Free sugar intakes are currently higher than recommended for health, yet effective strategies for reducing consumption are yet to be elucidated. This work investigated the effects of different dietary recommendations for reducing free sugar (FS) intakes, on relevant outcomes, in UK adults consuming > 5 % of total energy intake (TEI) from FS. Using a randomised controlled parallel-group design, 242 adults received nutrient-based (n 61), nutrient- and food-based (n 60), nutrient-, food- and food-substitution-based (n 63) or no (n 58) recommendations for reducing FS at a single timepoint, with effects assessed for the following 12 weeks. Primary outcomes were FS intakes as a percentage of TEI (%FS) and adherence to the recommendations at week 12. Secondary outcomes included TEI, diet composition, sugar-rich and low-calorie-sweetened food consumption and anthropometry. In intention-to-treat analyses adjusted for baseline measures, %FS reduced in intervention groups (%FSchange = –2·5 to −3·3 %) compared with control (%FSchange = –1·2 %) (smallest B = –0·573, P = 0·03), with effects from week 1 until week 12 and no differences between interventions (largest B = 0·352, P = 0·42). No effects of the interventions were found in dietary profiles, but change in %FS was associated with change in %TEI from non-sugar carbohydrate (B = 0·141, P < 0·01) and from protein (B = –0·171, P = 0·02). Body weight was also lower at week 12 in intervention groups compared with control (B = –0·377, P < 0·05), but associations with %FS were weak. Our findings demonstrate the benefit of dietary recommendations for reducing FS intakes in UK adults. Limited advantages were found for the different dietary recommendations, but variety may offer individual choice.

This study aimed to investigate the intake of dairy products during pregnancy in women with gestational diabetes mellitus (GDM) and its impacts on neonatal birth weight and pregnancy outcomes. A total of 386 women with GDM during the second trimester pregnancy participated in this prospective cohort study. We evaluated dairy products intake through the FFQ. Pregnancy outcomes were obtained from the delivery data. Participants were divided into insufficient and sufficient intake of milk and dairy products groups (< 300 g/d and ≥ 300 g/d, respectively). The average intake of dairy products during the second trimester pregnancy in women with GDM was 317·8 ± 179·5 g/d, and the total energy intake was 1635·4 ± 708·7 kcal/d. However, 76·68 % of them did not meet the recommended total energy intake of women with GDM. After adjusting for confounding factors, women with GDM who consumed ≥ 300 g/d of dairy products had an average reduction in birth weight of 93·1 g compared with women who consumed < 300 g/d of dairy products (95 % CI −171·343, −14·927). Women with GDM in sufficient intake group was also associated with lower risk of macrosomia (95 % CI 0·043, 0·695) and caesarean section (95 % CI 0·387, 0·933) and not related to low birth weight infant (95 % CI 0·617, 14·502) and preterm birth (95 % CI 0·186, 1·510) when compared with participants in insufficient intake group. Under the premise of insufficient total energy intake, the intake of dairy products during the second trimester pregnancy in women with GDM might be related to the decrease of neonatal birth weight.

Chronic kidney disease (CKD) poses a global health challenge, with dietary protein intake being a key factor in disease management. This review synthesises evidence on the impact of different protein intake strategies, including low-protein diet (LPD), very-low-protein diet (VLPD), high-protein diet (HPD) and plant-based diet (PBD), on CKD progression and patient outcomes. The review explores personalised nutrition strategies and identifies gaps in the literature. A systematic search of PubMed, Cochrane Library, Web of Science and Scopus was conducted, covering studies published from 1982 to 2024, including randomised controlled trials (RCT), observational studies and meta-analyses involving adult patients with CKD. The findings suggest that LPD and VLPD may slow CKD progression, particularly when supplemented with ketoanalogues, but adherence and long-term benefits remain uncertain. PBD are associated with reduced renal burden and improved metabolic health, although achieving adequate protein intake from plant sources requires careful planning. HPD, particularly those rich in animal protein, may exacerbate CKD progression, although recent research indicates that higher protein intake may benefit specific populations, such as older adults with mild-to-moderate CKD. In conclusion, managing protein intake in CKD is complex and necessitates a personalised approach. While LPD and PBD offer potential benefits, their long-term success is contingent upon patient adherence, individualised dietary management and further research into their sustained effects. Future research should focus on long-term RCT and the development of personalised nutrition strategies incorporating emerging technologies and multidisciplinary care to optimise CKD management.

