Artificial sweeteners are used to reduce energy intake, but studies suggest that consumption during pregnancy may impact the offspring’s risk of overweight. In this longitudinal cohort study, we aimed to examine the association between consumption of artificially sweetened or sugar-sweetened beverages during pregnancy and offspring overweight from birth to 18 years in the Danish National Birth Cohort (DNBC). 101,042 pregnancies were enrolled in the DNBC from 1996-2002. Follow-up was conducted throughout pregnancy, childhood, and adolescence. 72,821 women completed a Food Frequency Questionnaire during pregnancy reporting intake of beverages sweetened with artificial sweeteners or sugar. Offspring height and weight were obtained during childhood and adolescence. Multivariate logistic regression was performed to estimate the odds ratio (OR) for overweight concerning maternal beverage consumption. Analyses were adjusted for risk factors for childhood overweight, including maternal age, pre-pregnancy body mass index (BMI), physical activity and smoking in pregnancy, healthy eating index, paternal BMI, socioeconomic status, and duration of breastfeeding. We found increased odds of overweight in 7, 11, 14, and 18-year-old offspring, whose mothers reported drinking ≥1 artificially sweetened beverages daily during pregnancy compared to no consumption (18 years: adjusted OR 1.26 (95% confidence interval 1.12, 1.42)). We found decreased adjusted odds of overweight in 11 and 18-year-old offspring, whose mothers reported drinking ≥1 sugar-sweetened beverages daily during pregnancy compared to no consumption. We found that consumption of artificially sweetened beverages during pregnancy was associated with an increased risk of overweight in childhood and adolescence. Adjustment for risk factors for overweight and total energy intake did not explain the association. Further studies are warranted to establish the mechanism of the association.

N-3 polyunsaturated fatty acids (n-3 PUFAs) delivered by fish oil supplements alter the number and functions of circulating extracellular vesicles (EVs), but consumption of oily fish does not reproduce this effect. In order to assess the effects of fish oil supplements and oily fish, at a level achievable in the diet, on EV numbers, composition and procoagulant activity in healthy human volunteers, forty-two healthy subjects were assigned to one of three treatment groups: (i) fish oil supplements plus white fish meals, (ii) control supplements plus oily fish meals or (iii) control supplements plus white fish meals for 12 weeks in a randomized, double-blind, placebo-controlled, parallel trial; circulating EVs were enumerated and their procoagulant activity assessed using thrombin generation and fibrinolysis assays. Our results showed that fish oil supplements decreased circulating EV numbers and reduced EV-stimulated thrombin generation, but the consumption of oily fish at half the dose of EPA had no effect on either EV number or thrombogenic capacity. Consumption of both oily fish and fish oil supplements increased the EPA and DHA contents of EVs and the proportion of EPA in circulating EVs was strongly associated with EV-stimulated thrombin generation. This study revealed that the additional 1 g/d EPA delivered in the fish oil supplements is required to decrease the numbers and thrombogenic capacity of EVs, since oily fish at a level achievable in the diet had no effect. Increasing EPA intake beyond current guidelines for oily fish consumption may therefore be required for cardiovascular benefits relating to EVs.

Whole-body and regional raw bioelectrical impedance analysis (BIA) parameters have been used to develop lean soft tissue estimation prediction models. Still, no regional fat mass (FM) assessment models have been provided. Hence, we aimed to develop and validate BIA-derived equations to predict regional FM against dual-energy X-ray absorptiometry (DXA) in healthy adults. One hundred and forty-eight adults (77 females) were included in this cross-sectional investigation. DXA assessed whole-body and regional FM, and raw bioelectrical parameters of distinct body regions were measured using a 50 kHz phase-sensitive BIA analyzer. BIA-derived equations were developed for each sex using a stepwise multiple linear regression approach in 2/3 of the sample and cross-validated in the remaining sample. The BIA-derived equations exhibited moderate to very strong relationships (p < 0.001) with DXA-measured FM of all body regions in females (r=0.650 to 0.907) and males (r=0.401 to 0.807). Also, for all the models, no significant deviation from linearity was found (p>0.10). Agreement analyses revealed no associations between the differences and the means of the predicted and DXA-derived FM. However, the limits of agreement were large, with individual errors exceeding 50% in females and 70% in males. While the new BIA-derived equations provide a valid estimate of regional FM in middle-aged healthy adults at the population level, demonstrating a cost-effective alternative to DXA for assessing regional FM, caution is advised when applying these equations for individual-level analysis.

