Pub Date : 2025-12-01DOI: 10.1016/j.advnut.2025.100554
Kara Sampsell , Camila Schultz Marcolla , Samantha Tapping , Yi Fan , Carla L Sánchez-Lafuente , Benjamin P Willing , Raylene A Reimer , Jeremy P Burton
Fermented foods represent a diverse category of products shaped by microbial metabolism, offering distinctive sensory qualities and potential health benefits. Although prior reviews have explored the nutritional and microbial aspects of fermented foods or focused on specific health outcomes and mechanisms of action, few recent narrative reviews have integrated clinical and epidemiologic evidence across diverse health domains. This review addresses that gap by critically evaluating observational and interventional studies linking fermented food consumption with metabolic, cardiovascular, oncologic, and neuropsychological outcomes, while summarizing associated biomarkers that may underpin these effects. Emphasis is placed on clinical studies of fermented foods containing live microbes. Through mapping current evidence to noncommunicable disease outcomes, the review identifies consistent protective associations, methodological limitations, and key knowledge gaps, and outlines priorities to advance the field and its translation into dietary guidance. It further underscores the need for standardized product characterization and well-powered clinical trials to establish causality. Overall, this work provides the most current and integrative assessment of fermented foods and human health, highlighting their potential as a valuable yet underutilized component of strategies for chronic disease prevention and public health policy.
{"title":"Current Research in Fermented Foods: Bridging Tradition and Science","authors":"Kara Sampsell , Camila Schultz Marcolla , Samantha Tapping , Yi Fan , Carla L Sánchez-Lafuente , Benjamin P Willing , Raylene A Reimer , Jeremy P Burton","doi":"10.1016/j.advnut.2025.100554","DOIUrl":"10.1016/j.advnut.2025.100554","url":null,"abstract":"<div><div>Fermented foods represent a diverse category of products shaped by microbial metabolism, offering distinctive sensory qualities and potential health benefits. Although prior reviews have explored the nutritional and microbial aspects of fermented foods or focused on specific health outcomes and mechanisms of action, few recent narrative reviews have integrated clinical and epidemiologic evidence across diverse health domains. This review addresses that gap by critically evaluating observational and interventional studies linking fermented food consumption with metabolic, cardiovascular, oncologic, and neuropsychological outcomes, while summarizing associated biomarkers that may underpin these effects. Emphasis is placed on clinical studies of fermented foods containing live microbes. Through mapping current evidence to noncommunicable disease outcomes, the review identifies consistent protective associations, methodological limitations, and key knowledge gaps, and outlines priorities to advance the field and its translation into dietary guidance. It further underscores the need for standardized product characterization and well-powered clinical trials to establish causality. Overall, this work provides the most current and integrative assessment of fermented foods and human health, highlighting their potential as a valuable yet underutilized component of strategies for chronic disease prevention and public health policy.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 12","pages":"Article 100554"},"PeriodicalIF":9.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515057","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}
Pub Date : 2025-12-01DOI: 10.1016/j.advnut.2025.100555
Mona S Calvo, Jaime Uribarri
{"title":"Phosphorus","authors":"Mona S Calvo, Jaime Uribarri","doi":"10.1016/j.advnut.2025.100555","DOIUrl":"10.1016/j.advnut.2025.100555","url":null,"abstract":"","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 12","pages":"Article 100555"},"PeriodicalIF":9.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515113","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}
Pub Date : 2025-12-01DOI: 10.1016/j.advnut.2025.100552
Satori A Marchitti , Denali Boon , Maia Jack , Julie E Goodman
Globally, nonsugar sweeteners (NSSs) are commonly used in foods and beverages to enhance sweetness without added calories. NSSs have been the subject of numerous in vitro and animal studies to assess their potential carcinogenic risk to humans. As a complement to a larger systematic evaluation of the epidemiology evidence of NSSs and cancer, here we present a comprehensive review of the available experimental evidence from animal and mechanistic studies for the NSSs acesulfame-K (Ace-K), advantame, aspartame, cyclamate, neotame, saccharin, steviol glycosides, and sucralose within the context of ingredient safety. For this evaluation, we focused on genotoxicity, other potential cancer modes of action (MoAs), and carcinogenicity. Overall, high-quality studies have not shown evidence for carcinogenicity in animal models, except for saccharin, which causes bladder tumors in rats via a mechanism not relevant to humans. There is also no consistent or compelling evidence for any biologically plausible MoA by which any of these NSSs could cause cancer in humans. The results of this evaluation are consistent with the results of epidemiology studies, which have shown no consistent associations between NSS intake and cancer risk. Taken together, the body of available evidence supports previous conclusions by authoritative and regulatory bodies that Ace-K, advantame, aspartame, cyclamate, neotame, saccharin, steviol glycosides, and sucralose do not pose a genotoxic or carcinogenic risk to humans.