Adolescent girls often skip breakfast due to time constraints and reduced morning appetite. This study examined the acute impact of breakfast consumption timing v. breakfast omission (BO) on glycaemic and insulinaemic responses to lunch in infrequent breakfast-consuming girls. Fifteen girls (13·1 (sd 0·8) years) completed three conditions in a randomised crossover design: early-morning breakfast consumption (EM-BC; 08.30), mid-morning breakfast consumption (MM-BC; 10.30) and BO. A standardised lunch was provided at 12.30, followed by a 2-h post-lunch observation period. Blood and expired gas samples were collected periodically. Linear mixed models with Cohen’s d effect sizes compared outcomes between conditions. Pre-lunch glucose and insulin incremental AUC (iAUC) were higher in the breakfast conditions v. BO (P ≤ 0·009), with no differences between breakfast conditions. MM-BC reduced post-lunch glucose iAUC by 36 % and 25 % compared with BO and EM-BC, respectively (P < 0·001, d = 0·92–1·44). A moderate, non-significant 15 % reduction in post-lunch glucose iAUC was seen with EM-BC v. BO (P = 0·077, d = 0·52). These reductions occurred without changes in post-lunch insulinemia (P ≥ 0·323) and were accompanied by increased post-lunch carbohydrate oxidation compared with BO (P ≤ 0·018, d = 0·58–0·75); with no differences between EM-BC and MM-BC. MM-BC lowered glycaemic response over the experimental period compared with BO (P = 0·033, d = 0·98) and EM-BC (P = 0·123, d = 0·93), with no difference between EM-BC and BO. Compared with BO, both breakfast conditions lowered post-lunch glycaemic responses with mid-morning breakfast eliciting a greater second-meal effect than early-morning breakfast. These findings indicate the breakfast-to-lunch meal interval may be a crucial factor affecting postprandial glycaemia in infrequent breakfast-consuming girls.

The Pacific Islands region is home to a diversity of countries and territories, who are at the forefront of climate change and the triple burden of malnutrition. In recent years there has been increasing interest in schools as a setting for transforming food systems, improving nutrition and health outcomes, increasing educational outcomes, and enhancing livelihoods in the Pacific Islands. This review examines and describes current school food and nutrition initiatives within the literature that aim to promote healthier, sustainable diets within the Pacific Islands region. As there is a paucity of literature in this area of interest in the Pacific Islands, the review focuses on the policy landscape, the provision of food near, and in schools, nutrition education, and future opportunities. The available literature demonstrates that there is broad regional interest and momentum from numerous stakeholders to enhance SFNE in the Pacific Islands, with several opportunities for future activities. While there are frameworks to explore food environments available there is a need for a Pacific Islands school food environment conceptual framework that captures aspects, both within and around schools, that can guide research and assessment for robust comparable data collection. This may in turn support healthier SFNE and ultimately nutritious food choices for children and adolescents.

Accumulation of exogenous fatty acids such as the long-chain n-11 MUFA cetoleic acid (CA, C22:1n-11) may induce functional changes, through direct effects or by affecting the amounts of other fatty acids through changes in catabolic and anabolic processes including desaturation of fatty acids or by other processes. The primary aim of this study was to investigate if dietary CA was absorbed and accumulated in a TAG-rich tissue for storage (white adipose tissue), a stable phospholipid-rich tissue (brain), metabolically active tissues (liver and skeletal muscle) or circulating in the blood (blood cells) and metabolised. Secondary aims included investigating any effects on the levels of EPA and DHA. Eighteen male Zucker diabetic Sprague Dawley (ZDSD) rats were fed diets with herring oil (HERO) containing 0·70 % CA or anchovy oil (ANCO) devoid of CA, or a control diet with soyabean oil for 5 weeks. The HERO and ANCO diets contained 0·35 and 0·37 wt% EPA + DHA, respectively. Data were analysed using one-way ANOVA. CA from dietary HERO was absorbed, and CA and two chain-shortened metabolites were found in blood cells, liver, white adipose tissue (WAT) and muscle, but n-11 MUFAs were not found in the brain. The concentrations of EPA and DHA were similar in liver lipids (TAG, cholesteryl esters and NEFA) as well as in WAT, muscle and brain from rats fed the HERO or ANCO diets. To conclude, CA was taken up by tissues but did not affect levels of EPA and DHA in this diabetic rat model.

