Inflammation and infections such as malaria affect concentrations of many micronutrient biomarkers and hence estimates of nutritional status. We aimed to assess the relationship between malaria infection and micronutrient biomarker concentrations in pre-school children (PSC), school-age children (SAC) and women of reproductive age (WRA) in Malawi and examine the potential role of malarial immunity on the relationship between malaria and micronutrient biomarkers. Data from the 2015/2016 Malawi micronutrient survey were used. The associations between current or recent malaria infection, detected by rapid diagnostic test and concentration of serum ferritin, soluble transferrin receptor (sTfR), zinc, serum folate, red blood cell folate and vitamin B12 were estimated using multivariable linear regression. Factors related to malarial immunity including age, altitude and presence of hemoglobinopathies were examined as effect modifiers. Serum ferritin, sTfR and zinc were adjusted for inflammation using the BRINDA method. Malaria infection was associated with 68 % (95 % CI 51, 86), 28 % (18, 40) and 34 % (13, 45) greater inflammation-adjusted ferritin in PSC, SAC and WRA, respectively (P < 0·001 for each). In PSC, the positive association was stronger in younger children, high altitude and children who were not carriers of the sickle cell trait. In PSC and SAC, sTfR was elevated (+ 25 % (16, 29) and + 15 % (9, 22) respectively, P < 0·001). Serum folate and erythrocyte folate were elevated in WRA with malaria (+ 18 % (3, 35) and + 11 % (1, 23), P = 0·01 and P = 0·003 respectively). Malaria affects the interpretation of micronutrient biomarker concentrations, and examining factors related to malarial immunity may be informative.

Triceps skinfold thickness (TSF) is a surrogate marker of subcutaneous fat. Evidence is limited about the association of sex-specific TSF with the risk of all-cause mortality among maintenance hemodialysis (MHD) patients. We aimed to investigate the longitudinal relationship of TSF with all-cause mortality among MHD patients. A multicenter prospective cohort study was performed in 1034 patients undergoing MHD. The primary outcome was all-cause mortality. Multivariable Cox proportional hazards models were used to evaluate the association of TSF with the risk of mortality. The mean (standard deviation) age of the study population was 54.1 (15.1) years. 599 (57.9%) of the participants were male. The median (interquartile range) of TSF was 9.7 (6.3–13.3 mm) in males and 12.7 (10.0–18.0 mm) in females. Over a median follow up of 4.4 years (interquartile range, 2.4-7.9 years), there were 548 (53.0%) deaths. When TSF was assessed as sex-specific quartiles, compared with those in quartile 1, the adjusted HRs (95%CIs) of all-cause mortality in quartile 2, quartile 3 and quartile 4 were 0.93 (0.73, 1.19), 0.75 (0.58, 0.97) and 0.69 (0.52, 0.92), respectively (P for trend =0.005). Moreover, when analyzed by sex, increased TSF (≥9.7 mm for males and ≥18mm for females) was significantly associated with a reduced risk of all-cause mortality (quartile 3-4 vs. quartile 1-2; HR, 0.70; 95%CI: 0.55, 0.90 in males; quartile 4 vs. Quartile 1-3; HR, 0.69; 95%CI: 0.48, 1.00 in females). In conclusion, high TSF was significantly associated with lower risk of all-cause mortality in MHD patients.

Little is known about the association between iodine nutrition status and bone health. The present study aimed to explore the connection between iodine nutrition status, bone metabolism parameters, and bone disease (osteopenia and osteoporosis). A cross-sectional survey was conducted involving 391, 395, and 421 adults from iodine fortification areas (IFA), iodine adequate areas (IAA), and iodine excess areas (IEA) of China. Iodine nutrition status, bone metabolism parameters and BMD were measured. Our results showed that, in IEA, the urine iodine concentrations (UIC) and serum iodine concentrations (SIC) were significantly higher than in IAA. BMD and Ca2+ levels were significantly different under different iodine nutrition levels and the BMD were negatively correlated with UIC and SIC. Univariate linear regression showed that gender, age, BMI, menopausal status, smoking status, alcohol consumption, UIC, SIC, free thyroxine, TSH, and alkaline phosphatase were associated with BMD. The prevalence of osteopenia was significantly increased in IEA, UIC ≥ 300 µg/l and SIC > 90 µg/l groups. UIC ≥ 300 µg/l and SIC > 90 µg/l were risk factors for BMD T value < –1·0 sd. In conclusion, excess iodine can not only lead to changes in bone metabolism parameters and BMD, but is also a risk factor for osteopenia and osteoporosis.