在全球范围内，非糖甜味剂（nss）通常用于食品和饮料中，以在不增加卡路里的情况下增强甜味。为了评估nss对人类的潜在致癌风险，已经进行了大量体外和动物研究。作为对nss和癌症的流行病学证据进行更大的系统评估的补充，我们在此全面回顾了nss在成分安全性方面的动物实验证据和机制研究，包括安赛蜜- k （Ace-K）、advantame、阿斯巴甜、甜蜜素、纽甜、糖精、甜菊糖苷和三氯蔗糖。在这项评估中，我们主要关注遗传毒性、其他潜在的癌症作用模式（MoAs）和致癌性。总的来说，高质量的研究没有在动物模型中显示致癌性的证据，除了糖精，它通过与人类无关的机制导致大鼠膀胱肿瘤。也没有一致或令人信服的证据表明，任何生物学上合理的MoA表明，这些nss中的任何一种都可能导致人类癌症。这一评估结果与流行病学研究的结果一致，后者显示NSS摄入量与癌症风险之间没有一致的关联。综上所述，现有的大量证据支持权威机构和监管机构先前的结论，即Ace-K、advantame、阿斯巴甜、甜蜜素、纽甜、糖精、甜菊糖苷和三氯蔗糖不会对人类造成遗传毒性或致癌风险。
{"title":"Lack of Genotoxic and Carcinogenic Potential for Nonsugar Sweeteners: A Review of Animal and Mechanistic Evidence","authors":"Satori A Marchitti , Denali Boon , Maia Jack , Julie E Goodman","doi":"10.1016/j.advnut.2025.100552","DOIUrl":"10.1016/j.advnut.2025.100552","url":null,"abstract":"<div><div>Globally, nonsugar sweeteners (NSSs) are commonly used in foods and beverages to enhance sweetness without added calories. NSSs have been the subject of numerous in vitro and animal studies to assess their potential carcinogenic risk to humans. As a complement to a larger systematic evaluation of the epidemiology evidence of NSSs and cancer, here we present a comprehensive review of the available experimental evidence from animal and mechanistic studies for the NSSs acesulfame-K (Ace-K), advantame, aspartame, cyclamate, neotame, saccharin, steviol glycosides, and sucralose within the context of ingredient safety. For this evaluation, we focused on genotoxicity, other potential cancer modes of action (MoAs), and carcinogenicity. Overall, high-quality studies have not shown evidence for carcinogenicity in animal models, except for saccharin, which causes bladder tumors in rats via a mechanism not relevant to humans. There is also no consistent or compelling evidence for any biologically plausible MoA by which any of these NSSs could cause cancer in humans. The results of this evaluation are consistent with the results of epidemiology studies, which have shown no consistent associations between NSS intake and cancer risk. Taken together, the body of available evidence supports previous conclusions by authoritative and regulatory bodies that Ace-K, advantame, aspartame, cyclamate, neotame, saccharin, steviol glycosides, and sucralose do not pose a genotoxic or carcinogenic risk to humans.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 12","pages":"Article 100552"},"PeriodicalIF":9.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460602","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}
Pub Date : 2025-12-01DOI: 10.1016/j.advnut.2025.100562
Sabina Wallerer , Julia Stadelmaier , Eike Floegel , Eva Kiesswetter , Gina Bantle , Georg Hoffmann , Lukas Schwingshackl
Background
Given the global rise in type 2 diabetes mellitus (T2D), the Mediterranean diet (MedDiet) has gained attention as a promising preventive dietary pattern.
