Diets low in diverse fibre-rich plant foods contribute to the rise of chronic disease. The BIOME study (NCT06231706; 6-week parallel randomised controlled trial) in 399 adults (35–65 years; BMI 18·5–40 kg/m2; fibre intake < 20 g/d) investigated a whole-food plant blend containing > 30 ingredients, rich in (poly)phenols, fibre and micronutrients. Participants were randomised (1:1:1) to the blend (30 g/d), an isoenergetic control (bread croutons, 28 g/d) or probiotic (Lactobacillus rhamnosus, 15bn CFU/d). Analysts were blinded to allocation. The primary outcome was change in ‘favourable’ and ‘unfavourable’ gut microbiome species (ZOE Microbiome Health Ranking 2025); secondary outcomes included blood metabolites, symptoms, stool output, anthropometry, hunger, sleep, energy and mood. A crossover sub-study explored postprandial glucose, hunger and mood. Of 349 participants analysed (fifty excluded), self-reported adherence was > 98 %. The 30+ plant blend resulted in more species changing relative abundance at 6 weeks v. control (57 v. 14 species-level genome bins (SGB), P < 0·001) and probiotic (57 v. 4 SGB, P < 0·001). There were no significant between-group differences in microbiome health ranks of significantly changing species (increasing or decreasing). Blend participants self-reported reduced indigestion, constipation, heartburn and flatulence and increased energy v. control (all P < 0·05). Six related but no serious adverse events occurred. In the sub-study, adding the blend to a high-carbohydrate meal (v. meal alone) reduced hunger, increased fullness and energy (3-h incremental AUC, all P < 0·05), with no effect on postprandial glucose. This 30+ plant blend represents a simple strategy to modify gut microbiome composition and benefit gastrointestinal symptoms in healthy adults.

Asparagus (Asparagus officinalis) contains bioactive compounds such as polyphenols and saponins, which have been shown to influence cognition, mood, sleep, stress and related biomarkers. However, the evidence from human studies has not been systematically synthesised. To address this, we conducted a systematic review evaluating the effects of asparagus-based products on cognitive, affective, sleep outcomes and related biomarkers in adults. A systematic search of PubMed, Scopus, Web of Science, PsycINFO, Google Scholar and Amino Up Ltd’s website (up to April 2025) identified studies assessing asparagus supplementation in adults, following PRISMA guidelines (PROSPERO registration number: CRD42025636834). Human studies that employed randomised controlled trials or quasi-experimental designs and assessed the effects of orally administered asparagus-based products on cognition, mood, sleep or relevant biomarkers were included. Eighteen studies (thirteen randomised controlled trials and three pre-post-studies; 503 participants) were included. Cognitive improvements were observed in reaction time, accuracy and mental fatigue, while mood and stress-related outcomes showed reductions in anxiety and depressive symptoms. Sleep outcomes consistently demonstrated improvements in sleep quality and duration, while biomarker data showed effects on cortisol levels. Asparagus supplementation may offer modest benefits for cognition, mood and stress-related physiology, with particularly consistent effects on sleep quality. However, the magnitude of benefits varies by population, dose and duration, and the heterogeneity of interventions, small sample sizes and limited studies may constrain the generalisability of findings. Well-powered, long-term clinical trials are needed to determine optimal dosage, clarify mechanisms and assess efficacy across diverse populations.

