Epidemiological studies have reported an association between the planetary health diet (PHD), diet-related greenhouse gas emissions (GHGEs), and mortality. However, data from individuals from non-Western countries was limited. Therefore, we aimed to examine this association among Japanese individuals using a cross-sectional ecological study of all 47 prefectures in Japan. Prefecture-level data were obtained from government surveys. The dietary amount was estimated based on the weight of food purchased (211 items) from the 2021–2023 Family Income and Expenditure Survey. Adherence to PHD was scored using the EAT-Lancet index (range, 0 [worst] to 42 [best]) and categorised into four groups: ≤ 24 (n = 14, low), 25 (n = 17, medium-low), 26 (n = 10, medium-high), and 27 points (n = 6, high). Diet-related GHGEs were estimated using previously developed GHGE tables for each food item. Mortality data were obtained using the 2022 Vital Statistics. Mortality rate ratio (RR) was calculated using a multivariate Poisson regression model. After adjusting for confounders, compared to the prefecture in the medium-low group of adherence score, those in the low and high groups were associated with a higher mortality RR for all-cause (low group: RR = 1.03 [95% CI (confidence interval) = 1.01–1.05]; high group: RR = 1.03 [95% CI = 1.00–1.07]) and pneumonia. Moreover, although a higher adherence score was inversely associated with GHGE, it was linked to an increased mortality risk from heart disease and stroke. Our findings indicate a reverse J-shaped association between adherence to PHD and mortality.

Legume lectins represent a broad class of environmental toxicants that bind to cell surface glycoproteins. Raw red kidney beans (RRKB), a widely consumed common source of dietary protein, are rich in the lectin phytohemagglutinin (PHA). Consumption of improperly cooked (which may require overnight presoaking and boiling at least at 100°C for 45 min) red kidney beans causes severe gastrointestinal symptoms. Since the relationship between lectin toxicity and the cellular chaperone machinery remains unknown, the study aimed to determine the effects of heat-denatured PHA on epithelial barrier function and heat shock protein 70 (HSP70) expression and its function as a molecular chaperone in PHA-treated Caco-2 cells and animals. Twelve male Sprague-Dawley rats were randomised to an ad libitum diet of either standard rat chow or chow containing 26% crude red kidney beans. We measured HSP70 and heat shock factor 1 gene expressions in the small intestine and HSP70 protein expression in Caco-2 cells. In Caco-2 cells, luciferase activity was measured to investigate protein folding. Fluorescein-5-isothiocyanate (FITC)-labelled lectin was used to study its intracellular uptake by Caco-2 cells. PHA lectin reduced transepithelial electrical resistance in Caco-2 cells. FITC-labelled PHA entered Caco-2 cells within 3 h of treatment. PHA treatment significantly reduced HSP70 levels and luciferase activity in Caco-2 cells, which was prevented by HSP70 overexpression. In rats fed RRKB chow consisting of legume lectins, we found reduced levels of HSP70 and heat shock factor 1. These observations suggest that lectins counter the protective function of HSP70 on intestinal barrier function.

Interest in probiotics and prebiotics in sports nutrition is growing, but research on Jordanian athletes remains limited. While gut microbiota influences athletic performance, little is known about athletes’ understanding and use of probiotic- and prebiotic-rich foods in this region. This exploratory study investigates the knowledge, dietary habits, and correlations with gastrointestinal (GI) problems among Jordanian athletes to inform future research and interventions. The study provides insights into how awareness and consumption of gut-supportive foods can impact GI health, offering broader nutritional implications for global dietary strategies for athletes. A standardised questionnaire was administered to 324 athletes (ages 18–22) to assess knowledge, dietary practices, and GI symptoms. Descriptive statistics summarised the data, and chi-square tests examined associations among knowledge, diet, and GI symptoms (p < 0.05). Knowledge and diet were scored based on correct responses and reported intake of gut-supporting foods. Results showed that 55.9% of athletes were familiar with probiotics and 32.1% with prebiotics. The majority reported low consumption of probiotic- and prebiotic-rich foods, with 72.2% scoring low on diet intake. Although 60.5% seldom consumed fast food, overall intake of gut-supportive foods was limited. No statistically significant associations were found, but a weak positive trend between dietary habits and GI symptoms was observed, suggesting diet may have a modest influence on GI health. Living arrangements influenced both dietary choices and GI symptoms. This study highlights the need for targeted nutrition education to improve awareness and intake of probiotics and prebiotics, potentially supporting GI health and enhancing athletic performance.

