Nutrients最新文献

Background/Objectives: Food is Medicine (FIM) programs have been shown to be effective at addressing food and nutrition insecurity among individuals. However, more evidence is needed to determine effective interventions at the household level and their impact on child health outcomes. Feeding the Family is a randomized controlled trial which aims to determine whether the amount of food provided and the ability to select foods in FIM interventions have an incremental effect on child and caregiver clinical outcomes relative to nutrition counseling alone. The objective of this paper is to describe the population at baseline among those enrolled in Feeding the Family, an FIM family intervention. Methods: A pragmatic randomized controlled trial (pRCT) with a 2 × 2 factorial study design was used at an urban primary care clinic. Participants were randomized into one of four arms for a 3-month intervention: (1) medically tailored meals (MTMs), (2) grocery prescription (GP), (3) combined MTMs + GP, and (4) delayed control. Primary outcomes consisted of child and caregiver biomarkers (BMI, blood pressure, A1c, LDL, and HDL). Secondary outcomes included child and caregiver dietary behaviors, nutrition security, and food security. Spearman correlations and Kruskal-Wallis rank sum tests determined correlations between caregiver and child biomarkers, as well as correlations between caregiver socioeconomic factors and child outcomes, respectively. Results: Thirty-one caregivers and fifty-one children were enrolled. Nearly 90% of caregivers reported low-very low household food security; 93.6% experienced ongoing financial strain. Several caregiver-child biomarker correlations were observed, including caregiver and child BMI (r = 0.59, p = 0.043), caregiver LDL and child A1c (r = -0.79, p = 0.004), and caregiver total cholesterol and child BMI (r = -0.62, p = 0.032). In addition, food assistance status was associated with child vegetable intake (H = 6.16, df = 2, p = 0.046), and caregiver food security score was associated with child food security score (H = 18.31, df = 9, p = 0.032). Conclusions: There are robust correlations between caregiver and child clinical outcomes at baseline. These findings underscore the need for FIM research to examine how a tailored program can improve the clinical outcomes of entire households to address health disparities effectively.

Background/Objectives: Understanding the purchasing behaviour of sweetened beverages is important, as beverages have been highlighted as a key target for reducing sugar intake. This research aimed to provide a comprehensive understanding of trends in per capita volume sales of non-alcoholic water-based beverages (WBB) in Australia and their contribution to dietary sugars between 1997 and 2024. Methods: Volume sales data for the years 2018 to 2024 (Circana Connect) were integrated with three previously published datasets spanning 1997 to 2018, with adjustments to reflect the total market where applicable. Per capita volume sales were determined using national population data (Australian Bureau of Statistics) for each corresponding year. Linear regression analysis was performed to assess trends in per capita volume sales over time. Sugar contributions of each beverage category were modelled based on representative sugar content data. Results: Total WBB sales showed consistent growth over the 28-year period (1.68 L/person/year, 36.2%). Within this, sales of sugar-sweetened beverages (SSB) declined (-1.08 L/person/year), with a concurrent increase in non-sugar-sweetened and unsweetened beverage purchases (2.74 L/person/year). This transition became more pronounced from 2015 and coincided with a decreased contribution of WBB to dietary sugars (-0.13 kg/person/year, p < 0.001). There was variation in sales and sugar contribution trends by beverage category. Functional beverages (e.g., coconut water, protein water) showed increases in sales and sugar contribution. Conclusions: The last 28 years have seen a trend in beverage purchases away from sugar-sweetened to non-sugar-sweetened and unsweetened varieties. This comprehensive analysis of consumer beverage choices makes a valuable contribution to policy and health-focused food industry initiatives.

