Dairy foods offer essential nutrients and bioactive compounds crucial for growth and development(1), as such they are an important component of a balanced diet. However, despite their benefits, the consumption of dairy has declined in recent years, especially among adolescents(2–4). In this regard, this study aims to evaluate the nutritional contribution of dairy intakes to the diets of adolescents in Ireland.

Analyses were based on data from the nationally representative National Teens’ Food Survey II (NTFS II; 2019-2020) in Ireland (www.iuna.net) (n = 428; 13-18yrs, 50% female). Food and beverage intake data were collected using a four-day weighed food diary. Dairy intake was classified as the intake of milk, yogurt and cheese and calcium fortified non-dairy alternatives in line with the Irish food based dietary guidelines. Whole foods that contain milk, cheese and yogurt and any relevant dairy components of composite dishes were included in the estimation of dairy intakes. Diet quality was assessed using the Diet Quality Index for Adolescents(5). Descriptive statistics and covariateadjusted univariate general linear models were used to analyse dietary intakes. Trend analysis was conducted to identify patterns in nutrient intakes and anthropometric measurements across tertiles of dairy intake.

Overall, 98% of Irish adolescents consumed dairy products and the mean daily total dairy intake was 245 ± 227 g/d, with males having higher intakes per day compared to females (319 ± 272g/d vs 171 ± 152g/d respectively). The average daily servings of dairy were 1.9 servings/d, with only 4% of teenagers achieving the recommended intake of 5 servings of dairy per day. Dairy contributed to the majority of nutrients investigated and was a high contributor to intakes of micronutrients calcium (36%), vitamin B12 (31%) and iodine (49%). Higher consumers of dairy had significantly greater mean daily intakes of protein, total sugar, saturated fat, trans fat, folate, vitamin B12, calcium, iodine, magnesium, potassium, and phosphorus compared to those in the lowest tertile of dairy intake (p <0.001). Higher consumers of dairy also had an overall higher diet quality compared to low consumers (48.0 versus 39.4%; p <0.001). No differences were noted in body weight, body mass index, percentage body fat or waist and hip circumference across tertiles of dairy consumption.

In summary, while almost all Irish adolescents consumed dairy, only 4% achieved the recommended 5 servings of dairy per day. In those consuming higher amounts of dairy, a significantly higher diet quality was observed. While this study offers valuable insights into adolescents’ intake of dairy products, its cross-sectional nature highlights the need for continued monitoring of dairy consumption patterns and nutrient intakes in this population, particularly due to the observed decline in dairy consumption noted in this age group across Europe.

Despite national dietary guidelines, dairy intakes remain low in China, partially because of high prevalence of lactose malabsorption1. The fibre intake adequacy is also low comparing to the recommendation in China2. Milk-N is a new range of fortified and non-fortified low-lactose/highfibre milk products. In this study we analyzed the associations between consumption of Milk-N products and nutritional status using diet modelling3.

We used data from China Health and Nutrition Survey-20114, participants above 20y were included in the analysis (n = 12127, 47% men, 53% women). Nutrient intakes were estimated through 3 days dietary record and household food inventory. Two diet scenarios were modelled: A) Adding a serving (200ml) of generic milk or of Milk-N to participants not meeting the dairy recommendation, and B) Substituting dairy food intakes with Milk-N in equivalent amount for dairy consuming participants. Paired t-test and Pearson’s Chi-squared test were used to compare the amount of intake and prevalence of nutrient intake adequacy between the two types of addition, and before and after the substitution.

Overall, 17.4% of participants consumed dairy foods with an average intake of 160.5g/day, among those 81.2% consumed milk. Only 1.1% of the population met dairy intake recommendations.

In the addition scenario, compared to the addition of generic milk, adding one serving of fortified or non-fortified Milk-N increased fibre intake by 25-35% (from 17.6g/day to 22-23.8 g/day), leading to increased fibre intake adequacy from 16.4% to 27.0-32.8%, i.e. 65-100% increase. Addition of fortified Milk-N improved daily average intakes of calcium, iron, zinc, vitamins A and C by 27-31%, 9%, 8%, 3%, and 16%, respectively. Consequently, the proportion of the population with inadequate intakes decreased (p<0.01) for generic milk vs fortified Milk-N as follows, for calcium (66.3% vs. 23.4-29.6%), iron (5.5% vs. 2.2%), zinc (28.1% vs. 18.9%), vitamin A (61.7% vs. 52.7%) and vitamin C (62.4% vs. 51.5%).

