Understanding children’s diet quality is crucial for developing effective interventions to address dietary-related issues. Thus, this study examines the distribution of energy and nutrient intakes across meals and snacks among primary schoolchildren aged 6·0–12·9 years in Peninsular Malaysia and the implications of meal skipping on their nutritional status. Data from 1102 children in Peninsular Malaysia from the South East Asian Nutrition Surveys (SEANUTS) II were analysed. Children’s height, weight and waist circumference were measured. Questionnaires captured sociodemographic information and meal consumption patterns. Nutrient distribution across meals and snacks was assessed through a 1-d 24-h dietary recall approach. Logistic regression analysed the association between meal skipping and nutritional status. Breakfast contributed significantly to essential micronutrients but provided the least energy and macronutrients compared with lunch and dinner. Approximately one-third of daily nutrient intake came from snacking, with contributions ranging from 25 % for cobalamin to 36 % for both Ca and thiamine. Children who skipped main meals had higher odds of being overweight/obese (skipped one type of meal at least once weekly (1·59; 95 % CI (1·08, 2·33)); skipped > 1 type of meal (1·77; 95 % CI (1·12, 2·79)) and abdominal obese (skipped > 1 type of meal (1·91; 95 % CI (1·17, 3·12))). In conclusion, primary schoolchildren in Peninsular Malaysia tended to have higher micronutrient intakes at breakfast and higher energy and macronutrients in subsequent main meals. Meal skipping was linked to elevated body fat. This study underscores the need to prioritise continued education on the importance of healthy dietary habits among children.

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.

Given there is no prospective research evidence on the association between ultra-processed food (UPF) intake and human bone health, this study aimed to analyse the associations of UPF intake with bone mineral density (BMD) and risk of fractures using data from 163 855 participants in the UK Biobank. Multiple linear regression assessed BMD, and Cox regression models estimated fracture risk. Restricted cubic splines were used to evaluate non-linearity. Participants’ average age was 56·0 years, with 1097 hip fractures and 7889 all fractures recorded over 12·0 years of follow-up. Complex inverted U-shaped associations between UPF intake and BMD were found at the femur trochanter. Compared with the lowest UPF intake, the highest UPF intake was linked to a reduction in BMD at the femoral neck (β(se) = −0·0061 (0·0024), P < 0·05), femur trochanter (β(se) = −0·0083 (0·0024), P < 0·001), lumbar spine (β(se) = −0·0114 (0·0036), P < 0·01) and total body (β(se) = −0·0095 (0·0021), P < 0·001). The link was more pronounced in participants under 65 years of age and those who were underweight (Pinteraction < 0·01). Per sd increment of UPF intake was linked to 10·5 % and 2·7 % higher risks of incident hip fractures (hazard ratio (HR), 95 % CI 1·105, 1·029, 1·186; P < 0·01) and all fractures (HR, 95 % CI 1·027, 1·000, 1·055; P < 0·05), respectively. Our results suggest that higher UPF intake is associated with lower BMD and increased risk of fractures captured in hospital inpatient records, highlighting the need for dietary interventions to protect bone health.

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.