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Frontiers in Nutrition

Frontiers Media SA

Preprints posted in the last 30 days, ranked by how well they match Frontiers in Nutrition's content profile, based on 23 papers previously published here. The average preprint has a 0.06% match score for this journal, so anything above that is already an above-average fit.

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Dietary intake of plant bioactives among European adults

Michelini, C.; Bergamo, F.; Rosi, A.; Del Rio, D.; Mena, P.

2026-04-16 nutrition 10.64898/2026.04.14.26350848 medRxiv
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This work explores the dietary intake of plant bioactives in the European adult population. The information available in the scientific literature is quite fragmented, with only partial knowledge of dietary bioactive intake and their health effects, and without harmonised figures across populations and phytochemical families. In this context, we comprehensively evaluated the intake of (poly)phenols, terpenoids, N-containing compounds, and miscellaneous phytochemicals in the European adult population, using public data from 26 countries reporting on 38,944 individuals. Further research was conducted to investigate the contributions of classes, subclasses, and individual compounds, as well as their relationships. Main food sources of each class and subclass of phytochemicals were also identified. Finally, variability in phytochemical intake across European countries was evaluated. This work significantly advances the current knowledge of plant bioactive intake and sets the stage for future research in nutrition and health fields.

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Resolution of systemic inflammation in psoriasis following herring roe oil treatment: a post hoc analysis on inflammatory biomarkers in non-severe psoriatic patients

Ringheim-Bakka, T. A.; Gammelsaeter, R.; Tveit, K. S.

2026-04-22 dermatology 10.64898/2026.04.20.26350934 medRxiv
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BackgroundPsoriasis is a chronic immune-mediated inflammatory disease (IMID) with systemic involvement. In mild-to-moderate disease, circulating cytokines may inadequately capture systemic inflammatory burden. Composite haematological indices derived from complete blood counts, such as the systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), have emerged as sensitive prognostic markers of systemic inflammation, including in psoriasis. This exploratory post hoc analysis investigated the effects of orally administered herring roe oil (HRO), a phospholipid-rich marine oil, on systemic inflammation in patients with mild-to-moderate psoriasis utilizing these biomarkers. MethodsData were analysed from a randomized, double-blind, placebo-controlled 26-week clinical study which investigated HRO supplementation in patients (N = 64) with mild-to-moderate psoriasis (NCT03359577). SII, SIRI, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated at baseline, week 12, and week 26 for patients where baseline complete blood counts (CBCs) were available (n = 60). Patients missing baseline CBCs were excluded from the analysis. Continuous changes were assessed using ANCOVA with baseline adjustment. Categorical responder analyses were performed with 25% and 30% reduction thresholds and stratification by baseline biomarker medians were performed to evaluate treatment responses and impact of baseline inflammation. ResultsCompared with placebo, HRO treatment resulted in significant mean reductions in SII, SIRI, and PLR at week 26, with supportive trends and responder effects observed as early as week 12 compared to placebo. Patients with elevated baseline inflammatory indices showed the greatest reductions in systemic inflammation. Stratification by baseline SII further revealed enhanced clinical benefit, with statistically significant PASI50 response rates in the HRO arm at week 26 among patients with lower baseline SII. ConclusionHRO supplementation was associated with a time{square}dependent reduction in systemic inflammatory biomarkers in mild{square}to{square}moderate psoriasis patients. These findings support the utility of composite inflammatory indices for monitoring systemic inflammation and suggest that baseline SII may have utility in predicting treatment response and may be a useful tool for stratification in clinical trials in mild to moderate psoriasis patients. These results could also suggest platform-potential of HRO for resolution{square}oriented interventions across several inflammatory conditions.

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Konjac Glucomannan Improves Body Composition and Reduced Blood Cholesterol, Inflammation, and Cardiovascular Risk in Adults with Excess Weight: A Triple-Blind, Placebo-Controlled Randomized Clinical Trial

Escobar, J. S.; Corrales-Agudelo, V.; Ortega-Sierra, O. L.; Villota-Salazar, N. A.; Rivera, D. A.; Pulgarin-Zapata, I. C.; Hernandez-Londono, M.; Lara-Guzman, O. J.; Sierra, J. A.; Alvarez-Quintero, R.; Polanco, J. P.; Munoz-Durango, K.