Background: Ultra-processed food (UPF) consumption has increased significantly in Latin America and Spain, impacting both health and environmental sustainability. To our knowledge, this is the first multicenter study to examine the association between UPF consumption and sustainable lifestyle behaviors in Latin America and Spain. Objective: To evaluate the association between UPF consumption and sustainable lifestyle behaviors in Latin America and Spain. Methods: This was an observational, analytical, multicenter, cross-sectional study. A validated, self-administered online questionnaire was distributed in 14 countries between March 2023 and January 2024. The survey collected sociodemographic data, UPF intake (classified using the NOVA system), body mass index and sustainable lifestyle behaviors (food, transport, environment). Multivariate linear regression models were applied to assess associations, adjusting for age, sex, smoking, physical activity and BMI. Results: Among 6009 adults (mean age: 34.98 ± 12.55; 79.5% women), those with the highest consumption of UPF (fast food, beverages and juices, salty snacks and sweet snacks) were significantly more likely to be in the least sustainable quartile compared to those who did not consume these food products ((OR = 2.51; 95% CI: 1.79-3.54), (OR = 1.82; 95% CI: 1.50-2.22), (OR = 1.51; 95% CI: 1.32-1.73) and (OR = 1.42; 95% CI: 1.20-1.67), respectively, with p values < 0.001). Conclusions: High consumption of ultra-processed foods (UPFs) is inversely associated with sustainable lifestyles. These findings position UPF consumption not only as a health problem but also as a key indicator of unsustainable lifestyles.

Background/Objectives: Observational studies have found inverse associations between 25-hydroxyvitamin D concentration and risk of hypertension, hypercholesterolemia and type 2 diabetes (T2D). More robust evidence from large-scale randomized controlled trials, however, is limited or inconclusive. Methods: The D-Health Trial (N = 21,315) is a randomized, double-blind, placebo-controlled trial of supplementation with monthly doses of 60,000 international units of oral vitamin D₃, conducted in Australians aged 60-84 years. Commencing treatment with anti-hypertensive, lipid-modifying, or anti-diabetic drugs was used as a surrogate for incident hypertension, hypercholesterolemia, and T2D, respectively. Outcomes were ascertained via linkage with the Australian Pharmaceutical Benefits Scheme database. Follow-up began 6 months after randomization; we excluded participants without linked data, and those who were prevalent cases or who died prior to start of follow-up. Flexible parametric survival models were used to estimate the effect of vitamin D supplementation on each outcome. Results: We included 10,964 participants (vitamin D, n = 5456 [49.8%]; placebo, n = 5508 [50.2%]) in the analysis of hypertension, 12,126 participants (vitamin D, n = 6038 [49.8%]; placebo, n = 6088 [50.2%]) in the analysis of hypercholesterolemia, and 17,846 (vitamin D, n = 8931 [50.0%]; placebo, n = 8915 [50.0%]) in the analysis of T2D. Over a median follow-up of 4.6 years, 2672 (24.4%), 2554 (21.1%), and 779 (4.4%) participants developed hypertension, hypercholesterolemia, and T2D, respectively. Vitamin D supplementation had no material effect on the incidence of any of hypertension (HR 1.00; 95% CI 0.93 to 1.08), hypercholesterolemia (HR 1.05; 95% CI 0.97 to 1.13), or T2D (HR 0.97; 95% CI 0.84 to 1.12). Conclusions: Monthly supplements of vitamin D did not alter the incidence of any of the three conditions in older, largely vitamin D-replete Australians.

Background/Objectives: Vitamin D is a nutrient involved not only in bone metabolism but also in metabolic functions, and deficiency is common during adolescence. This study aimed to describe the distribution of serum 25-hydroxyvitamin D levels among Korean adolescents and to examine their associations with metabolic syndrome and its individual components. Methods: We analyzed data from the 2022-2023 Korea National Health and Nutrition Examination Survey. Adolescents aged 10-18 years with serum 25-hydroxyvitamin D measurements were included (unweighted N = 880). Weighted analyses were performed by categorizing serum 25-hydroxyvitamin D levels into quartiles. Associations between vitamin D quartiles and anthropometric and metabolic parameters were examined using complex-sample general linear models, and odds ratios for metabolic syndrome and its individual components according to vitamin D deficiency were estimated using complex-sample logistic regression models. Results: Weighted prevalence of vitamin D deficiency (<20 ng/mL) was 62.4%, higher in females than males. Higher 25(OH)D quartiles were inversely associated with obesity-related indices, including BMI, waist circumference, and waist-to-height ratio, after full adjustment (p for trend < 0.05). No significant associations were observed for blood pressure, fasting glucose, or lipid parameters. In dichotomous analyses (<20 vs. ≥20 ng/mL), vitamin D deficiency was associated with higher odds of waist circumference ≥ 90th percentile (OR 2.59), waist-to-height ratio > 0.5 (OR 2.63), and BMI ≥ 95th percentile (OR 1.89), while metabolic syndrome was not significant. Conclusions: Vitamin D appears to play an important role in metabolic health in adolescents and was particularly associated with general and central obesity.

