Bioelectrical impedance analysis (BIA)-derived water composition ratios are non-invasive and cost-effective indices that reflect body fluid distribution. This study aimed to investigate the associations between these BIA-derived ratios and overall survival (OS) in patients with gastric cancer. A retrospective multicentre study included 385 gastric cancer patients. Optimal cut-offs were determined via receiver operating characteristic curves. Kaplan–Meier survival analysis, Cox regression analysis and restricted cubic spline (RCS) evaluated associations with OS. The optimal cut-off values were 0.389 for extracellular water (ECW)/total body water (TBW), 0·611 for intracellular water (ICW]/TBW and 0·638 for ECW/ICW. Kaplan–Meier survival analysis revealed that elevated ECW/TBW (72·6% vs. 58·7%; P < 0·001) and ECW/ICW (59·1% vs. 72·4%; P < 0·001) were associated with poorer OS, while a higher ICW/TBW (73·4% vs. 57·3%; P < 0·001) indicated better prognosis. In RCS models, ECW/TBW (hazard ratio (HR) = 1·552, 1·202–2·005, P = 0·001) and ECW/ICW (HR = 1·735, 1·320–2·280, P < 0·001) independently predicted worse OS, whereas ICW/TBW inversely correlated with mortality (HR = 0·620, 0·486–0·790, P < 0·001). Multivariable Cox regression analysis further confirmed that higher ECW/TBW (HR =1·552, 95% CI 1·272–2·688, P < 0·001) and ECW/ICW (HR = 1·735, 1·320–2·280, P < 0·001) ratios independently predicted worse OS. Conversely, a higher ICW/TBW ratio was inversely correlated with mortality (HR = 0·567, 95% CI 0·390–0·824, P = 0·003). The ECW/ICW ratio demonstrated the highest C-index (0·596), outperforming other ratios in predicting survival. These associations were consistent across subgroups, including advanced-stage patients. BIA-derived water composition ratios, particularly ECW/ICW, are robust and independent predictors of survival in gastric cancer patients, reflecting underlying metabolic and inflammatory disturbances. These non-invasive and cost-effective markers could enhance prognostic accuracy and guide personalised treatment strategies.

This study investigated the relationships of total dietary grain fibre (TGF) and its two subtypes (whole-grain fibre (WGF) and refined grain fibre (RGF)) with essential hypertension (EHP) in a large-scale prospective cohort study. The participants were recruited by UK Biobank. Dietary grain fibre was assessed using the baseline touchscreen FFQ. New-onset EHP was defined by International Classification of Disease version 10. Cox proportional hazards model and restricted cubic spline analysis were utilised to examine the associations of TGF and its subtypes with EHP. Additionally, mediation analysis was applied to assess whether the triglyceride-glucose (TyG) index and inflammatory index score (INFLA-score) mediated these associations. Among 60 315 participants without prior hypertension, 3651 (6·05 %) developed EHP over a median follow-up of 10·3 years, with an incidence density of 6·08 per 1000 person-years. The adjusted hazard ratios for Q4 compared with Q1 were 0·828 (95 % CI: 0·750, 0·914) for TGF and 0·842 (95 % CI: 0·767, 0·936) for WGF. Restricted cubic spline analysis confirmed inverse relationships for TGF and WGF with EHP risk. But RGF showed no significant association with EHP. The TyG index and INFLA-score partially mediated the associations of TGF and WGF with EHP, with mediation proportions of 4·2 % and 3·3 % for TGF, and 4·9 % and 5·2 % for WGF, respectively. Jointly, TyG index and INFLA-score together mediated 5·6 % between TGF and EHP, and 7·4 % between WGF and EHP. In conclusion, higher intake of TGF and WGF reduces EHP risk, and this effect is only partly mediated by TyG index and INFLA-score.

Epidemiological and clinical research has confirmed a link between obesity and depressive symptoms, with inflammation as a potential common mechanism. Given that dietary components modulate inflammation and relate to both conditions, investigating dietary inflammation as a potential underlying pathway is necessary. Herein, we aimed to explore the potential role of the Energy-adjusted Dietary Inflammatory Index (E-DII) in explaining the relationship between obesity and depressive symptoms. We conducted a cross-sectional analysis of the 2007–2018 National Health and Nutrition Examination Survey cohort, enrolling 20 324 participants. Obesity and dietary inflammation were assessed by BMI and E-DII, respectively. Depressive symptoms were evaluated using the nine-item Patient Health Questionnaire-9. We found that obesity and inflammatory diets were positively associated with depressive symptoms (β = 0·50, 95 % CI 0·30, 0·69; β = 0·35, 95 % CI 0·19, 0·50; both P < 0·001), and variations in the association among obesity, pro-inflammatory diets and depressive symptoms were evident across various population subgroups (e.g. sex, age, chronic diseases and smoking status subgroups, Pfor interaction < 0·050). After adjusting for all covariates, E-DII accounted for 4 % of the obesity–depression association. Despite this modest proportion, the finding identifies dietary-induced inflammation as a statistically significant, modifiable pathway. In conclusion, obesity and pro-inflammatory diets are linked to an increased risk of depressive symptoms, with E-DII serving as a modest but significant modifiable pathway. These findings highlight dietary intervention as a potential strategy for mitigating depressive symptoms in individuals with obesity.

