Meta-analysis is a cornerstone of evidence synthesis, yet challenges arise when studies report heterogeneous summary statistics, such as means and standard deviations (SDs) versus medians, interquartile ranges (IQRs), or other percentiles. Excluding studies that report only medians and IQRs can introduce bias and reduce precision, particularly when outcomes are skewed, which is common in clinical research. Although several methods exist to estimate means and SDs from alternative summaries, many rely on strong normality assumptions, exhibit computational burden, or fail to adequately account for the precision of reported quantiles (e.g., extreme values versus medians). To address these limitations, we propose two flexible weighted estimators for estimating the mean and SD from reported quantiles. The methods leverage inverse-variance and inverse–variance–covariance weighting, respectively, to enhance both accuracy and precision. Additionally, our methods are flexible enough to accommodate any set of reported quantiles and various underlying distributions, and they can be readily implemented using standard statistical software. Simulation studies demonstrate that the weighted estimators provide nearly unbiased estimates of the mean and SD with high precision in most cases, especially for large sample sizes. In a real-world meta-analysis, the estimates obtained using the proposed estimators closely aligned with those derived from true sample statistics. These approaches are particularly valuable for skewed outcomes and offer a practical and user-friendly solution for researchers seeking to integrate heterogeneous data while improving accuracy and precision.

Malnutrition remains a major public health issue in Sub-Saharan Africa, with one-third of all malnourished children residing in the region. In Malawi, 37.1% of children under five are stunted, and 63% are anaemic. Poor diets and poverty contribute significantly. Legumes, being rich in protein, fibre, and micronutrients, offer a sustainable food-based approach to improve child nutrition and support local agriculture. This study aimed at assessing the association between legume consumption and nutritional status in children aged 6–59 months in rural Malawi. A community-based cross-sectional study was conducted in Mzimba, Mchinji, and Mangochi districts, involving 1275 children. Data were collected on dietary intake, socioeconomic status, and anthropometry using semi-structured questionnaires. Nutritional status was determined using WHO Anthro, and associations were analysed using logistic regression in Stata. Prevalence of stunting was 42.8%, underweight 17.4%, and wasting 8.4%. Over half of the children did not consume legumes. Pigeon pea consumption significantly reduced odds of wasting (AOR = 0.14), and common beans were associated with lower odds of both wasting and stunting. Conversely, groundnut consumption was linked to increased underweight (AOR = 1.68). Animal food consumption was associated with lower underweight but higher odds of wasting. Legume consumption showed both protective and adverse associations with child malnutrition. In conclusion, this study has shown that promoting dietary diversity and appropriate legume use could enhance nutrition outcomes. Findings highlight the potential of legumes in addressing undernutrition but also the need for targeted nutrition education and interventions in rural Malawi.

Alpha-ketoglutarate (AKG) is a well-known intermediate of the tricarboxylic acid cycle and plays an important role in the catabolism of branched-chain amino acids (BCAAs: leucine, isoleucine, and valine). While previous study suggested that AKG enhances glucose metabolism, its effect on the adaptation of muscles and adipocytes has not been well studied in diabetic condition. This study aimed to determine whether AKG improves glucose metabolism in the skeletal muscles and adipose tissues in diabetic mice. Male institute of cancer research mice were divided into control, diabetic, and diabetic + AKG groups. Diabetes (DM) was induced by a high fat diet consumption and streptozotocin (STZ) injection. Mice in the DM + AKG group were administered 1% AKG in drinking water for 6 weeks. The non-fasting plasma glucose level was significantly higher in the diabetic group than that in the control and DM + AKG groups (P < 0.05). No significant difference was observed in glucose transporter 4 (GLUT4) protein levels in the muscles between the DM and DM + AKG groups. AKG supplementation attenuated the decrease in peroxisome proliferator-activated receptor γ coactivator 1 alpha and GLUT4 protein levels in inguinal and epididymal adipose tissues in diabetic condition. In conclusion, the study findings suggested that AKG supplementation increased protein levels related to mitochondrial biogenesis and glucose transporters in adipocyte tissue accompanied with improved whole-body glucose metabolism in STZ and high-fat diet-induced diabetic mice.

