The aim of this study was to evaluate the relative validity of food and nutrient intakes estimated by a brief-type diet history questionnaire for Japanese children and adolescents (BDHQ15y) designed to assess habitual dietary intake during the previous month. A total of 432 boys and 412 girls aged 6–17 years from thirty-two prefectures in Japan completed the BDHQ15y and subsequently provided 8-day weighed dietary records (DR) on two non-consecutive days over four seasons for comparison. Among the intakes of forty-four nutrients and thirty-one food groups adjusted for energy intake using the density model, the BDHQ15y showed percentage differences in median intake of less than 10 % compared with the DR for nineteen nutrients in both sexes, as well as for eleven and seven food groups in boys and girls, respectively, indicating good agreement for key nutrients and food groups, including protein, fat, carbohydrate, dietary fibre, grains, vegetables, dairy products and sugar-sweetened beverages (SSB). The median values (25th–75th percentiles) of Spearman’s correlation coefficients in boys and girls were 0·33 (0·28–0·38) and 0·28 (0·23–0·35) for nutrients, respectively, and 0·36 (0·29–0·42) and 0·29 (0·24–0·36) for food groups, respectively. Bland–Altman plots showed wide limits of agreement, with overestimation at higher intakes for most nutrients and food groups, except SSB. In conclusion, the BDHQ15y shows promise for large-scale dietary monitoring, particularly for estimating group-level intakes of key nutrients and food groups. However, its limited ability to rank individual intakes and the variability in individual-level assessments necessitate cautious interpretation and application.

Passive smoking is associated with an increased risk of hypertension in children. Antioxidant nutrients are known to alleviate oxidative stress, a key factor in the development of hypertension. Riboflavin, with its antioxidant properties, may help mitigate oxidative damage caused by passive smoke exposure. This study aimed to examine whether riboflavin intake could influence the relationship between passive smoking and hypertension in children and adolescents aged 6–19 years. Data were extracted from the 2007–2018 National Health and Nutrition Examination Survey. Weighted logistic regression models were used to identify potential covariates, and weighted multiple logistic regression models assessed the associations between passive smoking, riboflavin intake and hypertension. The association was also investigated in diverse age, gender and race subgroups. Results were presented as OR and 95 % CI. A total of 11 445 children and adolescents with a mean age of 12·89 (0·06) years were included. After adjusting covariates, cotinine ≥ 0·05 ng/ml was associated with increased odds of hypertension (OR = 1·20, 95 % CI: 1·06, 1·36). When individuals had a riboflavin intake < 1·87 mg, passive smoking (OR = 1·98, 95 % CI: 1·25, 3·13) and active smoking (OR = 1·69, 95 % CI: 1·14, 2·51) were both related to higher odds of hypertension. When individuals had a riboflavin intake ≥ 1·87 mg, no association was observed between passive smoking (OR = 0·83, 95 % CI: 0·48, 1·44) and active smoking (OR = 1·05, 95 % CI: 0·68, 1·62) and hypertension. Riboflavin intake may modulate the association between smoking status and hypertension in children and adolescents aged 6–19 years. The moderating effect was also found in age < 13 years old, ≥ 13 years old, males and non-Hispanic Whites.

TNF-α polymorphisms may influence dyslipidaemia, but their role remains unclear. This case–control study investigated associations between TNF-α gene polymorphisms (–1031T/C, −863C/A, −857C/T, −308G/A and −238G/A) and dyslipidaemia in 595 participants (162 cases, 433 controls) from the Chaoshan region of China. Anthropometric, biochemical and genetic data were analysed using χ2 tests and logistic regression, with the false discovery rate (FDR) method applied to correct for multiple comparisons. Results revealed that only the −1031T/C and −863C/A polymorphisms were significantly associated with dyslipidaemia. Carriers of the TC + CC genotype for −1031T/C (OR = 0·48; 95 % CI: 0·30, 0·78; PFDR = 0·006) and the CA + AA genotype for −863C/A (OR = 0·41; 95 % CI: 0·24, 0·70; PFDR = 0·004) had lower odds of dyslipidaemia. Protective effects were observed for the C allele at −1031T/C (OR = 0·58, PFDR = 0·012) and the A allele at −863C/A (OR = 0·47, PFDR = 0·004). Stratified analyses showed that these associations were significant in males but not females. Functional annotation linked these TNF-α gene polymorphisms to transcription factors (e.g. HNF-1A, STAT1β) in the adipogenesis pathway. This study reveals genetic associations between TNF-α polymorphisms and dyslipidaemia, particularly in males, and provides mechanistic insights into their role in transcriptional regulation.