2026-04-20 nutrition 10.64898/2026.04.18.26351176 medRxiv
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Obesity and related cardiometabolic diseases pose significant global health challenges. Konjac glucomannan, a soluble dietary fiber, has shown promise in managing these conditions. However, rigorous studies are necessary to establish its benefits on human health. We designed a parallel-arm, triple-blind, placebo-controlled RCT to test the effects of glucomannan (3 g/day, 12 weeks) on body weight and composition, lipid profile, glucose metabolism, inflammation, adipokines, intestinal permeability, gut microbiota, and fecal metabolites in 40 adults. Participants were randomly assigned to either the glucomannan or placebo group, with both groups adhering to personalized hypocaloric diets and moderate physical activity. Outcomes were analyzed as intention-to-treat using linear mixed-effect models. Irrespective of the treatment, our intervention reduced body weight (mean: -2.39 kg; 95% CI: -3.38, -1.40), BMI (-0.83 kg/m2; -1.15, -0.52), and waist (-2.70 cm; -3.87, -1.53). Glucomannan promoted additional benefits not obtained with the placebo, reducing body fat measured by DEXA (body fat%: -2.16%; -3.04, -1.28; VAT: -20.0 cm2; - 29.2, -10.8; FMI: -0.98 kg/m2; -1.34, -0.62), LDL (-14.1 mg/dL; -23.4, -4.9), and the atherogenic index (-0.50; -0.80, -0.21). It also diminished the Framingham score of 10-year risk of coronary heart disease (-0.370; -0.625, -0.115), C reactive protein (-1.01 mg/L; -2.18, 0.15), leptin (-2.06 ng/mL; -4.48, 0.365), and leptin/adiponectin (-0.282; -0.603, 0.040). The two treatments had similar intakes, physical activity, and adherence to the intervention. There were no adverse effects. This intervention fostered health benefits in a population at high risk of cardiometabolic diseases. Konjac glucomannan was an effective co-adjuvant for further reducing risk factors.

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A randomized, double blind, placebo controlled study evaluating the impact of Hericium erinaceus (Lions Mane) on cognitive performance and subjective wellbeing

Daoust, J.; Farrar, S.; Grant, A. D.; Erfe, M. C. B.; Oliver, P. L.; Luna, V.; Moos, J.; Craft, N.

2026-04-17 nutrition 10.64898/2026.04.13.26350781 medRxiv
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Hericium erinaceus (Lions Mane) is a functional mushroom with a long history of culinary and traditional use, as well as potential neurotrophic and mood modulating properties. Evidence for its effects on cognitive performance under real world conditions, however, remains limited. In this randomized, double blind, placebo controlled trial, adults aged 40 to 75 years with self reported cognitive difficulty completed a one week baseline followed by eight weeks of daily supplementation with 2 g of H. erinaceus fruiting body and mycelial biomass or placebo. Cognitive performance using a computerized battery, as well as daily subjective assessments of sleep and wellbeing, were collected remotely. 109 Participants were included in the primary analysis (H. erinaceus, n = 57; placebo, n = 52). H. erinaceus was associated with significantly greater improvement in visual attention and working memory (Juggle Factor task), subjective sleep quality, morning restedness, and mood compared with placebo (p < 0.05). No adverse events were reported in participants receiving H. erinaceus. Together, H. erinaceus supplementation modestly improved visual attention and was associated with faster improvements in sleep quality, restedness, and mood in adults with subjective cognitive concerns.

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Evaluating the Impact of Socioeconomic Factors on Dietary Choices and Nutritional Status of Adults in Selected Urban and Rural Communities in Ekiti State

ADENIYI, B. M.; OGUNETIMOJU, A.; Olofinsanmabo, O. A.

2026-04-06 nutrition 10.64898/2026.03.31.26349759 medRxiv
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Introduction: Adults in Nigeria face a growing nutrition challenge: while some struggle with undernutrition, others are increasingly affected by overweight and obesity. This double burden of malnutrition reflects socioeconomic divides, where income, education, and household conditions shape food choices and health. This study examined how socioeconomic factors influence dietary diversity, nutritional knowledge, and nutritional status among adults in urban and rural communities of Ekiti State. Methods and Analysis: A descriptive cross-sectional survey was conducted among 350 adults selected via multistage sampling. Data were collected using structured questionnaires and anthropometric measurements. Dietary diversity was assessed using food group frequency, and nutritional status was determined by BMI. Associations were analyzed using chi-square tests (p < 0.05). Results: Significant urban-rural divides were identified: urban respondents were more educated (48.8% tertiary), while rural households were more dependent on farming (35.0%) and low-income (62.0% <70,000). Dietary patterns differed significantly: urban diets favored legumes (58.4%) and cereals (56.0%), while rural diets predominated in sugar/honey (90.0%) and roots/tubers (71.0%). Nutritional knowledge was higher in urban areas. Nutritional status revealed a dual burden: 20.4% of urban and 22.0% of rural respondents were underweight, while combined overweight/obesity affected 18.4% of urban and 25.0% of rural participants. Conclusion: Socioeconomic factors strongly dictate dietary choices and health in Ekiti State. Urban areas show greater diversity but rising obesity risks, while rural areas face persistent undernutrition. These findings highlight the need for tailored, state-specific interventions addressing both food insecurity and emerging diet-related chronic disease risks. Keywords: Socioeconomic factors, Dietary diversity, Nutritional knowledge, Double burden of malnutrition, Ekiti State, Nigeria.

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Colon-delivered vitamin B2 as a functional modulator of the human gut microbiome

Steinert, R. E.; Sybesma, W.; May, A.; Peng, C.; Abeel, T.; Myers, P. N.; Wu, L.; Obbink, F. K.; Loren van Themaat, E. V.; Schegg, J. W.; Wojcik, J.; Rehman, A.

