Pub Date : 2025-10-01DOI: 10.1016/j.advnut.2025.100500
Lindsay H Allen , Setareh Shahab-Ferdows , Sophie E Moore , Janet M Peerson , Gilberto Kac , Amanda C Figueiredo , Daphna K Dror , Kim F Michaelsen , M Munirul Islam , Fanta Nije , Daniela Hampel
This third article in the series presenting reference values (RVs) for nutrients in human milk describes the values for B vitamins. The mothers, infants, and lactation quality (MILQ) and early-MILQ studies, conducted at sites in Bangladesh, Brazil, Denmark, and The Gambia, were designed to measure human milk nutrient concentrations of well-nourished mothers during the first 8.5 mo of lactation. Applying ultrahigh-performance liquid chromatography–mass spectrometry (UPLC-MS/MS) to analyze multiple B vitamins simultaneously produced RVs for vitamin B2, B3, pantothenic acid, B6, and biotin. Choline was analyzed separately by UPLC-MS/MS, vitamin B1 by high-performance liquid chromatography–fluorescence detection, and vitamin B12 by competitive chemiluminescence enzyme immunoassay. Measured milk B-vitamin concentrations from the MILQ study were compared with those used by the Institute of Medicine (IOM) for setting recommendations for nutrient requirements of infants. MILQ estimates were substantially lower (<60% of the concentrations used by the IOM) for vitamins B1, B2, and B6; 60%–100% of concentrations used by the IOM for vitamin B3, vitamin B12, and choline; and consistent or slightly (100%–125%) higher than concentrations used by the IOM for pantothenic acid and biotin. Total daily median B-vitamin intakes from 1 to 6 mo were 29%–45% of IOM adequate intakes (AIs) for vitamins B1 and B2, 60%–75% of AIs for vitamins B3, B6, B12, and choline, and 118%–128% of AIs for pantothenic acid and biotin. The MILQ B-vitamin concentrations are provided as percentile curves to enable comparison and interpretation of data from other studies.
{"title":"Reference Values for B Vitamins in Human Milk: The Mothers, Infants and Lactation Quality (MILQ) Study","authors":"Lindsay H Allen , Setareh Shahab-Ferdows , Sophie E Moore , Janet M Peerson , Gilberto Kac , Amanda C Figueiredo , Daphna K Dror , Kim F Michaelsen , M Munirul Islam , Fanta Nije , Daniela Hampel","doi":"10.1016/j.advnut.2025.100500","DOIUrl":"10.1016/j.advnut.2025.100500","url":null,"abstract":"<div><div>This third article in the series presenting reference values (RVs) for nutrients in human milk describes the values for B vitamins. The mothers, infants, and lactation quality (MILQ) and early-MILQ studies, conducted at sites in Bangladesh, Brazil, Denmark, and The Gambia, were designed to measure human milk nutrient concentrations of well-nourished mothers during the first 8.5 mo of lactation. Applying ultrahigh-performance liquid chromatography–mass spectrometry (UPLC-MS/MS) to analyze multiple B vitamins simultaneously produced RVs for vitamin B2, B3, pantothenic acid, B6, and biotin. Choline was analyzed separately by UPLC-MS/MS, vitamin B1 by high-performance liquid chromatography–fluorescence detection, and vitamin B12 by competitive chemiluminescence enzyme immunoassay. Measured milk B-vitamin concentrations from the MILQ study were compared with those used by the Institute of Medicine (IOM) for setting recommendations for nutrient requirements of infants. MILQ estimates were substantially lower (<60% of the concentrations used by the IOM) for vitamins B1, B2, and B6; 60%–100% of concentrations used by the IOM for vitamin B3, vitamin B12, and choline; and consistent or slightly (100%–125%) higher than concentrations used by the IOM for pantothenic acid and biotin. Total daily median B-vitamin intakes from 1 to 6 mo were 29%–45% of IOM adequate intakes (AIs) for vitamins B1 and B2, 60%–75% of AIs for vitamins B3, B6, B12, and choline, and 118%–128% of AIs for pantothenic acid and biotin. The MILQ B-vitamin concentrations are provided as percentile curves to enable comparison and interpretation of data from other studies.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 ","pages":"Article 100500"},"PeriodicalIF":9.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374236","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 : 2025-10-01DOI: 10.1016/j.advnut.2025.100499
Lindsay H Allen , Sophie E Moore , Gilberto Kac , Kim F Michaelsen , Christian Mølgaard , M Munirul Islam , Setareh Shahab-Ferdows , Sophie Hilario Christensen , Jack I Lewis , Janet M Peerson , Xiuping Tan , Daphna K Dror , Andrew M Doel , Maria Andersson , Daniela de Barros Mucci , Amanda C Figueiredo , Bruna C Schneider , Farhana Khanam , Adriana Divina de Souza Campos , Gabriela Torres Silva , Daniela Hampel
The World Health Organization recommends exclusive breastfeeding for the first 6 mo of life and continued breastfeeding for 2 y or beyond. However, limited reliable, representative data on nutrient concentrations in milk from well-nourished mothers are available. Furthermore, there is a lack of data integrating human milk nutrient concentrations with the volume of milk transferred to infants during progressive stages of lactation. Accurate quantification of nutrient concentrations and milk volume is essential for setting macro- and micronutrient intake recommendations for infants and women’s additional requirements for lactation. This first article in a series of 7 in this Supplement describes the Mothers, Infants, and Lactation Quality (MILQ) study conducted at sites in Bangladesh, Brazil, Denmark, and The Gambia. The MILQ study measured human milk nutrient concentrations and quantified milk volume throughout the first 8.5 mo of lactation. Validated analytical methodologies were used for nutrient quantification. The stable isotope dilution dose-to-mother method was used for milk volume measurement. A total of 1242 mother–infant dyads participated in the MILQ study. Milk volumes, milk nutrient concentrations, percentile curves, and total nutrient intakes (concentration times milk volume at each time point) are presented in the series of articles in this supplement. Comparisons are made between values in the MILQ study and those used by the Institute of Medicine (now renamed the National Academy of Medicine) to set nutrient intake recommendations for infants and lactating women, and with other selected studies. Data from the MILQ study provide a valuable resource for updating existing nutrient intake recommendations, evaluating and improving infant nutrition strategies, and assessing interventions to optimize maternal and infant nutritional status and health.
