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Appetite

Elsevier BV

Preprints posted in the last 30 days, ranked by how well they match Appetite's content profile, based on 14 papers previously published here. The average preprint has a 0.01% match score for this journal, so anything above that is already an above-average fit.

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Adolescent food insecurity impairs gut signal sensitivity and cue-induced appetitive behaviours in female rats

Livermore, A.; Ong, Z. Y.

2026-05-04 animal behavior and cognition 10.64898/2026.04.29.721762 medRxiv
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Unpredictable and insufficient access to food, known as food insecurity, is associated with the development of obesity. However, causal mechanisms underlying this paradoxical relationship remain poorly understood. Using a rat model of food insecurity, this study investigated whether food insecurity causes dysregulated feeding behaviours, specifically impaired gut signal sensitivity and enhanced cue-driven appetitive responses. Adolescent female rats were assigned to receive either ad libitum chow access (Food secure), 90% caloric restriction (Food restricted) or unpredictable quantity and timing of food access (Food insecure), for 4 weeks. After which, rats were returned to an ad libitum chow diet for the remainder of the study. To examine gut signal sensitivity, we measured the effects of cholecystokinin (CCK) on 10% sucrose intake. To examine cue-driven feeding behaviours, we used Pavlovian appetitive conditioning and measured appetitive responses towards a food-predictive cue. Results showed that prior food insecure rats were less sensitive to the intake inhibitory effects of CCK and exhibited enhanced cue-induced appetitive behaviours, when compared to food secure and food restricted groups. Anxiety-like behaviours or learning and memory was not different between groups. At the end of the study, adolescent caloric restriction resulted in reduced fat mass, plasma leptin levels and body weight when compared to food secure, but not food insecure rats, suggesting that adolescent food insecurity somewhat overcame these metabolic effects. Taken together, our findings suggest that adolescent food insecurity impaired gut signal sensitivity and heightened food cue sensitivity, which may cause enduring metabolic and behavioural adaptations that promote overeating and weight gain.

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A tool for assessing changes in food preferences and health perceptions during nutritional interventions

Bar Or, M.; Vinegrad, N.; Menashe Auman, S.; Liberty, I. F.; Schonberg, T.

2026-05-07 nutrition 10.64898/2026.05.06.26352307 medRxiv
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Understanding how nutritional interventions alter food evaluations may help clarify mechanisms of dietary behavior change; however, most studies focus on intake outcomes and rarely assess within-person changes in subjective food evaluation. We developed a brief, image-based rating tool that measures two core dimensions of food evaluation, liking and perceived healthiness, using standardized food images. The tool was piloted in adults with type 2 diabetes participating in a medically supervised intervention that included structured glucose monitoring and professional dietary guidance. Ratings were collected at baseline, post-monitoring, and follow-up. In line with the methodological aim of this study, we examined whether the tool demonstrates internal coherence, sensitivity to change, and external validity against expert ratings and physiological measures, and whether it can capture item-level patterns relevant to eating behavior. Results provide preliminary evidence that the tool is feasible, it is low-burden, and capable of detecting coherent relationships between food liking and health perceptions, including coordinated within-person changes over time and meaningful associations with external benchmarks. To support scalability and self-administration, we also developed an online smartphone-based demonstration version to exemplify the task structure and user experience. Overall, this pilot study suggests that a short, flexible rating task can serve as a practical measurement tool for tracking intervention-relevant changes in food evaluation and for informing the design of future nutritional interventions.

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Dynamics of feeding behaviour and meal patterning in protein-restricted mice

Taghipourbibalan, H.; McCutcheon, J. E.

2026-05-11 neuroscience 10.64898/2026.05.07.723245 medRxiv
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Of the three dietary macronutrients, protein plays an especially pivotal role in physiological functions. Nevertheless, the behavioural control of protein intake is poorly understood. In this study, we used Feeding Experimentation Devices (FED3s) to examine the structure of ingestive behaviour in mice given access to diets varying in protein content. Adult C57BL/6NRj mice were contact-housed in pairs in custom-made cages with perforated dividers, each having access to an individual FED3 unit. Mice were given ad libitum access to either 20 mg control, non-restricted (NR) pellets (20% casein) or 20 mg protein-restricted (PR) pellets (5% casein) from FED3s on free-feeding mode. Each pellet retrieval event was timestamped ~24 h/day. All mice experienced both diets for 7 days with order of diet presentation counterbalanced (i.e., NR[->]PR and PR[->]NR). Analysis of dynamics of pellet intake per day revealed that mice that were initially protein-restricted first showed a decrease in pellet intake before increasing on later days and exhibiting a persistent high level of intake once non-restricted diet was available. The group that was initially non-restricted exhibited a blunted response to the same diet manipulation. In addition, we clustered pellet retrieval data into discrete clusters of feeding events and used a mathematical approach to determine the boundary of meals (2-5 pellets), separated from "snacks" (1 pellet) and "feasts" (>5 pellets). We identified alterations in meal patterning in response to diet manipulation with protein restriction increasing "snacking" and leading to increased meal number, and reduced meal size. Moreover, restored access to NR diet, elicited "feasting". These effects depended on the sequence of diets the mice experienced, such that the effects were stronger in initially protein restricted mice compared to those initially non-restricted. In summary, our findings show that manipulation of dietary protein levels affects meal patterning in adult mice.

