Current Developments in Nutrition

Background: Metabolic Syndrome (MS) is an escalating non-communicable disease (NCD) and public health crisis heavily driven by modern high-calorie dietary transitions. MS is closely linked to catastrophic cardiovascular dysfunction (CVD). Conventional CVD medications are frequently constrained by high financial costs, system-wide adverse effects, and poor population-level accessibility in lower-middle-income countries (LMICs). This underscores an urgent public health need to evaluate safe, scalable, and low-cost dietary nutraceuticals for primary prevention. This study evaluated the cardioprotective and preventative effects of Beta-caryophyllene (BCP)--an affordable, widely accessible, and GRAS-designated dietary cannabinoid--in a lifestyle-mimicking rodent model of MS. Methods: Seventy-two male Wistar rats (10 weeks old) were divided into six groups (n=12/group). Groups I and II served as controls given Normal Diet (ND) alone and ND+{beta}-caryophyllene (50 mg/kg p.o.), respectively. Metabolic Syndrome was induced in Groups III-VI using a High-Fat High-Fructose Diet (HF/HFD) for 16 weeks. For the subsequent 4 weeks, Group III continued on HF/HFD, Group IV received HF/HFD + BCP (50 mg/kg p.o.), Group V underwent dietary withdrawal (returned to a normal diet [ND]), and Group VI received ND + BCP. Conscious hemodynamic variables and electrocardiograms (ECG) were recorded via telemetry. Plasma apolipoprotein-B (Apo-B) and C-reactive protein (CRP) were quantified using ELISA. Lipid profiles, oxidative stress parameters, and organ histopathology were evaluated using standard biochemical and staining methods, with data analysed using ANOVA at = 0.05. Results: In Group II, BCP decreased SBP (145.00{+/-}12.13 vs 120.30{+/-}2.15 mmHg), DBP (105.70{+/-}10.80 vs 94.00{+/-}17.20 mmHg), heart rate (448.00{+/-}11.90 vs 280.00{+/-}18.70 beats/min), and PR-interval (49.50{+/-}3.53 vs 45.00{+/-}12.70 ms) compared with Group I. Group IV significantly decreased SBP (129.00{+/-}1.28 vs 125.5{+/-}11.1 mmHg) and heart rate (380.00{+/-}16.20 vs 351.00{+/-}3.00 beats/min) compared with Group III. Furthermore, BCP significantly increased HDL-cholesterol (10.80{+/-}1.70 vs 15.40{+/-}1.00 mg/dl), SOD (0.35{+/-}0.07 vs 0.76{+/-}0.30 U/mg protein), and GSH (1.64{+/-}0.02 vs 3.60{+/-}0.13 mM) in Group IV compared with Group III. Conversely, BCP significantly decreased total cholesterol (166{+/-}31.00 vs 113{+/-}18.50 mg/dl), Apo-B (26.70{+/-}1.68 vs 19.00{+/-}1.30 mg/dl), leptin (5.10{+/-}0.03 vs 2.18{+/-}0.01 ng/ml), NO (6.30{+/-}0.40 vs 4.30{+/-}2.61 M), and malondialdehyde (11.80{+/-}4.10 vs 9.90{+/-}2.30 M) in Group IV. BCP significantly decreased triglycerides (64.90{+/-}1.30 vs 55.90{+/-}1.30 mg/dl) in Group VI compared with Group IV, while lowering CRP across all groups. Distortion of the cytoarchitecture of the heart, liver, and pancreas observed in Group III was completely reversed by BCP treatment in Group IV. Conclusion: Beta-caryophyllene effectively ameliorates diet-induced metabolic syndrome and associated cardiovascular dysfunction via potent anti-atherogenic, anti-inflammatory, and antioxidant mechanisms. These findings suggest that integrating affordable, culturally accepted, BCP-rich indigenous functional ingredients into regional nutrition frameworks represents a highly scalable, low-cost public health strategy for global NCD prevention. Keywords: Cardiovascular dysfunction, Metabolic Syndrome, Beta-caryophyllene, High-fat-high-fructose diet, Public Health Nutrition, NCD Prevention.

