Telomere length is a biomarker of ageing, with shorter lengths associated with higher risk of age-related diseases and mortality. Oxidative stress and inflammation predominantly contribute to telomere shortening. Diets rich in antioxidant and anti-inflammatory properties may help preserve telomere length. Nuts and seeds contain antioxidant and anti-inflammatory nutrients and bioactive compounds. Their consumption is recognised as protective against age-related conditions. The objective of this review is to evaluate the role of nut and seed intake on telomere length in humans. A systematic search was conducted in four databases from inception to 12 March 2024 to identify observational and interventional studies assessing nut and seed intake and measured telomere length as an outcome in adults (aged ≥18 years). Data from the included articles were extracted by one reviewer and verified by another reviewer. Out of the nine observational studies included, three reported positive associations between nut and seed intake and telomere length. None of the four interventional studies included reported a significant positive effect. Meta-analysis was not performed due to high variability in reporting telomere length measurements. The evidence is insufficient to confirm a beneficial role of nut and seed intake on telomere length. Adequately powered long-term intervention studies are needed.

Muscular dystrophy (MD) encompasses inherited myopathies characterised by progressive skeletal and cardiac muscle degeneration, chronic inflammation, and metabolic dysfunction. While emerging therapies show pre-clinical promise, few reach clinical translation, highlighting the need for supportive interventions to improve function and quality of life (QoL). Nutritional strategies may offer such benefits; however, limited data exist characterising diet in MD or associations with functional outcomes. This study assessed diet, nutritional status, and associations with muscle strength, function, and QoL in MD adults. Adults with MD (n = 39; FSHD = 8, LGMD = 9, Other = 22) and matched controls (n = 15) completed two 3-day food records, strength/function assessments, and QoL questionnaires. Between-group differences were analysed using t-tests or Mann-Whitney U, and associations using Pearson’s r or Spearman’s Rho (p < 0.05). Compared to controls, individuals with MD consumed more energy (89% vs. 35% exceeded RDI, p = 0.023), but less carbohydrate (-21%, p = 0.013), sugar (-31%, p = 0.004), protein (-15%), BCAAs (-31%, p = 0.049), and vitamin C (-43%, p = 0.009). MD participants demonstrated reduced muscle thickness, strength, function, and reported lower QoL and physical capacity (all p < 0.05). Protein intake positively correlated with strength and function (p < 0.05); BCAA intake was associated with lean mass (r = 0.442, p = 0.02) and strength (r = 0.372, p = 0.036). Findings indicate adults with MD consume excess energy but insufficient protein and micronutrients, supporting the need for MD-specific dietary guidance to optimise musculoskeletal health and QoL.

This prospective study investigated associations of various diet quality indices with mortality in Japan. Participants were 13,355 men and 15,724 women from the Takayama study. Eight diet quality indices were assessed using a food frequency questionnaire: the Dietary Approaches to Stop Hypertension (DASH), Alternative Mediterranean diet scores (AMED), Healthy Eating Index-2015 (HEI-2015), Alternate Healthy Eating Index-2010 (AHEI-2010), Nutrient Rich Food Score 9.3 (NRF9.3), Diet Quality Score for Japanese (DQSJ), Japanese Food Guide Spinning Top (JFGST), and 12-item Japanese Diet Index (JDI12). Cox proportional models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality in 1 standard deviation (SD) difference for each index, with adjustment for confounders. During a mean follow-up of 14.1 years, 5,339 deaths were recorded. HRs (95% CIs) per 1 SD higher index were 0.90 (0.87 to 0.93) for AHEI-2010, 0.92 (0.89 to 0.95) for DQSJ, 0.93 (0.91 to 0.96) for NRF9.3, 0.94 (0.92 to 0.97) for AMED and DASH, 0.94 (0.91 to 0.97) for JFGST, 0.94 (0.91 to 0.98) for JDI12, and 0.97 (0.94 to 0.996) for HEI-2015. Similar protective associations were observed for cardiovascular disease mortality, but not for cancer mortality. These findings suggest that all eight indices are associated with lower mortality and that the strength of associations varies across indices; AHEI-2010 showed relatively strong associations, followed by the DQSJ, whereas the associations of HEI-2015 appeared relatively weaker in this Japanese population.

