, supporting the negative performance and medical risks associated with problematic LEA-I in marathon athletes., Competing Interests: Competing interests: KEA is a deputy editor for BJSM, (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Introduction: The aim of this study is to investigate the effects of acute exercise on appetite control and whether this differs between morning and late afternoon in individuals with overweight/obesity with or without type 2 diabetes (T2D)., Methods and Analysis: The hedonic and homeostatic appetite control in obesity and type 2 diabetes in the context of meal and exercise timing (TIMEX) study is a randomised, controlled, cross-over trial. Fifty-eight women and men (aged 18-75 years) with overweight or obesity (body mass index ≥25 kg/m 2 ) with or without T2D will be recruited. All participants will complete a screening and baseline visit followed by four test visits: two morning visits and two late afternoon visits. The participants will arrive in the fasted state during the visits. During one morning visit and one late afternoon visit, the participants will engage in a 45-min bout of acute high-intensity interval exercise on an ergometer bicycle. The remaining two visits (one morning and one late afternoon visit) will include 45 min of rest. Fifteen minutes after the rest or exercise period, the participants will be presented with an ad libitum meal. Blood samples will be collected and subjective appetite will be assessed using Visual Analogue Scales in the fasted state before exercise/rest, immediately post-exercise/rest and at 15, 30, 45 and 60 min post-exercise/rest. Food reward and food preferences will be assessed using the validated diurnal version of the Steno Biometric Food Preference Task in the fasted state before exercise/rest and 15 min after the ad libitum meal (45 min post-exercise/rest). The primary outcome is the difference in ad libitum energy intake after exercise compared with rest. Secondary outcomes include eating rate; 24-hour energy intake; appetite-related metabolites and hormones, and circulating biomarkers assessed from proteomics, metabolomics and lipidomics analyses; food choice, food attention and reaction time, explicit and implicit liking and wanting for different food categories, subjective appetite; ratings of perceived exertion during exercise. All outcomes will be compared between morning and late afternoon and between participants with and without T2D., Ethics and Dissemination: The study has been approved by the Ethics Committee of the Capital Region of Denmark (H-22019913) and the Capital Region of Denmark's Research Register (Privacy). The study will be conducted in accordance with the Declaration of Helsinki. All results will be published in national and international peer-reviewed journals and will be disseminated at national and international conferences., Trial Registration Number: NCT05768958., Competing Interests: Competing interests: LJ, NPL, MMJ, MBB, LGG and JSQ are employed by Steno Diabetes Center Copenhagen ( SDCC). SDCC is a hospital providing health services for the public health care system. SDCC is funded by the Novo Nordisk Foundation through unrestricted grants. The Novo Nordisk Foundation has no economic interests in the study. The Novo Nordisk Foundation will not have influence on (1) the study design; (2) the collection, analysis and interpretation of data; (3) the writing of the study report or any publication; and (4) the decision to submit the paper for publication. The investigators employed at SDCC will not benefit economically from conducting the study. Co-investigator MKG is employed at Novo Nordisk and will be responsible for exploratory investigations using the data collected in the TIMEX study. Due to the collaborative nature of the study, Novo Nordisk has been involved in designing the study and will be involved in analysing and interpreting data. Novo Nordisk will align with SDCC if and when data and/or biosamples from the study are used for publications. HEP and KF are now employed by Novo Nordisk. iMotions is a collaborator on the project and give advice for the use and analysis of biometric methods in the study design phase. iMotions A/S have no influence on (1) the study design; (2) the collection, analysis and interpretation of data; (3) the writing of the study report or any publication; and (4) the decision to submit the paper for publication. LGG and KF own shares in Novo Nordisk. The sponsor and principal investigator, JSQ, have no economic interest in the results of the study. All other authors have no competing interests to declare., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Nearly 4 decades after its landmark validation study, researchers undertook a major comprehensive reevaluation of the semiquantitative food frequency questionnaire (FFQ). Although it has evolved with trends in science and our expanding food environment, this FFQ has been administered continuously to over 250 000 US cohort participants for several decades and has contributed enormously to our understanding of the role long-term diet plays in health and disease across the lifespan. Nonetheless, it is critical that the field take time to validate, recalibrate, and reassure researchers that the FFQ continues to generate useful estimates of dietary intake. There are persistent misconceptions among both nutritional epidemiologists and the FFQ's critics about what the FFQ can and cannot measure that require regular re-education on the principles underlying FFQ development and validation. Thus, the carefully conducted validation study by Gu et al (Am J Epidemiol. 2024;193(1):170-179) provides an important benchmark for nutrition science, underscoring the continued value and utility that the FFQ brings to epidemiologic research., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Expected satiety is a key element in predicting meal portion size and food consumption; however, how this can be affected by different breakfast portion sizes is unknown. The study examined the impact of different breakfast portions on satiety, portion size, and energy intake and comprised an online survey and an experimental intervention. Sixteen adults (9 women, BMI: 24.9 ± 4.3 kg/m 2 ) rated images of three portion sizes (small, standard, large) of the same breakfast using an ordinal scale. Subsequently, they were asked to self-prepare and consume ad libitum the three breakfast portions in a randomised order on different days and to complete a food diary. Satiety and portion size perception were re-measured upon consumption of each breakfast. For both the visual image and breakfast consumption, the small breakfast portion was rated as the smallest and least filling, while the large portion was rated as the largest and most filling (p < 0.05). When consuming the small breakfast, participants reported being hungrier and less full between breakfast and lunch (p < 0.05) and had a higher energy intake from lunch onward, due to more snacking (p < 0.05). However, the total daily energy intake was not different among the three breakfast portion sizes. Individuals seemed accustomed to predicting satiety and portion size from images. The consumption of the small breakfast was judged as not filling enough and was accompanied by a higher energy intake via energy-dense snacks. Based on these preliminary findings, breakfast size reduction may lead to unhealthy compensatory energy intake by snacking on energy-dense foods., (© 2025 The Author(s). Nutrition Bulletin published by John Wiley & Sons Ltd on behalf of British Nutrition Foundation.)