Given there is no prospective research evidence on the association between ultra-processed food intake (UPF) and human bone health, this study aimed to analyze the associations of UPF intake with bone mineral density (BMD) and risk of fractures using data from 163855 participants in the UK Biobank. Multiple linear regression assessed BMD, and Cox regression models estimated fracture risk. Restricted cubic splines were used to evaluate non-linearity. Participants’ average age was 56.0 years, with 1097 hip fractures and 7889 all fractures recorded over 12.0 years of follow-up. Complex inverted U-shaped associations between UPF intake and BMD were found at the femur trochanter. Compared with the lowest UPF intake, the highest UPF intake was linked to a reduction in BMD at the femoral neck (β [SE] = –0.0061 [0.0024], P < .05), femur trochanter (β [SE] = –0.0083 [0.0024], P < .001), lumbar spine (β [SE] = –0.0114 [0.0036], P < .01), and total body (β [SE] = –0.0095 [0.0021], P < .001). The link was more pronounced in participants under 65 and those who were underweight (Pinteraction < .01). Per standard deviation increment of UPF intake was linked to 10.5% and 2.7% higher risks of incident hip fractures (HR, 95% CI: 1.105, 1.029-1.186; P < .01) and all fractures (HR, 95% CI: 1.027, 1.000-1.055; P < .05), respectively. Our results suggest that higher UPF intake is associated with lower BMD and increased risk of fractures captured in hospital inpatient records, highlighting the need for dietary interventions to protect bone health.

The endocannabinoid (EC) system in the central and peripheral nerves plays a crucial role in various physiological processes, including feeding behaviour and energy metabolism. In particular, gut ECs stimulate appetite, and excessive activation of the system can induce hedonic eating, leading to obesity. Previous studies have indicated elevation of gut EC levels in high-fat diet-induced or genetically obese rodents. The present study aimed to expand our understanding of gut ECs involved in feeding behaviour during obesity by characterising the profiles of arachidonic metabolites, including ECs, in the gut and by examining their impact on feeding behaviour in KK-Ay mice, an obesity model established by crossing diabetic KK mice with lethal yellow (Ay) mice. KK-Ay mice exhibit hyperphagia compared with lean mice under either free-feeding condition or refeeding condition after 24 h of food deprivation. Meal pattern analyses revealed that hyperphagia in KK-Ay mice was primarily due to higher meal frequency rather than meal size or interval, suggesting a defect in hunger control. In addition, levels of EC and other arachidonic acid metabolites such as prostaglandin E2 and F2α were elevated in KK-Ay mice. Pharmacological blockade of the peripheral cannabinoid receptor 1 (CB1) and diacylglycerol lipase, but not N-acyl phosphatidylethanolamine phospholipase D, reduced food intake, as did treatment with cyclo-oxygenase-2 inhibitors. These findings suggest that intestinal 2-arachidonoyl glycerol-dependent CB1 activation contributes to hyperphagic behaviour in KK-Ay mice and PGs are involved in feeding control.

High intake of processed foods, especially those with high sodium content, is a contributor to hypertension and cardiovascular disease. This study aimed to compare the sodium content of packaged foods and beverages in Nigeria to WHO Global Sodium Benchmarks and similar products in Kenya and South Africa. The study examined packaged foods from major retail stores in the capital cities of the Federal Capital Territory, Kano, and Ogun states in Nigeria from November 2020 to March 2021. Benchmark values were based on the 2021 WHO Global Sodium Benchmarks. We used secondary data from packaged food surveys conducted in South Africa (2015, 2016 and Kenya 2019). Approximately 40.0% (n = 36) of subcategories of packaged foods were captured in the WHO global sodium benchmark. Of these, 64.0% (n = 23) exceeded the benchmarks, including ‘processed meat’ (912.0 vs. 250.0 mg/100 g), cheese (776.0 vs. 190 mg/100 g), and ‘wholegrain chips’ (930.0 vs. 470 mg/100 g). Exactly 36.0% (n = 13) had lower sodium content, such as ‘rice-based snacks’ (113.0 vs. 520 mg/100 g) and ‘dried seafood’ (400 vs. 800 mg/100 g). In seven out of eleven main food categories (64%), Nigeria had a higher sodium content compared to Kenya. Similarly, Nigeria exhibited higher sodium content than South Africa in six out of eleven food categories (55.0%). With 64.0% of Nigerian subcategories exceeding WHO benchmarks and higher sodium levels than South Africa and Kenya in most categories. These findings highlight the urgent need for targeted sodium reduction and product reformulation to align Nigeria’s packaged foods with international benchmarks.

