Promoting fruit and vegetable (F&V) consumption is a public health priority. This study assessed compliance with the international recommendation of consuming at least 400g of F&V daily among Mexican adults and analysed its association with the five stages of behaviour change from the Transtheoretical Model (Precontemplation, Contemplation, Preparation for action, Action, and Maintenance). Using data from 5203 adults (ages 20–59) in the 2016 National Health and Nutrition Survey, dietary intake was collected via a food frequency questionnaire. Compliance was defined dichotomously (Yes/No), and readiness to change was assessed using a specific survey module. Multiple logistic regression models examined the association between stages of change and compliance, adjusting for demographic, socioeconomic, and health characteristics, as well as perceived barriers and self-efficacy. Nationally, 26.3% of adults met the F&V recommendation. Compliance was significantly higher among individuals in the Preparation for action (OR 3.62, 95% CI: 1.82–7.19), Action (OR 4.50, 95% CI: 1.8–11.25), and Maintenance (OR 9.54, 95% CI: 4.76–19.13) than those in the Precontemplation stage. Higher compliance was also significantly associated with greater self-efficacy (OR 1.86, 95% CI: 1.4–2.47), being in the highest socioeconomic tertile (OR 1.71, 95% CI: 1.25–2.33), and living in the central region (OR 1.70, 95% CI: 1.18–2.45). Conversely, individuals reporting a dislike for vegetables were less likely to meet recommendations (OR 0.67, 95% CI: 0.48–0.94). These findings highlight the value of developing stage-tailored interventions that consider both psychological and structural barriers to improve F&V consumption.

This population-based cross-sectional study investigated the complex interplay of factors influencing high ultra-processed food (UPF) consumption among Brazilian adolescents using a hierarchical socio-ecological model. Data from 100 028 adolescents (13–17 years) enrolled in public and private schools nationwide were collected via self-administered questionnaires from the 2019 National School Health Survey. High UPF consumption was defined as ≥ 7 subgroups consumed on the previous day based on the NOVA classification. Poisson regression adjusted for complex sampling and hierarchical structure identified prevalence ratios (PR) for associated factors. High UPF consumption was significantly associated with younger age (PR = 1·22; 95 % CI 1·11, 1·34), regular breakfast consumption (PR = 1·32; 95 % CI 1·23, 1·42), regular screen time during meals (PR = 1·36; 95 % CI 1·27, 1·45), frequent UPF purchases at and around school (PR for canteen: 1·57; 95 % CI 1·43, 1·72; street vendors: 1·71; 95 % CI 1·55, 1·89), higher maternal education (PR 1·23, 95 % CI 1·12, 1·36) and lower parental supervision (PR 1·34, 95 % CI 1·11, 1·62). Living in the South (PR 1·50, 95 % CI 1·34, 1·69), Southeast (PR 1·30, 95 % CI 1·17, 1·44) and Midwest regions (PR 1·21, 95 % CI 1·09, 1·34) also correlated with higher consumption. Conversely, high body satisfaction and attending private school showed an inverse association. These findings underscore the intricate, multilevel influences on UPF consumption among Brazilian adolescents. Integrated interventions, spanning schools, family environments and public policies are crucial for promoting healthier eating habits and preventing obesity in this vulnerable population.

Evidence regarding the association between dietary choline intake and mortality in individuals with diabetes remains limited. This study aimed to evaluate the relationship between dietary choline intake and all-cause, CVD and cancer-related mortality among adults with diabetes. A total of 4712 participants with diabetes were included from the National Health and Nutrition Examination Survey 2007–2018 cycles. Dietary choline intake was estimated using two 24-h dietary recalls, and mortality outcomes were ascertained via linkage to National Death Index records through 31 December 2019. Cox proportional hazards models and Kaplan-Meier analyses were employed to assess the associations between choline intake and mortality. Restricted cubic spline models were used to examine potential non-linear relationships, and threshold analyses were conducted to identify inflection points. Over a median follow-up of 6·42 years, 805 deaths were documented, including 267 from CVD and 126 from cancer. A U-shaped association was observed between dietary choline intake and all-cause mortality (Pfor non-linearity < 0·0001). Compared with the lowest quartile, multivariable-adjusted hazard ratios for all-cause mortality were 0·64 (95 % CI 0·47, 0·88) for the second quartile, 0·59 (0·43, 0·82) for the third and 0·69 (0·43, 1·09) for the highest quartile. No significant associations were found between choline intake and either CVD or cancer mortality. These findings indicate a U-shaped relationship between dietary choline intake and all-cause mortality in individuals with diabetes, with intakes between 286·77 and 538·86 mg/d associated with the lowest risk – providing potential implications for dietary guidance in diabetes management.