The aim of this study was to investigate the predictive validity of a proposed revision of the Nutri-Score and the current Nutri-Score by investigating associations between the diet quality scores measured in mid-pregnancy and the risk of dispensed prescription of medications for hypertension up to 11 years following delivery and blood pressure mid-pregnancy. The study population (n 70 730) were participants in the Norwegian Mother, Father and Child Cohort Study. Food intake was assessed in mid-pregnancy using a validated FFQ. Nutritional scores for each food item were calculated based on content of energy, sugars, saturated fat, salt, fibre, protein, fruit, vegetables and legumes. Diet quality scores were derived using energy-weighted means of nutritional scores. Anti-hypertensive medications were registered in the national prescription database. We estimated hazard ratios (HRs) with 95 % CIs using Cox regression models. During a mean follow-up of 6 years, 4736 (6·7 %) women were dispensed prescription for medications for hypertension. There was a non-linear association between diet quality and hypertension medication. Compared with the median diet quality score, poorer diet quality (90th percentile of the score) was associated with higher risk of medications for hypertension (HR = 1·08, 95 % CI 1·02, 1·14) and cross-sectional high diastolic blood pressure (OR = 1·18, 95 % CI 1·03, 1·32). Both diet quality scores yielded similar results overall. Poorer diet quality during pregnancy, assessed with a proposed version, and the current Nutri-Score, was associated with a higher risk of medications for hypertension, indicating its usefulness as a valuable tool for guiding consumers and improving public health.

Food literacy is important for understanding the factors that determine food choices, eating behaviours and diet quality. However, few studies have examined the relationship between food literacy, diet quality and food consumption. The present study aimed to examine this relationship in an adult population. This cross-sectional study included 639 adults (50·2 % female; age range: 19–65 years) at Ondokuz Mayıs University in Samsun, Türkiye. Participants completed the Short Food Literacy Questionnaire (SFLQ). Anthropometric measurements and 24-h food recall were recorded. Diet quality was assessed using the Healthy Eating Index (HEI)-2015. Total scores for vegetables and seafood and plant proteins (HEI-2015 components) were higher in the adequate–excellent food literacy group (2·9 (sd 2·25) v. 2·5 (sd 1·85), P = 0·041 and 12·8 (sd 12·51) v. 11·0 (sd 10·58), P = 0·040). Conversely, the refined grain scores were higher in the inadequate–limited food literacy group (3·6 (sd 5·77) v. 4·5 (sd 5·67), P = 0·041). In the regression model, the SFLQ score was positively associated with HEI-2015 scores (β = 0·364, P = 0·026) and total vegetable consumption (β = 0·029, P = 0·015). For each 1-point increase in the SFLQ score, the HEI-2015 score increased by 0·364 points on average (β = 0·364, P = 0·026). Furthermore, SFLQ scores were negatively associated with refined grain scores (β = −0·107, P = 0·001) and added sugar scores (β = −0·021, P = 0·042). Food literacy is an important factor associated with diet quality. Enhancing nutrition knowledge, skills and attitudes in adults may contribute to healthier eating behaviours.

This study examined the within- and between-day reliability of commonly employed laboratory-based body composition assessment methods. Eighteen healthy adults reported to the laboratory on two occasions, separated by 1–2 d, and were assessed with multiple methods under standardised conditions. These included two dual-energy X-ray absorptiometry (DXA) scanners with manual or automated regions of interest, air displacement plethysmography (ADP) with measured or estimated thoracic gas volume (TGV), two multi-frequency bioelectrical impedance analysers (MFBIA), single-frequency BIA (SFBIA) and bioimpedance spectroscopy. Within-day reliability was established via immediate test–retest assessments at the first visit (technical error) and between-day reliability by repeating assessments at the second visit (technical plus biological error). Within- and between-day measures were evaluated using technical error of measurement (TEM) and intraclass correlation coefficients (ICC). For body fat percentage, within-day TEM ranged from 0·03 to 0·70 %, with ICC of 0·993–1·000, while between-day ranged from 0·37 to 1·24 %, with ICC of 0·965–0·998. For fat and fat-free mass (FM and FFM), within-day TEM ranged from 0·02 to 0·53 kg, with ICC of 0·998–1·000 for FFM and 0·992–1·000 for FM. Between-day TEM ranged from 0·26 to 0·90 kg for FM and FFM, with ICC of 0·995–0·999 for FFM and 0·955–0·998 for FM. Across metrics, DXA demonstrated the best reliability, followed by one MFBIA and ADP with predicted TGV. Overall, laboratory-based body composition devices provide excellent within- and between-day reliability under standardised conditions, though observed differences in error may influence method selection when tracking small body composition changes.