There has been concern regarding the consumption of fruit juices because of the high levels of naturally occurring sugars they contain, which could rapidly elevate glycaemic response and increase the risk of cardiometabolic diseases. We conducted two trials in which each volunteer ingested (1) white bread with 200 mL of two types of orange juice prepared from ‘Moro’ and ‘Pera’ varieties (MOJ and POJ) – the former containing anthocyanins – and the same juices alone; and (2) 200 mL of POJ or MOJ followed by a sandwich made with white bread, plus light cheese or butter, and also the same juices alone. Capillary blood was collected over 120 minutes, and glucose and insulin levels were analysed. In the crossover clinical design with healthy volunteers, we observed that both orange juices do not increase blood glucose and insulin, even when co-consumed with other typical breakfast foods in Brazil. In conclusion, orange juice does not elevate postprandial glycaemic responses to the meal while providing additional sugars and nutrients.

Studies on longitudinal associations between diet quality and lipid and amino acid metabolism in children and adolescents are limited. We studied associations between diet quality and serum markers of lipid and amino acid metabolism in the Physical Activity and Nutrition in Children (PANIC) study. These analyses included 403 children aged 6–9 years at baseline, 360 re-examined two years later at age 9–11 years, and 219 eight years later at age 15–17 years. Food intake was recorded over four days, and diet quality assessed using the Finnish Children Healthy Eating Index (FCHEI). Fasting serum fatty acids, amino acids, apolipoproteins, and lipoprotein particle sizes were analyzed via nuclear magnetic resonance spectroscopy. Linear mixed-effects models, adjusted for sex, age, body fat percentage, pubertal stage, and physical activity, were used to analyze the associations. Better diet quality was linked to increased serum polyunsaturated fatty acids and reduced saturated and monounsaturated fatty acids, alanine and very low-density lipoprotein (VLDL) particle size. Consuming more vegetables, fruits, berries, vegetable oils and margarine with at least 60% fat, fish, and whole grains associated with higher serum polyunsaturated fatty acids and lower saturated fatty acids and smaller VLDL particles. Conversely, consuming higher-fat dairy products and sugary products associated with higher saturated and monounsaturated fatty acids, branched-chain and aromatic amino acids, and larger VLDL particles. A diet rich in fruits, vegetables, unsaturated fats, and fiber, with reduced processed meat and sugar consumption, promotes favorable metabolic changes relevant to cardiometabolic health.

Low vitamin D associated with high parathyroid hormone (PTH) is commonly reported in the context of HIV infection. We determined the association between total 25-hydroxyvitamin-D [25(OH)D] and PTH in adolescents living with HIV, in Zambia and Zimbabwe. Adolescents (11-19 years) perinatally-infected with HIV and established on antiretroviral therapy (ART) for ≥6 months were recruited into a cross-sectional study. Socio-demographic and clinical characteristics were recorded, anthropometry measured, and fasted serum concentrations of 1,25-dihydroxyvitamin-D (1,25(OH)2D), total 25(OH)D and intact PTH measured. The association between total 25(OH)D and PTH was examined using natural cubic spline regression modelling. 842 participants (female: 53.2%) with median age 15.5 (IQR:13.2-17.9) years were enrolled. Median ART duration was 9.8 [IQR:6.3-12.3] years and 165/841 (19.6%) had an HIV viral load >60copies/ml. Stunting (HAZ score<-2) and underweight (WAZ score<-2) were observed in 29.9% and 30.0% respectively. Three quarters (n=639) reported daily calcium intakes <150mg/day. The mean (SD) concentrations of total 25(OH)D and 1,25(OH)2D were 66.1(16.5) nmol/L and 210.6(70.4) pmol/L respectively, and median PTH level was 4.3 (IQR:3.3-5.5) pmol/L. There was an inverse non-linear relationship between total 25(OH)D and PTH, 25(OH)D levelling-off at 74.6nmol/L (95%CI: 74.5-75.2). Results were consistent in those taking tenofovir disoproxil fumarate (81.7%) and in those who were virally unsuppressed. In this population with extremely low habitual calcium intakes, the lack of association between 25(OH)D and PTH when 25(OH)D exceeded 75nmol/L, potentially suggests levels of 25(OH)D >75nmol/l may need to be achieved to improve bone health; investigation is needed in future research studies.

