Maternal gestational weight gain (GWG) is an important determinant of infant birth weight, and having adequate total GWG has been widely recommended. However, the association of timing of GWG with birth weight remains controversial. We aimed to evaluate this association, especially among women with adequate total GWG. In a prospective cohort study, pregnant women’s weight was routinely measured during pregnancy, and their GWG was calculated for the ten intervals: the first 13, 14–18, 19–23, 24–28, 29–30, 31–32, 33–34, 35–36, 37–38 and 39–40 weeks. Birth weight was measured, and small-for-gestational-age (SGA) and large-for-gestational-age were assessed. Generalized linear and Poisson models were used to evaluate the associations of GWG with birth weight and its outcomes after multivariate adjustment, respectively. Of the 5049 women, increased GWG in the first 30 weeks was associated with increased birth weight for male infants, and increased GWG in the first 28 weeks was associated with increased birth weight for females. Among 1713 women with adequate total GWG, increased GWG percent between 14 and 23 weeks was associated with increased birth weight. Moreover, inadequate GWG between 14 and 23 weeks, compared with the adequate GWG, was associated with an increased risk of SGA (43 (13·7 %) v. 42 (7·2 %); relative risk 1·83, 95 % CI 1·21, 2·76). Timing of GWG may influence infant birth weight differentially, and women with inadequate GWG between 14 and 23 weeks may be at higher risk of delivering SGA infants, despite having adequate total GWG.

The aim of this study was to ascertain the level of occupational stress before and during the COVID-19 pandemic, how it changed and its association with health outcomes of hospital workers in the Recôncavo of Bahia, Brazil. A longitudinal study was conducted with 218 hospital workers over 18 years old. A semi-structured questionnaire was used for collecting sociodemographic, occupational, lifestyle, anthropometric and health data. The main exposures were occupational stress, assessed through Job Content Questionnaire and classified according to the Demand-Control Model and reported shift work. Health outcomes considered were nutritional status assessed by BMI, waist circumference and body fat percentage, health self-perception and cardiovascular risk factors. We used McNemar χ 2 or Wilcoxon tests to compare the levels of exposure and outcome variables before and during the pandemic, and OR to evaluate associations between changes in occupational stress and shift work with health outcomes. During the pandemic, participants reported increased occupational stress and shift work and lower self-perceived health and had higher BMI and cardiovascular risk factors, compared with before the pandemic. No association was observed between change in occupational stress and health outcomes. However, increased amount of shift work was related to increased BMI in the overall sample (OR 3·79, 95 % CI (1·40, 10·30)) and in health workers (OR 11·56; 95 % CI (2·57, 52·00)). These findings support calls to strengthen labour policies to ensure adequate working conditions for hospital workers in context of the COVID-19 pandemic.

The objectives of this study were (1) to systematically review the literature on the association between birth weight in children born in the first and second generation and (2) to quantify this association by performing a meta-analysis. A systematic review was carried out in six databases (PubMed, Science Direct, Web of Science, Embase, Scopus, CINAHL and LILACS), in January 2021, for studies that recorded the birth weight of parents and children. A meta-analysis using random effects to obtain a pooled effect of the difference in birth weight and the association of low birth weight (LBW) between generations was performed. Furthermore, univariable meta-regression was conducted to assess heterogeneity. Egger’s tests were used to possible publication biases. Of the 9878 identified studies, seventy were read in full and twenty were included in the meta-analysis (ten prospective cohorts and ten retrospective cohorts), fourteen studies for difference in means and eleven studies for the association of LBW between generations (twenty-three estimates). Across all studies, there was no statistically significant mean difference (MD) birth weight between first and second generation (MD 19·26, 95 % CI 28·85, 67·36; P = 0·43). Overall, children of LBW parents were 69 % more likely to have LBW (pooled effect size 1·69, 95 % CI (1·46, 1·95); I 2:85·8 %). No source of heterogeneity was identified among the studies and no publication bias. The average birth weight of parents does not influence the average birth weight of children; however, the proportion of LBW among the parents seems to affect the offspring’s birth weight.