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Early indicators of child obesity to aid future clinical trials for lifecycle obesity prevention

Wang, C. A.; Connor, K. L.; Mohammadkhani, S.; Lye, S. J.; Mori, T. A.; Beilin, L. J.; Pennell, C. E.

2026-05-18 pediatrics 10.64898/2026.05.13.26353150 medRxiv
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Background: 39M children worldwide are overweight or have obesity, accelerating risk for adult non-communicable diseases. Presently, interventions to prevent obesity have had limited success due to poor timing and lack of personalisation. Objective: We aimed to identify early-life predictors of childhood obesity (ChOB) that could aid targeting specific population subsets for obesity prevention interventional studies. Methods: Data were from the Raine Study Gen2 participants (n=1494). Anthropometric and genetic predictors evaluated included birthweight (BW), early-life BMI (1-3 years), and three polygenic scores (PGS) [two BW-PGSs (BW-PGS2016 and BW-PGS2019) and a ChOB-PGS], developed from BW and ChOB genome-wide-association-studies, respectively. Multivariate analyses were performed to investigate associations between predictors and child-BMI (5-, 8-, 10-years). Results: BW-PGS2019 associate with child-BMI at 5-years. BW-PGS2016 was not associated with child-BMI. Remaining predictors positively associate with child-BMI at 5-, 8- and 10-years (p<0.001). Early-life BMI, ChOB-PGS and BW accounted for up to 38.7%, 5.8% and 3.4% of the variability in child-BMI, respectively. Conclusions: Our data suggest early-life BMI is a better predictor of child-BMI than ChOB-PGS, and BW, accounting for up to ten-fold more variance in child-BMI. Future interventional studies to mitigate obesity could target early-life BMI as a marker to identify children at the highest risk.

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Early economic modelling of a new pharmacotherapeutic treatment pathway for children with monogenic obesity

Dixon, P.; Stewart, H.; Onyimadu, O.; Lim, D. B.; Davis, N.

2026-05-17 health economics 10.64898/2026.05.13.26353098 medRxiv
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Background Early onset obesity in children, almost always accompanied by significant health complications, may be driven by rare genetic variants that influence appetite, metabolism, and nutrient absorption. Traditional treatment approaches are usually insufficient for those with monogenic obesity of this type. Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and related drugs such as melanocortin 4 receptor agonists, have emerged as promising first-line treatments for severe obesity. There is no established protocol or pathway in England for identifying children with monogenic obesity who could benefit from these and similar treatments Methods We undertook early economic modelling to examine the cost-effectiveness, from a health service perspective, of implementing a new pharmacotherapeutic care pathway for the identification and treatment of monogenic obesity in children. We modelled a hypothetical population of children with hyperphagia and body mass index (BMI) three standard deviations above mean values for age and sex. We evaluated the clinical decision to initiate the pathway using a decision tree model with patient quality-adjusted life years (QALYs) and NHS healthcare costs 12 months from an initial clinic visit as outcomes, and calculated incremental cost effectiveness ratios and a cost-effectiveness acceptability curve. Results Both costs and QALYs were higher under further investigation (GBP3,247 and 0.47 QALYs) compared to no further investigation (GBP1,589 and 0.24 QALYs). The incremental cost-effectiveness ratio in the base case was GBP7,133 per QALY. Further examination of these children was therefore likely to be cost effective in this model. Conclusion A decision-tree model suggested that further investigation of severely obese children potentially eligible for treatment with semaglutide is likely to be cost-effective for the NHS. However, this result is associated with uncertainty arising from a lack of evidence for many key model parameters.

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A Personalized Whole-Food Diet Differentially Modulates Glucoregulatory and Cognitive Responses Compared With Conventional Dietary Counseling in Young Black and White Adults With Overweight or Obesity: An 8-Week Randomized Controlled Trial

Ani, O.; Rabbani, E.; Dhillon, J.