To assess the relationship between total body fat percentage(TBFP), trunk fat percentage(TFP), and urinary flow rate(UFR).We stratified by age and sex and hypothesize that TBFP and TFP are negatively associated with UFR across all groups.The study utilized data from the National Health and Nutrition Examination Survey (NHANES), which includes a series of nationally representative cross-sectional surveys. The data analyzed in this study included 18-59-year-old females and males who participated in the NHANES surveys conducted between 2011 and 2018. Multivariable-adjusted logistic regression models were used to examine the association between body fat percentages measured by dual-energy X-ray absorptiometry (DXA) scans and UFR.A total of 10,521 participants were included and an increase in total body fat percentage(TBFP) was inversely associated with in UFR (β= -0.013,95% confidence interval[CI]-0.018 to -0.007), Similarly,an increase in trunk fat percentage(TFP)was inversely associated with UFR(β=-0.014,95%CI-0.018 to -0.009).Stratified analyses by gender revealed that among males, an increase in TBFP and TFP was inversely associated with in UFR (β=-0.011, 95% CI -0.019 to -0.004; β=-0.016, 95% CI -0.022 to -0.009), although this association was not observed in the 18-35 age group. Among females, an increase in TBFP and TFP was inversely associated with UFR (β= -0.016, 95% CI -0.023 to -0.008; β= -0.012, 95% CI -0.019 to -0.006), and this association was observed across all age groups.Our study shows that in the population aged 18 to 59, both total body fat and truncal fat accumulation are inversely associated with urinary flow rate. However, the association in males under 35 is not significant. Future research should delve into the mechanisms behind these gender and age differences to provide a more precise basis for developing targeted prevention and intervention measures.

There is a growing focus on understanding the complexity of dietary patterns and how they relate to health and other factors. Approaches that have not traditionally been applied to characterize dietary patterns, such as latent class analysis and machine learning algorithms, may offer opportunities to characterize dietary patterns in greater depth than previously considered. However, there has not been a formal examination of how this wide range of approaches has been applied to characterize dietary patterns. This scoping review synthesized literature from 2005-2022 applying methods not traditionally used to characterize dietary patterns, referred to as novel methods. MEDLINE, CINAHL, and Scopus were searched using keywords including latent class analysis, machine learning, and least absolute shrinkage and selection operator. Of 5274 records identified, 24 met the inclusion criteria. Twelve of 24 articles were published since 2020. Studies were conducted across 17 countries. Nine studies used approaches with applications in machine learning, such as classification models, neural networks, and probabilistic graphical models, to identify dietary patterns. The remaining studies applied methods such as latent class analysis, mutual information, and treelet transform. Fourteen studies assessed associations between dietary patterns characterized using novel methods and health outcomes, including cancer, cardiovascular disease, and asthma. There was wide variation in the methods applied to characterize dietary patterns and in how these methods were described. The extension of reporting guidelines and quality appraisal tools relevant to nutrition research to consider specific features of novel methods may facilitate consistent reporting and enable synthesis to inform policies and programs.

This study aimed to assess the concordance between different anthropometric indexes in the Global Leaders Initiated Malnutrition Standards (GLIM) and the Geriatric Risk Index (GNRI) for evaluating muscle mass, while also exploring performance-based criteria for GLIM muscle content suitable for elderly patients with intermediate and advanced tumors. A total of 312 patients admitted to Shanghai Tenth People’s Hospital between September 2022 and June 2023 were retrospectively included. Nutritional assessments were conducted using the GLIM framework, employing grip strength, upper arm circumference, and calf circumference as criteria for muscle content evaluation. The diagnostic value of these tools was compared against the GNRI as a reference standard. Among the participants, 127 (40.71%) were diagnosed as malnourished by GNRI, while the GLIM assessments yielded 138 (44.23%), 128 (41.03%), and 162 (51.92%) malnutrition diagnoses based on grip strength, calf circumference, and upper arm circumference, respectively. Both GNRI and GLIM-grip strength were significantly associated with complications and length of hospital stays. Notably, using GNRI as a reference, GLIM-grip strength demonstrated good consistency in diagnosing malnutrition (K value = 0.692, P < 0.001), with calf circumference having the highest diagnostic value. In conclusion, grip strength is a practical and effective performance-based criterion within the GLIM standards and has the potential to enhance malnutrition diagnosis in elderly patients with advanced malignancies, highlighting its relevance in nutritional science.