Barrett’s oesophagus (BE) is the precursor of oesophageal adenocarcinoma, which has become the most common type of oesophageal cancer in many Western populations. Existing evidence on diet and risk of BE predominantly comes from case–control studies, which are subject to recall bias in measurement of diet. We aimed to investigate the potential effect of diet, including macronutrients, carotenoids, food groups, specific food items, beverages and dietary scores, on risk of BE in over 20 000 participants of the Melbourne Collaborative Cohort Study. Diet at baseline (1990–1994) was measured using a food frequency questionnaire. The outcome was BE diagnosed between baseline and follow-up (2007–2010). Logistic regression models were used to estimate OR and 95 % CI for diet in relation to risk of BE. Intakes of leafy vegetables and fruit were inversely associated with risk of BE (highest v. lowest quartile: OR = 0·59; CI: 0·38, 0·94; P-trend = 0·02 and OR = 0·58; CI: 0·37, 0·93; P-trend = 0·02 respectively), as were dietary fibre and carotenoids. Stronger associations were observed for food than the nutrients found in them. Positive associations were observed for discretionary food (OR = 1·54; CI: 0·97, 2·44; P-trend = 0·04) and total fat intake (OR per 10 g/d = 1·11; CI: 1·00, 1·23), the association for fat was less robust in sensitivity analyses. No association was observed for meat, protein, dairy products or diet scores. Diet is a potential modifiable risk factor for BE. Public health and clinical guidelines that incorporate dietary recommendations could contribute to reduction in risk of BE and, thereby, oesophageal adenocarcinoma.

One potential mechanism by which diet and lifestyle may affect chronic disease risk and subsequent mortality is through chronic systemic inflammation. In this study, we investigated whether the inflammatory potentials of diet and lifestyle, separately and combined, were associated with all-cause, all-CVD and all-cancer mortality risk. We analysed data on 18 484 (of whom 4103 died during follow-up) Black and White men and women aged ≥45 years from the prospective REasons for Geographic and Racial Differences in Stroke study. Using baseline (2003–2007) Block 98 FFQ and lifestyle questionnaire data, we constructed the previously validated inflammation biomarker panel-weighted, 19-component dietary inflammation score (DIS) and 4-component lifestyle inflammation score (LIS) to reflect the overall inflammatory potential of diet and lifestyle. From multivariable Cox proportional hazards models, the hazards ratios (HR) and their 95 % CI for the DIS–all-cause mortality and LIS–all-cause mortality risk associations were 1·32 (95 % CI (1·18, 1·47); P for trend < 0·01) and 1·25 (95 % CI (1·12, 1·38); P for trend < 0·01), respectively, among those in the highest relative to the lowest quintiles. The findings were similar by sex and race and for all-cancer mortality, but weaker for all-CVD mortality. The joint HR for all-cause mortality among those in the highest relative to the lowest quintiles of both the DIS and LIS was 1·91 (95 % CI 1·57, 2·33) (P for interaction < 0·01). Diet and lifestyle, via their contributions to systemic inflammation, separately, but perhaps especially jointly, may be associated with higher mortality risk among men and women.

Portion sizes of many foods have increased over time. However, the size of effect that reducing food portion sizes has on daily energy intake and body weight is less clear. We used a systematic review methodology to identify eligible articles that used an experimental design to manipulate portion size served to human participants and measured energy intake for a minimum of 1 d. Searches were conducted in September 2020 and again in October 2021. Fourteen eligible studies contributing eighty-five effects were included in the primary meta-analysis. There was a moderate-to-large reduction in daily energy intake when comparing smaller v. larger portions (Standardised Mean Difference (SMD) = –0·709 (95 % CI: –0·956, –0·461), approximately 235 kcal (983·24 kJ)). Larger reductions to portion size resulted in larger decreases in daily energy intake. There was evidence of a curvilinear relationship between portion size and daily energy intake; reductions to daily energy intake were markedly smaller when reducing portion size from very large portions. In a subset of studies that measured body weight (four studies contributing five comparisons), being served smaller v. larger portions was associated with less weight gain (0·58 kg). Reducing food portion sizes may be an effective population-level strategy to prevent weight gain.