Background: Prediabetes is an intermediate state of increased glucose concentrations above the normal range but below the diagnostic threshold for type 2 diabetes (T2D). Adults with overweight and prediabetes are at increased risk of progression to T2D and metabolic imbalance. Feiolix -a whole-fruit feijoa powder rich in abscisic acid, polyphenols and dietary fibre which may support metabolic health with complementary pathways. Objective: To evaluate the effects of low and high-dose Feiolix compared with placebo, on HbA1C, glucagon like peptide (GLP-1) and other metabolic parameters. Methods: Adults aged 21-65 years with prediabetes i.e. glycosylated hemoglobulin (HbA1c) 5.7-6.4% and overweight with body mass index (BMI)- 25.0-29.9 kg/m2 were randomised to receive Feiolix-LD (300 mg/day) or Feiolix-HD (1,150 mg/day), or placebo (maltodextrin) for 12 weeks. Anthropometric measurements were obtained monthly, and fasting blood samples were collected at baseline and 12 weeks post intervention. Postprandial blood samples were collected at baseline and 12 weeks. Outcomes included HbA1c, GLP-1, fasting plasma glucose, insulin resistance lipid markers, body weight and BMI. Analyses were conducted using ANCOVA model with baseline values as covariates. Result: Of 41 individuals screened, 39 were randomised (13 per group); one participant withdrew from the Feiolix-LD. At week 12, HbA1c decreased by 0.5% in the Feiolix-HD and by 0.4% in the Feiolix-LD, with both reductions significantly greater than placebo (p < 0.05); Compared with placebo, Feiolix supplementation significantly lowered fasting glucose, insulin, HOMA-IR, total cholesterol and LDL-cholesterol. The Feiolix-HD significantly attenuated the increase in triglycerides observed in the placebo group and was associated with significant reductions in body weight and BMI versus placebo by month 2. However, no change in GLP-1 was observed between the treatments. No treatment-related adverse events were reported. Conclusion: This study supports the potential of Feiolix supplementation to improve metabolic health, including glycemic and lipid outcomes, with additional benefits for body weight and BMI at the higher dose. This study supports the potential of Feiolix supplementation to improve metabolic health, including glycemic and lipid outcomes, with additional benefits for body weight and BMI at the higher dose

Background & aims Food- and nutrient-based inflammatory scores may capture different dietary features. We compared the Food Inflammation Score for Individuals (FISI) and Dietary Inflammatory Index (DII) in relation to cognitive performance and incremental discrimination. Methods This cross-sectional analysis included 2,455 adults aged [&ge;]60 years in NHANES 2011-2014 with four cognitive tests and two reliable 24-h recalls. Daily FISI summed [(food FII per 100 g) x grams/100] across foods; two days were averaged. DII used 33 parameters averaged across the same days. Survey-weighted linear and logistic models incorporated strata, primary sampling units, and WTDR2D/2. Discrimination used survey-weighted AUROCs and 500 stratified primary-sampling-unit bootstrap replicates. Results After full adjustment, a 1-SD higher DII was associated with a 0.091 lower global cognitive Z-score ({beta} = -0.091; 95% CI, -0.143 to -0.040; P = 0.005), whereas FISI was not ({beta} = -0.019; 95% CI, -0.064 to 0.026; P = 0.341). The DII quartile trend was significant (P = 0.007), but nominal domain associations did not survive false-discovery-rate correction. Neither score was associated with low cognitive performance. The base AUROC was 0.8242; adding FISI changed it by <0.0001 (95% bootstrap CI, -0.0002 to 0.0007), and adding DII changed it by 0.0005 (-0.0003 to 0.0021). Conclusions Higher DII, but not FISI, was associated with lower global cognitive performance. Neither score materially improved discrimination for low cognitive performance. The two scores should not be assumed equivalent or interchangeable.

Objective: Observational studies have provided evidence for positive associations between inflammatory dietary patterns (IDP) and mental health, which might be mediated by immune activation. However, a causal relationship has not yet been established. Here we aim to investigate the causal nature of associations between IDP and mental health traits (depressed affect, mood swings, neuroticism, feed-up feelings, worry, irritability) using Mendelian Randomization (MR) analyses. Method: In the UK Biobank dataset, IDP was identified by conducting a partial least squares regression (PLSR) on the items of the food frequency questionnaire along with three inflammatory biomarkers as response variables: C-reactive protein, platelets, and white blood cell (WBC) counts. An individual-level genome-wide association study (GWAS) of IDP was performed within an unrelated European subsample from the UK Biobank (n=320,137) and summary-level GWAS data for mental health traits were utilized for bi-directional two-step MR to test the association between genetically predicted IDP and mental health traits. Result: The first PLSR component was retained for subsequent analysis, with a higher IDP score indicating a more frequent consumption of processed meat, beef, pork, lamb/mutton, and poultry. Genome-wide association analysis identified 101 independent genomic loci. MR analyses indicated a uni-directional positive relationship from IDP to neuroticism and a positive bi-directional relationships between IDP and depressed affect, mood swings, fed-up feelings, and irritability. The mediation effect of total white blood cell count on neuroticism score was also significant (adjusted P<0.05). Conclusion: Our findings identified genetic loci and functional properties of IDP and provided evidence for causal pathways with depressed affect, mood swings, irritability, and fed-up feelings. Implementing dietary advice and interventions should become part of a public mental health approach. Keywords: Inflammatory dietary pattern; Partial least squares regression; Genome-wide association study; Mendelian Randomization; Mental health.

