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Childhood overweight/obesity is a serious problem that has not been adequately addressed. As a key factor affecting weight gain, the association between dietary intake with childhood overweight and obesity is still unclear. The objective of this study was to analyze the association between sociodemographic, lifestyle factors and dietary intake with overweight or obesity. We used data from a large cross-sectional National Health and Nutrition Examination Survey (NHANES). The U.S. children aged 6–15 years with both weight data and dietary data were included. For univariate analysis of sociodemographic data, t tests was performed for continuous variables and chi-square tests was performed for discrete variables. Dietary intakes were described by median and quartile, and differences in dietary intake between children with normal weight and children with overweight or obesity were compared by rank sum tests. A modern statistical shrinkage technique, LASSO regression was used to examine the association between dietary intake and childhood obesity. Our study confirms that Hispanic ethnicity, increasing age, passive exposure to smoking, higher protein intake, and higher caffeine intake were positively associated with child overweight or obesity. Additionally, non-Hispanic White race, higher physical activity levels, higher household income, and higher vitamin A intake were negatively associated with child overweight or obesity. [ABSTRACT FROM AUTHOR]

• Composite dietary antioxidant index (CDAI) measures multiple antioxidants intake. • The Association of CDAI with kidney stones is analyzed in this cross-sectional study. • CDAI presents an inverse correlation with kidney stones, of which vitamin C is the most weighted. • Low nephrolithiasis risk of CDAI is more favorable in those younger than 60 and nondiabetics. The composite dietary antioxidant index (CDAI) is commonly utilized to assess antioxidant intake across diseases, but its association with kidney stones is unclear. We hypothesized that higher CDAI is associated with reduced kidney stone risk. Using National Health and Nutrition Examination Survey 2007-2020 data, we calculated CDAI based on vitamins A, C, E, selenium, zinc, and carotenoids intake in 29,280 adults. Stone formers had lower CDAI, with significant gender differences. Restricted cubic spline showed an L-shaped curve, with the steepest decline before CDAI of 1.449. In multivariate logistic regression, moderate and high CDAI tertiles were associated with reduced kidney stone odds compared to the lowest tertile (odds ratio [95% CI]): 0.85 [0.73, 0.99], P =.035 and 0.80 [0.66, 0.95], P =.014, respectively). Vitamin C had the highest negative correlation weight with kidney stones. Significant interactions were found for age and diabetes subgroups. In conclusion, higher CDAI may reduce kidney stone risk, especially with adequate vitamin C intake. Further cohort studies are warranted to confirm the causal association. This study enrolled 29,280 participants from NHANES, of which 2804 were stone-formers and 26,476 were nonstone participants. CDAI is used to measure antioxidant intake, including vitamins A, C, and E, selenium, zinc, and carotenoids. We find an L-shaped CDAI-nephrolithiasis relationship, with higher tertiles of CDAI showing a protective trend. Abbreviations: NHANES, National Health and Nutrition Examination Survey; CDAI, Composite dietary antioxidant index. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three‐arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian‐led telehealth intervention at 3 months. Methods: Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non‐core foods were reported. Results: The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) −0.0 to 12.9], p = 0.049), non‐core foods (−6.4%/day [95% CI −12.9 to 0.0], p = 0.049), sweetened drinks (−1.7%/day [95% CI −2.9 to −0.4], p = 0.013), takeaway foods (−2.3%/day [95% CI −4.5 to −0.1], p = 0.045) and sodium (−478 mg/day [95% CI −765 to −191 mg], p = 0.001). Conclusions: A dietitian‐led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change. Highlights: A full range of dietary intake variables, eating behaviours, sleep quality and physical activity was evaluated.There was a significant negative relationship between change in diet quality and change food addiction (FA) symptoms at 3 months compared to baseline, indicating that, as FA symptoms decreased, diet quality increased.Participants allocated to the active intervention group reported statistically significant improvements in a range of dietary intake variables compared to the participants allocated to the passive intervention or control groups. [ABSTRACT FROM AUTHOR]

Summary: Excessive patulin contamination in fruit juice products pose a significant risk to human health. However, there is a notable absence of a comprehensive and long‐term survey regarding the contamination of patulin in fruit juices within the Chinese market. The present study revealed a discernible decline in the patulin contamination levels, which were as follows: 60% (33/55), 18.28% (17/93), 0% (0/122), 15.58% (12/77), and 0% (0/63) at various survey time dates (2014, 2016, 2018, 2020, 2022). Among them, 18.18% (in 2014), 6.45% (in 2016), and 3.90% (in 2020) of samples exceeded the maximum limit concentration of 50 μg/L, respectively. Despite the presence of varying levels of patulin contamination, the average daily intake of patulin across all years did not present a discernible risk to human health. This investigation offers valuable insights for evaluating the extent of human exposure to patulin and establishing regulatory measures to ensure the safety of juice products. [ABSTRACT FROM AUTHOR]

Introduction: The knowledge regarding eating behavior and disorders in women with polycystic ovary syndrome (PCOS) and severe obesity is limited. This study aimed to assess eating behavior and lifestyle factors in women with severe obesity (BMI ≥35 kg/m2), with and without PCOS, and the effect of weight loss on these behaviors. Material and Methods: A prospective clinical trial with participants screened for PCOS using National Institutes of Health criteria. Participants completed the Food Frequency Questionnaire, International Physical Activity Questionnaire, Three‐Factor Eating Questionnaire, and Questionnaire of Eating and Weight Patterns‐revised, and were evaluated regarding binge eating disorder using DSM‐5 criteria before and after a 12‐month weight loss intervention. Clinicaltrials.gov: NCT01319162. Results: 246 women were included (PCOS n = 63, age 33.0 ± 8.4, BMI 39.9 ± 4.7; non‐PCOS n = 183, age 37.7 ± 8.7, BMI 39.6 ± 4.3). Women with PCOS showed elevated baseline scores in cognitive restraint eating (50.0 [33.3–63.2]) compared to women without PCOS (38.9 [27.8–55.6]; p = 0.012). No differences were observed between groups in emotional and uncontrolled eating. In both groups, cognitive restraint eating was negatively correlated with energy intake (PCOS: r = −0.315, p < 0.05; non‐PCOS: r = −0.214, p < 0.001), while uncontrolled eating displayed a positive correlation with energy intake (PCOS: r = 0.263, p = 0.05; non‐PCOS: r = 0.402, p < 0.001). A positive correlation was found between emotional eating and energy intake only in women without PCOS (r = 0.400, p < 0.001). Baseline self‐reported energy intake and physical activity did not differ between groups. At 12‐month follow‐up, women with PCOS reported reduced fat intake. Women without PCOS reported reduced energy intake, carbohydrates and sugar, increased protein, reduced scores for emotional and uncontrolled eating, and heightened scores for cognitive restraint eating. Comparing changes from baseline to follow‐up, differences were found between groups in cognitive restraint, intake of fat, carbohydrates, and sugar. The mean weight loss was 12–14 kg, with no between‐group difference (p = 0.616). Conclusions: Women with severe obesity and PCOS showed elevated cognitive restraint eating behaviors compared to women without PCOS. Although significant weight loss was seen in both groups, alterations in eating behavior more favorable for weight loss were only seen in women without PCOS. [ABSTRACT FROM AUTHOR]

Background: women aging is a normal process of life; however, hormonal changes create an imbalance between prooxidants and antioxidants and could be measured as the antioxidant capability (AC) of an organism. Objective: to find the association between plasma AC levels, dietary intakes, and body composition in 18–64-year-old women living in the northeast of Mexico. Methods: A total of n = 514 women (18–64 years old) were grouped according to STRAW criteria as reproductive, menopausal transition, and postmenopausal. Anthropometrics, body mass index (BMI), weight–hip ratio (WHR), and weight–height ratio WHtR were determined, and percentage of body fat was analyzed by bioelectrical impedance. Dietary intake of macronutrients and vitamins A, E, and C were analyzed by a 3-day food recall. The AC status in plasma was analyzed by the ORACFL assay. Results: Plasma AC levels were higher in postmenopausal women (815 µmol TE/L), and menopausal transition women (806 µmol TE/L) than in reproductive women (633 µmol TE/L). BMI was overweight (>25 kg/m2) in all three groups. WHtR and WHR are above the healthy limit of 0.5 and 0.8, respectively for both menopausal transition and postmenopausal women. In reproductive women, negative relationships were calculated between plasma AC and age (Rho = −0.250, p = 0.007), BMI (Rho = −0.473, p < 0.001), WHtR (Rho = −0.563, p < 0.001), WHR (Rho = −0.499, p < 0.001), and % body fat (Rho = −0.396, p < 0.001). A negative association was determined between plasma AC and WHtR in reproductive women (B = −2.718, p = 0.026). No association resulted for those in menopausal transition, and a positive association was obtained between plasma AC and protein (B = 0.001, p = 0.024) and vitamin E (B = 0.003, p = 0.013) intakes in postmenopausal women. Conclusions: the antioxidant capability (AC) in plasma was lower in reproductive women, and anthropometric parameters marking decreased physical fitness were associated with decreased AC. [ABSTRACT FROM AUTHOR]

Plant-based diets have gained attention for their potential benefits on both human health and environmental sustainability. The objective of this study was to investigate the association of plant-based dietary patterns with the endogenous metabolites of healthy individuals and identify metabolites that may act as mediators of the associations between dietary intake and modifiable disease risk factors. Adherence to plant-based dietary patterns was assessed for 170 healthy adults using plant-based diet indexes (PDI). Individuals with higher healthful PDI had lower BMI and fasting glucose and higher HDL-C, while those with higher unhealthful PDI had higher BMI, triacylglycerol and fasting glucose and lower HDL-C. Unhealthful PDI was associated with higher levels of several amino acids and biogenic amines previously associated with cardiometabolic diseases and an opposite pattern was observed for healthful PDI. Furthermore, healthful PDI was associated with higher levels of glycerophosphocholines containing very long-chain fatty acids. Glutamate, isoleucine, proline, tyrosine, α-aminoadipate and kynurenine had a statistically significant mediation effect on the associations between PDI scores and LDL-C, HDL-C and fasting glucose. These findings contribute to the growing evidence supporting the role of plant-based diets in promoting metabolic health and shed light on the potential mechanisms explaining their beneficial health effects. [ABSTRACT FROM AUTHOR]