2026-04-03 nutrition 10.64898/2026.04.01.26349391 medRxiv
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Vitamin B2 (riboflavin) is a key redox cofactor that may modulate gut microbial ecology, yet conventional supplements are absorbed proximally and have limited colonic exposure. We evaluated whether colon-targeted riboflavin alters microbiome composition, function and network structure as well as host biomarkers in healthy older adults. In a randomized, double-blind, placebo-controlled, parallel-group clinical trial (N=348; 50-70 years), participants received colon-targeted riboflavin (1.4, 10, or 75 mg/day) or placebo for 12 weeks. The primary endpoint was the change in fecal microbial composition, while secondary endpoints encompassed microbiome function, host health biomarkers, and clinical outcomes. Shotgun metagenomics and fecal/blood biomarkers were assessed at baseline, week 4, and week 12. Although no significant changes were observed between groups in overall community-wide diversity metrics (alpha and beta diversity), colon-delivered riboflavin significantly altered the relative abundance of several microbial taxa compared with placebo. The most pronounced effects on microbiome composition, function, and network structure were observed with the 10 mg dose at week 12, reflected by within-group increases in alpha diversity, the largest rise in total species counts, higher HACK index values indicating greater community resilience, and distinct shifts in KEGG module abundance, including enhanced potential for riboflavin biosynthesis. Supplementation with 75 mg riboflavin led to higher fecal butyrate concentrations at week 4 versus placebo, while the lowest dose (1.4 mg) significantly reduced the dysbiosis index within groups and modestly improved network structure across groups. All three doses (1.4, 10, and 75 mg) influenced keystone species abundance. No between-group differences were observed for gastrointestinal symptoms, quality-of-life measures, fecal pH, high-sensitivity C-reactive protein (hs-CRP), calprotectin, or soluble CD14, except for an increase in plasma riboflavin concentrations at 75 mg after 12 weeks, indicating colonic absorption. The product was safe and well-tolerated across all doses. These findings indicate that colon-targeted riboflavin can act as a functional modulator of the human gut microbiome, with the most consistent effects observed at 10 mg and additional dose-specific effects at 1.4 mg and 75 mg. Future studies are warranted to establish related health benefits, either as a standalone intervention or in combination with classical pre-, pro-, or postbiotics, particularly in target populations such as individuals with IBS, stress, mild cognitive decline, or early metabolic or inflammatory alterations.

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Proteomic associations with eating behaviors in young adults: a twin study

Masip, G.; Drouard, G.; Kaprio, J.

2026-04-15 nutrition 10.64898/2026.04.14.26350850 medRxiv
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Introduction: Eating behaviors are consistently associated with weight-related traits, yet the biological factors contributing to individual differences in these behaviors remain poorly characterized. Plasma proteomics offers an opportunity to investigate the biological processes underlying eating behaviors. Methods: Participants were 730 young adult twins from the FinnTwin12 cohort. Eating behaviors were measured through self-report questionnaires, including the Three-Factor Eating Questionnaire-R18 and four additional items on eating styles. Associations between plasma proteins and eating behaviors were examined using generalized estimating equation models adjusted for age and sex, with additional analyses adjusting for body mass index (BMI). Within-pair analyses were conducted in both monozygotic (MZ) and dizygotic twin pairs to assess whether associations were influenced by genetic or environmental factors. Results: We identified 51 significant protein-eating behavior associations involving 35 unique proteins (FDR <0.05). We observed 19 associations for the item "overeating when feeling down" and 12 for the TFEQ factor of emotional eating. The identified proteins were predominantly enriched in immune system pathways, including the complement cascade and adaptive immune signaling. After further adjustment for BMI, 12 associations persisted, most of which were associated with eating-style items, suggesting that BMI had a substantial influence on protein-eating behavior associations. Within-pair analyses of MZ pairs indicated that several associations persist after accounting for genetic effects. Conclusion: Our study identifies plasma proteins associated with eating behaviors, largely involving immune-related pathways. While some associations attenuated in twin analyses, several persisted, suggesting environmental influences. These results highlight potential biomarker candidates and indicate that modifiable environmental factors may contribute to the proteomic profiles associated with eating behaviors, with possible implications for weight-related traits.

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Demographic Factors Moderate the Effectiveness of Obesity Prevention Interventions: A Secondary Analysis of College Intervention Trials

Winn, C.; Groene, L.; Colby, S.; Ademu, L.; Olfert, M. D.; Byrd-Bredbenner, C.; Mathews, A.; Stabile Morrell, J.; Brenes, P.; Brown, O.; Barr-Porter, M.; Greene, G.; Dhillon, J.