Background Few dietary screeners are available for use with Hispanic/Latino adults in clinical or research settings, despite this group having a disproportionate burden of diet-related chronic disease risk amenable to nutrition intervention and counseling. We previously developed the 36-item Penn Healthy Diet (PHD) screener, which correlates with the Healthy Eating Index (HEI), and adapted it culturally and linguistically for use among Hispanic/Latino adults as the Screener of Alimentary Behaviors and Eating (SABE). Objective We aimed to develop a scoring algorithm for the SABE screener using data from Hispanic/Latino adults in the National Health and Nutrition Examination Survey (NHANES). Methods We used NHANES 2017-2018 dietary recall data from 1,126 Hispanic/Latino adults to simulate responses to SABE screener items. Using Spearman rank correlations, we examined the association between simulated SABE items and HEI-2020 components and validation using the Alternative Healthy Eating Index (AHEI)-2010. Items achieving {rho} [&ge;] 0.3 with any HEI-2020 component were retained in a simple scoring algorithm. A regression-weighted algorithm was then derived using ordinary least squares regression of all screener items on HEI-2020 total score. Reproducibility was evaluated in an independent validation sample of 1,633 Hispanic/Latino adults from NHANES cycle 2015-2016. Results Twelve of 24 screener items were moderately or strongly associated with HEI-2020 components, forming a simple scoring algorithm with a range of 0-60 points. The simulated SABE score was strongly correlated with HEI-2020 ({rho} [&ge;] = 0.73-0.74) and moderately correlated with AHEI-2010 ({rho} [&ge;] = 0.64-0.67). The regression-weighted algorithm improved HEI-2020 correlations ({rho} [&ge;] = 0.80) but not for AHEI-2010 ({rho} [&ge;] = 0.62-0.65). Conclusions The SABE screener is a brief and feasible dietary screener with demonstrated strong validity and reproducibility for assessing diet quality in Hispanic/Latino adults. Further validation of this screener is needed in Hispanic/Latinos subgroups of diverse heritage and acculturation level, and in real-world populations.

Micronutrient deficiencies are prevalent in Madagascar, where diets rely heavily on starchy staples and access to animal-source foods is limited. Small dried fish (SDF) are widely available, yet their nutritional value and health risks remain poorly documented. We combined market surveys, taxonomic identification, and micronutrient and heavy metal analyses of nine SDF types collected along National Road 7. The samples encompassed 33 fish families, were dominated by small pelagic species (Clupeidae and Engraulidae), and were appreciated by consumers. A daily portion (5 g for infants; 10 g for young children and women of childbearing age) contributed substantially to Recommended Nutrient Intakes (RNIs). Across samples and groups, SDF were rich (>30% of RNI) in selenium and, for infants and young children, in calcium. All samples were a source of (>15% of RNI), or rich in, phosphorus, whereas iron contributions were more variable but often substantial. Several samples exceeded 100% of RNIs for selenium, calcium, iron, or manganese in infants and young children, and some were also sources of magnesium and, less frequently, zinc. Vitamin A was absent from sun-dried samples but detected in a smoked freshwater type. Heavy metal concentrations varied markedly, and portions of several types led to estimated exposures to inorganic arsenic or cadmium exceeding reference values, whereas freshwater species and some pelagic types showed a more favorable nutrition-risk balance. Overall, SDF are affordable, nutrient-dense foods with strong potential to alleviate micronutrient deficiencies in Madagascar, while highlighting the need for type-specific guidance to balance nutritional benefits and contamination risks.