High sodium (Na) diet is one of the leading behavioural risks of disease identified in the Singapore Burden of Disease Study. We aim to estimate the cost attributable to a high Na diet in Singapore in 2019 from a societal perspective by employing a prevalence-based approach in cost-of-illness studies. We extracted national-level healthcare data and population attributable fractions by sex and age. Costs included direct and indirect costs from inpatient treatment and productivity losses. In 2019, the annual societal cost attributable to a high Na diet was conservatively estimated to be USA$262 million (95 % uncertainty interval (UI) 218, 359 million). At least USA$67·8 million (95 % UI 48·4, 120 million) and USA$194 million (95 % UI 153, 274 million) could be saved on healthcare and indirect costs, respectively, if the daily Na intake of Singaporeans was reduced to an average of 3 g. Overall, males had higher costs compared with females at USA$221 million (95 % UI 174, 312 million) and USA$41·1 million (95 % UI 33·5, 61·7 million), respectively. Productivity loss from foregone wages due to premature mortality had the largest cost at USA$191 million (95 % UI 150, 271 million). CVD had the largest healthcare expenditure at USA$61·4 million (95 % UI 41·6, 113 million), driven by ischaemic heart disease at USA$41·0 million (95 % UI 21·4, 88·9 million). Our study found that reducing Na intake could reduce future healthcare expenditures and productivity losses. This result is vital for policy evaluation in a rapidly ageing society like Singapore, where the burden of diseases associated with high Na diet is expected to increase.

This study evaluated the association between dietary patterns, gas-related symptoms (GRS) and their impact on quality of life (QoL) in a representative sample (n 936) of the French adult population. During the 2018–2019 ‘Comportements et Consommations Alimentaires en France’ survey (Behaviors and Food Consumption in France), online evaluation of GRS in adult participants was performed using the validated Intestinal Gas Questionnaire (IGQ), which captures the perception of GRS and their impact on QoL via six symptom dimensions scores (range 0–100; 100 = worse) and a global score (mean of the sum of the six symptom dimensions scores). Socio-demographics, lifestyle parameters and dietary habits (7-d e-food diary) were also collected online. Quality of diet was determined using the Nutrient-Rich Food 9.3 (NRF9.3) score (range 0–900; 900 = best). Univariate and multivariate linear regression models were applied to identify factors associated with IGQ global score. K-means was used to identify clusters of subjects based on their dietary records. Data from 936 adults who completed both the IGQ and the food diary showed a mean IGQ global score of 11·9 (sd 11·2). Younger age and female sex were associated with a higher IGQ global score. Only 7 % of subjects reported no symptom at all and nearly 30 % of study participants reported a high impact of GRS on their QoL. Two dietary clusters were identified: cluster 1, characterised by a higher consumption of fruits and vegetables, lower sugars intake and higher NRF9.3 score and cluster 2, characterised by higher intake of sugars, lower intake in dietary fibres and lower NRF9.3 score. The IGQ global score was lower in cluster 1 and higher in cluster 2 v. the total sample average (P < 0·001). The prevalence of GRS in the French adult population is high and is associated with impaired QoL and dietary patterns. A change in food habits towards healthier patterns could help reducing the burden of GRS.

Galactose and its metabolites, primarily derived from lactose, may have toxic effects on the ovary. We aimed to prospectively examine the associations of galactose and lactose intakes with the onset of natural menopause. The data of a population-based cohort study in a Japanese community (the Takayama study) initiated in 1992 were analysed, with follow-up data collected in 2002. Among the participants of the Takayama study, premenopausal women (n 3115) aged 35–56 years at baseline were included in this study. Dietary intake, including lactose and galactose was assessed only at baseline using a FFQ. The menopausal status and age at menopause were determined based on the participants’ self-reports, and natural menopause was defined as the absence of menstruation for 12 months or more. Cox proportional hazards models were used to estimate the hazard ratios (HR) and 95 % CI. A total of 1790 women experienced natural menopause within the 10-year follow-up. Lactose and galactose intakes were associated with a later onset of natural menopause after adjusting for potential confounding factors and the HR (95 % CI) for the highest v. lowest quartile were 0·80 (0·69, 0·92) (P-trend = 0·001) in lactose and 0·86 (0·74, 1·00) in galactose (P-trend = 0·036), respectively. High intakes of lactose and galactose were associated with a later onset of natural menopause. Despite the presumed ovotoxicity effects, lactose and galactose intakes at usual levels may not be deleterious to the ovarian aging process among Japanese community-dwelling women.

