American Journal of Clinical Nutrition最新文献

{"title":"Comparison of hemoglobin measurements from venous and capillary blood from the same individual using HemoCue 301 and automated hematology analyzer in a cross-sectional community-based study in India","authors":"V Sudhakar Reddy ,&nbsp;Samarasimha N Reddy ,&nbsp;Hemant Mahajan ,&nbsp;Karthikeyan Ramanujam ,&nbsp;G Bhanuprakash Reddy ,&nbsp;Jagajeevan Babu Geddam ,&nbsp;Challa Sairam ,&nbsp;Mahesh Kumar Mummadi ,&nbsp;Jayachandra Kadiyam ,&nbsp;Venkata Raji G Reddy ,&nbsp;Sai Santhosh V ,&nbsp;Jayaprakash Ithadi ,&nbsp;Shyam Sunder Katha ,&nbsp;Rajitha Triveni","doi":"10.1016/j.ajcnut.2025.11.009","DOIUrl":"10.1016/j.ajcnut.2025.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Accurate measurement of hemoglobin (Hb) is essential for diagnosing anemia, a widespread public health concern. Automated hematology analyzer (AHA) offers high accuracy using venous blood, whereas HemoCue (HC) 301 provides rapid point-of-care (POC) results often from capillary samples. Differences between capillary and venous blood can influence Hb values, impacting anemia prevalence estimates and public health policies.</div></div><div><h3>Objectives</h3><div>We compared Hb measurements from venous and capillary blood using the HC 301 [venous blood Hb analyzed by HC 301 (HC-V) and capillary blood Hb analyzed by HC 301 (HC-C)] with the reference method of venous blood analysis using the AHA (AHA-V) in the same participant.</div></div><div><h3>Methods</h3><div>Venous and capillary blood samples were collected in a community-based cross-sectional survey conducted in Kamrup Metro district, Assam, India, from 837 participants. The study covered all age and sex groups, including 2–5 y children, 6–9 y, 10–19 y, 20–59 y adults, and ≥60 y. Hb concentration was measured using the HC 301 (HC-C and HC-V) and AHA (AHA-V). Diagnostic accuracy was evaluated by comparing the HC 301 (HC-C and HC-V) with the AHA (AHA-V). Hb values were compared using a paired <em>t</em> test, anemia prevalence with McNemar’s test, and method agreement through weighted κ, Lin’s concordance coefficient, and Bland–Altman plots.</div></div><div><h3>Results</h3><div>The mean Hb difference among all age groups (<em>n</em> = 837) was 0.46 g/dL (AHA-V compared with HC-C), 0.59 g/dL (HC-V compared with HC-C), and −0.13 g/dL (AHA-V compared with HC-V), respectively. Anemia prevalence was highest with HC-C [71.1%, 95% confidence interval (CI): 67.9%, 74.1%] compared with AHA-V (58.9%, 95% CI: 55.5%, 62.2%) and HC-V (55.2%, 95% CI: 51.7%, 58.6%). κ agreement was weaker between AHA-V and HC-C (κ = 0.59, 95% CI: 0.52, 0.65) for all age groups but stronger for AHA-V and HC-V (κ = 0.84, 95% CI: 0.77, 0.91).</div></div><div><h3>Conclusions</h3><div>HC-C showed higher anemia prevalence and weaker agreement compared with AHA-V, indicating potential overestimation. Anemia prevalence estimated through capillary blood using POC devices in large-scale public health surveys needs cautious interpretation.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 1","pages":"Article 101119"},"PeriodicalIF":6.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steps toward better understanding the role of dietary intake on development of complications in people with type 2 diabetes","authors":"Daniel B Ibsen","doi":"10.1016/j.ajcnut.2025.10.021","DOIUrl":"10.1016/j.ajcnut.2025.10.021","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 1","pages":"Article 101104"},"PeriodicalIF":6.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to H Yoshida and Y Fujuioka","authors":"Sharayah Carter ,&nbsp;Alison M Hill ,&nbsp;Catherine Yandell ,&nbsp;Lisa Wood ,&nbsp;Alison M Coates ,&nbsp;Jonathan D Buckley","doi":"10.1016/j.ajcnut.2025.10.022","DOIUrl":"10.1016/j.ajcnut.2025.10.022","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 1","pages":"Article 101106"},"PeriodicalIF":6.