Vegetable consumption in many countries is less than recommended and even lower in low-income households. This study explored the determinants of current vegetable food choice in households with limited food budgets to inform the implementation of a national vegetable promotion programme. Five focus groups and one individual interview were conducted with twenty-nine parents who self-identified as ‘shopping on a budget’ in an area of multiple deprivation in the southeast of England. Transcripts of audio recordings were coded in NVivo and analysed using inductive thematic analysis. Four main themes which shaped the range of vegetables brought into the home were identified: (1) attributes of vegetables, (2) attributes of parents including their vegetable norms, knowledge and skills (veg-literacy), and interest and opportunity to invest time and effort in vegetables, (3) family food dynamics, and (4) influence of retailers. Overarching this was parents’ capacity to absorb the risk of wasting food, money, time, and effort on vegetables and damaging trust in the parent–child food relationship. The data suggest there is a common set of ‘core vegetables’, which are routinely bought. When money is tight, parents only buy vegetables they know their children will eat and are generally not persuaded to buy ‘off-list’ in response to price discounts or promotions. Cost is not always the main barrier to increased vegetable purchase. To avoid unintentionally widening dietary inequalities, supply-side interventions to promote vegetable consumption need to be designed alongside targeted actions that enhance the capacity of low-income households to respond.

Ultra-processed foods (UPFs) have negative health consequences. Food insecurity and Supplemental Nutrition Assistance Program (SNAP) are associated with higher UPF intake in U.S. adults, but this has not been examined in U.S. adolescents. This study assesses associations between food security status and SNAP participation with UPF intake in 3,067 adolescents aged 12–19 years with household incomes at or below 300% of the federal poverty line from the 2007–2016 National Health and Nutrition Examination Survey. UPF is defined using the Nova classification and measured as a percentage of daily total energy intake (TEI). High food security, marginal food security, or food insecurity status was determined through the U.S. Department of Agriculture’s eighteen-item Household Food Security Survey. SNAP participation was deemed affirmative if the household reported receiving SNAP benefits in the last year. Multivariable linear regressions that controlled for TEI and sociodemographic covariates and accounted for the complex survey design examined associations between food insecurity and SNAP participation with UPF intake. In the sample, the prevalence of marginal food security was 15.9%, the prevalence of food insecurity was 33.8%, and the prevalence of SNAP participation was 36.5%. After multivariate adjustment, there were no significant differences in UPF intake by food security status. Adolescents participating in SNAP consumed 2.7% higher UPF intake (95% CI: 0.1%, 5.2%, p = 0.04) compared to adolescents not participating in SNAP. Among lower-income U.S. adolescents, SNAP participation but not food security status was associated with higher UPF intake. Programs and policies promoting the intake of more healthful, minimally processed foods should be strengthened.

The aim of the study is to assess the dietary knowledge and practices of Lebanese patients with diabetes not receiving dietary counselling in a low-income setting. A cross-sectional study was conducted among 317 Lebanese adult patients, not receiving dietary counselling in North Lebanon. Patients completed a questionnaire evaluating their sociodemographic, health and clinical characteristics as well as their dietary knowledge (DK) and practices. The mean total DK score as well as the mean scores for each category were calculated for the whole sample, transformed into percentages of maximal score and classified into poor (< 50%), good (50–75%) and adequate (> 75%). Patients had a good, but not optimal total DK (51.66%). Similarly, they also had a good knowledge related to carbohydrates (52.16%) and fat (52.5%), and to food type (60.83%). On the other hand, they had a poor knowledge about food choices (35.66%) and protein (44%). Linear regression analysis revealed that a higher educational level (β = 1.96, p < 0.001), choosing whole grains (β = 1.19, p = 0.002), living with a partner (β = 1.01, p = 0.007), being recently diagnosed with diabetes (β = –1.23, p = 0.012) were positively associated with a better DK. Furthermore, patients who suffered from type I diabetes had a better DK compared to those suffering from type 2 diabetes (β = –1.31, p = 0.016). The nutritional knowledge of the patients with diabetes not receiving dietary counselling is good but not optimal. Dietitians and doctors should collaborate to provide patient-centred and individualised dietary education to patients with diabetes.