2026-05-29 nutrition 10.64898/2026.05.27.26354244 medRxiv
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Background: Black adults bear a disproportionate burden of cardiometabolic dysfunction, yet most dietary trial evidence comes from predominantly White cohorts. Objective: To evaluate whether a personalized whole-food dietary intervention improves cardiometabolic outcomes more in Black than White young adults with overweight or obesity. Methods: In this 8-week randomized, controlled trial (ClinicalTrials.gov: NCT04635917), 112 Black and White adults (18-35 years; BMI 25-45 kg/m2) were block-randomized by race to a personalized dietary intervention providing whole foods (PD, n=57) or conventional dietary counseling at baseline (BL) using MyPlate guidelines (CD, n=55). Primary outcomes were Matsuda Index and fasting and OGTT-derived glucose, insulin, and non-esterified fatty acids. Other glucoregulatory, cardiovascular, anthropometric, appetite, and cognitive outcomes were also assessed. Outcomes were analyzed using baseline-adjusted linear models with sensitivity analyses adjusting for baseline BMI and food security score. Results: Compliance with study food consumption was 85-91%. Diet quality was higher in PD than CD (P < 0.05), with larger gains in vegetable-related outcomes among Black participants (group x race, P < 0.05). HOMA-{beta} was lower in PD than CD overall (P < 0.05). In sensitivity analyses, Black PD participants had greater fasting insulin reductions than White, especially in the latter half of intervention (week x group x race, P < 0.05), with a similar tendency for HOMA-IR. Glucose AUC 0-30 min was higher in White than Black PD participants (group x race, P < 0.05). Concentration performance was higher in PD than CD overall (P < 0.05), with larger gains in processing speed and accuracy among Black than White participants (group x race, P < 0.05). No effects were observed for cardiovascular or appetite outcomes. Conclusions: The personalized whole-food intervention produced differential effects in fasting insulin and early-phase glucose handling, and greater benefits in attention, in Black compared with White young adults with overweight or obesity during weight maintenance.

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Diet-dependent effects of kombucha on the gut microbiome and its neuroactive potential: Associations with reduced anxiety and depressive-like behaviors in mice

Huma, N. E.; Davison, S.; Guse, K.; Walls, C.; Rutschke, S.; Sackett, A.; Blanco, G.; Zhang, J.; Chen, C.; Damian, J. P.; Faulk, C.; Gomez, A.

2026-05-12 microbiology 10.64898/2026.05.07.718715 medRxiv
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Fermented foods are increasingly recognized for their health-boosting potential, yet the mechanisms involved are not fully resolved. Here, we tested whether kombucha reshapes the gastrointestinal microbiome and whether these changes are associated with stress-related behaviors under contrasting dietary backgrounds. Male C57BL/6 mice were fed either a total Western diet (TWD) or a control diet (CTRL) supplemented with kombucha or water three times weekly for seven weeks. Depressive-like and anxiety-related behaviors were evaluated using the forced swimming (FST) and marble burying tests (MBT). Ileum, cecum, and colon microbiomes were profiled via 16S rRNA, ITS2, and shotgun metagenomics, while feces and whole brains were profiled by LC-MS metabolomics. Serum cytokines were measured by ELISA. Results highlight diet-dependent effects of Kombucha on behavioral, microbial and metabolic outcomes. Kombucha reduced immobility in the FST under both diets, whereas fewer marbles buried were observed only under TWD. Kombucha intake enriched Bifidobacterium pseudolongum in the ileum under CTRL and TWD diets, while cecal microbial functions related to amino acid metabolism were stimulated mainly under CTRL. Only CTRL mice receiving kombucha showed higher fecal acetate and butyrate together with lower fecal levels of neurochemically relevant amino acids, including glutamine, phenylalanine, tryptophan, and tyrosine. Under TWD, kombucha was associated with lower spleen weight and altered brain tryptophan/kynurenine profiles. These findings identify kombucha as a food intervention that can remodel gastrointestinal microbial and neuroactive metabolism in a diet depending manner. Associations with reduced depressive and anxiety-related behaviors are promising but warrant further exploration. Key HighlightsO_LIKombucha supplementation reshaped the mice gastrointestinal microbiome and its neuroactive potential C_LIO_LIKombucha intake was associated reduced depressive and anxious like behaviors C_LIO_LIThe potential of kombucha to modulate microbial, metabolic and behavioral outcomes may be dependent on subject dietary background C_LI

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Low-Cost Precision Nutrition Recommendations, Generated by Metataxonomy-based Microbiome Tests, Improve Food Group Choices and Gut Health Indicators in a Population with Obesity Diagnosis in Colombia

Caro-Miranda, V.; Blel-Jubiz, S.; Adarve-Rengifo, I.; Londono-Osorio, S.; Arrieta-Echeverri, M. C.; Gomez-Mesa, L.; Serna-Tangariffe, J. D.; Munoz, A.; Zapata, C. A.; Sierra-Zapata, L.