The Scientific Advisory Committee on Nutrition (SACN) provides independent advice on nutrition and related health matters to UK government organisations. In keeping with its commitment to openness and transparency, SACN follows a set ‘Framework’ to ensure a prescribed and consistent approach is taken in all its evidence evaluations. Following an update of the SACN Framework in 2020, which addressed some straightforward issues, the SACN Framework subgroup was established in 2021 to consider more complex matters that were not addressed in the 2020 update. The SACN Framework subgroup considered four main topics for update: (1) the different types of evidence evaluations produced by SACN, (2) interpretation of statistical data, (3) tools for assessment of study quality and (4) tools to assess the certainty of a body of evidence for exposure–outcome relationships. The Framework subgroup agreed clear definitions and processes for the different types of evidence evaluations produced by SACN and agreed that interpretation of P values should be informed by consideration of study size, power and methodological quality. The subgroup recommended use of the AMSTAR 2 tool for quality assessment of evidence from systematic reviews and use of the Grading of recommendations, assessment, development and evaluation approach to assess the certainty of evidence. The updated Framework was published in January 2023. This was followed by publication of a further update in October 2024. As a ‘living’ document, the Framework will be subject to regular review by the Framework subgroup and continue to evolve in line with best practice.

To address limited data on whole grain (WG) consumption in the UK, we investigated trends and socio-demographic patterns of WG consumption from the National Diet and Nutrition Survey from 2008/2012 to 2016/2019 and examined the relationship between WG and dietary intakes. We analysed 15 655 individuals aged ≥ 1·5 years who completed a 4-day food diary. WG consumption was quantified by estimating the WG content of individual foods using publicly available ingredient information. Survey-weighted mean WG consumption over time and by population sub-group was calculated. Survey-weighted trend tests and Wald tests were used. Total WG intake in the general population did not change from 2008/2012 to 2016/2019. WG from high-fibre cereals and bread declined by 16·2 % (11·1–9·3 g/d) and 19·4 % (12·4–10 g/d), respectively, while other cereals (e.g. rice/pasta) increased by 72·5 % (4·0–6·9 g/d), but contributed considerably less than other categories. In the most recent data (2016–2019), older adults (65+ years) had the highest energy-adjusted WG consumption, followed by children 1·5–3 years. Individuals with lower incomes, adolescents and current smokers consumed the least WG. Whole grain intake was associated with generally higher quality diets, specifically consuming more fibre, potassium, Ca, Fe, Mg, fruits/vegetables, pulses/nuts and oily fish and consuming less free sugars, total fat, saturated fat, Na and red/processed meat (Ptrend < 0·001 for all). Despite some dietary improvements in the UK, WG intake appears unchanged from 2008/2012 to 2016/2019.

We investigated the coverage of childhood vitamin A supplementation (VAS) across India from 2005–2006 to 2019–2021 and further explored how it related to childhood mortality. Data collected from mothers through standard questionnaires during the latest three rounds of the National Family Health Survey (2005–2006, 2015–2016 and 2019–2021) were used. Information on VAS in children aged 9–35 months was available from 2015–2016 to 2019–2021. Information on VAS among children aged 9–59 months was available from 2005–2006 to 2015–2016. Childhood VAS coverage was determined nationally and subnationally (viz. individual states, geography, socio-demographic index and developmental groups). Nearly 40 % eligible children aged 9–59 months and 30 % eligible children aged 9–35 months missed VAS during recent times. But improvements in VAS coverage were noticed over the years: from 18·6 % (2005–2006) to 60·5 % (2015–2016) among children aged 9–59 months and from 64·5 % (2015–2016) to 71·2 % (2019–2021) among children aged 9–35 months. There were coverage disparities, with Western India documenting the highest and Northeastern India documenting the lowest coverage values. During simple linear regression analysis, childhood mortality between 1 and 5 years of age varied inversely as a function of VAS coverage among children aged 9–59 months, with the association being less pronounced in 2015–2016 (β = −0·47) than in 2005–2006 (β = −0·40). However, this relationship disappeared when we accounted for potential confounders (viz. childhood immunisation and socio-economic factors) through multivariate analysis, suggesting that the role of VAS in promoting childhood survival may be limited during present times.

