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.

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.

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.

Phenolic compounds may reduce oxidative stress and inflammation, but evidence on inflammatory markers is limited. This study investigated associations between phenolic compounds intake and ten inflammatory markers in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The cross-sectional analysis included participants from the full cohort (n 14 151) and a São Paulo subsample (n 681). Food intake was assessed using a semiquantitative FFQ, and phenolic content was estimated from Phenol-Explorer and Brazilian Food Composition Database. Logistic regression models compared the highest v. lowest tertiles of phenolic intake for high-sensitivity C-reactive protein (hs-CRP), glycoprotein acetylation (GlycA), monocyte chemoattractant protein-1 (MCP-1), E-selectin, transforming growth factor β1, TNF α, IL-6, IL-10, fibrinogen and leptin levels. Inflammatory markers were dichotomised as low (tertiles 1–2) or high (tertile 3), except hs-CRP (> 3 mg/l). Multiple testing was corrected using P < 0·0036. Mean age was 52·1 years for hs-CRP/GlycA and 45·6 years for other markers. Compared with T1, participants in T3 of total phenolics, phenolic acids and flavonoids had 14 %, 18 % and 18 % lower odds of elevated hs-CRP, respectively. For GlycA, higher intakes of phenolic acids, stilbenes and other phenolics were associated with 18–48 % lower odds of high levels (all P ≤ 0·003). Higher intake of hydroxybenzoic acids and stilbenes was associated with lower E-selectin levels, while phenolic acid intake showed an inverse association with MCP-1. No associations were observed for other markers. Higher intakes of phenolic compounds were associated with lower systemic inflammation, suggesting a role in preventing inflammation-related chronic diseases.

Urinary iodine concentration (UIC) is the principal biomarker for assessing iodine status; however, it is subject to marked fluctuations and practical challenges. This proof-of-concept study evaluated protein-corrected salivary iodide (SI/P) as a potential alternative biomarker, comparing it with spot UIC in distinguishing between iodine-deficient and iodine-adequate individuals, assessing its responsiveness to short-term dietary iodine restriction and exploring its correlation with 24 h urinary iodine excretion (UIE). Twenty-six participants were categorised into low-iodine (n 17) and high-iodine (n 9) groups based on 24 h UIE collected on Day-1. Postprandial spot urine and unstimulated saliva samples were collected under habitual diet (Day-1) and low-iodine diet (Day-2). SI/P was significantly higher in the high-iodine group at all time points on both Day-1 (post-breakfast [1-PB]: 61·28 v. 27·89 µg/g, P = 0·03; post-lunch [1-PL]: 71·03 v. 27·4 µg/g, P = 0·003; post-dinner [1-PD]: 114·13 v. 31·58 µg/g, P = 0·002) and Day-2 (2-PB: 81·86 v. 26·51 µg/g, P = 0·013; 2-PL: 54·56 v. 18·83 µg/g, P < 0·001; 2-PD: 38·2 v. 18·79 µg/g, P = 0·043), whereas UIC only differed significantly post-dinner on Day-1 (156·15 v. 36·63 µg/l, P = 0·009). SI/P also showed stronger correlation with 24 h UIE (1-PB: r = 0·65, P = 0·001; 1-PL: r = 0·70, P < 0·001; 1-PD: r = 0·67, P < 0·001; 2-PB: r = 0·70, P < 0·001; 2-PL: r = 0·65, P = 0·001; 2-PD: r = 0·50, P = 0·01) compared with UIC (1-PB: r = 0·49, P = 0·011; 1-PL: r = 0·38, P = 0·055; 1-PD: r = 0·58, P = 0·002; 2-PB: r = 0·68, P < 0·001; 2-PL: r = 0·52, P = 0·007; 2-PD: r = 0·44, P = 0·027). Unlike UIC, which is primarily suited for population-level monitoring, SI/P demonstrated stable performance irrespective of diet/sampling time, suggesting utility as a reliable, individual-level biomarker of iodine status.