Objectives
This study aims to update and extend our previous systematic review by synthesizing current evidence from randomized controlled trials (RCTs) and prospective cohort studies on the association between MedDiet adherence and incident T2D in adults, and to evaluate the certainty of evidence.
Methods
We conducted a systematic search in MEDLINE, Cochrane CENTRAL, and Scopus from 2014 to May 2025. Eligible studies were prospective cohorts reporting on the adherence to an a priori-defined MedDiet or, for RCTs, MedDiet intervention compared with any other diet and T2D incidence. Random-effects dose–response meta-analyses were performed to estimate hazard ratios (HRs) for MedDiet adherence score. Risk of bias was assessed using the Cochrane risk of bias tool 2 and the Risk Of Bias In Nonrandomized Studies—of Exposures tool, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation approach.
Results
A total of 24 prospective cohort studies and 1 RCT were included, comprising 991,878 participants and 68,325 T2D cases and a mean follow-up duration of 12.2 y (range: 3.5– 25 y). Higher MedDiet adherence is likely associated with a reduced risk of T2D [HRper 2-point increment: 0.92; 95% confidence interval (CI): 0.90, 0.94; moderate certainty]. The dose–response curve shows a consistent decline in T2D risk with higher adherence to MedDiet. The association remained robust over several subgroup analyses, including age, sex, and MedDiet score. The included RCT confirmed the main findings (HR: 0.75; 95% CI: 0.56, 1.01, low certainty).
Conclusion
This updated systematic review and meta-analysis provides moderate-certainty evidence that greater adherence to the MedDiet is associated with a lower risk of T2D. These findings reinforce current dietary guidelines recommending MedDiet as a sound strategy for T2D prevention.
{"title":"Adherence to Mediterranean Diet and Risk of Type 2 Diabetes: An Updated Systematic Review and Dose–Response Meta-analysis","authors":"Sabina Wallerer , Julia Stadelmaier , Eike Floegel , Eva Kiesswetter , Gina Bantle , Georg Hoffmann , Lukas Schwingshackl","doi":"10.1016/j.advnut.2025.100562","DOIUrl":"10.1016/j.advnut.2025.100562","url":null,"abstract":"<div><h3>Background</h3><div>Given the global rise in type 2 diabetes mellitus (T2D), the Mediterranean diet (MedDiet) has gained attention as a promising preventive dietary pattern.</div></div><div><h3>Objectives</h3><div>This study aims to update and extend our previous systematic review by synthesizing current evidence from randomized controlled trials (RCTs) and prospective cohort studies on the association between MedDiet adherence and incident T2D in adults, and to evaluate the certainty of evidence.</div></div><div><h3>Methods</h3><div>We conducted a systematic search in MEDLINE, Cochrane CENTRAL, and Scopus from 2014 to May 2025. Eligible studies were prospective cohorts reporting on the adherence to an a priori-defined MedDiet or, for RCTs, MedDiet intervention compared with any other diet and T2D incidence. Random-effects dose–response meta-analyses were performed to estimate hazard ratios (HRs) for MedDiet adherence score. Risk of bias was assessed using the Cochrane risk of bias tool 2 and the Risk Of Bias In Nonrandomized Studies—of Exposures tool, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation approach.</div></div><div><h3>Results</h3><div>A total of 24 prospective cohort studies and 1 RCT were included, comprising 991,878 participants and 68,325 T2D cases and a mean follow-up duration of 12.2 y (range: 3.5– 25 y). Higher MedDiet adherence is likely associated with a reduced risk of T2D [HR<sub>per 2-point increment</sub>: 0.92; 95% confidence interval (CI): 0.90, 0.94; moderate certainty]. The dose–response curve shows a consistent decline in T2D risk with higher adherence to MedDiet. The association remained robust over several subgroup analyses, including age, sex, and MedDiet score. The included RCT confirmed the main findings (HR: 0.75; 95% CI: 0.56, 1.01, low certainty).</div></div><div><h3>Conclusion</h3><div>This updated systematic review and meta-analysis provides moderate-certainty evidence that greater adherence to the MedDiet is associated with a lower risk of T2D. These findings reinforce current dietary guidelines recommending MedDiet as a sound strategy for T2D prevention.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 12","pages":"Article 100562"},"PeriodicalIF":9.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530696","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}