2026-04-27 nutrition 10.64898/2026.04.22.26351238 medRxiv
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Background: College-attending young adults frequently experience declines in diet quality, physical activity, and psychological well-being during the transition to independent living, contributing to weight gain during the first year of college. Although multicomponent lifestyle interventions have been developed to address these behaviors, the responsiveness to such programs could differ across demographic factors associated with health behaviors, such as sex, race, and ethnicity. Hence, this secondary analysis of large-scale college health trials evaluated whether the effectiveness of such interventions differed by these demographic factors. Methods: Data were combined from two multi-site randomized controlled trials: Young Adults Eating and Active for Health (YEAH) trial and the Get FRUVED trial. Both interventions used theory-based approaches to promote healthy weight management through improvements in diet quality, physical activity, and stress management. Baseline-adjusted linear regression models evaluated the effects of group (intervention, control) and its interactions with sex, race (White, Black, Other), or Hispanic ethnicity. Models were adjusted for baseline outcome values, baseline BMI, study (YEAH vs. FRUVED), and state of data collection. Results: Intervention participants reported higher fruit and vegetable intake, lower processed meat intake, and longer sleep duration compared with controls. However, there was significant heterogeneity in these dietary outcomes by ethnicity, race, and sex. Non-Hispanic participants in the intervention group had higher fruit and vegetable intake compared to controls (p < 0.05). And, within the intervention group, Hispanic females had lower bacon/sausage intake than Hispanic males and non-Hispanic females (p < 0.05). With respect to race, Black participants reported higher total processed meat intake than White and Other race participants (p <0.05). These demographic factors did not moderate the intervention's impact on physical activity, sleep duration, and perceived stress. Overall, the intervention appeared to be the least effective for Hispanic males who exhibited higher body weight and waist circumference compared with Hispanic females and non-Hispanic males (p < 0.05). Conclusions: Multicomponent lifestyle interventions can improve selected dietary outcomes among college students, but effectiveness may differ across demographic subgroups. Culturally and sex-tailored strategies that consider the intersecting influences of sex, race, and ethnicity may enhance intervention effectiveness during the transition to college.

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Ultra-processed food consumption and frailty in older adults: a systematic review and meta-analysis

Pu, M.; Ma, Q.

2026-03-30 nutrition 10.64898/2026.03.29.26349639 medRxiv
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Frailty is an age-related syndrome characterized by biological dysfunction and reduced physiological reserve in response to stressors. Its prevalence is increasing with population aging, resulting in a substantial health burden due to adverse outcomes on health, such as cardiovascular disease and mortality. Ultra-processed foods (UPFs), defined as industrial formulations made primarily from processed ingredients, have received increasing attention due to their potential role in the development and progression of frailty. This systematic review and meta-analysis examined the association between ultra-processed food intake and the risk of frailty in older adults. This study systematically searched for all relevant studies published up to January 2026. Ten observational studies involving 105327 participants, comprising 6 prospective and 4 cross-sectional studies, were included in the systematic review, of which 6 were eligible for meta-analysis. Random-effects models were employed to estimate pooled effect sizes and 95% confidence intervals (95% CIs). Meta-analysis showed that higher consumption of UPFs was significantly associated with an increased risk of frailty (pooled OR = 1.43, 95% CI = [1.02-2.005], p = 0.041). Narrative synthesis further supported a positive association between UPF intake and frailty or related outcomes. Our findings suggest that a higher consumption of ultra-processed foods may contribute to frailty risk, potentially through inflammatory pathways. However, given the high heterogeneity, results should be interpreted with caution. Overall, our findings suggest that reducing UPF consumption may be a promising target for public health strategies to prevent frailty in ageing populations.

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N-3 Polyunsaturated Fatty Acids Ameliorate Post-infarction Cardiac Dysfunction Through Modulation Of Adiponectin-Ceramide Metabolism

Liu, Y.; Sun, W.; Liu, J.; Wu, H.; Liu, P.; Chen, Y.; Zhang, R.; Chen, W.; Wang, S.; Guo, X.; Zhang, W.; Cao, L.

2026-04-16 pharmacology and toxicology 10.64898/2026.04.13.718333 medRxiv
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BackgroundIt has been shown that n-3 polyunsaturated fatty acids (n-3 PUFA) of marine origin exert significant beneficial effects on myocardial infarction (MI); however, the underlying mechanisms remained unclear. Ceramides play a vital role in the regulation of energy metabolism, mitochondrial function, and apoptosis. Through the integration of clincial studies and animal experiments, this study aimed to determine whether n-3 PUFA improved myocardial function by modulating ceramide metabolism. MethodsIn a case-control study, 100 patients with AMI and 100 healthy pariticipants were enrolled to measure serum ceramide concentrations. Meanwhile, mice were randomly allocated into 4 groups and administrated to a 3-week intervention with n-3 PUFA in triglyceride and phospholipid forms. A mouse model of MI was then established, followed by an additional 4 weeks of continuous intervention. Subsequent comprehensive assessments of cardiac function were performed in the mice. Finally, the mice were euthanized to conduct targeted ceramide lipidomic analysis and other relevant assays. ResultsThe levels of serum C16:0-, C18:0-, C20:0-, C24:1-ceramides and total ceramides in patients with acute myocardial infarction (AMI) were significantly higher compared with the healthy controls. In the murine model of myocardial infarction, pathological analysis via TTC staining demonstrated that interventions with fish oil (triglyceride form) and krill oil (phospholipid form) both significantly reduced myocardial infarct size. Concomitant echocardiographic assessment confirmed that both treatments markedly elevated left ventricular ejection fraction (LVEF), with the magnitude of improvement being significantly superior to that of the model control group. Concurrently, compared with the model group, the concentrations of ceramides in cardiac tissue and serum were significantly lower in the groups with fish oil and krill oil intervention. Western blot analysis further confirmed that n-3 PUFA intervention upregulated adiponectin expression, reduced ceramide accumulation in myocardial tissue, and inhibited mitochondria-mediated cardiomyocyte apoptosis, thereby improving cardiac function and prognosis following myocardial infarction. ConclusionsThis work demonstrates that n-3 PUFA exert cardioprotective effects following MI mediated by adiponectin-ceramide axis. However, there is no significant difference regarding therapeutic efficacy of n-3 PUFA in triglyceride or phospholipid forms.