Immunoprophylaxis has not completely eliminated hepatitis B virus (HBV) infection due to hyporesponsiveness to hepatitis B vaccine (HepB). We explored the impact of folic acid supplementation (FAS) in pregnant women with positive hepatitis B surface antigen (HBsAg) on their infant hepatitis B surface antibody (anti-HBs) and the mediation effect of infant interleukin-4 (IL-4). We recruited HBsAg-positive mothers and their neonates at baseline. Maternal FAS was obtained via a questionnaire, and neonatal anti-HBs and IL-4 were detected. Follow-up was performed at 11–13 months of age of infants, when anti-HBs and IL-4 were measured. We applied univariate and multivariate analyses. A mediation effect model was performed to explore the mediating role of IL-4. A total of 399 mother–neonate pairs were enrolled and 195 mother–infant pairs were eligible for this analysis. The infant anti-HBs geometric mean concentrations in the maternal FAS group were significnatly higher than those in the no-FAS group (383·8 mIU/ml, 95 % CI: 294·2 mIU/ml to 500·7 mIU/ml v. 217·0 mIU/ml, 95 % CI: 147·0 mIU/ml to 320·4 mIU/ml, z = –3·2, P = 0·001). Infants born to women who took folic acid (FA) within the first trimester were more likely to have high anti-HBs titres (adjusted β-value = 194·1, P = 0·003). The fold change in IL-4 from neonates to infants partially mediated the beneficial influence of maternal FAS on infant anti-HBs (24·7 % mediation effect) after adjusting for confounding factors. FAS during the first trimester to HBsAg-positive mothers could facilitate higher anti-HBs levels in infants aged 11–13 months partly by upregulating IL-4 in infants.

In the context of the global childhood obesity, it is essential to monitor the nutrition value of commercial foods. A cross-sectional study (November 2018 to April 2019) aimed to evaluate the nutritional adequacy of processed/ultra-processed food products targeted at 0–36-month-old children in Portugal and in Brazil. The nutrient profiling model developed by the Pan American Health Organization was used. A total of food 171 products were assessed (123 in Portugal and forty eight in Brazil). From the fifteen available meat- or fish-based meals in Brazil, 60 % exceeded the amount of Na and 100 % exceeded the target for total fat. Given the lack of specification of sugars within carbohydrates in the label of the foods in Brazil, it was not possible to calculate free sugars. In Portugal, from the seventeen fruit and vegetable purees and the six juice/smoothie/tea/drinks available, 82 % and 67 %, respectively, surpassed the level of free sugar, while total and saturated fat was excessive in all yogurt and yogurt-related products (n 21), 40 % of biscuit/wafer/crisps (two out of five) and 13 % meat- or fish-based meals (two out of sixteen). These findings demonstrate the relevance of improving the nutritional profile of some food products targeted to young children.

It is unclear whether there is any association between psychological distress and unhealthy dietary habits among adolescents in low- and middle-income countries. We aimed to estimate the prevalence of these factors in South-East Asia region and investigate their associations. We used data from the Global School-based Health Survey for nine South-East Asian countries. Psychological distress was defined by presence of ≥ 2 factors from loneliness, anxiety, suicide ideation, suicide planning and suicide attempt. We assessed inadequate fruit intake, inadequate vegetable intake, daily soft drink and weekly fast-food consumption. We used random-effects meta-analysis to estimate pooled prevalence. Logistic regressions were used to estimate OR of unhealthy dietary behaviours for psychological distress. Among 30 013 adolescents (56 % girls) aged 12–15 years, the prevalence of psychological distress was 11·0 %, with girls reporting slightly higher than boys (11·8 % v. 10·1 %). The prevalence of inadequate fruit intake, inadequate vegetable intake, daily soft drink consumption and weekly fast-food consumption was 42 %, 26 %, 40 % and 57 %, respectively. Psychological distress was associated with inadequate fruit intake (pooled OR = 1·20, 95 % CI 1·03, 1·40), inadequate vegetable intake (pooled OR = 1·17, 1·05, 1·31) and daily soft drink consumption (pooled OR = 1·14, 1·03, 1·26); but not with weekly fast-food consumption (pooled OR = 1·13, 0·96, 1·31). We observed substantial cross-country variations in prevalence and OR estimates. In conclusion, South-East Asian adolescents have significant burden of psychological distress and unhealthy dietary behaviours, with those having psychological distress are more likely to have unhealthy dietary behaviours. Our findings will guide preventative interventions and inform relevant policies around adolescent nutrition in the region.