{"title":"The Mothers, Infants and Lactation Quality (MILQ) Study: Introduction and Study Design","authors":"Lindsay H Allen , Sophie E Moore , Gilberto Kac , Kim F Michaelsen , Christian Mølgaard , M Munirul Islam , Setareh Shahab-Ferdows , Sophie Hilario Christensen , Jack I Lewis , Janet M Peerson , Xiuping Tan , Daphna K Dror , Andrew M Doel , Maria Andersson , Daniela de Barros Mucci , Amanda C Figueiredo , Bruna C Schneider , Farhana Khanam , Adriana Divina de Souza Campos , Gabriela Torres Silva , Daniela Hampel","doi":"10.1016/j.advnut.2025.100499","DOIUrl":"10.1016/j.advnut.2025.100499","url":null,"abstract":"<div><div>The World Health Organization recommends exclusive breastfeeding for the first 6 mo of life and continued breastfeeding for 2 y or beyond. However, limited reliable, representative data on nutrient concentrations in milk from well-nourished mothers are available. Furthermore, there is a lack of data integrating human milk nutrient concentrations with the volume of milk transferred to infants during progressive stages of lactation. Accurate quantification of nutrient concentrations and milk volume is essential for setting macro- and micronutrient intake recommendations for infants and women’s additional requirements for lactation. This first article in a series of 7 in this Supplement describes the Mothers, Infants, and Lactation Quality (MILQ) study conducted at sites in Bangladesh, Brazil, Denmark, and The Gambia. The MILQ study measured human milk nutrient concentrations and quantified milk volume throughout the first 8.5 mo of lactation. Validated analytical methodologies were used for nutrient quantification. The stable isotope dilution dose-to-mother method was used for milk volume measurement. A total of 1242 mother–infant dyads participated in the MILQ study. Milk volumes, milk nutrient concentrations, percentile curves, and total nutrient intakes (concentration times milk volume at each time point) are presented in the series of articles in this supplement. Comparisons are made between values in the MILQ study and those used by the Institute of Medicine (now renamed the National Academy of Medicine) to set nutrient intake recommendations for infants and lactating women, and with other selected studies. Data from the MILQ study provide a valuable resource for updating existing nutrient intake recommendations, evaluating and improving infant nutrition strategies, and assessing interventions to optimize maternal and infant nutritional status and health.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 ","pages":"Article 100499"},"PeriodicalIF":9.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374614","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 : 2025-10-01DOI: 10.1016/j.advnut.2025.100501
Jack I Lewis , Daphna K Dror , Daniela Hampel , Gilberto Kac , Christian Mølgaard , Sophie E Moore , Janet M Peerson , Sophie Hilario Christensen , M Munirul Islam , Daniela de Barros Mucci , Amanda C Figueiredo , Adriana Divina de Souza Campos , Mehedi Hasan , Lindsay H Allen
This second article in the series establishing reference values (RVs) for nutrients in human milk describes RVs for protein, carbohydrate, fat, and energy. To establish RVs, the mothers, infants, and lactation quality (MILQ) and early-MILQ studies collected human milk samples throughout the first 8.5 mo of lactation in 1242 well-nourished women in Bangladesh, Brazil, Denmark, and The Gambia. Macronutrients were measured by near-infrared spectroscopy. Protein concentrations decreased from 12.4 g/L at 4–17 d to a 7.7–7.9 g/L plateau by 4–5 mo. Carbohydrate concentrations were stable throughout lactation, ranging from 68.2 to 70.1 g/L. Fat concentrations decreased from 37.0 g/L at 4–17 d to 31.2–32.8 g/L after 2–3 mo. Energy density mirrored fat trends, decreasing from 665 kcal/L at 4–17 d to 597–602 kcal/L by 3–4 mo. Compared with estimates used by the Institute of Medicine (IOM)--renamed the National Academy of Medicine (NAM) in 2015--to set nutrient intake recommendations for infants, MILQ values were ∼90% of concentrations used for carbohydrate and energy, and 70%–80% for protein and fat. Total daily median intakes (concentrations × milk volumes) from 1 to 6 mo were on par with IOM adequate intakes (AIs) for carbohydrate and energy, 65% of the AI for protein, and 84% of the AI for fat. These RVs offer a critical resource for understanding the nutritional contributions of human milk and informing public health practices to support infant growth and development.
