We have used multiple regression analyses to develop a series of metabolisable energy prediction equations from chemical analyses of pig diets that can be extended to murine diets. We compiled four datasets from an extensive range of published metabolism studies with grower/finisher and adult pigs. The analytes in the datasets were increasingly complex, comprising (1) the proximate or Weende analysis, (2) the previous analysis but with neutral detergent fibre replacing crude fibre, (3) the neutral detergent fibre package plus starch and (4) the neutral detergent fibre package plus starch and sugars. Diet manufacturers routinely provide most of the analytes for batches of murine diet, or they are easily obtainable. The study uniquely compares the four analytical packages side by side. The number of records in the datasets varies from 367 to 827. With increasing analytical complexity, adjusted R2 values for metabolisable energy prediction improved from 0·751 to 0·869 and the mean absolute error from 0·422 to 0·289 kJ/g. Overall, the models’ prediction interval improved from 1 to 0·7 kJ/g, which is ± 7 to 5 % for a typical dietary metabolisable energy density of 14·8 kJ/g. Although prediction accuracy increases as one extends the range and complexity of the analytes measured, the improvement is slight and may not justify the substantial increase in analytical cost. The equations were validated for use on future datasets by k-fold analysis. Although the equations are developed from pig data, they are suitable for rat and mouse diets, based on comparable digestibility measurements, and substantially improve existing methods.

A hospital-based cross-sectional study involving children aged 2–15 years attending the obesity clinic of a tertiary care hospital from January 2016 to March 2018 was carried out to study carotid intima media thickness (cIMT) and its association with cardiometabolic risk factors in children with overweight and obesity. Secondary objective was to compare children with elevated (EcIMT) and normal cIMT (NcIMT). Out of 223 patients enrolled for the study, 102 (45·7 %) had EcIMT. Mean cIMT of the study participants was 0·41 (sd 0·13) mm. Median alanine transaminase levels (27 v. 24, P= 0·006) and proportion of patients with fatty liver (63·7 % v. 48·8 %, P= 0·025) and ≥ 3 risk factors (80·4 % v. 66·1 %, P= 0·003) were higher in the EcIMT group compared with NcIMT group. Proportion of patients with hypercholesterolemia (36·4 % v. 16 %, P= 0·024), elevated LDL-cholesterol (38·6 % v. 16 %, P= 0·013), low HDL-cholesterol (40·9 % v. 20 %, P= 0·027) and dyslipidemia (84·1 % v. 58 %, P= 0·006) was higher in the pubertal EcIMT group and those with fatty liver (63·8 % v. 45·1 %, P= 0·034) was higher in the prepubertal EcIMT group compared with pubertal and prepubertal NcIMT groups, respectively. No significant correlations were observed between cIMT and various cardiometabolic parameters. Our finding of EcIMT in nearly half of the study participants including young children is very concerning as these children are at increased risk of atherosclerotic CVD in adulthood. Interventions starting at a young age are important when trajectories are likely to be more malleable and adverse cardiometabolic phenotypes and subclinical atherosclerosis are reversible.

Vitamin K exists naturally in foods as phylloquinone (vitamin K1, PK) and as a range of menaquinones (vitamin K2, MK). There is scarce information on the occurrence and distribution of PK and MK in dietary sources, particularly in seafood. This study aimed to comprehensively analyse the contents of vitamin K1, dihydro-K1, and MK-4 to MK-10 in various species, tissue types and processing degrees of shellfish. Additionally, seasonal differences in the vitamin K content of blue mussels (Mytilus edulis) were explored. Most shellfish products had low contents of total vitamin K (< 10 µg/100 g). The highest content of total vitamin K was found in the hepatopancreas of snow crab (170 µg/100 g), the brown meat of brown crab (35 µg/100 g), pre-packaged blue mussels (20 µg/100 g), stuffed brown crab shells (15 µg/100 g) and blue mussels in brine (12 µg/100 g). In general, the hepatopancreas of crustaceans contained considerably higher contents of vitamin K than their white meat counterparts. MK contributed most to total vitamin K contents, whereas most shellfish products contained low contents of PK, thus making only a minor contribution to the adequate intake established for adults. No statistically significant differences were observed in PK and MK contents of blue mussels sampled during spring v. late summer (P < 0·005). Nevertheless, a non-significant trend of increasing vitamin K content was observed towards the autumn months. This study presents novel vitamin K data for shellfish, an unexplored food group, and adds to the scarce vitamin K composition data worldwide.