Public health research faces challenges in recruiting socio-economically disadvantaged groups. This study evaluated whether machine learning (ML) algorithms developed using data from a general population could predict indices of diet quality among a socio-economically disadvantaged group. Data from 5367 adults (77·5 % females) in the NutriQuébec project and on 122 variables potentially associated with dietary intakes were used. Dietary intakes were measured using a web-based 24-h recall. Participants were categorised by fifths of a deprivation score based on income, education and material and social deprivation. Participants in the first four fifths formed the general NutriQuébec sample (n 4180) and those above the fifth quintile formed the high deprivation sample (n 1187). Three indices of diet quality defined as ‘high’ or ‘low’ were used: vegetable and fruit consumption (VFC, ≥ 5·0 reference amounts (RA)/d), ‘other foods’ consumption, meaning, foods not recommended in Canada’s Food Guide 2019 (OFC, > 5·0 RA/d) and overall diet quality measured using the Healthy Eating Food Index-2019 (HEFI-2019, > 48·9 points). The algorithms developed and tested in the general NutriQuébec sample predicted high VFC, OFC and HEFI-2019 with accuracies of 0·60 (95 % CI 0·58, 0·62), 0·58 (95 % CI 0·56, 0·60) and 0·61 (95 % CI 0·59, 0·63), respectively. In the high deprivation sample, the algorithms predicted the diet quality indices with comparable accuracies (VFC, 0·69, 95 % CI 0·67, 0·71; OFC, 0·56, 95 % CI 0·54, 0·58; HEFI-2019, 0·66, 95 % CI 0·65, 0·67). ML algorithms trained to predict three diet quality indices in the general NutriQuébec sample were applicable to a high deprivation group.

Tryptophan is an essential amino acid required for protein synthesis, immune regulation and the production of serotonin, melatonin and kynurenine. Its metabolism proceeds through three major pathways – the kynurenine, serotonin and gut microbiota–derived indole pathways – which are influenced by diet, microbiota and inflammation. The Mediterranean diet generally improves tryptophan bioavailability, enhances serotonin synthesis and limits excessive kynurenine activation through anti-inflammatory and microbiota-mediated mechanisms. In contrast, Western diets promote systemic inflammation, increase kynurenine production and reduce serotonin and beneficial indole metabolites. High-protein and ketogenic diets elevate substrate availability but may increase microbial production of indoles such as skatole and alter the balance of tryptophan utilisation, while calorie-restricted diets appear to downregulate pro-inflammatory tryptophan degradation and improve serotonin-related satiety regulation. Collectively, these findings demonstrate that diet is a key regulator of tryptophan metabolism, with implications for mood, sleep, inflammation, cancer progression and cardiometabolic health. Despite these advances, several knowledge gaps remain, including limited standardisation of dietary assessment methods, insufficient databases on the tryptophan content of foods and a lack of controlled comparative trials. Addressing these limitations may enable the development of nutritional strategies that optimise tryptophan metabolism and improve health outcomes.

Concerns about the environmental impact of animal-source foods have led to a shift towards plant-based alternatives (PBA). While dairy products and seafood are rich in iodine, an essential nutrient for thyroid function and cognitive development, PBA often lack iodine fortification. As the market expands, there is increasing concern that individuals replacing dairy products and seafood with unfortified PBA may be at risk of iodine deficiency. This study assessed changes in the iodine fortification of plant-based milk, yogurt, cheese and seafood alternatives through a cross-sectional survey of UK supermarkets (2020–2024). Supermarkets were surveyed online each December, and product nutrition and ingredient data were extracted. Between 2020 and 2024, the number of PBA increased by 55 %, with 466 PBA identified in 2024, including milk (n 246), yogurt (n 81), cheese (n 110) and seafood alternatives (n 29). Iodine fortification was inconsistent: in 2024, 48 % of non-organic milk alternatives were fortified, while only 5 % of non-organic yogurt and 4 % of cheese alternatives contained iodine. In comparison, 28 %, 6 % and 0 % of non-organic milk, yogurt and cheese alternatives were fortified with iodine in 2020. No fortified seafood alternatives were identified. Fortified PBA provided 75–83 % of the iodine content of cow’s milk, but most remained poor iodine sources. Although iodine fortification has increased, it lags behind that of calcium and vitamin B12 (48 % v. 88 % and 71 %, respectively). Given iodine’s critical role in health, clearer public health guidance and improved fortification policies are needed. Increased reliance on PBA may exacerbate iodine insufficiency in the UK without intervention.

