To assess the feasibility of using large language models (LLM) to develop research questions about changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages.

We conducted a controlled experiment using ChatGPT-4 and its plugin, MixerBox Scholarly, to generate research questions based on a section of the U.S. Department of Agriculture (USDA) summary of the final public comments on the WIC revision. Five questions weekly for 3 weeks were generated using LLM under two conditions: fed with or without relevant literature. The experiment generated ninety questions, which were evaluated using the Feasibility, Innovation, Novelty, Ethics and Relevance criteria. t tests and multivariate regression examined the difference by feeding status, artificial intelligence model, evaluator and criterion.

The United States.

Six WIC expert evaluators from academia, government, industry and non-profit sectors.

Five themes were identified: administrative barriers, nutrition outcomes, participant preferences, economics and other topics. Feeding and non-feeding groups had no significant differences (Coeff. = 0·03, P = 0·52). MixerBox-generated questions received significantly lower scores than ChatGPT (Coeff. = –0·11, P = 0·02). Ethics scores were significantly higher than feasibility scores (Coeff. = 0·65, P < 0·001). Significant differences were found between the evaluators (P < 0·001).

The LLM applications can assist in developing research questions with acceptable qualities related to the WIC food package revisions. Future research is needed to compare the development of research questions between LLM and human researchers.

Existing evidence suggests a potential association between coffee consumption and non-alcoholic fatty liver disease (NAFLD, now known as MASLD), yet the nature of this relationship remains ambiguous. The primary objective of this study was to comprehensively investigate and clarify the association between coffee intake and the occurrence of NAFLD.

A cross-sectional study design was employed, analysing data from National Health and Nutrition Examination Survey (NHANES) spanning from 2013 to 2018. Weighted univariate and multivariate logistic regression models were utilised to assess the relationship between coffee consumption and NAFLD. Restricted cubic spline analysis was conducted to explore any potential nonlinear associations. Forest plots were generated to visualise the impact of coffee consumption on NAFLD across different subgroups, and threshold effect analysis was performed to evaluate the nonlinear relationship between coffee consumption and NAFLD prevalence specifically in women.

Data were from the US – representative NHANES.

8062 subjects aged ≥ 20 years were included.

The weighted prevalence of NAFLD among the participants was 44·18 %. After controlling for confounding variables, coffee consumption was found to be negatively associated with the risk of NAFLD (OR = 0·96, 95 % CI: 0·94, 0·99). The association between coffee consumption and NAFLD was observed to vary by gender and education level. For the prevention of NAFLD in women, the optimal coffee intake was determined to be two cups.

Increasing coffee intake emerges as a potentially effective non-pharmacological strategy for the prevention and management of NAFLD. Notably, for women, consuming two cups of coffee appears to represent the optimal threshold for maximising this beneficial effect.

This study aimed (1) to characterise the use and prevalence of nutrition and health claims (NHC) and (2) to examine the association between NHC and the potential presence of Health Canada’s front-of-pack (FOP) nutrition symbol indicating high saturated fats, sugars and/or Na on a sample of Canadian prepackaged food products.

A cross-sectional analysis was conducted on five categories of prepackaged food products. Label components were classified using the International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS) labelling taxonomy. Products’ nutritional profile was evaluated using Health Canada’s FOP symbol nutrient thresholds for saturated fats, sugars and Na.

Data were obtained from the Food Quality Observatory database, collected between 2018 and 2022 from food retailers in Québec City and the Greater Montreal Area or online.

A total of 2937 food products were evaluated from five food categories: breakfast cereals (n 392), cookies and granola bars (n 983), flavoured milks and plant-based alternative beverages (n 202), salty snacks and crackers (n 1063) and yogurts and plant-based yogurt alternatives (n 297).

Overall, 74·2 % of food products had an NHC and 28·9 % had an NHC and would require to display the FOP symbol. Food products that would require the FOP symbol were less likely to carry an NHC.