2026-05-04 genetic and genomic medicine 10.64898/2026.04.28.25331845 medRxiv
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AimsThis study aimed to explore the relationship between gut microbiota composition, obesity, and the effects of a dietary intervention in 50 participants with obesity diagnosis from Antioquia, Colombia. MethodsA single-blind intervention study was conducted, with 25 participants assigned to a control group (CG) and 25 to an intervention group (IG), these last followed a microbiota-enhancing dietary plan for 90 consecutive days. Gut microbiota changes were assessed by sequencing region V3-V4 of 16S rRNA gene and applying the analytical methodology of Biomatest(R) gut health index. Blood biomarkers, including HbA1C, cholesterol, HDL, LDL, triglycerides, and glucose, were measured at baseline and post-intervention. ResultsPrevotella and Succinivibrio were prevalent in the study population. The IG showed significant increases in gut microbial diversity (Shannon index) from baseline to post-intervention. Both groups exhibited significant changes in the Biomatest gut health index, with significant improvements in the IG. Significant correlations were found between dietary intake, blood biomarkers, and microbial abundances, such as the direct association between serum glucose and ultra-processed food intake and between total cholesterol and Dialister. Fish and seafood consumption correlated positively with Akkermansia, while egg intake was associated with higher levels of Desulfovibrio, and Lactobacillus with decreased glycated hemoglobin. The IG experienced a significant rise in Roseburia, a gut health biomarker, while the CG showed higher levels in inflammatory groups like Fusobacteriota. ConclusionsDietary intake significantly influences gut microbiota composition and blood biomarkers. Nutritional programs that improve gut microbiota, as demonstrated by the IG, positively impact gut health in people with obesity diagnosis and may influence healthier dietary choices. These findings support integrating microbiota diagnostics into personalized nutrition strategies, contributing valuable data on Latin American populations. O_FIG O_LINKSMALLFIG WIDTH=195 HEIGHT=200 SRC="FIGDIR/small/25331845v1_ufig1.gif" ALT="Figure 1"> View larger version (48K): org.highwire.dtl.DTLVardef@1652035org.highwire.dtl.DTLVardef@25a04borg.highwire.dtl.DTLVardef@3ed98corg.highwire.dtl.DTLVardef@3caedf_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Impact of preoperative thyroid status on BMI change after lifestyle intervention and bariatric surgery: Results from the OBESEPI cohort

Nomine-Criqui, C.; Bihain, F.; Bachelin, L.; Scheyer, N.; Brunaud, L.; Meyre, D.

2026-05-04 surgery 10.64898/2026.04.30.26352121 medRxiv
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BackgroundObesity is a chronic multifactorial disease characterized by substantial interindividual variability in weight loss after lifestyle intervention and bariatric surgery. Thyroid hormones play a key role in energy homeostasis, but their influence on postoperative weight outcomes remains insufficiently studied. ObjectiveTo evaluate the association between preoperative thyroid status and changes in body mass index (BMI) after lifestyle intervention and bariatric surgery over a five-year follow-up. MethodsWe conducted a retrospective cohort study including adults with class II or III obesity enrolled in the Obesite Severe et Epigenetique (OBESEPI) study. All participants underwent preoperative lifestyle intervention followed by bariatric surgery. Thyroid status was classified as euthyroid or hypothyroid based on clinical and biochemical criteria. BMI was assessed at baseline and at nine postoperative time points over five years. ResultsAmong 435 included patients, 71 (16.8%) had hypothyroidism. Baseline BMI was similar between groups, whereas diabetes was more frequent in hypothyroid patients (52.1% vs 37.7%; p = 0.022). Hypothyroid patients had significantly higher BMI at 6-24 months after surgery, but differences were no longer significant beyond three years. BMI trajectories and magnitude of weight regain were comparable between groups. Higher preoperative TSH levels were independently associated with BMI regain (OR 1.32, 95% CI 1.00-1.72; p = 0.047). Higher baseline BMI, younger age, and female sex were also associated with greater BMI regain. ConclusionsHypothyroidism was associated with lower early postoperative weight loss but did not influence long-term BMI trajectories. Higher preoperative TSH levels were independently associated with BMI regain. KEYPOINTSO_LIPreoperative hypothyroidism is associated with reduced early weight loss during the first two years after bariatric surgery. C_LIO_LILong-term BMI trajectories and weight regain patterns are similar between hypothyroid and euthyroid patients beyond three years of follow-up. C_LIO_LIHigher preoperative TSH levels independently predict BMI regain. C_LIO_LIBaseline BMI, younger age, and female sex remain key determinants of the magnitude of BMI regain after bariatric surgery. C_LI

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Biased signaling at NTSR1 differentially regulates inhibitory synaptic transmission in the extended amygdala and suppresses motivated feeding in mice

Sizer, S. E.; Brown, A. R.; Anderson, J. K.; Summerlin, A. E.; Girgis, I.; Olson, S.; Slosky, L. M.; Leinninger, G. M.; McElligott, Z. A.

2026-05-05 neuroscience 10.64898/2026.04.30.722083 medRxiv
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Maladaptive consummatory behaviors can arise from dysregulated circuits, like the extended amygdala that governs motivation and feeding. Neurotensin (NTS) is expressed throughout the central, peripheral, and enteric nervous systems with well-established roles in energy balance and feeding. SBI-553, a {beta}-arrestin-biased allosteric modulator of NTSR1, recruits {beta}-arrestin while attenuating Gq-mediated signaling. We used SBI-553 to examine NTS modulation of extended amygdala GABAergic signaling, and probed its effects on food consumption in mice. Ex vivo, we found that NTS and SBI-553 differentially modulates GABAergic neurotransmission across extended amygdala subregions. In vivo, SBI-553 reduces palatable food consumption in both fed and food-deprived mice, with greater reductions under fasted conditions. SBI-553 alters activation across CeA subregions in a sex- and feeding-state-dependent manner: SBI-553 increases cFos immunofluorescence in the CeAL and CeAC, but not the CeAM. This work supports neurotensinergic modulation as a compelling target for further investigation into the neural substrates of consummatory behaviors. HighlightsO_LINTS enhances GABAergic transmission in the CeAL and the ovBNST C_LIO_LISBI-553 blocks NTS-induced modulation in the CeAL but not in the ovBNST C_LIO_LISBI-553 attenuates feeding of a palatable high-carbohydrate food C_LIO_LIThe effect of SBI-553 on feeding is driven by energy deficit/motivation to feed C_LI Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=156 SRC="FIGDIR/small/722083v2_ufig1.gif" ALT="Figure 1"> View larger version (46K): org.highwire.dtl.DTLVardef@198a6fborg.highwire.dtl.DTLVardef@fae407org.highwire.dtl.DTLVardef@1909d9corg.highwire.dtl.DTLVardef@15b8c57_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Vertical Sleeve Gastrectomy inhibits 11βHSD1 and subsequently reduces IL6 secretion in Mice and Humans: A Shared Anti-Inflammatory Mechanism

