Current Developments in Nutrition

IntroductionFiber intake is the most common nutritional inadequacy in the Western diet, with most adults consuming less than half of the recommended intake with only 5% of adults meeting the RDI. A novel, short-chain beta-glucan derived from oats (scOat Fiber), with improved solubility, low viscosity and enhanced palatability, compared to conventional oat fibers, was investigated for its benefits as a source of fiber supplementation. MethodsA 14-day pilot study evaluated the gastrointestinal tolerance and functional benefits of scOat Fiber in 63 healthy adults randomized to receive 5, 10 or 20 g daily doses. The primary outcome, gastrointestinal tolerability, was assessed using the Gastrointestinal Symptom Rating Scale (GSRS). Secondary outcome included glycemic response during rice challenges, measured via continuous glucose monitoring (CGM). CGM was also used to explore overall glucose dynamics. Additional exploratory outcomes (mood, energy, appetite and sleep) were assessed via validated questionnaires. ResultsscOat Fiber was exceptionally well tolerated across all doses, with no increase in GSRS scores, which remained in the low to mild range. Significant reductions in total GSRS scores were observed, with benefits evident after just one week at 5 g/day and maintained over time at both 5 and 10 g/day groups. Evaluation of GSRS sub-categories revealed that the 5 g/day and 10 g/day dose groups experienced significant reductions in abdominal pain symptoms. Both dose groups also demonstrated a significant decrease in constipation at the end of the study. Postprandial glucose responses were attenuated following product use, with a significant reduction in peak glucose during rice challenges after 2 weeks in the 20 g/day group. Both 10 and 20 g/day doses were associated with significant improvement in glycemic metrics during the study, including reductions in glucose mean, all glycemic excursions, and an increase in time-in-range. Exploratory analysis suggested that scOat Fiber may improve mental health and concentration in participants with elevated baseline symptoms. ConclusionsDespite the lack of a placebo control and short duration, the dose-dependent nature of the results supports the potential of scOat Fiber as a well-tolerated and functional source of fiber with benefits including glycemic control, digestive health and mental health (NCT06739941)

Outcomes from the COSMOS trial have reinforced the notion of flavanols as important plant-derived bioactives contributing to cardiovascular health. As discussions continue on whether specific dietary reference values for flavanols are warranted, it is possible that existing dietary guidelines emphasizing fruits and vegetables already yield sufficient flavanol intake levels. If this were the case, developing flavanol specific dietary reference values might be unnecessary. This study therefore aimed at assessing whether adherence to dietary recommendations for fruit and vegetable intake and overall diet quality achieves flavanol intake levels of 500 mg/day, the amount proven to mediate cardiovascular benefits in the COSMOS trial. Flavanol intake was objectively evaluated using two validated and complementary biomarkers, 5-(3{square},4{square}-dihydroxyphenyl)-{gamma}-valerolactone metabolites (gVLMB) and structurally related (-)-epicatechin metabolites (SREMB), in two geographically distinct studies: COSMOS (US; n=6,509) and EPIC-Norfolk (UK; n=24,154). The results showed that higher fruit and vegetable intakes and diet quality (assessed via the alternative healthy eating index-aHEI) were associated with increased flavanol intake in COSMOS. Nevertheless, fewer than 25% of participants meeting dietary guidelines achieved an estimated flavanol intake of [≥]500 mg/day. Similar findings were observed in EPIC-Norfolk as well as through flavanol intake simulations considering fruits and vegetables commonly consumed in the US diet. In conclusion, adherence to existing dietary guidelines does not yield flavanol intake levels comparable to those shown to provide cardiovascular benefits in COSMOS. Thus, specific dietary reference values for flavanols may still be necessary if aiming to increase the intake of these dietary compounds. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=101 SRC="FIGDIR/small/26346949v1_ufig1.gif" ALT="Figure 1"> View larger version (39K): org.highwire.dtl.DTLVardef@24faeaorg.highwire.dtl.DTLVardef@1d52a29org.highwire.dtl.DTLVardef@1c2ff33org.highwire.dtl.DTLVardef@100a384_HPS_FORMAT_FIGEXP M_FIG C_FIG