A high serum total cholesterol (TC) concentration is a major risk factor for CVD, and lifestyle modifications including a healthy diet are among the first-line strategies for lowering cholesterol concentration and reducing CVD risk. Several studies in rodents have demonstrated a lower circulating TC concentration after intake of cetoleic acid (CA, C22:1n-11). The primary aim was to investigate the effect of consuming herring oil (HERO) containing CA or a CA concentrate (CECO) on the circulating TC concentration in obese hypercholesterolaemic rats. Secondary aims included investigating effects of CA on a selection of hepatic enzymes and receptors involved in cholesterol metabolism, lipogenesis and VLDL assembly. Thirty male obese Zucker fa/fa rats were fed a diet containing either HERO or CECO, containing 0·70 or 1·40 wt% CA, respectively, or a Control diet with soyabean oil for 5 weeks. Data were analysed using one-way ANOVA. The serum TC concentration was lower in the HERO and CECO groups compared with the Control group (17 and 20 percent, respectively). Both the HERO and the CECO diets down-regulated de novo lipogenesis, cholesterol esterification and lipidation of VLDL in the liver compared with the Control diet, but did not affect the hepatic cholesterol synthesis, the LDL receptor or the faecal excretion of cholesterol and bile acids. To conclude, rats fed the HERO or CECO diets had a lower serum concentration of TC, probably as a result of down-regulated VLDL secretion in response to lower lipogenesis. This may have relevance for lowering TC in hypercholesterolaemic humans.

Dietary patterns are increasingly recognised as crucial factors influencing the progression of metabolic-associated steatotic liver disease (MASLD). This study aimed to explore the association between dietary patterns and MASLD risk among adults, using latent class analysis (LCA), to our knowledge, for the first time in this context. This cross-sectional study included 8549 adults from the general population. Dietary intake data were collected using a validated FFQ and analysed with Nutritionist IV software. A 3-step LCA was applied to determine distinct dietary patterns among participants using micro- and macronutrients. Liver fibrosis severity was evaluated using a validated non-invasive marker, FIB-4 Score. Our analysis identified three distinct dietary patterns, each significantly associated with the severity of liver fibrosis. Class 1 (high-volume, high-fibre/mineral-rich pattern) was associated with the lowest risk of liver fibrosis. Compared with Class 1, participants in Class 2 (moderate volume, low-fibre/high-Na/mineral-poor pattern) (OR = 1·24; P = 0·002) and Class 3 (restricted volume, nutrient-depleted pattern) (OR = 1·13; P = 0·027) had significantly higher odds of moderate-to-high liver fibrosis risk. Class-specific regression analysis showed that age and smoking were the most consistent predictors of fibrosis risk across all patterns. Dietary patterns rich in antioxidants, fibre and essential micronutrients appear effective in reducing the risk of liver fibrosis. Further longitudinal studies are required to confirm these findings and determine practical clinical applications.

This study investigated changes in serum folate and B12, and associations with endurance performance and bone outcomes, in women during military training. Women (n 137) had serum folate and B12, haematological markers and endurance performance (2·4 km run) measured at the start (week 1) and end (week 13) of British Army basic training. Whole-body areal bone mineral density and markers of bone metabolism were measured at week 1. Training decreased serum folate (mean change (95 % CI), −2·3 (−3·0, −1·6) nmol ∙ l−1, P < 0·001), B12 (−16 (−32, 0) pmol ∙ l−1, P = 0·042), Hb (−0·7 (−0·9, −0·5) g ∙ dl−1, P < 0·001) and erythrocyte count (−0·2 (−0·3, −0·2) × 10^9 ∙ l−1, P < 0·001), but had no effect on mean corpuscular volume (P = 0·438) or erythrocyte distribution width (P = 0·088). There was no association between serum folate, serum B12, Hb or erythrocyte count with run time (P ≥ 0·518). Serum B12 was not associated with areal bone mineral density or bone metabolism at week 1 (P ≥ 0·152). Higher serum folate was associated with lower plasma c-telopeptide cross-links of type I collagen (standardised β (95 % CI) = −0·31 (−0·48, −0·15), P < 0·001), but not whole-body bone mineral density or plasma procollagen type I N-terminal propeptide (P ≥ 0·152). Serum folate and B12 decreased after military training in women, resulting in a high prevalence of folate deficiencies at the end of training. Low serum folate may contribute to increased bone resorption, the implications of which are unclear.