In the substitution scenario, replacing current dairy food intake with fortified or non-fortified Milk-N increased fibre intake by 20-27% (from 18.4 to 22.0-23.4g/day), leading to increased proportion of dairy consumers with adequate fibre intake from 18.7% to 28.2-32.3%, i.e., 51-73% increase. Substitution with fortified Milk-N improved intakes of calcium, iron, zinc, vitamins A and C by 2327%, 7%, 7%, 10%, and 12%, respectively. Consequently, the proportion of dairy consumers with inadequate micronutrient intakes significantly decreased (p<0.01) for calcium (from 72.9% to 50.353.3%), iron (from 7.5% to 4.7%), zinc (from 33.0% to 26.1%), vitamin A (from 56.9% to 47.4%), and vitamin C (from 60.2% to 50.8%).

In addition to the reduced lactose that helps to address lactose malabsorption, consumption of any Milk-N alternative could improve fibre intake, while fortified Milk-N could also contribute to reducing micronutrient inadequacies in Chinese adults.

Cows’ milk (CM) and plant-based beverages (PBB), used as milk alternatives, are not nutritionally equivalent(1) and PBB composition is highly varied(2). However, assessing the potential nutritional risk for UK populations after dietary replacement of milk with PBB is challenging, because analytical determination of PBBs’ nutrient profiles is lacking(3). This study determined and compared the mineral concentrations of milk and PBB in the UK market.

Ultra-heat treated and pasteurised samples (n = 178), including 20 brands of semi-skimmed milks and 69 brands of fortified PBBs (based on almond (17; ALMO), coconut (14; COCO), oat (19; OAT) and soya (20; SOYA)) were collected in summer 2023 and winter 2024. All PBB samples had added Ca and Na, but only 62 were fortified with I. Minerals concentration was determined using microwave assisted digestion, inductively coupled plasma-optical emission spectrometry (for microminerals) and inductively coupled plasma and mass spectrometry (for trace elements and heavy metals). Data were analysed using Minitab®22.1, with linear mixed effects models using ingredient, thermal treatment and season, and their interactions, as fixed factors, and brand ID as a random factor.

The main ingredient affected all mineral concentrations (p<0.001), except Ca and Co. SOYA had more Mg than milk (+27.5mg/kg), and milk had more Mg than ALMO, COCO, and OAT (+41.783.3mg/kg). Milk and SOYA had more P and K than other PBB (P, +411 mg/kg and +381mg/kg; K, +920 mg/kg, and +631 mg/kg, respectively). Milk had less Na than PBB (-126-64 mg/kg) with the exception of COCO. Milk contained more I (+157-200.4 µg/kg) and Zn (+1.41-3.71 mg/kg) than PBB. SOYA contained more Cu, Mg, and Mo than other PBB (for Cu 65-70 mg/kg; for Mn +1.00-1.06 mg/kg; for Mo +46-93.5 µg/kg, respectively) and milk (Cu +0.77 mg/kg; Mn +1.44 mg/kg; Mo +84.1 µg/kg). Overall, SOYA contained the most Cd, Cr, and Ni (although difference to OAT was not significant for Cr and Ni), while milk had the lowest concentration of Cd. Concentrations of Mg, P, Cu, I, Mn, Mo, and Co varied according to season (P<0.05). When compared with summer, winter PBB and milk had more Mg (+4.4 mg/kg), Cu (+0.04 mg/kg), I (+41 µg/kg), and Mo (+9.8 µg/kg), but less P (-76 mg/kg), Mn (−0.08 mg/kg), Zn (−0.21 mg/kg), and Co (-5.21 μg/kg). There were no differences in mineral concentrations due to thermal processing (UHT, pasteurisation; P>0.05).