Phase Angle (PhA) has emerged as an important parameter to monitor body composition, fluid status, muscle integrity, and physical performance among athletes. However, limited information exists regarding the associations between PhA and dietary intake, especially in athletes. This study aimed to identify the dietary intake components associated with PhA in athletes. This cross-sectional observational study was carried out with 153 athletes across 17 sports. Body composition was assessed by tetrapolar multifrequency BIA, and dietary intake by 24-hour dietary recalls administered on non-consecutive days. Reported foods and supplements were categorised into different groups (i.e. cereals, vegetables, fruits, beans and nuts, meat and eggs, dairy products, oils, and sugars), with portions established based on the food’s total energy content. Fat-free mass and fat-free mass index were higher in male compared to female athletes, potentially influencing PhA (6.6º vs 5.5º; P < 0.01). Multiple linear regression analysis indicated that protein intake was a significant predictor of PhA in athletes. This association remained significant even after adjustments for sex, age, and fat-free mass (R2 = 0.48, β = 0.27, P = 0.02). The positive correlation observed between dietary protein and PhA reinforces the need for adequate daily protein intake to enhance PhA in athletes. Further studies investigating the effect of diet-induced changes in PhA within the athletic population are necessary.

This repeated cross-sectional study assessed the validity and reproducibility of the myfood24® dietary assessment tool against dietary intake biomarkers in healthy Danish adults. The study included 71 healthy adults (14/57 m/f), aged 53.2 ± 9.1 years with an average BMI of 26.1 ± 0.3 kg/m2. Participants were instructed to complete seven-day weighed food records using myfood24® at baseline and 4 ± 1 weeks thereafter. Estimated mean dietary intake was compared with objective measures of energy metabolism and selected dietary intake biomarkers in fasting blood (folate) and in 24-hour urine (urea, potassium). Resting energy expenditure was measured by indirect calorimetry. Application of the Goldberg cut-off classified 87% (n = 62) of participants as acceptable reporters. A strong Spearman’s rank correlation was observed between total folate intake and serum folate (ρ = 0.62). Acceptable correlations were noted for serum folate (ρ = 0.49) and urinary potassium excretion (ρ = 0.44) with estimated and measured protein intake (ρ = 0.45); energy intake and total energy expenditure (ρ = 0.38); potassium intake and potassium excretion (ρ = 0.42); and estimated fruit and vegetable intake. Reproducibility analysis revealed strong correlations (ρ ≥ 0.50) across most nutrients and food groups, except for fish and vitamin D (ρ = 0.30 and ρ = 0.26, respectively). Notably, reproducibility for folate and total vegetable intake exhibited the highest correlations (ρ = 0.84 and ρ = 0.78, respectively). In conclusion, while some limitations exist, myfood24® remains a useful tool for ranking individuals by intake, particularly in studies focusing on relative comparisons.

The objective of this study was to explore the knowledge and attitudes regarding seafood safety and consumption, along with preferences and environmental issues in coastal Bangladesh. A cross-sectional, consumer-based survey was conducted in Bangladesh from September to November 2023, targeting 1100 participants aged 18 years and older across seven coastal districts. Convenience sampling and in-person interviews were used for the data collection. The average knowledge and attitude scores toward seafood safety and consumption were 48.2% and 63.5%, respectively. Several factors influenced seafood safety and consumption knowledge, including age, education level, family size, religion, and residence in coastal areas (all P < 0.05). In contrast, attitudes toward seafood safety and consumption were shaped by education level, family size, employment status, seafood allergies, and history of seafood poisoning (all P < 0.05). The most commonly consumed seafood was rupchanda, followed by shrimp. Most participants consumed seafood for its health benefits, with no significant seasonal impact on seafood consumption. Overfishing and climate change were recognised as the most alarming environmental dangers identified by the participants. Coastal communities in Bangladesh have demonstrated moderate attitudes, but relatively low knowledge of seafood safety and consumption. Targeted educational programmes, including community workshops on safe handling and storage, school-based programmes on marine conservation, and digital campaigns via SMS/social media, are needed to improve seafood safety knowledge, while promoting sustainable consumption practices is crucial for addressing environmental concerns like overfishing. Additionally, improving market accessibility and highlighting the health advantages of seafood can drive more informed and healthier consumption choices.