The therapeutic effects of soy consumption on adipokine concentrations have yielded inconsistent results in previous meta-analyses. This umbrella meta-analysis aims to investigate the impact of soy and its isoflavones on serum adiponectin and leptin levels in adults. We searched the Cochrane Central, Web of Science, PubMed, and Scopus databases until October 10, 2024. The articles were restricted to those written in English. We included meta-analysis studies that evaluated the effects of soy and its isoflavones on levels of adiponectin and leptin and reported effect sizes (ES) and corresponding confidence intervals (CI). Two independent reviewers screened all articles based on eligibility criteria and extracted the required data from the included meta-analyses. The meta-analysis was performed using a random-effects model in STATA software. Six meta-analyses of randomized controlled trials meeting the inclusion criteria were included in the current umbrella meta-analysis. The findings indicated that soy and its isoflavones did not have a significant effect on adiponectin (ES= 0.10; 95% CI: -0.22, 0.41; P=0.55; I2= 51.8%) and leptin (ES= -0.37; 95% CI: -1.35, 0.61; P=0.46; I2= 71.2%) concentrations. Subgroup analysis based on participants’ mean age, total sample size, and duration was conducted. Results showed that the effect is not statistically significant in any of the subgroups. In conclusion, soy and its isoflavones could not improve the adipokines mentioned above. However, further high-quality research in different countries is required to substantiate these findings.

The primary causes of female mortality often involve diseases related to oxidative stress. Dietary total antioxidant capacity (TAC) evaluates its antioxidant content and potential health effects. This study, registered with PROSPERO (ID: CRD42024427784), explores the association between dietary TAC and women’s health outcomes, including endocrine conditions with gynecological implications, obstetric outcomes, gynecological conditions, and oncological diseases related to the female reproductive system. We conducted a systematic search in MEDLINE (via PubMed), EMBASE, LILACS, and CINAHL for observational studies published up to February 2024 that explored the relationship between dietary TAC and these health conditions. Data were analyzed using RevMan 5.4 software. Nineteen studies met the eligibility criteria (sample sizes: 64 to 3,209 women) and examined various conditions, including neoplasms (breast, endometrial, and ovarian), bacterial vaginosis, menopause, polycystic ovary syndrome (PCOS), pre-eclampsia (PE), gestational diabetes mellitus (GDM), miscarriage, infertility, and inflammation and oxidative stress markers. The meta-analysis identified a significant association between dietary total antioxidant capacity (TAC), measured in vitamin C equivalents, and breast cancer, revealing that women with the disease had a lower dietary TAC due to reduced antioxidant intake. Mixed results were found for endometrial cancer, while higher TAC levels were associated with a lower risk of PCOS and infertility. Among postmenopausal women, higher TAC correlated with fewer symptoms such as sleep issues and anxiety. In gestational conditions, higher dietary TAC was linked to a lower risk of miscarriage, GDM, and PE. Twelve of the nineteen studies demonstrated significant associations between dietary TAC and the outcomes of interest.

Measurement error undermines the accuracy of dietary intake data. The 24-hour dietary recall (24HR) is the standard data collection method in nutrition surveillance. Several neurocognitive processes underpin the act of recall, and individuals differ in their performance of these processes. This study aimed to investigate whether variation in neurocognitive processes, measured using four cognitive tasks, was associated with variation in measurement error of 24HRs. Participants (n 139) completed the Trail Making Test, the Wisconsin Card Sorting Test, the Visual Digit Span, and the Vividness of Visual Imagery questionnaire. During a controlled feeding study, participants completed three technology-assisted 24HR; the Automated Self-Administered Dietary Assessment Tool (ASA24), Intake24, and an Interviewer-Administered Image-Assisted 24HR (IA-24HR) one week apart. Percentage error between reported and true energy intakes was calculated. Using linear regression, the association between cognitive task scores and absolute percentage error in estimated energy intake was assessed. Longer time spent completing the Trail Making Test, an indicator of visual attention and executive functioning, was associated with greater error in energy intake estimation using ASA24 (B 0.13, 95% CI 0.04, 0.21) and Intake24 (B 0.10, 95% CI 0.02, 0.19). Regression models explained 13.6% (ASA24) and 15.8% (Intake24) of the variance in energy estimation error. No cognitive task scores were associated with error using IA-24HR. This study demonstrates that variation between individuals in neurocognitive processes explains some of the variation in 24HR error. Further investigation into the role of neurocognitive processes in 24HR and their role in the reliability of dietary intake data is warranted.