Diet in the first years of life is a key determinant of lifelong disease risk and is highly affected by socio-economic status (SES). However, the specific relation between SES and food consumption in toddlers and preschoolers is poorly understood. This study assesses SES-related differences in food consumption in 1- to 5-year-olds in Germany using weighed food records (3 + 1 d) of a subsample of 887 children from the cross-sectional Children’s Nutrition Survey to Record Food Consumption (KiESEL) undertaken between 2014 and 2017. Children were categorised as having a low, medium or high SES depending on parental income, education and occupation. A two-step generalised linear model corrected for age and sex was applied to assess differences in food consumption, using bootstrapping to address unequal group sizes. Differences between SES groups were found for unfavourable foods (and the subgroups sugar-sweetened beverages and confectionary/desserts), fruit, bread/cereals and fats/oils (PBoot < 0·05). Mean daily consumption in the low-SES group as compared with the high-SES group was 84 g lower for total fruit, 22 g lower for bread/cereals and 3 g lower for fats/oils, while being 123 g higher for sugar-sweetened beverages and 158 g higher for unfavourable foods in total (based on bootstrap 95 % CI). In conclusion, this study suggests a social gradient in the diet of German toddlers and preschoolers, with lower SES linked to lower diet quality. To prevent adverse health trajectories, public health measures to improve early life nutrition should address all children, prioritising those of lower SES.

This meta-analysis assesses the relationship between vitamin D supplementation and incidence of major adverse cardiovascular events (MACE). PubMed, Web of science, Ovid, Cochrane Library and Clinical Trials were used to systematically search from their inception until July 2024. Hazard ratios (HR) and 95 % CI were employed to assess the association between vitamin D supplementation and MACE. This analysis included five randomised controlled trials (RCT). Pooled results showed no significant difference in the incidence of MACE (HR: 0·96; P = 0·77) and expanded MACE (HR: 0·96; P = 0·77) between the vitamin D intervention group and the control group. Further, the vitamin D intervention group had a lower incidence of myocardial infarction (MI), but the difference was not statistically significant (HR: 0·88, 95 % CI: 0·77, 1·01; P = 0·061); nevertheless, vitamin D supplementation had no effect on the reduced incidence of stroke (P = 0·675) or cardiovascular death (P = 0·422). Among males (P = 0·109) and females (P = 0·468), vitamin D supplementation had no effect on the reduced incidence of MACE. For participants with a BMI < 25 kg/m2, the difference was not statistically significant (P = 0·782); notably, the vitamin D intervention group had a lower incidence of MACE for those with BMI ≥ 25 kg/m2 (HR: 0·91, 95 % CI: 0·83, 1·00; P = 0·055). Vitamin D supplementation did not significantly contribute to the risk reduction of MACE, stroke and cardiovascular death in the general population, but may be helpful for MI. Notably, the effect of vitamin D supplementation for MACE was influenced by BMI. Overweight/obese people should be advised to take vitamin D to reduce the incidence of MACE.

