The American Journal of Clinical Nutrition

Undernutrition in early childhood causes stunted growth, cognitive delays, and anemia, with effects often magnified among children from the poorest households. Small-quantity lipid-based nutrient supplements (SQ-LNS) are effective in addressing undernutrition and improving child development. As momentum builds to scale up SQ-LNS for children aged 6-24 months in the Global South, a key concern is achieving equity in its distribution and outcomes. We performed equity analysis of individual partici...

BackgroundBoth small-quantity (SQ) and medium-quantity (MQ) lipid-based nutrient supplements (LNS) have been used for prevention of child undernutrition. A meta-analysis of 14 trials of SQ-LNS vs no LNS showed effects on length-for-age (LAZ, +0.14 (95% confidence interval 0.11, 0.16)) and weight-for-length (WLZ, +0.08 (0.06, 0.10)) z-scores, as well as prevalence ratios (95% CI) for stunting (LAZ<-2, 0.88 (0.85, 0.91)) and wasting (WLZ < -2, (0.80, 0.93)). However, little is known about the effe...

BackgroundVegetarianism is widely recognized for its health and environmental benefits. However, its broader impacts on physical, mental, and social well-being remain underexplored. This study investigates the health and behavioral outcomes associated with vegetarianism across diverse populations. MethodsWe analysed polygenic scores for vegetarianism (VegPGS) in 495,971 UK Biobank (UKB) participants and performed phenome-wide association studies (PheWAS) on 443 health and behavioral traits. Cro...

BackgroundProbiotics may enhance host iron bioavailability, offering a strategy to address iron deficiency. Fecal iron may be a useful non-invasive biomarker of such effects in infants. ObjectiveTo examine the use of fecal iron quantification in a randomized placebo-controlled trial (RCT) of neonatal administration of Lactiplantibacillus plantarum ATCC 202195 (LP202195), with or without fructooligosaccharide (FOS), in Dhaka, Bangladesh. MethodsFecal iron quantification using atomic absorption ...

IntroductionTraditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can co-exist with overnutrition. Therefore, this work aimed to systematically review the associations between iron, zinc and vitamin A status and weight status (both under- and overweight) in children and young people. MethodsOvid Medline, Ovid Embase, Scopus, and Cochrane databases were systematically searched for observational studies assessing micronutrient status (blood, serum, ...

IntroductionMicronutrient deficiencies are prevalent in West Africa, particularly among women of reproductive age (WRA) and young children. Bouillon is a promising food fortification vehicle due to its widespread consumption. This study aims to evaluate the impact of multiple micronutrient-fortified bouillon cubes, compared to control bouillon cubes (fortified with iodine only), on micronutrient status and hemoglobin concentrations among lactating and non-lactating WRA and young children in nort...

BackgroundSevere acute malnutrition (SAM) among children under 5 years of age is generally treated in outpatient settings providing caregivers with weekly ready-to-use therapeutic food (RUTF) rations to be administered at home. Recent updates to global treatment guidelines suggest that RUTF dose can be reduced once children progress to moderate stage (MAM). No evidence exists on the optimal timing of the dosage reduction or on ideal visit frequency. ObjectivesWe aimed to test the impact of 1) i...

BackgroundPregnant women are advised to take folic acid supplements before conception and during the first three months of pregnancy. Many women continue folic acid supplementation throughout pregnancy, and concerns have been raised about associations between excess folic acid intake and adverse child health outcomes. Unmetabolized folic acid (UMFA) is found in serum at higher folic acid intakes and has been proposed as a biomarker for excess folic acid intake. ObjectiveTo determine if removing...

BackgroundDietary patterns consist of multiple interrelated components, while individuals have numerous characteristics that may jointly influence dietary patterns. Studies to assess associations between sociodemographic characteristics and dietary patterns typically do not consider this complexity. ObjectiveThe objective of this study was to examine joint relationships between dietary patterns and sociodemographic characteristics among adults in Canada. Methods24-hour dietary recall data for ...