High intake of dietary advanced glycation end products (AGEs), could induce oxidative stress, inflammation, and the gut microbiota dysbiosis, processes that play a major role in the development of functional gastrointestinal disorders (FGIDs). There is limited data on the association between AGEs intake and FGIDs. Therefore, the current study aimed to examine the association of AGEs with FGIDs in Iranian adults. In a cross-sectional analysis under the framework of the Isfahan functional disorders (ISFUN) study, data on 1892 Iranian apparently healthy adults, aged 18 to 65 years were examined. Participants’ dietary intakes were collected using a validated dish-based, 106- item food frequency questionnaire. Dietary AGEs content of 72 food items were measured for all participants. FGIDs was assessed using ROME IV criteria. In total, 38% of subjects had one of the most prevalent upper or lower FGIDs. The mean of AGEs intake was 14690.10±8797.25 (kU/gr). In the fully adjusted model, being in the highest versus lowest tertile of AGEs intake was associated with increased odds of FGIDs (OR= 1.78; 95% CI: 1.01, 3.36). In stratified analysis by sex, males in the highest tertile of AGEs intake showed higher odds of FGIDs than those in the lowest tertile (OR= 2.15; 95% CI: 1.04, 4.45). However, in females, the AGEs intake was not significantly associated with the risk of FGIDs in the fully adjusted model. Higher AGEs intake was significantly associated with increased risk of FGIDs, particularly in men. Further prospective studies are warranted to confirm these findings.

Prior studies have shown that plant-based diets are associated with lower cardiovascular risk. However, these diets encompass a large diversity of foods with contrasted nutritional quality that may differentially impact health. We aimed to investigate the pooled cross-sectional association between metabolic syndrome (MetS), its components, and healthy and unhealthy plant-based diet indices (hPDI and uPDI), using data from two French cohorts and one representative study from the French population. This study included 16,358 participants from the NutriNet-Santé study, 1,769 participants from the Esteban study and 1,565 participants from the STANISLAS study who underwent a clinical visit. The MetS was defined according to the International Diabetes Federation definition. The associations between these plant-based diet indices and MetS were estimated by multivariable Poisson and logistic regression models, stratified by gender. Meta-analysis enabled the computation of a pooled Prevalence Ratio. A higher contribution of healthy plant foods (higher hPDI) was associated with a lower probability of having MetS (PRmen: 0.85; 95% CI: 0.75–0.94, PRwomen: 0.72; 95% CI: 0.67–0.77), elevated waist circumferences and elevated blood pressure. In women, a higher hPDI was associated with a lower probability of having elevated triglycerides, low HDL-cholesterolemia and hyperglycemia; and a higher contribution of unhealthy plant foods was associated with a higher prevalence of MetS (PRwomen: 1.13; 95% CI: 1.01–1.26) and elevated triglycerides. A greater contribution of healthy plant floods was associated with protective effects on metabolic syndrome, especially in women. Gender differences should be further investigated in relation to the current sustainable nutrition transition.

The rising incidence of neurodegenerative diseases in an ageing global population has shifted research focus toward modifiable risk factors, such as diet. Despite potential links between dietary patterns and brain health, inconsistencies in neuroimaging outcomes underscore a gap in understanding how diet impacts brain ageing. This study explores the relationship between three dietary patterns—Mediterranean (MeDi), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)—and cognitive outcomes as well as brain connectivity. The study aimed to assess the association of these diets with brain structure and cognitive function, involving a middle-aged healthy group and an older cohort with subjective cognitive decline (SCD). The study included cognitive assessments and diffusion-weighted MRI data to analyse white matter microstructural integrity. Participants comprised 55 older individuals with SCD (54.5% female, mean age = 64) and 52 healthy middle-aged individuals (48.1% female, mean age = 53). Age inversely correlated with certain cognitive functions and global brain metrics, across both cohorts. Adherence to the MeDi, DASH, and MIND diets showed no significant cognitive or global brain metric improvements after adjusting for covariates (age, education, BMI). Network-based statistics (NBS) analysis revealed differences in brain subnetworks based on DASH diet adherence levels in the SCD cohort. In the healthy cohort, lower white matter connectivity was associated with reduced adherence to MIND and DASH diets. Ultimately, the study found no strong evidence connecting dietary patterns to cognitive or brain connectivity outcomes. Future research should focus on longitudinal studies and refine dietary assessments.