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of maternal diet on microbiota and health during pregnancy: a systematic review and correlational meta-analysis","authors":"Eduard Flores Ventura ,&nbsp;Marta Selma-Royo ,&nbsp;Sondra Turjeman ,&nbsp;Sonia González ,&nbsp;Omry Koren ,&nbsp;Maria Carmen Collado","doi":"10.1016/j.ajcnut.2025.101175","DOIUrl":"10.1016/j.ajcnut.2025.101175","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy complications like gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy, and obesity are rising. Emerging evidence suggests dietary strategies targeting maternal microbiota, such as increased fiber or polyphenols, may help manage these conditions.</div></div><div><h3>Objectives</h3><div>This study aimed to <em>1</em>) synthesize existing evidence on the relationship between maternal diet and the gut microbiota, with a focus on its potential link to gestational outcomes, and <em>2</em>) provide insights based on the available literature to inform future pregnancy guidelines.</div></div><div><h3>Methods</h3><div>This systematic review included observational and interventional studies on pregnant females assessing maternal diet and gut microbiota. Searches were conducted in PubMed and Web of Science up to July 2025. Risk of bias was assessed using appraisal tool for cross-sectional studies, Risk Of Bias In Nonrandomized Studies – of Interventions, and Risk Of Bias 2 tools. Narrative synthesis and a correlational meta-analysis stratified findings by trimester and obstetric condition.</div></div><div><h3>Results</h3><div>Across 29 studies involving 3077 pregnant females, high-fiber and vegetarian diets were consistently associated with increased abundance of taxa such as <em>Roseburia</em> spp. and <em>Bifidobacterium</em> spp., alongside more favorable metabolic markers. In contrast, high-fat and Westernized diets were frequently linked to reduced microbial diversity and increased proinflammatory taxa including <em>Collinsella</em> and members of the Lachnospiraceae family. In GDM pregnancies, interventions like medical nutrition therapy were associated with favorable microbial profiles, whereas proinflammatory diets were associated with reduced diversity. Meta-analyses indicated that maternal health status significantly moderated associations between fat intake and Gram-negative bacteria [Likelihood Ratio Test (LRT) = 53.929, <em>P</em> = 0.020], and between protein intake and Gram-positive bacteria (LRT = 68.735, <em>P</em> = 0.009), suggesting differential microbial responses by metabolic risk profile.</div></div><div><h3>Conclusions</h3><div>This systematic review found that specific dietary components, particularly fiber, omega-3 fatty acids, and micronutrients, were associated with differences in maternal gut microbiota, with potential relevance to metabolic outcomes such as GDM, obesity, and hypertensive disorders of pregnancy. Meta-analysis results indicate that maternal health status significantly moderated the associations between dietary fat and protein intake and microbial taxa, suggesting that precision nutrition interventions warrant evaluation in metabolically at-risk populations.</div><div>This study was registered at PROSPERO as CRD420251085137.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 3","pages":"Article 101175"},"PeriodicalIF":6.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of hemoglobin measurement error on accuracy of population anemia surveillance: results from mathematical simulations","authors":"Christine P Stewart,&nbsp;Charles D Arnold,&nbsp;Sika M Kumordzie,&nbsp;Reina Engle-Stone","doi":"10.1016/j.ajcnut.2025.101185","DOIUrl":"10.1016/j.ajcnut.2025.101185","url":null,"abstract":"<div><h3>Background</h3><div>Anemia is of public health concern among females of reproductive age and young children. Population anemia surveys are challenging because of inaccuracy and imprecision in common field-friendly assessment methods. However, there is uncertainty about how much error can be tolerated for effective surveillance.</div></div><div><h3>Objectives</h3><div>Our objective was to quantify the influence of random and systematic errors in hemoglobin (Hb) measurement on prevalence bias under varying population characteristics using mathematical simulations.