Nutrition is crucial for the growth of children and adolescents. This study investigated multiple nutritional problems and influencing factors among 2,423 students aged 6-17 in Guizhou Province, using questionnaire surveys, physical examinations, and blood tests. Multifactorial logistic and Poisson regression analyses were used to identify determinants of overnutrition and undernutrition. The results showed a distinct profile compared to national averages: wasting was more prevalent (9.6%), while overweight (8.6%) and obesity (5.0%) were less common. Notably, hyperuricemia (27.6%) and zinc deficiency (17.9%) were elevated, whereas classical metabolic syndrome (2.3%) was lower, delineating a regional pattern that prioritizes these emerging and micronutrient issues. Marginal vitamin A deficiency (17.2%) and vitamin D inadequacy (50.9%) remained significant. Older age (11-17 years) was a strong risk factor for overnutrition-related disorders and hyperuricemia (All p<0.001). Overweight/obesity increased risks of hyperuricemia and metabolic syndrome (All p<0.001). Being female was a major risk factor for undernutrition (PR=1.27, 95%CI: 1.19-1.35, p<0.001) and vitamin D deficiency (AOR=2.51, 95%CI: 2.10-3.00, p<0.001), but a protective factor against hyperuricemia (AOR=0.34, 95%CI: 0.27-0.41, p<0.001). Frequent sugary drink consumption (≥3/week) elevated hyperuricemia risk (AOR=1.33, 95%CI: 1.05-1.69, p=0.020). This study underscores a complex double burden of malnutrition in western China, characterized by specific priority areas, and necessitates tailored, multi-component interventions such as limiting sugary drinks and focusing nutrition support on adolescent girls.

This study aimed to evaluate the agreement between three body composition devices and dual-energy X-ray absorptiometry (DXA) in assessing segmental body composition among healthy Iranian adults. This comparative study recruited 62 healthy adults (33 men and 29 women) from Tehran, Iran, using a convenience sampling approach. Socio-demographic data were collected, and segmental body composition was assessed using several devices, including the InBody 770, Anea Bioelectrical Impedance Analysis (BIA), Tanita BC-418, and DXA. Agreement between DXA and the BIA devices was evaluated using Lin’s concordance correlation coefficient. Additionally, Bland–Altman plots and mean percentage error were applied to assess the consistency between the two methods. The Anea, InBody 770, and Tanita BC-418 devices showed strong correlation with DXA for all segmental measurements (r≥0.74, p<0.05). Moderate agreement (concordance correlation coefficient (CCC): 0.90 ≤ CCC < 0.95) with the DXA method was found for some segments using the Anea (trunk fat mass, arms fat-free mass, legs fat-free mass, and trunk fat-free mass) and the InBody 770 (trunk lean body mass and trunk fat mass) devices. The estimation of legs fat mass was the least accurate across all BIA devices. Furthermore, subgroup analyses showed that the BIA devices provided more precise results in men and in individuals with a Body Mass Index (BMI) <25.00 kg/m2. The Anea BIA and InBody 770 devices show relatively acceptable validity for segmental body composition assessment. More research is needed to confirm these findings.

Monocrotaline (MCT) induces lung injury and pulmonary hypertension (PH) by a mechanism that is in part due to oxidative stress. The purpose of this study was to determine how MCT affected nutrient antioxidants retinol and alpha-tocopherol in a rat lung and liver. Rats were fed a purified diet (AIN-93G) one-week prior to a subcutaneous injection of MCT (60 mg/kg) and remained on the diet throughout the study. Three weeks after injection, the animals were euthanized, and the lungs and livers were analyzed for retinol, alpha-tocopherol, phospholipid (PL), and cholesterol content. Lung retinol concentrations were significantly lower in MCT-treated rats, 2.0 ± 1.2 (nmol/g lung) vs. vehicle control (VEH), 5.8 ± 1.4 (P < 0.01). However, liver retinol concentrations were not significantly different, 3.3 ± 1.3 vs. 2.5 ± 0.9 nmol/g liver. Alpha-tocopherol was significantly greater in MCT-treated rats in the lung, 145 ± 24 vs. 99 ± 13 nmol/g lung (P < 0.001), and liver, 107 ± 30 vs. 47.7 ± 4.8 nmol/g liver (P < 0.001). Phospholipid and cholesterol were significantly lower in the lung of the MCT-treated group, but not significantly different in the liver. In conclusion, retinol along with phospholipid, and cholesterol were decreased in the lungs whereas alpha-tocopherol was elevated in the lungs and liver in response to MCT. These findings along with others suggest a novel mechanistic link between MCT-induced oxidative stress, lung vitamin A depletion, inflammation and the impairment of alveolar cell proliferation and repair. Pulmonary retinol is important in the pathogenesis of MCT-induced lung injury.