Background/ObjectivesNutrient interactions in multi-ingredient supplements may influence absorption and bioavailability, yet pharmacokinetic data in this context remains limited. This clinical trial assessed the post-prandial absorption kinetics of key micronutrients in AG1, a comprehensive supplement containing vitamins, minerals, probiotics, and phytonutrients. MethodsIn a randomized, double-blind, placebo-controlled crossover trial 16 healthy adults (8 males and 8 females) consumed a single serving (13g) of AG1 or a taste- and appearance-matched placebo mixed in water, following a 10-hour overnight fast. Each condition was separated by a 1-week washout. Blood samples were collected pre-consumption and at 30, 60, 90, 120, 180, 240, 360, and 480 minutes post-ingestion. Plasma concentrations of folate, calcium, zinc, vitamin C, biotin, nicotinamide, pyridoxine, riboflavin, thiamin, and hesperidin were measured. Area under the curve (AUC0-480 min) was used to assess nutrient absorption. Safety and tolerability were assessed throughout the study. Statistical analysis included repeated measures ANOVA and paired t-tests. ResultsAG1 significantly increased AUC0-480 min values (p<0.05) for all measured nutrients except pyridoxine which revealed a strong trend (p = 0.075) and hesperidin (p = 0.224). Both AG1 and placebo were well tolerated, with no serious adverse events reported. ConclusionsAcute consumption of AG1 resulted in measurable increases in circulating levels of most of the tested micronutrients, indicating effective absorption and bioavailability. These findings support the potential of AG1 to contribute meaningfully to nutritional status and overall health.

BackgroundCaloric restriction (CR) improves markers of biological aging, yet long-term effects on the human metabolome remain unclear. ObjectiveThis study examined the effects of CR (2 years) in healthy adults without obesity on circulating metabolites linked to aging and metabolic adaptations. MethodsUntargeted metabolomics was performed using fasted plasma samples collected at baseline, 12, and 24 months (BL, 12M, 24M) from CALERIE participants randomized to CR or ad libitum (AL) control. A total of 864 known metabolites were identified and grouped into nine biologically coherent super pathways to support pathway-level interpretation (amino acid, peptide, carbohydrate, energy, lipid, nucleotide, cofactors and vitamins, xenobiotics, and partially characterized molecules). Principal component analysis (PCA) summarized metabolite variation, and linear mixed models assessed intervention effects on each PC in group-by-time interactions. ResultsThree principal components showed significant group-by-time interactions: PC2 (carbohydrate), PC5 (partially characterized molecules), and PC4 (lipid). Carbohydrate (PC2) and partially characterized metabolites (PC5) decreased from baseline to 12M in both groups; from 12M to 24M, levels stabilized in CR but increased in AL for PC2, while PC5 continued to decline in CR and increased in AL. Lipid metabolites (PC4) decreased in CR and increased in AL at 12M, with the pattern reversing from 12M to 24M. Key contributors included malto-saccharides and related carbohydrate intermediates for PC2, glutamine degradants and lactone sulfates for PC5, and sphingolipids for PC4. ConclusionThis study provided insights into metabolic changes during CR, particularly for carbohydrate and lipid metabolism. Carbohydrate and lipid metabolites that were reduced by CR during the weight loss phase (BL to 12M) followed by stabilization or compensatory responses during the weight maintenance phase (12M to 24M) may link CR-induced changes in metabolism to inflammation. Future research is needed to tease out CR adaptations versus diet related changes in metabolites and explore the functional significance of these metabolic changes during CR for aging and long-term metabolic health. ConclusionCR produced distinct, time-dependent shifts in carbohydrate and lipid pathways. Early reductions during weight loss followed by stabilization or compensatory responses during weight maintenance suggest dynamic metabolic remodeling that may relate to inflammation-linked mechanisms. Further work is needed to distinguish CR-specific adaptations from dietary influences and to clarify the functional significance of these metabolic changes for aging and long-term metabolic health.

BackgroundTime-restricted eating (TRE) has gained popularity for weight loss and metabolic health. While some evidence suggests greater benefits when TRE aligns with circadian rhythms--characterized by early daytime eating and avoidance of nighttime intake, often referred to as early TRE (eTRE), other studies report no meaningful differences between eTRE, other TRE approaches with or without exercise, or calorie restriction (CR), and robust comparative evidence remains limited. AimTherefore, the aim of this network meta-analysis (NMA) is to evaluate the physiological effects of eTRE, midday time-restricted eating (mTRE), late time-restricted eating (lTRE), with and without exercise, CR, and control (without prescribed energy or fasting windows) on anthropometric measures and cardiometabolic markers in adults with cardiometabolic risk factors. MethodsA comprehensive literature search was conducted in four major databases (PubMed, Web of Science, Scopus, and Embase) up to April 24, 2025. A Bayesian NMA was performed, using a control group as the reference comparator across interventions. Treatment effects were expressed as mean differences with 95% confidence intervals. The relative ranking of the included arms on the outcomes was assessed using surface under the cumulative ranking curve, values derived from the NMA, where higher values reflect a higher probability of superior effectiveness. Resultsa total of 40 trials comprising 3259 subjects were included in the analysis. There were significant reductions in most anthropometric measures in all intervention groups compared to control group. Whereas eTRE and eTRE + exercise (EX) significantly improved glucoregulatory outcomes compared to control, eTRE + EX showed superior results over other interventions. ConclusionWhile our results did not detect statistically significant differences between TRE patterns and CR, the consistent SUCRA rankings in favor of eTRE (particularly with exercise) suggest that meal timing may play an important role in metabolic regulation.