{"title":"Reference Values for Macronutrients in Human Milk: the Mothers, Infants and Lactation Quality (MILQ) Study","authors":"Jack I Lewis , Daphna K Dror , Daniela Hampel , Gilberto Kac , Christian Mølgaard , Sophie E Moore , Janet M Peerson , Sophie Hilario Christensen , M Munirul Islam , Daniela de Barros Mucci , Amanda C Figueiredo , Adriana Divina de Souza Campos , Mehedi Hasan , Lindsay H Allen","doi":"10.1016/j.advnut.2025.100501","DOIUrl":"10.1016/j.advnut.2025.100501","url":null,"abstract":"<div><div>This second article in the series establishing reference values (RVs) for nutrients in human milk describes RVs for protein, carbohydrate, fat, and energy. To establish RVs, the mothers, infants, and lactation quality (MILQ) and early-MILQ studies collected human milk samples throughout the first 8.5 mo of lactation in 1242 well-nourished women in Bangladesh, Brazil, Denmark, and The Gambia. Macronutrients were measured by near-infrared spectroscopy. Protein concentrations decreased from 12.4 g/L at 4–17 d to a 7.7–7.9 g/L plateau by 4–5 mo. Carbohydrate concentrations were stable throughout lactation, ranging from 68.2 to 70.1 g/L. Fat concentrations decreased from 37.0 g/L at 4–17 d to 31.2–32.8 g/L after 2–3 mo. Energy density mirrored fat trends, decreasing from 665 kcal/L at 4–17 d to 597–602 kcal/L by 3–4 mo. Compared with estimates used by the Institute of Medicine (IOM)--renamed the National Academy of Medicine (NAM) in 2015--to set nutrient intake recommendations for infants, MILQ values were ∼90% of concentrations used for carbohydrate and energy, and 70%–80% for protein and fat. Total daily median intakes (concentrations × milk volumes) from 1 to 6 mo were on par with IOM adequate intakes (AIs) for carbohydrate and energy, 65% of the AI for protein, and 84% of the AI for fat. These RVs offer a critical resource for understanding the nutritional contributions of human milk and informing public health practices to support infant growth and development.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 ","pages":"Article 100501"},"PeriodicalIF":9.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374615","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 : 2025-10-01DOI: 10.1016/j.advnut.2025.100491
Demsina Babazadeh, Shawna Wyatt, Francene M Steinberg
Injectable antiobesity medications (AOMs), including liraglutide, semaglutide, and tirzepatide, have demonstrated significant efficacy in promoting weight loss and improving glycemic control. However, the extent to which diet and food intake and related eating behaviors are assessed or reported in clinical trials of these agents remains unclear. This scoping review aimed to evaluate the presence and quality of dietary data, nutritional counseling, and related behavioral measures in randomized controlled trials of subcutaneous AOMs. A systematic literature search was conducted in MEDLINE-PubMed through September 2024, with a gap search completed December 2024. Eligible studies included randomized trials investigating liraglutide, semaglutide, or tirzepatide in humans. Studies were screened and extracted in Covidence, with 129 meeting inclusion criteria. Data extraction included AOM being studied, primary outcome, presence and type of nutritional or physical activity counseling, diet intake assessment and tools used, and eating behavior outcomes. Of 129 included studies, 54 evaluated liraglutide, 43 semaglutide, and 22 tirzepatide. Although 57 trials reported lifestyle modification as part of the intervention, 36 recorded diet quality and food intake. Among the 36 studies that collected dietary data, only 10 reported outcomes and half used single-time point assessments like ad libitum meals or buffets. Seventeen trials assessed food cravings or eating behavior using a variety of assessments. Across trials, there was minimal uniformity in outcome reporting, study duration, or counseling frequency, with most trials lacking detailed reporting on nutritional behavior components. Despite the central role of diet in weight regulation, most clinical trials involving AOMs fail to report meaningful diet quality or food intake data. The heterogeneity and underreporting of lifestyle components limit interpretability and generalizability of outcomes. Greater emphasis on standardizing and reporting dietary and behavioral measures is warranted to understand how AOMs interact with real-world nutrition behaviors and to inform comprehensive obesity care.