Background/Aim: Fatigue is a common symptom in individuals with chronic obstructive pulmonary disease (COPD) and is associated with reduced quality of life. The aim of this study was to evaluate the relationships between dietary omega-3 (n-3) and omega-6 (n-6) fatty acid intake, obesity, and stress with fatigue in patients with COPD. Materials and Methods: This descriptive cross-sectional study was conducted between 1 February and 31 July 2025, in the pulmonary outpatient clinics of Ağrı Training and Research Hospital in Ağrı and Atatürk University Research Hospital in Erzurum, Türkiye. Study data were collected using a General Information Questionnaire, the COPD and Asthma Fatigue Scale (CAFS), the Perceived Stress Scale (PSS), and an Adult Semi-Quantitative Food Frequency Questionnaire. Higher CAFS scores indicate greater fatigue severity, while higher PSS scores reflect higher perceived stress. Results: CAFS scores correlated strongly with perceived stress (r = 0.718, p < 0.001) and moderately with COPD exacerbation frequency (r = 0.426, p < 0.001). Although higher n-3 intake was inversely associated with fatigue in univariate analyses, this association weakened after adjustment, suggesting that fatty acid composition was not an independent determinant of fatigue. The n-6/n-3 ratio showed a weak positive correlation with fatigue (r = 0.184, p = 0.024). Female reported higher fatigue levels than male (mean [SD], 60.2 [19.3] vs. 51.9 [19.8]; p = 0.042), and patients with comorbid conditions had higher fatigue scores than those without comorbidities (58.1 [18.3] vs. 46.8 [19.4]; p = 0.001). Smoking status was not significantly associated with fatigue (p = 0.788). In backward multiple linear regression analysis, perceived stress emerged as the strongest independent predictor of fatigue (β = 0.519, p < 0.001). Comorbidity presence (β = 0.206, p = 0.030) and smoking status (β = 0.178, p = 0.026) were also significant, while exacerbation frequency (p = 0.062) and female (p = 0.053) showed borderline associations. Conclusions: These findings indicate that fatigue in COPD is primarily influenced by psychosocial stress and multimorbidity, highlighting the importance of integrative management approaches that address mental health burden and comorbid conditions alongside respiratory treatment.

Background/objectives: Children with developmental disabilities (DD) may experience feeding problems that increase their risk of malnourishment. However, data concerning factors linked to feeding problems in children with DD are lacking. The present study aimed to investigate feeding problems and their associated factors in children with DD who are fed orally. This cross-sectional study included data from 160 children with DD aged 2-18 years, recruited from 9 disability centers and schools located in Madinah, Saudi Arabia.

Methods: A total of 666 envelopes were distributed randomly to children to take home. Caregivers were asked to provide sociodemographic, health, and nutrition information. Feeding problems were assessed using a validated screening tool for eating/feeding problems (STEP-AR), which included 17 items divided into 5 subdomains (Aspiration risk, Food refusal, Food selectivity, Nutrition behaviors, and Skill). Phone interviews were conducted with caregivers within two weeks of data collection for dietary assessment.

Results: The most frequently reported feeding problems involved feeding skills and food selectivity, with 39.3% unable to feed themselves, 33.1% showing overeating behavior, and 31.2% exhibiting pica-like behavior. Chewing difficulties (28.7%), limited food intake (25.6%), and swallowing challenges (21.2%) were moderately reported, while aspiration-related problems were less common. Multiple linear regression analysis revealed significant positive associations between feeding problems and caregiver education level, family income, caregiver's relationship to the child, and the child's living arrangement. Dietary intake was not associated with feeding problems.

Conclusions: The findings of this study indicate a range of feeding problems and key sociodemographic factors associated with feeding problems in children with DD. These results highlight the need for targeted interventions such as behavioral support and caregiver education to effectively address and manage feeding challenges in children.