Liang, S.; Samarasinghe, S.; Johnson, B.; Doria Durazzo, I.; Wang, W.; Tsou, H. L. P.; Riva, A.; Miras, A. D.; Akalestou, E.

2026-05-15 physiology 10.64898/2026.05.12.724611 medRxiv
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BackgroundVertical sleeve gastrectomy (VSG) improves glycaemic control in type 2 diabetes (T2D) through mechanisms that extend beyond weight loss. The interaction between glucocorticoid metabolism and inflammation in this context remains unclear. MethodsWe investigated the role of 11{beta}-hydroxysteroid dehydrogenase type 1 (11{beta}HSD1) in mediating the metabolic effects of VSG in humans and mice. Subcutaneous adipose tissue biopsies were collected before and 6 months after VSG. Parallel studies were conducted in lean and high-fat diet-fed mice undergoing VSG or sham surgery, alongside 11{beta}HSD1 knockout models. Glucose tolerance and expression of 11{beta}HSD1 and interleukin-6 (IL6) were assessed. Mechanistic interactions were examined in IL6-treated human hepatocytes. ResultsVSG reduced 11{beta}HSD1 and IL6 expression in human adipose tissue and improved insulin resistance. In lean mice, VSG improved glucose tolerance and downregulated both markers independently of weight loss. 11{beta}HSD1 knockout mice exhibited improved glucose tolerance despite increased adiposity, partially recapitulating the VSG phenotype. Both interventions reduced circulating and tissue IL6 levels. IL6 stimulation increased HSD11B1 expression in hepatocytes. Conclusions11{beta}HSD1 links glucocorticoid metabolism, inflammation, and glucose homeostasis following VSG. Targeting this pathway may offer a strategy to replicate key metabolic benefits of metabolic bariatric surgery.

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How the COVID-19 pandemic and cost-of-living crisis shaped reach and engagement in the ECAIL trial targeting socially disadvantaged families: an interdisciplinary implementation study

Poquet, D.; Le Gal, C.; Hincker, P.; Beghin, L.; Deplanque, D.; Subtil, D.; Sion, O.; Cavalli, B.; VANHOUTTE, L.; Jacobsen, V.; Marr, K.; Sakellaris, I.; de Lauzon Guillain, B.; Charles, M.-A.; Ley, D.; Sauvegrain, P.; Lioret, S.

2026-05-19 public and global health 10.64898/2026.05.14.26353230 medRxiv
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Background: The ECAIL trial, launched in 2017, targets hard-to-reach families and evaluates a multicomponent childhood obesity prevention intervention. At a maternity hospital in Lille, France, healthcare providers screened pregnant women experiencing social vulnerability, and dietitians delivered a home-based intervention until age 2. The COVID-19 pandemic led to a six-month suspension in 2020. This study compared eligibility and participation before the pandemic and after resumption, and examined how the pandemic and subsequent cost-of-living crisis shaped implementation and reach. Methods: We analyzed 5,744 eligibility questionnaires distributed at the maternity ward. Inclusion criteria included [&ge;]1 indicator of social vulnerability (e.g., socioeconomic disadvantage, precarious housing, or social isolation). To capture implementation experiences, a psychosocial researcher conducted a focus group with six dietitians delivering the intervention; it was recorded, transcribed, and analyzed thematically focusing on reach, acceptability, and adaptation. Results: Eligibility increased from 29.7% (n=955) prepandemic to 33.6% (n=849) after resumption, while the distribution of vulnerability criteriaremainedsimilar across periods:78.3% received social/medical benefits; employment was not the main source of household income for 58.7%; 24.4% experienced financial hardship; 14.7% reported social isolation; 6.0% lived in precarious housing; and 19.0% had three or more vulnerabilities. Participation among eligible women remained stable (24.6%; n=443). Qualitative findings indicated dietitians satisfaction and participants enthusiasm for the resumption of home visits, particularly in addressing social isolation. After resumption, the introduction of a pre-visit COVID-19 questionnaire reduced missed appointments. Converging qualitative and quantitative findings indicated sustained, and in some cases strengthened, provider engagement despite pandemic-related strain on hospital services. Conclusions: This study shows that a complex intervention can maintain reach and acceptability through adaptive implementation under major contextual disruptions.The rapid resumption of home-based services emerged as a robust strategy for engaging and retaining socially disadvantaged families, highlighting the importance of flexible, context-sensitive approaches during social and economic crises.