This study aimed to verify the association between the community food environment and dietary patterns in a population of different socio-economic levels. This cross-sectional study was conducted with a sample of 400 adults and elderly aged between 20 and 70 years residing in the central area of Porto Alegre, Rio Grande do Sul. Four dietary patterns were explored: healthy, traditional Brazilian, refined carbohydrates and sugars, and fast food. The community food environment included the identification of all food stores by areas where individuals lived and auditing based on the Nutrition Environment Measures Survey in Stores (NEMS-S) score. Poisson regression was used to estimate the prevalence ratios (PR) and their respective 95 % CI. After the adjustment for individual sociodemographic characteristics, residents of the area with the best community food environment (highest NEMS-S score) had 12 % and 18 % lower probabilities of high consumption (upper tertile) of the traditional (PR = 0·88; 95 % CI (0·78, 0·98)) and refined carbohydrate and sugar (PR = 0·82; 95 % CI (0·73, 0·92)) dietary patterns, respectively, compared with those living in the area with the worst community food environment (lowest NEMS-S score). Healthy and fast-food dietary patterns showed no association with the community food environment. In conclusion, the community food environment is a factor associated with the consumption of certain dietary patterns, independent of individual sociodemographic characteristics. Thus, aspects of the community food environment become important in food and nutrition actions and policies aimed at health promotion.

Accumulative evidence indicates that meal timing is associated with cardiometabolic risks by deteriorating circadian rhythms. However, evidence is unclear. This cross-sectional study aimed to investigate the relation between nightly fasting duration, meal timing and frequency and metabolic syndrome (MetS) among Iranian adults. Eight hundred fifty adults were recruited in this study. Dietary data were collected by 24-h dietary recalls. Time-related eating patterns were determined as nightly fasting duration, occasions of eating, time and energy proportion of first and last meal and meal frequency on a day. The MetS was recognised on the basis of the National Cholesterol Education Program Adult Treatment Panel III criteria. A binary logistic regression was applied to examine the relation between meal timing and MetS. A significant inverse relation between habitual nightly fasting duration with MetS (OR = 0·74, 95 % CI 0·55, 0·99, P = 0·04) and ‘increased TAG’ (OR = 0·73, 95 % CI 0·55, 0·98, P = 0·03) was found after confounder adjustment. Also, habitual first and last meal energy had no significant connection with MetS. However, the odds of ‘increased fasting blood glucose’ were lower in subjects who consumed ≥25% of habitual energy intake in the last meal (OR = 0·60, 95 % CI 0·42, 0·85, P = 0·005). Having longer nightly fasting duration may be useful for decreasing the risk of both MetS and ‘elevated TAG’. These findings introduce a new insight that time-related eating patterns, instead of nightly fasting duration alone, might be related to cardiometabolic risks in Iranian adults.

The INDDEX24 Dietary Assessment Platform (INDDEX24) was developed to facilitate the collection of 24-h dietary recall (24HR) data. Alongside validation studies in Viet Nam and Burkina Faso in 2019–2020, we conducted activity-based costing studies to estimate the cost of conducting a 24HR among women of reproductive age using INDDEX24 compared with the pen-and-paper interview (PAPI) approach. We also modelled alternative scenarios in which: (1) 25–75 % of dietary reference data were borrowed from the INDDEX24 Global Food Matters Database (FMDB); (2) all study personnel were locally based and (3) national-scale surveys. In the primary analysis, in Viet Nam, the 24HR cost US $111 004 ($755/respondent, n 147) using INDDEX24 and $120 483 ($820/respondent, n 147) using PAPI. In Burkina Faso, the 24HR cost $78 105 ($539/respondent, n 145) using INDDEX24 and $79 465 ($544/respondent, n 146) using PAPI. In modelled scenarios, borrowing dietary reference data from the FMDB decreased the cost of INDDEX24 by 17–34 % (Viet Nam) and 5–15 % (Burkina Faso). With all locally based personnel, INDDEX24 cost more than PAPI ($498 v. $448 per respondent in Viet Nam and $456 v. $410 in Burkina Faso). However, at national scales (n 4376, Viet Nam; n 6500, Burkina Faso) using all locally based personnel, INDDEX24 was more cost-efficient ($109 v. $137 per respondent in Viet Nam and $123 v. $148 in Burkina Faso). In two countries and under most circumstances, INDDEX24 was less expensive than PAPI. Higher INDDEX24 survey preparation costs (including purchasing equipment) were more than offset by higher PAPI data entry, cleaning and processing costs. INDDEX24 may facilitate cost-efficient dietary data collection.