</div></div><div><h3>Methods</h3><div>We conducted a literature review to identify parameters of interest: means and standard deviations (SDs) in capillary and venous blood, the mean bias (capillary mean – venous mean), and the SD inflation ratio (capillary SD/venous SD). We generated reference Hb distributions with varying means (105–135 g/L) and SDs (10–16 g/L), assuming measurement using venous blood on an autoanalyzer. We then generated capillary blood comparison distributions with mean biases ranging from –5 to +11 g/L and SD inflation ratios ranging from 0.5 to 2.0. Using target prevalence accuracies of ±5 and ±10 percentage points (pp), we identified maximum tolerable mean biases and SD inflation ratios.</div></div><div><h3>Results</h3><div>Among 92 contrasts reported in 16 studies, 90% of mean biases were between –6.6 g/L and 10.7 g/L, and 90% of SD inflation ratios were between 0.79 and 1.54. In simulations, the prevalence bias was heavily influenced by the mean Hb bias, but less by the SD inflation ratio. To achieve the target prevalence accuracy, the mean bias would need to be within ±1 g/L (for 5 pp) or ±2.5 g/L (for 10 pp) and SD inflation ratio between 0.85 and 1.20 (for 5 pp) or 0.7–1.5 (for 10 pp).</div></div><div><h3>Conclusions</h3><div>Random error (SD inflation ratio) has less influence than systematic error (mean bias) on anemia prevalence estimates. Efforts to reduce mean bias during data collection or through statistical adjustment may have a greater impact on anemia prevalence assessment.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 3","pages":"Article 101185"},"PeriodicalIF":6.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undernutrition or obesity: relationship with long-term survival in children with acute lymphoblastic leukemia in an upper-middle income country: a multicenter cohort study","authors":"Elva Jiménez-Hernández ,&nbsp;Janet Flores-Lujano ,&nbsp;Aurora Medina-Sansón ,&nbsp;Elisa María Dorantes-Acosta ,&nbsp;Laura Eugenia Espinoza-Hernández ,&nbsp;Raquel Amador-Sanchez ,&nbsp;José Gabriel Peñaloza-Gonzalez ,&nbsp;Betzayda Valdez-Garibay ,&nbsp;José Refugio Torres-Nava ,&nbsp;Rosa Martha Espinosa-Elizondo ,&nbsp;Luz Victoria Flores-Villegas ,&nbsp;María Luisa Pérez-Saldivar ,&nbsp;Karina Anastacia Solis-Labastida ,&nbsp;Haydee Rosas-Vargas ,&nbsp;Minerva Mata-Rocha ,&nbsp;Jorge Alfonso Martín-Trejo ,&nbsp;Silvia Jiménez-Morales ,&nbsp;Mariana García-Jiménez ,&nbsp;Marta Margarita Zapata-Tarrés ,&nbsp;José Arellano-Galindo ,&nbsp;Juan Manuel Mejía-Aranguré","doi":"10.1016/j.ajcnut.2025.101180","DOIUrl":"10.1016/j.ajcnut.2025.101180","url":null,"abstract":"<div><h3>Background</h3><div>Long-term survival rates for children with acute lymphoblastic leukemia (ALL) have not improved in some countries, with undernutrition and obesity identified as potential contributing factors.</div></div><div><h3>Objectives</h3><div>To evaluate the relationship between undernutrition and obesity in long-term survival in Mexican children with ALL.</div></div><div><h3>Methods</h3><div>A cohort study included children &lt;18 y, newly diagnosed with ALL between 2010 and 2013, treated at 8 public hospitals in Mexico City. Patients were followed from the diagnosis confirmation. Nutritional status at diagnosis was classified with body mass index (BMI) using the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) criteria. The primary outcome variables were relapse and death &gt;5 y of follow-up. Hazard ratios (HR) with 95% confidence intervals (CI) were reported using a Cox proportional hazards model adjusting for sex, socioeconomic status, immunophenotype, NCI risk classification, and treatment protocol.