Pub Date : 2025-12-01DOI: 10.1016/j.advnut.2025.100548
Jacintha Domić , Pol Grootswagers , Luc JC van Loon , Lisette CPGM de Groot
{"title":"Erratum to ‘Perspective: Vegan Diets for Older Adults? A Perspective On the Potential Impact On Muscle Mass and Strength’ Advances in Nutrition 13 (2022) 712-725","authors":"Jacintha Domić , Pol Grootswagers , Luc JC van Loon , Lisette CPGM de Groot","doi":"10.1016/j.advnut.2025.100548","DOIUrl":"10.1016/j.advnut.2025.100548","url":null,"abstract":"","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 12","pages":"Article 100548"},"PeriodicalIF":9.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515111","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}
Pub Date : 2025-12-01DOI: 10.1016/j.advnut.2025.100553
Emily R Smith , Filomena Gomes , Megan W Bourassa , Christopher R Sudfeld
{"title":"Corrigendum to Contribution of Maternal Adherence to the Effect of Multiple Micronutrient Supplementation During Pregnancy: A Systematic Review and Individual Participant Data Meta-analysis Vol 16 (2025) 100455","authors":"Emily R Smith , Filomena Gomes , Megan W Bourassa , Christopher R Sudfeld","doi":"10.1016/j.advnut.2025.100553","DOIUrl":"10.1016/j.advnut.2025.100553","url":null,"abstract":"","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 12","pages":"Article 100553"},"PeriodicalIF":9.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497519","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}
Pub Date : 2025-11-20DOI: 10.1016/j.advnut.2025.100564
Yi Liu , Zhijun Yang , Taotao Deng , Chongjun Bi , Huabin Li , Pengfeng Qu , Yamin Chen , Dong Liang , Jiao Xu , Ning Li , Gangqiang Ding , Haijun Wang
Childhood overweight/obesity has emerged as a pressing public health concern globally, and the impact of the food environment on children's diets and health outcomes has gained heightened attention. Comprehensive and child-specific monitoring systems are critical for guiding targeted interventions and policies. This review aimed to synthesize recent literature on food environment indicators associated with children with overweight/obesity using the 4A framework, including food availability, accessibility, affordability, and appeal. We conducted a systematic search of peer-reviewed literature (2020–2025). This systematic review is guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses and involved narrative synthesis and framework-based classification (CRD420251116187). A total of 75 observational and 6 intervention studies are included. Indicators related to availability (e.g., home food supply and fast food outlet density) and accessibility (e.g., proximity to healthy food stores) are most commonly studied, whereas affordability and appeal indicators (e.g., food pricing and marketing exposure) are less frequently addressed. Current evidence underscores deficiencies in the measurement and monitoring of the food environment for children, which is important to prevent and manage childhood overweight/obesity using integrated indicators at home, schools, communities, and society. Moreover, there is a necessity to develop a standardized, child-centered food environment monitoring system, facilitating prompt, equity-sensitive policy action to address children with overweight/obesity on a worldwide scale, which also supports global sustainable development. This systematic review paper will be useful for selecting indicators to construct a food environment monitoring system.