Improving dietary reporting among people living with obesity is challenging as many factors influence reporting accuracy. Reactive Reporting may occur in response to dietary recording, but little is known about how image-based methods influence this process. Using a 4-d image-based mobile food record (mFRTM), this study aimed to identify demographic and psychosocial correlates of measurement error and reactivity bias, among adults with BMI 25–40 kg/m2. Participants (n 155, aged 18–65 years) completed psychosocial questionnaires and kept a 4-d mFRTM. Energy expenditure (EE) was estimated using ≥ 4 d of hip-worn accelerometer data, and energy intake (EI) was measured using mFRTM. EI:EE ratios were calculated, and participants in the highest tertile were considered to have Plausible Intakes. Negative changes in EI according to regression slopes indicated Reactive Reporting. Mean EI was 72 % (sd = 21) of estimated EE. Among participants with Plausible Intakes, mean EI was 96 % (sd = 13) of estimated EE. Higher BMI (OR 0·81, 95 % CI 0·72, 0·92) and greater need for social approval (OR 0·31, 95 % CI 0·10, 0·96) were associated with lower likelihood of Plausible Intakes. Estimated EI decreased by 3 % per d of recording (interquartile range − 14 %,6 %) among all participants. The EI of Reactive Reporters (n 52) decreased by 17 %/d (interquartile range − 23 %,–13 %). A history of weight loss (> 10 kg) (OR 3·4, 95 % CI 1·5, 7·8) and higher percentage of daily energy from protein (OR 1·1, 95 % CI 1·0, 1·2) were associated with greater odds of Reactive Reporting. Identification of reactivity to measurement, as well as Plausible Intakes, is recommended in community-dwelling studies to highlight and address sources of bias.

Ultra-processed foods (UPF) have been associated with cardiometabolic outcomes, but the literature has still not reported their association with the incidence of dyslipidaemias, one of the most important risk factors for the occurrence of CVD. The objective of this study was to verify the association between consumption of UPF and incidence of dyslipidaemia in Brazilian civil servants at a 4-year follow-up. The study used data from 5275 participants at baseline and on the first follow-up visit in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We applied a FFQ at baseline and identified UPF from NOVA classification of foods as to the extent and purpose of processing. The proportion (weight) of UPF in the total diet was calculated for each participant and categorised in tertiles, corresponding to low (first tertile), medium (second tertile) and high (third tertile) consumption. A mixed-effects logistic model was used to obtain the incidence of dyslipidaemia associated with the consumption of UPF. Individuals with medium and high consumption of UPF showed increases in the risks of development of isolated hypercholesterolaemia by 12 % (OR = 1·12, CI 1·00, 1·27) and 28 % (OR = 1·28, CI 1·12, 1·47), of isolated hypertriacylglycerolaemia by 14 % (OR = 1·14, CI 1·03, 1·26) and 30 % (OR = 1·30, CI 1·17–1·45), of mixed hyperlipidaemia by 21 % (OR = 1·21, CI 1·05, 1·39) and 38 % (OR = 1·38, CI 1·18, 1·62), and of low-HDL by 12 % (OR = 1·12, CI 1·00–1·24) and 18 % (OR = 1·18, CI 1·05, 1·32), respectively, compared with participants who consumed less UPF. Our findings showed important cardiovascular risk associated with the consumption of UPF and a gradient in the consumption’s effect, so these products should be discouraged.