AO_SCPLOWBSTRACTC_SCPLOWO_ST_ABSIntroductionC_ST_ABSPolyunsaturated fatty acid (PUFA) status is an important marker of metabolic health across the lifespan, and omega-3 (n-3) PUFA were shown to have anti-inflammatory and cardioprotective effects. The omega-3 index, a composite of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is widely used to assess n-3 PUFA supplementation status, and product-to-precursor fatty acid ratios are used as proxy indices of desaturation and elongation. Previous data indicate a higher proportion of n-3 PUFA with age. Whether the same pattern can be found in an NHANES cohort, and whether long-chain n-3 status relates to phenotypic age (PhenoAge), a composite measure of biological age, has not been established. MethodsWe analyzed erythrocyte fatty acid profiles measured by electron capture negative-ion mass spectrometry in erythrocytes of participants of the National Health and Nutrition Examination Survey (NHANES) 2021-2023. Adults aged 20-79 years with a complete 21-fatty-acid panel were included (n = 4,863) and stratified into five age groups (20-34, 35-44, 45-54, 55-64, 65-79 years). In the fasting subsample with a measured fasting glucose (n = 2,822) we additionally computed PhenoAge according to Levine and assessed PhenoAge acceleration (PhenoAge regressed on chronological age) in relation to EPA and DHA. ResultsPercentage of summarized PUFA and n-6 PUFA decreased with age while percentage of n-3 PUFA and EPA + DHA increased. In contrast, total saturated fatty acids did not differ across age groups. EPA and DHA rose with age, whereas linoleic acid (LA), dihomo-{gamma}-linolenic acid (DGLA) and -linolenic acid (ALA) declined. The delta-5-desaturase (D5D) index (AA/DGLA) and the AA/LA ratio were positively associated with age, while elongation-related proxies ELOVL2 (DTA/AA, DPA/EPA) and ELOVL5 (DGLA/GLA) were inversely associated. Higher EPA + DHA was associated with lower PhenoAge acceleration with the most pronounced effect of - 4,7 years in the group with highest ([&ge;]8%) EPA+DHA content. DiscussionAge-related shifts in erythrocyte PUFA composition and in desaturase and elongase proxy indices reported previously in a clinical cohort from Germany are reproduced in a large US population. In addition, long-chain n-3 status was inversely associated with PhenoAge acceleration.

Background: Aging is associated with physiological, biological, socioeconomic and psychological changes that may increase vulnerability to poor dietary intake, reduced muscle strength and elevated blood pressure. In Ghana, evidence on dietary intake in relation to functional and cardiometabolic health among community-dwelling older adults remains limited. This cross-sectional study assessed dietary intake, handgrip strength (HGS) and elevated blood pressure (BP), and examined associations between diet quality indicators and these health outcomes among older adults in five peri-urban communities in the La Nkwantanang-Madina Municipality, Ghana. Methods: Data were collected from 200 community-dwelling adults aged 60 years and above. Dietary intake was assessed using a multiple-pass 24-hour dietary recall, while physical activity, HGS and BP were measured using standardized procedures. Categorical variables were summarized as frequencies and percentages. Non-normally distributed dietary variables were compared between health outcome groups using the Mann-Whitney U test. Adjusted binary logistic regression was used to examine associations between diet quality indicators and HGS or elevated BP. Results: The mean age of participants was 69.8 {+/-} 7.3 years. More than half did not meet the dietary reference intake for protein, fat, fiber, magnesium, potassium and vitamin E, and no participant met the dietary reference intake for calcium. The prevalence of inadequate minimum dietary diversity (MDD) and inadequate mean adequacy ratio (MAR) exceeded 50%. Energy, protein, carbohydrate and selenium intake differed significantly by HGS status (p < 0.05). Mean adequacy ratio differed significantly by HGS status (p = 0.021) and BP status (p = 0.016). In adjusted models, each one-unit increase in MDD was associated with lower odds of elevated BP (AOR = 0.68; 95% CI: 0.46-1.00; p = 0.05), while each one-unit increase in MAR was associated with higher odds of normal HGS (AOR = 8.77; 95% CI: 1.33-64.08; p = 0.034). Conclusions: Dietary inadequacy was common among older adults in this peri-urban Ghanaian setting. Better diet quality indicators were associated with normal HGS and lower odds of elevated BP. These findings support the need for nutrition-focused strategies and further longitudinal or intervention studies to clarify the role of dietary intake in functional and cardiometabolic health among older adults.