While the effects of multidisciplinary weight loss (WL) on resting energy expenditure remain unclear in adolescents with obesity, the potential presence of adaptive thermogenesis (AT) has never been explored, which was the objective of the present work. Twenty-six adolescents (14·1 (sd 1·5) years) with severe obesity completed a 9-month inpatient multidisciplinary intervention followed by a 4-month follow-up. Anthropometric measurements, body composition (dual X-ray absorptiometry) and resting energy expenditure (REE, indirect calorimetry) were assessed before (T0) and after 9 months of WL intervention (T1) and after a 4-month follow-up (T2). AT, at the level of REE, was defined as a significantly lower measured v. predicted (using regression models with baseline data) REE. Two pre-cited REE equations were used, using both fat mass and fat-free mass (FFM) (predicted REE using equation 1) or FFM only (predicted REE using equation 2). Measured and predicted REE significantly decreased between T0 and T1 (P < 0·001) and remained lower at T2 compared with T0 (measured REE: P = 0·017; predicted REE: P < 0·001). Predicted REE using equation 2 was significantly higher than measured REE at T1 (P = 0·012), suggesting the presence of AT. FFM at T0 was negatively correlated with ATp1T1 (Rho = –0·428; P = 0·033) and ATp2T1 (Rho = –0·485; P = 0·014). The variation of FFM between T0 and T1 was negatively correlated with AT at T1 and T2. These preliminary results suggest the existence of AT in response to WL in adolescents with obesity, independently of the degree of WL. AT was associated with subsequent body weight and fat regain, suggesting AT may represent a damper to WL attempts while increasing the adolescents’ risks for subsequent weight and adiposity rebounds.

There is a lack of knowledge available on how cats adjust their macronutrient partitioning due to the consumption of single-macronutrient meals. The objective of this study was to evaluate consumption of a single meal of ingredients that contained foods of strictly carbohydrates (CHO), fat (FAT) or protein (PRO), on energy expenditure (EE) and macronutrient metabolism in cats. Ten domestic shorthair adult cats (1·9 years; 4·12 kg) were fed 22–24 g of chicken fat (FAT), 56–62 g of whey protein solution (PRO) or 54–56 g of cornstarch solution (CHO) for a single day in a randomised complete block design. Indirect calorimetry was conducted for 24 h post-feeding. Mean average EE over 24 h was highest in cats fed PRO (44 kcal/kg BW) and FAT (43 kcal/kg BW) compared with that in cats fed CHO (42 kcal/kg BW; P < 0·01). During 0 to 4 h, cats fed FAT had greater EE (49 kcal/kg BW), suggesting that cats respond to oxidising more dietary fat over protein in the early postprandial stage. Mean 24 h respiratory quotient (RQ) was greatest for cats fed CHO (0·76) followed by PRO (0·75) and FAT (0·74; P < 0·05). During 4 to 8 h, the RQ of cats fed PRO was the greatest (0·77), suggesting that cats initially increase gluconeogenesis from amino acids for subsequent glucose oxidation. In comparison to omnivores and herbivores, obligate carnivores have unique responses to single macronutrient intake, where they apparently generate energy from carbohydrate metabolism and rely more on gluconeogenic precursors.

The threshold values of visceral fat area (VFA) proposed by existing studies for predicting metabolic syndrome (MetS) are contentious, necessitating further empirical evidence. We conducted a cross-sectional study to assess VFA using bioelectrical impedance analysis (BIA) technology among middle-aged and elderly individuals in the Sichuan area of China. Firstly, we compared the predictive ability of VFA, waist circumference (WC), and body mass index (BMI) among participants with MetS (excluding WC). In males, the area under the receiver operating characteristic curve (AUC) was 0.680 for VFA, 0.670 for WC, and 0.665 for BMI, with corresponding optimal cut-off values of 77.45 cm2, 83.50 cm, and 24.19 kg/m2. In females, the AUC values and optimal cut-offs were 0.628 (103.55 cm2) for VFA, 0.671 (77.50 cm) for WC, and 0.643 (24.32 kg/m2) for BMI. Additionally, for MetS defined with WC included, the AUC of VFA for prediction was higher in males (0.785) than in females (0.717), with optimal cut-offs of 85.15 cm2 (males) and 109.55 cm2 (females). Further age-stratified analysis revealed gender-specific VFA cut-offs: in males, 80.95 cm2 (45-59 years), 85.15 cm2 (60-74 years), and 77.50 cm2 (≥75 years); in females, 109.65 cm2 (45-59 years), 112.15 cm2 (60-74 years), and 103.05 cm2 (≥75 years). In conclusion, VFA is an effective predictor of MetS, with its optimal cut-off value varying by age and being higher in females than in males.