The minerals composition of fortified PBB varied between main ingredient, and compared to milk, and seasonal variation was high. To prevent micronutrient inadequacies from the substitution of milk for PBB (in particular for I and Zn), consumers should be aware of differences in the intrinsic nutrient composition between PBB derived from different ingredients and milk, as this study showed and adopt suitable dietary and supplementation adjustments.

There is no salt iodisation policy in the UK, and the majority of iodine intake is from milk and dairy products(1). The availability of iodised table salt in the UK was last investigated in 2009, and was found to be low(2). As table salt contributes only approximately 15% to total salt intake, it is important to know whether any of the salt in processed foods is iodised. This study therefore aimed to update the availability of iodised table salt and review its use in processed foods that are available in the UK.

Iodised table salt availability was investigated in ten supermarket chains (nine online and one instore), covering 96.6% of the market share(3). Data was collected on price per kilogram for iodised and own-brand table salt. A Google-site search of the supermarket wesbites was conducted between 28 February and 4 April 2024; both the terms “iodised” and “iodized” were searched to identify all processed foods containing iodised salt. Data on product name, ingredients, salt content per 100 g and per portion, and country of origin were extracted. Duplicate products and items no longer available were removed. Salt per portion was calculated using serving sizes on the product label or equivalent products, and estimated portion sizes were used if these were unavailable. Iodine per portion was then calculated by assuming that salt was iodised at a concentration of 20 mg/kg.

Iodised table salt was available in three of the ten (30%) supermarkets (as one brand). Iodised salt was over four-times more expensive than own-brand table salt (£4.17/kg vs.£1.02/kg); the difference was smaller than in 2009 when it was six-times the price. The iodine concentration of the iodised table was 20 mg/kg, an increase from 2009 when it was 11.5 mg/kg(2).

A total of 240 processed foods containing iodised salt were identified across all supermarkets. The country of origin was mostly unspecified (46.7%, n = 112) but where it was, most products were from Germany (19.6%, n = 47). The most common (35.4%, n = 85) food group containing iodised salt was meat products (including hot dogs, pâté, salami), followed by stock/sauce/spices/condiments (22.5%, n = 54) and pasta/noodle products (12.9%, n = 31). Average iodine per portion was 19.4 µg (range 0.44-94 µg), which would provide 13% (range 0.3-63%) of adult recommendations (150 µg/day).

Iodised table salt is available at fewer supermarket chains than in 2009. Iodised salt is used in some processed foods available in the UK though the iodine content is not provided on the nutrition label. When estimating iodine intake in dietary assessments, the potential contribution from iodised salt in some processed foods should be considered. Salt intake, even if iodised, should not exceed recommendations.

The Prime Diet Quality Score (PDQS) is a rapid dietary screener that assesses diet quality. It has been associated with cardiovascular disease (CVD) in a US population(1) and validated in a UK/Irish population against 4-day food dairies(2). Food Frequency Questionnaires (FFQ) are the most commonly used dietary assessment instrument in large epidemiological studies(3). To reduce the burden of standard dietary assessment methodology, having a valid screener such as the PDQS that can be applied to FFQ data may be especially relevant to public health(4,5). This study aimed to explore how the PDQS applied to EPIC FFQ data compares to the PDQS collected directly to assess diet quality in a population at risk of CVD on the Island of Ireland.

The PAD-Q trial is a six-month, parallel, randomised, controlled, single-blinded intervention study conducted at Queen’s University Belfast and University College Dublin. Volunteers at risk of CVD by being overweight and either having hypertension, hypercholesterolaemia and/or smoking, and who had a low PDQS score (≤21) were recruited. PDQS provides a total score ranging 0-42 derived from the sum of intake level scores of 21 healthy and unhealthy food groups. To apply the PDQS to the FFQ data, the FFQ food items were matched to the most appropriate PDQS food group or left uncoded when no appropriate match could be made. Intakes from FFQ were calculated into an estimation of weekly portions to enable calculation of scores according to PDQS categories. Pearson correlation coefficients, ICCs and weighted kappa were used to analyse correlation and agreement between total PDQS scores, and Spearman correlation coefficients for individual PDQS food items. Comparison of scores from individual PDQS groups were analysed via Wilcoxon test, with p-values <0.05 considered statistically significant.