The relationship between postoperative dietary intake and weight loss after bariatric surgery remains unclear. We performed a systematic review and meta-analysis of studies published between January 2000 and May 2023, reporting weight loss outcomes, and dietary intake before and after Roux-en-Y gastric bypass and sleeve gastrectomy. A total of 42 studies were included. There was no detectable difference in dietary intake between the two procedures. Roux-en-Y gastric bypass induced an average decrease in energy intake of 886 kcal/day at 12-month post-surgery; however, there was no correlation between daily energy intake and weight loss. These findings show a substantial reduction of energy intake in the first year after bariatric surgery but do not support a link between lower energy intake and greater weight loss. [ABSTRACT FROM AUTHOR]

Purpose: Dietary phytochemicals have been under examination as adjuvants for the prevention and treatment of obesity and diabetes. This study aimed at examining the potential associations of dietary "Phytochemical Index" (PI) and polyphenol intake with obesity and diabetes-related parameters. Materials and Methods: The case-control study involved 331 participants (156 overweight/obese and 175 normal weight), aged 18–50 years. Dietary intake was assessed using the 24-hr dietary recall method, and the PI score was calculated as the percentage of energy intake provided by phytochemical-rich foods. Polyphenol intakes were calculated using Phenol-Explorer and U.S. Department of Agriculture databases. Anthropometrical measurements were taken, serum glucose, insulin, and lipid profiles were analyzed, homeostatic model assessment for insulin resistance (HOMA-IR) was calculated, and blood pressure was measured. Linear regression analyses were used to examine the potential associations. Results: Participants with higher PI scores had higher total and some sub-classes polyphenol intakes compared with lower ones (P < 0.05, for each). Dietary PI score was not associated with any of the anthropometrical measurements; however, total polyphenol and flavonoids intakes were inversely associated with body mass index (β = −0.269, P = 0.049; β = −0.262, P = 0.048; respectively), waist circumference (β = −0.127, P = 0.021; β = −0.130, P = 0.016; respectively), and waist-to-hip ratio (β = −20.724, P = 0.032; β = −22.199, P = 0.018; respectively) after adjusting for potential confounders. Either dietary PI score or total and sub-class polyphenol intakes were not associated with a better metabolic profile, except for the lignan intake, which was inversely associated with HOMA-IR (β = −0.048, P = 0.011). Conclusions: Higher dietary polyphenol intake may have potential in the prevention of obesity and diabetes, and validated practical tools are essential for the assessment of polyphenol intake in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Tinnitus is the phantom perception of sound in the ears or head which may result from inflammation of the auditory pathway. A healthy diet consisting of a range of vitamins and minerals may be protective against tinnitus. This study aims to determine the association between intakes of dietary vitamins and minerals and the prevalence and incidence of tinnitus over 10 years. Methods: In this longitudinal cohort study of 2947 participants (aged ≥ 50 years), 935 (32%) cases of tinnitus were identified and included in prevalence analyses. The remaining 2012 participants were followed to establish 10-year incidence of tinnitus. A validated semi-quantitative food frequency questionnaire was used to determine intakes of dietary vitamins and minerals. Results: No significant associations with tinnitus prevalence were found. However, iron and zinc were significantly associated with incident tinnitus. There was a 44% (multivariate-adjusted HR: 1.44, 95% CI: 1.07–1.93) increased risk of developing incident tinnitus over 10 years with lower zinc intakes and a 35% increased risk with lower iron intakes (multivariate-adjusted HR: 1.35, 95% CI: 1.00–1.80). Conclusion: Higher intakes of zinc and iron were significantly associated with lower tinnitus risk. Due to a lack of comparable high-quality data, future research studies should include robust study designs. [ABSTRACT FROM AUTHOR]

Interventions aiming to reduce social inequalities of weight status in adolescents usually focus on lifestyle behaviours, but their effectiveness is limited. This study analysed the effect of achieving levels of dietary intake (DI) and/or physical activity (PA) guidelines on reducing social inequalities in weight status among adolescents. We included adolescents from the PRomotion de l'ALIMentation et de l'Activité Physique – INÉgalité de Santé (PRALIMAP-INÈS) trial with weight status data available at baseline and 1-year follow-up (n 1130). PA and DI were measured using the International Physical Activity Questionnaire and a validated FFQ, respectively. We estimated the likelihood of a 1-year reduction in BMI z-score (BMIz) and population risk difference (PRD) under hypothetical DI and PA levels and socio-economic status using the parametric G-formula. When advantaged and less advantaged adolescents maintained their baseline DI and PA, we found social inequalities in weight status, with a PRD of a 1-year reduction in BMIz of −1·6 % (–3·0 %, −0·5 %). These inequalities were not observed when less advantaged adolescents increased their proportion of achieving DI guidelines by 30 % (PRD = 2·2 % (–0·5 %, 5·0 %)) unlike the same increase in PA (PRD = −3·9 % (–6·8 %, −1·3 %)). Finally, social inequalities of weight status were not observed when levels of achievement of both PA and DI guidelines increased by 30 % (PRD = 2·2 % (–0·5 %, 4·0 %)). Enhancing DI rather than PA could be effective in reducing social inequalities in weight status among adolescents. Future interventions aiming to reduce these inequalities should mostly target DI to be effective. [ABSTRACT FROM AUTHOR]

This cross-sectional study aims to describe and compare energy, nutrient intake and food consumption according to eating location and by age groups using data from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015/2016). Dietary intake was estimated by two non-consecutive days of food diaries (children)/24-h recalls (other age groups), and four eating location categories were defined according to the proportion of meals consumed at out-of-home locations: Home (at least 80 % of meals at home), Other Homes , School or Work and Restaurants and Other Places. The majority of meals (69·1 %) were consumed at home. Meals were also often taken at school by children and adolescents and in restaurants and similar outlets by adults and elderly. Children and adolescents in the School or Work category ate more fruit, vegetables and pulses and cereals and starchy tubers, whereas adults in this category ate more red and processed meats, sugar-sweetened beverages and sweets. Compared with Home category, Restaurants and Other Places was associated with worse diet adequacies among children (β = –1·0; 95 % CI = –2·0, −0·04), adolescents: (β = –2·4; 95 % CI = –3·2, −1·5) and adults (β = –1·3; 95 % CI = –1·6, −1·0) reflecting higher intakes of energy, fat, trans -fatty acids and SFA, and Na. The elderly consumed more free sugars and fat when eating out of home in general. Overall, findings reflect important variation in nutrient profiles by eating location, with meals taken at school or work contributing to higher consumption of nutrient-dense foods and those taken in restaurants and other similar settings implying higher consumption of energy-dense foods. [ABSTRACT FROM AUTHOR]

Background: With the aging of the population worldwide, extending healthy life expectancy is an urgent issue. Muscle mass has been reported to be associated with physical independence and longevity. This study aimed to investigate the characteristics of food intake in urban community-dwelling older adults with low muscle mass. Methods: This cross-sectional study used baseline data from the Bunkyo Health Study, which included 1618 urban community-dwelling older adults aged 65–84 years. All participants underwent measurement of body composition using bioelectrical impedance analysis and evaluation of nutrient and food intake using the brief-type self-administered diet history questionnaire. Participants were stratified by sex and divided into robust or low skeletal muscle mass index (SMI) groups according to the Asian Working Group for Sarcopenia criteria to compare differences in nutrient and food intake. Results: The mean age and body mass index were 73.1 ± 5.4 years and 22.6 ± 3.1 kg/m2, respectively. The prevalence of low SMI was 31.1% in men and 43.3% in women. In men, all food intake, including total energy intake, was similar between the low SMI group and the robust group. In women, the low SMI group had less total energy intake, and consumed lower amounts of energy-producing nutrients (protein, fat, and carbohydrates), but there were only small differences in the intake of specific foods. Conclusions: There were sex differences in food intake characteristics between urban community-dwelling older adults with low SMI and those who were robust. Advising women to increase their energy intake may be important in preventing muscle loss, and further research is needed in men. [ABSTRACT FROM AUTHOR]

The main objective of this study was to explore the dietary behaviors of parents and their adult children, focusing on patterns, potential intrinsic and extrinsic predictors of body mass, and determinants of becoming overweight. Non-probability, cross-sectional sampling was used to select participants from a university student population. Young adults (19–21 years of age, n = 144) and their parents were examined. The data of those family pairs with complete sets of results were used. Dietary patterns and physical activity were assessed with questionnaires (QEB and IPAQ), and body height, weight measurements, and body mass indexes were calculated. A cophylogenetic approach with tanglegrams and heatmaps was used to study patterns, while predictors of body mass index were identified using multiple linear regression, stepwise logistic regression, and mediation analysis procedures. Cophenetic statistics confirmed significant incongruence between fathers and sons, confirmed by Baker's Gamma correlation (rBG = 0.23, p = 0.021), and mothers and daughters (rBG = 0.26, p = 0.030). The relationships between the dietary patterns of the fathers and daughters, as well as mothers and sons, were of medium strength (rBG = 0.33, p = 0.032, rBG = 0.43, p = 0.031; respectively). Most of the patterns were mixed. Fast food, fried meals, alcoholic drinks, energy drinks, and sweetened beverages were associated significantly with being overweight. Significant intrinsic predictors of excessive weight in young adults were sex (b = 2.31, p < 0.001), PA (b = −0.02, p < 0.001), and eating fermented milk and curd cheese (b = −0.55, p = 0.024), while extrinsic (parental) predictors included eating fast food and fried meals (b = −0.44, p = 0.049). Both physical activity and dietary behaviors independently determined the sons' overweight status (b = −1.25, p = 0.008; b = −0.04, p < 0.001; respectively); while only PA did in daughters (b = −0.04, p < 0.001). No mediating effects of physical activity were observed. Adult children and parental dietary patterns were divergent, reflecting the influence of multiple factors on a child's dietary habits. However, this divergence is moderated by sex. Reciprocal interactions between dietary intake—particularly positive dyads such as fruits and vegetables, fermented milk, and curd cheese—and physical activity significantly impacted children's body mass index (BMI). The study of dietary patterns in conjunction with physical activity (both as independent determinants), particularly in relation to the link between overweight/obese children and overweight/obese parents, presents a separate challenge. [ABSTRACT FROM AUTHOR]