</div></div><div><h3>Results</h3><div>A total of 1254 children were diagnosed with ALL. Information was complete for the WHO classification in 1072 patients (85.5%) and for the CDC classification in 997 patients (79.5%). Using WHO criteria, 7% of patients were undernourished, and 13% were overweight or obese; with CDC criteria, the corresponding prevalences were 14.8% and 27.1%. A higher risk of relapse was observed among patients with overweight and obesity (aHR = 1.43; 95% CI: 1.02, 2.00) using the WHO classification. Following the CDC classification, patients with obesity also showed an increased risk of relapse (aHR = 1.33; 95% CI: 0.94; 1.89). Additionally, a higher risk of death was noted among patients with overweight or obesity (aHR = 1.65; 95% CI: 1.25, 2.19) using WHO criteria, whereas under the CDC classification, the increased risk of death was observed in patients with obesity (aHR = 1.65; 95% CI: 1.24, 2.20). No significant associations were found between undernutrition and either relapse or death.</div></div><div><h3>Conclusions</h3><div>Undernutrition was not associated with long-term survival in pediatric patients with ALL. However, overweight and obesity at diagnosis were associated with relapse and increased mortality, highlighting the importance of addressing these factors through interventions focused on nutritional optimization, especially regarding obesity prevention and management, at or prior to diagnosis, to improve outcomes in Mexican children with ALL.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101180"},"PeriodicalIF":6.9,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of adiposity indices in anticoagulated patients with atrial fibrillation: the prospective Murcia AF Project III cohort","authors":"Eva Soler-Espejo ,&nbsp;Yang Chen ,&nbsp;Vanessa Roldán ,&nbsp;Francisco Marín ,&nbsp;José Miguel Rivera-Caravaca ,&nbsp;Gregory YH Lip","doi":"10.1016/j.ajcnut.2025.101184","DOIUrl":"10.1016/j.ajcnut.2025.101184","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a risk factor for atrial fibrillation (AF), but traditional measures such as body mass index (BMI) may not reflect true cardiometabolic risk. Novel adiposity indices better capture central fat, yet their prognostic value in AF remains unclear.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the association of different adiposity indices with cardiovascular and bleeding outcomes in anticoagulated patients with AF.</div></div><div><h3>Methods</h3><div>Consecutive AF outpatients initiating oral anticoagulation between January 2016 and November 2021 were enrolled in this prospective study. BMI, conicity index (C-index), weight-adjusted waist index, waist-to-height ratio, body roundness index, and a body shape index were evaluated. Primary outcomes were thromboembolic events, major bleeding (MB)/clinically relevant non-MB (CRNMB), and major adverse cardiovascular events (MACE). Secondary outcomes included cardiovascular and all-cause death. Through restricted cubic spline (RCS), Cox models, and receiver operating characteristic analyses, we assessed associations with clinical outcomes.</div></div><div><h3>Results</h3><div>A total of 2070 patients [52.8% female; age 77 y (interquartile range: 70–83)] were included. During a 1.8-y (standard deviation: 0.5) follow-up, 18.1% of patients experienced a thromboembolic event, 13.5% experienced a MB/CRNMB, and 11.3% suffered a MACE. RCS analysis revealed associations between all adiposity indices and adverse outcomes, but only the conicity index (C-index) showed a nonlinear relationship. In multivariable models, as a categorical variable, high C-index (&gt;1.34) was the only index independently associated with thromboembolic events [adjusted hazard ratio (aHR: 2.29; 95% confidence interval (CI): 1.58, 3.34)], MB/CRNMB (aHR: 2.10; 95% CI: 1.58, 2.79), and MACE (aHR: 2.48; 95% CI: 1.79, 3.43) compared with the low C-index group. A high C-index was also associated with cardiovascular and all-cause mortality. The C-index consistently showed the highest discriminative performance for all primary outcomes, which further improved when integrated with CHA₂DS₂-VASc and HAS-BLED.</div></div><div><h3>Conclusions</h3><div>In anticoagulated patients with AF, the C-index demonstrated the strongest and consistent prognostic value among all adiposity indices. Its integration into conventional risk scores may enhance risk stratification in this high-risk population.