{"title":"Food Environment and Childhood Overweight/Obesity: A Systematic Review","authors":"Yi Liu , Zhijun Yang , Taotao Deng , Chongjun Bi , Huabin Li , Pengfeng Qu , Yamin Chen , Dong Liang , Jiao Xu , Ning Li , Gangqiang Ding , Haijun Wang","doi":"10.1016/j.advnut.2025.100564","DOIUrl":"10.1016/j.advnut.2025.100564","url":null,"abstract":"<div><div>Childhood overweight/obesity has emerged as a pressing public health concern globally, and the impact of the food environment on children's diets and health outcomes has gained heightened attention. Comprehensive and child-specific monitoring systems are critical for guiding targeted interventions and policies. This review aimed to synthesize recent literature on food environment indicators associated with children with overweight/obesity using the 4A framework, including food availability, accessibility, affordability, and appeal. We conducted a systematic search of peer-reviewed literature (2020–2025). This systematic review is guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses and involved narrative synthesis and framework-based classification (CRD420251116187). A total of 75 observational and 6 intervention studies are included. Indicators related to availability (e.g., home food supply and fast food outlet density) and accessibility (e.g., proximity to healthy food stores) are most commonly studied, whereas affordability and appeal indicators (e.g., food pricing and marketing exposure) are less frequently addressed. Current evidence underscores deficiencies in the measurement and monitoring of the food environment for children, which is important to prevent and manage childhood overweight/obesity using integrated indicators at home, schools, communities, and society. Moreover, there is a necessity to develop a standardized, child-centered food environment monitoring system, facilitating prompt, equity-sensitive policy action to address children with overweight/obesity on a worldwide scale, which also supports global sustainable development. This systematic review paper will be useful for selecting indicators to construct a food environment monitoring system.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"17 1","pages":"Article 100564"},"PeriodicalIF":9.2,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582758","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}
Pub Date : 2025-11-14DOI: 10.1016/j.advnut.2025.100563
Alexia J Murphy-Alford , Aaron J Grossberg , Vickie E Baracos , Maha Barbar , Judy Bauer , Jonathan P Bennett , Elena Fidarova , Clifton D Fuller , Anastassia Löser , Amy C Moreno , Anurima Patra , Deepa Puttaswamy , David I Rosenthal , Judy Schoeman , Yavuz Anacak
Radiotherapy plays a vital role in cancer treatment, yet its effects on patients’ nutritional status can precipitate muscle loss, with significant implications for treatment tolerance and outcomes. Evidence from high-income countries increasingly links radiation-induced muscle loss to adverse clinical outcomes. In contrast, low- and middle-income countries face a stark evidence gap, despite the heightened vulnerability of cancer patients in these settings due to delayed diagnosis, limited access to care, and high rates of co-morbidities. This paper highlights the critical gaps in nutritional care for radiotherapy patients in low- and middle-income countries.