Ultra-processed foods are linked to adverse health outcomes, making it crucial to monitor consumption trends. Despite rising consumption due to Westernized diets in Asia, long-term studies targeting Asian adults are lacking. Thus, we analyzed ultra-processed food consumption trends among Korean adults from 1998 to 2022. Additionally, we compared intakes before and during the pandemic to evaluate the potential impact of the COVID-19 pandemic. Furthermore, we compared the nutrient profiles of ultra-processed and non-ultra-processed food group intakes. This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2022, classifying food into four NOVA groups. Dietary intake was assessed In 2020-2022, ultra-processed foods had a higher proportion using a single 24-hour recall for 96,447 individuals aged 20 years or older. Sampling weights were applied to adjust for the complex survey design and non-responses. We calculated the weighted means and confidence intervals for the proportion of energy intake by NOVA food groups and various nutrient profiles. The proportion of energy intake from ultra-processed foods among Korean adults steadily increased from 17.41% in 1998-2005 to 26.71% in 2016-2019 (mean difference: 9.30% [95% CI, 8.62-9.98%]), but declined for the first time during the pandemic, falling to 25.33% (mean difference: -1.39% [95% CI, -2.18% to -0.59%]). In 2020-2022, ultra-processed foods had a higher proportion of calories from carbohydrates (62.12% vs. 58.81%) and fats (28.22% vs. 22.31%) but a lower proportion from protein (10.32% vs. 17.26%) compared to non-ultra-processed foods. From 1998 to 2022, the fat content of both ultra-processed and non-ultra-processed foods significantly increased, rising from 26.24 to 28.15% for ultra-processed foods (mean difference: 1.91% [95% CI, 1.33-2.49%]) and from 16.81 to 22.26% for non-ultra-processed foods (mean difference: 5.45% [95% CI, 4.99-5.91%]). This study examined 25-year trends in ultra-processed food consumption among South Koreans, showing a consistent increase in energy intake from ultra-processed foods until the COVID-19 pandemic, during which it declined for the first time. However, this decline may be temporary, underscoring the need for sustained efforts to reduce ultra-processed food consumption., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical statement: The research protocol was approved by the Institutional Review Boards of the KDCA (2007-02CON-04-P, 2008-04EXP-01-C, 2009-01CON-03–2 C, 2010-02CON-21-C, 2011-02CON-06-C, 2012-01EXP-01–2 C, 2013-07CON-03–4 C, 2013-12EXP-035 C, 2018-01-03-P-A, 2018-01-03-C-A, 2018-01-03–2 C-A, 2018-01-03–5 C-A, 2018-01-03–4 C-A, 2022-11-16-R-A). Written informed consent was obtained from all participants prior to their participation. Furthermore, the KNHANES provides public access to its data, which can be utilized as a valuable resource for diverse epidemiological investigations., (© 2025. The Author(s).)

Background: Understanding the effects of balanced energy and protein (BEP) supplements on gestational weight gain (GWG) and how the effects differ depending on maternal characteristics and the nutritional composition of the supplements will inform the implementation of prenatal BEP interventions., Methods and Findings: Individual participant data from 11 randomized controlled trials of prenatal BEP supplements (N = 12,549, with 5,693 in the BEP arm and 6,856 in the comparison arm) in low- and middle-income countries were used. The primary outcomes included GWG adequacy (%) and the estimated total GWG at delivery as continuous outcomes, and severely inadequate (<70% adequacy), inadequate GWG (<90% adequacy), and excessive GWG (>125% adequacy) as binary outcomes; all variables were calculated based on the Institute of Medicine recommendations. Linear and log-binomial models were used to estimate study-specific mean differences or risk ratios (RRs), respectively, with 95% confidence intervals (CIs) of the effects of prenatal BEP on the GWG outcomes. The study-specific estimates were pooled using meta-analyses. Subgroup analyses were conducted by individual characteristics. Subgroup analyses and meta-regression were conducted for study-level characteristics. Compared to the comparison group, prenatal BEP led to a 6% greater GWG percent adequacy (95% CI: 2.18, 9.56; p = 0.002), a 0.59 kg greater estimated total GWG at delivery (95% CI, 0.12, 1.05; p = 0.014), a 10% lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.99; p = 0.025), and a 7% lower risk of inadequate GWG (RR: 0.93; 95% CI: 0.89, 0.97; p = 0.001). The effects of prenatal BEP on GWG outcomes were stronger in studies with a targeted approach, where BEP supplements were provided to participants in the intervention arm under specific criteria such as low body mass index or low GWG, compared to studies with an untargeted approach, where BEP supplements were provided to all participants allocated to the intervention arm., Conclusions: Prenatal BEP supplements are effective in increasing GWG and reducing the risk of inadequate weight gain during pregnancy. BEP supplementation targeted toward pregnant women with undernutrition may be a promising approach to delivering the supplements., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background and Aims: Energy and protein provision for critically ill patients who receive oral nutrition often falls below recommended targets. We compared characteristics and nutrition processes during hospital stay (within and post-intensive care unit [ICU] stay) of those who received oral nutrition as the sole nutrition source to those who first commenced enteral (EN) or parenteral nutrition (PN) within an Australian or New Zealand (ANZ) ICU., Methods: Multicentre, observational study of routine nutrition care in 44 hospitals across ANZ, including adult patients within ICU admitted for at least 48 h. Those receiving oral nutrition as the sole source of nutrition (with or without oral nutrition supplements) were included in the 'oral nutrition' group and those who first received EN and/or PN in the ICU as the 'EN/PN group'. The primary outcome was median daily energy delivery in ICU. Data are presented as number (%) or median [interquartile range]., Results: Of the 409 patients enroled, median [IQR] age was 64 [51-74] years and 257 patients (62%) were male. APACHE II score, use of invasive ventilation and hospital length of stay (LOS) were all lower in those receiving oral nutrition (n = 200) compared to those receiving EN/PN (n = 209). In ICU, 63 (31.5%) and 169 (81%) (p < 0.001), patients who were receiving oral nutrition and in the EN/PN group received a nutrition assessment, respectively. Oral nutrition supplements were provided for 40 (20%) patients in the oral nutrition group and 31 of 94 (33%) of those receiving oral nutrition in the EN/PN group (p = 0.019). Energy and protein intake in ICU for the oral nutrition group was 716 [597-1069] kcal/day and 37 [19-46] g/day versus 1158 [664-1583] kcal/day and 57 [31-77] g/day for those receiving EN/PN (p = 0.020 energy, p = 0.016 protein). Quantification of oral nutrition was attempted in 78/294 (27%) patients in ICU and completed on 27/78 (36%) occasions. On the ward, attempts were made for 120/273 (44%) patients, with 60/120 (50%) complete., Conclusion: Patients who received oral nutrition as the sole nutrition source in ICU had lower illness severity, rates of nutrition assessment and provision of oral supplements compared to those who first received EN/PN. Quantification of oral nutrition was often incomplete for all patients in ICU and on the ward., (© 2024 British Dietetic Association.)