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Food for frailty: Views of older adults on development and uptake of a foodbased frailty supplement

Valdes, A.; Hussain, B.; Timmons, S.

2026-04-07 nutrition 10.64898/2026.04.01.26348969 medRxiv
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Abstract Objective: Frailty is an important concern in old age. Inflammation can cause frailty. Anti-inflammatory food supplements can play a role in slowing down frailty processes and consequences. This study explored the views of people (aged 50-89 years) on the need to develop a frailty supplement, preferences for its form and how older people could be encouraged to use such a supplement. Design: We conducted semi-structured qualitative interviews and used a framework method to analyse the data. Participants: 30 participants from a city in the UK. Setting: These participants were recruited from social housing, care homes, foodbanks and the wider population. Participants were from diverse ethnic, gender and age backgrounds. Results: Participants identified a strong need for the development of a food-based supplement for frailty. They expressed excitement for the supplement and viewed it as something which they would be happy to integrate in their daily food routine. In terms of preferences, our participants wanted to have multiple options, however, a biscuit-based supplement was preferred by most. The participants preferences were mainly based on taste of the supplement, its effectiveness, convenience in use and affordability. Muslim participants in the sample said they would be happy to use this supplement if it was developed using Halal ingredients. In terms of creating awareness and encouraging people to use the proposed supplement, participants suggested a variety of marketing methods. These included: word of mouth, face to face sessions with older adults, social media, especially YouTube and advertising on TV. Conclusion: The participants were generally open to the idea of a food-based supplement and felt that it could easily fit with their existing food practices and lifestyles. Keywords: older adults, frailty, food supplement, co-creation, healthy ageing

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Evaluating a Multitask AI Model versus Humans for Portion Size Estimation

Nurmanova, B.; Omarova, Z.; Sanatbyek, A.; Varol, H. A.; Chan, M.-Y.

2026-04-18 nutrition 10.64898/2026.04.16.26351036 medRxiv
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Background: Accurate dietary assessment is essential for precision nutrition and effective nutrition surveillance. However, portion size estimation remains a persistent challenge, particularly in culturally diverse regions such as Central Asia. Traditional self-reporting tools often yield inconsistent results due to communal eating practices and unfamiliarity with standard measures. Objective: To address these limitations, this study aimed to compare three methods: unassisted human judgment, visual food atlas assistance, and an artificial intelligence (AI) model, using Central Asian food items. Methods: In this cross-sectional study, 128 participants from Astana, Kazakhstan, visually estimated portion sizes of 51 foods and 8 beverages from standardized photographs. Participants were randomized into two groups: one using unassisted visual estimation and the other aided by a regionally tailored digital food atlas. Additionally, an AI model trained on Central Asian food images was evaluated. Actual food weights served as the reference standard. Accuracy was assessed using Mean Absolute Error (MAE) and Mean Absolute Percentage Error (MAPE) across food types and portion sizes. Results: The atlas-assisted group demonstrated the highest accuracy, with the lowest MAE (80.81g) and MAPE (44.76%) across all portions. The AI model showed promising results for average portions (MAE: 79.07g, MAPE: 67.91%) but underperformed on small portions, particularly for meat-based items. Unassisted estimates were the least accurate (MAE: 133.86g, MAPE: 79.40%). Across food categories, visual aids consistently improved accuracy, while AI demonstrated variability by texture and portion size. Conclusions: Culturally adapted visual atlases significantly enhance portion size estimation accuracy in non-Western, communal-eating contexts. While AI models hold promise for dietary assessments, particularly with standard portions and beverages, further refinement is needed for complex food items and small portion types. These findings support the integration of visual and AI-based tools into region-specific dietary monitoring strategies.

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Nutritional Knowledge And Associated Factors Among Pregnant Women In Ghana: A Cross-Sectional Study

Nkansah, M.; Salu, P. K.; Gyimah, L. A.