Although B vitamins have been shown to play beneficial roles in bone health, the effects of vitamin B1 in humans are still unclear. This study aimed to investigate the effects of vitamin B1 supplementation on middle-aged and older adults. This single-armed trial study included community-dwelling adults in Japan and used a pre- and post-test design. The participants were given 28.0 mg of vitamin B1 supplementation per day for 1 month in addition to their daily usual diet. The effect of this treatment on bone turnover markers and metabolism was evaluated at baseline and after 1 month. Forty-two participants were enrolled (mean age, 58.6 ± 10.4 years; 36 women). The vitamin B1 levels in whole blood increased significantly from baseline after vitamin B1 supplementation. The level of serum tartrate-resistant acid phosphatase 5b (TRACP 5b), a bone resorption marker, reduced significantly (378 ± 135 vs. 335 ± 120 mU/dL, p < 0.001), while the level of N-terminal propeptide of type I procollagen (P1NP), a marker specific to bone formation, did not change. Moreover, the serum phosphorus and parathyroid hormone (PTH) concentrations did not change, whereas the corrected serum calcium concentrations increased and vitamin D concentrations decreased. The serum TRACP 5b levels decreased after vitamin B1 supplementation in the middle-aged and older adults. Further definitive trials are needed to determine the efficacy of vitamin B1 in improving bone health.

This cross-sectional study aimed to investigate the correlation between magnesium consumption and periodontitis in different body mass index (BMI) and waist circumference (WC) groups. 8385 adults who participated in the National Health and Nutrition Examination Survey during 2009–2014 were included. The correlation between dietary magnesium intake and periodontitis was first tested for statistical significance by descriptive statistics and weighted binary logistic regression. Subgroup analysis and interaction tests were performed to investigate whether the association was stable in different BMI and WC groups. There was a statistical difference in magnesium intake between periodontitis and non-periodontitis populations. In model 3, participants with the highest magnesium consumption had an odds ratio of 0.72 (0.57-0.92) for periodontitis compared to those with the lowest magnesium consumption. However, in subgroup analysis, the relationship between magnesium intake and periodontitis remained significant only in the non-general obese (BMI ≤ 30 kg/m2) and non-abdominal obese populations (WC ≤ 102 cm in men and ≤ 88 cm in women). Dietary magnesium intake might decrease the periodontitis prevalence in the American population, and this beneficial periodontal health role of magnesium consumption might only be evident in non-general obese and non-abdominal obese populations.

Comorbidities, which are additional health conditions that occur alongside diabetes, can have a significant effect on blood sugar control. These conditions often complicate the management of diabetes and worsen overall health. Malnutrition, on the other hand, is a common concern for people with diabetes due to difficulties with food intake and metabolism. Proper nutrition is crucial for maintaining general health and effectively managing the disease. However, the extent of comorbidities and malnutrition within this group is not well understood in the study area. A cross-sectional study was conducted at Hawassa governmental hospitals between April and May 2023, involving 422 adult outpatients living with diabetes. The study aimed to evaluate their comorbidities, nutritional status, and associated factors. The required data were collected using structured and semi-structured questionnaires. Bivariate and multivariate logistic regression analyses were conducted using SPSS version 25.0. Undernutrition and concordant comorbidities were prevalent in the study population, occurring at rates of 15.2% and 57.8%, respectively. Additionally, 18.5% of participants were classified as overweight and obese with a BMI greater than 25 kg/m2. Three significant predictors of undernutrition among adult outpatients living with diabetes were identified: alcohol intake (P < 0.05), comorbidities (P < 0.01), and educational status (P < 0.05). Concordant comorbidity was notably common in these patients. It is recommended that the healthcare system consider comorbid conditions when managing diabetes. A longitudinal study is suggested to provide stronger evidence on these findings.