Objectives: The optimal nutritional management during a severe flare of inflammatory bowel disease is uncertain. The goal of this study was to describe variations in nutritional practices between different countries, professions and types of hospitals, as well as between ulcerative colitis (UC) and Crohn's disease (CD)., Methods: In this cross-sectional study, a novel questionnaire was distributed in the ECCO Congress 2022 and via ECCO country representatives., Results: The survey was completed by 313 participants. In total, 68% of the respondents were physicians. No specific nutritional screening tool was used by 45% of respondents. Almost a quarter of respondents reported less than 25% of patients being assessed by a dietitian in the first 3 days of a flare. The most common form of nutritional therapy was oral nutritional supplements (ONS) with easy-to-digest food. Total parenteral nutrition (TPN) was used by 10% of respondents for UC patients and 7% for CD. Energy intake, stool frequency and inflammatory biomarkers were the most common factors in determining when to change nutritional therapy. There were significant differences between different countries and health care professions for all the outcomes ( P  < 0.05). Nutritional management did not generally vary according to hospital type (university vs. general). During the first 3 days of a flare, a diet consisting exclusively of ONS was significantly more frequently used for CD than UC ( P  = 0.018). Otherwise, similar nutritional therapy strategies were reported for CD and UC, including using TPN to a similar extent., Conclusion: There is significant variation in nutritional management practices. Country is the main determinant of differences in practice., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Nut consumption in Australia is low, perhaps due to concerns with weight gain. However, nut consumption is not associated with increased weight, in part because of their lower metabolisable energy. Current energy labelling for nuts use Atwater factors, which over-represent the available energy from nuts. Therefore, this research aimed to examine stakeholders' knowledge, practices and perceptions of displaying true metabolisable energy on nutrition labels and its perceived impact on nut consumption., Methods: An anonymous and voluntary survey was conducted online. Eligible respondents lived in Australia, were aged 18 years or older and had either no formal nutrition education (consumer group) or had formal training and were working as a stakeholder (stakeholder group; working in nutrition/dietetics, public health, food industry, food regulation or nut growing). Convenience sampling and snowballing were used to recruit respondents primarily via online advertisement., Results: Three hundred and forty-eight respondents (63.2% female; 71.0% aged 18-39 years; 69.0% Bachelor's degree or higher) were included in the analyses. A larger proportion of stakeholders agreed that nut consumption assists with weight management (67.9%) compared with consumers (47.6%). Theoretical food packaging showing both Atwater and metabolisable energy in the nutrition information panel was favoured among consumers and stakeholders, though 62.3% of consumers reported that a lower metabolisable energy of nuts would not impact their consumption., Conclusions: This study indicates a need to further investigate the impact of metabolisable energy labelling on nut intake. Further education about the relationship between nuts and body weight is required for consumers and stakeholders., (© 2024 The Author(s). Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Background: Current dietary assessment methods are affected by memory-related bias and heavily burden respondents. To reduce respondent burden and associated measurement error, we recently developed an innovative smartphone-based 2-h recall (2hR) method., Objectives: Evaluation of the use of random 2hRs, administered via the smartphone-based dietary assessment tool "Traqq", for assessing habitual intake against a validated food frequency questionnaire (FFQ) and blood concentration markers., Methods: Dietary intake was assessed in 215 Dutch adults by repeated 2hRs on randomly selected days and times (i.e. equivalent to 3 full days of 2hRs) over a 4-wk period. At the end of the study period, participants completed a validated semiquantitative FFQ. Sixty-five random participants also provided 2 fasting blood samples, to assess plasma carotenoid and plasma n-3 polyunsaturated fatty acid (PUFA) concentrations., Results: Intake estimates of energy (2132 ± 665 kcal vs. 2017 ± 572 kcal) were slightly higher with 2hRs than FFQ, whereas the percentage energy intake from macronutrients where similar (i.e. protein: 37 ± 14 en% vs. 37 ± 13 en%; fat: 35 ± 6 en% vs. 44 ± 7 en%; carbohydrates: 44 ± 7 en% vs. 44 ± 6 en%). For food groups, a larger variation in intake estimates was found ranging from -65% (legumes) to 62% (pastry, cake and biscuits). Spearman correlations between 2hRs and FFQ ranged from 0.33 to 0.69 for energy and macronutrients, from 0.32 to 0.58 for micronutrients, and from 0.27 to 0.67 for food groups. For all nutrients and food groups, ≥70% of the participants were classified in the same/adjacent quartile. Spearman correlations between 2hRs and plasma carotenoids and n-3 PUFA ranged between 0.34 and 0.57 and cross-classification ranged between 61% and 83% in the same/adjacent quartile., Conclusions: Comparing 2hRs with FFQ and blood concentration markers showed good ranking ability for energy, most nutrients, and most frequently consumed foods. More variation was seen for episodically consumed foods and nutrients., Trial Registration Number: This trial was registered at the Dutch Central Committee on Research Involving Human Subjects (CCMO) registry as ABR No. NL69065.081.19 (https://www.toetsingonline.nl/to/ccmo&#95;search.nsf/fABRpop?readform&unids=26E81F6A56186B1EC12587BD001C7AC9)., Competing Interests: Conflict of interest Corresponding authors will be queried for their own and their co-authors’ conflict of interest disclosures during the manuscript submission process using the Declaration of Interests tool (https://declarations.elsevier.com/). The tool will generate a Word file for upload with your manuscript submission., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Maternal nutrition during pregnancy is crucial to ensure positive outcomes for both the mother and newborn. Despite its importance, maternal nutritional status remains poor, particularly in low- and middle-income countries, where social, cultural and economic factors play a pivotal role. This study assessed the adequacy