One of the most significant challenges in research related to nutritional epidemiology is the achievement of high accuracy and validity of dietary data to establish an adequate link between dietary exposure and health outcomes. Recently, the emergence of artificial intelligence (AI) in various fields has filled this gap with advanced statistical models and techniques for nutrient and food analysis. We aimed to systematically review available evidence regarding the validity and accuracy of AI-based dietary intake assessment methods (AI-DIA). In accordance with PRISMA guidelines, an exhaustive search of the EMBASE, PubMed, Scopus and Web of Science databases was conducted to identify relevant publications from their inception to 1 December 2024. Thirteen studies that met the inclusion criteria were included in this analysis. Of the studies identified, 61·5 % were conducted in preclinical settings. Likewise, 46·2 % used AI techniques based on deep learning and 15·3 % on machine learning. Correlation coefficients of over 0·7 were reported in six articles concerning the estimation of calories between the AI and traditional assessment methods. Similarly, six studies obtained a correlation above 0·7 for macronutrients. In the case of micronutrients, four studies achieved the correlation mentioned above. A moderate risk of bias was observed in 61·5 % (n 8) of the articles analysed, with confounding bias being the most frequently observed. AI-DIA methods are promising, reliable and valid alternatives for nutrient and food estimations. However, more research comparing different populations is needed, as well as larger sample sizes, to ensure the validity of the experimental designs.

Environmental impacts of food systems have stimulated research to examine how to create healthy diets that will be more sustainable while meeting nutrient requirements. Increasing compliance with existing food-based dietary guidelines in most jurisdictions could be a first step to improve health and reduce environmental impact. MyPlanetDiet was an all-Ireland 12-week randomised controlled trial designed to inform sustainable healthy dietary guidelines. Healthy adults (n 355) aged 18–64 years with moderate-to-high greenhouse gas emitting (GHGE) diets were recruited from three study sites on the island of Ireland. The aim of this research is to assess the relationship between dietary intakes, diet-related environmental impacts and metabolic health using baseline data collected during the MyPlanetDiet study. Dietary assessments collected using Foodbook24 were used to calculate diet-related GHGE, adherence to healthy eating guidelines (HEG) and healthy eating index (HEI) score. Anthropometrics and metabolic health markers (e.g. lipids, glucose and insulin) were included. Overall HEG adherence was low, with 43 % meeting zero or one HEG food group recommendations. Adherence to 4 + HEG food group targets was associated with 31 % lower diet-related GHGE compared with those with lowest adherence. Higher HEG adherence was associated with lower BMI and waist circumference and higher HEI scores. While our findings suggest HEG adherence is associated with positive health and environmental impacts, substantial behaviour change will be needed to meet existing HEG. Further research is needed to assess response and acceptability to HEG. However, adherence to HEG may be an important first step to reducing the environmental impact of food consumption.

Artificial sweeteners are used to reduce energy intake, but studies suggest that consumption during pregnancy may impact the offspring’s risk of overweight. In this longitudinal cohort study, we aimed to examine the association between consumption of artificially sweetened or sugar-sweetened beverages during pregnancy and offspring overweight from birth to 18 years in the Danish National Birth Cohort. A total of 101 042 pregnancies were enrolled in the Danish National Birth Cohort from 1996 to 2002. Follow-up was conducted throughout pregnancy, childhood and adolescence. Additionally, 72 821 women completed an FFQ during pregnancy, reporting intake of beverages sweetened with artificial sweeteners or sugar. Offspring height and weight were obtained during childhood and adolescence. Multivariate logistic regression was performed to estimate the OR for overweight concerning maternal beverage consumption. Analyses were adjusted for risk factors for childhood overweight, including maternal age, pre-pregnancy BMI, physical activity and smoking in pregnancy, healthy eating index, paternal BMI, socio-economic status and duration of breastfeeding. We found increased odds of overweight in 7-, 11-, 14- and 18-year-old offspring whose mothers reported drinking ≥ 1 artificially sweetened beverage daily during pregnancy compared with no consumption (18 years: adjusted OR 1·26 (95 % CI 1·12, 1·42)). We found decreased adjusted odds of overweight in 11- and 18-year-old offspring whose mothers reported drinking ≥ 1 sugar-sweetened beverage daily during pregnancy compared with no consumption. We found that consumption of artificially sweetened beverages during pregnancy was associated with an increased risk of overweight in childhood and adolescence after adjustment for risk factors for childhood overweight.