The Mediterranean and a low carbohydrate diet are two popular dietary approaches recommended for cardiovascular and metabolic health, respectively. This trial will compare the combined effect of these diets to either approach alone for the treatment of the metabolic syndrome (MetS). Males and females (n=222), 30-75 years, with at least three MetS risk factors will be randomised to one of 3 diets: i) Traditional Mediterranean (∼55% of energy carbohydrate [CHO]:15% Protein [Pro]: 30% Fat), ii) Lower Carbohydrate (∼35%CHO:20%Pro:45%Fat), or iii) Lower Carbohydrate Mediterranean (∼35%CHO:20%Pro:45%Fat) diet for 12-weeks. The primary outcome measure is the MetS Severity Z Score (MetS-Z), a composite score of risk factors, sex and ethnicity. MetS-Z will be calculated pre and post intervention using fasted blood samples for plasma triglycerides, HDL-cholesterol and glucose, systolic blood pressure, body weight and waist circumference measures. The findings from this trial will offer new insights into the most effective dietary strategy for managing diabetes and reducing cardiovascular risk in individuals with metabolic syndrome.

Responsive feeding characterised by recognising and appropriately addressing children’s hunger and satiety signals, plays a key role in health. Despite children’s innate ability to self-regulate food intake, caregivers can override these cues, especially in child care settings. The study determined the effects of a 6-month coaching intervention on the responsive feeding environments of child care centres. CELEBRATE Feeding was a 6-month, coaching, pre-post intervention design conducted in eight child care centres across Nova Scotia and Prince Edward Island, Canada. Child care centres’ feeding environments and educator practices were observed using a modified Environment and Policy Assessment and Observation tool at baseline and follow-up in two rooms per centre (n = 16). Twenty-one responsive feeding components were scored from 0–3 (3 as best practice). The average centre scores were summed for an overall score ranging from 0–63 at each time point. Paired samples t-tests and Wilcoxon signed rank tests were conducted to assess the impact of the intervention on overall rooms’ and individual responsive feeding components’ scores. There was an increase in scores from baseline (M = 38.16, SD = 6.55) to follow-up (M = 45.75, SD = 5.87), t (15) = 4.91, P < 0.001. All but one score improved, where 3 of the 21 scores were significantly more responsive after the intervention after applying a Bonferroni correction (P < 0.002). The score with the greatest positive change was ‘Educators provide gentle comments or nudges towards feeding’, with a mean difference of 1.33, P < 0.001. The CELEBRATE Feeding coaching intervention was successful in improving responsive feeding practices and environments in child care settings.

The objective of this study was to develop and validate an educational comic book designed to promote healthy eating among caregivers of young children. The study was conducted in four phases: (1) literature review and script development; (2) creation of the initial version of the comic book, including illustrations, layout and design, and calculation of the Flesch Readability Index (FI); (3) expert validation of the initial version and calculation of the Content Validity Index (CVI); and (4) adaptation of the comic book based on expert suggestions, recalculation of the FI, and pilot testing (CVI) with a lay population. A total of 64 volunteers participated in the validation process, including 14 expert judges and 50 caregivers responsible for feeding children aged 0 to 5 years. Statistical analysis included descriptive measures and inferential testing using the Wilcoxon signed-rank test. The FI score for the initial version was 85.0%, indicating a reading level classified as “easy to understand.” After expert evaluation, the CVI reached 94%, reflecting high agreement among participants. In the revised version, the FI remained high at 84.7%, reinforcing the “easy to understand” reading level, while the CVI increased to 98% following the pilot test, demonstrating strong consensus among participants. A significant improvement in knowledge regarding healthy eating was observed after reading the comic book (p < 0.05). The comic book was validated for appearance, content and readability, showing a positive impact on caregivers’ knowledge about healthy eating practices. It represents an accessible and effective resource that can be integrated into community-based nutrition education programmes.