{"title":"Examining the Omission of Dietary Quality Data in Glucagon-Like Peptide 1 Clinical Trials: A Scoping Review","authors":"Demsina Babazadeh, Shawna Wyatt, Francene M Steinberg","doi":"10.1016/j.advnut.2025.100491","DOIUrl":"10.1016/j.advnut.2025.100491","url":null,"abstract":"<div><div>Injectable antiobesity medications (AOMs), including liraglutide, semaglutide, and tirzepatide, have demonstrated significant efficacy in promoting weight loss and improving glycemic control. However, the extent to which diet and food intake and related eating behaviors are assessed or reported in clinical trials of these agents remains unclear. This scoping review aimed to evaluate the presence and quality of dietary data, nutritional counseling, and related behavioral measures in randomized controlled trials of subcutaneous AOMs. A systematic literature search was conducted in MEDLINE-PubMed through September 2024, with a gap search completed December 2024. Eligible studies included randomized trials investigating liraglutide, semaglutide, or tirzepatide in humans. Studies were screened and extracted in Covidence, with 129 meeting inclusion criteria. Data extraction included AOM being studied, primary outcome, presence and type of nutritional or physical activity counseling, diet intake assessment and tools used, and eating behavior outcomes. Of 129 included studies, 54 evaluated liraglutide, 43 semaglutide, and 22 tirzepatide. Although 57 trials reported lifestyle modification as part of the intervention, 36 recorded diet quality and food intake. Among the 36 studies that collected dietary data, only 10 reported outcomes and half used single-time point assessments like ad libitum meals or buffets. Seventeen trials assessed food cravings or eating behavior using a variety of assessments. Across trials, there was minimal uniformity in outcome reporting, study duration, or counseling frequency, with most trials lacking detailed reporting on nutritional behavior components. Despite the central role of diet in weight regulation, most clinical trials involving AOMs fail to report meaningful diet quality or food intake data. The heterogeneity and underreporting of lifestyle components limit interpretability and generalizability of outcomes. Greater emphasis on standardizing and reporting dietary and behavioral measures is warranted to understand how AOMs interact with real-world nutrition behaviors and to inform comprehensive obesity care.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 10","pages":"Article 100491"},"PeriodicalIF":9.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857164","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 : 2025-09-30DOI: 10.1016/j.advnut.2025.100527
Denali Boon , Satori A Marchitti , Kyle J Colonna , Ilkania M Chowdhury-Paulino , Wenchao Li , Axel Berky , Catalina Restrepo , Maia Jack , Julie E Goodman
Nonsugar sweeteners (NSSs) are added to foods and beverages to provide sweetness in place of sugar while reducing the total caloric content. Reducing sugar intake, and corresponding calories, may decrease the risk of diabetes and other health conditions associated with obesity (e.g., cancer). Numerous observational epidemiology studies have evaluated the effect of NSSs on cancer risk, sometimes focusing on a specific NSS or a specific cancer, other times focusing on all NSSs or all cancers. We conducted a systematic review of epidemiology studies of NSS intake (of all types in aggregate and individually) and the risks of all types of cancer published through Fall 2024 [preregistered with Open Science Framework (https://osf.io/gc8v6)]. We considered how major study quality concerns might have impacted the interpretation of individual study results, as well as the evidence as a whole. We identified 90 studies of acesulfame potassium (ace-K), aspartame, cyclamate, saccharin, sucralose, or nonspecific NSSs in aggregate [e.g., diet sodas, artificially sweetened beverages], and 17 specific types of cancer. We found no consistent associations between any NSS or NSSs in aggregate and any cancer overall, and no evidence for dose–response. NSS intake information was always self-reported, rendering exposure misclassification an ongoing challenge in all studies, and recall bias remains a significant possibility in all case-control studies. Many studies also did not fully account for potential confounders. Experimental animal and mechanistic evidence for NSSs does not support human-relevant carcinogenicity or any biologically plausible mechanisms by which NSSs could cause genotoxicity or cancer in humans. Overall, the epidemiology evidence does not support associations between any NSS and any cancer type.
{"title":"A Systematic Review of Nonsugar Sweeteners and Cancer Epidemiology Studies","authors":"Denali Boon , Satori A Marchitti , Kyle J Colonna , Ilkania M Chowdhury-Paulino , Wenchao Li , Axel Berky , Catalina Restrepo , Maia Jack , Julie E Goodman","doi":"10.1016/j.advnut.2025.100527","DOIUrl":"10.1016/j.advnut.2025.100527","url":null,"abstract":"<div><div>Nonsugar sweeteners (NSSs) are added to foods and beverages to provide sweetness in place of sugar while reducing the total caloric content. Reducing sugar intake, and corresponding calories, may decrease the risk of diabetes and other health conditions associated with obesity (e.g., cancer). Numerous observational epidemiology studies have evaluated the effect of NSSs on cancer risk, sometimes focusing on a specific NSS or a specific cancer, other times focusing on all NSSs or all cancers. We conducted a systematic review of epidemiology studies of NSS intake (of all types in aggregate and individually) and the risks of all types of cancer published through Fall 2024 [preregistered with Open Science Framework (<span><span>https://osf.io/gc8v6</span><svg><path></path></svg></span>)]. We considered how major study quality concerns might have impacted the interpretation of individual study results, as well as the evidence as a whole. We identified 90 studies of acesulfame potassium (ace-K), aspartame, cyclamate, saccharin, sucralose, or nonspecific NSSs in aggregate [e.g., diet sodas, artificially sweetened beverages], and 17 specific types of cancer. We found no consistent associations between any NSS or NSSs in aggregate and any cancer overall, and no evidence for dose–response. NSS intake information was always self-reported, rendering exposure misclassification an ongoing challenge in all studies, and recall bias remains a significant possibility in all case-control studies. Many studies also did not fully account for potential confounders. Experimental animal and mechanistic evidence for NSSs does not support human-relevant carcinogenicity or any biologically plausible mechanisms by which NSSs could cause genotoxicity or cancer in humans. Overall, the epidemiology evidence does not support associations between any NSS and any cancer type.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 12","pages":"Article 100527"},"PeriodicalIF":9.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214474","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 : 2025-09-29DOI: 10.1016/j.advnut.2025.100528
Miaobing Zheng , Seon Y Park , Kristy A Bolton , Mary Foong-Fong Chong , Sara Grafenauer , Bo Xi
The vital role of early dietary intake in shaping later health has been widely acknowledged, but how changes in dietary intake from early life influence health outcomes remains unclear. This review systematically synthesized the literature that examined the longitudinal associations between changes in dietary intake (i.e., trajectories) from early life and health outcomes. Electronic searches were conducted in PubMed, Embase, and ScienceDirect to gather longitudinal cohort studies that investigated dietary intake trajectories from infancy, childhood, or adolescence (with first dietary assessment before age 18 y) and any health outcomes published from inception to September 2024 (CRD42024512716). Of 16 included studies, 14 reported significant associations between dietary intake trajectories (intakes of macronutrients, food groups, diet quality or dietary patterns) in childhood or from childhood to adolescence/early adulthood and dental, obesity, cardiometabolic, neurocognitive, liver or gut health outcomes from age 2 y up to age 41 y. Most studies were of high (n = 2) or acceptable (n = 12) quality. A high or increasing sugar intake trajectory during infancy was linked to an increased risk of dental caries in early childhood, whereas a healthy dietary pattern trajectory was associated with lower risk. Trajectories of poor diet quality, red meat dietary pattern, and high discretionary food intake from infancy/early childhood were associated with adiposity and adverse cardiometabolic outcomes at adolescence and adulthood. Significant associations were also found between trajectories of dietary patterns or macronutrient intakes (e.g., protein, carbohydrate, and dietary fiber) from infancy and neurocognitive outcomes in childhood. High energy intake trajectory from early childhood to adolescence and carbohydrate intake from infancy to early adulthood were associated with poor liver health outcomes and gut microbiota composition in adulthood, respectively. Dietary intake trajectories established from infancy or early childhood were associated with various health outcomes. Dietary interventions should be initiated from infancy or early childhood for early health promotion.