{"title":"Perspective: Radiotherapy and Body Composition: Unmet Needs in Low- and Middle-Income Countries","authors":"Alexia J Murphy-Alford , Aaron J Grossberg , Vickie E Baracos , Maha Barbar , Judy Bauer , Jonathan P Bennett , Elena Fidarova , Clifton D Fuller , Anastassia Löser , Amy C Moreno , Anurima Patra , Deepa Puttaswamy , David I Rosenthal , Judy Schoeman , Yavuz Anacak","doi":"10.1016/j.advnut.2025.100563","DOIUrl":"10.1016/j.advnut.2025.100563","url":null,"abstract":"<div><div>Radiotherapy plays a vital role in cancer treatment, yet its effects on patients’ nutritional status can precipitate muscle loss, with significant implications for treatment tolerance and outcomes. Evidence from high-income countries increasingly links radiation-induced muscle loss to adverse clinical outcomes. In contrast, low- and middle-income countries face a stark evidence gap, despite the heightened vulnerability of cancer patients in these settings due to delayed diagnosis, limited access to care, and high rates of co-morbidities. This paper highlights the critical gaps in nutritional care for radiotherapy patients in low- and middle-income countries.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"17 1","pages":"Article 100563"},"PeriodicalIF":9.2,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535115","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}
Pub Date : 2025-11-03DOI: 10.1016/j.advnut.2025.100550
Duoduo Lu , Xiang Ji , Yu An , Huiyuan Liu , Gang Zheng , Yashu Liu , Honghao Yang , Yuhong Zhao , Lu Zhao , Yang Xia
It is unclear whether various obesity phenotypes are differently associated with cognitive disorders. The aim of this study was to examine the associations of general obesity [measured by body mass index (BMI)], central obesity [measured by waist circumference (WC), waist-to-hip ratio (WHR)], or body fat percentage (BFP), and visceral obesity with cognitive disorders in older adults using meta-analysis and Mendelian randomization (MR) approaches. We identified observational studies published from the inception of 4 (PubMed, Embase, Medline, and Web of Science) databases until November 2024. A random-effects model was employed to construct the pooled odds ratio (OR) and 95% confidence interval (CI) for exploring the associations of general, central, and visceral obesity with cognitive impairment. The mean, median, or range age of participants is ≥60 y. Subsequently, a 2-sample MR analysis was performed using genetic variation data to investigate the potential causal relationships of general, central, and visceral obesity with cognitive impairment. A total of 70 studies comprising 2,810,410 participants were included. In meta-analysis, general obesity (measured by BMI) showed an inverse association with cognitive disorders. Compared with normal BMI, the pooled ORs (95% CIs) were 1.29 (1.21, 1.38) for underweight, 0.87 (0.84, 0.90) for overweight, and 0.88 (0.85, 0.91) for obesity. In contrast, no significant association was observed for central obesity (WC or WHR) or visceral obesity. Subgroup analyses by sex, study design, region, and disease type produced results consistent with the overall findings. In MR analyses, higher BMI, BFP, WC, and WHR were associated with a reduced risk of cognitive impairment, with WHR also inversely related to mild cognitive impairment. No causal association was observed for dementia or Alzheimer’s disease. The research results indicate that there might be a negative correlation between obesity (especially generalized obesity) and cognitive impairment in the elderly.
背景：目前尚不清楚不同的肥胖表型是否与认知障碍有不同的关联。本研究的目的是通过荟萃分析和孟德尔随机化（MR）方法，研究老年人一般肥胖（以体重指数[BMI]测量）、中心性肥胖（以腰围[WC]、腰臀比[WHR]测量）或体脂率（BFP）和内脏肥胖与认知障碍之间的关系。方法：我们确定了从四个数据库（PubMed, Embase， Medline和Web of Science）开始到2024年11月发表的观察性研究。采用随机效应模型构建合并优势比（OR）和95%置信区间（CI），探讨全身性、中枢性和内脏性肥胖与认知障碍的关系。参与者的平均、中位数或年龄范围为60岁及以上。随后，利用遗传变异数据进行了两样本磁共振分析，以调查全身性、中枢性和内脏性肥胖与认知障碍的潜在因果关系。结果：共纳入70项研究，包括2,810,410名受试者。在荟萃分析中，一般肥胖（由BMI测量）与认知障碍呈负相关。与正常BMI相比，体重过轻组的合并or （95% ci）为1.29(1.21-1.38)，超重组为0.87(0.84-0.90)，肥胖组为0.88（0.85-0.91）。相反，没有观察到中心性肥胖（WC或WHR）或内脏肥胖的显著关联。按性别、研究设计、地区和疾病类型进行的亚组分析得出的结果与总体发现一致。在MR分析中，较高的BMI、BFP、WC和腰宽比与认知障碍风险降低相关，腰宽比也与轻度认知障碍呈负相关。没有观察到痴呆或阿尔茨海默病的因果关系。结论：研究结果提示老年人肥胖（尤其是全身性肥胖）与认知功能障碍可能存在负相关关系。
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Pub Date : 2025-11-01DOI: 10.1016/j.advnut.2025.100531
Annabel Biruete , Pius Sarfo Buobu , Robert V Considine , Erisa Met Hoxha , Heather A Eicher-Miller , Kimberly P Kinzig , Anita A Panjwani , Cordelia A Running , Giorgia Rutigliani , Dennis A Savaiano , Amanda Veile , Patricia G Wolf , Richard D Mattes