Prenatal exposure to polyunsaturated fatty acids (PUFAs) has been associated with child weight at birth and may have a persistent effect on adiposity development across childhood. Fish is the richest source of n-3 PUFAs within the diet; albeit few studies have investigated associations between maternal fish consumption during pregnancy and child weight. This study examines associations between maternal fish consumption and prenatal PUFA status (n-3 and n-6), with longitudinal measures of child weight in the high-fish-eating Seychelles Child Development Study Nutrition Cohort 2. Maternal fish consumption during pregnancy was assessed using a Fish Use Questionnaire administered at 28-weeks’ gestation. Serum PUFAs were quantified in maternal blood collected at 28-weeks’ gestation and in cord blood collected at delivery. Birth weight was measured at delivery and classified according to WHO growth standards (n=1185). Child length/height (m) and weight (kg) were recorded at 20 months (n=1182), 7 (n=1167) and 13 (n=878) years. Child BMI was classified according to child z-scores. Maternal total fish consumption (range: 0.0-584.71 g/day) was not associated with child weight at any age. At 7 and 13 years maternal total n-6 PUFAs were associated with an increased risk of overweight/obesity (7yr; OR=1.62, p=0.037, 13yr; OR=2.05, p=0.005). Lower (<0.071mg/ml) cord docosahexaenoic acid (DHA) concentrations were associated with a greater likelihood of being large for gestational age (LGA; >90th percentile) when compared to higher (>0.129mg/ml) cord DHA concentrations (OR 4.17, p=0.017). This study suggests prenatal maternal n-3 and n-6 PUFA status may influence postnatal outcomes, including child adiposity from birth until adolescence.

The aim of this review is to examine why cultural food security and cultural food sovereignty should be prioritised and embedded within conventional food security frameworks. It demonstrates how culturally grounded, community-driven approaches foster more just, sustainable and empowering food systems for ethnically diverse, Indigenous and local communities, while highlighting the limitations of conventional metrics that overlook socio-cultural, political and ecological dimensions essential to resilience. Conventional food security focuses on access to sufficient, safe and nutritious food, often sidelining access to culturally appropriate and spiritually meaningful foods that are integral to cultural identity and tradition (cultural food security) and the authority and decision-making power held by local people over their foodways (cultural food sovereignty). Its market-based, individualistic measurement paradigms further neglect collectivist, traditional and spiritual food values, resulting in assessments that may conform to global standards yet produce flawed outcomes, misaligned interventions and continued marginalisation of ethnically diverse, Indigenous and local communities. Drawing on socio-cultural, political, economic and environmental frameworks, the review demonstrates how food sovereignty and cultural food security provide more sustainable, equitable and empowering pathways for communities. It underscores the need for community-driven, culturally grounded food policies.

Digital technologies provide a convenient and scalable approach to dietary assessment and personalised feedback, facilitating behaviour change. This is essential for reducing the prevalence of non-communicable diseases at a population level. However, the evaluation of the acceptability and feasibility of dietary feedback delivered via online platforms has not been thoroughly investigated. By utilising the term ‘system architecture’ to describe the essential components of the digital approach to capturing dietary feedback, this systematic review outlines the platform, dietary assessment methodology, reference values for assessing dietary intake, and elements of personalised dietary feedback. When reported, the acceptability and feasibility of personalised feedback were captured. OVID Medline, OVID Embase, Scopus via Elsevier, and Cinahl Plus via EBSCO identified 5,839 studies. Search terms included dietary assessment, feedback, and digital technologies. In total, 28 studies involving 301,271 participants were included. Food frequency questionnaires were the most commonly used dietary assessment method, accessed via web-based platforms. Dietary intake was commonly assessed using a diet quality index, and feedback was provided on food groups, often combined with a diet quality score or macronutrient analysis. While participant acceptance of personalised dietary feedback was generally high, the overall completion rates for acceptability questionnaires were low, and feasibility was seldom reported. Methods used to measure acceptability and feasibility varied, preventing comparisons across studies. Study quality was high; however, future research would benefit from the involvement of stakeholders and end-users in designing feedback messages.