• Higher peer problem is associated with increased portion sizes in various food groups. • Higher emotional well-being is linked to smaller sweet/snack portions in children. • Higher emotional/peer scores are linked to larger sugar-fatty portions in females. • Emotional status influences portion sizes, underscoring their impact on diet. This study aims to investigate the influence of psychosomatic and emotional status on food portion sizes (PSs) consumption from high energy-dense food groups in European children and adolescents. We hypothesized that psychosomatic and emotional status would have a significant association with the PS selection of energy-dense food. The study included 7355 children aged between 2 and 9.9 years at baseline (T0) (48.8% females); 3869 after 2 years (T1) (48.2% females), and 2971 (51.8% females) after 6 years of follow-up (T3). Psychosomatic and emotional status were measured using emotional well-being during the last week score (KINDL) and Strengths and Difficulties Questionnaire. PS was calculated from daily food intake recorded in 24-hour dietary recalls. The associations between emotional status indicators and PS from selected energy-dense food groups were assessed by multilevel linear regression models. In the cross-sectional analysis, we observed that higher KINDL scores were linked to lower PS consumption from sweet bakery products and savory snacks in both genders. Moreover, we found that adolescent females with high emotional and peer problem scores tended to consume larger PS of carbohydrate-rich and sugar-fatty food items (P <.017). Longitudinally, higher peer problem scores were associated with increased PS from bread and rolls, margarine and lipids, and dairy products in all genders and age groups (P <.017). In adolescents, psychosomatic and emotional status could be a trigger for consuming large PS from carbohydrate-rich and sugar-fatty energy-dense foods. Thus, nutritional interventions should consider emotional status to decrease unhealthy dietary habits in children and adolescents. Psychosomatic and emotional status have a significant association with the portion size selection of energy-dense food. Adolescents' females with more emotional and peer problems tend to consume more carbohydrate-rich and sugar-fatty food products. Higher emotional and peer problem scores were inversely associated with consumption larger portion sizes from bread and rolls, pasta, breakfast cereals, and cheese in both genders and only in school-age children. [Display omitted] [ABSTRACT FROM AUTHOR]

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) has become a worldwide public health problem. Current evidence on the association between dietary iron intake and the risk of NAFLD is limited. The present study aimed to investigate the associations of animal-derived dietary iron (ADDI) intake, plant-derived dietary iron (PDDI) intake, and the ratio of PDDI:ADDI with NAFLD risk among U.S. adult population. Methods and Study Design: This was a repeated cross-sectional study. Data were collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. NAFLD was defined as a United States Fatty Lives Index ≥30, and dietary iron intake was assessed through two 24-h dietary recall interviews. Logistic regression and restricted cubic spline models were applied to examine the associations between dietary iron intake from different sources and NAFLD risk. Results: A total of 9478 participants aged ≥20 years were enrolled in the present study. After adjustment for multiple confounding factors, relative to the lowest quartile, the odds ratio (OR) and 95% confidence interval (CI) of NAFLD for the highest quartile was 1.01(95% CI, 0.82-1.24) for ADDI intake, 0.82 (95% CI, 0.64-0.99) for PDDI intake, and 1.00 (95% CI, 0.81-1.24) for the PDDI: ADDI intake ratio. In stratified analysis by sex and age, the significantly negative associations of PDDI intake with NAFLD was observed in women and participants older than 45 years. Dose-response analyses indicated that NAFLD was negatively associated with PDDI intake in a non-linear manner. Conclusions: PDDI intake was negatively associated with NAFLD in U.S. adults. [ABSTRACT FROM AUTHOR]

Background and Objectives: If the proportion of calcium intake over a whole day is related to the risk of cognitive impairment in adults is still largely unknown. This research aimed to examine the relation of dietary calcium intake at dinner versus breakfast with the risk of cognitive impairment by using data from the China Health and Nutrition Survey (CHNS). Methods and Study Design: A total of 2,099 participants (including 668 cognitive impairment) in the CHNS (1997–2006) were included. The participants were categorized into 5 groups in accordance with the ratio of dietary calcium intake at dinner and breakfast (Δ = dinner/breakfast). After adjustment was conducted for a series of confounding factors, Cox hazard regression modelling was performed to discuss the relation of Δ with cognitive impairment. Dietary substitution models were used to explore the changes in cognitive impairment risk when a 5% dietary calcium intake at dinner was replaced with dietary calcium intake at breakfast. Results: Participants in the highest distribution of Δ showed a greater susceptibility to cognitive impairment than those in the lowest quintile, with an adjusted hazard ratio of cognitive impairment of 1.38 (95% CI: 1.08–1.76). When maintaining total calcium intake, substituting 5% of dietary calcium intake at dinner with calcium intake at breakfast was related to an 8% decrease in the risk of cognitive impairment. Conclusions: Higher dietary calcium intake at dinner was associated with an increased risk of cognitive impairment, emphasizing the importance of appropriately distributing dietary calcium intake between breakfast and dinner. [ABSTRACT FROM AUTHOR]

The hormonal changes in women influence creatine dynamics, emphasizing its potential importance during menstruation, pregnancy, postpartum, menopause, and postmenopause. Yet, limited research explores creatine's impact on female reproductive health at the population level. Our study investigated the relationship between dietary creatine intake and reproductive health indices in US women using data from the 2017–2020 National Health and Nutrition Examination Survey (NHANES). We extracted a dataset containing females aged 12 years and above who provided details about their reproductive health and dietary habits. Daily creatine intake was quantified as a relative amount (mg per kg body mass) and did not include creatine from dietary supplements and pharmacological agents. A daily requirement for dietary creatine for healthy women was employed to classify respondents into two separate subpopulations: (1) suboptimal intake of creatine (<13 mg per kg body mass per day) or (2) recommended intake (dietary creatine ≥ 13 mg per kg body mass per day). A total of 4522 female participants from the NHANES study (age 44.5 ± 20.5 years) provided data on their reproductive health and dietary intake. The average daily creatine intake for the group was 10.5 ± 10.8 mg per kg body mass. The odds ratio for having irregular periods in women consuming ≥13 mg of creatine per kg body mass daily (recommended intake) compared to those with suboptimal intake was 0.75 (95% CI, from 0.66 to 0.86), indicating a significant association between higher intake of dietary creatine and lower risk of oligomenorrhea (p <.001). Moreover, women consuming less than 13 mg of creatine per kg body mass faced an increased risk of fetal macrosomia (OR 1.26; p =.04), pelvic infection (OR 1.68; p =.01), hysterectomy (OR 1.42; p <.001), oophorectomy (OR 1.54; p <.001), and receiving hormone replacement therapy (OR 1.26; p =.02). Consuming a creatine‐rich diet has been linked to lower risks of reproductive issues in US women aged 12 and above. Those consuming ≥13 mg of creatine per kg body mass daily showed notably lower risks of irregular menstrual periods, obstetric conditions, and pelvic pathology. Further studies are needed to confirm these potential benefits. [ABSTRACT FROM AUTHOR]

Purpose: Advanced cancer patients have nutrition impact symptoms (NISs), while many of them have depressive moods. This study aimed to determine the associations of NISs with depression. Methods: This study was a secondary analysis. The dietary intake and 19 NISs in patients receiving palliative care were evaluated using 10-point scales, and the patients were categorized into two groups (non-depression and depression groups) using the cutoff based on the Patient Health Questionnaire-9 (PHQ-9). To determine associations between depression and the number of NISs with a score of ≥ 4, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the logistic regression model were calculated. Results: A total of 225 participants were divided into the non-depression group (n = 148) and the depression group (n = 77). The prevalence of depression was 34.2%. Dietary intake was lower, and the number of NISs with a score of ≥ 4 was higher in the depression group (both p < 0.001). All NISs were more severe in the depression group. Significant differences were observed in 15 of the 19 NISs. In the logistic regression model, significantly higher adjusted ORs were observed in the groups with 4–6 NISs and 7 or more NISs with a score of ≥ 4 (10.76 [95% CI, 2.07–55.91], p = 0.016; 17.02 [95% CI, 3.08–94.22], p < 0.001) than in the group with no NISs with a score of ≥ 4. Conclusion: Having four or more NISs with a score ≥ 4 was associated with depression. [ABSTRACT FROM AUTHOR]

BACKGROUND: Egg consumption may be associated with the risk of depression. OBJECTIVES: We aimed to assess this possible relationship in the context of the Birjand longitudinal aging study (BLAS). METHODS: In this cross-sectional study PHQ-9 was used to assess depression in a total of 1364 adults above 60 years of age, participating in the first stage of BLAS between September 2018 to April 2019. Socio-demographic information, anthropometric indices, and number of whole eggs consumed per week were assessed. Depression was assessed across the egg consumption groups: low (≤1 eggs/week), moderate (≥2 to ≤3 eggs/week), and high (≥4 eggs/week), and the association was investigated using logistic regression. RESULTS: Mean egg intake in the studied population was 2.4 eggs/week. In the crude model and after adjustment for age and sex, moderate and high egg consumption were both associated with lower risk of depression in older adults (P≤0.05). Adjustment for more confounding variables revealed that only moderate egg consumption protected against depression, while high egg consumers were still at risk of depression. CONCLUSION: Both moderate and high egg intake had reverse association with depression, and reduced the odds of depression among the elderly to approximately 30–40%. Future longitudinal studies could better confirm this association. [ABSTRACT FROM AUTHOR]

