We conducted a systematic review and meta-analysis to quantify associations between overall and subtypes of CM, global/trait resilience, and five resilience domains (coping, self-esteem, emotion regulation, self-efficacy, and well-being) in adults, and to examine moderators and mediators of these associations. A systematic search was undertaken on 12 June 2024 to identify published peer-reviewed articles in five databases (PROSPERO-CRD42023394120). Of 15,262 records, 203 studies were included, comprising 145,317 adults (Mage = 29.62 years; 34.96% males); 183 studies and 557 effect sizes were pooled in random-effect meta-analyses. Overall CM and its subtypes were negatively associated with global/trait resilience and its domains (r = −0.081 to −0.330). Emotional abuse/neglect showed the largest magnitude of effect (r = −0.213 to −0.321). There was no meta-analytic evidence for an association between sexual abuse and coping, and physical abuse/neglect and self-esteem. Meta-regressions identified age, sample size, and study quality as moderators. Subgroup analyses found that associations between emotional abuse and emotion regulation were stronger, while associations between emotional abuse and self-esteem were weaker, in western versus non-western countries. No differences were found in associations between CM and resilience in clinical versus non-clinical samples. Narrative synthesis identified several mediators. Associations were of small magnitude and there were a limited number of studies, especially studies assessing CM subtypes, such as physical neglect, bullying, or domestic violence, and resilience domains, such as coping or self-efficacy, in males, and clinical samples. CM exposure negatively impacts resilience in adults, an effect observed across multiple maltreatment types and resilience domains. Interventions focused on resilience in adults with CM histories are needed to improve health and psychosocial outcomes.

Research on the association between the Chinese visceral adiposity index (CVAI) and hyperuricaemia (HUA) is scarce, and whether the association differs by sex is unclear. This research aimed to explore sex-specific associations between CVAI and HUA and to compare CVAI’s predictive performance with other adiposity indices using data from 22 171 adults (30–79 years) in the China Multi-Ethnic Cohort study (Chongqing region). The prevalence of HUA was 20·9 % in men and 9·7 % in women. Multivariable logistic regression analyses were utilised to assess the adjusted OR and 95 % CI. After multivariable adjustment, CVAI was associated with HUA in men (OR Q4 v. Q1 = 3·31, 95 % CI 2·73, 4·03) and women (OR Q4 v. Q1 = 7·20, 95 % CI 5·12, 10·12). Moreover, significant interactions were observed between BMI and CVAI on HUA in both sexes (all Pinteraction < 0·001), with the strongest associations in those with BMI < 24·0 kg/m2. The OR (95 % CI) across different BMI groups (< 24·0, 24·0–27·9, ≥ 28·0 kg/m²) were 1·87 (1·63, 2·13), 1·65 (1·48, 1·85) and 1·30 (1·14, 1·49) for men and 2·76 (2·18, 3·51), 2·46 (1·98, 3·07) and 1·87 (1·47, 2·39) for women, respectively. Additionally, CVAI showed satisfactory predictive performance for HUA in women, with the largest area under the receiver operating characteristic curve of 0·735, but not in men (0·660). These findings suggest a close association between CVAI and HUA, particularly pronounced in those with BMI < 24·0 kg/m², and a stronger association in women than in men.

Many people with rheumatoid arthritis (RA) believe that certain foods may influence disease activity. Elimination reintroduction diets and oral food challenges are dietary strategies used to identify foods that may exacerbate symptoms. This review summarises and appraises the literature on elimination diet interventions that include food reintroductions or oral food challenges in adults with RA. It describes study design, measures used to assess the effects of food exclusion and challenge, foods identified that may affect RA symptoms, and the measures used to assess the outcome of excluding those foods. A search of five databases, two thesis repositories and Open Grey was conducted to identify records published from inception to January 2025, using terms related to RA, elimination diets and food sensitivity. Eligible records were screened independently by two reviewers, and data extraction followed Joanna Briggs Institute guidelines. Data are presented using a narrative synthesis approach with descriptive data analysis. In total, forty-eight records met inclusion criteria comprising twenty intervention studies (sample sizes 4–94) and seventeen case studies, conducted across twelve countries (1949–2024). Interventions included single-food exclusions, few-food diets, low-allergen meal replacements and fasting protocols. Reintroduction methods varied from a single-food challenge to multiple reintroductions, with five studies using blinded challenges. Outcome measures included physician- or participant-observed symptom changes, clinical assessments and laboratory measures, though these were heterogeneous. Findings reveal a lack of standardised protocols, dated methodologies and limited contemporary research. Controlled studies are needed to establish evidence-based protocols, investigate mechanisms, and guide dietary strategies as adjuncts to RA pharmacological treatment.