This study aims to illustrate a process approach for the calculation of minimum dietary diversity (MDD) indicators for interpretation of dietary diversity (DD) scores and to validate the MDD indicator as a proxy for adequate micronutrient intake using an existing dataset for 2 to younger than 10-year-old South African children. The DD scores were derived from nine food groups, adjusted from the ten food groups for women of reproductive age by combining pulses, nuts and seeds. Three reference methods were used to inspect micronutrient adequacy, namely the mean adequacy ratio and the mean probability of adequacy (MPA) using a single 24-h recall, and the MPA derived from usual intake using more than one 24-hour recall in a sub-sample. Adequacy threshold levels and candidate MDD indicators were inspected and validated using several performance criteria. Results show that the mean and median DD scores were 3·6 and 3·1, respectively. The resulting MDD indicators varied between 3 and 4 out of nine food groups favouring the identification of children with adequate and inadequate intake, respectively, depending on the method used and the age group. Our results and those from others furthermore support a simplified method or ‘rule of thumb’ for the determination of an MDD indicator to establish the integer values below and above the median of the DD scores. We conclude that finding a valid MDD indicator can be done using different methodologies and that results underscore the potential of a simplified method for determining an MDD indicator.

Irritable bowel syndrome (IBS) is a common gut–brain interaction disorder. The aetiology of IBS is not entirely elucidated; however, among the risk factors, dietary factors are regarded as crucial. Previous studies have primarily investigated the association of single nutrients and food groups with the odds of IBS, rather than diet quality, which considers the interaction of food groups in the odds of disease. Thus, this study sought to investigate the association between dietary quality index international (DQI-I) and the odds of IBS in Iranian adults. In this case–control study, dietary intakes of 100 IBS cases and 310 healthy controls were examined using a validated dish-based semi-quantitative FFQ (DB-FFQ). DQI-I score was then calculated based and categorised into tertiles. The Persian version of the Rome IV questionnaire was utilised to assess IBS. Multivariable logistic regression was used to assess the association between DQI-I score and the odds of IBS. After controlling for potential confounders, no significant association was shown between DQI-I scores and IBS odds among whole and gender-stratified groups. Although DQI-I represents a healthy diet, the results of the current case–control study demonstrated that a higher DQI-I score was not associated with reduced odds of IBS in fully adjusted regression models. Considering inherent limitations as well as the scarce evidence regarding the association between DQI-I and odds of IBS, further large-scale, prospective studies are required to confirm our findings.

One of the most significant challenges in research related to nutritional epidemiology is the achievement of high accuracy and validity of dietary data to establish an adequate link between dietary exposure and health outcomes. Recently, the emergence of artificial intelligence (AI) in various fields has filled this gap with advanced statistical models and techniques for nutrient and food analysis. We aimed to systematically review available evidence regarding the validity and accuracy of AI-based dietary intake assessment methods (AI-DIA). In accordance with PRISMA guidelines, an exhaustive search of the EMBASE, PubMed, Scopus and Web of Science databases was conducted to identify relevant publications from their inception to 1 December 2024. Thirteen studies that met the inclusion criteria were included in this analysis. Of the studies identified, 61·5 % were conducted in preclinical settings. Likewise, 46·2 % used AI techniques based on deep learning and 15·3 % on machine learning. Correlation coefficients of over 0·7 were reported in six articles concerning the estimation of calories between the AI and traditional assessment methods. Similarly, six studies obtained a correlation above 0·7 for macronutrients. In the case of micronutrients, four studies achieved the correlation mentioned above. A moderate risk of bias was observed in 61·5 % (n 8) of the articles analysed, with confounding bias being the most frequently observed. AI-DIA methods are promising, reliable and valid alternatives for nutrient and food estimations. However, more research comparing different populations is needed, as well as larger sample sizes, to ensure the validity of the experimental designs.