A significant association between tomato consumption and a lower risk of developing hypertension has been reported. In this study, we aimed to investigate the relationship between tomato intake and prehypertension risk among Korean adults. Hypertension was defined according to the criteria established by the Korean Society of Hypertension. The study participants were selected from the Health Examinees cohort study. Tomato consumption was measured using an FFQ and categorised into quintiles based on the amount consumed. Higher tomato consumption was associated with a lower risk of prehypertension in men (hazard ratio (HR) 0·86, 95 % CI 0·80, 0·92, Pfor trend 0·0005). Women in the highest quintile also showed a similar trend (HR 0·94, 95 % CI 0·90, 0·99, Pfor trend 0·0091). Stratified analyses revealed a reduced risk of prehypertension across all subgroups, except underweight individuals and those with a history of alcohol consumption (all Pfor interaction < 0·05). These findings indicate that higher tomato intake may offer potential advantages for managing blood pressure levels.

Household food security plays a critical role in determining the nutritional status of children, which in turn impacts their growth and development. This study assessed factors influencing household food security and childhood nutritional status and explored the relationship between these variables in Namutumba District. A total of 299 child-caregiver pairs participated in the study. Data were collected through structured interviews and analyzed, with multi-level mixed effects generalized linear models to examine factors associated with severe household food insecurity and children’s nutritional status. Multilinear regressions were used to evaluate the relationship between severe household food insecurity and child nutritional status. The results revealed that most households (60.2%) were severely food insecure. A double burden of malnutrition was observed, with 28.0% of children stunted and 2.8% overweight or obese. Factors positively associated with improved household food security included secondary-level education (p = 0.011), medium to high wealth percentile (p < 0.001), and the presence of at least one income-earning household member (p = 0.045). Conversely, lack of access to agricultural land, food stocks, and access to treated drinking water were significantly linked to severe food insecurity (p < 0.001). Severe food insecurity was positively associated with wasting (β = 0.81, p = 0.007) and negatively associated with stunting (β = −0.37, p = 0.039). In conclusion, multiple factors influence household food security, and the nutritional status of children aged 24–59 months. A comprehensive, food systems-based approach may be key to addressing malnutrition in Namutumba District.

Family meals are positively associated with healthier diets among children and parents. We aimed to deepen the understanding of these relationships by exploring the associations between shared meals and dietary quality among children, fathers and mothers. A subset of parent-child dyads (296 children aged 3–6 years, 103 fathers, 293 mothers) from the DAGIS Intervention baseline assessment was included in this cross-sectional study. The parents reported how often they shared meals with the child and filled in a food frequency questionnaire assessing their child’s and their own food consumption. A Healthy Food Intake Index (HFII) describing dietary quality was calculated for all family members. We used linear regression to investigate the associations between shared meals and the HFII of the children, fathers and mothers. Models were adjusted for child’s age and gender, parent’s age and educational level and number of children in the household. Children whose fathers reported less frequently sharing a weekend lunch with the child had a lower HFII (B estimate –1·58, 95 % CI –2·66, –0·50). The association remained close to statistical significance with adjustments (B estimate –0·99, 95 % CI –2·17, 0·19). A less frequently shared weekend lunch was also borderline significantly associated with lower HFII among the fathers (adjusted model, B estimate –1·13, 95 % CI –2·30, 0·04). Fathers should be encouraged to share meals with their family, since it might have a role in the dietary quality of both children and fathers. Future studies should recognise fathers as important contributors to a healthy home food environment.