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Resting energy expenditure and thermic effect of a high-fat meal in the early follicular and mid-luteal phases of the menstrual cycle: a crossover trial protocol

Goulet, N.; Lyndon, S.; Beauregard, N.; McInnis, K.; Mauger, J.-F.; Doucet, E.; Imbeault, P.

2026-05-30 nutrition 10.64898/2026.05.25.26354032 medRxiv
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Introduction: Menstrual cycle phase has been proposed as a source of intra-individual variability in resting energy expenditure and the thermic effect of food in premenopausal females, yet studies examining the thermic effect of food across menstrual cycle phases report conflicting findings. Methods: This protocol describes a secondary analysis of prespecified outcomes from a non-randomized, two-period crossover trial primarily designed to assess postprandial plasma triglyceride concentrations across menstrual cycle phases (ClinicalTrials.gov: NCT07459465) in 12 premenopausal females aged 18-30 years, free of chronic disease and hormonal contraceptive use, recruited in Ottawa, Canada. Participants complete two experimental sessions: one in the early follicular phase and one in the mid-luteal phase, each involving consumption of a high-fat meal. Eleven secondary outcomes will be reported: fasting resting energy expenditure, thermic effect of food, respiratory exchange ratio, carbohydrate oxidation rate, lipid oxidation rate, desire to eat, hunger, fullness, prospective food consumption, serum beta-estradiol, and serum progesterone. Masked outcome analyses are performed using linear mixed-effects models. Results: Recruitment began on 26 March 2026; results will be reported in the Stage 2 manuscript. Discussion: Findings from this trial may help clarify whether menstrual cycle phase constitutes a meaningful source of intra-individual variability in energy metabolism, with implications for the design of metabolic research in premenopausal females.

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Nutritional-Metabolic Lipid Profiling with LipidOne for plasma lipidomics interpretation in metabolic health

Frongia Mancini, D.; Alabed, H. B. R.; Pellegrino, R. M.

2026-05-18 bioinformatics 10.64898/2026.05.14.725104 medRxiv
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Background/ObjectivesHuman plasma lipidomics provides valuable information on dietary and metabolic phenotypes, but the interpretation of high-dimensional lipid datasets remains challenging. We developed the Nutritional-Metabolic Lipid Profile (NMLP) module within LipidOne to translate plasma lipidomics data into interpretable nutritional-metabolic indices, functional categories, visual outputs, and biological statements. Subjects/MethodsNMLP calculates lipid indices reflecting cardiometabolic lipid status, fatty acid remodelling, overall lipid quality, oxidative protection, and omega-3/essential fatty acid status. The module was applied to three human plasma lipidomics public datasets: a randomized crossover glycemic-load feeding study, a eucaloric high-fat diet intervention in normal-weight women, and a large public dataset stratified by insulin sensitivity. ResultsAcross datasets, NMLP converted complex lipidomic matrices into coherent nutritional-metabolic profiles. In the glycemic-load study, the module highlighted metabolic lipid shifts not captured by standard clinical lipid panels, mainly involving cardiometabolic lipid status, oxidative protection, and fatty acid remodelling. In the high-fat diet intervention, NMLP tracked temporal lipid remodelling across pre-diet, on-diet, and post-diet states, consistent with metabolic adaptation to increased dietary fat exposure. In the insulin-sensitivity dataset, insulin-resistant subjects showed a storage-oriented lipid phenotype characterized by increased neutral lipid storage indices and altered lipid quality and oxidative-protection features. Category-level clustering further revealed heterogeneous nutritional-metabolic states within insulin-resistant subjects. ConclusionsNMLP provides a deeper and clearer interpretative framework for human plasma lipidomics in nutrition and metabolic health research. By translating lipid species into functional indices and category-level readouts, the module may facilitate the use of lipidomics in clinical nutrition, metabolic phenotyping, and precision nutrition studies. NMLP is freely accessible as part of the online LipidOne platform.

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Understanding Disordered Eating Attitudes and Patterns in University Students and the Relationship to Campus Dining Services

Bartling, B. A.

2026-05-15 health informatics 10.64898/2026.05.11.26352946 medRxiv
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University Students are particularly vulnerable to disordered eating behaviors (DEB) and attitudes (DEA). This study expands upon the knowledge base of DEA and DEB in university students by employing a netnography as a precursor to the main study to establish the following research questions: What is the relationship between the perceived quality of dining services and DEA? What is the relationship between the perceived availability of dining services and DEA? And lastly, how does prior experience with dining services affect eating patterns and attitudes toward food? The first study utilized a netnographic approach in order to evaluate issues with university dining services, leading to the design of the second study. Students at an upper Midwestern university (n=88) were surveyed via convenience sampling. Eating attitudes, eating behaviors, and relationships with dining services were measured. A statistically significant relationship between the availability of services and the DEA was found. A statistically significant relationship between the availability of services and risk behaviors was found. However, no statistically significant correlation existed between first-year dependence on on-campus dining services and risk behavior related to eating disorders or eating attitudes. Based on this, we know the quality of nutrition and the availability of services impacted students eating attitudes and behaviors, not inherent dependence.