This study aimed to investigate the relationship between serum folate levels and the risk of psoriasis by integrating observational study with Mendelian Randomisation (MR) analysis. We firstly conducted an observational study using data from the National Health and Nutrition Examination Survey (NHANES). Subsequently, genetic instruments were selected for two-sample MR analyses to investigate the causal relationship between serum folate levels and the risk of psoriasis. The observational study showed no significant association between serum folate levels and psoriasis. In the fully adjusted model, neither serum folate level as a continuous variable (OR = 0·99, 95 % CI: 0·98, 1·00, P = 0·071) nor serum folate quartiles Q4 compared to Q1 (OR = 0·83, 95 % CI: 0·58, 1·19, P = 0·309) showed statistical significance. The MR analysis revealed that higher genetically predicted serum folate levels from Icelandic and Danish populations were significantly associated with a reduced risk of psoriasis (OR = 0·63, 95 % CI: 0·45, 0·88, P = 0·005). Similarly, higher genetically predicted serum folate levels from South Asian populations were significantly associated with a lower risk of psoriasis (OR = 0·84, 95 % CI: 0·72, 0·98, P = 0·025). Integrating observational study with MR analysis suggests that serum folate levels are protective factors against psoriasis, indicating that higher serum folate levels may help prevent the onset of the disease.

Nations are revising dietary guidelines to include sustainability recommendations in response to climate change concerns. Given low adherence to current guidelines, consumer inertia is a challenge. A proliferation of nutrition information providers and dietary messages contributes to confusion. All this suggests that health professionals will face considerable obstacles in facilitating a population shift towards sustainable and healthy (SuHe) diets. This review explores the role of nutrition science in shaping dietary behaviour and the challenges of shifting the nutrition narrative to encompass both health and sustainability. Societal transformation towards the ‘asks’ of a SuHe diet will rely on consumer-level transformation of food acquisition, preparation, consumption, storage and disposal behaviours. Acceptance of a higher share of plant-based food and a reduction in animal protein in the diet is likely to provoke disorientations as consumers’ previously unexamined beliefs are challenged. The challenges presented by portion size distortion, protein reduction and replacement, and the role of ultra-processed food are discussed here in terms of sources of confusion. The routes to change involve deeper understanding of responses to disorientations through processes of belief formation and transformation, which are the foundations of subjective knowledge and attitudes, likely mediated through affective factors. In tandem with introducing new potentially disorienting-to-consumers information, health professionals need to consider the environments where this information is presenting and consider how these environments are designed to support action. In doing so, reactance and backlash through belief rejection and behavioural non-adherence could be reduced.

Se is particularly necessary in infants because of their rapid physical growth period in addition to being indispensable for neurodevelopment. Severe deficiency can lead to cardiomyopathy, hypothyroidism and faltering growth. However, Se can be toxic at high doses. In the paediatric age group, plasma/serum and erythrocyte Se levels seem to increase with age, except in the first year of life. Understanding the variability in Se status during this period can help to identify infants at risk of deficiency and develop strategies for controlling and preventing its consequences. This review aimed to identify the extent and characteristics of the variability of Se status during the first year of life. A search was conducted across five databases to find articles published until 30 July 2024, with no limitations on the language or date of publication. Articles were screened, data were extracted independently by two reviewers, and any disagreement was resolved by a third reviewer. A total of 22 studies comprising 1288 participants were included in this review, 21 of which assessed plasma/serum Se and 12 assessed erythrocyte Se. In the first 4 months of age, serum/plasma Se decreased, remained stable or increased depending on feeding, with an increase in supplemented formula-fed infants and breastfed infants of supplemented mothers. Erythrocyte Se levels showed a declining trend, except in infants fed supplemented formula or breastfed by supplemented mothers. Variability of serum/plasma and erythrocyte Se levels in the first year was associated with maternal Se intake/supplementation and the Se content of the infant’s diet.