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 3","pages":"Article 101184"},"PeriodicalIF":6.9,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet quality and nutritional adequacy during a 2-year calorie restriction intervention: the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy 2 trial","authors":"Susan B Racette ,&nbsp;Rachel E Silver ,&nbsp;Valene Garr Barry ,&nbsp;Jasmyn J DeGraff ,&nbsp;Jordan A Gunning ,&nbsp;Maryam Kebbe ,&nbsp;Cheryl H Gilhooly ,&nbsp;Sai Krupa Das","doi":"10.1016/j.ajcnut.2025.101182","DOIUrl":"10.1016/j.ajcnut.2025.101182","url":null,"abstract":"<div><h3>Background</h3><div>Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE) was the first randomized controlled trial of calorie restriction (CR) on biomarkers of aging and cardiometabolic health in humans without obesity.</div></div><div><h3>Objectives</h3><div>The aim of this secondary data analysis was to evaluate diet quality and nutritional adequacy during a 2-y CR intervention among healthy adults in the CALERIE trial.</div></div><div><h3>Methods</h3><div>CALERIE 2 was a multisite trial of healthy adults randomly assigned to 2 y of 25% CR or an ad libitum (AL) control condition. CR participants received extensive dietary education and support. Food records at baseline (BL) and months 6, 12, 18, and 24 were analyzed using Nutrition Data System for Research. Diet quality was evaluated using the Probability of Adequate Nutrient Intake (PANDiet) diet quality index, Healthy Eating Index (HEI), and Dietary Inflammatory Index (DII). Nutritional adequacy was defined using sex- and age-specific Estimated Average Requirement or Adequate Intake criteria for each nutrient.</div></div><div><h3>Results</h3><div>Two hundred eighteen participants began the trial and are included in the analyses [143 CR, 75 AL; 69.7% females, age 38.1 ± 7.2 y (mean ± SD), BL body mass index: 25.1 ± 1.7 kg/m²]. One hundred eighty-eight participants completed the trial (82% CR, 95% AL). Average CR achieved during the 2-y intervention was 11.9% ± 7.2%. Diet quality scores improved during CR according to all 3 metrics, both within group and when compared with AL (all <em>P &lt;</em> 0.01): PANDiet [CR BL 76.27%, 95% confidence interval: 75.45%, 77.09%; CR 2 y average 77.38% (76.58%, 78.19%)], HEI: [BL 59.40 (57.62, 61.18); 2 y average 66.83 (65.11, 68.55)], and DII: [BL –0.28 (–0.58, 0.01); 2 y average –1.05 (–1.35, –0.74)]. Nutritional adequacy was not compromised during the CR intervention.</div></div><div><h3>Conclusions</h3><div>Diet quality improved and nutritional adequacy was maintained during a 2-y moderate CR intervention designed to enhance healthspan and comprised comprehensive nutrition counseling among healthy adults without obesity.</div><div>The study was registered at clinicaltrials.gov as NCT00427193 (<span><span>https://clinicaltrials.gov/study/NCT00427193?term=NCT00427193&amp;rank=1</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 3","pages":"Article 101182"},"PeriodicalIF":6.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum 25-hydroxyvitamin D status and respiratory tract infections requiring hospital admission: unmatched case-control analysis of ethnic groups from the United Kingdom Biobank cohort","authors":"Abigail R Bournot ,&nbsp;Kathryn H Hart ,&nbsp;S Johnsen ,&nbsp;D Ian Givens ,&nbsp;Julie A Lovegrove ,&nbsp;José M Ordóñez-Mena ,&nbsp;Simon de Lusignan ,&nbsp;David B Bartlett ,&nbsp;Susan A Lanham-New ,&nbsp;Andrea L Darling","doi":"10.1016/j.ajcnut.2025.101179","DOIUrl":"10.1016/j.ajcnut.2025.101179","url":null,"abstract":"<div><h3>Background</h3><div>Vitamin D status has been found to be inversely associated with risk of respiratory tract infections (RTIs). Although vitamin D status varies by ethnicity, the relationship between serum 25-hydroxyvitamin D (25[OH]D) and RTIs in United Kingdom ethnic groups remains unclear.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the association between serum 25(OH)D status and hospitalization for RTI in United Kingdom adults.</div></div><div><h3>Methods</h3><div>An unmatched case-control study was conducted using data from United Kingdom Biobank, which includes 500k adults with serum 25(OH)D status and hospital episodes from linked records. Survival analyses and binary logistic regression models were used to explore the association between serum 25(OH)D and RTIs.