There is limited research on the association between soda consumption and the risk of metabolic syndrome (MetS), particularly during the COVID-19 pandemic. This study investigated the relationship between soda consumption and MetS in Korean adults, stratified by sex, and compared differences before and after the pandemic using data from the Korea National Health and Nutrition Examination Survey (2017–2021). A total of 13,051 adults aged 19–64 years were included. Soda consumption was assessed using 24-hour recall and categorized into five groups (nondrinkers and four quartiles). Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for MetS and its components. After adjusting for multiple covariates, no significant association was found between soda consumption and MetS overall. However, adults in the highest quartile of soda consumption (≥373g/day) had higher risks of abdominal obesity (P-trend=0.006) and hypertriglyceridemia (P-trend=0.003), compared to nondrinkers. When analyzed by gender, women in the highest quartile of soda consumption (≥315g/day) had significantly increased risks: MetS by 70% (OR=1.70; 95% CI: 1.08–2.68), abdominal obesity by 63% (OR=1.63; 95% CI:1.12–2.38), hypertriglyceridemia by 83%(OR=1.83; 95% CI:1.23–2.74), and low HDL cholesterol by 46%(OR=1.46; 95% CI:1.06–2.01), whereas no significant associations were observed in men. Post-pandemic analysis revealed a significant association between high soda consumption (≥ 416g/day) and MetS (OR=1.56; 95% CI:1.04–2.34), which was not significant in the pre-pandemic period (P-interaction=0.031). These findings suggest that high soda consumption may increase the risk of MetS, particularly among Korean women.

Coenzyme Q10 (CoQ10) is biologically plausible as an ergogenic aid through roles in mitochondrial energy production and antioxidant defence, yet findings from randomised trials are inconsistent. This review included 24 studies from 6 databases published up to November 2025, assessing effects of CoQ10 on exercise performance, subjective fatigue, and circulating CoQ10 levels in healthy adults. Randomised trials comparing CoQ10 with placebo were synthesised using a three-level model. Risk of bias was assessed with RoB2 and certainty judged with GRADE.

Supplementation consistently increased blood CoQ10, indicating robust biochemical responsiveness. In contrast, performance effects were small and inconsistent. In primary analyses, chronic supplementation showed a small benefit, whereas acute supplementation showed no benefit. After excluding outliers, the chronic effect was no longer stable and the acute effect remained trivial. All subgroup analyses were restricted to chronic supplementation. Within this context, aerobic endurance was significant in primary analyses but became borderline after outlier exclusion, while anaerobic and strength outcomes showed little change. Evidence for reduced subjective fatigue was suggestive and became more consistent after outlier exclusion. Benefits in trained individuals were unstable and became consistent only after outlier exclusion. No stable dose–response pattern emerged for supplementation dosage or duration. Heterogeneity and moderate-to-high risk of bias reduced certainty.

Collectively, CoQ10 reliably elevates circulating levels but provides at most modest and context-dependent benefits for exercise performance, largely under chronic use. Overall certainty is very low to low. Well-controlled randomised trials that standardise formulation, dose, and duration and examine sex-specific and endurance-related responses are needed.

Food literacy and mindful eating are increasingly recognized as key factors in the prevention and management of chronic diseases, particularly Type 2 Diabetes Mellitus (T2DM) and Metabolic Syndrome (MetS). This study aimed to assess the association between food literacy and mindful eating and the risk of developing type 2 diabetes mellitus and metabolic syndrome. This cross-sectional study included 1091 adults (777 females, 314 males) aged 18–65 years. General characteristics, anthropometric measurements, risk of T2DM (Finnish Diabetes Risk Score-FINDRISC) and MetS (Metabolic Syndrome Index), food literacy (Food Literacy Tool), and mindful eating (Mindful Eating Inventory) were assessed using a questionnaire. Food literacy and mindful eating scores were significantly and negatively correlated with both the FINDRISC score (r = -0.153 and r = -0.168, respectively; p < 0.001) and the Metabolic Syndrome Index score (r = -0.181 and r = -0.171, respectively; p < 0.001). Linear regression analyses indicated that age, marital status, education level, body mass index (BMI), waist circumference, and total scores from the Food Literacy Tool and the Mindful Eating Inventory were significant predictors of the risk of T2DM (R2 = 0.580; p < 0.001) and MetS (R2 = 0.440; p < 0.001). Given the association between food literacy, mindful eating, and the risk of T2DM and MetS, public health interventions should incorporate these factors. The long-term effects of such interventions should be evaluated and their adaptability to different socio-cultural contexts should be explored to support effective global prevention and management.