Children and adolescents diagnosed with autism spectrum disorder (ASD) present feeding problems that may influence food acceptance and refusal. However, data regarding dietary intake variability in this population are either not available in the literature or not well-known. This cross-sectional study aimed to identify the within-person and between-person variability, and the number of days needed for a 24-hour recall (24HR) to estimate the usual intake of children and adolescents with ASD. Data were collected from 284 patients assisted at a public neuropediatric health service in the city of Pelotas, Southern Brazil. Food consumption was assessed using three non-consecutive 24HR. Within-person (S2w) and between-person (S²b) variances, the variance ratio (VR), and the distribution of energy, macronutrients, and micronutrients were obtained using the Multiple Source Method® (version 1.0.1). The number of days of 24HR needed was calculated for correlation coefficients of 0.7, 0.8, and 0.9. For most nutrients, S²w was greater than S²b, resulting in RV>1, except for age-group analyses where children up to 5 years old showed VR<1. Two to three days of 24HR were estimated for most nutrients, considering a correlation coefficient of 0.8. Differences were observed according to sex and age group, with adolescents requiring more days of 24HR. These findings indicate the need to assess dietary variability among individuals with ASD according to the characteristics of this investigated population.

The diet proposed by the EAT-Lancet Commission has faced criticism concerning its affordability. This study aimed to investigate the cost associated with a greater alignment to the EAT-Lancet reference diet in the province of Québec, Canada. The dietary habits of 1147 French-speaking adults were assessed using repeated Wed-based 24-hour recall data collected between 2015 and 2017 in the cross-sectional PRÉDicteurs Individuels, Sociaux et Environnementaux (PREDISE) study. Diet costs were calculated using a Nielsen food price database. Usual dietary intakes and diet costs were estimated using the National Cancer Institute’s multivariate Markov Chain Monte Carlo method. Adherence to the EAT-Lancet diet was assessed using the EAT-Lancet dietary index (EAT-I). Associations between diet costs and EAT-I scores were evaluated using linear regression models with restricted cubic splines. After adjustment for energy intake, a higher EAT-I score (75th vs. 25th percentiles) was associated with a 1.0 $CAD increase in daily diet costs (95%CI, 0.7 to 1.3). This increase in diet costs was mostly driven by the following component scores of the EAT-I (75th vs. 25th percentiles, higher scores reflecting greater adherence): Vegetables (1.6$CAD/day, 95%CI: 1.2, 2.1), Free sugars (1.6$CAD/day, 95%CI: 1.3, 1.9), Fish and plant-based proteins (1.4$CAD/day, 95%CI: 1.0, 1.8), Fruits (0.9$CAD/day, 95%CI: 0.4, 1.3), and Whole-grains (0.4$CAD/day, 95%CI: 0.0, 0.8). Inversely, greater scores for the Poultry and eggs component were associated with reduced diet costs (-1.2$CAD/day, 95%CI: -1.7, -0.7). This study suggests that adhering to the EAT-Lancet diet may be associated with an increase in diet costs in the province of Québec.

This review aimed to assess the impact of okra (Abelmoschus esculentus L.) consumption on cardiovascular disease risk factors. Relevant studies were identified through electronic searches of databases including PubMed, Scopus, Web of Science, CENTRAL, and EMBASE up to January 2025. Twelve trials involving 770 participants with interventions ranging from 2 to 12 weeks and doses varying from 125 to 40,000 mg/day, were included. Okra supplementation significantly reduced body mass index (BMI) (Standardized Mean Difference [SMD] = -0.70; 95% Confidence Interval [CI]: -1.23, -0.16; P = 0.011), fat mass (FM) (SMD = -0.74; 95% CI: -1.13, -0.36; P < 0.001), hip circumference (HC) (SMD = -0.85; 95% CI: -1.41, -0.28; P = 0.003), weight (SMD = -0.77; 95% CI: -1.42, -0.11; P = 0.022), fasting insulin (SMD = -0.35; 95% CI: -0.63, -0.07; P = 0.013), fasting plasma glucose (FPG) (SMD = -1.07; 95% CI: -1.75, -0.38; P = 0.002), hemoglobin A1c (HbA1c) (SMD = -0.38; 95% CI: -0.71, -0.05; P = 0.023), homeostatic model assessment of insulin resistance (HOMA-IR) (SMD = -0.56; 95% CI: -0.84, -0.29; P < 0.001), low-density lipoprotein cholesterol (LDL-C) (SMD = -0.32; 95% CI: -0.52, -0.11; P = 0.003), total cholesterol (TC) (SMD = -0.45; 95% CI: -0.74, -0.16; P = 0.003), and aspartate aminotransferase (AST) (SMD = -0.45; 95% CI: -0.73, -0.17; P = 0.002). Okra supplementation demonstrated significant benefits in improving anthropometric measures, glycemic control, lipid profiles, and liver function tests, suggesting its potential as an adjunct therapy for improving cardiovascular disease risk factors.