of energy and dietary nutrient intake among Sri Lankan pregnant women compared to their dietary reference intakes., Methods: This study was part of the Sri Lanka Mother and Newborn Growth study, a nationwide prospective cohort of 2000 pregnant women. We prospectively investigated maternal dietary intake using a validated food frequency questionnaire during the first, second and third trimesters., Results: We observed an imbalanced macronutrient distribution, with carbohydrates contributing over 67% of total median energy intake, while protein and fat contributed approximately 11% and 17%, respectively. Ethnic and socio-economic disparities in energy and macronutrient intake were notable. The Sinhalese ethnic group showed the highest median percentage of energy consumption derived from carbohydrates at 68.0% (IQR: 64.6%‒71.1%), significantly exceeding the intake of Tamil and Moor groups. Estate residents reported the lowest proportion of energy from protein (10.6%, IQR: 10.1%‒11.3%), which was significantly lower than the intakes of urban and rural residents. Additionally, women in the lowest income group had a lower total energy intake (1871 kcal/day, IQR: 1464-2392) than those in higher income groups, highlighting socio-economic influences on maternal nutrition. Micronutrient deficiencies were pervasive, particularly for vitamin B2 (88.6%-91.0%), folate (99.3%-99.8%), vitamin B12 (97.8%-99.5%), calcium (80.8%-91.4%) and iron (91.1%-96.5%). Sodium intake exceeded recommended levels for over 75% of women across all trimesters., Conclusion: Imbalances in macronutrient intake and widespread micronutrient deficiencies among Sri Lankan pregnant women underscore the urgent need for interventions targeting maternal nutrition. Addressing socio-economic disparities is critical to improving maternal and neonatal health outcomes., (© 2025 The Author(s). Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Objectives: To determine whether daily provision of a high protein, high energy meal for 12-weeks to under-nourished older adults living independently in the community can improve physical, physiological, and psychological outcomes., Design: A randomised crossover trial., Setting: Participant homes within a 15-mile radius to meal supplier; Dartmoor Community Kitchen Hub., Participants: Fifty-six community dwelling older adults (82 ± 7 years, 70% female) were randomised (stratified for baseline mini nutritional assessment (MNA) score and cohabiting or living alone) to receive 12-weeks of meal provision followed by 12-weeks no intervention (meals first group, n = 28), or, 12-weeks without intervention followed by 12-weeks of meal provision intervention (meals second group, n = 28)., Intervention: A daily high protein and high energy home-delivered meal for 12-weeks. Each meal contained >50% daily protein requirements (0.6 g kg -1 of the recommended 1.2 g kg -1 .day -1 , ∼42 g protein per meal) and >40% daily energy requirements (∼715 kcal)., Measurements: Physical, physiological and psychological health (including MNA score, body composition, hand grip strength, self-esteem, and depression) were evaluated in participants' homes before and after each 12-week period (baseline, 12-weeks, and 24-weeks). The effect of meal provision was assessed by t-test then effects were combined using meta-analysis. Retention of any meal provision effect after cessation of meal delivery was quantified as change from the end of the meal intervention versus 12-weeks follow-up via paired t-test., Results: The meal intervention significantly increased MNA score with a medium effect size (MNA: pooled Cohen's D = 0.74, p < 0.001). Energy and protein intake increased significantly during the control period where participants were asked to maintain their habitual diet in the meals second group (energy intake: increase = 252 kcal [95% CI 36-487 kcal], t(22) = 2.408, p = 0.025, protein intake: increase = 0.20 g kg -1 [95% CI 0.04-0.357 g kg -1 ], t(22) = 2.629, p = 0.015), which confounded the principle of a randomised crossover design analysis. When the control effect in those in the meals second group was removed from the analysis, the effect of the meal provision was much greater (meal provision significantly improved energy and protein intakes (311 kcal D = 0.52 (95% CI 0.22 to 0.82), p < 0.001; 0.24 g kg -1 D = 0.52 (0.19-0.81), p < 0.001, respectively), MNA score (2.6 points D = 1.14 (0.78-1.50), p < 0.001), and handgrip strength (1.5 kg D = 0.36 (0.06-0.66), p = 0.02), but did not change levels of depression or self-esteem). Twelve weeks after meal removal, the following % of the meal effect was retained: 68% for MNA score, 27% for negative mood score, 15% for daily energy intake, 6% for daily protein intake and 0% for handgrip strength., Conclusion: Provision of high protein, high energy meals to community dwelling older adults for 12-weeks improved nutritional status and handgrip strength, indicative of reduced frailty risk. Benefits were not retained upon withdrawal of the intervention, suggesting a need for sustained interventions in this cohort to meet nutritional needs. Home-delivered meals offer a popular, and scalable intervention for community dwelling older adults to prevent malnutrition, promote health and sustain high quality independent living thus reducing the burden of ageing and frailty on health and social care systems., (Crown Copyright © 2024. Published by Elsevier Masson SAS. All rights reserved.)

The global obesity epidemic results from a complex interplay of genetic and environmental factors, with diet being a prominent modifiable element driving weight gain and adiposity. Although excess intake of energetic macronutrients is implicated in causing obesity, ongoing debate centers on whether sugar or fat or both are driving the rising obesity rates. This has led to competing models of obesity such as the "Carbohydrate Insulin Model", the "Energy Balance Model", and the "Fructose Survival Hypothesis". Conflicting evidence from studies designed to focus on individual energetic macronutrients or energy rather than macronutrient mixtures underlies this disagreement. Recent research in humans and animals employing the nutritional geometry framework (NGF) emphasizes the importance of considering interactions among dietary components. Protein interacts with carbohydrates, fats, and dietary energy density to influence both calorie intake ("protein leverage") and, directly and indirectly, metabolic physiology and adiposity. Consideration of these interactions can help to reconcile different models of obesity, and potentially cast new light on obesity interventions., (© 2024 Wiley Periodicals LLC.)