2026-04-17 nutrition 10.64898/2026.04.13.26350744 medRxiv
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BackgroundAdequate maternal nutritional knowledge is essential for healthy pregnancy outcomes, yet many pregnant women lack good nutritional knowledge. This study assessed nutritional knowledge and associated factors among pregnant women in the Krowor Municipality of Ghana. MethodsA facility-based cross-sectional study was conducted among pregnant women attending antenatal clinics in two public health facilities. Structured questionnaires were used to collect data on sociodemographic characteristics and nutritional knowledge. Data were analysed using descriptive statistics and chi-square tests at a 5% significance level. ResultsMost respondents demonstrated moderate nutritional knowledge (mean score =11.24 {+/-} 2.48), with 45% classified as having moderate knowledge. Income level (p = 0.00), education (p = 0.007), gestational age (p = 0.042), employment status (p = 0.007), and religion (p = 0.005) were significantly associated with nutritional knowledge. ConclusionThe study highlights notable gaps in nutritional knowledge among pregnant women in Krowor Municipality. Socioeconomic and obstetric factors strongly influenced nutritional knowledge. Strengthening antenatal nutrition counselling and improving socioeconomic support may help improve the nutritional knowledge of pregnant women.

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Health-related quality of life in mild-moderate patchy alopecia areata: Results from the first controlled Phase 2 clinical trial in this population with STS01 (dithranol/ProSilic) and challenges for the future

Fleet, D. M.; Messenger, A.; Bryden, A.; Harris, M. J.; Holmes, S.; Farrant, P.; Leaker, B.; Takwale, A.; Oakford, M.; Kaur, M.; Mowbray, M.; Macbeth, A.; Gangwani, P.; Gkini, M. A.; Jolliffe, V.

2026-04-04 dermatology 10.64898/2026.04.02.26349940 medRxiv
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A phase 2, randomised, double-blind, placebo controlled trial has been conducted in mild to moderate patchy alopecia areata (AA). This demonstrated significant and dose related improvements in hair regrowth with STS01, a controlled release, topical formulation of dithranol. Here we report the results of the Alopecia Areata Symptom Impact Scale (AASIS) that assesses the severity of symptoms, daily functioning and feelings. Similar to trials in severe AA, significant improvements in hair regrowth did not translate into significant health-related quality of life (HRQoL) improvements, even in patients with complete hair regrowth, although there was some treatment-related correlation between changes in AASIS scores from baseline and clinical assessment SALT scores. The use of current HRQoL methods or indeed new measures in development for future trials, will have considerable challenges: patients may not have a true baseline at entry, may develop coping mechanisms, and there may be a delay between physical and psychological improvement.

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High Dietary Linoleic Acid Intake Suppresses Eicosapentaenoic Acid Status and Shifts Oxylipin Metabolism Towards Arachidonic Acid in Healthy Adults: A Randomized Controlled Trial

Sergeant, S.; Easter, L.; Mustin, T.; Ivester, P.; Legins, J.; Seeds, M. C.; Standage-Beier, C. S.; Cox, A.; Furdui, C. M.; Hallmark, B.; Chilton, F. H.

2026-04-13 nutrition 10.64898/2026.04.09.26350499 medRxiv
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The modern Western diet (MWD) provides high linoleic acid (LA) exposure, typically contributing 6-9% of total caloric intake. These high LA levels have fueled a longstanding debate regarding whether this dietary pattern confers benefit or risk. Importantly, LA intake is disproportionately elevated among lower socioeconomic populations due to greater reliance on industrial seed oils and ultra-processed foods. Despite decades of research, controlled dietary intervention studies directly evaluating the biological consequences of varying LA exposure remain limited. The current randomized, double-blind intervention compared the effects of a 12-week Low LA diet (2.5% energy) versus a High LA diet (10.0% energy) in healthy adults. Primary outcomes included plasma highly unsaturated fatty acid (HUFA) concentrations and ex vivo zymosan-stimulated whole-blood oxylipin generation. Fifty- two participants completed the intervention. High LA exposure resulted in a marked reduction in plasma n-3 eicosapentaenoic acid (EPA) concentrations compared with the LowLA arm. In contrast, levels of arachidonic acid (ARA), dihomo-gamma-linolenic acid (DGLA) and docosahexaenoic acid (DHA) did not differ by dietary LA exposure. Analysis of oxylipin species revealed that levels of EPA-derived relative to ARA-derived mediators were significantly reduced in the High LA arm. These findings reveal that higher dietary LA selectively suppresses EPA pools and EPA-derived oxylipins without altering ARA, shifting the lipid mediator balance toward a more n-6-dominant profile.

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Short-Term Safety of Low-Dose Creatine Hydrochloride: A 28-Day Single-Arm Pilot Study

Wagner, J. C.; Ostojic, S.; Faulkner, W.; Faulkner, M.