BackgroundPrediabetes is associated with an increased risk of progression to type 2 diabetes. While dietary interventions in prediabetes traditionally primary focus on energy and macronutrient intake, the role of eating timing has recently been highlighted. This study aimed to examine the relationships between components of eating timing patterns and glycaemic parameters in prediabetes. MethodsIn 297 individuals with prediabetes, i.e. impaired fasting glucose or impaired glucose tolerance (age 59.4 {+/-} 9.0 y, BMI 31.3 {+/-} 6.2 kg/m2), glycaemic traits were assessed using the oral glucose tolerance test (OGTT). Parameters of eating timing pattern (eating timing itself, daily calorie distribution, and meal number) were extracted from four-day food records. Eating start (ES) was defined as the start of the first caloric event of the day. ResultsAmong eating timing components, the most associations with glycaemic parameters were observed for ES. Individuals with late ES showed higher fasting insulin (p = 0.006), AUC insulin (p = 0.020), insulinogenic index (p = 0.049), HOMA-IR (p = 0.004), and lower Matsuda insulin sensitivity index (p = 0.004) compared to those with early ES, even after adjustment for age, sex, daily energy intake, and body fat. Participants with late ES had decreased insulin clearance (p<0.001) upon comparable glucose and C-peptide levels. ConclusionLate ES is associated with estimates of lower insulin sensitivity and hyperinsulinemia in prediabetes, independent of energy intake and body fat. Our findings suggest that an earlier ES is related to improved glucose metabolism which might lower the risk of progression to diabetes.

BackgroundHuman milk (HM) bioactive components can have immune modulatory functions, impact the gut microbiome, and may result in functional benefits when added to infant formula (IF). In this single-arm, prospective, intervention study, we tested the effectiveness of an IF with a whey protein concentrate co-enriched in -lactalbumin, milk fat globule membrane (MFGM), and Sn-2 palmitate resulting in protein and lipid profiles observed in HM. The outcomes tested were feeding tolerance, Bifidobacteria abundance, and intestinal and immune health of Chinese infants. MethodsPredominantly formula-fed (FF) and breastfed (BF) infants were enrolled between 3 and 28 days and assigned to the FF (N= 60) or BF (N=60) group, per their feeding practice, for 6 weeks. The primary endpoint was Infant Gastrointestinal Symptom Questionnaire (IGSQ) index score assessed using a validated IGSQ-13 questionnaire after 6 weeks of intervention; non-inferiority of FF vs BF was tested. Secondary endpoints included fecal Bifidobacteria abundance assessed using shotgun metagenomics sequencing; fecal short chain fatty acids (SCFAs) analyzed by ultra-performance liquid chromatography-tandem mass spectrometry; fecal markers of immune response, inflammation, intestinal barrier integrity (secretory immunoglobulin A sIgA), cytokines, calprotectin, 1 antitrypsin, lipocalin-2) assessed using enzyme-linked immunosorbent assay; stool consistency assessed using gastrointestinal (GI) diary; anthropometric assessments; quality of life; physician reported adverse events; and use of medications. ResultsGood GI tolerance was observed in both groups at V2 (mean{+/-}SD IGSQ score FF: 19.9{+/-}7.4; BF: 16.8{+/-}4.2); difference of means 1.35 [95% CI: -1.312, 4.012]). After 6 weeks, Bifidobacterium genus relative abundance was not significantly different between the groups. Total SCFAs were significantly higher (p<0.05) in the FF versus BF group, driven by increased levels of valeric and propanoic acids (p<0.05 for both). The IGSQ domain scores, stool consistency, fecal markers of immunity, inflammation, and intestinal barrier integrity (except lipocalin-2 which was significantly higher in BF vs FF), anthropometric Z-scores, common illnesses, antibiotic use, and adverse events were not significantly different between groups at week 6. ConclusionsOur results support the effectiveness of this tested infant formula in supporting good GI tolerance, growth, specific intestinal and immune health markers, and Bifidobacteria abundance similar to that of the BF group. Trial registrationNCT04880083 (2021-05-06)