Evidence of an association between metabolic syndrome (MetS) and irritable bowel syndrome (IBS) is emerging but is still inconclusive. The current cross-sectional study was conducted to explore the relationship between the two syndromes in a sample of Lebanese adults (n 221; mean age: 43·36 years; 62·9 % females), recruited from a large urban university and its neighbouring community. MetS was diagnosed based on the International Diabetes Federation criteria, and IBS was assessed using the Birmingham IBS scale. Logistic regression analyses were performed taking MetS and its components as dependent variables and IBS and its subscales as independent variables. Covariates included socio-demographic, dietary and lifestyle variables. MetS was positively associated with visual analogue scale (VAS) IBS (total scale (Beta = 4·59, P = 0·029) and VAS–diarrhoea subscale (Beta = 4·96, P = 0·008). Elevated blood pressure (Beta = 5·02, P = 0·007), elevated fasting blood sugar (Beta = 4·19, P = 0·033) and elevated waist circumference (Beta = 5·38, P = 0·010) were positively associated with VAS–Diarrhoea subscale. MetS and IBS were found to be positively associated in a sample of the Lebanese adult population. We suggest that it might be of value to screen for either condition if one of the syndromes exists. Future longitudinal studies are essential to establish a causal relationship between the two syndromes to further understand the commonality related to pathogenesis and explore potential underlying mechanisms.

The marketing of unhealthy foods has been implicated in poor diet and rising levels of obesity. Rapid developments in the digital food marketing ecosystem and associated research mean that contemporary review of the evidence is warranted. This preregistered (CRD420212337091)1 systematic review and meta-analysis aimed to provide an updated synthesis of the evidence for behavioural and health impacts of food marketing on both children and adults, using the 4Ps framework (Promotion, Product, Price, Place). Ten databases were searched from 2014 to 2021 for primary data articles of quantitative or mixed design, reporting on one or more outcome of interest following food marketing exposure compared with a relevant control. Reviews, abstracts, letters/editorials and qualitative studies were excluded. Eighty-two studies were included in the narrative review and twenty-three in the meta-analyses. Study quality (RoB2/Newcastle–Ottawa scale) was mixed. Studies examined ‘promotion’ (n 55), ‘product’ (n 17), ‘price’ (n 15) and ‘place’ (n 2) (some > 1 category). There is evidence of impacts of food marketing in multiple media and settings on outcomes, including increased purchase intention, purchase requests, purchase, preference, choice, and consumption in children and adults. Meta-analysis demonstrated a significant impact of food marketing on increased choice of unhealthy foods (OR = 2·45 (95 % CI 1·41, 4·27), Z = 3·18, P = 0·002, I2 = 93·1 %) and increased food consumption (standardised mean difference = 0·311 (95 % CI 0·185, 0·437), Z = 4·83, P < 0·001, I2 = 53·0 %). Evidence gaps were identified for the impact of brand-only and outdoor streetscape food marketing, and for data on the extent to which food marketing may contribute to health inequalities which, if available, would support UK and international public health policy development.