BackgroundGlobally, stunting affects [~]150 million children under five, while wasting affects nearly 50 million. Current interventions have had limited effectiveness in ameliorating long-term sequelae of undernutrition including stunting, cognitive deficits and immune dysfunction. Disrupted development of the gut microbiota has been linked to the pathogenesis of undernutrition, providing potentially new treatment approaches. Methods124 Bangladeshi children with moderate acute malnutrition (MAM...

There are scarce resources available for analyzing 24-hour dietary records. Here we introduce DietR, a set of functions written in R for the analysis of 24-hour dietary recall or records data, collected with either the Automated Self-Administered 24-hour (ASA24) dietary assessment tool or two-day data from the National Health and Nutrition Examination Survey (NHANES). The R functions are intended for food and nutrition researchers who are not computational experts. DietR provides users with func...

We have previously shown that high-dose vitamin D3 improved weight gain and neurodevelopmental indices in children receiving standard therapy for uncomplicated severe acute malnutrition (SAM). We conducted a randomised placebo-controlled trial to determine whether two oral doses of 200,000 international units (IU) vitamin D3 would benefit children aged 6-59 months receiving standard therapy for complicated SAM in Lahore, Pakistan. The primary outcome was mean weight-for-height or -length z-score...

BackgroundTrans fats remain on the market in parts of the world. Emerging evidence suggests that factors beyond calorie balance may affect fat deposition and body mass index (BMI). Trans fats are prooxidant, proinflammatory, and have shown adverse metabolic effects and increased fat deposition in animals. ObjectiveTo assess the relation of dietary trans fatty acid consumption (dTFA) to BMI in humans. DesignCross-sectional analysis of baseline data from a broadly-sampling study. SettingCommuni...

BackgroundU.S. adults exceed recommended intakes of multiple nutrients of concern ObjectiveThis study uses a recently-developed food-level classification method for identifying foods exceeding thresholds for nutrients of concern to investigate sociodemographic differences in their contribution to total energy intake among U.S. adults. DesignCross-sectional. Participants/settingParticipants 20 - 80 years of age in the 2017-2020 National Health and Nutrition Examination Survey (n=7706). Main o...

ImportanceEating timing has been increasingly linked to human health, yet national trends in macronutrient/food group timing and their health implications remain unclear. ObjectiveTo characterize trends in timing of energy, macronutrient, and food group intake among US adults and examine their associations with mortality. DesignCross-sectional analysis of eating timing trends using National Health and Nutrition Examination Survey (NHANES, 1999-March 2020) data; longitudinal analysis of mortali...

BackgroundGlobal dietary guidelines for polyunsaturated fatty acids (PUFAs), especially linoleic acid (LA) and its metabolite arachidonic acid (ARA), remain debated. Almost all research to date has used fatty acid (FA) data expressed as percent of total FA (% total). ObjectiveThe objective of this study was to determine whether expressing fatty acid (FA) data as % of total or as absolute concentrations alters associations with clinical biomarkers. MethodsSerum FA data obtained via electron cap...

BackgroundEarly-life interventions targeting maternal and child health, nutrition, and psychosocial care may influence infant growth and immune development by modulating systemic inflammation and growth factor pathways. However, causal evidence of comprehensive, integrated interventions initiated during early life is limited. MethodsThe study was nested in a factorial randomized controlled trial (RCT) in women aged 18-30 years. Participants included in this study were randomized to receive eith...

BackgroundEvidence regarding the effectiveness of prenatal nutritional supplements has mainly considered anthropometric pregnancy outcomes. The effect on markers of health and disease, such as offspring telomere length (TL) and mitochondrial DNA content (mtDNAc) is unknown. ObjectivesWe assessed the efficacy of maternal multiple micronutrient (MMN)-fortified balanced-energy protein (BEP) and iron-folic acid (IFA) supplementation on newborn TL as a secondary outcome and mtDNAc as a non-declared ...

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 to...

BackgroundMaternal nutritional interventions aim to address nutrient deficiencies in pregnancy, a leading cause of maternal and neonatal morbidity and mortality worldwide. How these interventions influence the placenta, which plays a vital role in fetal growth and nutrient supply, is not well understood. This is a major gap in understanding how such interventions could influence pregnancy outcomes and fetal health. We hypothesised that nutritional interventions influence placental phenotype, and...