The use of dietary supplements (DS) is increasing worldwide. There is limited evidence of their intake level and mode of consumption in association with the Greek population’s dietary and lifestyle habits. Adults (n 4011, 1873 males and 2138 females) aged > 18 years old living in Greece were included in the 2013–2014 National Health and Nutrition Survey – HYDRIA. A dietary supplement user (DSU) was defined as anyone who reported one or more DS on either a Food Propensity Questionnaire, two 24-h dietary recalls, or a questionnaire completed during the blood sample collection examination. DS use was examined according to socio-economic, anthropometric and lifestyle characteristics and the participants’ health and dietary status. DS use was reported by 31 % of the population (40 % women and 22 % men), and it was higher among individuals living in urban areas, men with good self-reported health status and women with a chronic medical condition and higher consumption of fruits. The types of DS more frequently reported were multivitamins with minerals (5·4 %), Ca (5·3 %), multivitamins (4·7 %) and Fe (4·6 %). MVM supplements were preferred by men, while Ca was more frequently reported by women and participants with low education levels. Plant- and oil-based supplement use was below 5 %. Whether DS intake benefits health must be explored. It should also be assessed if dietary supplement intake is as efficient as food intake.

Dietary inflammatory potential assessed by the Dietary Inflammatory Index (DII®) has been associated with health outcomes. However, longitudinal changes in the DII in relation to health outcomes rarely have been studied. This study aimed to examine change in the DII score over 10 years and its association with subsequent mortality in the Multiethnic Cohort. The analysis included 56 263 African American, Japanese American, Latino, Native Hawaiian and White participants who completed baseline (45–75 years) and 10-year follow-up surveys, including a FFQ. Mean energy-adjusted DII (E-DII) decreased over 10 years in men (from −0·85 to −1·61) and women (from −1·80 to −2·47), reflecting changes towards a more anti-inflammatory diet. During an average follow-up of 13·0 years, 16 363 deaths were identified. In multivariable Cox models, compared with anti-inflammatory stable individuals, risk of all-cause mortality was increased with pro-inflammatory change in men (hazard ratio (HR) = 1·13, 95 % CI 1·03, 1·23) and women (HR = 1·22, 95 % CI 1·13, 1·32). Per one-point increase in E-DII score over time, HR was 1·02 (95 % CI 1·00, 1·03) for men and 1·06 (95 % CI 1·04, 1·07) for women (P for heterogeneity < 0·001). While no heterogeneity by race and ethnicity was observed for men, the increased risk per one-point increase among women was stronger in non-Whites than in Whites (P for heterogeneity = 0·004). Our findings suggest that a change towards a more pro-inflammatory diet is associated with an increased risk of mortality both in men and women, and that the association is stronger in women, especially non-White women, than in men.

Neuromedin U (NMU) has a critical function on the regulation of food intake in mammals, while the information is little in teleost. To investigate the function of NMU on appetite regulation of Siberian sturgeon (Acipenser baerii), this study first cloned nmu cDNA sequence that encoded 154 amino acids including NMU-25 peptide. Besides, the results showed that nmu mRNA was widely distributed in various tissues especially in the hypothalamus and telencephalon. The results of nutritional status (pre-feeding and post-feeding, fasting and re-feeding) experiments showed that nmu mRNA expression was significantly decreased at 1 and 3 h after feeding in different brain regions. Similarly, after feeding, the expression of nmu significantly decreased in peripheral tissues. Moreover, nmu expression in the hypothalamus was significantly increased after fasting 1 d, but decreased after fasting 17 d, which was significantly reversed after re-feeding. However, other brain regions like telencephalon and peripheral tissues like oesophagus, intestinum valvula and liver have different change patterns. Further study showed that acute i.c.v. and i.p. injection of NMU and chronic i.p. injection of NMU significantly reduced the food intake in a dose-dependent mode. In addition, the expressions of several critical appetite factors (nmu, aplein, cart, cck, ghrelin, npy, nucb2, pyy and ucn3) were significantly affected by acute NMU-25 administration in the hypothalamus, intestinum valvula and liver. These results indicate that NMU-25 has the anorexigenic function on food intake by affecting different appetite factors in Siberian sturgeon, which provides a foundation for further exploring the appetite regulation networks in fish.