Cancer-related fatigue is a common problem among colorectal cancer (CRC) survivors even after completion of treatment. In a randomised trial, we assessed the effect of a person-centred lifestyle programme on cancer-related fatigue among CRC survivors who completed treatment. Survivors who completed treatment at least 6 months but no longer than 5 years ago and who were experiencing cancer-related fatigue were randomised to intervention or control group. The intervention group worked with a lifestyle coach for 6 months during twelve sessions to stepwise increase adherence to the World Cancer Research Fund/American Institute of Cancer Research cancer prevention guidelines on healthy diet and physical activity. The control group did not receive lifestyle coaching. Changes in cancer-related fatigue from baseline to 6 months were assessed with the FACIT (Functional Assessment of Chronic Illness Therapy) – Fatigue Scale. As a secondary outcome, we assessed changes in health-related quality of life (HRQoL). Higher scores indicate less fatigue and better HRQoL. Eighty participants were randomised to the intervention group; eighty-one to the control group. Baseline characteristics were similar: mean age 64·1 (sd 10·9) years; 55·3 % were women; and 72 % had colon cancer. There were favourable changes in dietary behaviours and physical activity in the intervention group; the control group did not show changes to the same extent. The programme did not result in statistically significant differential changes over time between intervention and control group in cancer-related fatigue (0·8; 95 % CI −1·6, 3·2) or HRQoL (1·3; 95 % CI −2·2, 4·8). A person-centred lifestyle programme improved the lifestyle of CRC survivors, but the programme was not effective in reducing cancer-related fatigue or in improving HRQoL.

The limbic system is a brain structure involved in emotional regulation. Since nutritional interventions in very low birth weight (VLBW) infants may be associated with measurable differences in brain structure and function, we designed this prospective study to evaluate the impact of early nutritional support in VLBW infants on the volume of the regions that comprise the limbic system, as well as on the emotional and neuropsychological development of these infants. This is a prospective observational study of a historical cohort of children with a history of prematurity. Seventy-four preterm infants, with a mean age of 11·1 (sd 2·9) years, underwent neuropsychological assessment using the Wechsler Intelligence Scale for Children and functional MRI (fMRI). We recorded the nutritional intake during the first week of the neonatal period, as well as data related to neonatal morbidity. The association between the results of the brain structural analysis, psychometrics variables and nutritional intake was determined using simple and multivariate linear regression adjusted for child age and BMI in the structural analysis of fMRI. Lipids intake was also associated with the volume of the left thalamus (b = 50·7; P = 0·014), the right thalamus (b = 47·4; P = 0·018) and the left nucleus accumbens (b = 5·02; P = 0·031). We conclude that lipids intake in the first week of life in VLBW newborns is associated with the volume of various structures of the limbic system, namely the thalamus and the nucleus accumbens.

A growing body of evidence shows an association between in utero Ramadan exposure and negative long-term consequences. Nonetheless, there is a scarcity of studies utilizing clinical measures in adults. This study investigates a possible association between in utero Ramadan exposure and mean arterial pressure (MAP) as well as random blood glucose (RBG) measures in the adult offspring. Using cross-sectional data from the Southeast Asia community observatory health and demographic surveillance system (SEACO) in Malaysia for two survey rounds (year 2013 and 2018), we compared MAP and RBG of in utero Ramadan-exposed Muslims with unexposed Muslims and non-Muslims. In utero Ramadan exposure was estimated based on the overlap between pregnancy (estimated from birth dates) and Ramadan periods. We conducted difference-in-differences analyses adjusted for age and birth months (seasonal effects). A total of 20,575 participants aged 35 or older were included in the analysis, comprising 12,696 Muslims and 7,879 non-Muslims. Difference-in-differences analyses revealed no statistically significant association between in utero Ramadan exposure and MAP, or between in utero Ramadan and RBG. These findings persisted in additional analyses examining the timing of Ramadan exposure during pregnancy.

We aimed to investigate the association of chrono-nutrition components with anthropometric measures and body composition in adults living in Tehran. This cross-sectional study was conducted on 450 healthy adults. The exposures of the study were meal frequency, meal timing, meal irregularity, breakfast skipping, night fasting duration, time of the first and last eating occasion and the time interval from the last meal to bed. The outcomes were BMI, waist circumference, neck circumference (NC), waist:hip ratio, waist:height ratio (WHtR), body adiposity index (BAI), body roundness index (BRI), a body shape index, percentage of body fat (PBF), fat mass (FM), fat-free mass and muscle mass. Bonferroni correction was applied, and the significance level was less than 0·004. Using ANCOVA, after adjusting for confounders, late lunch eating was associated with a lower PBF. There was a positive trend across the tertiles of dinner time with greater WHtR (mean difference = 0·019; Ptrend = 0·025) and BRI (mean difference = 0·24; Ptrend = 0·022). Moreover, increased irregularity at dinner time was associated with higher levels of PBF (Ptrend = 0·026) and FM (Ptrend = 0·025). Also, longer overnight fasting was associated with lower NC (Ptrend = 0·049) and a greater BRI (Ptrend = 0·050). We found differences across the time interval from the last meal to bed with greater means of BAI (Ptrend = 0·026), PBF (Ptrend = 0·014) and FM (Ptrend = 0·020). However, after applying the Bonferroni correction, we found no significant association between chrono-nutrition components and anthropometric measures and body composition in adults living in Tehran. Further studies are necessary to confirm the results.