Vitamin A deficiency (VAD) is common among pregnant women (PW) and has been associated with anaemia and adverse birth outcomes. However, in the Free State Province of South Africa, evidence regarding this is limited. Hence, this cross-sectional study investigated the vitamin A (vitA) intake and status of PW in Bloemfontein and its association with anaemia, iron status and birth outcomes. Blood was taken from 427 PW to assess the status of vitA (retinol-binding protein 4 (RBP4)), iron (ferritin, soluble transferrin receptor (sTfR)) and anaemia (Hb). Sociodemographic, HIV, birth outcomes (birthweight and gestational age) and dietary vitA intake data were obtained using a questionnaire in an interview and medical records. Descriptive statistics and linear regression were used to describe variables and the association between vitA and iron status and birth outcomes. Median vitA intake was 1007 µgRAE/d with 19 % of participants’ intake below the estimated average requirement of 550 µgRAE/d. Median (IQR) RBP4 was 1·51 (0·78) µmol/l. Insufficient vitA status and VAD prevalence were 12·2 % and 1·2 %, respectively. VitA intake was positively associated with RBP4 (β = 0·068; 95 % CI 0·020, 0·116; P = 0·006). RBP4 was positively associated with Hb (β = 0·363; 95 % CI 0·186, 0·539; P < 0·001) and ferritin (β = 0·359; 95 % CI 0·139, 0·579; P = 0·001) but negatively with sTfR (β = −0·125; 95 % CI −0·246, −0·005; P = 0·041). No significant association between plasma RBP4 and birth weight, as well as preterm birth, was observed. There was a low prevalence of VAD in the study population. Nonetheless, the positive association between RBP4 and Hb and ferritin highlights the importance of optimal vitA status in preventing anaemia in pregnancy.

Previous estimations of the associations between fruits and vegetables (F/V) intake with diabetes markers showed mixed results, possibly partly because of the subjective assessment of dietary intake. We aimed to examine the relationship between plasma carotenoids and α-tocopherol (as objective markers of F/V intake) and fasting glucose. This was a population-based cross-sectional study in 592 adults in Cameroon. Self-reported F/V intake was assessed using the WHO STEPS questionnaire, and the biomarkers were analysed by HPLC. The mean age of participants was 38·5 (sd 8·6) years (63·7 % women). The median (IQR) number of times participants self-reported consuming fruits in a typical week was 2(1–5) and vegetables was 4(2–7) times/week. Plasma total carotenoids was positively correlated with self-reported intake of fruits (r = 0·13) and vegetables (r = 0·29), both P-values < 0·01. In unadjusted analysis, the difference in fasting glucose comparing the highest against the lowest tertile of the biomarkers concentrations was −0·28 (95 % CI −0·56, −0·001) mmol/l for total carotenoids and −0·31 (–0·59, −0·03) mmol/l for plasma α-carotene. The associations became stronger after adjusting for sociodemographics, lifesyle factors and cholesterol (–0·36 (–0·73, −0·002) mmol/l for total carotenoids and −0·41 (–0·79, −0·03) mmol/l for α-carotene). There was no evidence of an association between α-tocopherol and fasting glucose. We showed an inverse association of total carotenoids and α-carotene, objective indicators of F/V intake, with fasting glucose; suggesting that higher F/V intake may be beneficial for diabetes prevention in African populations where F/V intake is low.

Limited evidence exists on the combined effects of lifestyle factors on breast cancer (BC) risk, particularly in developing countries. This study aimed to investigate the association between adherence to the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and BC risk among Moroccan women. We conducted a large case–control study including 1,400 cases and 1,400 matched controls (by age and place of residence) between 2019 and 2023. A structured general questionnaire and a validated Food Frequency Questionnaire were used for data collection. Adherence to cancer prevention recommendations was assessed using a score ranging from 0 to 7, comprising seven components covering dietary patterns, physical activity, healthy weight, and breastfeeding. Multivariable logistic regression models were used to estimate OR and 95 % CI, accounting for potential confounding variables. For each one-point increase in the WCRF/AICR adherence score, the odds of BC decreased by 67 % overall (OR = 0·33; 95 % CI: 0·29–0·37). This inverse association was consistent among both premenopausal women (OR = 0·29; 95 % CI: 0·24–0·35) and postmenopausal women (OR = 0·35; 95 % CI: 0·30–0·41). Analysis of individual recommendations indicated that physical activity, maintaining a healthy weight, breastfeeding, consuming a plant-rich diet, and limiting the intake of fast and other processed foods were the main drivers of the observed inverse association with BC. In conclusion, greater adherence to the WCRF/AICR recommendations is associated with a reduced risk of breast cancer in Morocco. Prevention strategies should incorporate comprehensive interventions targeting multiple lifestyle factors.