The Brazilian Worker’s Food Program (WFP) is a public policy initiative that focuses on nutritional assistance for low-income formal workers (less than five minimum wages). Currently, it serves more than 25 million formal workers (around 54%). This systematic review aimed to assess the nutritional quality of meals offered and/or consumed by beneficiaries of the WFP. Observational studies conducted with workers from companies registered in the programme were eligible, with no restrictions on the period of publication. The nutritional quality was assessed according to the guidelines of the programme (Normative Ordinance No. 66/2006). Twenty cross-sectional studies and one cohort study met the inclusion criteria. Most of the participants were male, from manufacturing industries, and their average age was 35.0 years. The results of the analysis showed that fibre, sodium, calories, and proteins were the nutrients that most exceeded the recommended amounts, whereas carbohydrate was the nutrient that had the least amount. The results showed that the nutritional quality of the food offered to or consumed by workers did not fully meet the required guidelines and, in some companies, did not promote an adequate and healthy diet. The WFP has great potential and needs to be reformulated to make it a programme that contributes to strengthening the realisation of the human right to adequate food.

Dietary habits, particularly vegetable consumption, play a crucial role in preventing noncommunicable diseases. However, despite international guidelines advocating daily vegetable intake, adherence remains low across many populations. As a result, more focused efforts to boost vegetable consumption at the population level are essential. This study aimed to assess the impact of a health communication campaign (HCC) in City A, which combined information dissemination and incentives to promote vegetable consumption. In 2021, a new app-based vegetable quiz was introduced as part of the ongoing campaign, which had been implemented since 2017. Participants earned 10 points per correct quiz answer, which could be redeemed for product certificates, with a maximum of 30 points. To evaluate the effectiveness of the quiz, we analysed vegetable intake data from 786 quiz users. A multiple regression analysis was conducted to consider factors such as sex, age, body mass index, pre-campaign points, prior vegetable intake, and frequency of food recording during the campaign. We ensured robustness of the results by analysing data from 605 individuals whose vegetable intake had been tracked one year earlier, during a non-incentivized version of the campaign. The results demonstrated that participants who completed all three quizzes consumed 10.7% more vegetables than non-participants. Year-over-year comparisons further showed a significant increase in vegetable intake among frequent quiz participants compared to the previous year, highlighting the positive impact of gamified quizzes on vegetable consumption. These findings suggest that incentivized HCC, especially those incorporating gamification elements, can be highly effective in encouraging healthier eating habits.

This study aimed to assess the extent to which first-morning void (FMV) urine samples can estimate sodium and potassium excretion compared with 24-hour (24-h) urine samples at the population level. We conducted a cross-sectional study collecting urine samples (FMV and 24-h) and two non-consecutive 24-h dietary recalls in a sub-sample from the Portuguese IAN-AF sampling frame. Six predictive equations were used to estimate 24-h sodium and potassium excretion from FMV urine samples. Pearson correlation coefficients were calculated to compare the association between FMV and 24-h urine collections. Cross-classifications into tertiles were computed to calculate the agreement between measured and estimated excretion with and without calibration. Pearson correlation coefficients were calculated to compare the excretion estimation from FMV and reported intake from 24-h dietary recalls. Bland–Altman plots assessed the agreement between two-day dietary recall and the best-performing calibrated equation. Data from eighty-six subjects aged 18–84 were analysed. Estimated sodium and potassium concentrations from the predictive equations moderate or strongly correlated with the measured 24-h urine samples. The Toft equation was the most predictive and reliable, displaying a moderate correlation (r=0.655) with no risk of over or underestimation of sodium excretion (p=0.096). Tanaka and Kawasaki equations showed a similar moderate correlation (r=0.54 and r=0.58, respectively) but tended to underestimate the 24-h urine excretion of potassium (p<0.001). Calibrated predictive equations using FMV urine samples provide a moderately accurate alternative and resource-efficient option for large-scale nutritional epidemiology studies when 24-h urine collection is impractical.