Insulin-like growth factor 1 (IGF-1) is an important growth factor in childhood. We aimed to investigate the impact of food supplements for the treatment of moderate acute malnutrition (MAM) on serum IGF-1 (sIGF-1). Secondary analysis of a randomised 2 × 2 × 3 factorial nutrition trial was performed. Children aged 6–23 months with MAM received 2093 kJ/d as lipid-based nutrient supplement (LNS) or corn soy blend (CSB), containing either dehulled soya or soya isolate and different quantities of dried skimmed milk (0 %, 20 % or 50 % of total protein) for 12 weeks. The trial was double-blind with regard to soya and milk but not to matrix (LNS v. CSB). sIGF-1 was measured at inclusion and after 12 weeks of supplementation. Of 1609 children enrolled, 1455 (90 %) had sIGF-1 measured at both time points. During supplementation, sIGF-1 increased 6·7 (95 % CI 6·1, 7·3) ng/ml compared with an expected age-dependent decrease of 0·3 (95 % CI 0·2, 0·4) ng/ml. Children who received LNS v. CSB had a lower increase in sIGF-1 (–8 %, 95 % CI − 12, −3). The effect of LNS was partly attenuated when sIGF-1 was corrected for inflammation. Children who received soya isolate compared with dehulled soya had a higher increase in sIGF-1 (6 %, 95 % CI 1, 12). Milk content did not affect sIGF-1. Overall, sIGF-1 increased during supplementation. The lower increase with LNS v. CSB was only partly explained by increased inflammation with LNS and needs further investigation. Isolate v. dehulled soya led to a higher increase which may be due to antinutrients in dehulled soya.

This study aims to assess the therapeutic effects of probiotic oral therapy in paediatric patients with anorexia nervosa (AN) and to investigate its impact on intestinal flora composition, brain–gut peptide levels and overall clinical outcomes. A retrospective study was conducted involving 100 children diagnosed with AN at Xingtang County People’s Hospital between January 2023 and June 2024. Patients were divided into two groups: a control group (n 50) receiving zinc gluconate oral solution alone and an observation group (n 50) receiving zinc gluconate plus probiotics. Outcome measures included intestinal flora analysis, brain–gut peptide levels (somatostatin (SS) and nitric oxide (NO)), clinical efficacy, serum trace element levels (Ca, Zn and Fe) and prognosis, including recurrence rates 6 months post-treatment. Baseline characteristics were similar between the two groups (P > 0·05). After treatment, the observation group showed significantly higher levels of Bifidobacterium and Lactobacillus and lower levels of Enterobacter compared with the control group (P < 0·05). Additionally, the observation group had lower levels of SS and NO (P < 0·05), indicating improved brain–gut communication. Clinical efficacy was significantly higher in the observation group (P < 0·05), with improved serum trace element levels (P < 0·05 for Ca, Zn and Fe). Furthermore, the recurrence rate 6 months post-treatment was significantly lower in the observation group compared with the control group (P < 0·05). Probiotic supplementation in children with AN effectively modulates intestinal flora, improves brain–gut peptide levels and enhances clinical outcomes.

Flavonoids are a key class of polyphenols, i.e., phytochemical compounds present in foods and beverages, which have been described as having health benefits in preventing several chronic diseases. Estimating flavonoid intake has already been conducted in several countries but has yet to be performed in Portugal. This study included 5005 participants aged 3–84 years and aimed to estimate dietary flavonoid intake in the Portuguese population, using data from the National Food and Physical Activity Survey 2015–2016, providing information on intake, main food contributors and the socio-demographic factors associated with the intake. Food intake data from the survey was converted to flavonoid intake using a database built to include the most updated USDA databases on flavonoids, isoflavones and proanthocyanidins and the Phenol-Explorer database. The rationale for combining food consumption data and different flavonoid databases using the FoodEx2 classification system was established. Linear regressions assessed the associations between socio-demographic factors and dietary flavonoid intake. The total flavonoid intake of the Portuguese population was estimated to be 107·3 mg/d. Flavanols were the most representative subclass, followed by flavonols, anthocyanidins, flavanones, flavones and isoflavones. Fruits and vegetables were the primary food contributors, providing 31·5 % and 12·4 % of the total flavonoid intake. Adolescents had the lowest total flavonoid intake, and older adults had the highest. This study provides information on the Portuguese population’s dietary flavonoids, allowing for international comparisons. It can also streamline forthcoming investigations into the link between flavonoid consumption and its impact on health, contributing to the future establishment of dietary reference values.