Introduction: It is unclear how dietary intake changes after sodium-glucose cotransporter 2 inhibitor (SGLT2i) treatment is started in patients with type 2 diabetes. Methods: We performed a non-controlled, open-label study that enrolled 51 patients with type 2 diabetes. The patients were newly administered empagliflozin, and their dietary habits were examined using a self-administered diet history questionnaire at the beginning of the study and after 24 weeks. We investigated the association of changes in HbA1c and body weight with changes in energy, nutrient, and food group intakes. Results: At 24 weeks after the start of the study, HbA1c improved significantly and body weight decreased. In the food group, only the intake of confectionery increased, and there were no significant differences in the association between changes in HbA1c and body weight and changes in energy, nutrient, and food group intakes after 24 weeks. However, a significant negative correlation was found between change in HbA1c after 4 weeks and change in energy intake after 24 weeks, and principal component analysis showed an association between change in HbA1c levels after 4 weeks and change in energy intake and some food group intakes including confectionery after 24 weeks. Conclusion: In this study, after 24 weeks of treatment with empagliflozin, only intake of confectionery increased. Early assessment by dietitians after initiation of SGLT2i treatment might be important because our data suggested that the reduction in blood glucose levels after the start of empagliflozin was associated with a subsequent increase in energy intake. Trial registration: University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) on September 5, 2016 (registration ID, UMIN000002309|| http://www.umin.ac.jp/ctr/). [ABSTRACT FROM AUTHOR]

Introduction: The prevailing nutritional conditions and the triple challenge of malnutrition faced by adolescents have adverse consequences for both the present and future generations' health and nutrition. Summarizing the available research on the nutritional status and dietary habits of adolescents in Nigeria is crucial. Objective: This study aims to systematically evaluate available literature on the nutritional status of adolescent aged 10 to 19years in Nigeria. Methodology: A systematic search using PRISMA guideline was conducted. Three electronic databases were searched i.e., PubMed, Web of Science and Scopus using specific terms and keywords for online articles published between 2013 and 2023. After applying specified inclusion and exclusion criteria, 51 articles were selected for data extraction, synthesis and quality assessment. Results: Of the 51 included studies, 78.4% were conducted in the Southern Nigeria, 11.8% in the Northern Nigeria and 9.8% included both regions. The prevalence of overweight ranged between 0.8 and 31% and obesity ranged between 0.1 and 14%. The prevalence of thinness, stunting and underweight ranged between 3 and 31%, 0.4 to 41.6%, 0.3 to 73.3% respectively. The review also identified an inadequate intake of essential nutrients including iron, zinc, calcium, vitamin A, C, D, niacin, thiamin, riboflavin, cobalamin, and folate, with vitamin A deficiency prevalence ranges from 44 to 96%. The dietary patterns were characterized by a high consumption of cereals grains and starchy foods, low animal proteins, fast-food with soft drinks, and limited consumption of fruits and vegetables along with meal skipping. Conclusion: These findings portray a complex picture of the nutritional challenges faced by this demographic group, highlighting both undernutrition and overnutrition, poor eating behaviour and micronutrient deficiency as significant concerns. The review revealed regional disparities in research representation, with a concentration of studies in Southern Nigeria. This highlights the importance of directing research efforts toward the northern regions, where the prevalence of nutritional issues is equally severe, but less studied. Systematic review registration number: PROSPERO CRD42023481095. [ABSTRACT FROM AUTHOR]

Background and Aim: Colorectal cancer (CRC) is one of the most prevalent cancers around the world. The link between nutrients and the likelihood of developing CRC remains uncertain. The primary objective of the present study was to investigate the potential connection between dietary intake/dietary supplements and the occurrence of CRC through a literature review. Methods: A comprehensive online search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library from January 1990 to March 2023 using appropriate keywords. A systematic search was conducted for clinical trials and cohort studies in order to determine the relationship between dietary components/supplements and CRC. Results: The intake of long‐chain n‐3 polyunsaturated fatty acids (n‐3 LCPUFAs), consisting of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has the potential to decrease the likelihood of developing CRC (eight studies found positive effects and four studies found no association). Some other dietary components such as probiotics, prebiotics, and synbiotics may contribute to suppressing CRC development (three studies found positive effects, whereas three studies did not find any association). There is inconclusive evidence that supplementation with certain micronutrients including vitamin D (one trial found positive effects and another trial reported no association), folate, zinc, and selenium may reduce the risk of CRC. Conclusion: Some dietary supplements such as n‐3 LCPUFAs and probiotics have the potential to reduce the risk of developing CRC. Further studies are necessary to validate these results and understand the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Many children in the Netherlands do not adhere to dietary guidelines. Therefore, the Healthy School (HS) program stimulates healthier dietary intake of students through schools. However, evaluating the effectiveness of school health promotion in improving dietary intake is challenging due to the influence of contextual factors. Qualitative Comparative Analysis (QCA) considers these contextual factors. Therefore, we performed a QCA to examine which (combinations of) contextual factors contribute to the healthier dietary intake of students during school hours in primary schools (approximate age range children 4–12 years) and secondary schools (age range 12–18 years) when implementing the HS program for nutrition. Data were collected mainly through interviewing school staff and a school-level questionnaire in fifteen primary schools and twelve secondary schools. We included five factors for primary schools: implementation of the HS program for nutrition, degree of implementation, socioeconomic status, parental support, and student support. For secondary schools, we included school environment instead of parental and student support. For primary schools, the best results were obtained if the HS program for nutrition was implemented in high socioeconomic status schools with a combination of high implementation, parental support, and student support. Findings indicate that if secondary schools have an impeding environment and low socioeconomic status, implementation of the HS program for nutrition can result in healthier dietary intake. [ABSTRACT FROM AUTHOR]

Background/Aim: This study aimed to investigate the differences in the postoperative dietary intake (DI) loss between men and women after radical resection for early gastric cancer (GC), and to identify effective nutritional support for both sexes. Patients and Methods: This prospective, observational study enrolled patients who underwent gastrectomy for GC. DI was assessed using the food frequency questionnaire containing 82 food items (FFQW82) during nutritional counseling before surgery and one and three months postoperatively. Results: The median preoperative DI of all participants was 1,856.3 kcal/day, and DI at 1 and 3 months were 1,532.5 kcal/day and 1,637 kcal/day, respectively. The median preoperative DI was 1805 kcal/day (1,300-2,330 kcal/day) and 1481 kcal/day (1,126-1,957 kcal/day) in men and women, respectively (p<0.0001). The median DI at 1 month was 1627 (1,101-2,195) kcal/day and 1,308 (986-1,915) kcal/day in men and women, respectively (p<0.0001). At 3 months postoperatively, the median DI was 1737 (1,130-2,443) kcal/day in men and 1428 (816-2,005) kcal/day in women (p<0.0001). However, there was no significant difference in the DI loss rate at 1 month (median: -9.7% vs. -9.3%, p=0.765) and 3 months (median: -3.5% vs. -4.8%, p=0.137) between men and women. Conclusion: Although the DI loss rate in men and women after gastrectomy for GC was almost similar, the postoperative DI and DI loss differed significantly. Therefore, differences in DI loss after gastrectomy between men and women should be considered while assessing the efficacy of additional nutritional support such as oral nutritional supplements after gastrectomy. [ABSTRACT FROM AUTHOR]

Produced in the process of anaerobic digestion, the effluent called digestate is rich in nutrients and can be used as a growing media for mushrooms. However, it can also be rich in non-essential and trace elements, heavy metals, various organic pollutants, pharmaceuticals, and other unwanted compounds with potential negative effects. Therefore, two button mushroom species, Agaricus bisporus (brown cultivar) and Agaricus subrufescens, were cultivated on digestate based substrate. The mineral composition of the experimental mushroom compost (EMC), mushrooms (M), spent mushroom compost (SMC) and spent casing (SC) was evaluated by means of ICP OES. Mineral distribution and quantity were substrate dependent, digestate origin was determined for most of investigated elements, excluding Ca, Mo, Pb, Ce and Nd, where the source was straw. However, content of elements with high mobility such as Cd, Cu, Pb and Zn for EMC was low. Short composting method for mushroom compost preparation used in this study could be suitable method for reducing available Cd, Cr, Ni, Pb, Zn and total As. For the casing material, bark was richer in major essential elements (MEE's) and essential trace elements (ETE's), besides Ca, where peat indicated higher content (1490 mg kg-1). From the trace elements with detrimental health effects (TEWDHE) group, bark was richer in Ba and Pb, but peat contained significant content of As (3.92 mg kg-1). The results clearly indicated both the studied mushrooms are valuable source of K, Na and Se, while A. subrufescens provided higher amounts of Cu and Zn. No threat for human consumption for Ni, Pb, As, and Cd, their content is under the limits and decreases with each subsequent mushroom yield. SMC and SC were nutrient rich especially for Fe, Mg, Mn, Si and Zn, giving them added value as biobased product for boosting vegetable crop yield. However, Cr and Ni, ETS's for plants in lower amounts, were elevated in SMC/SC, therefore the mineral composition should be monitored. Low concentration of hazardous elements in the spent substrates allows for subsequent use.

The nutritional content of prey plays a pivotal role in shaping the predatory behavior and effectiveness of natural pest control agents like Eocanthecona furcellata. We assessed the biological performance and life history of E. furcellata on three diets, larvae of Spodoptera frugiperda, larvae of Tenebrio molitor, and an artificial diet. We also analyzed their nutritional content and quantified consumption and nutritional intake by E. furcellata. The three diets differed substantially in water, protein, and fat content. The moisture content of T. molitor larvae was significantly lower (35.0 ± 0.3 %) than that of S. frugiperda larvae (61.0 ± 0.6 %) or the artificial diet (88.7 ± 0.1 %). Female E. furcellata obtained 8.3 mg of protein per day feeding on S. frugiperda, significantly more than on T. molitor (2.4 mg) or the artificial diet (0.4 mg). 15-day fecundity ranged from 140.2 (±9.3) eggs on S. frugiperda, to 103.3 (±4.8) eggs on T. molitor, and 75.1 (±7.1) eggs on the diet. Our study provides insights into the nutritional ecology of E. furcellata and ways to improve the breeding of this beneficial species for augmentation in agricultural applications.

