While there is an increasing prevalence of dieting in the overall population, weight loss (WL) practices could be a risk factor for weight gain (WG) in normal-weight (NW) individuals. The aim of the present work was to systematically review all the studies implicating diet restriction and body weight (BW) evolution in NW people. The literature search was registered in PROSPERO (CRD42021281442) and was performed in three databases from April 2021 to June 2022 for articles involving healthy NW adults. From a total of 1487 records initially identified, eighteen were selected in the systematic review. Of the eight dieting interventional studies, only one found a higher BW after weight recovery, but 75 % of them highlighted metabolic adaptations in response to WL favouring weight regain and persisting during/after BW recovery. Eight of the ten observational studies showed a relationship between dieting and major later WG, while the meta-analysis of observational studies results indicated that ‘dieters’ have a higher BW than ‘non-dieters’. However, considering the high methodological heterogeneity and the publication bias of the studies, this result should be taken with caution. Moreover, the term ‘diet’ was poorly described, and we observed a large heterogeneity of the methods used to assess dieting status. Present results suggest that dieting could be a major risk factor for WG in the long term in NW individuals. There is, however, a real need for prospective randomised controlled studies, specifically assessing the relationship between WL induced by diet and subsequent weight in this population.

‘Dietary variety’ has been identified as a factor associated with food intake. Whilst this relationship may have longer-term benefits for body weight management when eating low-energy, nutrient-dense foods, it may increase the risk of overconsumption (and body adiposity) when foods are high energy density. This study sought to further explore pathways underpinning the relationship between dietary variety and body weight, by considering energy density as a moderating factor and portion size as a mediating factor in this relationship. Using prospective data from the UK Biobank, dietary variety scores (DVS), cumulative portion size and energy density were derived from 24-h dietary recall questionnaires at baseline and follow-up. BMI, whole-body fat percentage and fat-free mass were included as outcomes. Contrary to predictions, linear multiple regression models found some evidence of a negative, direct association between DVS and body weight outcomes at baseline (b = –0·13). Though dietary variety was significantly associated with larger portions across time points (b = 41·86–82·64), a moderated mediation effect was not supported at baseline or follow-up (Index ≤ 0·035). Taken together, these findings provide population-level evidence to support a positive association between variety and food intake, which in turn has potential implications for body weight management, both in terms of moderating food intake and benefitting diet quality.

Background: Cancer has become a significant public health issue around the world and an increasingly important contributor to disease burdens. In countries like Ethiopia with high nutrient demands, people with chronic diseases like cancer are at a high risk of macro and micronutrient deficiencies. Therefore, the present study attempted to assess dietary diversity and associated factors among adult cancer patients attending treatment at Black Lion Specialized Hospital, Addis Ababa, Ethiopia. Method and Materials: Hospital-based cross-sectional study was conducted from 22 April 2021 to 22 May 2021 on 416 adult cancer patients at Black Lion Specialized Hospital (BLSH). A systematic random sampling technique was applied to select study subjects. Quantitative data were collected using a structured, pretested and interviewer-administered questionnaire. The questionnaire comprised the standard dietary diversity measurement tool, which was adopted from the Food and Technical Assistance (FANTA) then data were entered into EPI INFO software and analysed using Statistical Package for the Social Sciences (SPSS) version 25. Frequency, mean and standard deviation were used to describe variables. A binary logistic regression model was fitted to elicit factors associated with the dietary diversity of cancer patients and a P-value of less than 0⋅2 was used as a cut-off for further analysis. Logistic regression analysis with a 95 % confidence interval (CI) was estimated to measure the strength of association at P < 0⋅05. Results: The present study revealed that 61⋅5 % of patients had low dietary diversity. Being from a family size of five and more (AOR = 1⋅48, 95 % CI 1⋅28, 1⋅83), having no permanent income (AOR = 1⋅31, 95 % CI 1⋅15, 1⋅67), alcohol consumption (AOR = 3⋅97, 95 % CI 1⋅20, 13⋅1), not doing regular physical exercise (AOR = 1⋅83, 95 % CI 1⋅07, 3⋅12), lack of nutritional information (AOR = 2⋅23, 95 % CI 1⋅30, 3⋅82), poor nutritional knowledge (AOR = 1⋅84, 95 % CI 1⋅05, 3⋅25) and minimum meal frequency (AOR = 10⋅7, 95 % CI 5⋅04, 22⋅7) were factors associated with inadequate dietary diversity. Conclusion: The present study showed that the majority of cancer patients had low dietary diversity, suggesting that they are highly vulnerable to micronutrient deficiencies. Therefore, efforts should be strengthened to improve patients’ income level, access to nutrition information and nutritional knowledge.