A randomised parallel intervention study was conducted with male patients diagnosed with CHD. Participants were assigned to three groups: Group A abstained from alcohol (n 20), Group B consumed red wine (n 21) and Group C (n 16) consumed an alcoholic beverage without wine micro-constituents. Biological samples were collected at baseline, 4 and 8 weeks. Enzyme activities of acetyl-CoA:lyso-platelet-activating factor (PAF) acetyltransferase, cytidine 5’-diphospho (CDP)-choline:1-alkyl-2-acetyl-sn-glycerol cholinephosphotransferase (PAF-cholinephosphotransferase), PAF-acetylhydrolase in leukocyte homogenates, serum lipoprotein-associated phospholipase-A2 and plasma markers of thrombosis were measured. PAF-, ADP- and collagen-induced platelet aggregation was measured in human platelet-rich plasma. Red wine consumption led to a 15·3 % reduction in LysoPAF-acetyltransferase activity at 4 weeks (P= 0·008) compared with baseline and Group A (P= 0·01). PAF-cholinephosphotransferase activity was reduced by 11·1 % at 8 weeks (P= 0·04) compared with baseline and by 24·9 % compared with Group C (P= 0·02). PAF-acetylhydrolase activity was reduced by 36·2 % at 8 weeks compared with baseline (P= 0·001) and compared with Group A (P< 0·000) and Group C (P= 0·009). Fibrinogen levels in Group B reduced by 6–9 % at 4 (P= 0·04) and 8 weeks (P= 0·01) compared with baseline while D-dimer in Group C increased by 16·1 % at 8 weeks (P= 0·005) compared with baseline. Platelet aggregation against PAF and collagen was reduced in Group B (82·6 and 35·4 %, respectively), and in Group C (158·4 and 37·1 %, respectively) compared with baseline and Group A (P< 0·05). In conclusion, moderate wine consumption improved the activity of PAF-metabolism enzymes regardless of ethanol and reduced platelet aggregation, probably through mechanisms different from those of ethanol.

Insulin-like growth factor 1 (IGF-1) is an important growth factor in childhood. We aimed to investigate the impact of food supplements for the treatment of moderate acute malnutrition (MAM) on serum IGF-1 (sIGF-1). Secondary analysis of a randomised 2 × 2 × 3 factorial nutrition trial was performed. Children aged 6–23 months with MAM received 2093 kJ/d as lipid-based nutrient supplement (LNS) or corn soy blend (CSB), containing either dehulled soya or soya isolate and different quantities of dried skimmed milk (0 %, 20 % or 50 % of total protein) for 12 weeks. The trial was double-blind with regard to soya and milk but not to matrix (LNS v. CSB). sIGF-1 was measured at inclusion and after 12 weeks of supplementation. Of 1609 children enrolled, 1455 (90 %) had sIGF-1 measured at both time points. During supplementation, sIGF-1 increased 6·7 (95 % CI 6·1, 7·3) ng/ml compared with an expected age-dependent decrease of 0·3 (95 % CI 0·2, 0·4) ng/ml. Children who received LNS v. CSB had a lower increase in sIGF-1 (–8 %, 95 % CI − 12, −3). The effect of LNS was partly attenuated when sIGF-1 was corrected for inflammation. Children who received soya isolate compared with dehulled soya had a higher increase in sIGF-1 (6 %, 95 % CI 1, 12). Milk content did not affect sIGF-1. Overall, sIGF-1 increased during supplementation. The lower increase with LNS v. CSB was only partly explained by increased inflammation with LNS and needs further investigation. Isolate v. dehulled soya led to a higher increase which may be due to antinutrients in dehulled soya.