2026-04-16 nutrition 10.64898/2026.04.10.26349886 medRxiv
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Background: Creatine monohydrate (typically 5 to 20 g/day) has a well-established safety profile across diverse populations. Creatine hydrochloride (CR-HCl) is a highly soluble creatine formulation that may allow effective supplementation at substantially lower doses (750 mg to 3 g/day); however, controlled human safety data specific to CRHCl remain limited. Objective: To evaluate the short-term laboratory safety and tolerability of low dose CRHCl supplementation administered for 28 days in healthy adults. Methods: This single center, single arm, singl blind pilot safety study enrolled 11 healthy adults (10 females, 1 male; mean age 44.6 plus/minus 7.2 years). Participants consumed 750 mg/day CRHCl for 28 consecutive days while maintaining their usual diet and physical activity patterns. Fasting blood and urine samples were collected at baseline and Day 28. Laboratory assessments included hematological, lipid, and clinical chemistry biomarkers. Pre and post changes were evaluated using paired parametric and nonparametric tests, baseline-adjusted regression models, bootstrap confidence intervals, and false discovery rate (FDR) correction. Results: All participants completed the intervention. No clinically meaningful changes were observed in lipid parameters, hematologic indices, renal markers, or most chemistry analytes after adjustment for multiple comparisons. Fasting glucose increased modestly (8.1 mg/dL) prior to multiplicity adjustment but was not statistically significant after FDR correction and remained within reference ranges. Serum bicarbonate decreased slightly (2.4 mmol/L); although statistically detectable in parametric analysis, values remained within physiological limits and were not consistently supported by nonparametric testing.

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Meal Timing Patterns and Associations with Fat Mass in Adolescents

Decker, J. E.; Morales, K. H.; Chen, P.-W.; Master, L.; Kwon, M.; Jansen, E. C.; Zemel, B. S.; Mitchell, J. A.

2026-04-23 nutrition 10.64898/2026.04.22.26351498 medRxiv
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Background: The timing of energy intake could be important in the development of obesity. However, most observational evidence stems from adults, anthropometric defined obesity outcomes, single meal timing phenotyping, and traditional regression modeling. Objective: We aimed to describe meal timing patterns in adolescents and determine if they associated with fat mass by modeling the median and all other percentiles of the frequency distribution. Methods: We analyzed data from the Sleep and Growth Study 2 (S-Grow2, N=286, 12-13y). Participants completed 3-day 24-hour dietary recalls and time stamped eating occasions were used to define 8 meal timing traits, with aide from self-reported wake and bed timing. Principal component analysis (PCA) identified multi-dimensional meal timing patterns. Fat mass index (FMI) was estimated using dual energy X-ray absorptiometry. Quantile regression assessed if there were associations between meal timing traits and FMI across the entire FMI frequency distribution. Results: The typical first and last eating occasions were 8:00am (40 minutes after waking) and 8:00pm (2.7 hours before sleep), respectively, thus the eating period typically lasted 11.5 hours per day. The typical eating period midpoint was 2:15pm, and the timing when 50% of energy intake was consumed typically occurred at 3:15pm. PCA revealed three meal timing patterns: 1) Delayed Start, Condensed Eating Period (43% of variance; shorter eating period and delayed timing of first eating); 2) Late, Sleep Proximal Eating (30% of variance; later timing of last eating and extended eating period), and 3) Later Energy Intake (10% of variance; delayed energy intake midpoint). Higher scores for the Delayed Start, Condensed Eating Period pattern associated with higher body mass index and FMI at the upper tails of their distributions. Conclusions: Distinct multidimensional meal timing patterns emerged in early adolescence, with the delayed start, condensed eating period pattern potentially associated with higher adiposity.

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Ultraprocessed foods elicit distinct metabolic and neural responses when compared to non-ultraprocessed foods

Hutelin, Z.; Ahrens, M.; Baugh, M. E.; Nartey, E.; Herald, D. L.; Hanlon, A. L.; DiFeliceantonio, A. G.

2026-04-11 nutrition 10.64898/2026.04.10.26350599 medRxiv
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Dietary patterns worldwide have shifted toward increased consumption of ultraprocessed foods (UPFs), which has been linked to higher disease burden. One mechanism proposed to impact both their consumption and contribution to metabolic disease is altered post-ingestive metabolic response in comparison to nutritionally similar foods. Here, we recruited 57 healthy-weight 18-45-year-old adults to examine the effects of food processing on postprandial metabolism and brain response. Despite nutritional matching, UPF meals evoked a greater insulinemic and energetic response with attenuated carbohydrate oxidation relative to non-UPF meals. Next, between-condition differences in peak carbohydrate oxidation were associated with mesolimbic and superior temporal gyrus activation in response to food cues. Finally, although food value did not differ between conditions, brain responses correlated with food valuation were positive for non-UPF but negative for UPF in visual cortex and striatum. These findings demonstrate that food processing influences post-ingestive metabolism in a way that could help explain long term health effects and differences in food reward through mechanisms beyond calories and macronutrient composition alone.

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Combined Dietary Supplementation of Bacillus subtilis DSM 29784 and a Phytogenic Blend Modulates the Microbiome-Gut-Bone Axis in Broilers

theapparat, y.; Saikhwan, N.; Faroongsarng, D.; Ruangpanit, Y.; Thodsapol, A.; Rassmidatta, K.; Goossens, T.; Vieco-Saiz, N.; Preveraud, D. P.

