Children with moderate acute malnutrition (MAM) have an increased risk of iron deficiency, anaemia and death from infectious diseases. The iron-regulating hormone hepcidin is increased in inflammation and may be important in regulating iron metabolism in children with MAM. Asymptomatic malaria has previously been associated with elevated s-hepcidin. We assessed the association between inflammation, iron status, anthropometry and malaria and serum hepcidin (s-hepcidin) and evaluated the effect of food supplementation on s-hepcidin in a secondary analysis in 1019 children with MAM from a randomised intervention trial in Burkina Faso. Children received 12 weeks of supplementation of 500 kcal/d as either corn–soy blend (CSB) or lipid-based nutritional supplements (LNS). S-hepcidin was measured at baseline and after 12 weeks. At baseline, correlates of s-hepcidin were determined using Tobit regression. The effect of supplementation was determined using mixed effects Tobit regression. Children with iron deficiency had 82 % (95 % CI 76, 87) lower s-hepcidin than those without, whereas children with acute infection and inflammation had elevated s-hepcidin. Children with symptomatic malaria had 103 % (95 % CI 32, 210) higher s-hepcidin than afebrile children without detectable malaria, while children with recent or asymptomatic malaria had 51 % (95 % CI 35, 63) lower s-hepcidin. S-hepcidin increased 61 % (95 % CI 38, 87) after 12 weeks of food supplementation with 22 % higher (95 % CI 2, 45) concentration in those who received LNS compared with CSB. Expectedly, morbidity and inflammation were associated with higher, and iron deficiency with lower, s-hepcidin. Further studies are needed to corroborate the finding of decreased s-hepcidin in malnourished children with asymptomatic malaria.

Creatine is a vital bioenergetic compound that remains largely overlooked within food systems despite its well-established role in human health and performance. Unlike creatinine – a downstream breakdown product of creatine metabolism commonly measured as a biomarker of kidney function – creatine functions as an energy buffer, facilitating the rapid regeneration of ATP in tissues with high metabolic demands such as skeletal muscle, brain and heart. Although a portion of daily creatine requirements is met through endogenous synthesis, dietary intake – primarily from animal-source foods – remains essential to maintain optimal physiological levels. Emerging evidence indicates that suboptimal creatine status, or creatine insufficiency, may be widespread, particularly among vegetarians, vegans, older adults, individuals with chronic illness and those with increased energy needs. This paper examines the evolving role of creatine across four domains: its natural occurrence in foods, incorporation into fortified food products, use as a dietary supplement and potential future classification as a pharmaceutical agent. Special emphasis is placed on differences in regulatory status, intended use, dosage, labelling and public health implications. In light of mounting evidence that creatine insufficiency may contribute to adverse outcomes – including impaired cognition, reduced muscular performance and vulnerability to stressors – integrating creatine into food policy and nutrition strategies represents a promising, scalable and preventive approach to improve population health.

This study evaluated the effect of different medium-chain to long-chain fatty acid (MCFA:LCFA, M:L) ratios on growth performance, intestinal function, antioxidant capacity and gut microbiota in piglets. A total of 250 piglets were randomly assigned to five groups with five replicates, each containing ten pigs. The diets, containing varying amounts of MCFA-rich coconut oil and LCFA-rich soyabean oil, resulted in M:L ratios of 0, 2·1, 4·2, 8·8 and 33·8 %. Results showed that both final body weight and average daily weight gain increased as the M:L ratio increased (P < 0·05), while the 8·8 % M:L ratio diet exhibited the lowest feed:gain ratio (P < 0·05). As the M:L ratio increased, the contents of superoxide dismutase and glutathione peroxidase were increased, and MDA was decreased in serum (P < 0·05). The 8·8 and 33·8 % M:L diets improved ileal and jejunal morphology (P < 0·05), as indicated by greater villus height and villus height:crypt depth ratios. Furthermore, increasing M:L ratios from 0 to 33·8 % increased expression of tight junction proteins occludin and ZO-1 in the jejunum (P < 0·05). The 33·8 % M:L ratio reduced microbial α-diversity (P < 0·05), while 8·8 % M:L diet significantly increased the abundance of beneficial bacteria (e.g. Lactobacilli, Prevotella) and decreased harmful bacteria (e.g. Escherichia-Shigella, Enterococcus) in the cecum (P < 0·05). In summary, our study found that 8·8 % of dietary M:L ratios significantly improved growth performance, likely through modulating intestinal function, antioxidant activity and gut microbial composition.