Children with moderate acute malnutrition (MAM) have an increased risk of iron deficiency, anaemia and death from infectious diseases. The iron-regulating hormone hepcidin is increased in inflammation and may be important in regulating iron metabolism in children with MAM. Asymptomatic malaria has previously been associated with elevated s-hepcidin. We assessed the association between inflammation, iron status, anthropometry and malaria and serum hepcidin (s-hepcidin) and evaluated the effect of food supplementation on s-hepcidin in a secondary analysis in 1019 children with MAM from a randomised intervention trial in Burkina Faso. Children received 12 weeks of supplementation of 500 kcal/d as either corn–soy blend (CSB) or lipid-based nutritional supplements (LNS). S-hepcidin was measured at baseline and after 12 weeks. At baseline, correlates of s-hepcidin were determined using Tobit regression. The effect of supplementation was determined using mixed effects Tobit regression. Children with iron deficiency had 82 % (95 % CI 76, 87) lower s-hepcidin than those without, whereas children with acute infection and inflammation had elevated s-hepcidin. Children with symptomatic malaria had 103 % (95 % CI 32, 210) higher s-hepcidin than afebrile children without detectable malaria, while children with recent or asymptomatic malaria had 51 % (95 % CI 35, 63) lower s-hepcidin. S-hepcidin increased 61 % (95 % CI 38, 87) after 12 weeks of food supplementation with 22 % higher (95 % CI 2, 45) concentration in those who received LNS compared with CSB. Expectedly, morbidity and inflammation were associated with higher, and iron deficiency with lower, s-hepcidin. Further studies are needed to corroborate the finding of decreased s-hepcidin in malnourished children with asymptomatic malaria.

Adolescents from low-income households are at increased risk of growth failures due to inadequate food intake. This cross-sectional study assessed dietary practices and nutritional status according to FANTA measurement standards. Among 610 randomly selected adolescents attending public primary schools in rural and semi-urban Kuyu district. Dietary diversity and anthropometric measurements (height, weight, and Body Mass Index) were collected and analysed using SPSS version 26 and WHO Anthro Plus software. The study population included 36% females and 69% semi-urban residents. Dietary analysis revealed that most adolescents consumed two or fewer daily meals, primarily cereals and legumes. Over 90% of the households consumed less than four food groups during the 7-day recall period. The anthropometric assessment showed significant undernutrition: 19% of early adolescent girls and 34% of late adolescent boys were underweight; 27.5% were stunted; 8% and 5.9% had moderate and severe undernutrition, respectively; and 13.8% exhibited thinness, with boys more affected (35%) than girls (10%). Additionally, 7% were overweight, and 64% presented single, double, or triple growth failures. Regression analysis showed that Children in female-headed households had 1.7 times higher odds of stunting, adolescent girls had 1.8 times higher odds of thinness, late adolescents had 70% lower odds of being overweight, and adolescents from households with off-farm activities had 4.5 times higher odds of being overweight. Inadequate meal frequency and limited dietary diversity contribute to the high prevalence of undernutrition among Kuyu district adolescents. A school feeding programme is strongly recommended.

This pilot study evaluated the effect of an online cooking intervention: Up for Cooking. Seventy-three Dutch families participated in four 1.5-hour sessions, before which they received ingredients and intervention materials. Parental questionnaires (pre-post) assessed food literacy skills (planning, selecting and making a healthy meal), knowledge and self-efficacy towards cooking and healthy eating (quantitative). Interviews assessed whether families changed their cooking behaviour at home (qualitative). A Wilcoxon Signed Rank test and inductive thematic coding were used. Thirty-nine parents completed questionnaires and eleven parents participated in interviews. Scores on food literacy items related to selecting and making a healthy meal improved significantly post-intervention. Parents’ knowledge of healthy eating and self-efficacy in cooking with their children also improved significantly. Interviews revealed an increased involvement of children in meal preparation and positive changes in family cooking behaviour. This online cooking intervention is a promising nutrition intervention, but implementation and long-term changes need further exploration.

High-fat diets are closely implicated in the pathogenesis of chronic conditions, including obesity and hepatic steatosis. Recently, coconut oil, which is rich in medium-chain fatty acids, has attracted significant attention for its potential anti-obesity and anti-inflammatory properties. This study aimed to evaluate the effects of medium-chain fatty acids derived from coconut oil on metabolic disorders, particularly fatty liver, using a mouse model established by a high-fat diet. C57BL/6J mice were assigned to either the lard diet group or the coconut oil diet group and fed for 12 weeks. Glucose tolerance was assessed, and biochemical parameters, liver histology, and gene expression in the liver were analysed. Additionally, the concentrations of medium-chain fatty acids within the liver were determined through gas chromatography-mass spectrometry analysis. Mice fed a coconut oil diet exhibited suppressed weight gain and improved glucose tolerance compared to mice fed a lard diet. Furthermore, the coconut oil diet resulted in reduced hepatic fat accumulation, decreased expression levels of genes implicated in inflammation and lipid metabolism within the liver, and higher concentrations of medium-chain fatty acids in the liver. Coconut oil may contribute to the suppression of hepatic fat accumulation in the liver and the prevention of non-alcoholic fatty liver disease/metabolic dysfunction-associated steatotic liver disease by increasing the levels of medium-chain fatty acids in the liver and suppressing the expression of genes implicated in inflammation and lipid metabolism.