White potatoes are a major contributor to energy and nutrient intake in the US, which supports investigating their relationship with cardiometabolic health. This cross-sectional analysis assessed relationships of total white potato intake and dietary patterns containing white potatoes prepared by various methods with diet quality and markers of cardiometabolic health in adults categorized by diabetes status. The dietary intake assessment component of NHANES (2001-2018), What We Eat in America (WWEIA), was linked with the Food and Nutrient Database for Dietary Studies and Food Patterns Equivalents Database to rank consumption of white potato-containing foods. Dietary patterns were determined by percent calories from white potatoes and main food groups in WWEIA using cluster analysis. Regression analysis assessed trends in individuals with (n=5,467) and without (n=38,159) diagnosed diabetes. P < 0.01 was significant. The most consumed white potato-containing foods were French fries, potato chips, and home fries. In adults without diagnosed diabetes, total white potato intake was positively associated with glucose, insulin, HOMA-IR, and waist circumference. Glycated hemoglobin was lower in those who primarily consumed dietary patterns with baked/boiled potatoes and waist circumference was higher in those who primarily consumed dietary patterns with chips, fried potatoes, or mashed potatoes compared to adults with no white potato intake. In adults without diagnosed diabetes, total white potato intake was associated with greater cardiometabolic risk, which may be due, in part, to frying as the predominate preparation method of white potatoes in the US.

This study aimed to identify linear growth trajectories from 0-5 years and assess their associations with cognitive function and school achievement in Ethiopian children aged 10 years. Latent class trajectory modelling was used to identify distinct height-for-age (HAZ) trajectories. Cognitive function was assessed using the Peabody Picture Vocabulary Test (PPVT), while school achievement was measured by Math, English, and Science (MES) combined scores and grade-for-age. Associations were assessed using multiple linear or logistic regressions.

We identified 4 distinct HAZ trajectories. Decreasing trajectory (n=145, 31.9%) started high at birth but dropped sharply. The increasing-decreasing trajectory (n=196, 43.2%) increased up to 3 months followed by a decrease. The stable low (n=74, 16.3%) had low HAZ at birth, followed by a slight decrease. The rising trajectory (n=39, 8.6%) started low but then increased to HAZ above, yet close to zero. At 10 years, children in the rising trajectory had 4.54 (95% CI: -0.45, 9.55, p=0.075) higher MES combined score and 2.4 times (95% CI: 1.12, 5.15, p=0.025) higher odds of being in the appropriate grade-for-age compared to those in the increasing-decreasing trajectory. The association between stable low and decreasing trajectory with appropriate grade-for-age had odds ratio close to null.

In conclusion, we found that three of the four linear growth trajectory classes showed a declining pattern. Data suggest that greater linear growth in early childhood may be associated with higher school achievement and better cognitive function.

Undernutrition is common amongst older people and can lead to adverse health outcomes and increased dependence. This review focuses on an aspect of undernutrition that is often overlooked, namely loss of appetite, and will discuss the challenges in this under-researched field from the perspective of geriatric medicine. Appetite decline is common in later life and predicts undernutrition in older populations. As such, timely identification and intervention on poor appetite could delay onset or progression of undernutrition to optimise healthy ageing and maintain independence. In addition, management of undernutrition ultimately requires the individual to meet their nutritional requirements. However, unless attention is paid to mitigating appetite decline, strategies to improve intake are likely to be ineffective. Treatment for appetite decline is challenging due to the multiple and complex underlying mechanisms. Current evidence is limited to a few trials targeting older people including flavour enhancement and fortification or supplementation, lifestyle measures such as increasing physical activity and social interaction, and medications, all with mixed results. Progress on treatments for appetite decline has been hampered by a lack of distinction from undernutrition, but also perhaps the approach to it as a concept. Categorising appetite decline in ageing as a geriatric syndrome could aid progress in the unification of approaches to mechanistic research, assessment and management strategies, which are likely to be most effective when in multi-component form and underpinned by the principles of Comprehensive Geriatric Assessment (CGA).