Aim: This study aimed to estimate the prevalence and distribution of minimum dietary diversity for women (MDD-W) and underweight/thinness and examine sociodemographic and dietary factors associated with underweight/thinness among Cambodian women aged 15-49 years. Methods: We conducted a cross-sectional analysis of 9,181 women aged 15-49 years (9,262.5 weighted) from the 2021-22 Cambodia Demographic and Health Survey. Survey-weighted descriptive statistics and provincial mapping were used to describe MDD-W, food-group consumption and underweight/thinness. Rao-Scott chi-square tests assessed group differences, and survey-weighted logistic regression estimated factors associated with underweight/thinness. MDD-W and household wealth were retained a priori in the adjusted model, while other covariates with an overall crude Wald P value <0.20 were included. Results: The analysis included 9,181 women (9,262.5 weighted). Overall, 57.2% achieved MDD-W, and 6.7% had underweight/thinness; 22.8% were overweight, and 5.7% had obesity. Underweight/thinness was highest among women aged 20-24 years (17.7%). Achieving MDD-W was not associated with underweight/thinness in crude analysis (OR 0.93, 95% CI 0.74 to 1.17; P=0.545). In the adjusted analysis, the association remained imprecise (aOR 0.86, 95% CI 0.67 to 1.09; P=0.219). Provincial estimates showed geographic variation in both MDD-W and underweight/thinness. Conclusion: More than half of Cambodian women achieved MDD-W, while underweight/thinness coexisted with overweight and obesity. MDD-W was not clearly associated with underweight/thinness. These findings support monitoring dietary diversity, anthropometric status, and socioeconomic inequalities together in women's nutrition.

Background: The growing burden of lifestyle-related chronic diseases has increased the need for clinically interpretable decision-support tools capable of integrating artificial intelligence with evidence-based preventive nutrition. Although machine learning has shown considerable potential for health risk prediction, most existing approaches remain limited to isolated predictive models or conventional nutritional software, with little integration of multidimensional clinical assessment and personalized recommendations. Objective: To develop and internally validate NutrIA, a hybrid web-based Clinical Decision Support System (CDSS) that combines machine learning, validated clinical assessment, structured clinical reasoning and personalized nutritional recommendations for preventive medicine. Methods: NutrIA was developed using harmonized data from the National Health and Nutrition Examination Survey (NHANES, 1988 to 2018). A supervised machine learning model was trained to estimate 5-, 10- and 20-year all-cause mortality risk and subsequently integrated with an adaptive clinical questionnaire, validated screening instruments, nutritional indicators, dietary clustering, clinical phenotyping and a transparent rule-based recommendation engine within a unified web-based platform. Results: The predictive model achieved ROC-AUC values of 0.894, 0.914 and 0.923 for 5-, 10- and 20-year mortality prediction, respectively. The implemented CDSS incorporates an adaptive questionnaire (151 items), 39 validated clinical assessment instruments, 17 clinical phenotypes and 31 dietary clustering modules to generate individualized nutritional and lifestyle recommendations together with an automated clinical report. The integrated framework translates probabilistic risk estimates into clinically interpretable decision support for personalized preventive nutrition. Conclusions: NutrIA demonstrates the technical feasibility of integrating machine learning with knowledge-based clinical reasoning within a single web-based CDSS for preventive nutrition. Although external validation and prospective clinical evaluation are required before routine implementation, the proposed architecture represents a promising step toward clinically interpretable artificial intelligence for personalized nutritional care.

We conducted a pilot study in adults with and without type 2 diabetes (T2D), measuring whole-blood thiamine diphosphate (TDP) concentrations alongside erythrocyte transketolase activity (TKT) and activity coefficients (ETKAC), and evaluated these findings alongside dietary and ETKAC data from the U.K. National Diet and Nutrition Survey (NDNS). In the pilot cohort, circulating TDP concentrations did not differ between T2D and control groups, and ETKACs were largely sufficient, yet absolute TKT activities varied approximately sixfold among participants. Magnesium supplementation of erythrocyte lysates increased TKT activity, demonstrating that cofactor availability beyond TDP can influence functional measurements. Discordance between circulating TDP and functional status was also observed, including ETKAC-defined deficiency despite a TDP concentration within the reference range. Among participants with T2D, TDP was positively associated with fasting glucose and HbA1c, a relationship absent in controls. In NDNS analyses, higher thiamine intake and dietary density were strongly associated with lower ETKAC-defined non-sufficiency, although substantial non-sufficiency persisted despite adequate intake. Dietary thiamine density, ethnicity, age, and magnesium intake were independently associated with ETKAC status. Collectively, these findings support the conclusion that circulating TDP, dietary intake, and ETKAC provide related, but non-equivalent measures and support integrating both direct and functional assessments of thiamine status.