Front-of-pack nutrition labels (FOPLs) have been adopted as a key government strategy to address the significant burden of diet-related noncommunicable diseases. However, research on public knowledge and perceptions of FOPLs and their relationships with sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption remains limited. A cross-sectional study with 2870 individuals was conducted to explore their knowledge and perceptions of Nutri-Grade, a national front-of-pack nutrition labeling scheme introduced in Singapore in 2022. Knowledge was not significantly associated with SSB consumption; however, individuals who perceived these labels more positively were significantly less likely to consume SSBs daily (AOR=0.72, p<0.001) and consumed fewer types of SSBs weekly (IRR=0.91, p<0.001). Moderation analyses indicated that greater knowledge of Nutri-Grade FOPLs was associated with a higher likelihood of SSB consumption among younger individuals and those residing in areas with higher house prices. Additionally, individuals with positive perceptions were more likely to consume SSBs daily when living in areas with food court density exceeding 2.99 per km{superscript 2} (AOR = 1.12, p = 0.004). Individuals with positive perceptions of Nutri-Grade FOPL were also less likely to consume ASBs (AOR=0.69, p<0.001), whereas, in contrast to SSBs, greater knowledge of Nutri-Grade FOPLs was associated with increased ASB consumption (AOR=1.42, p<0.001). These findings indicate that informational labeling itself is insufficient to change consumption behavior. Although positive perceptions of Nutri-Grade FOPLs provide a protective effect, this effect diminishes when the food environment is taken into account.

BackgroundThe surgical stress response is a predictable, physician-managed metabolic state triggered by anesthesia and tissue injury, marked by insulin resistance and hypercatabolism that create unique nutritional needs unmet by standard, pre-surgical fasting diets. We developed a multi-nutrient medical food to support perioperative metabolic homeostasis and piloted its safety/tolerability and exploratory outcomes. MethodsIn a single-center pilot trial (n=67) of adults undergoing elective abdominal, cardiac/thoracic, gynecological, or orthopedic surgery, participants were allocated to medical food or no-treatment control. The product was taken twice preoperatively (evening before and 4 h pre-op) with standard care. Primary safety outcomes were adverse events, postoperative nausea/vomiting (PONV), 30-day readmission, and infections. Exploratory outcomes were fasting glucose, HbA1c, electrolytes, cortisol, pre-operative emotional state, and post-operative pain. ResultsAll participants completed the intervention. No product-attributed adverse events occurred. Gastric clearance was achieved within 2 h in all, and there were no 30-day readmissions or infections. PONV occurred in 30.3% vs 35.3% (risk ratio 0.86, 95% CI 0.43-1.71, p=0.796). Post-operative glycemia favored the intervention; at 48 hr the intervention group showed lower glucose (HL -9 mg/dL, g=0.35, p=0.030), while earlier timepoints were nonsignificant. Post-operative magnesium was numerically lower with intervention (4.76 vs 5.10) without statistical significance; other electrolytes and cortisol showed minimal differences. Post-operative pain was 5.33 vs 5.62 (g=0.19, p=0.43). Positive pre-operative emotion was more frequent with intervention (17/33 vs 9/34; risk ratio 1.95, p=0.046). ConclusionThe medical food was safe and well tolerated without increased PONV or readmissions. Preliminary metabolic and emotional signals justify a larger, adequately powered efficacy trial. Clinical Relevancy StatementThis pilot trial demonstrates that a preoperative multi-nutrient medical food was well tolerated and feasible to administer in a routine clinical setting: all participants achieved gastric clearance within 2 hours of the pre-operative dose, with no increase in PONV and no readmissions. Exploratory findings indicate potential benefits that could nutritionally support recovery if confirmed. These results support the feasibility of administering a targeted nutrition intervention shortly before surgery and justify evaluation in a larger efficacy trial. Clinical Trial RegistrationNCT07359222

Maternal dietary diversity is vital for the health of both mothers and children during lactation, yet it is often compromised in low- and middle-income countries. This cross-sectional study among 251 lactating mothers in Tarakeswor Municipality, Nepal, assessed dietary diversity using a 24-hour dietary recall and the Minimum Dietary Diversity for Women (MDD-W) indicator. Overall, 68.1% of mothers achieved the minimum dietary diversity ([&ge;]5 of 10 food groups), with a mean score of 5.03 {+/-} 1.25. In multivariable analysis, higher odds of meeting MDD were observed among mothers with secondary or higher education (aOR = 7.5; 95% CI: 3.8-15.0), employment (aOR = 2.9; 95% CI: 1.4-5.8), joint or extended family structure (aOR = 3.7; 95% CI: 1.9-7.0), the highest wealth quintile (aOR = 4.2; 95% CI: 1.9-9.1), food-secure households (aOR = 4.5; 95% CI: 2.3-7.9), adequate nutrition knowledge (aOR = 5.2; 95% CI: 2.7-9.8), [&ge;]4 antenatal care visits (aOR = 1.9; 95% CI: 1.0-3.4), and higher empowerment (aOR = 3.9; 95% CI: 1.9-7.8). These findings highlight substantial socioeconomic disparities in maternal dietary diversity and underscore the need for integrated, equity-focused nutrition interventions in rapidly urbanizing settings in low- and middle-income countries.