Cross-cutting issues like nutrition have not been adequately addressed for children with severe visual impairment studying in integrated schools of Nepal. To support advocacy, this study aimed to determine the nutritional status of this vulnerable group, using a descriptive cross-sectional design involving 101 students aged 5–19 years from two integrated public schools near Kathmandu Valley and two in western Nepal. The weight-for-age z-score (WAZ), height-for-age z-score (HAZ), and body mass index-for-age z-score (BAZ) were computed and categorised using World Health Organization cut-off values (overnutrition: z-score > +2.0 standard deviations (SD), healthy weight: z-score −2.0SD to +2.0SD, moderate undernutrition: z-score ≥ −3.0SD to <−2.0SD, severe undernutrition: z-score < −3.0 SD) to assess nutritional status. A child was considered to have undernutrition for any z-scores <−2.0SD. Multivariate logistic regression was used to analyse variables linked to undernutrition. The mean age of participants was 11.86 ± 3.66 years, and the male-to-female ratio was nearly 2:1. Among the participants, 71.29% had blindness, and 28.71% had low vision. The mean BAZ and HAZ scores decreased with age. The WAZ, HAZ, and BAZ scores indicated that 6.46% were underweight, 20.79% were stunted, and 5.94% were thin, respectively. Overall, 23.76% of students had undernutrition and 7.92% had overnutrition. More than three in ten students had malnutrition and stunting was found to be prevalent. Older students and females were more likely to have undernutrition. These findings highlight the need for nutrition interventions within inclusive education settings, particularly targeting girls with visual impairments who may face compounded vulnerabilities.

Infants born at high altitudes, such as in the Puno region, typically exhibit higher birthweights than those born at low altitudes; however, the influence of ethnicity on childhood anthropometric patterns in high-altitude settings remains poorly understood. This study aimed to characterise the nutritional status, body composition and indices, and somatotype of Quechua and Aymara children aged 6–10 years. A cross-sectional, descriptive, and comparative design was employed, with a simple random sampling of children from six provinces representative of the Puno region, including 1,289 children of both sexes. Twenty-nine anthropometric measurements were taken, and fat, muscle, and bone components were assessed using bioelectrical impedance analysis. Standardised equations were applied to determine body indices. Among the findings, most children presented normal nutritional status according to BMI-for-age and height-for-age Z-scores. However, high rates of overweight and obesity were observed in Aymara (39%) and Quechua (28.4%) children, with differences in fat content between ethnic groups at the 5th, 10th, 50th, and 75th percentiles. Both groups were characterised by brachytypy and brachybrachial proportions; Quechua children were mesoskelic and Aymara brachyskelic, with macrocormic proportions, rectangular trunks, and broad backs. The predominant somatotype was mesomorphic, with a stronger endomorphic tendency among Aymara. It is concluded that both groups exhibit normal nutritional status; however, Aymara children show a greater tendency towards fat accumulation and notable morphological differences. Differences were also observed in limb proportions, particularly a relatively shorter lower limb.

We aimed to compare the mean sodium content of New Zealand (NZ) packaged breads in 2013 and 2023 and assess compliance with the NZ Heart Foundation (HF) and World Health Organization (WHO) sodium reduction benchmarks. Sodium data were obtained from a supermarket food composition database. Mean differences between years were assessed using independent samples t-tests and chi-square tests. There was a significant reduction in the sodium content of all bread from 2013 (n=345) to 2023 (n=309) of 46 mg/100g (p<0.001). In 2013, 20% (n=70/345) of breads met the HF benchmarks, and 10% (33/345) met the WHO benchmarks; corresponding values for 2023 were 45% (n=138/309) and 18% (n=57/309) (p<0.001 for both). If continued, the modest reduction in sodium content and increase in the percentage of NZ breads meeting relevant sodium reduction benchmarks could positively affect public health, particularly if extended across the packaged food supply.

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.