This study investigated the association between screen time and ultra-processed food (UPF) consumption across the lifespan, using data from the 2019 Brazilian National Health Survey, a cross-sectional and population-based study. A score was used to evaluate UPF consumption, calculated by summing the positive answers to questions about the consumption of ten UPF subgroups on the previous day. Scores ≥5 represented high UPF consumption. Daily time spent engaging with television or other screens was self-reported. Crude and adjusted models were obtained through Poisson regression and results were expressed in prevalence ratios by age group. The sample included 2315 adolescents, 65 803 adults and 22 728 older adults. The prevalence of UPF scores ≥5 was higher according to increased screen time, with dose–response across all age groups and types of screen time. Adolescents, adults and older adults watching television for ≥6 h/d presented prevalence of UPF scores ≥5 1·8 (95 % CI 1·2, 2·9), 1·9 (95 % CI 1·6, 2·3) and 2·2 (95 % CI 1·4, 3·6) times higher, respectively, compared with those who did not watch television. For other screens, the prevalence of UPF scores ≥5 was 2·4 (95 % CI 1·3, 4·1) and 1·6 (95 % CI 1·4, 1·9) times higher for adolescents and adults using screens for ≥ 6 h/d, respectively, while for older adults, only screen times of 2 to < 3 and 3 to < 6 h were significantly associated with UPF scores ≥5. Screen time was associated with high consumption of UPF in all age groups. Considering these associations when planning and implementing interventions would be beneficial for public health across the lifespan.

It is well-known that many modern lifestyles, including the use of artificial light, shift work, irregular or short sleep, sedentary activity, and unhealthy diet can disrupt the circadian rhythm. This disruption can result in the so-called Circadian Syndrome (CircS) which has been identified as a risk factor for a variety of chronic diseases. The concept of Circadian Syndrome (CircS) was first proposed by Zimmet et al in 2019. CircS has been shown to be a better predictor for cardiovascular diseases (CVD) than the metabolic syndrome (MetS) in adults in China and USA 1,2. Dietary patterns are found to be associated with CircS 3, whereby western dietary pattern was positively related, while prudent pattern was inversely associated, with CircS in the US adults. However, no prior study has investigated the association between fiber intake and CircS. We, thus, aimed to fill this research gap. We analysed data from 10,486 adults aged 20 years and above years who attended the 2005-2016 National Health and Nutrition Examination Survey (NHANES). Fiber and other nutrients intake were assessed using two days 24 hours recall. CircS was derived from all five components of MetS (i.e. central obesity, elevated fasting glucose, elevated triglyceride, reduced HDL-Cholesterol and elevated blood pressure), in addition to short sleep (sleep duration <6 hours/day) and depressive symptoms (PHQ-9 score ≥5). A cut-off for CircS was set as ≥ 4 components. Multivariable logistic regression was used to assess the association between fiber intake and CircS. Mean age of participants was 50.3(SD 17.6) years, and 41.3% had CircS. The mean (SD) fiber intake was 7.8 (2.1), 12.9 (1.3), 17.9 (1.7), and 28.9 (8.2) g/day across the quartiles of fiber intake. The prevalence of CircS decreased across quartiles of fiber intake (44.5% in Q4 and 37.1% in Q1). In the multivariable logistic model adjusting for age, gender, ethnicity, energy intake, education and lifestyle factors, across the quartiles of fiber intake, the odds ratios (ORs) (95%CI) for CircS were: 1.00, 0.91 (0.76-1.08), 0.82 (0.70-0.96), 0.79 (0.63-0.98) (p trend 0.012), respectively. No significant interactions were found between fiber intake and race, gender, smoking, alcohol drinking, and physical activity, in relation to CircS. In conclusion, a high fiber intake was associated with a lower prevalence of CircS among US adults. The findings highlight the importance of fiber intake for the prevention of metabolic and circadian syndrome, suggesting a potentially accessible and cost-effective lifestyle approach to improve public health. Our results underscore the concern that most of the US adults had fiber intake below the recommended level. Longitudinal studies are needed to validate the findings in different populations.