ObjectiveHypertension is the leading cause of preventable cardiovascular disease (CVD) and is associated with obesity. Body mass index (BMI), the most common measure of obesity, does not distinguish between fat and muscle mass. By contrast, dual-energy X-ray absorptiometry (DXA) is the gold standard for measuring fat composition with high accuracy and minimal variability. To our knowledge, no United States studies have examined the association between BMI or fat-to-muscle-ratio (FTMR) (using DXA) and hypertension. MethodsWe analyzed NHANES data of adults aged 20-59 years from 5 consecutive cycles (2011-2012 through 2017-2018). The primary outcome was hypertension. Logistic regression was used to determine the associations between FTMR and odds of hypertension, and between BMI and hypertension. ResultsThe mean FTMR was higher in the hypertension compared to the non-hypertension group (0.57 {+/-} 0.01 vs. 0.53 {+/-} 0.004, p < 0.001), with a similar pattern observed for BMI (32.3 {+/-} 0.2 vs. 28.1 {+/-} 0.1, p < 0.001). Logistic regression analysis showed each one-unit increase in FTMR was associated with 2.80 times higher odds of hypertension, while each 1 kg/m{superscript 2} increase in BMI was associated with 1.08 times higher odds. The sex specific odds ratio (OR) for FTMR were even higher after adjusting for age (males 24.58 (11.74-51.46), females 8.77 (5.04-15.26), p<0.001). However, after adjusting for sex in a receiver operator curve (ROC) analysis, FTMR (Area Under the Curve [AUC] 0.63; 95% CI 0.62-0.64) did not outperform BMI (AUC 0.67; 95% CI 0.66-0.68) regarding their association with hypertension. ConclusionAlthough logistic regression showed a stronger relation of FTMR than BMI and the odds of hypertension, the ROC curve indicated no difference in association of hypertension and FTMR and BMI. Further research should examine the ability of FTMR compared to BMI to predict hypertension and CVD related-complications in high-risk subgroups.

Background/ObjectivesHuman lactoferrin (hLF) is glycoprotein of commercial interest as a food ingredient for gut health. Here, we report an exploratory analysis evaluating the effects of Helaina hLF (effera(R)), produced by Komagataella phaffii, on the adult gut microbiome and fecal metabolites in comparison to bovine LF (bLF). MethodsIn a randomized, double-blind, parallel-arm, controlled trial, 66 healthy adults received either high-dose (HD) effera(R) (3.4 g/day), low-dose (LD) effera(R) (0.34 g/day), or bLF (3.4 g/day) supplementation for 28 days. Fecal samples were collected at baseline (Day 0), Day 28, Day 56, and Day 84 and analyzed for microbial diversity, taxonomic shifts, and volatile fatty acids (VFA). ResultsAlpha-diversity remained stable across all groups. Beta-diversity showed no main effect of treatment; however, bLF was associated with significant visit-related shifts, as assessed by weighted UniFrac. At the phylum level, significant changes associated with effera(R) were observed, including decreases in Bacillota (LD) and Verrucomicrobiota (HD), and notable genera increases in Lachnospira, Paraprevotella, and Faecalibacterium (HD), while bLF was associated with an increase in Roseburia. Both effera(R) and bLF were associated with decreases in Blautia and Dorea. VFA analysis revealed that bLF increased absolute total short-chain fatty acids (SCFAs) and branched-chain fatty acids (BCFAs) concentrations, while both effera(R) groups produced proportional changes in SCFAs, individual BCFAs, and acetate. ConclusionsIn healthy adults, effera(R) supplementation promoted a proportional increase in acetate and supported potentially beneficial taxa while maintaining microbial diversity, without disrupting community structure. (clinicaltrials.gov: NCT06012669).