Studies on longitudinal associations between diet quality and lipid and amino acid metabolism in children and adolescents are limited. We studied associations between diet quality and serum markers of lipid and amino acid metabolism in the Physical Activity and Nutrition in Children (PANIC) study. These analyses included 403 children aged 6–9 years at baseline, 360 re-examined 2 years later at age 9–11 years and 219 eight years later at age 15–17 years. Food intake was recorded over 4 days, and diet quality was assessed using the Finnish Children Healthy Eating Index (FCHEI). Fasting serum fatty acids, amino acids, apolipoproteins and lipoprotein particle sizes were analysed via NMR spectroscopy. Linear mixed-effects models, adjusted for sex, age, body fat percentage, pubertal stage and physical activity were used to analyse the associations. Better diet quality was linked to increased serum PUFA and reduced saturated and MUFA, alanine and VLDL particle size. Consuming more vegetables, fruits, berries, vegetable oils and margarine with at least 60 % fat, fish and whole grains is associated with higher serum PUFA, lower SFA and smaller VLDL particles. Conversely, consuming higher-fat dairy products and sugary products is associated with higher saturated and MUFA, branched-chain and aromatic amino acids and larger VLDL particles. A diet rich in fruits, vegetables, unsaturated fats and fibre, with reduced sugar consumption, promotes favourable metabolic changes relevant to cardiometabolic health.

This study examined the relationship between total body fat percentage (TBFP), trunk fat percentage (TFP), and urinary flow rate (UFR) using NHANES data (2011–2018) from 10 521 participants aged 18–59. Multivariable-adjusted regression models assessed associations between dual-energy X-ray absorptiometry-measured fat percentages and UFR. Results showed that increased TBFP and TFP were inversely associated with UFR (TBFP: β = −0·013, 95 % CI [–0·018, −0·007]; TFP: β = –0·014, 95 % CI [–0·018, −0·009]). Stratified analyses revealed gender differences: in males, higher TBFP and TFP correlated with lower UFR (TBFP: β = –0·011, 95 % CI [−0·019, −0·004]; TFP: β = –0·016, 95 % CI [−0·022, −0·009]), but this association was absent in males aged 18–35. In females, both TBFP and TFP were consistently linked to reduced UFR across all age groups (TBFP: β = −0·016, 95 % CI [−0·023, −0·008]; TFP: β = −0·012, 95 % CI [−0·019, −0·006]). These findings suggest that body and trunk fat accumulation negatively impact UFR, with stronger effects in females and age-dependent variations in males. Further research should explore mechanisms behind these disparities to guide targeted interventions.

Low vitamin D associated with high parathyroid hormone (PTH) is common in HIV infection. We determined the association between total 25(OH)D and PTH in adolescents living with HIV, in Zambia and Zimbabwe. Adolescents (11–19 years) perinatally infected with HIV and established on antiretroviral therapy for ≥ 6 months were recruited into a cross-sectional study. Socio-demographic and clinical characteristics were recorded, anthropometry measured and fasted serum concentrations of 1,25(OH)2D, total 25(OH)D and intact PTH measured. The association between total 25(OH)D and PTH was examined using natural cubic spline regression. 842 participants (female: 53·2%) with a median age of 15·5 (IQR: 13·2–17·9) years were enrolled. Median antiretroviral therapy duration was 9·8 (IQR: 6·3–12·3) years, and 165/841 had an HIV viral-load >60 copies/ml. Stunting (height-for-age z-score <–2) and underweight (weight-for-age z-score <–2) were observed in 29·9 and 30·0%, respectively. Three-quarters reported daily Ca intakes <150 mg/d. The mean (sd) concentrations of total 25(OH)D and 1,25(OH)2D were 66·1(16·5) nmol/l and 210·6 (70·4) pmol/l, respectively, and median PTH level was 4·3 (IQR: 3·3–5·5) pmol/l. There was an inverse non-linear relationship between total 25(OH)D and PTH, 25(OH)D levelling off at 74·6 nmol/l (95 % CI: 74·5, 75·2). Results were consistent in those taking tenofovir disoproxil fumarate and virally unsuppressed participants. In this population with extremely low habitual Ca intakes, the lack of association between 25(OH)D and PTH when 25(OH)D exceeded 75 nmol/l potentially suggests that levels of 25(OH)D >75 nmol/l may need to be achieved to improve bone health; investigation is needed in future research studies.