In the last decades, it has been well known that low-grade inflammation plays a potential role in the pathogenesis of different cancers. The aim of this systematic review and meta-analysis of observational studies was to evaluate the association between inflammatory potential of diet measured through the Dietary Inflammatory Index (DII), Energy-adjusted DII (E-DII), Empirical Dietary Inflammatory Pattern (EDIP), the Inflammatory Score of Diet (ISD), and risk of colorectal cancer (CRC) and site-specific colon cancer. A systematic electronic search of PubMed/Medline, Scopus, the Web of Sciences and reference lists up to 21 November 2023 was performed. Data were pooled by the generic inverse variance method using random effect model. To assess the heterogeneity of included studies, the I2 index was used. A total of twenty-eight original studies, comprising 2 287 836 participants, were selected to include in this meta-analysis. Pooled results showed a significant association between higher adherence to pro-inflammatory diet and increased risk of CRC (effect size (ES): 1·39; 95 % CI 1·29, 1·51; I2 = 82·9 %), colon (ES: 1·40; 95 % CI 1·26, 1·55; I² = 73·3 %, P< 0·01), proximal colon (ES: 1·28; 95 % CI 1·17, 1·40; I² = 29·1 %), distal (ES: 1·50; 95 % CI 1·30, 1·74; I² = 63·5 %) and rectal (ES: 1·46; 95 % CI 1·23, 1·74; I² = 80 %). Stratified analysis by type of dietary indices noted that greater adherence to the DII, E-DII and EDIP were related to significant increase in the risk of overall CRC and site-specific colon cancers. Our results highlighted the proposed role of inflammatory potential of diet as important risk factor for CRC. Adherence to an anti-inflammatory dietary pattern should be recommended to reduce incidence of CRC, globally.

This study aimed to investigate the association between family characteristics and adherence to the EAT-Lancet dietary recommendations in 7-year-old children. This is a prospective birth cohort study with 2125 children from Generation XXI (Porto, Portugal), who provided 3-day food diaries at age 7, used to assess habitual food consumption. At the age of 4, maternal diet was assessed using a Food Frequency Questionnaire, and a diet quality score was calculated (higher scores indicating a better maternal diet), and parental–child feeding practices were assessed with the Child Feeding Questionnaire. Adherence to the EAT-Lancet dietary recommendations was evaluated using the World Index for Sustainability and Health (WISH) at the age of 7 years, previously adapted to paediatric age. Hierarchical linear regression models (consecutive addition of blocks of variables based on a theoretical framework) were employed to evaluate the associations between family characteristics and adherence to the WISH at age 7 (β regression coefficients and the respective 95 % confidence intervals (95 % CI)). Higher maternal age and education at child’s birth were associated with increased adherence to the WISH at age 7 (β = 0·018, 95 % CI 0·005, 0·031; β = 0·038, 95 % CI 0·024, 0·053, respectively). A better maternal diet quality and using more restrictive practices on child’s diet, at 4 years old, were both associated with higher scoring in the WISH at 7 years old (β = 0·033, 95 % CI 0·018, 0·049; β = 0·067, 95 % CI 0·009, 0·125, respectively). Early maternal sociodemographic and diet quality play a significant role in influencing the adherence to a healthy and environmentally sustainable dietary pattern at school-age.

There is a lack of information from Middle Eastern countries regarding diet–disease associations. We examined dietary glycaemic and insulinemic potential in relation to risk of incident diabetes among a large group of Iranian adults. The present study was carried out using data from Yazd Health Study-Taghzieh Mardom Yazd, a prospective cohort study on adults aged 20–70 years in Yazd Greater Area, Iran. This study was initiated in 2014–2016 (baseline examination), and data are collected prospectively at one 5-year intervals. Data on demographic characteristics, dietary intakes and potential confounders were gathered by interview. During the follow-up phase of the study, diabetes incidence was confirmed by laboratory tests and physician diagnoses. This study included a total of 6178 participants in the cross-sectional analysis and 5105 subjects in the prospective phase. Examining the cross-sectional phase, we failed to find any significant association between dietary glycaemic index (GI) and glycaemic load (GL) as well as dietary insulin index (DII) or dietary insulin load (DIL) and prevalence of diabetes. No significant relationship was also seen between DII/DIL and risk of T2DM in the prospective phase; however, in the stratified analysis by BMI status, there was an inverse significant association between DII and risk of type 2 diabetes mellitus (hazard ratio for T3 v. T1: 0·19; 95 % CI: 0·04, 0·92; P = 0·03) in non-obese (BMI ≥ 25 kg/m2) and overweight (BMI < 25 kg/m2) participants. No significant association was found between dietary GI/ dietary GL/ DII/ or DIL with risk of T2DM. More research, particularly with a longer follow-up duration, is needed to confirm these findings.