Background: Mindful eating (ME) is a promising approach for promoting healthy eating. Although an association between ME and healthier eating habits has been indicated in the literature, data remain limited. The aim of this cross-sectional study was to investigate the association between ME and several nutritional indicators, including overall diet quality, consumption of ultra-processed foods (UPF), organic foods, food groups, and intake of energy and nutrients in a large population sample., Methods: In 2023, 13,759 participants of the NutriNet-Santé cohort study completed the Mind-Eat Scale, assessing total ME (range: 1-5), and its six sub-dimensions, and at least three 24-h dietary records. Multivariable linear regressions were performed to analyze the association between ME (independent variable) and various indices reflecting the nutritional quality of the diet: two scores reflecting the adherence to the French dietary guidelines (sPNNS-GS2) and the Mediterranean diet (MEDI-LITE score), the consumption of UPF (using the NOVA classification), organic foods and food groups, and energy and nutrient intake (dependent variables), adjusted for socio-demographic and lifestyle characteristics., Results: ME was positively associated with French dietary guideline (β = 0.33; 95%CI: 0.30, 0.45) and Mediterranean diet (β = 0.37; 95%CI: 0.30, 0.45) scores and with organic food consumption (β = 9.72; 95%CI: 8.84, 10.60). Furthermore, ME was negatively associated with energy intake (β = -36.79; 95%CI: 50.92, -22.67) and UPF consumption (β = -1.55; 95%CI: 1.81, -1.29). ME was also associated with the intake of several food groups and nutrients., Conclusion: Overall, ME was associated with a healthier diet. These results suggest that ME could be an interesting lever for promoting healthy eating habits. Further studies are required to better understand the relationships between ME, dietary intake, and health, particularly through the use of longitudinal studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Results regarding the impact of bariatric surgery (BS) on food choices are inconsistent between studies based on self-reported questionnaires, and those using direct measurements. Moreover, the determinants of the modifications of food choices after BS, if any, are still poorly understood. This study compared food choices, food liking, microstructure of ingestive behavior and sensory perceptions between women who had BS in the last 18 months (BS group, n = 19; Roux-en-Y gastric bypass or sleeve gastrectomy) and women with BMI ≥35 kg m -2 (OB group, n = 17) in ecological conditions and explored the associations of food choices with sensory perceptions and food liking., Methods: Food choices and liking were assessed using a standardized ad-libitum buffet. Taste Strips and Scratch and Sniff cards were used to measure sensory perceptions. Microstructure of ingestive behavior of solid foods was studied using video recordings while eating the ad-libitum buffet., Results: Women in the BS group consumed half as many calories at the buffet (p = .004) as the OB group, taking smaller bites (7.5 ± 1.9 vs 9.7 ± 2.4 g/bite; p = .020) at a slower ingestion rate (2.1 ± .7 vs 3.8 ± 1.1 bites/min; p = .035). No differences were found in food choices, food liking and sensory perceptions. In the BS group, consuming very high energy density foods was negatively associated with salt taste perceived intensity (p = .021) and the liking of fruits and vegetables (p = .045)., Conclusion: This is the first study that assessed the microstructure of ingestive behavior of solid foods in a population who has had BS. Ingestive behavior, but not food choices or liking, were different in women who had BS compared to women with obesity who did not have BS. However, only women with BS had their food choices associated with gustatory perceptions and food liking. Whether taste perceptions or types of food appreciations should be used as healthy-food choice predictors following BS should be further explored in future research., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Nina RITSCH reports financial support was provided by French National Research and Technology Agency, and by Lyfe Institute Foundation. Erika GUYOT reports financial support was provided by APICIL. Sylvain ICETA reports a relationship with Quebec Health Research Fund that includes: funding grants. Sylvain ICETA reports a relationship with Takeda Canada Inc that includes: consulting or advisory, funding grants, and speaking and lecture fees. Sylvain ICETA reports a relationship with Novo Nordisk Inc that includes: consulting or advisory and speaking and lecture fees. Sylvain ICETA reports a relationship with Bausch Health Companies Inc Canada that includes: consulting or advisory and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Overfeeding and underfeeding are associated with negative outcomes during critical illness. The purpose of this retrospective study was to assess the association between nutrition intake and outcomes for patients receiving venovenous (VV) extracorporeal membrane oxygenation (ECMO)., Methods: Adults who received VV ECMO August 2017 to June 2020 were screened. Patients with <3 ECMO nutrition support days were excluded. Age, sex, height, weight, ideal body weight (IBW), body mass index, sequential organ failure assessment score, respiratory ECMO survival prediction score, energy, and protein goals were collected. All nutrition intake was collected for the first 14 days of ECMO or until death, decannulation, or oral diet initiation. Outcomes analyzed included mortality and VV ECMO duration. The relationship between nutrition delivery and outcomes was tested with multivariate analysis. Univariate analyses were conducted on obese and nonobese subgroups., Results: A total of 2044 nutrition days in 178 patients were analyzed. The median estimated needs were 24 (interquartile range: 22.3-28.3) kcal/kg/day and 2.25 (interquartile range: 2.25-2.77) g/kg/day of protein using IBW in patients with obesity and actual weight in patients without obesity. Patients received 83% of energy and 63.3% of protein targets. Patients with obesity who received ≥2 g/kg IBW of protein had a significantly shorter ECMO duration (P = 0.037). Increased protein intake was independently associated with a reduced risk of death (odds ratio: 0.06; 95% confidence interval: 0.01-0.43)., Conclusion: Higher protein intake was associated with reduced mortality. Optimal energy targets for patients receiving ECMO are currently unknown and warrant further study., (© 2024 American Society for Parenteral and Enteral Nutrition.)