This parallel randomised controlled trial examined the effect of a 4-week, high dose (Lf-High, 600mg/d) or low dose (Lf-Low, 200mg/d) oral lactoferrin (Lf) intervention versus placebo, on immune cell responses to respiratory virus, circulating immune cell subsets, and systemic inflammation. In healthy older adults (n=103, ≥50 years old), ex vivo cytokine release of interferon (IFN)-α2, IFN-γ, interleukin (IL)-6, and tumour necrosis factor (TNF)-α from isolated peripheral blood mononuclear cells (PBMCs) stimulated with rhinovirus A-16 (RV-16) or influenza A virus (H1N1), circulating immune cell subsets, and plasma IL-6, C-reactive protein (CRP) and TNF-α were assessed at baseline and 4 weeks. Ninety-seven participants completed the intervention (Lf-High n=32, Lf-Low n=31, placebo n=34, withdrawals n=6). There was no difference in RV-16 or H1N1-induced IFN-γ release between groups. At 4-weeks, RV-16-induced IL-6 was lower in Lf-High compared to placebo (P=0.001), and RV-16-induced IFN-α2 was higher in Lf-High compared to Lf-Low (P=0.04). Lf-High increased total T cells (P=0.03) and CD4+ T cells (P=0.03) compared to placebo. Lf-Low reduced neutrophil (P=0.04), natural killer cell (P=0.045), activated CD8+ T cell (P=0.03), and γδ T cell (P=0.03) frequency compared to placebo. Plasma IL-6 (P=0.004) and CRP (P=0.03) were lower following Lf-High compared to Lf-Low, but not placebo. Both high and low dose lactoferrin altered ex vivo immune cell responses after 4 weeks. High dose lactoferrin increased T-cell subsets, promoting adaptive immunity, and reduced systemic inflammation, while low dose lactoferrin reduced proinflammatory and cytotoxic immune cells. High and low dose lactoferrin supplements may have immunoceutical benefits in older adults.

The current study was designed to examine the association between a composite Healthy Lifestyle Score (HLS) and thyroid function biomarkers among American adults. This cross-sectional study utilized data from 5,693 adults aged ≥18 years in the NHANES 2007–2012 cycles. A HLS (range 0–6) was constructed based on six modifiable factors: non-smoking, no heavy alcohol intake, normal BMI (18.5–24.9 kg/m²), high physical activity (upper tertile of MET-min/week), adequate sleep (7–9 h/night), and appropriate energy intake. Serum concentrations of thyroid-stimulating hormone (TSH), free and total thyroxine (FT4, TT4), free and total triiodothyronine (FT3, TT3), thyroglobulin (Tg), and thyroid antibodies (TPOAb, TgAb) were measured. Multivariable linear regression adjusted for sociodemographic factors was used to assess associations. In fully adjusted models, each one-point increase in HLS was associated with lower serum FT4 (β = −0.07 ng/dL; 95% CI: −0.10, −0.03; p < 0.001) and TT4 (β = −0.11 µg/dL; 95% CI: −0.15, −0.06; p < 0.001). Compared with participants with an HLS of 0–1, those with HLS 4–6 had lower FT4 (β = −0.20; 95% CI: −0.30, −0.09; p < 0.001) and TT4 (β = −0.36; 95% CI: −0.49, −0.22; p < 0.001). Associations for other thyroid markers were not statistically significant after correction for multiple comparisons (p > 0.05). A healthier lifestyle is inversely associated with serum FT4 and TT4 levels, highlighting potential links between modifiable behaviors and thyroid physiology.

