British Journal of Nutrition最新文献

Skinfold callipers are used internationally in research, clinical and field settings to assess body composition and nutritional status. Notably, currently available instruments differ in important specificities that impact measurement. In this sense, this report proposes a methodological approach that organises skinfold callipers into three categories (Original, Generic and Hybrid) and three configurations (Type A, Type B and Type C) based on physical-mechanical properties and characteristics. Therefore, this concept provides technical support for choosing the most appropriate skinfold calliper in different contexts.

Nutraceuticals are increasingly of interest in nutritional psychiatry, where creatine has been investigated in several randomised trials for its effects on depressive symptoms. However, these findings have not yet been systematically synthesised. We conducted a systematic review to assess the effects of creatine supplementation on symptoms of depression. Four databases were searched up to February 2025 for trials comparing creatine with placebo in individuals with or without depression. Study selection, data extraction and risk of bias assessment (RoB 2) were conducted independently, and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Random-effects meta-analyses with Hartung-Knapp-Sidik-Jonkman adjustment including eleven trials (1093 participants) found a standardised mean difference of -0·34 (95 % CI -0·68, -0·00; GRADE: very low quality of evidence), equivalent to 2·2 points on the seventeen-item Hamilton Depression Rating Scale, below the minimal important difference of 3·0 points. CI include non-clinically important effects, and heterogeneity was substantial (I² = 71·3 %). While effects appeared larger in clinically depressed populations, subgroup analyses and trim-and-fill adjustments indicated substantial bias favouring creatine. Results for secondary endpoints were significant for remission (three trials, OR 3·60; 95 % CI 1·76, 7·56), but not for treatment response (two trials, OR 0·72; 95 % CI 0·28, 1·88). Our findings suggest that creatine may offer a small-to-moderate benefit for individuals with depression, but average effects were not clinically important and the true effect may be trivial or null. The evidence on which these results are based is very uncertain. Larger, more rigorous randomised trials are required to draw definitive conclusions.

Shift work-induced circadian disruption has been linked to various cardiometabolic diseases, including obesity, diabetes and CVD. Limited studies have explored the impact of different variables such as night work durations, intensities and chronotype on cardiometabolic risk. This study aimed to determine the impact of circadian disruption on cardiometabolic risk markers in shift workers. This case-control study was conducted with 104 male workers (shift workers; n 52, mean age; 43·3 (sd 10·2), and non-shift workers; n 52, mean age; 41·2 (sd 9·8)). Shift work details were determined via an interviewer-administered questionnaire. Cardiometabolic risk was evaluated through anthropometric (height, weight, waist circumference and body composition), biochemical (fasting glucose and lipid profile), clinical (blood pressure) and dietary assessment (24-h recalls from working and non-working days). The chronotype was determined via the Munich Chronotype Questionnaire (MCTQ). Shift workers had significantly higher mean body fat percentage (31·7, 22·7 % P = 0·031), systolic blood pressure (SBP) (138·6, 128·5 mmHg P = 0·009), pulse rate (78·7, 72·3 bpm P = 0·015), TAG (1·60, 1·30 mmol/l P = 0·021) and LDL-cholesterol (3·90, 3·40 mmol/l P = 0·012) than non-shift workers. Evening chronotype shift workers had significantly higher visceral fat levels (12·8, 8·90 P = 0·001), SBP (137·0, 127·6 mmHg P = 0·006), pulse rate (82·7, 73·3 bpm P = 0·005) and LDL-cholesterol (4·00, 3·40 mmol/l P = 0·039) than shift workers with a morning chronotype. In conclusion, shift workers exhibited higher metabolic risk markers than non-shift workers. Shift workers with evening chronotypes had higher cardiometabolic risk than morning chronotypes. Further research is warranted to elucidate the underlying mechanisms and inform targeted interventions for individuals engaged in shift work, considering chronotypes.

Inadequate eating habits in adolescence are an important risk factor for obesity and other chronic non-communicable diseases in adulthood. The school environment can have a relevant impact on adolescent behaviour, since many habits acquired in this phase affect the individual throughout life, with visible effects on health. In this study, we aimed to evaluate the association between food sales at Brazilian schools and ultra-processed food consumption among adolescents. The Study of Cardiovascular Risk Factors in Adolescents (ERICA) was a nationwide, school-based survey conducted from 2013 to 2014, including public and private schools in 121 Brazilian cities. Dietary intake was assessed via a 24-h recall, and foods were divided according to the Nova classification based on the degree of processing. Unadjusted and adjusted linear regression models were used to assess the association between exposure to school food sales and intake of ultra-processed food. The prevalence of exposure to food sales was 55·2 %, and the mean diet share of ultra-processed foods was 34·5 %. Exposure to food sales in schools was associated with higher consumption of ultra-processed food (β = 0·11; P = 0·002). The results were similar when the analyses were stratified according to sex, usual intake of school meals and public school attendance (β = 0·11; P = 0·002). The association between exposure to food sales in schools and higher consumption of ultra-processed food suggests that school sales can influence adolescents' food choices.