Measurement error undermines the accuracy of dietary intake data. The 24-h dietary recall (24HR) is the standard data collection method in nutrition surveillance. Several neurocognitive processes underpin the act of recall, and individuals differ in their performance of these processes. This study aimed to investigate whether variation in neurocognitive processes, measured using four cognitive tasks, was associated with variation in measurement error of 24HR. Participants (n 139) completed the Trail Making Test, the Wisconsin Card Sorting Test, the Visual Digit Span and the Vividness of Visual Imagery questionnaire. During a controlled feeding study, participants completed three technology-assisted 24HR: the Automated Self-Administered Dietary Assessment Tool, Intake24 and an Interviewer-Administered Image-Assisted 24HR (IA-24HR) 1 week apart. The percentage error between reported and true energy intakes was calculated. Using linear regression, the association between cognitive task scores and absolute percentage error in estimated energy intake was assessed. Longer time spent completing the Trail Making Test, an indicator of visual attention and executive functioning, was associated with greater error in energy intake estimation using ASA24 (B 0·13, 95 % CI 0·04, 0·21) and Intake24 (B 0·10, 95 % CI 0·02, 0·19). Regression models explained 13·6 % (ASA24) and 15·8 % (Intake24) of the variance in energy estimation error. No cognitive task scores were associated with error using IA-24HR. This study demonstrates that variation between individuals in neurocognitive processes explains some of the variation in 24HR error. Further investigation into the role of neurocognitive processes in 24HR and their role in the reliability of dietary intake data is warranted.

Prior studies have shown that plant-based diets are associated with lower cardiovascular risk. However, these diets encompass a large diversity of foods with contrasted nutritional quality that may differentially impact health. We aimed to investigate the pooled cross-sectional association between metabolic syndrome (MetS), its components and healthy and unhealthy plant-based diet indices (hPDI and uPDI), using data from two French cohorts and one representative study from the French population. This study included 16 358 participants from the NutriNet-Santé study, 1769 participants from the Esteban study and 1565 participants from the STANISLAS study who underwent a clinical visit. The MetS was defined according to the International Diabetes Federation definition. The associations between these plant-based diet indices and MetS were estimated by multivariable Poisson and logistic regression models, stratified by gender. Meta-analysis enabled the computation of a pooled prevalence ratio. A higher contribution of healthy plant foods (higher hPDI) was associated with a lower probability of having MetS (PRmen: 0·85; 95 % CI: 0·75, 0·94, PRwomen: 0·72; 95 % CI: 0·67, 0·77), elevated waist circumferences and elevated blood pressure. In women, a higher hPDI was associated with a lower probability of having elevated triacylglyceride (TAG), low HDL-cholesterolaemia and hyperglycaemia; and a higher contribution of unhealthy plant foods was associated with a higher prevalence of MetS (PRwomen: 1·13; 95 % CI: 1·01, 1·26) and elevated TAG. A greater contribution of healthy plant floods was associated with protective effects on metabolic syndrome, especially in women. Gender differences should be further investigated in relation to the current sustainable nutrition transition.

The rising incidence of neurodegenerative diseases in an ageing global population has shifted research focus towards modifiable risk factors, such as diet. Despite potential links between dietary patterns and brain health, inconsistencies in neuroimaging outcomes underscore a gap in understanding how diet impacts brain ageing. This study explores the relationship between three dietary patterns – Mediterranean, Dietary Approaches to Stop Hypertension (DASH) and Mediterranean-DASH Intervention for Neurodegenerative Delay – and cognitive outcomes as well as brain connectivity. The study aimed to assess the association of these diets with brain structure and cognitive function, involving a middle-aged healthy group and an older cohort with subjective cognitive decline. The study included cognitive assessments and diffusion-weighted MRI data to analyse white matter microstructural integrity. Participants comprised fifty-five older individuals with subjective cognitive decline (54·5 % female, mean age = 64) and fifty-two healthy middle-aged individuals (48·1 % female, mean age = 53). Age inversely correlated with certain cognitive functions and global brain metrics, across both cohorts. Adherence to the Mediterranean, DASH and Mediterranean-DASH Intervention for Neurodegenerative Delay diets showed no significant cognitive or global brain metric improvements after adjusting for covariates (age, education, BMI). Network-based statistics analysis revealed differences in brain subnetworks based on DASH diet adherence levels in the subjective cognitive decline cohort. In the healthy cohort, lower white matter connectivity was associated with reduced adherence to Mediterranean-DASH Intervention for Neurodegenerative Delay and DASH diets. Ultimately, the study found no strong evidence connecting dietary patterns to cognitive or brain connectivity outcomes. Future research should focus on longitudinal studies and refine dietary assessments.