A 5-week feeding trial was conducted in the cleaner fish Ballan wrasse (Labrus bergylta) for a better understanding of the basic biology of the intestinal functions and health in this stomach less species. During the trial, Ballan wrasse was fed either a reference diet, the reference diet supplemented with (i) a commercial prebiotic (Aquate™ SG, 0·4 %) expected to have beneficial effects, (ii) soya saponins (0·7 %) expected to induce inflammation or (iii) a combination of the prebiotics and the soya saponins to find a remedy for gut inflammation. Blood, intestinal tissue and gut content from four consecutive intestinal segments (IN1 – IN4) were collected. No significant differences in fish growth were observed between the four dietary groups. Saponin supplementation, both alone and in combination with prebiotics, increased weight index of IN2 and IN3 and decreased blood plasma glucose, cholesterol and total protein. Dry matter of intestinal content and activity of digestive enzymes were not affected by diet. Histomorphological analyses revealed a progressing inflammation with increased infiltration by immune cells particularly into the distal parts of the intestine in fish fed diets with saponins, both alone and in combination with prebiotics. Gene expression profiles obtained by RNA sequencing and quantitative PCR mirrored the histological and biochemical changes induced by the saponin load. The study demonstrated that Ballan wrasse gut health and digestive function may be markedly affected by feed ingredients containing antinutrients.

Automated visual anthropometrics produced by mobile applications are accessible and cost effective with the potential to assess clinically relevant anthropometrics without a trained technician present. Thus, the aim of this study was to evaluate the precision and agreement of smartphone-based automated anthropometrics against reference tape measurements. Waist and hip circumference (WC; HC), waist:hip ratio (WHR) and waist:height ratio (W:HT) were collected from 115 participants (69 F) using a tape measure and two smartphone applications (MeThreeSixty®, myBVI®) across multiple smartphone types. Precision metrics were used to assess test-retest precision of the automated measures. Agreement between the circumferences produced by each mobile application and the reference were assessed using equivalence testing and other validity metrics. All mobile applications across smartphone types produced reliable estimates for each variable with intraclass correlation coefficients ≥ 0·93 (all P < 0·001) and root mean square coefficient of variation between 0·5 and 2·5 %. Precision error for WC and HC was between 0·5 and 1·9 cm. WC, HC, and W:HT estimates produced by each mobile application demonstrated equivalence with the reference tape measurements using 5 % equivalence regions. Mean differences via paired t-tests were significant for all variables across each mobile application (all P < 0·050) showing slight underestimation for WC and slight overestimation for HC which resulted in a lack of equivalence for WHR compared with the reference tape measure. Overall, the results of our study support the use of WC and HC estimates produced from automated mobile applications, but also demonstrates the importance of accurate automation for WC and HC estimates given their influence on other anthropometric assessments and clinical health markers.

The consumption of locally nutrient-rich edible plants in rural areas can be used to satisfy the dietary diversity of pregnant women. Date palm is one of the wild edible plants in different parts of the world. Studies on wild edible plants in Ethiopia cover only about 5 % of the country's districts. Furthermore, the nutrient composition of the palm heart of Phoenix reclinata is not yet investigated as it is commonly consumed by indigenous people in western Ethiopia. The utilization of such plants requires strong policy support based on scientific evidence to maintain the nutrition security of pregnant women. Homogeneous samples of 1000 grams (g) of palm hearts were collected randomly. The macronutrient contents were determined using standard methods of the Association of Official Analytical Chemists (AOAC, 2000). The flame Photometric method was used for potassium and sodium determination. The carbohydrate concentration (g/100 g) was 78⋅2. It covers approximately 78⋅5 % of the total daily Recommended Dietary Allowance (RDA). In line with this, the concentrations of minerals such as potassium (K+) and sodium (Na+), per milligram (mg/100 g) of the sample were 1962⋅3 and 7⋅9, respectively. The palm heart of Phoenix reclinata has many nutritional values and is important for pregnant women. Its nutrient composition is comparable with different staple foods of the country and can contribute to household food security in rural communities.