Nutrition plays a key role in shaping children's eating behaviours, which can be influenced by environment and social interactions, making careful management essential at home and school. This cross-sectional study aimed to evaluate the perceptions of caregivers in these settings regarding the consumption and eating behaviours of children aged 3-6 years. Food preferences and frequency questionnaires were administered to children, and their teachers and caregivers, supplemented by free drawing and colouring activities. The results revealed discrepancies between parents and teachers, with parents recognising the importance of fruits and vegetables for health and reporting that children have access to these foods at home. Although parents recognised the importance of vegetable consumption, teachers did not share this perception, as they observed limited access to these foods among children and even reported difficulties in introducing them into the school environment. The most consumed foods during main meals were rice, beans, vegetables and meats, while fruits and dairy products were predominant in breakfast and snacks. Children frequently mentioned fruits such as watermelon, strawberry, and apple using free drawing and colouring activities. These findings highlight significant differences in perceptions between parents and teachers regarding children's access to healthy foods, underscoring the need for improved communication to promote healthier eating habits.

Dietary phytosterols exert hypocholesterolemic effects by inhibiting cholesterol absorption in the small intestine. However, oxidised phytosterols exert harmful effects. In this study, we compared the effects of dietary stigmasterol or oxidised stigmasterol (OS) on cholesterol absorption and metabolism in mice. Institute of Cancer Research (ICR) male mice were fed one of the following diets: a standard American Institute of Nutrition (AIN) diet; the standard diet plus 0·25 % cholesterol; the standard diet plus 0·25 % cholesterol and 0·25 % stigmasterol or the standard diet plus 0·25 % cholesterol and 0·25 % OS. Stigmasterol, but not OS, decreased plasma total cholesterol levels. Unlike stigmasterol, dietary OS increased the cholesterol levels in micellar solutions. Thus, OS could not exert hypocholesterolemic effects as it could not displace cholesterol in micellar solutions. In contrast, dietary OS downregulates the mRNA expression of genes involved in cholesterol synthesis and upregulates the mRNA expression of genes involved in cholesterol catabolism in mice fed cholesterol. In addition, dietary stigmasterol and OS increased the levels of faecal-neutral steroids by downregulating the mRNA expression of Niemann-Pick C1-like 1 protein (NPC1L1) in the small intestine. Dietary stigmasterol may directly regulate the mRNA expression of NPC1L1, whereas dietary OS may reduce the mRNA expression of sterol regulatory element-binding protein 2 and act as a Liver X receptor α agonist, reducing the mRNA expression of NPC1L1. Therefore, OS may affect cholesterol absorption and metabolism through a mechanism different from that of stigmasterol.

Obesity is characterised by chronic low-grade inflammation, which is a key factor in the development of obesity-related co-morbidities. Intake of n-3 long-chain PUFAs is associated with anti-inflammatory effects. Recent studies suggest that also n-11 long-chain MUFAs may reduce the concentrations of inflammatory markers, possibly by increasing the biosynthesis of EPA. The primary aim was to investigate if diets added herring oil containing cetoleic acid (CA, C22:1n-11) or a CA concentrate (CECO) affected the fatty acid composition in tissues from obese rats with chronic inflammation. Secondary aims included investigating the effects on inflammatory markers. Thirty male obese Zucker fa/fa rats were fed diets containing herring oil (HERO) or a CECO, containing 0·70 or 1·40 wt% CA, respectively, with a comparable content of EPA (0·17 and 0·20 wt%, respectively), or a control diet with soyabean oil for 5 weeks. Data were analysed using one-way ANOVA. CA from HERO and CECO diets were recovered in liver, adipose tissue, muscle and blood cells. The EPA concentration was similar between HERO and CECO groups in tissues, whereas the hepatic concentrations of fatty acid desaturases were lower or similar to Controls. The concentrations of TNFα, matrix metalloproteinase-3, IL6, monocyte chemotactic protein 1 and integrin α M in adipose tissue, and the hepatic concentration of CD68 were lower after CECO intake but were not affected by the HERO diet. To conclude, rats fed the CECO diet had lower concentrations of inflammatory and macrophage infiltration markers, but this effect was probably not mediated through increased EPA biosynthesis.