BackgroundFood systems--particularly livestock production--account for substantial greenhouse gas (GHG) emissions, while unhealthy diets, characterized by excessive animal-based and insufficient plant-based food consumption, are a major risk factor for all-cause mortality in Europe. Implementing climate mitigation policies related to the GHG emissions of the food system could therefore bring important health co-benefits. MethodsWe developed a health impact assessment model based on a life table approach and evaluated the mortality impact of transitions in food consumption through four contrasting scenarios leading to net-zero GHG emissions for France in 2050. These involved varying dietary shifts, all moving toward more plant-based foods. For each scenario, we modeled the evolution of the diet, as well as the impacts on all-cause mortality by applying the most recent and robust dose-response relationships derived from meta-analyses for 13 food groups. FindingsThe different trajectories of dietary shifts translated into a health impact ranging from 19% [uncertainty interval, UI: 17%-21%] to 24% [UI: 21%-26%] of all-cause mortality prevented in 2050 in the French population. Variation in intakes of nuts, red meat, processed meat, whole grains and legumes bring most of the health benefits. Whatever the parameters chosen in the sensitivity analyses, the results remained robust, with about 100,000-200,000 deaths that could be prevented yearly by 2050 in France. InterpretationThe present study highlights the considerable potential health benefits that trajectories toward net-zero emissions can bring, especially through shifts toward sustainable diets. These results reinforce the strong convergence of environmental and human health issues in the agri-food sector. FundingFrench High Council for the Future of Health Insurance (HCAAM) and the National Agency for Ecological Transition (Ademe). Research in contextO_ST_ABSEvidence before this studyC_ST_ABSFood systems are a significant contributor to climate change and in parallel, dietary risks are one of the leading causes of all-cause mortality globally, notably in high-income countries such as France. A recent systematic review by Moutet et al. revealed that only two studies evaluating health co-benefits through dietary shifts in net-zero GHG emissions scenarios were published to date. This suggests a convergence and a possible win-win situation between climate change and human health challenges regarding food production and consumption. In order to face the climate crises, governments around the world, and particularly those of the countries historically the largest contributors to climate change, must cut their greenhouse gas emissions to achieve net-zero emission by 2050. Dietary shifts would be a major driver to pursue this objective and could bring important health benefits to the population conducting these changes. For instance, Hamilton et al. showed that dietary changes in line with the Paris Agreements could result in 188 deaths prevented per 100,000 persons in 2040 in Germany and 141 in the UK. Added value of this studyOf the two previously published studies, only one assumed a gradual implementation of changes in diets, combined with a time lag in health effects. We also made these assumptions and considered the gradual change in consumption of thirteen food groups for which recent meta-analyses provided all-cause mortality dose-response relationships with a high level of quality. This study is also among the first to combine nutritional and environmental optimization, through four scenarios; all of which are expected to lead to net-zero emission by 2050 via very contrasting climate change mitigation trajectories. Nevertheless, all of them require a dietary shift toward more plant-based foods. We conducted a health impact assessment for France and showed that achieving net-zero emission by 2050 while considering nutrition references set by national guidelines would provide health co-benefits. Depending on the scenarios, health gains could range from 19% to 24 % of all-cause mortality prevented in the adult French population in 2050, compared to a scenario assuming that we would maintain the current observed dietary habits in the future. Implications of all the available evidenceThis study adds to the available evidence that taking action to mitigate climate change is an opportunity to strongly improve public health. Engaging populations in a shift toward a healthier and more sustainable diet could bring major human health and environmental benefits.

Ultra-processed foods (UPFs) are associated with adverse health outcomes, but measurement of UPF intake in epidemiological studies remains challenging. Dietary assessments typically employ recall questionnaires, which may lead to measurement errors and misclassifications. Here, we develop a plasma metabolite index of UPF consumption to objectively measure UPF intake. Using two years of authentic food purchasing records from the ChooseWell 365 cohort, we identify metabolites associated with long-term UPF intake. We then apply the UPF-metabolite index to the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, a population-based cohort of U.S. adults followed for incident health outcomes. The UPF-metabolite index was associated with leading causes of morbidity and mortality, including incident stroke, all-cause mortality, and cancer mortality. Mediation analysis revealed that the UPF-metabolite index accounts for 62% of the association between UPF intake and stroke risk. These findings suggest that the UPF-metabolite index offers an objective method for assessing UPF intake and its contribution to diet-related disease risk. TeaserPlasma-based markers of ultra-processed foods (UPFs) predict disease risk, including stroke, cancer mortality, and all-cause mortality.

The gut microbiota has been implicated in regulating body composition, insulin resistance, and energy metabolism through microbial metabolites, including short-chain fatty acids (SCFAs) and amino acids. However, evidence in adolescents, particularly regarding sex-specific differences and lifestyle such as alcohol intake, remains limited. Characterizing sex-specific metabolic signatures in adolescence may improve early identification of metabolic risk. To address this gap, we investigated associations between fecal metabolites, body composition, insulin resistance, and energy expenditure in 158 adolescents aged 18 from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000). Quantitative fecal metabolomics was performed using proton nuclear magnetic resonance (1H-NMR) spectroscopy, profiling 32 metabolites. Associations with body composition, insulin resistance, and energy expenditure were evaluated using sex-stratified univariate and multivariate modelling with false discovery rate (FDR [&le;] 0.05 and 0.2). Fecal acetate and ethanol were more associated with fat-free mass index (FFMI) and waist-to-height ratio (WHtR) than with body mass index (BMI) in females; in males, no associations remained after FDR. Lysine and leucine showed associations with BMI and insulin resistance in females. Acetate, butyrate, glucose, and methanol were associated with total energy expenditure (TEE) in females, whereas no association survived in males. Alcohol intake was positively associated with fecal ethanol, glucose, and methanol, and inversely with trimethylamine in females, while galactose showed a positive association in males. These findings demonstrate that gut microbiota-derived metabolites are related to body composition, insulin sensitivity, and energy balance in adolescents, particularly females, highlighting the utility of fecal metabolomics in exploring mechanisms underlying metabolic variation.