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Socioeconomic modification of the diet quality-HbA1c association among U.S. adults: A survey-weighted interaction analysis

AMPOFO, E.; Apprey, C.; Amoako, M.; Turkson, F. D.

2026-05-06 nutrition 10.64898/2026.05.04.26352401 medRxiv
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1.Traditional nutrition science often proceeds under the assumption of a universal metabolic return to healthy eating, yet social environments may fundamentally modify these biological associations. This investigation utilized survey-weighted data from the National Health and Nutrition Examination Survey (NHANES 2017-2023) representing a weighted population of 286 million adults aged 20 years and older to test for association heterogeneity in the dietglycemia relationship. Dietary exposure was operationalized as energy-adjusted nutrient density scores derived via the residual method to measure the healthfulness of intake independent of total caloric volume. The primary outcome was HPLC-measured glycated hemoglobin (HbA1c) modeled as a continuous variable. Multivariable interaction models evaluated the Income-to-Poverty Ratio (PIR) as a formal effect modifier, adjusting for age, sex, race/ethnicity, body mass index, and smoking status. Analysis demonstrated that while quality-weighted nutrient intake levels remained statistically uniform across income tiers (p=0.207), multivariable interaction models identified significant modification of the diet-HbA1c association by socioeconomic position (p=0.028 for interaction). In the low-income reference group, higher quality nutrient intake was associated with a significant protective decline in HbA1c ({beta}=-6.11x10-5 percentage points per kilocalorie, p=0.017). Conversely, this protective association was attenuated to non-significance for the middle-income stratum ({beta}=3.31x10-6, p=0.849). Sensitivity analysis restricted to participants without clinical diabetes showed the interaction was non-significant (p=0.859), identifying an observed boundary condition where differential associations are most evident in pathological states. These findings suggest association heterogeneity where identical dietary behaviors relate to divergent glycemic patterning across socioeconomic groups. Socioeconomic position appears to function as an effect modifier of the diet-HbA1c relationship rather than a mere confounder. Such patterns suggest that the metabolic correlates of healthy eating are socially patterned, potentially due to structural factors that constrain the associations expected from improved nutrition.

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Pandemic-related changes in postpartum depression and anxiety among breastfeeding mothers: a systematic review and meta-analysis

Yu, J.; McCann, M.; Clesham, M.; Fewtrell, M.

2026-05-20 epidemiology 10.64898/2026.05.18.26353483 medRxiv
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Background: The COVID-19 pandemic caused major disruptions to maternity care, breastfeeding support, and social networks. These changes may have increased the risk of postpartum depression, anxiety, and stress among breastfeeding mothers, a population that has been underrepresented in previous reviews. This systematic review and meta-analysis aimed to compare maternal mental health outcomes among breastfeeding mothers before and during the COVID-19 pandemic. Methods: We searched MEDLINE, EMBASE, AMED, Web of Science, WanFang Data, MedRxiv, WHO COVID-19 databases, and grey literature from database inception to December 2023. Eligible studies compared mental health outcomes in breastfeeding mothers before and during the COVID-19 pandemic using validated assessment tools, including the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder Scale (GAD-7), State-Trait Anxiety Inventory (STAI), or Perceived Stress Scale (PSS). Studies with fewer than 10 participants per group were excluded. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Joanna Briggs Institute checklist or Newcastle-Ottawa Scale, depending on study design. Random-effects meta-analysis was performed when at least two studies reported comparable outcomes. Results: Twenty-three studies involving breastfeeding mothers from 15 countries were included. Meta-analysis showed significantly higher depressive symptoms during the pandemic compared with the pre-pandemic period, measured by EPDS (standardized mean difference [SMD] = 0.21, 95% confidence interval [CI] 0.14 to 0.29). Maternal anxiety measured by GAD-7 was also significantly higher during the pandemic (SMD = 0.27, 95% CI 0.13 to 0.41). Findings for perceived stress were mixed across studies and could not be pooled because of heterogeneity in reporting methods. Limited evidence suggested that mother-infant bonding did not substantially decline during the pandemic despite increased maternal psychological distress. Conclusions: Breastfeeding mothers experienced increased postpartum depression and anxiety symptoms during the COVID-19 pandemic. These findings highlight the importance of maintaining breastfeeding support services, ensuring access to maternal mental health screening, and developing flexible models of postpartum care during future public health emergencies. PROSPERO registration: CRD42022354670.

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Establishing a Bidirectional Correspondence Table between the Japanese Standard Tables of Food Composition 2020 (8th Edition) and the USDA FoodData Central Using Large Language Model-Based Matching

Nakagawa, S.; Yamamoto, A.