Despite the numerous benefits associated with higher dietary quality, many older Veterans do not meet national dietary recommendations. Existing programs are not typically tailored for older Veterans who may experience physical and environmental limitations that hinder their ability to access and prepare healthy foods. This project piloted the incorporation of age-friendly, tailored, virtual nutrition education into an existing health promotion program for older Veterans. Programming followed an iterative design process over two years. Year 1 included 14 weeks of virtual nutrition education on healthy aging paired with weekly produce bags and recipe suggestions. In Year 2, virtual nutrition education shifted to more hands-on learning emphasizing basic meal preparation and adaptive cooking strategies for mobility limitations. Produce distribution in Year 2 shifted to a farmer's market model, based on feedback from year 1, allowing participants to self-select items. Primary outcomes included program satisfaction, dietary intake assessed via 24-hour recall to calculate the Healthy Eating Index (HEI-2015), and health-related quality of life (PROMIS Global Health). Findings demonstrate the feasibility and acceptability of a virtual nutrition program incorporating age-friendly cooking instruction and adaptive strategies to improve dietary quality among older Veterans.

Phosphatidylserine (PS) is a functional phospholipid widely studied for cognitive support, yet evidence in healthy adults with subjective cognitive decline remains limited. This 12-week randomized, double-blind, placebo-controlled trial evaluated the safety and cognitive effects of 300 mg/day of soybean-derived PS in 70 adults aged 35-65 years reporting subjective memory complaints. PS was well tolerated, with no adverse events or clinically significant changes in safety parameters. In the prespecified primary analysis, the primary endpoint of composite memory score did not differ significantly between groups at week 12. Exploratory secondary analyses suggested possible domain-specific effects, including favorable changes in working memory (p = 0.037) and motor speed (p = 0.005), with the latter appearing to vary according to blood fatty-acid profiles. These findings should be interpreted cautiously and require confirmation in future studies designed to evaluate these domains and potential nutritional moderators.

Low protein (LP) diets improve metabolic health in rodents and humans. In rodents, LP diets are typically implemented by replacing protein with carbohydrates like sucrose or cornstarch, keeping diets isocaloric. However, humans can choose from many different types of carbohydrate, and how dietary carbohydrate quality - the precise composition of the dietary sugars - impacts the response to dietary protein remains largely unexplored. Here, mice were fed control (21% protein) or LP (7% protein) diets with four different carbohydrate sources: sucrose, a 1:1 glucose/fructose mixture, glucose, or fructose. While LP diets improved metabolic health across all groups in male mice, carbohydrate quality also significantly altered specific health outcomes, with fructose-fed mice having the lowest body weight and adiposity of all control diets. In female mice, responses to LP diets were influenced by carbohydrate quality, with certain sugars inducing a stronger metabolic response to LP diets than previously seen. Finally, in female APP/PS1 mice, a model of Alzheimer's disease, we find that although LP diets reduce A-beta; plaque burden irrespective of carbohydrate type, dietary sugar type does influence spatial memory. Together, these results demonstrate that while dietary protein is a critical determinant of metabolic and neurological health, carbohydrate quality influences these outcomes in a sex-specific manner.

High low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels are associated with heavy alcohol consumption, but the accuracy of LDL-C estimation equations according to drinking status remains unclear. We analyzed direct LDL-C and drinking-status data from 28,882 participants in the Korea National Health and Nutrition Examination Survey, classified as non/ex-drinkers, moderate drinkers, or binge drinkers. Mean absolute deviation (MAD) was calculated for the Friedewald, Martin-Hopkins, and Sampson equations relative to directly measured LDL-C, and 95% confidence intervals for the median absolute deviation (MeAD) were determined by TG level. Estimation error increased with heavier alcohol consumption and higher TG level. In binge drinkers, all three equations underestimated LDL-C, with the largest deviation at higher TG levels. The Sampson equation showed the lowest MAD and MeAD across drinking categories and TG strata and was most accurate at a TG level of 150-400 mg/dL, whereas the Martin-Hopkins equation was more accurate at TG levels of [&ge;]400 mg/dL. The Sampson or Martin-Hopkins equation estimates LDL-C more accurately than the Friedewald equation regardless of drinking status and should be preferred, with the choice further individualized by TG level in heavy drinkers.