Greater consumption of red meat has been linked to a higher risk of mortality and chronic diseases, including diabetes. We aim to examine the associations between total, processed and unprocessed red meat intake and diabetes and to evaluate the substitution effects of other protein sources for red meat on diabetes. This population-based cross-sectional study utilised data from the National Health and Nutrition Examination Survey (NHANES) 2003–2016. Diabetes was defined as a self-reported diagnosis by a physician or other health professional, having a fasting plasma glucose of 126 mg/dl or higher, an HbA1c level of 6·5 % or higher, or the use of antidiabetic drugs. Multivariable logistic regression models were conducted. The study included 34 737 adult participants (mean (sd) age of 45·8 (17·5) years) from NHANES 2003–2016. After adjusting for major confounders, compared with the first quintile, higher intakes of total, processed and unprocessed red meat were positively associated with higher odds of diabetes, with adjusted OR of 1·49 (95 % CI 1·22, 1·81), 1·47 (95 % CI 1·17, 1·84) and 1·24 (95 % CI 1·06, 1·44), respectively. The corresponding P-trend values were (< 0.001, 0.001, and 0.006). In this nationally representative sample of US adults, participants in the highest quintiles of total, processed and unprocessed red meat intake had higher odds of diabetes than those in the lowest quintile. Substituting 1 serving/d of dietary protein from foods of plant origin (including nuts, seeds, legumes and soya) for total, processed or unprocessed red meat was associated with 9 % to 14 % lower odds of diabetes.

Growing evidence supports early eating to control appetite and energy balance but there are few controlled studies to assess the amount and/or type of breakfast meal. This randomised, within-participant, diet intervention examined the effects of higher-fibre (HF) and higher-protein (HP) breakfasts in adults with overweight/obesity. Nineteen healthy adults consumed two randomised 28-d weight loss (WL) diets, as higher-fibre (HFWL) or higher protein (HPWL), with all food provided. Both WL diets were designed as 45 %, 35 % and 20 % of calories to be consumed in the morning, afternoon and evening, respectively. The primary outcome was energy balance, analysed by body weight changes. The secondary outcomes were gut health (assessed by changes in faecal microbiota composition and microbial metabolite concentrations) and subjective appetite assessed with visual analogue scales. There was a diet effect on WL, with mean loss of −4·87 kg and −3·87 kg for the HFWL and HPWL diets, respectively (P = 0·002). The HPWL diet was superior to the HFWL diet for suppressing subjective appetite (P = 0·003). The faecal microbiota analysis showed beneficial groups of bacteria, including bifidobacteria, and the butyrate producers Faecalibacterium and Roseburia, were significantly increased in proportional abundance on the HFWL diet. Breakfast composition has an important role in influencing subjective appetite with the HP diet promoting greater feelings of satiety. The proportional abundance of putatively beneficial groups of gut microbiota was markedly higher on the fibre-enriched diet, which may be preferable for gut health.

Grip strength is a simple and practical method for evaluating overall muscle strength and a key health biomarker that is linked to sarcopenia, chronic conditions and overall mortality. Although protein intake plays a vital role in muscle protein synthesis, its association with grip strength in adults remains unclear. This study examined the cross-sectional relationship between total, animal and plant protein intake and grip strength among local government workers in Japan. Participants were 349 workers (175 men and 174 women; mean age, 42·9 years; range, 19–71 years) who received a health check-up and participated in a nutrition and health survey. Protein intake was assessed using a validated self-administered diet history questionnaire. Grip strength was measured with a digital dynamometer. Multiple linear regression analysis was used to estimate adjusted means of grip strength according to the tertile of protein intake. Higher animal protein intake was significantly associated with higher grip strength in women, but not in men. After adjustment for covariates including lifestyle and dietary factors, mean (95 % CI) grip strength for the lowest through highest tertile of animal protein intake was 24·6 (21·7, 27·5) kg, 25·8 (22·9, 28·7) kg and 26·8 (23·7, 29·9) kg (Pfor trend = 0·015) in women. No association was found between total and plant protein intake and grip strength in either men or women. These findings suggest that animal protein is important for muscle strength in women, with potential sex differences in the relationship between protein intake and grip strength.