Sustainable diets can improve environmental health by supporting food security and promoting healthy living for future generations. This study aimed to assess changes over time in the consumption of foods within the national diet and diet-related environmental indicators, specifically greenhouse gas emissions (GHGE) and water footprint (WF). Individual food consumption was assessed using 24-hour dietary recalls from the Türkiye Nutrition and Health Surveys (TNHS) conducted in 2010 and 2017. Greenhouse gas emissions (GHGE) and water footprint (WF) were calculated based on these dietary data. According to the TNHS 2010 and 2017, GHGE increased by 16.1%, total WF by 17%, green WF by 19.3%, blue WF by 9.4%, and grey WF by 10.9% (p < 0.001). During the same period, the consumption of red meats (by 72%), eggs (by 42.5%), and fats (by 53.6%) increased significantly (p< 0.001). Conversely, the most notable decrease in consumption was observed for fresh vegetables and fruits, which declined by 17.5% and 6.9%, respectively (p<0.001). In 2010 and 2017, red meats (GHGE: +29.8%; total WF: +23.6%) and fats (GHGE: +14.3%; total WF: +13.6%) were the foods that increased their contribution to GHGE and total WF the most. Although the GHGE and total WF values of Türkiye’s national diet remain below the global average, both indicators increased in 2017 compared to 2010. Despite the rising consumption of animal-based foods in recent years, the predominance of cereals in the national diet has played a key role in keeping GHGE and total WF below the global average.

The Global Leadership Initiative on Malnutrition (GLIM) provides a consensus-based diagnostic framework for malnutrition in hospitalized patients which includes at least one phenotypic and one etiologic criterion. In GLIM, Appendicular Skeletal Muscle based on Bioelectrical Impedance Analysis (ASMBIA) and calf circumference (CC) are two commonly techniques for muscle mass assessment, but their accuracy remains debated. Therefore, current study evaluates the prevalence of malnutrition upon hospital admission applied by GLIM criteria and mainly compares the effectiveness of ASMBIA and CC. We screened a total of 605 patients from four hospitals in Indonesia (August–October 2024). Multivariate logistic regression analyzed associations with clinical outcomes. Prevalence of malnutrition was 72.7% using three phenotypes, 55.9% with two phenotypes, 22.1% via ASMBIA, and 62.6% using CC. Significant associations (p < 0.05) were found between malnutrition and weight loss, BMI, mid-upper arm circumference (MUAC), handgrip strength (HGS), sarcopenia, and fat-free mass index (FFMI). For all criteria combinations, sensitivity was greater in CC (86.1%), followed by two phenotypes (76.8%), while the ASMBIA had the poorest sensitivity (30.5%). All GLIM-based diagnostic methods correlated with malnutrition risk screening and nutrition status indicators. The GLIM criteria provide a standardized, clinically relevant approach for diagnosing malnutrition in hospitalized patients, with CC emerging as a highly sensitive assessment to examine muscle mass.

Coconut oil, extracted from coconut kernels, is a rich source of medium-chain fatty acids (MCFAs), including lauric acid, capric acid and caprylic acid. This experiment aimed to investigate the protective effect of coconut oil against intestinal injury induced by lipopolysaccharide (LPS) challenge in piglets. A total of 24 piglets were used in a 2 × 2 factorial experiment with dietary treatment (3% soybean oil vs 3% coconut oil) and LPS challenge (saline vs LPS). After 28 days of the experiment, piglets were injected intraperitoneally with LPS (100 μg/kg body weight) or saline. Piglets were slaughtered and sampled for testing. Pigs fed coconut oil had higher average daily gain and body weight during the entire study. Supplementation with coconut oil improved intestinal morphology and barrier function, indicated by increased jejunal villus height, as well as enhanced protein expression of ZO-1 and Occuldin. Furthermore, coconut oil supplementation improved plasma antioxidant capacity indicated by enhanced glutathione peroxidase (GSH-Px) activity and decreased malondialdehyde (MDA) concentration. Moreover, Coconut oil ameliorated the LPS-induced release of pro-inflammatory cytokines, as indicated by decreased IL-1β expression in the jejunum. Coconut oil also alleviated the up-regulation of the expression of necroptosis protein receptor-interacting protein kinase 3 (RIPK3) and mixed lineage kinase-like protein (MLKL) in the jejunum of piglets stimulated by LPS. In conclusion, dietary supplementation of coconut oil can improve the growth performance of piglets, and alleviate LPS-induced intestinal injury and inflammation by inhibiting necroptosis signaling pathway.