{"title":"Dietary Intake Trajectories from Early Life and Associated Health Outcomes: A Systematic Review","authors":"Miaobing Zheng , Seon Y Park , Kristy A Bolton , Mary Foong-Fong Chong , Sara Grafenauer , Bo Xi","doi":"10.1016/j.advnut.2025.100528","DOIUrl":"10.1016/j.advnut.2025.100528","url":null,"abstract":"<div><div>The vital role of early dietary intake in shaping later health has been widely acknowledged, but how changes in dietary intake from early life influence health outcomes remains unclear. This review systematically synthesized the literature that examined the longitudinal associations between changes in dietary intake (i.e., trajectories) from early life and health outcomes. Electronic searches were conducted in PubMed, Embase, and ScienceDirect to gather longitudinal cohort studies that investigated dietary intake trajectories from infancy, childhood, or adolescence (with first dietary assessment before age 18 y) and any health outcomes published from inception to September 2024 (CRD42024512716). Of 16 included studies, 14 reported significant associations between dietary intake trajectories (intakes of macronutrients, food groups, diet quality or dietary patterns) in childhood or from childhood to adolescence/early adulthood and dental, obesity, cardiometabolic, neurocognitive, liver or gut health outcomes from age 2 y up to age 41 y. Most studies were of high (<em>n</em> = 2) or acceptable (<em>n</em> = 12) quality. A high or increasing sugar intake trajectory during infancy was linked to an increased risk of dental caries in early childhood, whereas a healthy dietary pattern trajectory was associated with lower risk. Trajectories of poor diet quality, red meat dietary pattern, and high discretionary food intake from infancy/early childhood were associated with adiposity and adverse cardiometabolic outcomes at adolescence and adulthood. Significant associations were also found between trajectories of dietary patterns or macronutrient intakes (e.g., protein, carbohydrate, and dietary fiber) from infancy and neurocognitive outcomes in childhood. High energy intake trajectory from early childhood to adolescence and carbohydrate intake from infancy to early adulthood were associated with poor liver health outcomes and gut microbiota composition in adulthood, respectively. Dietary intake trajectories established from infancy or early childhood were associated with various health outcomes. Dietary interventions should be initiated from infancy or early childhood for early health promotion.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 11","pages":"Article 100528"},"PeriodicalIF":9.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208558","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}
Chronic inflammation plays a significant role in the development and progression of diabetes. Despite growing interest in probiotic and synbiotic supplementation, there is limited consensus on their efficacy in modulating inflammatory cytokines. This meta-analysis evaluates the impact of these supplements on inflammatory cytokines in adults with prediabetes and type 2 diabetes mellitus (T2DM). A comprehensive search was conducted on online databases from their inception to September 2025 to identify relevant randomized controlled trials (RCTs). Data were extracted from selected studies, and the overall effect size was determined using weighted mean differences (WMD) with 95% confidence intervals (CIs) through a random-effects model. The pooled analysis of 22 RCTs, including 1321 individuals with prediabetes and T2DM, showed that probiotic and synbiotic supplementation significantly reduced C-reactive protein (CRP) (WMD: −0.46 mg/L, 95% CI: [−0.77, −0.15], p=0.003), interleukin-6 (IL-6) (WMD: −0.43 pg/ml, 95% CI: [−0.76, −0.09], p=0.012), and tumor necrosis factor-alpha (TNF-α) (WMD: −1.42 pg/ml, 95% CI: [−2.15, −0.69], p<0.001). Subgroup analyses revealed that CRP reduction was greatest among participants with baseline CRP ≥3 mg/L, those undergoing longer interventions (≥12 weeks), individuals with T2DM, overweight participants, and when probiotics were administered. IL-6 levels were significantly reduced in obese individuals, particularly with longer treatment durations and synbiotic interventions, while TNF-α reductions were most pronounced in long-term interventions (≥12 weeks), especially among T2DM patients with normal BMI and when probiotics were used. In conclusion, probiotic and synbiotic supplementation significantly reduces inflammatory cytokines (CRP, IL-6, TNF-α) in individuals with prediabetes and T2DM, with the strongest effects observed in those with higher baseline inflammation and longer intervention durations, underscoring the importance of tailoring supplementation strategies to individual inflammation status, intervention duration, and metabolic profile to optimize therapeutic outcomes.