Understanding adolescents’ diet and eating behaviours is crucial for informing public health strategies and policies, allowing interventions to be tailored effectively to enhance dietary patterns and improve overall health and quality of life. This study examined dietary patterns, dietary diversity, eating habits, food choice and the factors influencing these among adolescent girls in the Mion District, Ghana. A convergent parallel mixed-method design employing in-depth interviews (n = 30), two focus group discussions (n = 10) and survey data from 882 mother-daughter pairs was used. Key findings indicate that approximately 90% of girls achieved the minimum dietary diversity for women of reproductive age (MDD-W), with most consuming three meals daily. Staples were eaten daily, while fruits and unhealthy foods were less frequently eaten. Moderate/severe food insecurity was negatively associated with the MDD-W, whereas larger household size was positively correlated with the MDD-W. Older girls were less likely to eat breakfast, while household crop farm diversity increased the odds of eating supper on weekends. Moderate/severe food insecurity was inversely associated with intake of animal-sourced foods (ASFs), fruit, and unhealthy foods but positively correlated with vegetable consumption in the past month. Maternal non-literacy was linked to a lower intake of unhealthy foods, while specific ethnic backgrounds negatively influenced ASF intake. Wealthier households demonstrated higher consumption of staples. Qualitatively, health considerations, availability, taste, and cravings were major influencers of food choices. Food aversions were often tied to intolerance, fatigue from consuming the same foods repeatedly, and preferences related to taste and texture. These findings underscore the need for targeted nutritional interventions considering socio-economic and household factors to improve adolescent girls’ dietary habits and overall health.

Recommended dietary fibre consumption is rarely met in high-income countries. Detailed analysis of fibre consumption patterns is essential to identify strategies for increasing intake. This study investigated the timing and sources of fibre intake in Switzerland, using data from the Swiss Nutrition Survey, menuCH (n = 2057, 18–75 years). Dietary characteristics were summarised for the adult population and for subgroups stratified by absolute (< 15 g/day, 15-<30 g/day, and >=30 g/day) and relative (< 10 g/1000 kcal/day, 10-<14 g/1000 kcal/day, and >=14 g/1000 kcal/day) fibre intake. Mean fibre intake of both 24 HDRs for each individual and contribution of food groups and timing (before breakfast, breakfast, during the morning, lunch, during the afternoon, dinner, after dinner/at night) was calculated. Fibre was mainly consumed at breakfast (4.1 g/day), lunch (6.0 g/day), and dinner (6.4 g/day). Intake at breakfast differed between the lowest and highest fibre intake groups by 6.4 g/day (absolute) and 4.3 g/day (relative). Breakfast skipping was more frequent among low-fibre intake groups (29% for absolute intake, 19% for relative intake) than in the overall population (15%). The main sources of dietary fibre were grain products (35.6%), followed by vegetables (18.3%) and fruits (18.2%), with whole grains accounting for 17.5% of grain intake. Legumes contributed only to 1% of total fibre intake. Public health efforts encouraging regular breakfast consumption, and intake of whole grains and legumes are recommended to improve fibre intake.

There are few studies on what diet mothers following a vegan diet (VD; or strict plant-based diet) choose for their children and how the child’s diet is implemented in everyday life. The present study aimed to explore choices that mothers following a VD make regarding their child’s diet and feeding practices, and what determines these choices. Mothers on a VD whose youngest child was <4 years old were recruited via social media or newsletters about a VD. Participants (N=28) were between 27 and 45 years old and had been adhering to a VD between 0.5 and 23 years. Online semi-structured interviews based on the Theory of Planned Behaviour were audio-recorded and transcribed verbatim. A hybrid thematic analysis approach was used to identify themes that emerged from the data. Mainly driven by ethical considerations of eating animal products, 21 (75%) women chose a VD for their child(ren). When the participant’s partner followed a vegetarian diet (VEGD) or omnivorous diet (OMD), most women chose a VEGD (N=4) or OMD (N=3) for their child as well. Overall, women indicated to make well-considered choices regarding children’s diet and related feeding practices. Determinants for the dietary choice for their children involved various motivations, attitudes, norms, facilitating/hindering factors and knowledge. In conclusion, driven mainly by ethical motivations, most women on a VD chose this diet for their children as well. Despite experiencing several hindering factors and acknowledging the potential negative effects of a VD, mothers seemed to make well-considered choices concerning their child’s diet.