IntroductionStudies have suggested that dietary intake may influence the incidence and progression of open-angle glaucoma. However, dietary modification is not usually included in the clinical management of glaucoma. The aim of this scoping review was therefore to map the evidence and determine the nature and extent of research done on “diet and glaucoma” and identify any gaps in this area of scholarship.Materials and methodsA comprehensive search of academic literature was conducted from two relevant electronic databases: PubMed and ScienceDirect. Primary studies that explored the relationship between dietary intake and glaucoma were included if the principal exposure was “diet” and if dietary habits were assessed with dietary questionnaires. The glaucoma outcomes of interest were visual field, retinal nerve fibre layer and/or optic nerve head features.ResultsNineteen studies were included in the final qualitative synthesis. The dates of publication ranged from 2003 to 2023. About 80% of the studies found some significant associations between glaucoma and dietary intake. However, most studies (95%) were observational, i.e., 7 (37%) used a cross-sectional design, 10 (53%) used a prospective cohort design; and 1 (or 5%) used a nested case–control study design. Only 1 study (or 5%) used a randomized intervention trial. Furthermore, while all studies investigated dietary intake with questionnaires, only 2 studies (or 11%) went further to include assessment of nutritional biomarkers.ConclusionAlthough miscellaneous evidence supports the concept that diet may play a role in glaucoma, most data are unfortunately observational without proven causality, reporting associations from subjective dietary questionnaires. More well-designed studies are required, especially randomized controlled trials that can prove causality.

Selenium is an important micronutrient that plays key functions in antioxidant defense, immune function, and thyroid health. However, its benefits and risks are closely linked to selenium methylation, a process that significantly influences its biological activity and potential toxicity. This review critically analyse the role of selenium methylation in modulating selenium’s effects on health, highlighting its impact on both protective and adverse outcomes. it also discusses the current understanding of selenium’s essential functions and toxicity risks, emphasizing the complexities of Se methylation. The review addresses notable research gaps and controversies, including inconsistent findings on selenium’s cancer-preventive properties, the diverse biological activities of different selenium species, and the challenges in determining optimal selenium intake levels. By synthesizing existing knowledge and identifying key areas for further investigation, this review aims to advance readers’ understanding of selenium’s multifaceted roles that guide future research and public health strategies.

Background This study was conducted to investigate the nutritional knowledge of elite athletes undergoing weight loss and to identify differences in weight-loss strategies according to nutritional knowledge.Methods The participants included 22 coaches and 88 elite athletes registered under the same affiliation. The survey involved translating the General Nutrition Knowledge Questionnaire (GNKQ), and interviews were used to confirm the diet and weight loss patterns of the athletes. The coaches and athletes were divided into high-rank (12 coaches and 57 athletes) and low-rank (10 coaches and 31 athletes) groups based on GNKQ scores. Paired t-tests, correlation analysis, and logistic regression analysis were performed.Results GNKQ results showed significant differences between high-ranking and low-ranking coaches (p

Background: Sustainable dietary practices can help reduce greenhouse gas emissions and promote planetary health. The importance of investigating how to promote sustainable dietary practices is therefore crucial. Nature Relatedness measures an individual’s connection to nature and can predict environmental concern and stewardship. While emerging research has suggested those with a higher degree of Nature Relatedness report the intention to follow more sustainable dietary practices, the relationship between actual dietary intake and Nature Relatedness has yet to be fully explored. Therefore, the purpose of this pilot study was to assess the relationship between diet quality and Nature Relatedness. Methods: In this cross-sectional study, participants across the United States completed the online survey from September to November 2023. Diet History Questionnaire II and Nature Relatedness scale were completed by the participants. Diet quality was assessed using the Healthy Eating Index (HEI)-2020 total and component scores. Nature Relatedness total and subscale scores were computed. Pearson and Spearman Rho correlation coefficients assessed associations between HEI-2020 and Nature Relatedness. Simple linear regression models examined the relationships between HEI-2020 total and component scores and Nature Relatedness (controlling for age, gender, race, and education). Results: Three hundred adults completed the study. HEI-2020 total score was positively associated with Nature Relatedness (p

ObjectivesTo evaluate the effectiveness of a nutrition counseling intervention on food consumption according to the Nova classification that reflects levels of food processing.MethodsControlled community trial was conducted in quilombola communities in the South of Brazil. Four communities were allocated to the control group (CG) and the intervention group (IG), two communities comprised each group. A total of 158 individuals (CG = 87; IG = 68) were included in the study. The intervention consisted of six theoretical and practical workshops on food and nutrition education, conducted over a 4-month period. We used a 24-hour recall at baseline and another post-intervention.ResultsThere was an increase in the consumption of traditional quilombola food as an effect of the intervention (from 14.5% to 20.7% in the IG, and from 12.7% to 16.0% in the CG, p = 0.05). There was no significant variation in the other Nova food groups according to time and intervention.ConclusionAn increase in traditional quilombola food indicates a resumption of traditional food intake and appreciation of local culture as an effect of this intervention at the community level.Clinical Trial Registration:www.clinicaltrials.gov, identifier NCT02489149.

Reducing the oral bioavailability of metal contaminants including As, Cd, and Pb in foods can protect human health. Studies showed reduced metal bioavailability with elevated Ca and Fe intake; however, the effectiveness of enhancing food Ca and Fe bioavailability remains unknown. Based on a mouse bioassay and using metal accumulation in mouse tissues (kidneys and liver) as the bioavailability endpoint, this study investigated the roles of casein phosphopeptides (CPP, food nutrition fortifier) in lowering the As, Cd, and Pb bioavailability from consuming a metal-contaminated wheat. The CPP amendment at 0.10–0.50% in wheat promoted its Ca bioavailability, causing 33–62% and 59–80% decreases in the gene expression encoding for duodenal Ca and phosphate transporters in mice. This limited transcellular transport of Cd2+ and inorganic arsenate via Ca and phosphate transporters respectively, thus leading to 27% and 34% decreases in Cd and As contents in mouse kidneys fed with wheat at 0.50% CPP amendment. In addition, CPP promoted the colonization of Feacalibaculum and Bifidobacterium in mouse gut, likely promoting As excretion in feces by 81–112%. In contrast to As and Cd, CPP failed to reduce Pb contents in mouse tissue after consuming CPP-amended wheat, probably by elevating wheat-Pb solubility in the intestinal fluid by 48–136%. However, co-amendment of 0.30% CPP and 500 ​μg ​g−1 Ca as Ca gluconate lowered the As, Cd, and Pb contents in mouse kidneys by 38–71%. The data indicate that fortifying Ca together with CPP in wheat can reduce human exposure to multi-metals via dietary intake.