</div></div><div><h3>Results</h3><div>Of the 36,258 participants included in the analysis, 34% were White, 28% Asian, 19% Black, 11% other, and 7% of mixed ethnicity. The RTI rate was 8.5% (median time to RTI, 14.8 y). Higher serum 25(OH)D (each +10 nmol/L increase) was significantly associated with a 4% lower hazard ratio (HR) for RTI hospitalization [HR: 0.96, 95% confidence interval (CI), 0.94, 0.99]. When stratifying for serum 25(OH)D, compared to those with ≥75 nmol/L (reference), those with &lt;15 nmol/L had a higher HR for RTI hospitalization (HR: 1.33, 95% CI: 1.05, 1.67). Categories 15 to 24 nmol/L, 24 to 49 nmol/L, and 50 to 74 nmol/L were not statistically significant. Logistic regression models supported the above findings. Inclusion of an interaction term for 25(OH)D × ethnicity was trialed in the survival analysis, but the interaction term was not statistically significant.</div></div><div><h3>Conclusions</h3><div>Serum 25(OH)D status &lt;15 nmol/L is associated with 33% higher HR for RTI hospitalization among United Kingdom adults, compared with ≥75 nmol/L. Furthermore, studies are warranted to validate these findings and explore the mechanisms underlying the association between vitamin D status and RTIs in different ethnic groups.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101179"},"PeriodicalIF":6.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consuming an unprocessed diet reduces energy intake: a post-hoc analysis of an randomized controlled trial reveals a role for human \"nutritional intelligence\".","authors":"Jeffrey M Brunstrom, Mark Schatzker, Peter J Rogers, Amber B Courville, Kevin D Hall, Annika N Flynn","doi":"10.1016/j.ajcnut.2025.101183","DOIUrl":"10.1016/j.ajcnut.2025.101183","url":null,"abstract":"<p><strong>Background: </strong>In 2019, Hall et al. reported a randomized clinical trial showing that an ultraprocessed diet increases energy intake by ∼500 kcal/d compared with an unprocessed diet.</p><p><strong>Objective: </strong>This post-hoc analysis assessed whether participants selected meal components with specific nutritional characteristics and how this affected energy intake.</p><p><strong>Methods: </strong>Twenty weight-stable adults received an ad libitum ultraprocessed or unprocessed diet for 2 wk, followed by the alternate diet. ANOVA and t tests assessed diet effects; a linear mixed model assessed predictors of meal size.</p><p><strong>Results: </strong>With the unprocessed diet, participants selected components with a less-equal blend of energy from carbohydrate and fat [\"blend index\" difference; lunch = 0.22 (95% CI: 0.19, 0.26), P< 0.0001, d = 0.76; dinner = 0.24 (95% CI: 0.19, 0.28), P< 0.0001, d = 0.71]. These components formed meals that had a lower blend index (less balanced) than ultraprocessed meals [lunch, F(1, 19) = 18.49, P < 0.0004, partial η² = 0.493; dinner, F(1, 19) = 24.85, P < 0.0001, partial η² = 0.57]. With the unprocessed diet, participants preferentially chose low-energy-dense components (<1.0 kcal/g, mostly fruits and vegetables), creating meals lower in energy (unprocessed = 719.4 ± 11.6 kcal compared with ultraprocessed = 829.5 ± 12.51 kcal), [F(1,19) = 14.9, P < 0.001, η²G = 0.0457], yet significantly larger (57%) by mass (unprocessed = 665.5 ± 10.74 g compared with ultraprocessed = 423.5 ± 8.03 g), [F(1,19) = 82.9, P < 0.001, η²G = 0.274]. Modeled together, low-energy-dense mass and blend index strongly predict observed energy intakes (r = 0.78, df = 1676, P < 0.001).</p><p><strong>Conclusions: </strong>Unprocessed meals may reduce energy intake because: 1) they have a less balanced carbohydrate-fat blend; and 2) they promote a form of nutritional intelligence whereby a compromise is struck between consuming calories and consuming micronutrients, which we refer to as \"micronutrient deleveraging.\" This trial was registered at clinicaltrials.gov as NCT03407053.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":"101183"},"PeriodicalIF":6.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}