Dieting is a global emerging trend in recent years as more people strive to adhere to food restriction plans for weight management in obese people and to achieve desired slim body. This strategy may have unforeseen repercussions in females that may affect reproductive potential. Therefore, we aimed to investigate the impact of dietary stress on reproductive hormone levels, histoarchitecture of the ovary, autophagy and apoptosis markers in the rat ovary. Data suggest that dietary stress caused due to food deprivation decreased body weight and ovary weight, luteinising hormone, follicular-stimulating hormone and estradiol-17β levels. The dietary stress reduced the number of primary follicles, altered the histoarchitecture of the ovary, increased number of fragmented and irregularly shaped oocytes. Dietary stress induced autophagy signalling by inhibiting mammalian target of rapamycin and increasing Lamp-1, LC-3 and Beclin-1 in the ovarian follicles. In addition, dietary stress induced proapoptotic signalling pathway by decreasing Bcl-2 and increasing Bax as well as cytochrome-c expressions in the ovary. Taken together, these findings suggest that dietary stress caused due to food deprivation reduced reproductive hormones levels, induced autophagy and apoptotic signalling pathways that affected histoarchitecture of the ovary, ovarian function, oocyte quality and thereby reproductive potential.

Intrinsic capacity, introduced by the WHO, represents a shift in focus from treating disease to maintaining physical and mental capacities individuals as they age. It encompasses five interrelated domains: vitality, sensory, cognition, psychology, and locomotion. Vitality refers to the body’s physiological reserve and is shaped by processes such as energy metabolism, immune function, and neuromuscular integrity. By definition, vitality is closely linked to nutritional status, which plays a central role in maintaining resilience and health in older adults. However, integrating nutritional status into the vitality domain presents several challenges due to inconsistent definitions and varied measurement approaches. This review examines these challenges and explores possibilities for integrating nutritional status in the vitality domain. The absence of standardised nutrition-related indicators limits comparability across studies and constrains the practical application of intrinsic capacity in both research and clinical contexts. To strengthen the role of intrinsic capacity in nutritional monitoring, it is essential to reach consensus on which nutritional indicators to include and how to score them consistently. Addressing these methodological challenges will support the use of intrinsic capacity in identifying early signs of nutritional decline and guiding timely interventions to promote healthy ageing.

This study aimed to investigate the effects of caffeic acid (CA) on the inflammatory response induced by hydrogen peroxide (H2O2) in porcine small intestinal epithelial cells (IPEC-J2 cells) and to elucidate the potential molecular mechanisms involved. Firstly, we treated IPEC-J2 cells with different concentrations of H2O2 to establish the inflammation model caused by oxidative stress. Subsequently, we treated IPEC-J2 cells with CA and/or H2O2 to investigate the effect of CA on the inflammatory response of IPEC-J2 cells induced by H2O2. In addition, IPEC-J2 cells were treated with a nuclear factor kappa-B (NF-κB) inhibitor and a Nucleotide-binding Oligomerization Domain (NOD)-like receptor thermal protein domain associated protein 3 (NLRP3) inhibitor, so as to investigate the molecular mechanism by which CA alleviates H2O2-induced damage in porcine intestinal epithelial cells. The changes in cell morphology, intestinal epithelial cell damage and the expression of genes related to the NF-κB/NLRP3 signalling axis were examined. The results showed that CA attenuated H2O2-induced intestinal epithelial cell injury, and the mechanism may be related to the inhibition of NF-κB-mediated NLRP3 inflammasome activation. These findings were expected to provide a theoretical basis for more reasonable and effective application of CA, and provide new ideas for nutritional regulation measures to alleviate intestinal inflammation in piglets.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a serious disease and increasingly prevalent in children. MASLD is associated with health consequences such as type 2 diabetes and CVD. While vitamin E is a potent antioxidant that has been proposed to improve liver function and cardiometabolic health including liver markers, lipid profile, glycaemic control and anthropometric measurements. A comprehensive search was conducted up to March 2025. Data on anthropometric measures, liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT)), glycaemic indices (fasting blood sugar (FBS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR)), lipid profiles (total cholesterol (TC), TAG, LDL-cholesterol, HDL-cholesterol) and serum vitamin E levels were extracted. Statistical analyses were performed using a random-effects model. Eleven randomised controlled trials involving 665 participants were included in this study. Vitamin E significantly reduced ALT (weighted mean difference (WMD) = −5·23 U/L; 95 % CI: −7·72, −2·75; P < 0·001) and AST (WMD = −3·00 U/L; 95 % CI: −4·59, −1·41; P < 0·001), reflecting improved liver function. It also decreased TC (WMD = −5·77 mg/dl; 95 % CI: −11·46, −0·09; P = 0·04) and HOMA-IR (WMD = −0·82; 95 % CI: −1·28, −0·37; P < 0·001), while significantly increasing serum vitamin E levels (WMD = 9·16 mg/l; 95 % CI: 3·29, 15·03; P = 0·002). No significant changes were observed in the BMI, GGT, FBS, insulin, LDL-cholesterol, HDL-cholesterol or TAG levels. Vitamin E supplementation in paediatric MASLD appears to favourably influence key liver enzymes such as ALT, AST and certain metabolic factors including TC, and HOMA-IR levels, supporting its potential role as adjunctive therapy.