Plant-based diets may benefit planetary and human health. However, the molecular pathways linking plant-based diet quality to chronic diseases remain unclear. In 4,372 participants from the European Prospective Investigation into Cancer and Nutrition, we assessed 7,285 SomaScan-measured aptamers to identify circulating proteins associated with healthful (hPDI) and unhealthful (uPDI) plant-based dietary patterns using complementary statistical and machine-learning approaches. We then applied cis-pQTL Mendelian randomization (MR) and colocalization to prioritize diet-associated proteins with genetic evidence for associations with overall and site-specific cancers, type 2 diabetes (T2D), and cardiovascular disease (CVD). Among diet-associated proteins with MR evidence, 8 hPDI- and 12 uPDI-related protein-disease associations showed strong colocalization, including EGFR-breast cancer, MMP10-endometrial cancer, NCAN-T2D, and PCSK9-CVD. These findings identify candidate proteins that may link plant-based diet quality to chronic diseases and provide biological insights into the potential health benefits of healthful plant-based diets, which are increasingly relevant to public and planetary health.

Objective To develop and evaluate an automated large language model (LLM)-based framework for conducting meta-analyses of nutrition-related exposures and the risk of breast, ovarian, and uterine cancers. Design We developed MetaFemina, an automated evidence-synthesis pipeline for women's cancers that integrates keyword-based literature retrieval, LLM-assisted evidence extraction, and random-effects meta-analysis. We evaluated its performance against two recently published peer-reviewed meta-analyses and compared exposure-outcome associations across the three cancer types. Data sources PubMed articles identified through keyword-based searches of titles and abstracts. Methods MetaFemina was developed as a web platform that identifies relevant scientific articles, automatically extracts relevant information using LLMs, and synthesizes extracted evidence using random-effects meta-analysis. Additional analyses included assessment of heterogeneity, publication bias, and leave-one-out sensitivity analyses. The platform also provides sample size calculations based on synthesized effect sizes and generates visual summaries and plain-language interpretations. Results Compared with two recent peer-reviewed meta-analyses of folate and vitamin E intake in relation to breast cancer risk, MetaFemina demonstrated high sensitivity (81.82% and 80%, respectively) in identifying eligible studies and additionally retrieved relevant articles that had been missed by manual screening (27 and 13, respectively). Among 226 exposures considered, lutein and beta-carotene were significantly associated with lower risks of breast, ovarian, and uterine cancers. Vitamin D, antioxidants, and soy were significantly associated with lower risks of both breast and ovarian cancers, whereas calcium and folic acid were significantly associated with lower risks of both breast and uterine cancers. In contrast, iron, red meat, and copper were significantly associated with higher risks of both breast and uterine cancers. omega-6 fatty acids showed contrasting associations, being significantly associated with higher breast cancer risk but lower ovarian cancer risk. After restriction to dietary-intake studies, these cross-cancer significant associations remained statistically significant except for copper, which no longer met the two-study threshold for either breast or uterine cancer. Additionally, calcium became significantly associated with lower ovarian cancer risk, resulting in significant negative associations across all three cancer types, while vitamin E became significantly associated with lower breast cancer risk and remained significantly associated with lower ovarian cancer risk. Conclusions MetaFemina demonstrated high sensitivity for identifying relevant scientific literature, extracts key evidence, and performs statistically rigorous automated meta-analyses. The framework may facilitate more rapid evidence synthesis in nutritional epidemiology and may support researchers in study design, hypothesis generation, and interpretation of emerging evidence.