{"title":"Probiotics and Synbiotics Supplementation Reduce Inflammatory Cytokines in Individuals with Prediabetes and Type 2 Diabetes Mellitus: Findings from a Systematic Review Meta-analysis","authors":"Azin Setayesh , Mehdi Karimi , Fereshteh Valizadeh , Omid Asbaghi , Samira Pirzad , Sayed Hossein Davoodi , Bagher Larijani","doi":"10.1016/j.advnut.2025.100526","DOIUrl":"10.1016/j.advnut.2025.100526","url":null,"abstract":"<div><div>Chronic inflammation plays a significant role in the development and progression of diabetes. Despite growing interest in probiotic and synbiotic supplementation, there is limited consensus on their efficacy in modulating inflammatory cytokines. This meta-analysis evaluates the impact of these supplements on inflammatory cytokines in adults with prediabetes and type 2 diabetes mellitus (T2DM). A comprehensive search was conducted on online databases from their inception to September 2025 to identify relevant randomized controlled trials (RCTs). Data were extracted from selected studies, and the overall effect size was determined using weighted mean differences (WMD) with 95% confidence intervals (CIs) through a random-effects model. The pooled analysis of 22 RCTs, including 1321 individuals with prediabetes and T2DM, showed that probiotic and synbiotic supplementation significantly reduced C-reactive protein (CRP) (WMD: −0.46 mg/L, 95% CI: [−0.77, −0.15], p=0.003), interleukin-6 (IL-6) (WMD: −0.43 pg/ml, 95% CI: [−0.76, −0.09], p=0.012), and tumor necrosis factor-alpha (TNF-α) (WMD: −1.42 pg/ml, 95% CI: [−2.15, −0.69], p<0.001). Subgroup analyses revealed that CRP reduction was greatest among participants with baseline CRP ≥3 mg/L, those undergoing longer interventions (≥12 weeks), individuals with T2DM, overweight participants, and when probiotics were administered. IL-6 levels were significantly reduced in obese individuals, particularly with longer treatment durations and synbiotic interventions, while TNF-α reductions were most pronounced in long-term interventions (≥12 weeks), especially among T2DM patients with normal BMI and when probiotics were used. In conclusion, probiotic and synbiotic supplementation significantly reduces inflammatory cytokines (CRP, IL-6, TNF-α) in individuals with prediabetes and T2DM, with the strongest effects observed in those with higher baseline inflammation and longer intervention durations, underscoring the importance of tailoring supplementation strategies to individual inflammation status, intervention duration, and metabolic profile to optimize therapeutic outcomes.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 11","pages":"Article 100526"},"PeriodicalIF":9.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193912","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 : 2025-09-23DOI: 10.1016/j.advnut.2025.100524
Justin Tang , Luke Krushelnycky , Abir Shaqo , Clara E Cho
Serotonin (5-hydroxytryptamine) is a critical monoamine neurotransmitter and hormone that orchestrates a vast array of physiological and psychological processes, including mood, sleep, appetite, and gastrointestinal motility. Serotonin synthesis is dependent on the availability of its dietary precursor, the essential amino acid tryptophan, and it affects biochemical pathways that may be modulated by other nutrients. We conducted a literature search to comprehensively examine the nutritional influences on the serotonergic system. Relevant original research, systematic reviews, meta-analyses, and clinical trial reports were retrieved from PubMed, Scopus, and Google Scholar, with additional articles identified from reference lists of published review papers. Key nutritional determinants of serotonergic function include macronutrients that influence the tryptophan-to-large neutral amino acid ratio (a regulator of tryptophan availability in the brain) and micronutrients, such as B-vitamins, vitamin D, iron, and magnesium, that serve as essential cofactors in serotonin synthesis and metabolism. Emerging evidence also highlights the role of the gut microbiota, shaped by dietary components, prebiotics, and probiotics, in modulating serotonergic function across both central and peripheral systems. Nutritional factors that affect serotonin have been increasingly linked to conditions such as depression, anxiety, sleep disturbances, disordered eating, obesity, and irritable bowel syndrome. Altogether, this review emphasizes the profound impact of nutrition on serotonergic regulation and advocates for targeted dietary approaches as promising catalysts for optimizing human health. Key research gaps and future directions are outlined to help advance the translation of current evidence into precise nutritional guidelines and clinical applications, with the complexity of serotonin pathways as an important consideration.