This study aimed to investigate the association between the timing and quality of the last meal and sleep quality among Iranian adults. In this cross-sectional study, healthy Iranian adults were included. Dietary intake and meal timing were assessed using three non-consecutive 24-h dietary recalls to calculate the interval between the last meal and bedtime. Dinner quality was evaluated using the NRF9·3 index, and sleep quality was measured using the Pittsburgh Sleep Quality Index. Multivariable logistic and ordinal regressions assessed associations of meal timing and dinner quality with sleep outcomes, adjusting for confounders. The study included 450 adults (mean age: 38·1 (sd 9·7) years), of whom 55·8 % had good sleep quality. The mean interval between the last meal and sleep was 2·38 (sd 1·08) h. A longer interval between the last meal and bedtime was associated with higher odds of poor global sleep quality (OR = 2·03, 95 % CI: 1·24, 3·32; P = 0·005). Longer intervals were significantly associated with better subjective sleep quality, shorter sleep latency, longer sleep duration and higher habitual sleep efficiency. Dinner quality demonstrated a mixed pattern of association with sleep quality, showing higher odds of poor sleep in the second tertile (OR = 1·66, 95 % CI: 1·01, 2·73), whereas this association was not observed in the highest tertile (OR = 1·24, 95 % CI: 0·75, 2·04). In conclusion, longer dinner-to-bedtime intervals may improve specific sleep quality aspects, though results remain inconsistent. Further research is essential to clarify these associations and determine optimal meal timing.

This population-based cross-sectional study investigated the associations of sleep, nutrition and physical activity with overweight and obesity among 4108 school-aged children and adolescents (9–17 years) in Punjab, Pakistan, alongside 3371 parental responses. BMI was calculated using anthropometric measurements, and weight status was classified according to the 2007 WHO growth reference. Socio-economic status was determined through parental education, occupation and household income, while lifestyle behaviours were assessed via validated questionnaires. Multivariate logistic regression analyses were conducted, adjusting for sex, grade and socio-economic variables. The prevalence of overweight and obesity was 19·4 % and 10·7 %, respectively. Girls had a higher obesity prevalence than boys (12·3 % v. 8·9 %), whereas boys showed a higher combined prevalence of overweight and obesity. Among boys, obesity was significantly associated with urban residence (adjusted OR (aOR) 1·37; 95 % CI 1·13, 1·83), being an only child (aOR 2·74; 95 % CI 1·92, 3·92), frequent fast-food consumption (≥ 3 times/week; aOR 1·56; 95 % CI 1·23, 1·97) and lower parental education (aOR 1·22; 95 % CI 1·05, 1·41). Among girls, long weekend sleep duration increased obesity risk (aOR 1·38; 95 % CI 1·14, 1·67), while being an only child (aOR 0·36; 95 % CI 0·25, 0·52), frequent fast-food consumption (aOR 0·64; 95 % CI 0·50, 0·80) and lower parental education (aOR 0·81; 95 % CI 0·70, 0·94) were linked to lower odds. Physical activity and soft drink intake were not significant after adjustment. These findings underscore complex, gender-specific relationships between lifestyle and socio-economic factors, highlighting the need for targeted interventions promoting healthy sleep, nutrition and equity-focused strategies.