Returning individual results to research participants is increasingly expected in genomic studies. Yet, genomic dietary data have unique characteristics. New DNA sequencing techniques reconstruct diet from the residual plant and animal DNA recoverable in stool, reporting not nutrients or calories but a list of the species a person ate. Turning that list into something a participant can understand does not yet have an established framework. The Everyone EATS (Edible Atlas Through Sequencing) study returned personalized genomic dietary profiles to a non-clinical pilot cohort. Participants collected a stool sample at home, samples were processed with FoodSeq, and each participant received an interactive Diet Data Return Report that translated detected taxa into familiar food groups and benchmarked them against prior FoodSeq cohorts. No monetary compensation was offered, and the Diet Data Return Report was the sole incentive. Of 111 kits mailed, 80 were returned (72.1%) and sequenced (100% sequencing success for plant DNA; 98.7% for animal). Among report recipients with engagement data (n = 73), all accessed their report and 74% engaged interactively with its content. Among 16 feedback survey completers, 13/16 (81.2%) found the report easy to understand, 13/16 (81.2%) reported improved understanding of their dietary variety, and 5/16 (31.2%) reported a dietary behavior change. Curiosity about personal dietary data and supporting broader research goals were the most common reasons for enrolling (79.8%, respectively). Notably, the foods participants flagged as missing or unexpected clustered among herbs, spices, seafood, and processed items, the foods most easily forgotten in self-report and least readily assigned from sequence. Overall, our results suggest that genomic dietary data can be returned in a form participants find understandable and engaging, and that curiosity alone can motivate participation without payment.

Introduction: Study to evaluate the pharmacokinetics (PK), subject satisfaction, and gastrointestinal (GI) tolerability of single and multiple doses of a novel oral iron formulation based on iron enriched microalgae Spirulina platensis supplemented with inactivated yeast. Methods: Twelve healthy women with baseline serum iron 4-12 mol/L (22.3-67.0 g/dL) were admitted to the study site for 3 days in this single centre, multiple-dose, open-label study. Subjects received an oral dose of Monurelle(R) Ferro Naturale (MFN) on Days 1, 2, and 3. Blood for PK analysis was collected pre-dose (0) and at 1, 2, 3, 4, 5, 8 hours after dosing on Days 1 and 3, with assessment of subject satisfaction and GI tolerability performed 3 hours after each dose. Results: Both single and multiple dosing with MFN led to a defined peak level (Cmax) and increased systemic exposure (AUC0-t), with serum iron rising to almost double the circulating amount at 5 h post-dose (tmax). Mean ({+/-}SD) percent change from baseline at 5 h post-dose was 94.7% ({+/-}56.1) on Day 1 and 72.0% ({+/-}70.7) on Day 3. The majority of subjects reported being satisfied with the product and would use it again in the future. MFN was very well tolerated, with only one adverse event (AE) reported (episode of vomiting after the first dose, that lasted for one minute and did not recur after the two further doses of MFN). No other subject experienced any GI side effects. Discussion: This first report of oral Monurelle(R) Ferro Naturale in humans shows this novel formulation to provide a favourable PK profile with respect to serum iron concentrations, with excellent tolerability and high subject satisfaction.

Background: There is a growing availability of plant-based alternatives for bovine milk. However, plant-based drinks differ e.g. in protein quantity, protein quality and carbohydrate composition. Knowledge on the impact this has on digestion-related outcomes such as postprandial amino acid (AA) availability and gastric behavior is still limited. Additionally, data on milk alternatives with higher overall protein concentration are lacking. Objective: We aimed to compare the differences in postprandial AA profiles, glycemic response, and gastric behavior between bovine milk and plant-based drinks with or without added protein using representative commercial drinks. Methods: 12 healthy males participated in a randomized crossover study with three treatments. After an overnight fast, participants drank 750 ml of semi-skimmed milk (Milk), a standard oat-based drink (OBD) or an oat-based drink enriched with pea protein (OBD+Pea). Blood samples were taken for measurement of plasma AA, glucose, insulin and FGF21 over 5 hours. Gastric content changes were assessed using magnetic resonance imaging scans for Milk and OBD+Pea over 2 hours. Results: Compared with Milk, both oat-based drinks elicited lower 5-h total AA iAUC (OBD -169706; OBD+pea -139552 microM*min; both P<0.001) and EAA iAUC (OBD -91748; OBD+pea -78199; both P<0.001), with no differences between oat-based drinks. Gastric content volume was lower for OBD+Pea versus Milk from 60-120 min (range -48 - -84 ml, all P<0.001). Compared to Milk, OBD and OBD+Pea increased glucose more from 15-45 min (range 0.86 - 1.73 mmol/l, all P<0.001) and insulin from 30-60 min (1.84 - 2.14-fold, all P<0.001). Conclusions: Protein enrichment in plant-based milk alternatives can be a valuable strategy to increase protein content and improve amino acid composition. However, such products still show faster gastric emptying, lower postprandial essential amino acid and higher glycemic and insulinemic responses compared to bovine milk because of their different carbohydrate and protein content and quality.