{"title":"A Comprehensive Review of Nutritional Influences on the Serotonergic System","authors":"Justin Tang , Luke Krushelnycky , Abir Shaqo , Clara E Cho","doi":"10.1016/j.advnut.2025.100524","DOIUrl":"10.1016/j.advnut.2025.100524","url":null,"abstract":"<div><div>Serotonin (5-hydroxytryptamine) is a critical monoamine neurotransmitter and hormone that orchestrates a vast array of physiological and psychological processes, including mood, sleep, appetite, and gastrointestinal motility. Serotonin synthesis is dependent on the availability of its dietary precursor, the essential amino acid tryptophan, and it affects biochemical pathways that may be modulated by other nutrients. We conducted a literature search to comprehensively examine the nutritional influences on the serotonergic system. Relevant original research, systematic reviews, meta-analyses, and clinical trial reports were retrieved from PubMed, Scopus, and Google Scholar, with additional articles identified from reference lists of published review papers. Key nutritional determinants of serotonergic function include macronutrients that influence the tryptophan-to-large neutral amino acid ratio (a regulator of tryptophan availability in the brain) and micronutrients, such as B-vitamins, vitamin D, iron, and magnesium, that serve as essential cofactors in serotonin synthesis and metabolism. Emerging evidence also highlights the role of the gut microbiota, shaped by dietary components, prebiotics, and probiotics, in modulating serotonergic function across both central and peripheral systems. Nutritional factors that affect serotonin have been increasingly linked to conditions such as depression, anxiety, sleep disturbances, disordered eating, obesity, and irritable bowel syndrome. Altogether, this review emphasizes the profound impact of nutrition on serotonergic regulation and advocates for targeted dietary approaches as promising catalysts for optimizing human health. Key research gaps and future directions are outlined to help advance the translation of current evidence into precise nutritional guidelines and clinical applications, with the complexity of serotonin pathways as an important consideration.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 11","pages":"Article 100524"},"PeriodicalIF":9.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151812","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 : 2025-09-22DOI: 10.1016/j.advnut.2025.100525
Andrea Mazzanti , Matteo Floriano , Deni Kukavica , Alessandro Trancuccio , Silvia G Priori
Long QT syndrome (LQTS) is an umbrella term for a group of genetic cardiac channelopathies characterized by prolonged ventricular repolarization and increased risk of life-threatening arrhythmias. Although β-blockers and lifestyle modifications remain central to management, specific dietary components may influence repolarization and arrhythmic risk, particularly in genetically predisposed individuals. This review summarizes mechanistic and clinical evidence on the electrophysiological effects of selected nutrients, food constituents, and supplements—including grapefruit juice, licorice, over-the-counter products, and energy drinks. Gene–nutrient interactions and their impact on ion channel function, drug metabolism, and electrolyte balance are discussed. The second part of the review outlines genotype-specific considerations, such as potassium supplementation and dietary guidance for rare forms of LQTS, including Andersen-Tawil and Timothy syndromes. Clinical data are presented in tabular format to facilitate interpretation. By integrating mechanistic and clinical data, the review aims to support dietary counseling and inform clinical decision making in the management of LQTS.
{"title":"Nutritional Factors and Arrhythmic Risk in Long QT Syndrome: A Narrative Review of Mechanistic and Clinical Evidence","authors":"Andrea Mazzanti , Matteo Floriano , Deni Kukavica , Alessandro Trancuccio , Silvia G Priori","doi":"10.1016/j.advnut.2025.100525","DOIUrl":"10.1016/j.advnut.2025.100525","url":null,"abstract":"<div><div>Long QT syndrome (LQTS) is an umbrella term for a group of genetic cardiac channelopathies characterized by prolonged ventricular repolarization and increased risk of life-threatening arrhythmias. Although β-blockers and lifestyle modifications remain central to management, specific dietary components may influence repolarization and arrhythmic risk, particularly in genetically predisposed individuals. This review summarizes mechanistic and clinical evidence on the electrophysiological effects of selected nutrients, food constituents, and supplements—including grapefruit juice, licorice, over-the-counter products, and energy drinks. Gene–nutrient interactions and their impact on ion channel function, drug metabolism, and electrolyte balance are discussed. The second part of the review outlines genotype-specific considerations, such as potassium supplementation and dietary guidance for rare forms of LQTS, including Andersen-Tawil and Timothy syndromes. Clinical data are presented in tabular format to facilitate interpretation. By integrating mechanistic and clinical data, the review aims to support dietary counseling and inform clinical decision making in the management of LQTS.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 11","pages":"Article 100525"},"PeriodicalIF":9.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139699","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 : 2025-09-19DOI: 10.1016/j.advnut.2025.100523
Serena Gandino , Tanya Cassidy , Marzia Giribaldi , Magdalena Babiszewska-Aksami , Agnieszka Bzikowska-Jura , Laura Cavallarin , Karolina Karcz , Daniel Klotz , Chiara Peila , Carolyn Smith , Bartłomiej Walczak , Aleksandra Wesolowska
When feeding at the breast is not possible, infants can still receive expressed mother’s own milk (MOM). Method of expression, hygiene practices and settings during expression, and processing can affect MOM composition. This study aimed to review current evidence on the influence of feeding MOM expressed using varying expression methods, hygiene practices or settings during expression, or treatments on the health and growth of recipient infants. We systematically searched CENTRAL, CINAHL, clinicaltrials.gov, Embase, Emcare, EU trials, Global Health, Global Index Medicus, MEDLINE, Scopus, Web of Science, and WHO for primary research studies, including observational studies, published up to March 2024 evaluating different methods of MOM expression, hygiene practices or settings during expression, and methods processing of MOM and reporting clinical outcomes on recipient infants. Key outcomes of interest were growth, mortality, morbidity, feeding tolerance, adverse events, cytomegalovirus (CMV) infection, retroviral infection, other infections, nutrient deficiencies, neurodevelopment, and breastfeeding. Qualitative thematic synthesis was conducted. An evidence gap map was produced using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Of 29,320 studies screened, 45 met the inclusion criteria. No expression method or pump type showed clear benefits for breastfeeding rates or infant growth. Three studies reported improved weight gain in infants receiving hindmilk. Evidence on the effect of processing methods on morbidity and mortality was inconclusive. Limited evidence was found on the efficacy of the freeze-thaw cycle in reducing CMV transmission, whereas pasteurization proved more effective. No studies assessed clinical outcomes related to hygiene practices or expression settings. The use of hindmilk improves infant weight gain with some certainty of evidence. Hand expression of MOM has similar efficacy to that of electric pumping on the growth of recipient infants, including preterm infants. Evidence on clinical outcomes of different MOM expression practices and treatments is very limited. This work underscores the need for future studies to address the substantial evidence gaps identified.