Sepsis affects 50 million people globally, contributing to 20 % of all deaths and significantly increasing healthcare costs due to intensive care needs. Although the role of n-3 fatty acids in reducing sepsis mortality remains debated, recent studies suggest their potential in modulating immune responses and improving outcomes. This umbrella review aims to clarify the benefits of n-3 supplementation on mortality rate, length of intensive care unit (ICU) stays and days on mechanical ventilation in patients with sepsis. Following Cochrane and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodologies, a systematic search was conducted across multiple databases up to February 2025. After independent screening, data extraction and critical appraisal, meta-analyses were reassessed using the DerSimonian and Laird model. Evidence was graded using the GRADE approach, categorising outcomes based on strength and quality. A comprehensive search identified 934 records, of which thirty-four randomised controlled trials (RCT) from twenty-one systematic reviews and meta-analyses focused on n-3 supplementation in sepsis patients. n-3 significantly reduced mortality (risk ratio: 0·79, 95 % CI 0·69, 0·90), length of ICU stays (mean difference (MD): -3·6 d, 95 % CI -4·39, -2·81) and ventilation days (MD: -2·86 d, 95 % CI -4·46, -1·26). Parenteral nutrition showed slightly better outcomes than enteral nutrition, and EPA and DHA provided superior results compared with mixed oils. These findings suggest n-3 supplementation could improve mortality, ICU stays and ventilator dependency in patients with sepsis. However, the certainty of the evidence ranges from low to very low, emphasising the need for further high-quality RCT to validate these benefits. Also, clinicians should prescribe n-3 supplements cautiously in this regard.

The objective of this study was to evaluate the impact of incorporating group-based nutritional education into usual care on adherence to nutritional counselling among outpatients with type 2 diabetes (T2DM). This parallel-group, randomised controlled superiority trial was conducted with outpatients diagnosed with T2DM and poor glycaemic control. The control group received individual usual care, while the intervention group received usual care plus group-based nutritional education, which included three sessions: 'Let's Go Shopping,' 'Healthy Plate' and 'Hunger and Satiety.' Baseline and four-month follow-up assessments were conducted, and outcome measures included adherence to nutritional counselling, glycaemic control, weight and physical activity. A total of 213 participants were included: 61·9 % were women, aged 60 years (interquartile range (IQR) = 53-65), 67·6 % with low socio-economic status, 67·3 % had obesity and the glycated Hb (HbA1c) was 9·3 % (IQR = 8·3-10·2 %). The intervention did not result in superior glycaemic control; however, short-term reductions in HbA1c were observed across all participants (-0·3 % (IQR = -0·7-0·3 %)). The intervention group demonstrated an increase in physical activity levels between visits (262 metabolic equivalent tasks (IQR = 99-257); P = 0·038), but no significant difference between the groups. Participants in the intervention group adhered to 67 % of combinations, compared with 50 % in the control group (P = 0·012), and adherence to the diabetes plate method was significantly higher in this group (75·9 % v. 62·2 %; P = 0·05). In conclusion, no significant between-group differences in glycaemic control were found, although both groups improved HbA1c short-term. Group-based nutritional education increased dietary adherence, particularly to the diabetes plate method and physical activity. Long-term effects on metabolic outcomes warrant further study.

This population-based cross-sectional study investigated the complex interplay of factors influencing high ultra-processed food (UPF) consumption among Brazilian adolescents using a hierarchical socio-ecological model. Data from 100 028 adolescents (13-17 years) enrolled in public and private schools nationwide were collected via self-administered questionnaires from the 2019 National School Health Survey. High UPF consumption was defined as ≥ 7 subgroups consumed on the previous day based on the NOVA classification. Poisson regression adjusted for complex sampling and hierarchical structure identified prevalence ratios (PR) for associated factors. High UPF consumption was significantly associated with younger age (PR = 1·22; 95 % CI 1·11, 1·34), regular breakfast consumption (PR = 1·32; 95 % CI 1·23, 1·42), regular screen time during meals (PR = 1·36; 95 % CI 1·27, 1·45), frequent UPF purchases at and around school (PR for canteen: 1·57; 95 % CI 1·43, 1·72; street vendors: 1·71; 95 % CI 1·55, 1·89), higher maternal education (PR 1·23, 95 % CI 1·12, 1·36) and lower parental supervision (PR 1·34, 95 % CI 1·11, 1·62). Living in the South (PR 1·50, 95 % CI 1·34, 1·69), Southeast (PR 1·30, 95 % CI 1·17, 1·44) and Midwest regions (PR 1·21, 95 % CI 1·09, 1·34) also correlated with higher consumption. Conversely, high body satisfaction and attending private school showed an inverse association. These findings underscore the intricate, multilevel influences on UPF consumption among Brazilian adolescents. Integrated interventions, spanning schools, family environments and public policies are crucial for promoting healthier eating habits and preventing obesity in this vulnerable population.