2026-05-13 nutrition 10.64898/2026.05.10.26352824 medRxiv
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BackgroundNo official correspondence table exists between the Japanese Standard Tables of Food Composition 2020 (8th edition; MEXT) and the USDA FoodData Central (FDC), despite their widespread use in nutritional research. This absence has hindered international comparison of food composition data for over six decades. MethodsWe developed a bidirectional matching pipeline using Claude Haiku (Anthropic), a large language model (LLM), combining food category mapping, 17-nutrient Euclidean distance ranking, and LLM-based conceptual judgment. Survey (FNDDS) data were excluded from FDC, yielding 8,158 items (Foundation Foods and SR Legacy). Matching was performed in both directions: MEXT[-&gt;]FDC and FDC[-&gt;]MEXT. ResultsOf 2,478 MEXT items, 1,927 (77.8%) were matched to FDC items, while 549 (22.2%) had no FDC equivalent (JP-only foods). Of 8,158 FDC items, 5,445 (66.7%) were matched to MEXT items, while 2,698 (33.1%) had no MEXT equivalent (US-only foods). Bidirectional consensus yielded 435 confirmed food pairs across 13 food categories. Notably, FDC items showed systematically higher calcium (+6.0 mg/100g) across 12 of 13 categories, while MEXT items showed systematically higher potassium (-3.7 mg/100g) across 9 of 13 categories and higher vitamin A as RAE (-3.7 g/100g) across 8 of 13 categories. ConclusionsThis study presents the first systematic bidirectional food correspondence table between MEXT and USDA FDC. The 435 confirmed pairs constitute a validated common vocabulary for international food composition research. The systematic cross-national differences in calcium, potassium, and vitamin A represent novel findings with direct implications for international dietary comparison studies. The complete correspondence table (Version 0.1) is openly available at https://github.com/shnkgw-rincom/jbfd-correspondence-table (DOI: 10.5281/zenodo.20103327).

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Effects of Maternal Obesity on Fetal Cerebral Glucose Transporter Expression

King, T. L.; Prifti, K. K.; Gill, R. M.; England, S. K.; Frolova, A. I.

2026-05-13 developmental biology 10.64898/2026.05.11.723868 medRxiv
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Emerging evidence indicates that the maternal in utero environment has enduring effects on offspring neurodevelopment. The obesity epidemic in the United States affects nearly one-third of women before pregnancy, potentially predisposing offspring to harmful developmental conditions. Glucose, the primary energy source for the brain, is highly regulated by facilitative diffusion glucose transporters (GLUTs). However, our understanding of how maternal obesity influences perinatal cerebral glucose metabolism remains limited. We hypothesized that maternal obesity is associated with altered expression of key GLUTs and dysregulated energy-sensing mechanisms in the fetal brain. Female C57BL/6J mice were randomly assigned to either a control diet (CON) or an obesogenic diet (DIO) (60% kcal from fat, 17.5% kcal from sucrose) for 10 weeks, time-mated with control males, and fed their respective diets throughout gestation. At 18.5 days post coitum, fetal brain tissue was collected for protein analysis. DIO diet did not affect litter size, offspring body weight, or brain weight when compared to CON. Whole brain GLUT1 expression was elevated only in female DIO offspring, while GLUT3 and GLUT4 expression was increased in all DIO offspring without modification by sex. However, maternal diet was not associated with differences in the activation of energy regulatory pathways adenosine monophosphate-activated protein kinase (AMPK) or the nutrient-sensing pathway mechanistic target of rapamycin (mTOR) in the fetal brain. These findings suggest that maternal obesogenic diet alters glucose transporter expression in the fetal brain, indicating a potential disruption in cerebral glucose metabolism during critical periods of perinatal development.

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Sympathetic activation of sensory input and learning

Flo, E. E.; Flo, G. M.

2026-05-05 neuroscience 10.64898/2026.05.01.722216 medRxiv
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Summary paragraphA hallmark of learning is the need for sensory stimuli (Ginns, 2015; McGraw et al., 2009; Reinwein, 2012; Spence, 1950) so that learning is fundamentally based on sensory input signals affecting behaviour, physiology, and neurology. If behavioural measures of learning can be causally linked to physiological and neurological variables, a broader understanding of the mechanisms related to learning in schools, learning disabilities, and learning and health issues may emerge (McGraw et al., 2009). Despite decades of research on the physiological/neurological variable of sympathetic activation, learning, and achievement (Horvers et al., 2021), any causal relation remains unclear (Cowley et al., 2014; Mason et al., 2020; Pijeira-Diaz et al., 2016; Sung et al., 2023; Yu et al., 2024) and issues with instrument validation remain (Costantini et al., 2023; Hu et al., 2024; Milstein & Gordon, 2020; Van Der Mee et al., 2021). Here we investigate the effect of sensory input on sympathetic activation by using validated instruments for skin conductance measurement (Batista et al., 2019) and whether sympathetic activation is connected to learning in a cognitive laboratory context and an ecologically valid classroom context. In both contexts, we found a physiological variable which correlated with learning and that sensory input affected this variable while student movement did not. These sensory inputs varied depending on the different instructional activities the students participated in. Together, these findings bring us one step closer to a model linking sensory input to behavioural, physiological, and neurological variables.