No existing dietary metric simultaneously captures key dimensions of sustainable healthy diets: dietary variety; intake of animal products; and extent of food processing. This methods and construct development study aimed to identify indicators of a sustainable healthy diet that can be used to inform a multidimensional diet quality score. A modified Delphi was used to gain expert consensus regarding development of a sustainable healthy diet score. Three iterative surveys were conducted between November 2022 and May 2023. Surveys asked participants’ opinion regarding measurement of the three dimensions of sustainable healthy diets (Dimension 1: variety of unprocessed and minimally processed foods; Dimension 2: intake of animal products and; Dimension 3: intake of ultra-processed foods (UPF)) and weighting and aggregation of a score that assesses these three dimensions. Thirteen international experts completed all three surveys. Consensus from experts led to the identification of food-based indicators of sustainable healthy diets. Experts agreed that Dimension 1 should be comprised of 12 food groups, with food groups and scoring ranges informed by the Global Diet Quality Score; Dimension 2 comprised of five food groups with scoring ranges informed by the EAT-Lancet planetary health diet; and Dimension 3 as one food group measured as a cut-off value of ≤10% energy from UPF. There was consensus that each dimension should be equally weighted. Outcomes from this work have been used to inform the development and validation of a multidimensional diet quality score to assess the healthfulness and environmental sustainability of diets among healthy adult populations.

International studies show that school food programmes (SFP) can improve children’s diets but evidence from Canada is nascent. We examined whether SFP are linked to better dietary intake and diet quality among Canadian elementary schoolchildren. This cross-sectional study surveyed 2366 grade 4–8 students (age 9–14 years; 48·9 % girls) from 32 schools in socioeconomically disadvantaged communities in Alberta and Ontario, Canada. Students completed a 24-hour diet recall, recording foods and beverages consumed during school hours (breakfast, morning snack, lunch, afternoon snack), and their source (school, other). Multivariable linear models examined the association of accessing SFP (≥1 meal/snack provided by school) with student daily intakes of vegetables and fruit, grains and grain products, milk and alternatives, meat and alternatives, free sugars, sodium and diet quality, adjusting for relevant confounders. Only 293 (12·4 %) students accessed SFP. Overall, accessing SFP was associated with higher intake of vegetables and fruit (β = 0·4, 95 % CI = 0·1; 0·7) and better diet quality score (β = 1·8, 95 % CI = 0·7; 3·0). Specifically, morning snacks provided by schools were associated with lower intake of free sugars (β = –8·9, 95 % CI = –16·5; −1·4), while school-provided lunches were associated with higher intake of milk and alternatives (β = 0·5, 95 % CI = 0·2; 0·8). Further, school-provided afternoon snacks were associated with higher intake of vegetables and fruit (β = 1·1, 95 % CI = 0·6; 1·6), lower sodium intake (β = –258·4, 95 % CI = –506·7; −10·0) and better diet quality (β = 3·1, 95 % CI = 1·1; 5·1). One in eight elementary schoolchildren accessed SFP. Students who accessed SFP had better diets, highlighting the potential of SFP (particularly snacks) in improving children’s diets.

Vitamin B6 is implicated in multiple mental disorders, and accumulating evidence suggests an inverse relationship with depression; however, important aspects of the underlying dose–response patterns and the roles of individual circulating vitamin B6 metabolites remain incompletely understood. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010. Depression was defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥10. Vitamin B6 status was assessed using serum pyridoxal 5′-phosphate (PLP), the biologically active coenzyme form, and 4-pyridoxic acid (PA), the principal catabolic and urinary excretion product of vitamin B6. Among 12,620 participants, 1,070 (8.5%) met criteria for depression. After adjusting for relevant covariates, multiple logistic regression revealed that individuals in higher quartiles of serum PLP and PA (Q2-Q4) had significantly lower odds of depression compared to those in the lowest quartile (Q1). Restricted cubic spline analyses identified nonlinear relationships: L-shaped for PLP (P-nonlinearity=0.001) and U-shaped for PA (P-nonlinearity=0.017). Below the inflection points (90.7 nmol/L for PLP; 73.9 nmol/L for PA), both metabolites showed significant inverse associations with depression (PLP: OR=0.992, 95%CI: 0.988–0.996, P<0.001; PA: OR=0.994, 95%CI: 0.993–0.996, P<0.001). Above these thresholds, the association became non-significant for PLP (P=0.353), while PA demonstrated a positive association with depression (OR=1.008, 95%CI: 1.002–1.013, P<0.01). Subgroup analyses confirmed the robustness of these inverse associations across demographic categories. Serum vitamin B6 metabolites, PLP and its excretion product PA, exhibit non-linear associations with depression, with distinct threshold effects and metabolite-specific patterns that likely reflect both vitamin B6 availability and turnover.