The diet proposed by the EAT-Lancet Commission has faced criticism concerning its affordability. This study aimed to investigate the cost associated with a greater alignment to the EAT-Lancet reference diet in the province of Québec, Canada. The dietary habits of 1147 French-speaking adults were assessed using repeated web-based 24-h recall data collected between 2015 and 2017 in the cross-sectional PRÉDicteurs Individuels, Sociaux et Environnementaux (PREDISE) study. Diet costs were calculated using a Nielsen food price database. Usual dietary intakes and diet costs were estimated using the National Cancer Institute’s multivariate Markov Chain Monte Carlo method. Adherence to the EAT-Lancet diet was assessed using the EAT-Lancet dietary index (EAT-I). Associations between diet costs and EAT-I scores were evaluated using linear regression models with restricted cubic splines. After adjustment for energy intake, a higher EAT-I score (75th v. 25th percentiles) was associated with a 1·0 $CAD increase in daily diet costs (95 % CI, 0·7, 1·3). This increase in diet costs was mostly driven by the following component scores of the EAT-I (75th v. 25th percentiles, higher scores reflecting greater adherence): vegetables (1·6 $CAD/d, 95 % CI: 1·2, 2·1), free sugars (1·6 $CAD/d, 95 % CI: 1·3, 1·9), fish and plant-based proteins (1·4 $CAD/d, 95 % CI: 1·0, 1·8), fruits (0·9 $CAD/d, 95 % CI: 0·4, 1·3) and whole grains (0·4 $CAD/d, 95 % CI: 0·0, 0·8). Inversely, a greater score for the poultry and eggs component was associated with reduced diet costs (–1·2 $CAD/d, 95 % CI: −1·7, −0·7). This study suggests that adhering to the EAT-Lancet diet may be associated with an increase in diet costs in the province of Québec.

Free sugar intakes are currently higher than recommended for health, yet effective strategies for reducing consumption are yet to be elucidated. This work investigated the effects of different dietary recommendations for reducing free sugar (FS) intakes, on relevant outcomes, in UK adults consuming > 5 % of total energy intake (TEI) from FS. Using a randomised controlled parallel-group design, 242 adults received nutrient-based (n 61), nutrient- and food-based (n 60), nutrient-, food- and food-substitution-based (n 63) or no (n 58) recommendations for reducing FS at a single timepoint, with effects assessed for the following 12 weeks. Primary outcomes were FS intakes as a percentage of TEI (%FS) and adherence to the recommendations at week 12. Secondary outcomes included TEI, diet composition, sugar-rich and low-calorie-sweetened food consumption and anthropometry. In intention-to-treat analyses adjusted for baseline measures, %FS reduced in intervention groups (%FSchange = –2·5 to −3·3 %) compared with control (%FSchange = –1·2 %) (smallest B = –0·573, P = 0·03), with effects from week 1 until week 12 and no differences between interventions (largest B = 0·352, P = 0·42). No effects of the interventions were found in dietary profiles, but change in %FS was associated with change in %TEI from non-sugar carbohydrate (B = 0·141, P < 0·01) and from protein (B = –0·171, P = 0·02). Body weight was also lower at week 12 in intervention groups compared with control (B = –0·377, P < 0·05), but associations with %FS were weak. Our findings demonstrate the benefit of dietary recommendations for reducing FS intakes in UK adults. Limited advantages were found for the different dietary recommendations, but variety may offer individual choice.

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.