The results demonstrate substantial use of marketing techniques highlighting positive product attributes. Given the potential for inconsistent messaging on food products carrying NHC and the FOP symbol, these results highlight an opportunity to improve Canadian labelling regulations by restricting the use of NHC on products high in saturated fats, sugars and/or Na.

This study sought to explore how food company representatives perceive the food industry’s role in responding to and driving consumer demand for healthy and unhealthy foods.

Semi-structured interviews were conducted in 2022 by 2–3 researchers to explore food company representatives’ perspectives related to consumer demand for healthy and unhealthy food. Detailed field notes, including verbatim quotes, were recorded, and the data were analysed thematically.

This study was part of a government-funded 12-month intervention programme to assess the impact of tailored support for food companies on company nutrition-related policies and practices.

Thirty-two food company representatives from thirteen large food and beverage manufacturers in Australia.

Six themes were identified. Company representatives acknowledged that manufacturers actively shaped demand for both healthy and unhealthy foods. Healthy reformulation and aspects of nutrition labelling were constrained by anticipated consumer resistance, while demand for ‘less healthy’ products was driven by non-health attributes such as taste, comfort and affordability. Internal company marketing teams held significant influence regarding product development, promotion and labelling. Supermarkets were perceived as shaping demand via their marketing strategies. The competitive landscape, driven by the pursuit of market share, was seen to fuel an ongoing cycle of promotion of ‘less healthy’ products.

Food companies acknowledge playing an active role in influencing consumer demand for healthy and unhealthy food and beverages. A whole-of-system response, including changes in government regulation and practice change by the food industry, is needed to drive stronger action and accountability from food companies to support healthier diets.

To determine whether gestational vitamin D status modulates the effect of pre-pregnancy obesity on gestational diabetes mellitus (GDM) risk while stratifying by maternal age.

Birth cohort.

A major maternity hospital in Kuwait.

Pregnant women in their second/third trimester of gestation were enrolled. Pre-pregnancy BMI (kg/m2) was categorised as under/normal weight (< 25·0), overweight (25·0 to < 30·0) and obesity (≥ 30·0). Gestational 25-hydroxyvitamin D concentrations were categorised as deficiency (< 50 nmol/l) or insufficiency/sufficiency (≥ 50 nmol/l). GDM status was ascertained according to international guidelines. Adjusted OR (aOR) and 95 % CI were estimated using logistic regression.

Data from 957 pregnant women were analysed, with GDM affecting 166 (17·4 %) pregnancies. Pre-pregnancy obesity and gestational vitamin D deficiency were ascertained in 275 (28·7 %) and 533 (55·7 %) pregnant women, respectively. The association between pre-pregnancy obesity and GDM risk differed according to maternal age and gestational vitamin D status (Pinteraction[BMI × age × vitamin D] = 0·041). Among women aged < 35 years (n 710), pre-pregnancy obesity compared to under/normal weight was associated with increased GDM risk among women with gestational vitamin D deficiency (aOR: 2·72, 95 % CI: 1·18, 6·23) and vitamin D insufficiency/sufficiency (2·55, 1·15, 5·62). In contrast, among women aged ≥ 35 years (n 247), pre-pregnancy obesity compared to under/normal weight was associated with increased GDM risk among women with gestational vitamin D deficiency (6·92, 1·45, 33·04), but not among women with vitamin D insufficiency/sufficiency (1·13, 0·36, 3·56).

Gestational vitamin D status modulates the effect of pre-pregnancy obesity on GDM risk in an age-specific manner.

To investigate the extent to which the associations of socio-economic position (SEP) with stunting and wasting are mediated by minimum acceptable diet (MAD) and a family care indicator (FCI) in Sri Lanka.

Secondary data analysis of children from the 2016 Sri Lanka Demographic and Health Survey. The outcomes were stunting and wasting, the exposure was a composite measure combining maternal education and household wealth, and the mediators were binary MAD and FCI variables (adequate v. inadequate). Analyses were performed using counterfactual mediation models adjusted for age, sex and place of residence.

A nationally representative sample of children from Sri Lanka.