It is unknown if fibre intake differs across diabetes status in USA adults and is associated with glycaemic outcomes. This cross-sectional analysis utilised National Health and Nutrition Examination Survey cycles 2013–2018 data to estimate usual total dietary fibre intake in USA adults and across diabetes status (no diabetes, prediabetes and type II diabetes (T2D)). Associations among dietary fibre intake and glycaemic outcomes were also reported across groups. Adults (≥ 19 years) with at least one dietary recall were included. Diabetes status was determined from self-report data and measured HbA1c. Independent samples t tests were used to compare mean (se) intake across sub-populations. 14 640 adults (51·3 % female) with 26·4 % and 17·4 % classified as having prediabetes and T2D, respectively. Adults with T2D reported greater mean (se) dietary fibre intake compared with no T2D for females (9·5 (0·13) v. 8·7 (0·11) g/1000 kcal/d and males (8·5 (0·12) v. 7·7 (0·11) g/1000 kcal/d; P < 0·01)). However, only 4·2 (0·50)% and 8·1 (0·90)% of males and females with T2D, respectively, met the adequate intake for fibre. Fibre intake was associated with lower insulin (β = −0·80, P < 0·01), serum glucose (β = −1·35, P < 0·01) and Homeostatic Model Assessment for Insulin Resistance (β = −0·22, P < 0·01) in adults without diabetes, and no relationships in adults with prediabetes or T2D were found. Although dietary fibre intake was highest among adults with T2D, intake was suboptimal across all groups. In adults without diabetes, dietary fibre intake was associated with improved glycaemic outcomes and insulin resistance; however, these associations were attenuated by anthropometric and lifestyle covariates.

Different factors, such as inflammation, oxidative stress, extracellular matrix degradation and apoptosis, affect the pathophysiology of chronic obstructive pulmonary disease (COPD), as a progressive disease characterised by permanent airflow limitation. Herbal supplements with anti-inflammatory and antioxidant properties can help treat certain chronic diseases. The current study aimed at investigating the preventive effects of crocin supplementation on the serum concentrations of IL-6, TNF-α, exercise capacity and pulmonary function tests (PFT) in patients with COPD. The present prospective randomised clinical trial equally divided fifty-seven patients with COPD into a placebo and an intervention group, who respectively received a placebo and crocin (15 mg twice day for 12 weeks) as a supplement. ELISA was used to measure serum levels of IL-6 and TNF-α, also PFT and exercise capacity based on 6-min walking distance test (6MWD), which was performed at the beginning and end of the study. Crocin improved the results of PFT (P < 0·05) and 6-MWD (P < 0·001) and exerted preventive effects by increasing the serum levels of IL-6 in patients with COPD compared with those in the placebo group (P < 0·05). Intervention with crocin significantly lowered serum levels of TNF-α at the end of the study (P < 0·01). The present findings suggest crocin supplementation improves exercise capacity and PFT in patients with COPD by reducing serum levels of inflammatory factors.

We aimed to assess the dietary Fe intake and the prevalence of inadequate Fe intake over two post-fortification periods in Brazil. The intake was analysed according to sex, life stage, geographic region and stratum of family income per capita. Excluding pregnant and lactating women, this population-based study included 32 749 and 44 744 participants aged ≥ 10 years from the National Dietary Survey-Brazilian Household Budget Surveys 2008–2009 and 2017–2018, respectively. The National Cancer Institute method was used to predict usual dietary Fe intakes. The prevalence of Fe intake inadequacy was estimated following a probabilistic approach for women of childbearing age or with the Estimated Average Requirement cut-off point method. Over an interval of 10 years, the mean Fe intake remained almost unchanged for most sex-age groups, except for women of childbearing age. In this specific group, the prevalence of Fe intake inadequacy was > 20 % in 2008–2009 and have increased to > 25 % in 2017–2018, with the highest reductions in mean Fe intake found in the highest income strata and richest Brazilian regions. Meanwhile, the highest prevalence of Fe intake inadequacy (> 40 %) occurred among the poorest women aged 31–50 years from the lowest family income stratum, irrespective of the study period. Beans were the main Fe source, while fortified breads, pastas, pizzas, cakes and cookies contributed approximately 40 % of the Fe intake. The results provide important insights into the long-standing dietary impacts of food fortification, which can guide future (re)formulation of effective public health strategies to combat Fe deficiency.

Long-chain omega-3 polyunsaturated fatty acid (LC n-3 PUFA) supplements, rich in eicosapentaenoic acid and/or docosahexaenoic acid, are increasingly being recommended within athletic institutions. However, the wide range of doses, durations and study designs implemented across trials makes it difficult to provide clear recommendations. The importance of study design characteristics in LC n-3 PUFA trials has been detailed in cardiovascular disease research, and these considerations may guide LC n-3 PUFA study design in healthy cohorts. This systematic review examined the quality of studies and study design considerations used in evaluating the evidence for LC n-3 PUFA improving performance in physically trained adults. SCOPUS, PubMed and Web of Science electronic databases were searched to identify studies that supplemented LC n-3 PUFA in physically trained participants. Forty-six (n = 46) studies met inclusion. Most studies used a randomised control design. Risk of bias, assessed using the design-appropriate Cochrane Collaboration tool, revealed that studies had a predominant judgment of ‘some concerns’, ‘high risk’ or ‘moderate risk’ in randomised controlled, randomised crossover or non-randomised studies, respectively. A custom five-point quality assessment scale demonstrated that no study satisfied all recommendations for LC n-3 PUFA study design. This review has highlighted that the disparate range of study designs is likely contributing to the inconclusive state of outcomes pertaining to LC n-3 PUFA as a potential ergogenic aid. Further research must adequately account for the specific LC n-3 PUFA study design considerations, underpinned by a clear hypothesis, to achieve evidence-based dose, duration and composition recommendations for physically trained individuals.