Autism Spectrum Disorder (ASD) has been frequently associated with an increased risk of obesity and metabolic disorders, including dyslipidaemia. However, research on lipid profiles and dietary intake in this population remains scarce. This cross-sectional study aimed to evaluate dietary patterns and their association with serum lipid profile in children and adolescents diagnosed with ASD. The study included 233 individuals from 2 to under 19 years assisted by the public health system in Pelotas, Brazil. Fasting blood samples were collected and analysed for serum concentrations of total cholesterol (TC), HDL-C, LDL-C, and triglycerides (TG). Dietary intake was assessed using three non-consecutive 24-hour food recalls (two weekdays and one weekend day). Dietary patterns were derived through reduced rank regression, using food group intakes as predictors and fibre density, energy density, carbohydrate, and saturated fat intakes as response variables. Standardised pattern scores were calculated to assess individual adherence, and linear regression models, adjusted for potential confounders, were applied to examine the association between the dietary pattern scores and lipid profiles. Elevated TG concentrations were observed in 48.9% of the participants. Four dietary patterns were identified: Healthy, Sugar and Starches, Mixed and Dairy and Biscuits. After adjustment, no significant associations were observed between dietary pattern scores and lipid profile. These findings underscore the complex nature of lipid metabolism in individuals with ASD, and suggest that dietary patterns alone may not fully explain variations in lipid profiles. This reinforces the need for further research and development of appropriate nutritional interventions for this population.

The aim of this paper is to review the latest evidence on food reformulation as a public health policy to improve our understanding of how different policy designs can drive reformulation and influence food system change. The focus is on three key nutrients of concern—trans fatty acids, salt and sugar.

In recent times, food reformulation has been categorised as either mandatory or voluntary, a distinction that can help assess policy effectiveness. However, this binary classification oversimplifies a far more complex landscape. Some policies—whether mandated by government or voluntarily suggested to industry—are explicitly intended to trigger reformulation. Others, by contrast, may have never been designed with the intention to encourage reformulation but have nonetheless prompted significant changes in product composition, intake and potential health outcomes.

Within what is commonly described as mandatory reformulation, for example, we find a broad mix of policy tools that operate very differently. Some, such as the UK’s Soft Drinks Industry Levy, were deliberately created to incentivise reformulation by applying financial pressure. Others, including front of pack nutrition labelling systems (particularly warning labels) and school food standards have encouraged reformulation only as a positive unintended consequence. These indirect drivers are not always evaluated for their impact on reformulation, which may lead to an incomplete understanding of their contribution to reducing intake nutrients of concern and health outcomes.

Nevertheless, emerging evidence suggests no single policy encourages reformulation alone, instead a combination of approaches are likely to drive it and contribute to meaningful and sustained food system change.

Patients with chronic liver disease (CLD) often experience hypozincemia. The clinical factors associated with hypozincemia have not been established. We investigated clinical factors that may be useful to predict hypozincemia in patients with CLD. The serum zinc levels CLD patients were measured; Study 1 investigated the predictive factors of hypozincemia, and Study 2 was performed to validate the factors identified in Study 1. Study 1 included 197 participants, of whom 28 and 106 had serum zinc levels <60 µg/dL and <80 µg/dL, respectively. A multivariate analysis revealed that serum zinc levels <60 µg/dL or <80 µg/dL were associated with the albumin–bilirubin (ALBI) score and serum albumin level. A receiver operating characteristic curve analysis revealed that the ALBI score ≥ −1.83 and the serum albumin level ≤3.3 g/dL were the cut-off values for a serum zinc level <60 µg/dL, whereas the ALBI score ≥ −2.44 and the serum albumin level ≤3.6 g/dL were the cut-off values for a serum zinc level <80 µg/dL. In Study 2 (n = 177), the diagnostic accuracy rates for serum zinc <60 µg/dL were 81.9% for the ALBI score and 75.1% for the serum albumin level, and those for serum zinc <80 µg/dL were 70.1% for both parameters. Together these findings indicate that the ALBI score may serve as a predictive factor of hypozincemia in CLD patients.