Psoriasis is a chronic immune-inflammatory skin disease. Cross-sectional research examining diet quality indices in psoriasis has focused on the Mediterranean diet and is confined to Mediterranean populations, thereby lacking generalisability to other populations. We explored associations between diet quality indices and the likelihood of reporting a higher psoriasis severity. This was an online cross-sectional study recruiting adult volunteers with psoriasis (n 257). A 147-item FFQ evaluated adherence to the Mediterranean diet score, the Dietary Approaches to Stop Hypertension score and the Plant-based Diet Index (PDI), including its original (oPDI), healthy (hPDI) and unhealthy (uPDI) subtypes. Psoriasis severity was determined with the self-assessed Simplified Psoriasis Index. When adjusted for age, sex, smoking, alcohol overconsumption, energy intake and psychological morbidity, multinomial logistic regression analyses revealed an increased likelihood of reporting a higher psoriasis severity in participants with a very low adherence to Dietary Approaches to Stop Hypertension (OR = 3·75; 95 % CI 1·313, 10·700; P = 0·01) and hPDI (OR = 4·04; 95 % CI 1·251, 13·064; P = 0·02) patterns. A reduced likelihood of reporting a higher psoriasis severity was shown in participants with low adherence to the uPDI (OR = 0·25; 95 % CI 0·085, 0·716; P = 0·01). With further adjustment for BMI, a very low adherence to the oPDI was significantly associated with an increased likelihood of reporting a higher psoriasis severity (OR = 3·46; 95 % CI 1·029, 11·656; P = 0·05). Dietary interventions and assessment should be introduced in the care pathway for psoriasis management.

The study aim was to determine the prevalence of food addiction (FA) in individuals with type 2 diabetes and to assess the association between FA and type 2 diabetes. MEDLINE, EMBASE, Web of Sciences, Latin American and Caribbean Literature in Health Sciences, ScienceDirect, Scopus and PsycINFO were searched until November 2024. This study was registered with PROSPERO (CRD42023465903). Cross-sectional studies, case–control, cohorts and clinical trials that were carried out with individuals with type 2 diabetes, regardless of age and sex, were included. The complete data extracted included the prevalence, OR and/or risk ratio of FA, the number of individuals evaluated, age, sex, weight, presence of co-morbidities, age of participants and FA symptoms. A pooled prevalence of FA of 30 % (95 % CI (18, 44) with estimated predictive interval (0; 85); I2 = 99·51; 12 studies; 15 947 participants) was identified. For the associations between FA and type 2 diabetes, we found a grouped crude OR value of 2·35 (95 % CI (1·71, 2·98)). The pooled OR adjusted for age and sex was 2·60 (95 % CI (1·77, 3·42)). Finally, the OR adjusted for age, sex and BMI was 2·01 (95 % CI (1·39, 2·64)). The results of the meta-analyses showed a high prevalence of FA in individuals with type 2 diabetes and that the associations between these two conditions remained even after adjustment for age, sex and BMI, although with a high heterogeneity among individual estimates.

The influence of appetite and energy intake (EI) on energy compensation in response to chronic exercise remains poorly understood. This study examined the temporal impact of habitual exercise on EI and the homeostatic appetite regulators that influence energy compensation. Twelve-week-old male Sprague Dawley rats (n 30) fed an AIN-93M diet were randomised into one of three groups: (1) sedentary control (SED); (2) voluntary wheel exercise (EX) and (3) sedentary, weight-matched to aerobic exercise (SED-WM) for 8 weeks. Measures of EI, body weight and adiposity were assessed. Appetite-regulating hormones acyl ghrelin, active glucagon-like peptide (GLP)-1, leptin and insulin were measured in response to an oral glucose tolerance test. Rats with running wheels completed an average of 192 km over 8 weeks. While EI was initially reduced in EX, EI gradually increased with exercise training after week 1 (P < 0·05). Body weight was lower in EX relative to SED from weeks 3 to 5 but did not differ at the end of the study. Fat mass and long-term satiety hormones leptin and insulin were lower in EX (P < 0·05). No differences were observed in concentrations of the satiety hormone active GLP-1 or the orexigenic hormone acyl ghrelin. Short-term homeostatic regulators of appetite do not appear to be altered with exercise training. The reduction in adiposity and associated decrease in tonic satiety hormones leptin and insulin are likely contributors to the coupling of energy expenditure with EI over time with voluntary exercise.