This study examined whether supplementation with collagen peptides (CP) affects appetite and post-exercise energy intake in healthy active females. In this randomised, double-blind cross-over study, fifteen healthy females (23 (sd 3) years) consumed 15 g/d of CP or a taste matched non-energy control (CON) for 7 d. On day 7, participants cycled for 45 min at ∼55 % Wmax, before consuming the final supplement. Sixty-min post supplementation an ad libitum meal was provided, and energy intake recorded. Subjective appetite sensations were measured daily for 6 d (pre- and 30 min post-supplement) and pre (0 min) to 280 min post-exercise on day 7. Blood glucose and hormone concentrations (total ghrelin, glucagon-like peptide-1 (GLP-1), and peptide YY (PYY), cholecystokinin (CCK), dipeptidyl peptidase-4 (sDPP-4), leptin, and insulin) were measured fasted at baseline (day 0), then pre-breakfast (0 min), post-exercise (100 min), post-supplement (115, 130, 145, 160 min) and post-meal (220, 280 min) on day 7. Ad libitum energy intake was ∼10 % (∼41 kcal) lower in the CP trial (P = 0·037). There was no difference in gastrointestinal symptoms or subjective appetite sensations throughout the trial (P ≥ 0·412). Total plasma GLP-1 (AUC, CON: 6369 (sd 2330); CP: 9064 (sd 3021) pmol/l; P < 0·001) and insulin (+80 % at peak) were higher after CP (P < 0·001). Plasma ghrelin and leptin were lower in CP (condition effect; P ≤ 0·032). PYY, CCK and glucose were not different between CP and placebo (P ≥ 0·100). CP supplementation following exercise increased GLP-1 and insulin concentrations and reduced ad libitum energy intake at a subsequent meal in physically active females.

This study explored whether lifestyle therapy that promoted adherence to a Mediterranean-style diet as a treatment for depression led to environmental co-benefits. Participants (n 75 complete case) were Australian adults in the Curbing Anxiety and Depression using Lifestyle Medicine non-inferiority, randomised controlled trial, which showed that lifestyle therapy was non-inferior to psychotherapy in reducing depressive symptoms, when delivered in group format via video conferencing over an 8-week treatment period. In this secondary analysis, we hypothesised that the lifestyle arm would be superior to the psychotherapy arm in reducing the environmental impact of self-reported diet over time. Dietary intake derived from FFQ at baseline and 8 weeks was transformed into environmental impact scores by calculating global warming potential (GWP)*. GWP* was calculated for total dietary intake and distinct food groups (Australian Dietary Guidelines and NOVA classifications). Within-arm changes in GWP* over time were calculated using the median difference. Neither arm showed significant changes. Between-arm differences in percentage change in GWP* scores over time were analysed using generalised estimating equations models. No between-arm difference for total GWP* score was found (β = 11·06 (–7·04, 29·15)). When examining distinct food groups, results were mixed. These novel findings contribute to the sparse evidence base that has measured the environmental impact of diets in a clinical trial context. Whilst lifestyle therapy that reduced depressive symptoms did not have clear environmental benefits relative to psychotherapy, nutritional counselling that focuses on the environmental impact of food choices may drive more pronounced planetary co-benefits.

Using a behavioural intervention to target nutrition during pregnancy may be key in meeting recommendations for healthy eating. The aim was to assess the use of a short-term dietary intake measurement tool (3-day food intake record) to infer long-term habitual dietary intake during pregnancy (using a short-form FFQ). A convenience sample (n 90) between 12- and 18-weeks’ gestation was recruited from a larger randomised controlled trial for cross-sectional analysis. Participants completed a forty-four-item FFQ and 3-day food intake record. Using the participant food intake record, the investigator blindly completed a second frequency questionnaire. The frequency questionnaires were scored using dietary quality scores (DQS) and compared. Aggregate data were evaluated using a Wilcoxon signed rank test, and individual-level data were evaluated using a Bland–Altman plot. No significant difference was observed in the scores (Z = –1·88, P = 0·06), with small effect size (r= 0·19). The Bland–Altman plot showed that comparing the DQS derived from the two different dietary assessments underestimated scores by a mean difference of 0·4 points (95 % limits of agreement: −3·50 to 4·26). The data points were evenly spread suggesting no systematic variation for over- or underestimation of scores. Minimal difference was observed between the functionality of the two assessment instruments. However, the food intake record can be completed by pregnant individuals to estimate short-term nutrient intake and then scored by the investigator to estimate long-term dietary quality. Combining these two instruments may best capture the most accurate representation of dietary habits over time.