Background: Accurate monitoring of energy balance is essential for effective weight management, but the role of energy excretion is often neglected., Objectives: This study aimed to develop and validate a standardized method for assessing energy excretion using dye-labeled meal replacement bars with consistent and stable ingredients., Methods: We utilized baseline data from a registered cross-over trial involving 12 healthy adults (7 females and 5 males) with a body mass index of 18-25 kg/m 2 . Participants consumed dye-labeled meal replacement bars under a standardized protocol, and their feces and urine were collected for energy measurement using bomb calorimetry. Correlation analysis was conducted to explore associations between these variables., Results: The total energy excretion rate averaged 10.48% [standard deviation (SD) 2.56%] of energy intake, with fecal and urinary excretion accounting for 7.95% (SD 2.67%) and 2.52% (SD 0.6%), respectively. Significant individual variability was observed, with total energy excretion ranging from 6.34% to 15.07%, resulting in a maximum difference of 209.64 kcal/d. Fecal energy excretion was positively correlated with fecal wet weight and energy density, whereas urinary energy excretion was associated with digestible energy., Conclusions: This study presents a standardized and efficient methodology for accurately assessing energy excretion using dye-labeled replacement bars. The findings underscore the notable yet variable role of energy excretion in energy balance and suggest that this method could enhance the precision of future energy balance studies., Registration Number: This study was registered at chictr.org.cn as ChiCTR2000038421., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Underprovision of food energy within the hospital environment can negatively affect clinical outcomes. Hence, the supply of hospital foods/beverages and the ability to assess their calorie provision is critical. The aim of this study was to directly measure the energy density of foods/beverages supplied to patients by Gold Coast University Hospital (GCUH) foodservice and compare these to caloric values established from nutrition information panels (NIPs) on product packaging., Methods: Bomb calorimetry was used to determine the gross energy density of 58 food/beverage items (~47% of total menu) using standardised procedures. Food items included those from the general menu, in addition to therapeutic menu items. Equivalence between directly measured values and those derived from NIPs was determined by comparing the measured mean and ±90% confidence interval (CI) against two pre-defined equivalence bounds (i.e., ±10% NIP value [consensus criteria] and ±20% NIP value [United States Food and Drug Administration (US FDA) criteria]). Caloric values from NIPs were considered equivalent to measured values when the 90% CI of the measured values fell within these thresholds., Results: Overall, 34 (59%) and 19 (33%) items had measured energy density values not equivalent to those from product NIPs according to the consensus and US FDA thresholds, respectively. When employing the US FDA criteria, 12 (21%) items contained a higher calorie density than that established from the label, while seven (12%) items were lower. While non-equivalent items were identified across all therapeutic menus, food labels from items exclusively prepared for the smooth-pureed menu were particularly inaccurate (~60% non-equivalency)., Conclusion: This study found a discrepancy between energy density that was directly measured and that derived from manufacturers' NIPs for many foods and beverages supplied via a hospital foodservice. Given the importance of accurate energy provision for hospitalised patients, this level of inaccuracy is concerning and may warrant a revision of food labelling procedures for items supplied in hospital settings., (© 2024 The British Dietetic Association Ltd.)

Genetic and environmental factors have important role in the pathogenesis of obesity and metabolic diseases. We hypothesized that genes involved in energy intake, cellular lipid metabolism and pro-inflammatory adipokines influence obesity-related metabolic disturbances and food intake. We explored the association of GHRL (rs26311G>C and rs4684677A>T), PLIN1 (rs2289487G>A and rs894160G>A), RETN (rs3745367C>T and rs7408174G>A), and NAMPT (rs1319501T>C) variants with obesity, metabolic and inflammatory markers, and food intake composition. Clinical, anthropometric, and laboratory data were obtained from 237 adults. Genomic DNA was extracted and genetic variants were analyzed by real-time polymerase chain reaction. Food intake was assessed in 81 subjects with obesity, who underwent a 9-week nutritional orientation program. Multivariate logistic regression analysis adjusted by covariates showed association of GHRL rs26311-G and rs4684677-A alleles with risk of type 2 diabetes (T2D) and/or metabolic syndrome (P < .05), and RETN rs7408174-C allele with risk of T2D and obesity (P < .05). Covariate-adjusted multivariate linear regression analysis showed association of PLIN1 rs894160-G allele with increased waist-to-hip ratio (P = .003). The nutritional orientation program reduced carbohydrate and total fat intake, in subjects with obesity (P < .05). Analysis of basal data revealed associations of PLIN1 rs894160-G with increased body mass index, PLIN1 rs2289487-A with reduced intake of total fat, monosaturated fatty acids and cholesterol, and RETN rs3745367-A with increased intake of protein and saturated fatty acids (P < .05). GHRL rs26311-G was associated with increased postprogram protein intake (P = .044). In conclusion, variants in GHRL, RETN, and PLIN1 are associated with obesity, T2D, metabolic syndrome, and increased waist-to-hip ratio, and influence food consumption in adults with obesity., Competing Interests: Declaration of Competing Interest The authors have no conflict of interests to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The prevalence of overweight and obesity and an unhealthy diet and lifestyle are the key causes of rising diabetes burden in India. Bariatric surgery is gaining popularity in India as a favored approach to manage obesity and its accompanying comorbidities. Despite this, there is a scarcity of Indian studies evaluating dietary intake. Our goal was to analyse the dietary intake of Indian patients with type 2 diabetes mellitus (T2DM) who have undergone laparoscopic sleeve gastrectomy (LSG) or duodeno-jejunal bypass with sleeve gastrectomy (DJB-SG) or surgeries., Methods: The longitudinal observational study included 64 T2DM patients (32 in each procedure) enrolled through purposive sampling. The patients underwent surgery (LSG or DJB-SG procedure) between January 2017 and July 2019. Dietary data was collected at baseline and postsurgery (12 months) using a 24-h dietary recall method for 2 days (one working and one holiday)., Results: The total sample consisted of 27 (42.2%) females and 37 (57.8%) males. The mean age was 46.8 years. At 12 months, the follow-up for the LSG and DJB-SG procedures was 100% and 78%, respectively. In the short term, a significant reduction was seen in weight, body mass index and haemoglobin A1C (HbA1C) in both surgical groups. The two procedures were comparable with respect to weight loss but improvement in glycaemia was higher in the DJB-SG group. The dietary intake (food groups and nutrients) was similar in the two surgical groups at baseline and 12 months postsurgery. Dietary intake assessment showed significant reduction in calorie dense foods (cereals, roots and tubers, fats and oils, table sugar, and biscuits) in both surgical groups. Among nutrients, intake of energy, fats, carbohydrates, dietary fibre, thiamine, riboflavin, niacin, folate and iron were reduced significantly in both procedures. Vitamin D (84.4% patients in LSG group and 81.3% patients in DJB-SG) and iron (62.5% patients in LSG group and 68.8% patients in DJB-SG) were commonly prevalent nutritional deficiencies at baseline and were significantly reduced at 12 months., Conclusions: In the short term, bariatric surgery resulted in weight loss and improvement in glycaemia. Bariatric surgery does significantly affect dietary intake leading to nutritional deficiencies. Therefore, patients should be recommended vitamin and mineral supplements and regular patient education and counselling by a trained bariatric dietitian to prevent nutritional deficiencies and maintain nutritional status., (© 2024 British Dietetic Association.)