To identify associations between Hb concentration in different trimesters, Hb changes and Hb trajectories during pregnancy with risk of preterm birth (PTB) and low birth weight (LBW). A retrospective cohort study included 18 980 participants from Haidian District Maternal and Child Health Care Hospital from 2018–2021. Hb concentrations were measured at first (0–12 weeks), second (13–27 weeks) and third trimesters (≥ 28 weeks). Hb was categorised into four groups (< 110, 110–119, 120–129, ≥ 130 g/l), and Hb changes between trimesters were calculated. The latent class growth mixed model was employed to estimate Hb trajectories. Association assessment and dose–response relationship used logistic regression and restricted cubic spline. Compared with Hb 110–119 g/l, women with Hb ≥ 130 g/l significantly increased odds of PTB (OR: 1·74, 95 % CI 1·29, 2·31) and LBW (OR: 2·31, 95 % CI 1·65, 3·20) during the second trimester. In the third trimester, women with Hb 120–129 g/l showed 26 % (OR: 1·26, 95 % CI 1·04, 1·51) increased odds of PTB and 72 % (OR: 1·72, 95 % CI 1·36, 2·17) increased odds of LBW, while the OR of Hb ≥ 130 g/l for PTB and LBW were 1·45 (95 % CI 1·12, 1·86) and 2·60 (95 % CI 1·96, 3·43). Hb changes exhibited a linear increase in odds of PTB and LBW. Women with a decline-sharp-rise trajectory had a 1·48-fold odds of PTB (OR: 1·48, 95 % CI 1·26, 1·75), compared with a decline-gradual-rise trajectory. These findings underscore the importance of monitoring Hb during pregnancy.

Black African women face disproportionately high rates of obesity, with prevalence reaching 37 % in the UK. These elevated rates significantly contribute to chronic non-communicable disease burdens, yet comprehensive dietary data for this group in the UK remain limited. Accurate dietary assessment is essential for identifying nutritional risks and guiding interventions, especially in ethnically diverse populations. Standard tools, including the European Prospective Investigation into Cancer and Nutrition (EPIC) FFQ, often lack cultural specificity and have not been adapted or validated for Black African populations in the UK. This study aimed to modify and validate a culturally tailored EPIC FFQ for dietary assessment among Black African adults in the UK. A cross-sectional study with 112 Black African women (BMI > 25 kg/m2) was conducted. The EPIC FFQ was adapted by including culturally relevant African foods, identified via literature review and three non-consecutive 24-h recalls using Intake24. Participants completed the modified FFQ, and nutrient intakes from both methods were compared using correlation analyses, adjusted for within-person variation. Bland–Altman plots and energy-adjusted correlations assessed agreement. The modified FFQ expanded to 141 food items and showed significant correlations with 24-h recalls for various nutrients. Crude correlation coefficients ranged from 0·21 (fibre) to 0·87 (protein); energy-adjusted values ranged from 0·19 to 0·86. De-attenuated correlations improved further. Bland–Altman plots showed systematic overestimation of intake, particularly protein and fibre, but good overall agreement. The adapted EPIC FFQ is a valid tool for dietary assessment in Black African adults, though overestimation occurred. Further validation using dietary biomarkers is recommended.

Micronutrient deficiencies are modifiable risk factors for CVD, yet their relative importance and combined effects across populations require further characterisation. We performed a binational analysis integrating cross-sectional data from the US National Health and Nutrition Examination Survey (NHANES, 2007–2018; n 3848) and prospective data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018; n 11 391). Associations of specific micronutrient biomarkers (vitamin D, folate, vitamin B12, Ca and Fe) and dietary patterns with CVD were assessed using multivariable-adjusted logistic regression, Cox proportional hazards models and restricted cubic splines. A composite micronutrient deficiency score evaluated cumulative risk. In NHANES, Fe deficiency was independently associated with prevalent CVD after full adjustment (OR 1·49, 95 % CI: 1·09, 2·01), with a population prevalence of 23·4 %. Although most prevalent (33·1 %), vitamin D deficiency showed no independent association. Nonlinear analyses revealed a U-shaped relationship for Fe (P-nonlinearity = 0·003) and an inverse association for vitamin D (P-nonlinearity < 0·001). A dose–response relationship was observed for cumulative deficiencies; participants with ≥ 2 deficiencies had 91 % higher CVD odds (OR 1·91, 95 % CI: 1·20, 2·99). In CHARLS, frequent consumption of fruits/vegetables (adjusted hazard ratio (aHR) 0·81, 95 % CI: 0·70, 0·93), nuts (aHR 0·82, 0·71, 0·95) and fish (aHR 0·85, 0·74, 0·98) was associated with reduced incident CVD risk. Fe deficiency is an underrecognised independent risk factor for CVD, and multiple concurrent deficiencies synergistically increase risk. Plant-based dietary patterns are consistently protective. Findings advocate for Fe status screening in cardiovascular risk assessment and emphasise holistic nutritional approaches.