Background School food standards are a legal requirement for state-funded schools in England and are designed to promote healthy eating in pupils. However, state-funded academies/free schools established between 2010 and 2014 are exempt from this legislation. To complement the school food standards, the government launched the School Food Plan in 2013, which outlines voluntary actions that schools can take to support healthy eating and increase school meal uptake. There has been little evaluation of the school food standards and School Food Plan in secondary schools. Objectives To compare implementation and costs of the school food standards and School Food Plan, and pupil dietary and dental outcomes in two groups of secondary schools: those mandated and those not mandated to comply with the school food standards legislation. Methods An observational, multiple-methods study. We sampled state-funded secondary school academies/free schools, pupils aged 11–15 years, and school staff/governors with a role in food provision/education from the Midlands. We collected qualitative data in four schools. The primary outcome was pupil free sugar intake at lunch; across the school day; and during 24-hours. Secondary outcomes were additional nutritional outcomes and dental caries measures. We assessed school food standards/School Food Plan implementation and costs using researcher observation, document analysis, and surveys with staff/governors, schools and pupils. Dietary intake and dental outcomes were measured online using 24-hour dietary recall and surveys, respectively. In the qualitative study we conducted staff/governor interviews and pupil focus groups in a subsample of schools. We used multilevel analyses to explore variation in pupil outcomes across the school food standards-mandated and school food standards-non-mandated school groups. Data were analysed using the Framework approach. Results Thirty-six schools (13 school food standards-mandated, 23 school food standards-non-mandated), 2453 pupils and 151 staff/governors participated. On average, schools were compliant with 64% of school food standards and implemented 41% of School Food Plan actions, with no differences across school food standards-mandated/non-mandated schools. There was a wide variation in annual costs of the school food standards and School Food Plan reported by schools (mean of £195 per pupil). Pupils in school food standards-mandated schools had lower lunch intakes of free sugar than those in school food standards-non-mandated schools (adjusted mean difference = –2.78 g, 95% confidence interval –4.66 to –0.90 g). After further adjustment for total energy intake, there was no significant difference in free sugar intake, but the school food standards-mandated group had lower fruit and vegetable intake at all time points, and higher consumption of confectionery during the school day and sugar-sweetened beverages over 24 hours. There were no differences in dental outcomes between the two groups. Twenty-one staff/governors and 137 pupils participated in the qualitative study. Staff described balancing school food standards compliance with conflicting priorities related to financial viability. Some pupils felt that school food did not meet their needs for convenience, speed, value for money and taste, and disliked the lunchtime experience. Little time was afforded to healthy-eating education within the curriculum. Limitations There were large numbers of missing data for some study elements, including assessment of some School Food Plan actions and cost data. Conclusions In the secondary school context, the current school food standards are difficult to comply with and the School Food Plan has not achieved the desired outcomes. We found no evidence to show that school food standards legislation has positively influenced nutritional intake. Future research We need to develop healthy secondary-school food provision models that meet pupils’ preferences, and better understand how to situate the food and healthy-eating agenda in secondary schools. Trial registration This trial is registered as ISRCTN68757496. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/92/39) and is published in full in Public Health Research; Vol. 12, No. 12. See the NIHR Funding and Awards website for further award information. Plain language summary Why have we done this research? We wanted to find out how well secondary schools meet the school food standards in England and how these standards influence the dietary intake and dental health of pupils. We also wanted to explore how secondary schools provide other ways of supporting pupils’ healthy eating. What did we do? We compared schools that are required to meet the school food standards with those that are not required to meet them. We looked at school food, menus, and eating environments in 36 secondary schools and did surveys with 151 staff/governors. We asked 2453 secondary school pupils about their diet and dental health. We held interviews with 21 staff/governors and focus groups with 137 pupils at four schools. We gathered their views on school food and healthy eating. What did we find? On average, the schools met 64% of the school food standards, regardless of whether they were required to meet them. Pupils in the schools required to meet the standards had lower intakes of sugar and calories at lunchtime than pupils in the schools not required to meet them; however, they ate less fruit and vegetables. Pupils in the schools required to meet the standards ate more confectionery during the school day and drank more sugary drinks overall. There were no differences in the dental health of pupils in the two school groups. School staff told us that some standards were difficult to meet. Catering staff had to think about pupil preferences and financial considerations, as well as the school food standards. Some pupils felt that school food did not meet their needs and preferences. Some pupils disliked the lunchtime experience. Healthy-eating education was not very visible within the curriculum. What does this mean? Secondary schools are struggling to meet the school food standards and implement actions to support healthy eating. We found no evidence to show that the school food standards have improved dietary intake in secondary school pupils. Scientific summary Background National school food standards (SFS) legislation has been in place since 2006. In 2013, the School Food Plan (SFP) was introduced, which contained recommendations for schools to support healthy eating. Following this, in 2015, the government introduced updated SFS legislation. Evaluation of the impact of the 2006 SFS on nutritional intake has focused on primary school-aged children, and evidence relating to secondary school pupils is more limited. To the best of our knowledge, implementation of the updated SFS and the SFP, and their impact on pupil nutritional intake, has not been evaluated in secondary schools. The national SFS legislation applies to state-funded schools in England, except for academies and free schools established between 2010 and 2014. The exemption of these schools provided an opportunity to compare implementation of the SFS and SFP, pupil nutritional intake, and dental health between schools that are mandated and schools that are not mandated to comply with the SFS. However, exempt schools have been encouraged to voluntarily comply with the standards, and in the last 18 months of this study there has been a government expectation that all schools, regardless of their exemption status, should comply with the SFS. Despite their legislative status, there are no formal national arrangements for monitoring or reporting schools’ compliance with the SFS. Objectives The three research objectives were: in secondary schools either mandated (SFS-mandated) or not mandated (SFS-non-mandated) to comply with the national SFS legislation, to compare – school food provision and compliance with the SFS the school food environment/culture and the food curriculum, and implementation of the SFP actions the nutritional intake and dental health of school pupils, focusing on free sugar intake as the primary outcome the costs of food provision, food curriculum delivery and other measures to influence the school food culture and environment. to explore the variation in compliance with the SFS and implementation of SFP actions in secondary schools and use this to develop a typology of schools to use the developed school typology to explore associations between the school types and pupil dietary and dental outcomes. Methods We conducted an observational, multiple-methods study comprising two phases: (1) collecting a variety of data to assess school SFS/SFP implementation, pupil dietary intake and dental outcomes in SFS-mandated and SFS-non-mandated schools and (2) a qualitative case study with four school sites to understand the experiences of schools in implementing and embedding the SFS and SFP. In addition, we undertook an economic evaluation to assess how the costs and outcomes compared across SFS-mandated and SFS-non-mandated schools. State-funded secondary school academies/free schools were sampled from the Midlands, England, using a stratified sampling approach. Pupils were sampled from one class in each of years 7 (age 11–12 years), 9 (age 13–14 years) and 10 (age 14–15 years) in participating schools. School staff and governors with a role in food provision or education were also recruited. Schools were recruited by invitation, and for participating in the study they received a £300 payment and a report detailing the school’s implementation of the SFS/SFP. Case study schools received an additional £150. Written, informed consent was provided by all participants. Parents of invited pupils provided passive consent for their child’s participation. Pupils were given a £5 voucher as a thank-you for their participation. Data collection was guided by a logic model and was undertaken at the school and pupil level. It incorporated assessment of food provision (to assess compliance with the SFS); the school food culture, curriculum and environment (to assess implementation of the SFP actions); costs related to food provision and the food culture/curriculum/environment; school contextual data; and pupil nutritional and dental outcomes. School food standards and School Food Plan implementation Assessment of SFS implementation was guided by published checklists and comprised a 1-day researcher observation of all school mealtimes and food outlets and a review of school menus. Assessment of implementation of SFP actions was guided by published resources for schools and comprised researcher observation, document analysis, and surveys to schools, staff and pupils. Compliance with each SFS was judged as a binary yes/no, and level of implementation of each SFP action was categorised into high, medium or low. The embedding of the SFS and SFP policies overall was assessed through school/catering staff and governor surveys. Contextual data were provided by schools via surveys and/or documents. School-level data were also used to develop a school typology using a two-stage process. In stage 1 we used SFS compliance data to generate school types based on high/medium/low compliance with two sets of standards relating to two key dietary patterns: (1) food/drinks that are energy-dense and/or high in fat or sugar; and (2) variety/balance of food groups. In stage 2, we identified subtypes based on the implementation of selected SFP actions. Pupil outcomes The primary outcome was pupil free sugar intake (defined as all sugars added to foods by the manufacturer, cook or consumer, and natural sugars found in honey, syrups and unsweetened fruit juices). Secondary nutritional outcomes were percentage of total energy intake (TEI) from free sugars; TEI (kcal); total fat intake (g); fibre intake (g); number of portions of fruit and vegetables (F&V) consumed; number of sugar-sweetened beverages (SSB) consumed; number of confectionery items consumed; and number of foods high in fat, sugar and salt (HFSS) consumed. These nutritional outcomes were calculated for three time periods: the school day lunch; while present at school; and during the full 24-hour period of the same school day. Additional secondary nutritional outcomes were free sugar intake providing ˃ 5% of 24-hour TEI; consumption of five or more portions of F&V during a 24-hour period; and number of eating/drinking occasions (excluding plain water) during a 24-hour period. Dental outcomes were the presence of dental caries symptoms in the previous 3 months; the number of dental caries symptoms in the previous 3 months; and past dental caries treatment. Data on nutritional outcomes were collected by pupil self-report using an online 24-hour dietary recall (Intake24), with one or two recalls per participant on non-consecutive school days. Dental outcome data and sociodemographic data were collected by pupil self-report using online surveys. Postcodes were mapped to Index of Multiple Deprivation (IMD) 2019 scores and used to obtain water fluoridation levels at participants’ homes. Linear or Poisson multilevel models were used to explore differences in pupil outcomes across the SFS-mandated and SFS-non-mandated school groups. The models were adjusted for relevant school-level and pupil-level variables. We explored two-way interaction effects between school SFS-mandated/non-mandated status and lunch source (school-provided vs. obtained from elsewhere), year group and IMD group. We conducted exploratory analyses to compare pupil outcomes across identified school types. Statistical analyses were conducted in Stata version 17 (StataCorp LP, College Station, TX, USA). Economic evaluation The economic evaluation took the form of a micro-costing and a cost–consequences analysis. Costs to schools associated with school food were collected via a school survey. In addition, public data on catering expenditure were used to supplement the analysis. Pupil expenditure on school food was collected through the online surveys. Outcomes were pupil dietary intake and dental health (detailed above); pupil health-related quality of life (HRQoL), measured via the online surveys using the Child Health Utility 9-Dimensions tool; and school-level educational outcomes relating to absenteeism and attainment (publicly available). Case study We explored the way in which the SFS, SFP and local school policy or initiatives were introduced, embedded and sustained in the schools, and their perceived influence on the dietary intake of pupils. We selected four schools from the phase 1 sample based on their SFS-mandated/non-mandated status, the percentage of pupils eligible for free school meals (FSM), and their catering model. We conducted four to six interviews per school with relevant staff/governors and three focus groups with pupils from years 7, 9 and 10. All interviews/focus groups were thematically analysed using the Framework approach. Public involvement At multiple time points, we consulted with public representatives (young people, parents and school staff/governors), who advised on participant information, recruitment, data collection tools, interpretation of the findings and dissemination. Results Thirty-six schools participated (SFS-mandated, n = 13; SFS-non-mandated, n = 23) and 2453 pupil participants provided nutritional and/or dental outcome data (SFS-mandated, n = 836; SFS-non-mandated, n = 1617). On average, schools were compliant with 64% of SFS, with standards applying to lunchtime provision (average of 81% of standards met) more likely to be implemented than those applied to food provided across the whole school day or outside lunch (average of 43% and 64% standards met, respectively). The standards with low compliance mostly related to the restriction of HFSS foods and drinks. On average, schools implemented 41% of SFP actions to a high level. SFS compliance and SFP implementation were similar across SFS-mandated and SFS-non-mandated schools. School Food Plan assessment revealed a lack of implementation of actions relating to leadership and oversight on school food, engagement (with pupils, parents and the community) and catering practices (catering staff encouraging healthy behaviours and nutritional balance) in the majority of schools. Implementation of actions relating to the lunchtime experience was variable; for example, most schools (77%) had strategies in place to reduce queuing, but many schools (58%) did not ask for feedback on the lunchtime experience from their pupils. Curricular education relating to food and healthy eating was well implemented in most schools, but education around growing and extracurricular food education was not. Specifically relating to leadership and oversight on school food, governor leadership and engagement with school food, independent checking of compliance of the school with the SFS and governor review of school food uptake data were actions that were poorly implemented across schools (implemented to a low level in 64%, 79% and 74% schools, respectively). None of the governors responding to the staff/governor survey reported that they were involved in managing or overseeing the implementation of the SFS, and only 31% of senior leader respondents stated that they were involved. Compared with pupils in SFS-non-mandated schools and adjusting for other variables, pupils in SFS-mandated schools had lower free sugar intake (–2.78 g, 95% CI –4.66 to –0.90 g) and lower TEI (54.97 kcal; 95% CI –88.87 to –21.07 kcal) at lunch, but there was no significant difference in the percentage of energy intake from free sugars. When TEI was adjusted for, compared with pupils in SFS-non-mandated schools, pupils in SFS-mandated schools had a significantly lower intake of F&V at lunch (–0.20 portions; 95% CI –0.32 to –0.08 portions), during the school day and over 24 hours. There was also significantly higher consumption of confectionery during the school day and SSB over 24 hours in the SFS-mandated schools group than in the SFS-non-mandated school group, when TEI was adjusted for. Participants who had a 100% school-provided lunch had lower lunchtime free sugar, TEI, fat, fibre and F&V intake. There were no significant differences in dental outcomes between the SFS-mandated and SFS-non-mandated school groups, and no clear interaction effects between school SFS-mandated/non-mandated status and lunch source, IMD group or year group. We identified four school types based on SFS compliance and two further subtypes based on SFP implementation in stages 1 and 2 of our school typology development. We noted some differences in pupil nutritional outcomes across the four school types. Compared with type 1 schools (low implementation of obesity/dental health-related SFS and high implementation of dietary variety-related SFS), pupils in the type 2 school (medium implementation of both sets of SFS) had a lower percentage of TEI from free sugar at lunch (–8.12%, 95% CI –14.48% to –1.76%) but higher consumption of confectionery items during the school day [incidence rate ratio (IRR) 2.70, 95% CI 1.30 to 5.59]. Pupils in the type 4 school (high implementation of obesity/dental health-related SFS and dietary variety-related SFS) had a higher consumption of confectionery items at lunch than those in type 1 schools (IRR 2.15, 95% CI 1.16 to 3.98). Twenty-two schools contributed data on costs related to food (SFS-mandated, n = 6; SFS-non-mandated, n = 16). Annual ongoing costs of food provision from a societal perspective included costs to schools, costs to catering providers and volunteer time, and ranged from £8500 to £974,563, with a mean of £207,094. The annual ongoing costs per pupil (from a societal perspective) ranged from £9 to £982, with a mean of £195 (based on the total number of pupils). Staff costs constituted the largest cost category. The average annual ongoing costs of implementing and delivering the SFS and SFP and of food provision was lower in SFS-mandated schools than in SFS-non-mandated schools (£167 vs. £206 per pupil). SFS-mandated schools also reported spending slightly less on catering, on average, than SFS-non-mandated schools (£128 vs. £133 per pupil, based on the total number of pupils). Pupils in SFS-mandated schools reported slightly higher HRQoL than pupils in SFS-non-mandated schools (0.8302 vs. 0.8274); however, potential confounding factors were not adjusted for, and there was variation in the number of missing HRQoL data across SFS-mandated/non-mandated groups. Twenty-one staff/governors and 137 pupils from 4 schools participated in the qualitative case study phase, with variation across the schools in relation to FSM eligibility (9–53%), SFS-mandated/non-mandated status (50% SFS-mandated) and catering model (50% external). Schools described patchy implementation of the SFS, acknowledging that some standards were difficult to adhere to, especially at breakfast/breaktime. Staff described balancing SFS compliance with conflicting priorities around maintaining viable levels of school food uptake, cost/profit and pupil preferences. Drivers of pupils’ food choices included convenience, speed, perceived value for money and taste. Some pupils felt that these were not met by school food and described negative lunchtime experiences, which discouraged a sit-down meal and influenced their eating behaviours. Some school staff felt that their influence on pupils’ food choices was limited, acknowledging difficult social and environmental contexts. School staff/governors had a low awareness of the SFP and generally were not taking steps to implement it. The time dedicated to healthy eating in relevant lessons was perceived to be low, despite staff acknowledging its importance, while pupils felt that healthy-eating education was sporadic. In general, governors reported minimal oversight of school food and SFS compliance. Conclusions Our findings suggest that the current SFS are difficult to comply with in a secondary school context, partly due to the style of food provision (e.g. extensive provision at breakfast/breaktime) and the need to provide foods and drinks to meet the pupils’ demands to ensure school food uptake and financial viability. There is currently a lack of oversight and monitoring of SFS compliance within schools. Our findings also indicate that the SFP has not achieved the desired outcomes in the secondary school setting, which suggests that a different approach may be needed to better support secondary schools in cultivating a healthy-eating culture. Finally, our findings suggest that even when the SFS are relatively well implemented, this may have no beneficial effect on the nutritional intake of pupils or may even lead to marginally worse nutritional intake. Schools need to be considered as only one part of the food system that influences adolescents’ dietary intake, and it is important to address other aspects of this system to substantially influence nutritional intake in this age group. A key focus for future research is to develop alternative models of healthy food provision that better meet the needs of secondary school pupils and to better understand how to situate the food and healthy-eating agenda in secondary schools. Trial registration This trial is registered as ISRCTN68757496. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/92/39) and is published in full in Public Health Research; Vol. 12, No. 12. See the NIHR Funding and Awards website for further award information.