This study was registered at PROSPERO as CRD42024523299.
背景：当不能母乳喂养时，婴儿仍然可以接受母乳（MOM）。表达方法、表达过程中的卫生习惯和设置以及加工都会影响MOM的组成。目的：回顾目前关于不同表达方法、不同表达过程中的卫生习惯或环境、或不同治疗对受体婴儿健康和生长的影响的证据。方法：我们系统地检索了CENTRAL、CINAHL、ClinicalTrials.gov、Embase、Emcare、EU trials、Global Health、Global Index Medicus、MEDLINE、Scopus、Web of Science、WHO，检索了截至2024年3月发表的主要研究，包括观察性研究，评估了不同的MOM表达方法、表达过程中的卫生实践或设置、MOM处理和报告受体婴儿的临床结果。主要结局为生长、死亡率、发病率、喂养耐受性、不良事件、巨细胞病毒感染、逆转录病毒感染、其他感染、营养缺乏、神经发育、母乳喂养。进行了定性的专题综合。使用GRADE评估生成证据缺口图。结果：在筛选的29,320项研究中，有45项符合纳入标准。没有表达方法或泵类型显示出明显的母乳喂养率或婴儿生长的好处。三项研究报告说，接受母乳的婴儿体重增加有所改善。关于加工方法对发病率和死亡率影响的证据尚无定论。有限的证据表明冻融在减少巨细胞病毒传播方面的有效性，而巴氏杀菌被证明更有效。没有研究评估与卫生习惯或表达设置相关的临床结果。结论：使用后乳可改善婴儿体重增加，有一定的证据。手表达MOM对受体婴儿生长的影响与电抽吸相似，对早产儿母亲也是如此。关于不同MOM表达方法和治疗的临床结果的证据非常有限。这项工作强调了未来研究解决已确定的实质性证据差距的必要性。系统评价或荟萃分析的注册和注册号：该研究在PROSPERO上注册（CRD42024523299）。意义说明：以前的综述主要集中在对母乳的处理方法的影响，如表达方法，表达过程中的卫生习惯/设置，以及储存和加工处理对母乳成分的影响；然而，成分的变化并不一定对应于临床结果的变化。据我们所知，这是唯一一项评估这些做法对受体婴儿大量临床相关结果（生长、主要发病率、喂养耐受性、不良事件、病毒和逆转录病毒感染、其他感染、营养缺乏、神经发育和母乳喂养）影响的系统综述。在这种背景下，目前的工作对于确定知识差距（包括现有证据的方法局限性）和指导未来的研究非常重要。
{"title":"A Systematic Review on the Influence of Feeding Expressed Mother’s Own Milk Using Varying Expression Practices or Treatments on Health and Growth of Recipient Infants","authors":"Serena Gandino , Tanya Cassidy , Marzia Giribaldi , Magdalena Babiszewska-Aksami , Agnieszka Bzikowska-Jura , Laura Cavallarin , Karolina Karcz , Daniel Klotz , Chiara Peila , Carolyn Smith , Bartłomiej Walczak , Aleksandra Wesolowska","doi":"10.1016/j.advnut.2025.100523","DOIUrl":"10.1016/j.advnut.2025.100523","url":null,"abstract":"<div><div>When feeding at the breast is not possible, infants can still receive expressed mother’s own milk (MOM). Method of expression, hygiene practices and settings during expression, and processing can affect MOM composition. This study aimed to review current evidence on the influence of feeding MOM expressed using varying expression methods, hygiene practices or settings during expression, or treatments on the health and growth of recipient infants. We systematically searched CENTRAL, CINAHL, <span><span>clinicaltrials.gov</span><svg><path></path></svg></span>, Embase, Emcare, EU trials, Global Health, Global Index Medicus, MEDLINE, Scopus, Web of Science, and WHO for primary research studies, including observational studies, published up to March 2024 evaluating different methods of MOM expression, hygiene practices or settings during expression, and methods processing of MOM and reporting clinical outcomes on recipient infants. Key outcomes of interest were growth, mortality, morbidity, feeding tolerance, adverse events, cytomegalovirus (CMV) infection, retroviral infection, other infections, nutrient deficiencies, neurodevelopment, and breastfeeding. Qualitative thematic synthesis was conducted. An evidence gap map was produced using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Of 29,320 studies screened, 45 met the inclusion criteria. No expression method or pump type showed clear benefits for breastfeeding rates or infant growth. Three studies reported improved weight gain in infants receiving hindmilk. Evidence on the effect of processing methods on morbidity and mortality was inconclusive. Limited evidence was found on the efficacy of the freeze-thaw cycle in reducing CMV transmission, whereas pasteurization proved more effective. No studies assessed clinical outcomes related to hygiene practices or expression settings. The use of hindmilk improves infant weight gain with some certainty of evidence. Hand expression of MOM has similar efficacy to that of electric pumping on the growth of recipient infants, including preterm infants. Evidence on clinical outcomes of different MOM expression practices and treatments is very limited. This work underscores the need for future studies to address the substantial evidence gaps identified.</div><div>This study was registered at PROSPERO as CRD42024523299.</div></div>","PeriodicalId":7349,"journal":{"name":"Advances in Nutrition","volume":"16 11","pages":"Article 100523"},"PeriodicalIF":9.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115082","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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