This study aimed to examine infant feeding practices and associated factors among infants affected by the great earthquakes in Türkiye. This descriptive, cross-sectional study included mothers of infants aged 4–12 months who experienced earthquakes in Kahramanmaraş, Kilis, Diyarbakır, Adana, Osmaniye, Gaziantep, Şanlıurfa, Adıyaman, Malatya and Hatay and who were residing in Hatay at the time of data collection. A total of 396 mothers participated in the study. All participants voluntarily completed the Family Introduction Form and the Complementary Feeding Transition Questionnaire. Data were analysed using descriptive statistics and χ2 tests. Among the infants, 50 % were aged between 10 and 12 months and 61·6 % were male. 50·8 % did not continue breast-feeding after the earthquake, 59·6 % of infants under one year were not breastfed, and only 19·2 % were exclusively breastfed for the first six months. Additionally, 58·3 % of the infants began complementary feeding before six months of age, and 49·5 % initiated complementary feeding with jarred baby food. A statistically significant difference was observed among the number of relocations, first-degree loss due to the earthquake and continuation of breast-feeding (P = 0·016 and P < 0·001, respectively). Mothers ceased breast-feeding after the earthquake and experienced a decline in milk supply; both relocation and the loss of a relative were found to adversely affect infant nutrition. To support optimal infant feeding, it is recommended that mothers be provided with comprehensive education and counselling on breast-feeding and transition to complementary foods.

This study aimed to develop an amino acid composition table for Japanese foods and evaluate the relative validity of the Meal-based Diet History Questionnaire (MDHQ) in estimating total and meal-specific amino acid intake, using a 4-d weighed dietary record (DR) as the reference. A total of 111 Japanese women and 111 Japanese men completed both online and paper MDHQ, along with a 4-d non-consecutive DR. The amino acid composition table was constructed based on the Standard Tables of Food Composition in Japan 2020. Median amino acid intakes estimated by the online MDHQ were generally lower than those from the DR across all calculation methods (crude, residual, density and %protein) in both sexes, with significant differences observed for most of the eighteen amino acids. Median Spearman’s correlation coefficients between the online MDHQ and DR for total amino acid intake were 0·43–0·44 in women and 0·31–0·37 in men. Concordance correlation coefficients (CCC) were lower than the corresponding Spearman coefficients, and Bland–Altman analyses showed wide limits of agreement with proportional bias. Similar findings were observed for the paper MDHQ. In conclusion, the MDHQ showed limited relative validity for ranking total and individual amino acid intakes at main meals, with weaker performance for snacks and limited ability to estimate absolute individual intakes. Despite these limitations, the MDHQ provides a novel approach for examining meal-specific dietary patterns and may offer useful insights in epidemiological studies when its limitations are appropriately considered.