2026-04-21 molecular biology 10.64898/2026.04.18.719340 medRxiv
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Disruptions within the microbiome-gut-bone axis are increasingly recognized as key contributors to impaired bone metabolism and leg disorders in broiler chickens. This study investigated the effects of a combined dietary additive containing Bacillus subtilis DSM 29784 and a phytogenic blend of garlic and essential oil components (BsP) on the modulation of microbial communities, intestinal integrity, mineral utilization, and bone-associated immune-osteogenic pathways. Five hundred and sixty-one-day-old male Ross 308 broilers were randomly assigned to a basal control diet or the same diet supplemented with BsP for 42 days, with eight replicates per treatment. Growth performance, cecal microbiome composition, jejunal tight junction expression, pro-inflammatory cytokines, ileal calcium-phosphate transporters, and femoral inflammatory and osteogenic gene expression were evaluated. The results demonstrated that BsP supplementation significantly improved body weight, weight gain, and feed conversion ratio while enhancing intestinal barrier function. Birds receiving BsP displayed upregulated expression of tight junction-related genes (CLDN-1, OCLD-1, TJP-1, MUC-2) and reduced jejunal inflammatory markers (TNF-, NF-{kappa}B). Improved mineral transport capacity was indicated by increased ileal CaSR and NaPi-IIb expression. Microbiome profiling revealed higher species richness (Chao1 and Shannon indices; P<0.05) and diversity (Bray-Curtis, PERMANOVA; P <0.001) on days 21, 35, and 42, with enrichment of beneficial taxa such as Clostridium butyricum, Enterococcus faecium, Lactobacillus salivarius, L. crispatus, and Bifidobacterium longum, accompanied by reduced Escherichia coli, and Enterococcus cecorum. Functional predictions suggested activation of serotonin-, melatonin-, and L-tryptophan-related pathways, indicating engagement of the microbiome-gut-brain axis. At the skeletal level, BsP reduced femoral expression of IL-6, IL-17, TNF-, and NLRP3 and enhanced BMP-2, SMAD-1, RUNX-2, and SPARC, aligning with improved mineral deposition. Network analysis revealed distinct inflammation-, bone-, and microbiota-dominant modules, highlighting the structured interactions linking microbial signals to osteoimmunological responses. Overall, BsP effectively modulated the microbiome-gut-bone axis, supporting intestinal homeostasis, mineral absorption, and bone formation. These findings underscore the potential of BsP as a functional feed additive to promote both intestinal and skeletal health in broilers.

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Comparative Effects Of Flaxseed Supplementation On Hematological Parameters, Lipid Profile And Immunity Of Male Rabbit

Kanwal, A.; Iqbal, R.; Farhan, F.; Kanwal, A.

2026-04-08 zoology 10.64898/2026.04.06.716729 medRxiv
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Flaxseeds have high nutritive value due to the presence of proteins, lignins (SDG), fatty acids, vitamins, dietary fibers, minerals and carbohydrates. This research was conducted to evaluate the effect of distinct doses of flaxseeds on hematological parameters, immunity and lipid profile of male rabbit. In this research, 60 male rabbits were isolated into four groups, three treatment groups T1, T2 and T3 and a control group T0, with 15 rabbits in each group. The treatment groups were given 4%, 6% and 8% of flaxseeds per daily diet for 45 days. On 15th, 30th and 45th day of experiment, blood samples were collected to examine their hematological parameters. Serum was separated from the collected blood sample to perform ELISA and serum lipid profile test to assess antibody titer and lipid profile of the rabbits respectively. The results indicated a significant reduction in TC, TG, and LDL-C levels in contrast to HDL-C which increased significantly in all treatment groups. Whereas, the statistical analysis of hematological parameters showed an HSD (p[&le;]0.05) in flaxseed treated groups. A maximum level of Hb, WBCs, RBCs, MCHC, MCV, HCT, MCH and differential leukocytes count was recorded in high dose group T3 (8% flaxseeds) followed by medium dose group T2 (6% flaxseeds) and low dose group T1 (4% flaxseeds) respectively. There was a significant rise in antibody titer (p[&le;]0.05) against RHDV (Rabbit Hemorrhagic Disease Virus) comparable to non-treated group. The outcomes illustrated that flaxseeds as nutritional supplement are undoubtedly beneficial to health and prevent various diseases. Study contributionThis research specifically explores how dietary supplementation with flaxseeds, a widely recognized source of omega-3 fatty acids, fiber, and antioxidants, can influence metabolic health and immune function. These findings have significant implications for nutritional interventions aimed at improving cardiovascular health, immune support, and overall well-being, making it highly relevant to the journals readership. The aim of this study was to investigates the dose-dependent effect of flaxseeds on hematological parameters, lipid profile and immunity of male rabbits. Using a controlled experimental design, male rabbits were fed a diet supplemented with varying doses of flaxseeds over a period of 45 days. Key parameters such as total cholesterol, triglycerides, LDL-C, HDL-C, antibody titer, red, white blood cell, platelet counts, Hb, HCT, MCV. MCHC, MCH and differential leukocytes levels were measured to assess the impact of flaxseeds. The results demonstrated that flaxseed supplementation significantly restored lipid profiles by reducing total cholesterol and triglycerides, LDL-C and increasing HDL-C while also enhancing immune function by rising antibody titer and maintaining healthy blood profiles in the subjects.