Understanding the determinants of malnutrition is pivotal for public health interventions. This study aimed to identify socio-economic, demographic, dietary and maternal determinants of wasting and overweight among Brazilian children between 6 and 59 months. Data from the Brazilian National Survey on Child Nutrition were analysed (n 11 789). Children’s weight-for-height Z-scores were calculated according to the WHO growth standard and classified as wasting (Z < −2), normal weight (–2 ≤ Z ≤ 1), overweight risk (1 < Z ≤ 2) and overweight (Z > 2). Socio-economic, demographic, dietary and maternal covariables were considered. Adjusted multinomial logistic regression (OR and 95 % CI) was employed. The prevalence of overweight and wasting was 9·5 and 2·6 %, respectively. In the adjusted model, younger age (6–23 months: OR: 1·7; 95 % CI: 1·3, 2·2), consumption of ≥ 5 ultra-processed food groups (OR: 1·8; 95 % CI: 1·1, 3·1), maternal underweight (OR: 0·4; 95 % CI: 0·2, 0·9), overweight (OR: 1·5; 95 % CI: 1·2, 1·9) and mild food insecurity (OR: 0·8; 95 % CI: 0·6, 1·0) were associated with child overweight. The Brazilian Northeast (OR: 4·9; 95 % CI: 2·1, 11·3), Southeast (OR: 7·1; 95 % CI: 3·0, 16·6), South (OR: 4·7; 95 % CI: 1·8, 12·1), Midwest regions (OR: 2·7; 95 % CI: 1·2, 6·2) and maternal underweight (OR: 5·4; 95 % CI: 2·7, 10·7) were associated with wasting. Overweight in Brazil is prevalent among children between 6 and 59 months, while wasting is not a major public health problem. The main determinants of these Brazilian children’s nutritional status were age, ultra-processed food consumption and maternal nutritional status.

Postpartum maternal diet quality has been linked with optimal infant feeding practices. However, whether maternal diet quality during pregnancy influences infant feeding practices remains unclear. The present study explored the relationship between maternal diet quality in pregnancy and infant feeding practices in Australian women. A brief 15-item FFQ was used to collect maternal dietary data (n 469). Diet quality was calculated using a modified 2013 Dietary Guideline Index (DGI). Multivariable linear and logistic regressions with adjustment for covariates were used to examine associations between maternal diet quality in pregnancy and infant feeding practices: infant feeding mode, breast-feeding duration and timing of solids introduction. Higher DGI score during pregnancy was associated with higher odds of breast-feeding than formula/mixed feeding (adjusted OR (AOR) 1·03, 95 % CI 1·00, 1·07), longer breast-feeding duration (adjusted β 0·09, 95 % CI 0·03, 0·15) and higher odds of breast-feeding for ≥ 6 months (AOR 1·04, 95 % CI 1·02, 1·07) than for < 6 months. Associations between maternal DGI score and breast-feeding variables were moderated by maternal country of birth, with significant associations observed in Australian-born mothers only. No association was found between maternal DGI score and timing of solids introduction. Higher maternal diet quality was associated with better infant feeding practices, and the association was moderated by country of birth. Our findings provide evidence to support the initiation of dietary interventions to promote diet quality during pregnancy, particularly among Australian-born women. Further research could explore underlying mechanisms linking maternal diet quality and infant feeding practices.

Vitamin K exists naturally in foods as phylloquinone (vitamin K1, PK) and as a range of menaquinones (vitamin K2, MK). There is scarce information on the occurrence and distribution of PK and MK in dietary sources, particularly in seafood. This study aimed to comprehensively analyse the contents of vitamin K1, dihydro-K1, and MK-4 to MK-10 in various species, tissue types and processing degrees of shellfish. Additionally, seasonal differences in the vitamin K content of blue mussels (Mytilus edulis) were explored. Most shellfish products had low contents of total vitamin K (< 10 µg/100 g). The highest content of total vitamin K was found in the hepatopancreas of snow crab (170 µg/100 g), the brown meat of brown crab (35 µg/100 g), pre-packaged blue mussels (20 µg/100 g), stuffed brown crab shells (15 µg/100 g) and blue mussels in brine (12 µg/100 g). In general, the hepatopancreas of crustaceans contained considerably higher contents of vitamin K than their white meat counterparts. MK contributed most to total vitamin K contents, whereas most shellfish products contained low contents of PK, thus making only a minor contribution to the adequate intake established for adults. No statistically significant differences were observed in PK and MK contents of blue mussels sampled during spring v. late summer (P < 0·005). Nevertheless, a non-significant trend of increasing vitamin K content was observed towards the autumn months. This study presents novel vitamin K data for shellfish, an unexplored food group, and adds to the scarce vitamin K composition data worldwide.