BackgroundOlder adults living in nursing homes (NHs) are considered a vulnerable population in terms of nutrition. The aim of the present study was to explore the usual intake of energy, macronutrients, and specific food groups, along with offers in the NH menus on a nationally representative sample of Slovenian NH residents and compare dietary patterns with the established recommendations.MethodsThe study was conducted as part of a cross-sectional NutriCare study on 317 residents (65–101 years) from 20 Slovenian NHs in 9 health regions. Relatively independent residents were selected using quota sampling by sex and age. Data collection involved interviews and anthropometric measurements. Usual dietary intake was assessed by a multiple-source method from two 24-h dietary recalls and food frequency questionnaires. Adherence of dietary intake to the recommendations and dietary composition of NH menus were assessed. The Mini Nutritional Assessment (MNA) was used to explore nutritional status.ResultsNotable variability in energy and macronutrient intakes was observed with some participants showing intakes below and others above the recommended values. A high prevalence of BMI > 30 kg/m2 was observed in 39% of participants, indicating potential discrepancies between total energy intake and expenditure. The usual intake of fat was 36% of total energy intake (TEI). The intake of foods of animal origin exceeded dietary guidelines. Intake of carbohydrates (46% TEI in men and 47% TEI in women) as well as dietary fibre (20 g/day for both sexes) was below recommendations. A scarce intake of fruits, vegetables, and cereals was observed. In total, 40% of men and 35% of women had usual daily protein intakes lower than 1 g/kg of body weight. The protein content of breakfast and dinner could be improved. NH residents consumed little food from outside NH. The usual nutrient and food group intakes of residents reflected the NH menu offers.ConclusionThe study results on the usual intake of energy, macronutrients, specific food groups, and offers in the NH menus indicate the potential for optimisation. According to the World Health Organisation, the prevalence of BMI > 30 kg/m2 is notable and warrants attention. Careful meal planning and regular monitoring of the nutritional status of NH residents should be considered.

PurposeAge-related macular degeneration (AMD) is one of the common causes of blindness in the elderly worldwide. Its prevention and monitoring indicators remain a key area of research. This study aims to examine the association between vitamin intake and AMD prevalence.MethodsData from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008 were used for cross-sectional analysis. Logistic regression models, subgroup analyses and multicollinearity regression were employed to assess the association between vitamin intake and AMD.ResultsA total of 1,627 participants were included, with 54.5% (weighted) males and 45.5% (weighted) females. Significant differences were observed in the intake of vitamins B (B1, B2, B6, and B12), E, and folic acid between the AMD and Non-AMD groups. The Non-AMD group had higher average intakes (weighted) of vitamin B1 (1.71 ± 1.10 vs. 1.37 ± 0.64), B2 (2.42 ± 1.22 vs. 1.86 ± 0.70), B6 (2.05 ± 1.25 vs. 1.71 ± 0.85), B12 (5.73 ± 6.18 vs. 4.54 ± 3.27), E (7.93 ± 5.47 vs. 6.39 ± 2.86), and folic acid (181.87 ± 178.04 vs. 140.72 ± 124.60). Logistic regression and subgroup analyses further supported these findings.ConclusionThis study found that higher vitamin intakes B and E were associated with a lower prevalence of AMD in the U.S. population. Eating a healthy diet rich in vitamins B and E, particularly B2 (eggs, green vegetables, meat, mushrooms, and almonds) may help to reduce vision loss due to AMD. However, since this is a cross-sectional study, causal associations between vitamin intake and AMD cannot be established. Further randomized clinical trials are needed to confirm these findings.

BackgroundNumerous studies have suggested a link between dietary micronutrient intake and the onset of constipation. Nevertheless, there has not been much research done on the potential relationship between vitamin B6 and constipation. The purpose of this study was to determine whether dietary vitamin B6 consumption and chronic constipation are related among adult participants in the National Health and Nutrition Examination Survey (NHANES).MethodThe study made use of information from the 2009–2010 NHANES health and nutrition survey. Respondents’ dietary information was gathered using 24-h dietary recalls. A range of statistical techniques, including as interaction tests, subgroup analyses, and curve fitting analyses, were used to examine the connection between dietary vitamin B6 intake and chronic constipation.ResultThis study included 3,643 patients, with 270 (7.41%) diagnosed with persistent constipation. A fully adjusted multiple logistic regression analysis found that increasing dietary vitamin B6 consumption (OR = 0.78, 95% CI: 0.68–0.89) was linked to a lower incidence of constipation, with significance at p

BackgroundEndometriosis is a multifaceted disorder with genetic, immune, inflammatory, and multifactorial origins. Vitamin B6 serves as a pivotal coenzyme in various metabolic pathways involving lipids, hemes, nucleic acids, proteins, and carbohydrates. Dysregulation or deficiency of vitamin B6 can perturb human physiology. However, the relationship between dietary vitamin B6 and endometriosis remains elusive. This study aims to explore how dietary intake of vitamin B6 is associated with the risk of endometriosis.MethodsUsing cross-sectional data from the National Health and Nutrition Examination Survey, we analyzed information from American women aged 20–54 years between 1999 and 2006. After adjusting for relevant covariates, multivariable logistic regression analysis was employed to evaluate correlations.ResultsA total of 4,453 women were included in the study. The multiple linear regression model revealed a positive association between dietary vitamin B6 intake and the risk of endometriosis, even after controlling for confounding variables. Compared to individuals with lower vitamin B6 consumption (Q1: 1.90 mg/day) were 1.22 (95% CI: 0.88–1.69, p = 0.23), 1.22 (95% CI: 0.86–1.73, p = 0. 279), and 1.51 (95% CI, 1.01–2. 24, p = 0.04), respectively.ConclusionOur findings suggest a positive correlation between endometriosis and dietary vitamin B6 intake. Further investigations are imperative to establish a causal relationship between dietary vitamin B6 intake and endometriosis.