Mothers/caregivers of children under 36 months (4325).

Twenty per cent of children were stunted, and 14 % were wasted. Lower SEP was associated with higher odds of stunting and wasting and inadequate MAD and FCI. Inadequate FCI was associated with higher odds of stunting (OR = 1·47, 95 % CI = 1·24, 1·74) but not wasting (OR = 1·14, 95 % CI = 0·94, 1·38), whereas MAD was not associated with stunting or wasting. Neither MAD nor FCI significantly mediated the relationship between SEP and stunting and wasting. All mediation estimates were statistically non-significant at the 5 % level. For example, the proportion mediated by FCI on the association between the lowest composite SEP and stunting was 13 % (mean difference = 0·13, 95 % CI = < 0·00, 0·26).

We did not find consistent or strong evidence that the associations of SEP with childhood stunting and wasting in Sri Lanka are mediated by MAD and FCI. Research with larger samples is needed for more precise estimates.

To examine the efficacy of a food-based intervention on preschool children’s (3–5 years) fruit and vegetable (FV) consumption, as measured by skin carotenoid status (SCS) using the Veggie Meter®.

Quasi-experimental intervention with baseline (T1), pre-intervention (T2) and post-intervention (T3) assessments of children’s SCS. Intervention classrooms (ICs) received the programme, which featured food-based learning (FBL) and gardening. Comparison classrooms (CC) received a standard curriculum. Child and Adult Care Food Program (CACFP) aligned menus were identical across all centres. Intervention teachers participated in semi-structured interviews to contextualise quantitative findings.

Head Start centres (n 7) across three counties in North Carolina.

183 Head Start children (n 88 IC; n 95 CC)

During the intervention period (T2–T3), significant SCS increases were observed in both groups: IC (T2 = 253·7, sd = 77·7; T3 = 299·0, sd = 77·4) and CC (T2 = 226·6, sd = 77·5; T3 = 255·9, sd = 79·9). The IC demonstrated a greater gain in SCS (17·8 % gain) than the CC (12·9 % gain). However, additional analyses revealed no significant difference in the SCS rate of change over time (P = 0·33). Teachers reported that the intervention improved children’s willingness to try fruits and vegetables and encouraged positive feeding practices beyond the mealtime setting.

The findings suggest that increased access to FVs through CACFP-supported meals and snacks may influence children’s overall improved FV consumption. However, improved food access paired with FBL may also support higher gains in FV consumption.

This study aimed to assess the understanding, perceptions and preferences of different front-of-pack labelling (FOPL) formats among Thai consumers.

We conducted a mixed-methods study comprising a cross-sectional online survey and semi-structured interviews between February and March 2022. The survey assessed comprehension and preferences for six FOPL formats (Guideline Daily Amounts (GDA), Healthier Choice logo (HCL), warning labels (WLs), Nutri-Score, Health Star Rating and Traffic Light labels). Quantitative data were analysed using descriptive statistics, chi-square tests and multiple logistic regression. Qualitative data underwent thematic analysis.

Bangkok and metropolitan areas

Thai residents aged 12–78 years (n 410)

While awareness of existing labels was high (GDA: 95·4 %, HCL: 82·4 %), only 23·9 % regularly read GDA labels. WLs and Nutri-Score were the most effective at providing information to consumers in a format that translated into choosing healthier products. WLs demonstrated the highest effectiveness in guiding healthier choices. HCL received the highest agreement across multiple attributes, including packaging inclusion preference (59·8 %), visibility (58·5 %) and visual appeal (57·3 %), although effectiveness was not tested. Qualitative findings revealed preferences for colour-coded systems but identified barriers including time constraints, small font sizes and difficulty interpreting numerical information.

While interpretive labels, particularly WLs, are most effective for guiding consumers to healthier choices, successful implementation requires consideration of both consumer preferences and real-world usage constraints. Findings support replacing the current GDA system with an interpretive design, accompanied by comprehensive public education campaigns. These results provide evidence-based recommendations for FOPL policy development in Thailand.