Background: The Carnivore Diet (CD) is an almost exclusively animal-based dietary pattern that has gained increasing popularity on social media. Despite numerous health-related claims, a standardized definition is lacking, and scientific evidence regarding the long-term effects of this diet remains unclear. Methods: The literature search for this scoping review was conducted in accordance with PRISMA guidelines (PRISMA-ScR) using the databases PubMed, LIVIVO, Web of Science, and the Cochrane Library. Results: Nine human studies were included. Individual publications reported positive effects of the CD, such as weight reduction, increased satiety, and potential improvements in inflammatory or metabolic markers. At the same time, potential risks of nutrient deficiencies, particularly in vitamins C and D, calcium, magnesium, iodine, and dietary fiber, as well as elevated low-density-lipoprotein (LDL-) and total cholesterol (TC) levels, were identified, along with one case describing a deterioration in health status. Overall, the quality of evidence is very limited due to small sample sizes, short study durations, and the absence of control groups. Conclusions: The CD may offer short-term health benefits but carries substantial risks of nutrient deficiencies, reduced intake of health-promoting phytochemicals, and the development of cardiovascular disease. At this time, long-term adherence to a CD cannot be recommended.

Background: Consumption of fruits of different origins with specific (poly)phenolic profiles can modulate the gene expression of enzymes and the levels of metabolites in a photoperiod-dependent manner. However, there is little information on how this affects the profile of hepatic and muscular fatty acids (FAs) and how it interferes with metabolic pathways. This study aimed to determine whether consuming local or non-local cherries alters liver and muscle FA profiles under different photoperiods, and to identify the associated changes in metabolic gene expression and serum metabolites. Methods: Seventy-two Fischer 344 rats, fed a standard diet and either vehicle (VH), Local Cherry (LC), or non-Local Cherry (nLC), were exposed to different hours of light to simulate photoperiods (winter, spring/autumn, or summer) for 7 weeks. The FA profiles of the liver and muscle were determined using GC-FID, and the gene expression of key enzymes involved in FA metabolism was evaluated. Moreover, the composition of hydrophilic and lipophilic metabolites in the serum and liver was analyzed using nuclear magnetic resonance (NMR), and pathway analysis was performed. Results: Consumption of cherries in season (18 h of light) decreased saturated FAs levels in the liver, mainly palmitate, compared to their respective VH; interestingly, this effect was not observed in other photoperiods. Furthermore, muscle polyunsaturated FA (PUFAs) decreased, possibly due to increased oxidation. Conclusions: Seasonal cherry consumption improves the hepatic lipid profile and increases muscular oxidation. Future studies are needed to better define these effects and uncover the differences in lipid metabolism in response to cherry consumption.

Background/Objectives: Adherence to the EAT-Lancet Planetary Health Diet (PHD) may promote human health and environmental sustainability, yet evidence regarding adherence and nutritional adequacy in Australia is limited. Globally, no research to date has used the recently updated 2025 PHD guidelines. We benchmarked the compatibility of Australian adults' dietary patterns with the 2025 PHD and examined its associations with nutritional adequacy and sociodemographic factors. Methods: This was a cross-sectional analysis of dietary data from 5655 adults who participated in the National Nutrition and Physical Activity Survey. Usual intakes were estimated from two 24 h recalls using the Multiple Source Method. PHD adherence was measured using the Healthy Reference Diet Score (0-130 points). Nutrient adequacy was assessed using the full probability method for iron and the Australian/New Zealand Estimated Average Requirement Cut-Point Method for all other nutrients. Survey-weighted regression models examined associations with nutritional adequacy and sociodemographic factors. Results: The mean PHD adherence score was 50 (SE 0.3) points. Higher adherence was associated with lower odds of inadequate intakes of several micronutrients, but with higher odds of inadequacy for vitamin B12 (OR: 1.24; 95% CI: 1.06, 1.45) and calcium (OR: 1.09; 95% CI: 1.01, 1.17). PHD adherence was higher among females, older adults, those with higher educational attainment, those born in countries where English is not the main language, two-person households and non-smokers; adherence was non-linearly associated with alcohol and was lower among those with a Body Mass Index ≥ 30 kg/m². Conclusions: PHD adherence in Australia was low. Higher adherence was associated with improved adequacy for several micronutrients. Trade-offs for vitamin B12 and calcium warrant consideration. Equity-conscious strategies will be needed to support the adoption of nutritionally adequate, environmentally sustainable diets.