The dynamic physiological and hormonal changes through the menopause transition predispose women to an increased risk of multiple chronic diseases including cardiovascular disease, metabolic disease, depression and dementia. The underlying mechanisms remain unclear, yet it is thought that chronic systemic inflammation and changes to lifestyle behaviors across menopause play important roles. The LIfestyle risk Factors for chronic disease across the stagEs of reproductive ageing (LIFE study) is a cross-sectional study aimed to develop an understanding of how hormonal and lifestyle factor differences across pre, peri and postmenopause influence chronic systemic inflammation visceral adiposity, cognitive function and sleep health. A total of 165 women aged between 40-65 years have been recruited and classified into pre, peri or postmenopausal groups. Body composition measures and blood glucose samples were collected. Sleep and physical activity were objectively measured using activPAL4 and ActiGraph GT9X link accelerometer over 7 days. Participants were also provided with a sleep log diary. Physical function was assessed using the Short Physical Performance Battery. Cognitive function was evaluated using Addenbrookes Cognitive Examination-III and Cambridge Neuropsychological Test Automated Battery. Participants completed a series of questionnaires including the Depression, Anxiety, and Stress Scale-21, RuSATED, Berlin Questionnaire, Insomnia Severity Index, Activities-specific Balance Confidence Scale, and the Australian Eating Survey. The LIFE study aims to firstly determine how differences in lifestyle behaviors (physical activity, diet and sleep) across menopause influence chronic systemic inflammation and visceral adiposity. Secondly, to determine the association between chronic systemic inflammation, visceral adiposity, and cognitive function, elucidating the relationship between lifestyle behaviors and menopausal symptoms. Collectively this will provide an understanding and characterization of lifestyle behaviors and links to inflammatory markers, cognition, mental health and sleep health in pre, peri and postmenopausal women that will inform targeted strategies to improve long-term, wellbeing, heart, brain, and metabolic health.

BackgroundValidated food portion size photographs can increase accuracy of estimatingportion sizes during dietary surveys. Our objective was to assess the validity of food portion size photographs in estimating portion sizes to be used in 24-hour dietary recall food consumption study. MethodsWe recruited two hundred and six women of reproductive age (13-45 years) residing in Roysambu sub-county in the northern parts of Nairobi City, Kenya. Eleven foods from the Photographic Food Atlas for Kenyan Adolescents (9-14 years) were examined. Participants were served pre-weighed portions. After eating, each participant was asked to estimate the amount of food they consumed, using the Food Atlas. Validity was assessed by calculating percentage of estimates within and outside of {+/-}10% of consumed portion size, the mean percent difference between estimated and consumed portions, Spearmans correlation coefficients, and Pearsons chi-square test. ResultsThe proportion of participants with estimates within {+/-} 10% of the consumed portion size ranged between 15-65%. Mean differences between the consumed and estimated portion sizes varied -45% for stewed beans to +60% for watermelon. Generally, small portions were overestimated while large portions were underestimated. Correlation coefficients ranged from 0.12 to 0.77 and all the coefficients were statistically significant except for watermelon (p=0.22). Accuracy of estimations was not associated with participants age or educational level. ConclusionsThe validity of the tested food proportion size photographs was adequate for quantifications of most food items. However, the studys findings also indicated that further improvement is needed before wider use in Kenya.