Reminiscence theatre (RT), an applied drama technique, is an effective tool for improving health-related outcomes for older adults in clinical settings. However, no research has explored the potential for a food-themed RT intervention to improve the nutrition, health and wellbeing of this population. Therefore, the current study explored the feasibility and acceptability of such an intervention - the CURTAIN intervention - in residential care-homes. Two care-homes, their residents and staff were recruited to a cluster randomised crossover feasibility study with post-hoc interviews. Over two months, participants (n = 42) took part in the CURTAIN activity and a control activity before consuming their lunch, with momentary hunger, activity/meal enjoyment, and food intake measured around each activity. Continuation to a full-scale trial was assessed against progression criteria for data-collection-sheet completion and residents' enjoyment of the intervention. The intervention was highly enjoyed by residents (median score = 8/10), with only 1% of data-collection cells blank. Attrition rate was 5% and preliminary data suggest CURTAIN has the potential to improve residents' appetite and energy intake. Aspects of evaluation design and recruitment strategy to optimise sample diversity require some amendments; however, overall, the CURTAIN intervention is feasible and acceptable to care-home residents and staff, and a full intervention evaluation is warranted., Competing Interests: Declaration of Competing Interest At the time of publishing, CJM worked for the UK government Department of Health and Social Care (DHSC) and was conferred the position of Visiting Fellow at Loughborough University. This research and manuscript was facilitated by CJM as an affiliate of Loughborough University and not of DHSC. All opinions presented in the manuscript reflect those of the authors and not of DHSC or the UK government., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: Food price is a determining factor in food choice which affect diet quality accordingly. However, the association between food price and diet quality has not been thoroughly discussed among Chinese adults. This study aimed to analyze the association of daily energy-adjusted dietary costs (CNY/2000 kcal) and diet quality among Chinese adults., Methods: A total of 680 Chinese adults aged above 25 years from Henan province were investigated in 2020. Three indices were adopted for evaluating diet quality: the nutrient-rich foods 9.2 (NRF 9.2) index for evaluating nutrient density, the mean adequacy ratio (MAR) for evaluating nutrient adequacy, energy density (ED) based on solid foods only for evaluating energy density. The daily energy-adjusted diet cost was calculated by dividing the estimated daily diet costs (CNY/day) by the energy intake per day (kcal/day) and multiplying the result by 2000., Results: Subjects who closely adhered to the NRF9.2, MAR, and ED paid ¥8.92, ¥13.17, and ¥14.34 more for daily food consumption, respectively, than those who weakly adhered to these dietary patterns did. Furthermore, multiple linear regression analysis adjusted covariance revealed that an increase in ¥1 of the energy-adjusted diet cost per day was associated with changes of 0.494 units (P < 0.001), 0.003 units (P < 0.001), and - 0.018 units (P < 0.001) in the NRF9.2, MAR, and ED, respectively., Conclusion: Higher energy-adjusted diet cost was associated with higher quality diets. This might be important for public health policies to develop strategies to promote healthy diets by regulating food supply and its costs., Competing Interests: Declarations. Ethics approval and consent to participate: The Committee on Human Subjects at The First Affiliated Hospital of Zhengzhou University approved the study design (Protocol 2020–KY-066). All the subjects signed a consent form to participate in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Purpose: The objective of this study is to investigate the effects of acute diet and exercise manipulation on resting metabolic rate (RMR) measurement variability and dual-energy x-ray absorptiometry (DXA) body composition estimates., Methods: Ten male and 10 female endurance athletes (12 cyclists, 5 triathletes, 4 runners) of tier 2 ( n = 18) to tier 3 ( n = 2) caliber underwent five conditions using a Latin square counterbalance design. For 24 h, athletes consumed a diet providing excessive energy availability (EA) (75 kcal⋅kg fat-free mass (FFM) -1 ) without exercise (GEA rest ), high-EA (45 kcal⋅kg FFM -1 ) without (HEA rest ) or with exercise (HEA ex ), or low-EA (15 kcal⋅kg FFM -1 ) without (LEA rest ) or with exercise (LEA ex ). Exercise involved two bouts of cycling (morning bout: 149 ± 34 min at 55% of maximal aerobic capacity (V̇O 2max ); afternoon bout: 60 min at 65% of V̇O 2max ) that resulted in a cumulative exercise energy expenditure of 30 kcal⋅kg FFM -1 . The following day, RMR and DXA measurements occurred after a 10-h fast and 12-h postexercise., Results: There were neither sex differences in relative RMR ( P = 0.158) nor effects of any of the five conditions on RMR ( P = 0.358). For both male and female athletes, FFM estimates were decreased following the LEA rest (-0.84 ± 0.66 kg; P = 0.001) and LEA ex (-0.65 ± 0.86 kg; P = 0.016) conditions compared with the GEA rest condition and following the LEA rest (-0.73 ± 0.51 kg; P = 0.001) and LEA ex (-0.54 ± 0.79 kg; P = 0.024) conditions compared with the HEA ex condition. There was no effect of condition on fat mass estimates ( P = 0.819)., Conclusions: Acute periods of diet and exercise manipulation did not create artifacts in next-day RMR measurements. However, as changes in estimates of FFM were seen, diet and exercise should be controlled in the 24-h before DXA scans., (Copyright © 2024 by the American College of Sports Medicine.)