The marked individual variability in response to common dietary exposures necessitates tailoring of dietary guidance to individuals, or small groups of individuals with similar needs, to optimize health. This is a complex task requiring integration of environmental, cultural, psychological, and biological contributions. Work in the area of precision nutrition is an effort to translate science into practice. A research roadmap developed through a National Institutes of Health conference identified many of the inputs that require quantification. Better characterization of ingestive behaviors is one key area. The aim of this narrative review is to summarize current understanding of the influences of age, sex, body mass index, ethnicity, and genetics on ingestive behaviors, including culture, sensory function, appetite, dietary intake, the gut–brain axis, and microbiome. To do so, the extant literature was accessed through search engines relevant to the various topics covered. Outcomes assessed varied topically. In addition to compiling evidence on the nature and magnitude of these relationships, this review highlights the degree of individual variability in attributes or responses to an intervention. More broadly, it documents: 1) that cause-and-effect relationships are difficult to establish as most are dynamic and interactive; 2) there are inherent and learned contributions to both behavior and biology that will require different considerations and offer different opportunities for manipulation; 3) a focus on intuitive approaches may not be as successful as desired; 4) that external influences can, and often do, override internal influences of biology; and 5) there are multiple ways to construct healthful diets. At the same time, it is vital that improved methods to characterize the multiple relevant inputs to ingestive behavior be developed. It is hoped that the evidence compiled here will inform efforts to develop precision nutrition guidance.
{"title":"Ingestive Behavior and Precision Nutrition: Part of the Puzzle","authors":"Annabel Biruete , Pius Sarfo Buobu , Robert V Considine , Erisa Met Hoxha , Heather A Eicher-Miller , Kimberly P Kinzig , Anita A Panjwani , Cordelia A Running , Giorgia Rutigliani , Dennis A Savaiano , Amanda Veile , Patricia G Wolf , Richard D Mattes","doi":"10.1016/j.advnut.2025.100531","DOIUrl":"10.1016/j.advnut.2025.100531","url":null,"abstract":"<div><div>The marked individual variability in response to common dietary exposures necessitates tailoring of dietary guidance to individuals, or small groups of individuals with similar needs, to optimize health. This is a complex task requiring integration of environmental, cultural, psychological, and biological contributions. Work in the area of precision nutrition is an effort to translate science into practice. A research roadmap developed through a National Institutes of Health conference identified many of the inputs that require quantification. Better characterization of ingestive behaviors is one key area. The aim of this narrative review is to summarize current understanding of the influences of age, sex, body mass index, ethnicity, and genetics on ingestive behaviors, including culture, sensory function, appetite, dietary intake, the gut–brain axis, and microbiome. To do so, the extant literature was accessed through search engines relevant to the various topics covered. Outcomes assessed varied topically. In addition to compiling evidence on the nature and magnitude of these relationships, this review highlights the degree of individual variability in attributes or responses to an intervention. More broadly, it documents: <em>1</em>) that cause-and-effect relationships are difficult to establish as most are dynamic and interactive; <em>2</em>) there are inherent and learned contributions to both behavior and biology that will require different considerations and offer different opportunities for manipulation; <em>3</em>) a focus on intuitive approaches may not be as successful as desired; <em>4</em>) that external influences can, and often do, override internal influences of biology; and <em>5</em>) there are multiple ways to construct healthful diets. At the same time, it is vital that improved methods to characterize the multiple relevant inputs to ingestive behavior be developed. It is hoped that the evidence compiled here will inform efforts to develop precision nutrition guidance.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 11","pages":"Article 100531"},"PeriodicalIF":9.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226376","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}
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