The aim of this study was to examine the potential mediating role of intuitive eating in the relationship between food insecurity and adherence to the Mediterranean diet. A total of 1039 adults aged between 20 and 64 years living in Niğde, Türkiye, were evaluated using a questionnaire. The questionnaire included items on participants’ general characteristics, dietary habits, the Household Food Security Survey Module – Short Form, the Mediterranean Diet Adherence Screener and the Intuitive Eating Scale-2. Intuitive eating was found to play a partial mediating role in the relationship between food insecurity and adherence to the Mediterranean diet. Food insecurity was directly and negatively associated with adherence to the Mediterranean diet, and this association remained significant even after the inclusion of intuitive eating as a variable in the model. In conclusion, food insecurity was found to negatively affect adherence to the Mediterranean diet not only directly but also indirectly by weakening intuitive eating skills. Interventions aimed at promoting intuitive eating may help mitigate unhealthy dietary behaviours associated with food insecurity; however, improving food access and living conditions remains essential for a long-term solution.

Growing evidence has linked both the onset and symptoms of various mental disorders to lifestyle factors such as diet, exercise and sleep. The link between diet and mental health in particular in depressive disorders has gained interest in recent years. Previous reviews assessing the link between the Mediterranean diet (MedDiet) and mental health predominantly focused on depression, whilst others failed to integrate a summary of possible underlying mechanisms related to a link between MedDiet and mental health to complement their findings. In the present review, we provide a comprehensive synthesis of evidence on the MedDiet and diverse mental health outcomes complemented by narration of potential mechanisms involved. A literature search was conducted across MEDLINE, PsycINFO, Scopus, Cochrane library, Google scholar, CINAHL and Embase database. A total of 10,249 articles were found through the primary literature search and 104 articles (88 observational and 16 interventional studies) were eligible for inclusion. The Mediterranean diet (MedDiet) has been associated with favourable mental health outcomes in adult populations, including reduced depressive and anxiety symptoms, lower perceived stress, and improved quality of life and overall well-being, both in healthy individuals and those with comorbidities, across diverse geographical settings. Mechanisms involved include anti-oxidant, anti-inflammatory potential of MedDiet and its effect on gut microbiota. Further research is warranted to rigorously establish causal inferences and to guide the optimal incorporation of Mediterranean diet principles into comprehensive prevention and treatment strategies aimed at improving mental health outcomes.

Children with coeliac disease (CD) on a gluten-free diet (GFD) often have poor dietary quality (DQ). A Gluten-Free Food Guide (GFFG) was developed to address this. This pilot randomised controlled trial evaluated the impact of GFFG dietary counselling on DQ and ultra-processed food (UPF) intake in newly diagnosed CD children. Child–parent pairs were randomised to the standard of care only (CON: n 20) or the intervention (INT: standard of care + GFFG; n 20). Primary outcomes included DQ (Healthy Eating Index-Canadian) and UPF intake (NOVA classification), assessed at baseline (BL), 3 and 6 months. In INT, dietary variety scores, a subcomponent of DQ, increased between BL and 3 months (BL: 6·7 (3·3–6·7) v. 3 months: 10 (10–10); P = 0·01) and in higher variety scores than CON at 3 months (P < 0·01). Total DQ and UPF intake remained unchanged. Increased dietary variety in INT was associated with increases in dairy products (BL: 7·5 (sd 3·6) % v. 3 months: 12·4 (sd 6·7) %; P = 0·01) and unsweetened milk (BL: 2·5 (sd 2·2) % v. 3 months: 4·7 (sd 3·0) %; P = 0·01) servings, consumed as a percentage of the total food group servings. These improvements were not observed at 6 months. A greater number of INT children met the GFFG protein recommendation at 3 months (BL: 0/19 v. 3 months: 5/19; P = 0·01), with no change in CON. A single GFFG session improved short-term dietary variety and unsweetened milk intake. Ongoing work addressing the GF food environment, dietitian access and policies to improve DQ are needed.