Persistent malnutrition is associated with poor clinical outcomes in cancer. However, assessing its reversibility can be challenging. The present study aimed to utilise machine learning (ML) to predict reversible malnutrition (RM) in patients with cancer. A multicentre cohort study including hospitalised oncology patients. Malnutrition was diagnosed using an international consensus. RM was defined as a positive diagnosis of malnutrition upon patient admission which turned negative one month later. Time-series data on body weight and skeletal muscle were modelled using a long short-term memory architecture to predict RM. The model was named as WAL-net, and its performance, explainability, clinical relevance and generalisability were evaluated. We investigated 4254 patients with cancer-associated malnutrition (discovery set = 2977, test set = 1277). There were 2783 men and 1471 women (median age = 61 years). RM was identified in 754 (17·7 %) patients. RM/non-RM groups showed distinct patterns of weight and muscle dynamics, and RM was negatively correlated to the progressive stages of cancer cachexia (r = –0·340, P < 0·001). WAL-net was the state-of-the-art model among all ML algorithms evaluated, demonstrating favourable performance to predict RM in the test set (AUC = 0·924, 95 % CI = 0·904, 0·944) and an external validation set (n 798, AUC = 0·909, 95 % CI = 0·876, 0·943). Model-predicted RM using baseline information was associated with lower future risks of underweight, sarcopenia, performance status decline and progression of malnutrition (all P < 0·05). This study presents an explainable deep learning model, the WAL-net, for early identification of RM in patients with cancer. These findings might help the management of cancer-associated malnutrition to optimise patient outcomes in multidisciplinary cancer care.

Previous studies on the association between fruit juice consumption and type 2 diabetes remain controversial, which might be due to heterogeneity in the polygenic risk score (PRS) for type 2 diabetes. We examined the association between fruit juice and type 2 diabetes by PRS for type 2 diabetes. We investigated whether fruit juice influences type 2 diabetes risk differently among individuals with varying genetic risks. Data from the Japan Multi-Institutional Collaborative Cohort (J-MICC) study, a cross-sectional study of 13 769 Japanese individuals was used for our analysis. The primary exposure was the frequency of fruit juice, categorised as do not drink, less than 1 cup per day or more than 1 cup per day. We selected PGS002379, a PRS for type 2 diabetes developed using East Asian populations. The primary outcome was physician-diagnosed type 2 diabetes, reported by participants. The consumption of fruit juice was significantly inversely associated with type 2 diabetes in the group with a high PRS for type 2 diabetes (OR: 0·78, 95 % CI: 0·65, 0·93 for < 1 cup/d and OR: 0·54, 95 % CI: 0·30, 0·96 for > 1/d), but this association was not observed in the low PRS group. Fruit juice consumption was inversely associated with type 2 diabetes, especially in genetically high-risk populations for type 2 diabetes.

A local food-based approach, including school lunch with multiple-micronutrient fortified biscuits (MMB) as supplementary snacks, may enhance dietary adequacy, although current evidence remains limited. This study assessed nutrient inadequacies and developed food-based dietary recommendations (FBR) incorporating school lunch from the Ghana School Feeding Programme (GSFP) and MMB. Data from 292 girls aged 10–17 years, enrolled in the Ten2Twenty-Ghana study was analysed. Dietary intake was assessed via a quantitative 24-h dietary recall. Usual intakes were estimated using the National Cancer Institute method. Linear programming with Optifood was used to develop FBRs based on commonly consumed foods (≥5% of participants) and their median serving sizes, intake frequency, nutrient content, and cost per 100 g. Constraints included estimated energy needs and harmonised average nutrient requirements. The mean usual energy intake was 2351 (sd 66) kcal/d. Ca (99·8 %), vitamin B12 (99·8 %), riboflavin (96·2 %), vitamin A (91·5 %), vitamin C (87·6 %), Fe (73·7 %), folate (49·3 %) and Zn (8·5 %) inadequacies were prevalent. Optimised diets achieved adequacy for protein and most micronutrients, except Ca and vitamin B12, besides vitamin A for 15–17-year-old girls. School lunch from the GSFP did not enhance micronutrient levels when added to the daily diet. Adding MMB to the daily diet ensured adequacy for vitamin C, riboflavin and Fe, although marginal for Fe. Ca and vitamin A improved substantially with MMB for girls aged 15–17 but remained below the harmonised average requirements. Integrating regular school lunch with specialised fortified foods may be a cost-effective strategy to enhance dietary adequacy for adolescent girls in rural areas.