Background: During lactation, maternal requirements for many nutrients increase due to the physiological demands of breast milk production, reflected in dietary recommendations. BMI is negatively associated with dietary quality postpartum, and 40% of women in Norway have pre-pregnancy overweight and obesity. Currently, there is limited data on dietary intake among lactating women in Norway and whether they meet nutritional requirements. We aimed to evaluate the nutrient intake in a study sample of lactating women with overweight and obesity, compared with the Nordic Nutrition Recommendations (NNR 2023)., Methods: In this cross-sectional analysis, we included baseline data from 112 lactating women with a pre-pregnancy BMI of 25-35 kg/m 2 , participating in a weight loss and breastfeeding promotion intervention trial in Oslo, Norway. Data were collected at 2 weeks postpartum (subject characteristics, anthropometry and dietary supplement use), at 7 weeks postpartum (dietary assessment) and post-weaning (retrospective dietary supplement use). Dietary data were obtained from a 4-day dietary record before randomisation to dietary treatment for weight loss. Nutrient intake was compared to the dietary reference values for lactating women in NNR 2023. Increased risk of inadequate intake of micronutrients was assessed as the proportion of women with intakes below the average requirement (AR), with and without dietary supplements., Results: Mean ± SD BMI at 2 weeks postpartum was 30.7 ± 2.5 kg/m 2 . At 7 weeks postpartum the women reported a mean energy intake of 9.2 ± 2.0 MJ/day, with a higher intake of saturated fat and a lower intake of carbohydrate, dietary fibre and docosahexaenoic acid than recommended. The majority had an increased risk of inadequate intake of vitamin A (92%), folate (92%), vitamin D (84%), selenium (87%) and iodine (71%) from the diet alone. When dietary supplements were taken into account, ≥ 50% of the women still had an increased risk of inadequate intake of vitamin A, folate and selenium., Conclusions: The high proportion of lactating women with overweight and obesity failing to meet the newly updated Nordic Nutrition Recommendations highlights the need to raise awareness among new mothers and healthcare professionals about the increased maternal nutritional demands during lactation and hence, the importance of nutrient-dense diets., (© 2025 The Author(s). Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Background: Critically ill patients are at high risk of Intensive Care Unit (ICU) Acquired weakness, which negatively impacts clinical outcomes. Traditional muscle mass and nutritional status assessments are often impractical in the ICU. Ultrasound offers a promising, non-invasive alternative. This study evaluates the relationship between ultrasound-based muscle assessments, patients' nutritional support, and clinical outcomes in the ICU., Methods: A prospective cohort study was conducted in three ICUs of a tertiary center. Daily nutritional intake, ultrasound measurements of the quadriceps muscle (rectus femoris cross-sectional area - RFCSA - and quadriceps muscle layer thickness - QMLT), and clinical data were collected on days 1, 3, and 7 of ICU., Results: A total of 128 patients were included in the analysis, with a mean age of 65.4 (±18.1) years and a median ICU stay of 6 (4-10) days. QMLT decreased by 5 % and 13 %, and RFCSA decreased by 10 % and 27 % on days 3 and 7, respectively. A significant correlation was found between lower caloric and protein intake and greater muscle mass loss within the initial 3 days of ICU admission. Multivariate logistic regression indicated that QMLT reduction significantly contributed to 28-day mortality (adjusted OR 1.088, 95 % CI: 1.018-1.113, p = 0.015). Lower daily caloric and protein intake was depicted in non-surviving patients (p < 0.001)., Conclusions: Our study demonstrates that critically ill patients experience significant muscle mass loss within the first 72 h of ICU. QMLT reduction significantly impacts 28-day mortality, with an 8.8 % increase in the odds of death per 0.1 cm reduction., Competing Interests: Declaration of competing interest The authors do not declare conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Limited literature exists on nutrition practices for long-stay patients in the intensive care unit (ICU). We aimed to compare nutrition practices in the first and second weeks of an ICU admission., Method: A post hoc exploratory analysis of The Augmented vs Routine Approach to Giving Energy Trial (TARGET) randomized controlled trial (RCT) was undertaken. Inclusion criteria were: enrolled in TARGET on day 1 or 2 of ICU admission and ICU length of stay (LOS) >14 days. Clinical characteristics are described, and nutrition delivery and management compared between days 1-7 and 8-14. Data are n (%), mean ± SD, median (interquartile range [IQR]), or mean difference (MD) and 95% confidence interval (95% CI), with P < 0.05 considered significant., Results: Data from 664 patients were analyzed (56.2 ± 16.3 years; 61% male; body mass index 29.2 ± 7.5 kg/m 2 and APACHE II 21.9 ± 8.1). When comparing days 1-7 to 8-14: (1) energy delivery was greater (all sources: 1826 ± 603 vs 1729 ± 689 (MD: 97 [95% CI: 52-140] kcal/day, P < 0.001) and nonnutrition sources: 317 ± 230 vs 192 ± 197 (MD 125 [95% CI: 111-139] kcal/day; P < 0.001); (2) protein delivery was similar (66 ± 20 vs 68 ± 24 (MD: -1.4 [95% CI: -3.2 to 0.4] g/day; P = 0.125]); and (3) fewer patients received parenteral nutrition (PN) (5% vs 9%, P < 0.001) or small intestine feeding (3% vs 8%; P < 0.001)., Conclusion: In this post hoc analysis, patients with an ICU LOS >14 days had greater energy delivery and fewer patients received PN or small intestine feeding during days 1-7 than days 8-14. Uncertainty remains regarding whether these data reflect usual practice and the clinical implications of this., (© 2024 American Society for Parenteral and Enteral Nutrition.)