India’s nutrition transition has led to an increased burden of overweight/obesity (body mass index of ≥23 kg/m2), driven by lifestyle factors like poor diet, inactivity, and substance use, prompting public health interventions. However, these interventions lack supporting evidence, especially in rural areas, hindering effective strategies for this population. To address this evidence gap, this study used cohort data (baseline: 2018–19, follow-up: 2022–23) from the Birbhum Population Project (West Bengal, India) to analyse lifestyle risk factors and their association with incidence and remission of overweight/obesity among adults aged ≥18 years (sample: 8,974). Modified Poisson regression model was employed to attain the study objective. From 2017–2018 to 2022–2023, the prevalence of overweight/obesity increased from 15.2% (95% CI: 14.1%–16.4%) to 21.0% (95% CI: 19.7%–22.3%) among men and from 24.1% (95% CI: 22.9%–25.2%) to 33.8% (95% CI: 32.5%–35.1%) among women. Overall, 23.0% (95% CI: 21.8%–24.3%) of adults experienced incidence of overweight/obesity, while 13.9% (95% CI: 12.4%–15.6%) experienced remission. Use of motor vehicles among unemployed participants was associated with incident overweight/obesity (relative risk or RR: 1.058; 95% CI: 1.023–1.095; P: 0.001). Vigorous activity at home (including gardening, yard work, and household chores) was linked to higher odds of recovering from overweight/obesity (RR: 1.065; 95% CI: 1.008–1.125; P: 0.025). Frequent tobacco use (often/daily vs. none) was inversely associated with remission of overweight-obesity (RR: 0.689; 95% CI: 0.484–0.980; P: 0.038), as was each 1 ml in alcohol consumption (RR: 0.995; 95% CI: 0.991–0.999; P: 0.022). Discouraging habitual motor vehicle use may help prevent overweight/obesity, while promoting home-based activities may aid remission, particularly for women who are at higher risk for overweight/obesity.

Psychosocial stimulation is one of the recommended interventions in the management of hospitalised children with severe acute malnutrition (SAM). However, there is currently limited scientific evidence supporting the effectiveness of the intervention. The study aimed to examine the effects of psychosocial stimulation on the development, nutrition, and treatment outcomes of hospitalised SAM children. A cluster-randomised controlled trial was conducted among health facilities that provide inpatient care for children with SAM in Silti Zone, Ethiopia. Fifty-eight children enrolled in the intervention facilities were provided stimulation intervention during their inpatient care and for 6 months after discharge. Sixty-eight children enrolled from control health facilities received routine inpatient care without stimulation and were followed for six months. Health education was provided to all caregivers on child health-related topics. Child development and nutrition outcomes were assessed four times using Denver II-Jimma and anthropometric measurements while the length of hospitalisation was used to measure treatment outcome. Children in the intervention group showed significantly better scores in Personal Social (p=0.001, effect size=0.77), Fine Motor (p=0.001, effect size=1.87), and Gross Motor (p=0.001, effect size=0.78) developmental domains from baseline to end line. Language domain however showed a significant difference only after discharge and intervention children scored better at six months (p<0.001, effect size=0.59). The intervention significantly improved treatment outcomes (p=0.010), but no significant changes in nutritional outcomes were documented. The findings highlighted the benefits of the intervention and the need to promote these interventions in health facilities within resource-limited settings.

The influence of appetite and energy intake (EI) on energy compensation in response to chronic exercise remains poorly understood. This study examined the temporal impact of habitual exercise on EI and the homeostatic appetite regulators that influence energy compensation. Twelve-week-old male Sprague Dawley rats (n 30) fed an AIN-93M diet were randomised into one of three groups: (1) sedentary control (SED); (2) voluntary wheel exercise (EX) and (3) sedentary, weight-matched to aerobic exercise (SED-WM) for 8 weeks. Measures of EI, body weight and adiposity were assessed. Appetite-regulating hormones acyl ghrelin, active glucagon-like peptide (GLP)-1, leptin and insulin were measured in response to an oral glucose tolerance test. Rats with running wheels completed an average of 192 km over 8 weeks. While EI was initially reduced in EX, EI gradually increased with exercise training after week 1 (P < 0·05). Body weight was lower in EX relative to SED from weeks 3 to 5 but did not differ at the end of the study. Fat mass and long-term satiety hormones leptin and insulin were lower in EX (P < 0·05). No differences were observed in concentrations of the satiety hormone active GLP-1 or the orexigenic hormone acyl ghrelin. Short-term homeostatic regulators of appetite do not appear to be altered with exercise training. The reduction in adiposity and associated decrease in tonic satiety hormones leptin and insulin are likely contributors to the coupling of energy expenditure with EI over time with voluntary exercise.