British Journal of Nutrition最新文献

Pregnant women are exposed to various contaminants through foods, with environmental toxicants and aflatoxin (AF) being among the major food contaminants. Therefore, this review was conducted for a better perspective on the AF exposure during pregnancy or infancy, highlighting how exposure through the mother (via placenta and breast milk) and directly through infant foods ultimately affects infant health. The literature suggests that AF exposure during pregnancy may lead to maternal anaemia, premature delivery, pregnancy loss or decreased number of live births. AF crosses through the placenta and also passes through breast milk. AF exposure during pregnancy may also lead to deleterious effects on the fetus or infants such as reduced fetal growth, low birth weight, impairment of linear or long bone growth and developmental delay such as small head circumference and reduced brain size, stillbirth or fetal death. It may also have an adverse effect on some organs and organ systems, causing aberrations such as neonatal jaundice and disrupting hormone synthesis. In the Indian context, there are limited clinical studies to assess the health effects of AF exposure during pregnancy. For the first time, we have made an attempt to estimate the AF exposure by calculating the AF estimated daily intake using the empirical formulae based on several reported studies. However, more research needs to be undertaken to understand the AF exposure outcomes during pregnancy. The data presented in this review warrant more clinical studies in India on maternal AF exposure to elucidate the birth outcomes and associated infant health outcomes.

The aim of this study was to examine the potential mediating role of intuitive eating in the relationship between food insecurity and adherence to the Mediterranean diet. A total of 1039 adults aged between 20 and 64 years living in Niğde, Türkiye, were evaluated using a questionnaire. The questionnaire included items on participants' general characteristics, dietary habits, the Household Food Security Survey Module - Short Form, the Mediterranean Diet Adherence Screener and the Intuitive Eating Scale-2. Intuitive eating was found to play a partial mediating role in the relationship between food insecurity and adherence to the Mediterranean diet. Food insecurity was directly and negatively associated with adherence to the Mediterranean diet, and this association remained significant even after the inclusion of intuitive eating as a variable in the model. In conclusion, food insecurity was found to negatively affect adherence to the Mediterranean diet not only directly but also indirectly by weakening intuitive eating skills. Interventions aimed at promoting intuitive eating may help mitigate unhealthy dietary behaviours associated with food insecurity; however, improving food access and living conditions remains essential for a long-term solution.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a serious disease and increasingly prevalent in children. MASLD is associated with health consequences such as type 2 diabetes and CVD. While vitamin E is a potent antioxidant that has been proposed to improve liver function and cardiometabolic health including liver markers, lipid profile, glycaemic control and anthropometric measurements. A comprehensive search was conducted up to March 2025. Data on anthropometric measures, liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT)), glycaemic indices (fasting blood sugar (FBS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR)), lipid profiles (total cholesterol (TC), TAG, LDL-cholesterol, HDL-cholesterol) and serum vitamin E levels were extracted. Statistical analyses were performed using a random-effects model. Eleven randomised controlled trials involving 665 participants were included in this study. Vitamin E significantly reduced ALT (weighted mean difference (WMD) = -5·23 U/L; 95 % CI: -7·72, -2·75; P < 0·001) and AST (WMD = -3·00 U/L; 95 % CI: -4·59, -1·41; P < 0·001), reflecting improved liver function. It also decreased TC (WMD = -5·77 mg/dl; 95 % CI: -11·46, -0·09; P = 0·04) and HOMA-IR (WMD = -0·82; 95 % CI: -1·28, -0·37; P < 0·001), while significantly increasing serum vitamin E levels (WMD = 9·16 mg/l; 95 % CI: 3·29, 15·03; P = 0·002). No significant changes were observed in the BMI, GGT, FBS, insulin, LDL-cholesterol, HDL-cholesterol or TAG levels. Vitamin E supplementation in paediatric MASLD appears to favourably influence key liver enzymes such as ALT, AST and certain metabolic factors including TC, and HOMA-IR levels, supporting its potential role as adjunctive therapy.

Children with coeliac disease (CD) on a gluten-free diet (GFD) often have poor dietary quality (DQ). A Gluten-Free Food Guide (GFFG) was developed to address this. This pilot randomised controlled trial evaluated the impact of GFFG dietary counselling on DQ and ultra-processed food (UPF) intake in newly diagnosed CD children. Child-parent pairs were randomised to the standard of care only (CON: n 20) or the intervention (INT: standard of care + GFFG; n 20). Primary outcomes included DQ (Healthy Eating Index-Canadian) and UPF intake (NOVA classification), assessed at baseline (BL), 3 and 6 months. In INT, dietary variety scores, a subcomponent of DQ, increased between BL and 3 months (BL: 6·7 (3·3-6·7) v. 3 months: 10 (10-10); P = 0·01) and in higher variety scores than CON at 3 months (P < 0·01). Total DQ and UPF intake remained unchanged. Increased dietary variety in INT was associated with increases in dairy products (BL: 7·5 (sd 3·6) % v. 3 months: 12·4 (sd 6·7) %; P = 0·01) and unsweetened milk (BL: 2·5 (sd 2·2) % v. 3 months: 4·7 (sd 3·0) %; P = 0·01) servings, consumed as a percentage of the total food group servings. These improvements were not observed at 6 months. A greater number of INT children met the GFFG protein recommendation at 3 months (BL: 0/19 v. 3 months: 5/19; P = 0·01), with no change in CON. A single GFFG session improved short-term dietary variety and unsweetened milk intake. Ongoing work addressing the GF food environment, dietitian access and policies to improve DQ are needed.