Circadian syndrome (CircS) appears to be a better predictor for CVD than metabolic syndrome, and n-3 fatty acids are generally suggested to alleviate negative health outcomes. This study aims to investigate the association between n-3 intake and CircS and examine the effect modification by sociodemographic and lifestyle factors. In this cross-sectional study, data from the National Health and Nutrition Examination Survey 2005–2018 were analysed (n 12 028). Survey-weighted multivariable logistic regression was applied to analyse the associations of n-3 intake with CircS and its components. Subgroup analyses examining the effect modification by sociodemographic and lifestyle factors were followed by a restricted cubic spline investigating the non-linear associations between n-3 intake and CircS by race. The weighted prevalence of metabolic syndrome and CircS was 45·8 and 37·3 %, respectively. Overall, no significant associations were found between the intake of total n-3, EPA or DHA and CircS. However, n-3 intake was associated with a lower risk of depression – a component of CircS. Comparing extreme quartiles of n-3 intake (highest v. lowest), the OR (95 % CI) for depressive symptoms was 0·77 (0·64, 0·90). Among the Black, those in the highest quartile of n-3 intake were more likely to have CircS, with the OR (95 % CI) of 1·36 (1·02, 1·82). No association between n-3 intake and CircS in the total study population was observed. However, n-3 intake was inversely associated with depressive symptoms in American adults. Interactions between race and n-3 intake in relation to CircS were also identified.

Current approaches to measurement of diet quality lack precision, do not translate well beyond academia and may have unintended consequences. A novel metric ‘unrefined plantfoods’ (UP) is proposed. The UP metric is grounded in established science, precise, easy to measure, consistent with wider nutrition agendas and policies, reduces potential commercial and ideological exploitation of public health nutrition goals, is unbiased, translatable and inclusive. The concept is value-aware and grounded in a harm minimisation approach.

Maternal nutrition is critical for foetal brain development, and dietary polyphenolic compounds play an important role in mitigating oxidative stress, inflammation, and neurotoxic damage. This narrative review explored the potential promotion of brain development by polyphenols such as resveratrol, curcumin, quercetin, naringin, ferulic acid, genistein, and fisetin through their antioxidant, anti-inflammatory, and neurotrophic effects. The key molecular mechanisms are central to the advantageous actions of these polyphenols in the neurogenesis process. These compounds protect against neurodevelopmental challenges induced by maternal high-fat diet, immune activation, environmental toxins, and psychological stressors. However, their efficacy may depend on dosage, timing of administration, and maternal-foetal metabolic interactions, emphasising the need for personalised maternal nutrition strategies. Further research is needed to investigate the long-term effects and interactions of these compounds with other nutrients toward personalised maternal nutrition strategies. This narrative review presents the potential of polyphenols to support foetal brain health with an emphasis on their possible incorporation into maternal dietary interventions.

This study aims to address a critical gap in literature by examining the mediating role of coping strategies in the relationship between mental health issues and food addiction among university students, contributing to the understanding of how stress management mechanisms affect addictive eating behaviours during this vulnerable period. A cross-sectional, quantitative study was conducted with 1947 students enrolled at a university in Istanbul during the 2024–2025 academic year. Data were collected online, using a Personal Information Form, the Depression-Anxiety-Stress-21 Scale (DASS-21), the Coping Orientation to Problems Experienced Inventory (Brief COPE) and the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). Data were analysed using Pearson’s correlation analysis, multiple regression analysis and PROCESS Macro Model 4. Moderate, positive and statistically significant correlations were observed between depression, anxiety and stress levels and food addiction (r = 0·398–0·417; P < 0·001). Multiple regression analysis demonstrated that mental health issues explained 20·8 % of the variance in food addiction scores. Mediation analyses indicated that adaptive coping strategies (e.g. humour, acceptance and using instrumental social support) and maladaptive coping strategies (e.g. restraint coping, behavioural disengagement and suppression of competing activities) significantly mediated the relationship between mental health issues and food addiction. Mental health issues represent a substantial risk factor for food addiction among university students in metropolitan areas, influenced by their coping strategies. Promoting adaptive coping strategies and reducing maladaptive ones are essential for preventing food addiction. These findings underscore the need to integrate psychological support and stress management into intervention programmes targeting university students.