Background: Previous studies indicate a link between non-alcoholic fatty liver disease (NAFLD) and unhealthy dietary patterns or nutrient intake. However, it remains unclear whether ultra-processed foods (UPF) contribute to an increased risk of NAFLD. This study aimed to explore how ultra-processed food consumption correlates with severe NAFLD using the UK Biobank data. Methods: This prospective cohort study included 143,073 participants from the UK Biobank. UPF consumption levels were determined using the NOVA classification and quantified from 24-h dietary recall data. The association between UPF consumption and severe NAFLD (hospitalization or death) was initially examined using Cox proportional hazards models with intake quartiles. Nonlinear associations were investigated using penalized cubic splines fitted in the Cox proportional hazards models. Adjustments were made for general characteristics, sociodemographic factors, body mass index (BMI), and lifestyle. Results: Throughout the median follow-up period of 10.5 years, 1,445 participants developed severe NAFLD. The adjusted models indicated a significant increase in severe NAFLD risk in higher UPF intake groups compared to the lowest quartile (HR: 1.26 [95% CI: 1.11–1.43]). Subgroup analysis revealed that individuals with a BMI of 25 or higher were at greater risk in the highest quartile of UPF consumption. Sensitivity analyses yielded results consistent with these findings. Conclusion: Higher consumption of UPF is associated with an increased risk of severe NAFLD. Reducing the intake of UPF can be a potential approach to lower the risk of NAFLD.

Background: Guidance from the United States Food and Drug Administration (FDA) includes targets for the food industry to voluntarily reduce the sodium content (mg/100 g) of packaged, processed, and prepared foods sold by stores and restaurants. Assessments of sodium intake by the United States population are needed to inform sodium-reduction efforts. Objectives: The objectives of this study were to assess the sodium content and sodium intake contributions of categories and subgroups of foods obtained from stores and restaurants and determine sodium intake reductions that would be achieved by meeting FDA targets. Methods: Analyses used dietary data from the National Health and Nutrition Examination Survey, What We Eat in America (WWEIA), 2009–2018, to assess sodium in foods consumed by the United States population aged 2 y or older. Data describing where foods were obtained were used to identify store-bought and restaurant-prepared foods. Combination codes were used to group foods, such as separate salad ingredients, which were eaten together. Foods in their as-eaten form were then classified into WWEIA food categories and subgroups corresponding to FDA targets. Sample-weighted estimates generated by SUDAAN analyses were used to calculate projected sodium intake reductions. Results: Store-bought, restaurant-prepared, and other foods contributed 62%, 26%, and 12%, respectively, of sodium in United States diets. Top-ranked food category contributors of sodium included sandwiches, tortilla products, pizza, poultry, soups, and breads. Subgroups of these categories contributing the most sodium included store-bought lunchmeat sandwiches and hotdogs, restaurant-prepared burgers, store-bought and restaurant-prepared tacos/burritos, restaurant-prepared pizza with meat, and store-bought white/wheat bread. Meeting the FDA targets for these subgroups achieved the highest projected sodium intake reductions. Conclusions: Reductions of sodium in widely consumed foods, such as luncheon-meat sandwiches and restaurant-prepared pizza, have the greatest impact on reducing sodium intake by the United States population. These findings could be used by restauranteurs, food manufacturers, policymakers and regulators, and clinical practitioners to inform sodium-reduction efforts.

Background: Dietary quality plays an important role in disease development and prognosis, and diet is also a key contributor to disparities in many chronic diseases and health conditions. Objectives: This study aimed to assess racial and ethnic disparities experienced by veterans; we examined food intake and dietary quality across different racial and ethnic groups of United States veterans. Methods: The study included 420,730 males and females aged 19–107 y (91.2% males) enrolled in the Veterans Affairs Million Veteran Program with plausible dietary intake measured by food frequency questionnaire. Dietary quality was evaluated with dietary approaches to stop hypertension (DASH) score. Dietary intakes of various race and ethnicity groups were standardized to the age distribution of non-Hispanic White participants, separately for males and females. Differences across race and ethnicity groups were compared using general linear regression models after adjustment for socioeconomic and lifestyle factors as well as military service. Results: Compared to non-Hispanic White males, non-Hispanic Black males had a relatively lower DASH score, higher red and processed meats, higher sugar-sweetened beverages (SSBs), and lower low-fat dairy intakes. Non-Hispanic Asian males had a relatively higher DASH score as compared to non-Hispanic White males with relatively higher intakes of fruits and vegetables and relatively lower intakes of sodium, red meat and SSBs. Age-standardized DASH scores of Hispanic males and “Other” race/ethnicity groups were not statistically different from non-Hispanic White males. Similar race and ethnicity dietary patterns were found in females, although not all reached a statistically significant level. Conclusions: A modest difference in overall dietary quality (i.e., DASH score) was observed, but unique differences in food preferences across the different racial/ethnic groups were identified. Findings from our study may provide insight for the potential development of specific interventions to help address nutritional disparities experienced among veterans.

ObjectivesA prevalent symptom of many mental health issues, such as depression, is anhedonia, which is the inability to feel joy or pleasure. Tension-induced sensations, anxious thoughts, and bodily alterations are the hallmarks of anxiety. One known environmental factor that affects mental health is diet. In this implication, eating appetizing meals has been proposed to reduce unpleasant feelings like worry. This study aimed to indicate whether eating habits among postgraduate students are related to symptoms of anhedonia and/or anxiety.MethodsIn a cross-sectional study, responses were collected from a total of 393 postgraduate students. Each student self-answered the General Anxiety Disorder-7, Snaith-Hamilton Pleasure Scale for Anhedonia, and the Food Consumption Questionnaire and reported the body weight.ResultsThe prevalence of anhedonia was 28%, moderate anxiety and severe anxiety were 15.7 and 10.9%, respectively. In this research, results showed that sugary foods, fast food, and fried foods were positively associated with anxiety and anhedonia. However, fruits and vegetables were negatively associated with anxiety and anhedonia. Linear regression showed that fruit and drinking water consumption was significant with the number of meals/day. There was no significance between the number of meals per day and anhedonia; however, there was statistical significance with the total GAD-7 scale score regarding the number of meals/per day.ConclusionAnhedonia and anxiety are associated with food consumption, especially foods rich in sugars, fast and fried, which help to increase positive feelings. Future studies should focus on understanding the relationship between food consumption and following a healthy diet and improving and reducing symptoms of anxiety and anhedonia in those who suffer from a stressful or task-filled lifestyle, such as students, especially postgraduate students. In addition, it focuses on the importance of awareness of the symptoms of anhedonia, which is classified as a depressive disease, and how to control anxiety to maintain better mental health.

Abstract Studies on the beneficial role of dietary antioxidants in preventing or managing hypertension in postmenopausal women are infrequent. The present cross-sectional study aimed to assess the association between dietary antioxidants and hypertension among menopausal women in Rafsanjan, a city located in the southeast of Iran. This study was based on data from the Rafsanjan Cohort Study (RCS), as part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Among 2359 postmenopausal women, finally, 1936 women were included in this study. Participants were grouped as having normal blood pressure (BP), elevated BP, stage 1 hypertension, or stage 2 hypertension as defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline. A food frequency questionnaire (FFQ), was utilized to ascertain the levels of various nutrients and dietary antioxidants in the diet. The association between dietary intakes of antioxidants and blood pressure groups was evaluated by crude and adjusted models in the multinominal logistics regression analysis. Normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension were observed in 35.69%, 3.62%, 10.59%, and 50.10% of postmenopausal women respectively. In the adjusted model, in subjects with higher consumption of β-carotene, the odds ratios of elevated BP in the 3rd quartile was about 2 times (OR: 2.04 (1.06–3.93) higher than 1st quartile. Also, in subjects with medium quality of DAQS, the odds ratios of elevated BP and stage 1 blood pressure were about 2 times (OR: 2.09 (1.05–4.17) and 1.69 times (OR: 1.69 (1.09–2.63) higher than subjects with low quality respectively. Furthermore, we did not find any statistically significant association between increased intake of dietary antioxidants and decreased odds of hypertension. After controlling the effects of confounding variables, increased dietary intake of selenium, carotenoids, vitamin A, vitamin C, and vitamin E did not decrease the odds of hypertension in postmenopausal women. Accordingly, it is suggested that this association be further investigated in the follow-up phase of this prospective study.

Rui-lian Ding,1,&ast; Cheng Fu,2,3,&ast; Yu Zheng,1 Jin Bu,1 Er-Xia Shen2 1Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China; 2Sino-French Hoffmann Institute, School of Basic Medical Sciences; The Second Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangdong Provincial Key Laboratory of Allergy & Clinical Immunology, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China; 3Shenzhen Children’s Hospital, Shenzhen, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jin Bu; Er-Xia Shen, Email dr.jinbu@gmail.com; erxia_shen@gzhmu.edu.cnObjective: Psoriasis is a common chronic inflammatory disease. However, trace elements are essential to biochemical processes of the skin, it is suspected that the trace elements are vital in the pathogenesis of psoriasis. Our research is aimed to investigate the association between serum levels and dietary intake levels of selenium, zinc, and copper with psoriasis.Methods: In this cross-sectional study, we utilized the National Health and Nutrition Examination Survey data from 2011 to 2014 to examine the association between psoriasis and serum concentration and dietary intake of trace elements including copper, zinc, and selenium in the US individuals. Our research combined two cycles and weighted the data. Student’s t-tests and χ 2 test were used. Subgroup analyses and interaction tests were conducted by IBM SPSS Statistics 22 and EmpowerStats.Results: This study indicates that the population with psoriasis has a lower dose of dietary intake selenium than the controls, and risk analysis showed that the men with selenium daily intake > 150 mcg/day have a decreasing risk for psoriasis compared to those with daily intaking selenium < 75 mcg/day. However, there are no differences on daily intake of selenium, zinc, and copper and serum levels of Zinc and Copper between psoriasis and healthy controls. The current study showed that the psoriasis group was significantly older with a bigger waist circumference, a higher education level, a higher ratio of people with smoke every day, and a higher ratio of people in USA and being non-Hispanic White.Conclusion: This cross-section study showed that a high selenium intake may benefit USA adults from psoriasis, especially for males. The social and cultural background and ethnic differences between the two groups influence the eating and living models, including the trace element intake. The national recommended dietary allowances (RDAs) might be considered to be modified with more reliable investigative clinical data and certain considering the social and cultural models.Keywords: trace elements, selenium, zinc, copper, serum level, dietary intake