Accumulation of exogenous fatty acids such as the long-chain n-11 MUFA cetoleic acid (CA, C22:1n-11) may induce functional changes, through direct effects or by affecting the amounts of other fatty acids through changes in catabolic and anabolic processes including desaturation of fatty acids or by other processes. The primary aim of this study was to investigate if dietary CA was absorbed and accumulated in a TAG-rich tissue for storage (white adipose tissue), a stable phospholipid-rich tissue (brain), metabolically active tissues (liver and skeletal muscle) or circulating in the blood (blood cells) and metabolised. Secondary aims included investigating any effects on the levels of EPA and DHA. Eighteen male Zucker diabetic Sprague Dawley (ZDSD) rats were fed diets with herring oil (HERO) containing 0·70 % CA or anchovy oil (ANCO) devoid of CA, or a control diet with soyabean oil for 5 weeks. The HERO and ANCO diets contained 0·35 and 0·37 wt% EPA + DHA, respectively. Data were analysed using one-way ANOVA. CA from dietary HERO was absorbed, and CA and two chain-shortened metabolites were found in blood cells, liver, white adipose tissue (WAT) and muscle, but n-11 MUFAs were not found in the brain. The concentrations of EPA and DHA were similar in liver lipids (TAG, cholesteryl esters and NEFA) as well as in WAT, muscle and brain from rats fed the HERO or ANCO diets. To conclude, CA was taken up by tissues but did not affect levels of EPA and DHA in this diabetic rat model.

Adolescent girls often skip breakfast due to time constraints and reduced morning appetite. This study examined the acute impact of breakfast consumption timing v. breakfast omission (BO) on glycaemic and insulinaemic responses to lunch in infrequent breakfast-consuming girls. Fifteen girls (13·1 (sd 0·8) years) completed three conditions in a randomised crossover design: early-morning breakfast consumption (EM-BC; 08.30), mid-morning breakfast consumption (MM-BC; 10.30) and BO. A standardised lunch was provided at 12.30, followed by a 2-h post-lunch observation period. Blood and expired gas samples were collected periodically. Linear mixed models with Cohen’s d effect sizes compared outcomes between conditions. Pre-lunch glucose and insulin incremental AUC (iAUC) were higher in the breakfast conditions v. BO (P ≤ 0·009), with no differences between breakfast conditions. MM-BC reduced post-lunch glucose iAUC by 36 % and 25 % compared with BO and EM-BC, respectively (P < 0·001, d = 0·92–1·44). A moderate, non-significant 15 % reduction in post-lunch glucose iAUC was seen with EM-BC v. BO (P = 0·077, d = 0·52). These reductions occurred without changes in post-lunch insulinemia (P ≥ 0·323) and were accompanied by increased post-lunch carbohydrate oxidation compared with BO (P ≤ 0·018, d = 0·58–0·75); with no differences between EM-BC and MM-BC. MM-BC lowered glycaemic response over the experimental period compared with BO (P = 0·033, d = 0·98) and EM-BC (P = 0·123, d = 0·93), with no difference between EM-BC and BO. Compared with BO, both breakfast conditions lowered post-lunch glycaemic responses with mid-morning breakfast eliciting a greater second-meal effect than early-morning breakfast. These findings indicate the breakfast-to-lunch meal interval may be a crucial factor affecting postprandial glycaemia in infrequent breakfast-consuming girls.

Postpartum maternal diet quality has been linked with optimal infant feeding practices. However, whether maternal diet quality during pregnancy influences infant feeding practices remains unclear. The present study explored the relationship between maternal diet quality in pregnancy and infant feeding practices in Australian women. A brief 15-item FFQ was used to collect maternal dietary data (n 469). Diet quality was calculated using a modified 2013 Dietary Guideline Index (DGI). Multivariable linear and logistic regressions with adjustment for covariates were used to examine associations between maternal diet quality in pregnancy and infant feeding practices: infant feeding mode, breast-feeding duration and timing of solids introduction. Higher DGI score during pregnancy was associated with higher odds of breast-feeding than formula/mixed feeding (adjusted OR (AOR) 1·03, 95 % CI 1·00, 1·07), longer breast-feeding duration (adjusted β 0·09, 95 % CI 0·03, 0·15) and higher odds of breast-feeding for ≥ 6 months (AOR 1·04, 95 % CI 1·02, 1·07) than for < 6 months. Associations between maternal DGI score and breast-feeding variables were moderated by maternal country of birth, with significant associations observed in Australian-born mothers only. No association was found between maternal DGI score and timing of solids introduction. Higher maternal diet quality was associated with better infant feeding practices, and the association was moderated by country of birth. Our findings provide evidence to support the initiation of dietary interventions to promote diet quality during pregnancy, particularly among Australian-born women. Further research could explore underlying mechanisms linking maternal diet quality and infant feeding practices.

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.

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.

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.

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.