Nutraceuticals are increasingly of interest in nutritional psychiatry, where creatine has been investigated in several randomised trials for its effects on depressive symptoms. However, these findings have not yet been systematically synthesised. We conducted a systematic review to assess the effects of creatine supplementation on symptoms of depression. Four databases were searched up to February 2025 for trials comparing creatine with placebo in individuals with or without depression. Study selection, data extraction and risk of bias assessment (RoB 2) were conducted independently, and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Random-effects meta-analyses with Hartung–Knapp–Sidik–Jonkman adjustment including eleven trials (1093 participants) found a standardised mean difference of −0·34 (95 % CI −0·68, −0·00; GRADE: very low quality of evidence), equivalent to 2·2 points on the seventeen-item Hamilton Depression Rating Scale, below the minimal important difference of 3·0 points. CI include non-clinically important effects, and heterogeneity was substantial (I2 = 71·3 %). While effects appeared larger in clinically depressed populations, subgroup analyses and trim-and-fill adjustments indicated substantial bias favouring creatine. Results for secondary endpoints were significant for remission (three trials, OR 3·60; 95 % CI 1·76, 7·56), but not for treatment response (two trials, OR 0·72; 95 % CI 0·28, 1·88). Our findings suggest that creatine may offer a small-to-moderate benefit for individuals with depression, but average effects were not clinically important and the true effect may be trivial or null. The evidence on which these results are based is very uncertain. Larger, more rigorous randomised trials are required to draw definitive conclusions.

Although metabolic syndrome (MetSyn) patients are frequently reported to experience alterations in ghrelin levels, appetite regulation and mood, these issues have been largely overlooked. Thus, the present randomised controlled trial (RCT) examined the effects of incorporating brown rice bran powder (BRBP) into a standard diet on ghrelin levels, appetite control, depression, insulin resistance and atherogenicity indices. This secondary analysis used data from our 8-week RCT involving forty-three MetSyn patients, with nineteen on a standard diet and twenty-four receiving an additional 15 g/d of BRBP. Serum ghrelin levels were measured using an ELISA kit, and seven atherosclerosis-related indicators were assessed before and after the intervention. Appetite rating and depression status were evaluated using a four-component visual analogue scale (VAS) and the Beck Depression Inventory (BDI) questionnaires. The ANCOVA model adjusted for baseline values (and BMI for ghrelin) indicated that patients receiving BRBP plus the standard diet experienced significant increases in ghrelin levels and feelings of satiety and fullness compared with those on the standard diet alone (P-value < 0·008; effect sizes (ES) of 0·95, 1·14, and 1·34, respectively). BRBP intake led to significant reductions in atherogenic coefficient, Castelli risk index-II, cholesterol index, metabolic score for insulin resistance, BDI scores, and hunger sensations (P-value ≤ 0·05; ES of −0·94, −0·96, −0·81, −1·74, −0·98 and −0·71, respectively) compared with the standard diet alone. Overall, this secondary analysis of the RCT supports the efficacy of BRBP administration in enhancing ghrelin levels while reducing appetite-related indices, depression scores, as well as markers of atherogenicity and insulin resistance. Nevertheless, given the study’s limitations, namely small sample size and lack of a placebo, further research is needed.

Dietary patterns are key modifiable determinants in cardiovascular disease (CVD) prevention, accounting for over half of CVD-related deaths and disabilities. This study aimed to examine whether changes in diet quality and six predefined diet scores were associated with incident cardiovascular (CV) events over four years among secondary care cardiology patients. We conducted a secondary prospective analysis of participants aged ≥45 years from the Brazilian Cardioprotective Nutritional Program Trial, including 1,704, 1,629 and 1,286 individuals for the 12-, 24- and 36-month change analyses, respectively. The assessed diet scores included the Dietary Inflammatory Index (DII), Dietary Total Antioxidant Capacity (dTAC), overall, healthful and unhealthful Plant-Based Diet Index (PDI, hPDI, uPDI), and the modified Alternative Healthy Eating Index (mAHEI). The primary outcome was the incidence of new CV events in each follow-up period, adjudicated by the Clinical Endpoints Committee. Associations were estimated using Cox proportional hazards models, combining intervention and control groups. A total of 162 incident CVD cases occurred over a median follow-up of 3.25 years. After 36 months, improvements in mAHEI scores were inversely associated with CV event incidence in both crude (HR: 0.96; 95% CI: 0.92–0.99) and adjusted models (HR: 0.94; 95% CI: 0.89–1.00). No significant associations were found for changes in DII, dTAC, PDI, hPDI or uPDI across any time point. These findings suggest that, in individuals receiving secondary CV care, sustained improvements in diet quality, particularly those reflected by the mAHEI, may require longer periods to translate into measurable benefits for cardiovascular health.