While rapid four-compartment (4C) models have demonstrated cross-sectional validity in diverse populations, including athletes, their longitudinal validity remains unverified. This study aims to evaluate the longitudinal validity of utilising dual-energy X-ray absorptiometry (DXA)-derived estimates of body volume (BV) and bioelectrical impedance spectroscopy (BIS)-derived total body water (TBW) in rapid 4C models in athletes. Criterion 4C used DXA for bone mineral content, air displacement plethysmography for BV and 2H dilution for TBW. Analyses of longitudinal changes in fat mass (FM), in both kilograms and percentage, were performed in participants who experienced changes greater than 1 % (n 60) and in a subgroup exceeding the least significant change (1·97 kg, n 25). All alternative estimates underestimated changes relative to criterion 4C, with 4C TBWBIS providing the smaller mean difference (MD) (0·41 kg) and DXA the larger (0·94 kg). The MD for 4C BVSilvaTBWBIS and 4C BVHeymsfieldTBWBIS were 0·48 kg and 0·50 kg, respectively. Bland–Altman analyses showed wide limits of agreement (LOA) for all methods. Even the alternative with the smaller 95 % LOA had a wide LOA (4C TBWBIS: −2·9 %, 4·0 %, n 60). This investigation demonstrates that these rapid 4C models exhibit precision superior to or equivalent to DXA alone while offering reduced assessment times and broader accessibility than the criterion 4C. Regarding accuracy for evaluating changes over time, despite acceptable results at the group level, interpretation should be careful at the individual level.

Evidence on the association between the Mediterranean diet and premenstrual syndrome (PMS) remains inconclusive; therefore, this study examined the relationship between adherence to a Mediterranean-style diet and overall PMS severity and specific psychological and physical symptoms. This cross-sectional study included 606 women aged 18–35 years. Premenstrual symptoms and their severity were assessed using the validated Premenstrual Symptoms Screening Tool and the Calendar of Premenstrual Experiences. Adherence to the Mediterranean diet was assessed using a modified Mediterranean diet score (mMDS; range 0–9 points), derived from a validated 138-item semi-quantitative FFQ. Logistic regression was used to estimate OR with 95 % CI to examine the association between adherence to the Mediterranean-style diet and PMS severity. Three overall PMS severity groups were identified: No-PMS (21·8 %), Mild-PMS (50·2 %) and Moderate/Severe-PMS (28·0 %). No association was observed between adherence to the Mediterranean-style diet and overall PMS severity. Compared with women with Low mMDS (0–3 points), women with Moderate mMDS (4–5 points) had an OR of 1·11 (95 % CI 0·63, 1·94) for Moderate/Severe-PMS. Among women with High mMDS (6–9 points), the corresponding OR was 1·37 (95 % CI 0·75, 2·53). Of the thirty-two specific premenstrual symptoms, only headache was inversely associated with Mediterranean-style diet adherence in the Moderate v. Low mMDS group (OR = 0·75, 95 % CI 0·59, 0·95), but not in the High v. Low mMDS group (OR = 0·80, 95 % CI 0·63, 1·03). Given the lack of a significant association, further prospective and intervention studies are needed.

Low dietary diversity is a predictor of depression in high-income countries, but evidence from low-income settings where poor nutrition and depression often co-occur is scarce. We examined the association between dietary diversity and depression in rural Western Kenya. We conducted a cross-sectional analysis of data collected between June and August 2025 from 311 participants enrolled in a group-based microfinance (‘BIGPIC’) program. Depression was measured using twenty-item Centre for Epidemiologic Studies for Depression Scale, and dietary diversity was assessed based on the consumption of five food groups in the previous 24 hours using a validated scale. We used linear regression models to estimate the association between high dietary diversity and depression scores and assessed effect measure modification by wealth status. Quantile regression was used to examine variation across the distributions of depression scores. Higher dietary diversity was associated with lower depression scores (adjusted β (95 % CI): −3·49 (–6·62, −0·38)). This association was stronger among individuals with lower wealth (adjusted β (95 % CI): −6·00 (–10·46, −1·42)), compared with those with high wealth (adjusted β (95 % CI): −0·53 (–4·76, 3·68); Wald P–value for interaction = 0·0003). Effect sizes were larger at higher quantiles across 75th (Q75: β = −7·56; 95 % CI: −12·82, −2·27) and 90th (Q90: β = −6·01; 95 % CI: −12·43, 0·43) quantiles, though estimates were imprecise. These findings suggest that greater dietary diversity may be associated with improved mental health, particularly among socio-economically vulnerable individuals, and those with severe depression. Future work using longitudinal and quasi-experimental designs are needed to strengthen causal inference and clarify underlying mechanisms.