BackgroundObservational studies have linked high adherence to the "Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay" (MIND) diet to improved cognitive functions in older adults. The underlying peripheral and central mechanisms of this association remain poorly understood, although multiple nutrients in the MIND diet are known for their anti-inflammatory effects. Therefore, we explored the cross-sectional relation between MIND diet adherence (Dutch version), systemic inflammation, neuroinflammation, and cognitive functioning in older adults. In addition, we examined the role of intestinal barrier permeability in MIND diet associations with (neuro)inflammation. MethodsWe included 88 older adults (60-75 year) at risk of cognitive decline. MIND-NL diet adherence was assessed using a food frequency questionnaire. Systemic inflammation (C-reactive protein levels, white blood cell-counts and neutrophil-to-lymphocyte ratio) and intestinal barrier permeability (lipopolysaccharide-binding protein, zonulin, and lipopolysaccharide) markers were measured in blood. Neuroinflammation-associated metabolites (myo-inositol, choline and creatine) were measured in the dorsolateral prefrontal cortex with proton magnetic resonance spectroscopy (1H-MRS). Cognitive functioning was assessed with a neuropsychological test battery. ResultsLinear models showed that both MIND diet adherence and systemic inflammation did not predict neuroinflammation or cognition independently. However, MIND diet adherence significantly moderated the relation between systemic inflammation and neuroinflammation ({beta}=-0.11, p=0.04) as well as between systemic inflammation and cognition ({beta}=0.044, p=0.02). Specifically, in individuals with lower MIND diet adherence (identified as scores [&le;]7), systemic inflammation was positively related to neuroinflammation, and negatively to cognition. Similarly, MIND diet adherence significantly moderated the relation between intestinal barrier permeability and neuroinflammation ({beta}=-0.17, p=0.05). Finally, within participants with lower MIND adherence (median split at [&le;]8.75), systemic inflammation mediated the relation between the intestinal barrier permeability and neuroinflammation ({beta}=0.427 [0.072; 0.891], p=0.04). ConclusionOur findings suggest that higher MIND diet adherence might protect against the detrimental effect of systemic inflammation on neuroinflammation and cognitive functioning. Moreover, we demonstrated that greater adherence to the MIND diet may specifically protect against the systemic inflammation-mediated relationship between intestinal barrier permeability and neuroinflammation. These findings should be confirmed in randomised controlled trials.

As plant-based (PB) diets become more common among UK children, understanding their nutritional adequacy and environmental impact is vital. This study assessed nutrient intake and dietary greenhouse gas emissions among children following omnivorous, vegetarian, and vegan diets. A cross-sectional analysis was conducted using three-day weighed food diaries from 39 UK children aged 2-12 years (omnivore n=15; and PB: vegetarian n=11; vegan n=13). Nutrients were analysed with and without supplementation using Nutritics software. GHGEs were calculated at the ingredient level (kgCO2e/day) and grouped by Eatwell Guide food categories. No dietary group met all nutrient reference values. Omnivores exceeded recommended intakes for saturated fat and free sugars while failing to meet the recommended intake for fibre, whereas PB children had intakes of these nutrients in the healthy range. PB diets were adequate in protein and vitamin B12 even in the absence of supplementation. Vegan children also met iron requirements from diet alone, whereas omnivore and vegetarian children did not meet iron targets without supplementation. Vitamin D intake was insufficient across all groups when supplements were excluded, with only vegan children achieving recommended levels through supplementation. Zinc requirements were met only by vegetarian children with the aid of supplements and were not met by vegan or omnivore children with or without supplementation. Iodine intake remained inadequate in vegan children even with supplementation. Mean daily GHGEs differed significantly between diet groups (p < 0.001): omnivores having the highest emissions, while vegans had the lowest emissions: 46% lower than omnivores, and 20% lower than vegetarians. Well-planned PB diets can meet most nutrient needs in UK children when supported by fortified foods and supplements, while substantially reducing dietary GHGEs compared with omnivorous diets. Shifting away from animal protein and dairy provides the greatest opportunity for improving both nutritional quality and environmental sustainability.

Poor sleep is linked to consumption of sugary foods/beverages and high neural responsivity to palatable food cues. Yet, whether hedonic liking for sweet taste explains these associations remains unclear. We examined cross-sectional associations of five sleep traits (chronotype, sleep duration, insomnia frequency, snoring, daytime dozing) and a composite sleep score with sweet food liking, and total and free sugar intake in 76,734 UK Biobank participants (39-72 years, 56.3% female). Models adjusted for age, sex, ethnicity, socioeconomic deprivation, and body mass index (Bonferroni-corrected =0.0025). Evening chronotype, more frequent insomnia and daytime dozing, and lower composite sleep score were associated with higher sweet food liking. Associations with intake were stronger for free than total sugar. Evening chronotype was associated with higher free sugar intake (g/day: {beta}=1.523, 1.309-1.737; g/1000 kcal: {beta}=0.450, 0.361-0.538), and daytime dozing showed a dose-response (dozing often vs never/rarely: g/day {beta}=6.307, 4.631-7.983). Snoring was associated with higher absolute (but not energy-adjusted) free sugar intake. A healthier sleep score was associated with lower free sugar intake (g/day {beta}=-2.193 [-2.464 to -1.922]; g/1000 kcal {beta}=-0.691 [-0.804 to -0.579]) but higher energy-adjusted total sugar intake ({beta}=0.633 [0.485-0.781]). Mediation analyses indicated sweet liking accounted for 15%-91% of several sleep trait and free sugar intake associations (indirect effects p<0.001). Poorer sleep health, particularly evening chronotype and daytime sleepiness, was associated with greater sweet liking and higher free sugar intake, with sweet liking partially mediating associations between sleep traits and sugar consumption. Sweet-taste liking may represent an underexamined pathway linking sleep/circadian disruption to free sugar intake.