Adequate dietary fibre (DF) intake is recommended to relieve constipation and improve gut health(1). It is often assumed that individuals with constipation have relatively low DF intake and do not meet the recommended adequate intake of 25 g and 30 g for females and males, respectively. The 2008/09 New Zealand Adult Nutrition Survey confirmed that the mean DF was 17.9 grams (g) per day for females and 22.8 g per day for males, which was well below the recommended adequate intake(2). With the continuous shift of dietary patterns over time, we sought to compare the current usual DF intake of two cohorts of New Zealand adults: those who have constipation with those without constipation but with relatively low DF intake. We report baseline dietary data from two randomised controlled dietary studies (Kiwifruit Ingestion to Normalise Gut Symptoms (KINGS) (ACTRN12621000621819) and Bread Related Effects on microbiAl Distribution (BREAD) (ACTRN12622000884707)) conducted in Christchurch, New Zealand in 2021 and 2022, respectively. The KINGS study included adults with either functional constipation or constipation-predominant irritable bowel syndrome to consume either two green kiwifruit or maltodextrin for four weeks. The BREAD study is a crossover study and included healthy adults without constipation but with relatively low DF intake (<18 g for females, <22 g for males) to consume two types of bread with different DF content, each bread for four weeks separated by a two-week washout period. All participants completed a non-consecutive three-day food diary at baseline. Dietary data were entered into FoodWorks Online Professional (Xyris Software Australia, 2021) to assess mean daily DF intake. Fifty-six adults from the KINGS study (n = 48 females, n= 8 males; mean age ± standard deviation: 42.8 ± 12.6 years) and BREAD study (n = 33 females, n= 23 males; mean age: 40.4 ± 13.4 years) completed a baseline food diary. In the KINGS study, females with constipation had a daily mean DF intake of 25.0 ± 9.4 g whilst male participants consumed 26.9 ± 5.0 g per day. In the BREAD study, females without constipation had a mean daily DF intake of 19.4 ± 5.8 g, whereas males had 22.6 ± 8.5 g per day. There was a statistically significant difference in the mean daily DF intake between females with constipation and those without constipation (p < 0.001) but not between males (p = 0.19). These two studies found that DF intakes among females with constipation were not as relatively low as previously assumed, as they met their adequate intake of 25 g. Further data analysis from the KINGS and BREAD studies will reveal the effects of using diet to manage constipation and promote better gut health in these two cohorts of New Zealand adults.

Cow’s milk is the primary source of calcium in the NZ diet(1). The absence of dietary planning in a vegan diet can result in the individual unknowingly obtaining low intakes of calcium. Prolonged low calcium intakes can result in negative implications on bone mineral density by increasing the risk of osteoporosis later in life. The measurement of bone health parameters in NZ vegan adults have not been investigated. Therefore, we measured bone mineral density, markers of calcium homeostasis and assessed intake of essential nutrients for optimal bone health in vegans. This cross-sectional study included adults (>18yrs), who followed a vegan diet for 2 years minimum. Demographic and lifestyle information was obtained from questionnaires including previous history of bone fractures and background of familial osteoporosis. A 4-day food record was completed for analysis of calcium, zinc, protein, magnesium, phosphorus and vitamin C intake and compared to the Estimated Average Requirement (EAR)(2). Weight, height and BMI were obtained, bone mineral density was measured at the hip and spine via dual x-ray absorptiometry (DXA) and reported as Z and T scores. Plasma calcium concentrations were corrected for albumin. All values are presented as mean and standard deviation. The study included 212 participants, aged 39 ± 12.38 years, 71% female. T scores at the lumbar spine and femoral neck were −0.63 ± 1.22 (Z score: −0.29 ± 1.12) and −0.66 ± 1.00 (Z score: −0.24 ± 0.89), respectively. Nine participants had a Z-score of <-2.0 at the lumbar spine, and three at the femoral neck. Corrected calcium concentrations were 2.21 ± 0.33 mmol/L. Calcium intake was 917 ± 347.23 (range 195 to 2,429 mg/day) in all participants, which exceeded the EAR of 840 mg/day for adults aged 19-50 years. Men had higher intakes of calcium than women, 1,051 ± 363.7 mg/day (range 382 to 2,267 mg/day) vs. 867 ± 328.04 mg/day (range 194 to 2,428 mg/day), P-value <0.001. The main source of calcium in the vegan diet was tofu. The intake of protein (77 ± 27.80) g/day, magnesium (569 ± 181.05) mg/day, and vitamin C (145 ± 96.94) mg/day met the EAR, excluding vitamin and mineral supplements. However, the intake of phosphorus (1,472 ± 459.98) mg/day and zinc (10.6 ± 4.01) mg/day were below the EAR. The findings of this study suggest that bone health of vegans are not negatively affected by the exclusion of dairy in the diet, provided that appropriate dietary planning is included to avoid nutrient deficiencies associated with poor bone health. Despite mean intake of calcium exceeding the EAR, very low intakes demonstrated significant variations between participants.