Dietary patterns are key modifiable determinants in cardiovascular disease (CVD) prevention, accounting for over half of CVD-related deaths and disabilities. This study aimed to examine whether changes in diet quality and six predefined diet scores were associated with incident cardiovascular (CV) events over four years among secondary care cardiology patients. We conducted a secondary prospective analysis of participants aged ≥45 years from the Brazilian Cardioprotective Nutritional Program Trial, including 1,704, 1,629 and 1,286 individuals for the 12-, 24- and 36-month change analyses, respectively. The assessed diet scores included the Dietary Inflammatory Index (DII), Dietary Total Antioxidant Capacity (dTAC), overall, healthful and unhealthful Plant-Based Diet Index (PDI, hPDI, uPDI), and the modified Alternative Healthy Eating Index (mAHEI). The primary outcome was the incidence of new CV events in each follow-up period, adjudicated by the Clinical Endpoints Committee. Associations were estimated using Cox proportional hazards models, combining intervention and control groups. A total of 162 incident CVD cases occurred over a median follow-up of 3.25 years. After 36 months, improvements in mAHEI scores were inversely associated with CV event incidence in both crude (HR: 0.96; 95% CI: 0.92-0.99) and adjusted models (HR: 0.94; 95% CI: 0.89-1.00). No significant associations were found for changes in DII, dTAC, PDI, hPDI or uPDI across any time point. These findings suggest that, in individuals receiving secondary CV care, sustained improvements in diet quality, particularly those reflected by the mAHEI, may require longer periods to translate into measurable benefits for cardiovascular health.

Although metabolic syndrome (MetSyn) patients are frequently reported to experience alterations in ghrelin levels, appetite regulation and mood, these issues have been largely overlooked. Thus, the present randomised controlled trial (RCT) examined the effects of incorporating brown rice bran powder (BRBP) into a standard diet on ghrelin levels, appetite control, depression, insulin resistance and atherogenicity indices. This secondary analysis used data from our 8-week RCT involving forty-three MetSyn patients, with nineteen on a standard diet and twenty-four receiving an additional 15 g/d of BRBP. Serum ghrelin levels were measured using an ELISA kit, and seven atherosclerosis-related indicators were assessed before and after the intervention. Appetite rating and depression status were evaluated using a four-component visual analogue scale (VAS) and the Beck Depression Inventory (BDI) questionnaires. The ANCOVA model adjusted for baseline values (and BMI for ghrelin) indicated that patients receiving BRBP plus the standard diet experienced significant increases in ghrelin levels and feelings of satiety and fullness compared with those on the standard diet alone (P-value < 0·008; effect sizes (ES) of 0·95, 1·14, and 1·34, respectively). BRBP intake led to significant reductions in atherogenic coefficient, Castelli risk index-II, cholesterol index, metabolic score for insulin resistance, BDI scores, and hunger sensations (P-value ≤ 0·05; ES of -0·94, -0·96, -0·81, -1·74, -0·98 and -0·71, respectively) compared with the standard diet alone. Overall, this secondary analysis of the RCT supports the efficacy of BRBP administration in enhancing ghrelin levels while reducing appetite-related indices, depression scores, as well as markers of atherogenicity and insulin resistance. Nevertheless, given the study's limitations, namely small sample size and lack of a placebo, further research is needed.

Ultra-processed foods (UPF) are often energy dense and low in nutrients. High consumption of UPF has been associated with non-communicable diseases, premature mortality and environmental impacts. The objective of this study was to assess UPF consumption in relation to diet quality and associated greenhouse gas (GHG) emissions, previously not examined in Iceland. Data from the Icelandic National Dietary Survey (2019–2021, n 822) were utilised. The NOVA classification system was used classifying all food and drinks reported. Dietary GHG emissions were quantified using an open-source life cycle assessment database. On average, 45 %±15 of the total calories consumed daily were derived from UPF, ranging from 24 % in the lowest quartile (UPFQ1) to 64 % in the highest quartile (UPFQ4). The energy contribution of UPF considered to fall within the Icelandic dietary guidelines was 4 %±4. UPFQ4 had significantly lower consumption of, e.g. red meat, fruits, vegetables and whole grains and higher consumption of, e.g. refined grains, sweets and soft drinks, compared with UPFQ1. UPFQ4 had a significantly higher energy intake, added sugar intake and lower intake of, e.g. proteins and iodine. The median (interquartile range (IQR)) share of dietary GHG emissions was 21 % (IQR: 11–34) of total kg CO₂-eq/d, while significantly lower in UPFQ4 compared with UPFQ1. Almost half of the daily energy intake of Icelandic diets was derived from UPF, reflecting relatively poor diet quality. However, dietary GHG emissions were relatively low in high consumers of UPF, reflecting higher meat consumption in low consumers of UPF. Findings underline the urgency of policy implementation, aligning food consumption with dietary guidelines.

Nutritional status has been compromised by ongoing war and restrictions on food deliveries in the Gaza Strip. We developed a mathematical model that outputs retrospective estimates and scenario-based projections of acute malnutrition prevalence among children given caloric intake and other factors. We present here the model and its application to the crisis in Gaza. We extended an existing mechanistic model for weight change as a function of energy balance, calibrating it to represent variability in growth curves observed in pre-war Gaza. We simulated open cohorts of children exposed to time-varying caloric intake, infant exclusive breast-feeding prevalence, incidence of infectious disease and coverage of malnutrition treatment, while allowing for adult caloric sacrifice to supplement child intake in times of food scarcity. The model accurately replicates growth standards, pre-war growth patterns and expected parameter dependencies. It suggests that a considerable increase in acute malnutrition occurred in northern Gaza during early 2024. Projections for late 2024 include a serious nutritional emergency if relatively pessimistic assumptions are made about food availability. The model may hold considerable promise for informing decisions in humanitarian response but requires further validation and development.