During the initial wave of the COVID-19 pandemic, symptoms of infection varied widely among adults younger than 60 years. This cross-sectional investigation of adults ages 18–59 years explored associations between SARS-CoV-2 symptomatology and supplementation of micronutrients involved in immune function, such as multivitamins, vitamin D, vitamin C, vitamin E and zinc. Between August and December 2020, an online survey was completed by 287 respondents, averaging 33⋅3 ± 10⋅5 years, who recovered from SARS-CoV-2 infection within the previous 4 months. In regression models, intake of supplements over the previous year was not protective against number of symptoms or symptom severity. Despite higher rates of supplementation over the previous year, smokers experienced more symptoms and greater symptom severity than non-smokers. Micronutrient supplementation did not protect young adults from experiencing symptoms of SARS-CoV-2, but our results suggest that smoking cessation may be a more effective modifiable lifestyle factor.

According to the World Cancer Research Fund International, vitamin D might decrease the risk of colorectal cancer (CRC). However, less is known about the association with cancers in different subsites of the colon and in the rectum. The aim of this study was to examine associations between pre-diagnostic intake of vitamin D and risk of CRC by anatomical subsites. Data from 95 416 participants in the Norwegian Women and Cancer Cohort Study was included, and vitamin D intake was estimated from two repeated FFQ. Associations between vitamin D intake and incidence of CRC were assessed using multivariable Cox regression. During follow-up, there were 1774 incident cases of CRC. A small but borderline significant inverse association was found for a 5-µg increase in vitamin D intake and risk of CRC (hazard ratio (HR) = 0·97; 95 % CI 0·93, 1·01) and colon cancer (HR = 0·96; 95 % CI 0·91, 1·01). High (≥ 20 µg) compared with low (< 10 µg) vitamin D intake was associated with 17 % borderline significant reduced risk of CRC (HR = 0·83; 95 % CI 0·68, 1·02). Medium (10–19 µg) v. low intake (< 10 µg) was associated with 27 % reduced risk of proximal colon cancer (HR = 0·73; 95 % CI 0·57, 0·94). No significant associations were observed between vitamin D intake and risk of distal colon or rectal cancer. Our study indicates that vitamin D may be differently associated with subsites of the colon. The association between vitamin D intake and proximal colon cancer is novel.

Sound general and sports nutrition knowledge in athletes is essential for making appropriate dietary choices. Assessment of nutrition knowledge enables evaluation and tailoring of nutrition education. However, few well-validated tools are available to assess nutrition knowledge in athletes. The objective of the present study was to establish the validity of the Platform to Evaluate Athlete Knowledge Sports – Nutrition Questionnaire (PEAKS-NQ) for use in the United Kingdom and Irish (UK-I) athletes. To confirm content validity, twenty-three sports nutritionists (SNs) from elite, UK-I sports institutes provided feedback on the PEAKS-NQ via a modified Delphi method. After minor changes, the UK-I version of the PEAKS-NQ was administered to UK-I SN from the British Dietetic Association Sport and Exercise Nutrition Register, and elite athletes (EA) training at elite sports institutes in the UK and Ireland. Independent samples t-test and independent samples median tests were used to compare PEAKS-NQ total and subsection scores between EA and SN (to assess construct validity). Cronbach's alpha (good ≥ 0⋅7) was used to establish internal consistency. The SN achieved greater overall [SN (n 23) 92⋅3 (9⋅3) v. EA (n 154): 71⋅4 (10⋅0)%; P < 0⋅001] and individual section scores (P < 0⋅001) except Section B, Identification of Food Groups (P = 0⋅07). Largest knowledge differences between SN and EA were in Section D, Applied Sports Nutrition [SN: 88⋅5 (8⋅9) v. EA: 56⋅7 (14⋅5)%; P < 0⋅00]. Overall ES was large (2⋅1), with subsections ranging from 0⋅6 to 2⋅3. Cronbach's alpha was good (0⋅83). The PEAKS-NQ had good content and construct validity, supporting its use to assess nutrition knowledge of UK-I athletes.