In total, n = 152 participants completed baseline questionnaires. Mean age of participants was 49 years (SD: 12), 70% were female, 29.5% were classified with overweight and 70.5% with obesity. PDQS total score derived from FFQ data (15.0 (SD: 3.7)) was correlated (r = 0.69, p<0.01) with PDQS total score at baseline (15.5 (SD: 4.2)). Similar association was observed via ICC (0.68 (95%CI: 0.58−0.76)). Weighted kappa indicated moderate agreement between measures (0.52 (SE: 05)). In the analysis of individual food group scores, correlation (r) ranged 0.32 - 0.68 (p<0.01). PDQS applied to FFQ demonstrated higher scores for most (9/13) of the healthy PDQS food groups and lower scores for all the unhealthy PDQS food groups (7/7) compared to PDQS data.

Diet quality assessed via PDQS applied to FFQ data was significantly moderately correlated with diet quality assessed via PDQS at baseline in the PAD-Q trial. Results are comparable with dietary questionnaire validation studies. FFQ data higher estimated the intake of both healthy and unhealthy PDQS food groups compared to PDQS data.

Extensive research has investigated the impact of individual foods and nutrients on development and progression of cardiometabolic disease (CMD)(1). However, there are only limited data on the influence of overall dietary patterns on CMD within the UK population. Therefore, this analysis aimed to empirically identify dietary patterns and explore their association with CMD risk factors in UK adults.

For this secondary data analysis, habitual dietary data was collated from four randomised controlled trials (DIVAS, DIVAS-2, SATgenε, RESET) and one observational study (BODYCON) conducted at the Hugh Sinclair Unit of Human Nutrition, University of Reading. This dietary data was categorised into 38 food groups before performing principal component analysis to identify specific dietary patterns. After stratifying the principal components into increasing quartiles (Q) and determining the eNutri-DQS (a measure of diet quality), ANCOVA was performed to assess variations in estimated marginal means of CMD risk factors and eNutri-DQS between quartiles of dietary pattern adherence.

The dataset included 646 individuals, 58% female with a mean± SD age of 44 ± 14 years, and body mass index (BMI) of 25.2 kg/m2 (SD 4.0). Two main dietary patterns (DP) were identified which explained 11.7% of the total variance of food intake. Higher adherence to DP1 (Q4), characterised by diets rich in fermented dairy, fruits, wholegrains, vegetables and lower in red/processed meat products, was associated with lower BMI, waist circumference, diastolic blood pressure, fasting triacylglycerol, non-high-density lipoprotein (HDL)-cholesterol and higher HDL-cholesterol concentrations compared with the lowest quartile of adherence (Q1) (P<0.01). DP2, characterised by high consumption of sugar, honey and jam and other sweet spreads, refined grains and cereals with lower intakes of vegetables, nuts and wholegrains, was associated with lower HDLcholesterol concentrations compared to those with lower adherence (P = 0.006). Relative to Q1, diet quality, as measured by the eNutri-DQS, was significantly higher across increasing quartiles of adherence to DP1 (P<0.001), whereas the eNutri-DQS was significantly lower in Q4 versus Q1 of DP2 (P<0.001).

This analysis has revealed two main dietary patterns in disease-free UK adults. Greater adherence to a diet higher in fermented dairy, fruits, wholegrains, and vegetables and lower in red and processed meat was associated with a higher diet quality and favourable associations with CMD risk markers.

Dyslipidemia and insulin resistance are pivotal in diabetes mellitus and cardiovascular disease (CVD) pathogenesis, underscoring the necessity for lifestyle interventions(1). Previous research has highlighted the efficacy of dietary modifications in improving metabolic parameters and reducing CVD risk(2,3). However, understanding the gender-specific responses to such interventions remains underexplored. This study aims to investigate the gender-specific effects of a 3-month nutrition intervention, aimed at improving lipid profiles and insulin sensitivity in patients with dyslipidemia and insulin resistance.

107 patients (pts), 53 men (49,5%), 54 women (50,5%), mean age 44,6 ± 11,3, mean BMI 33,1 ± 6,8, with dyslipidemia and insulin resistance were studied, 58 pts (54,2%) were with obesity. During the intervention, participants were provided with a dietary plan consisting of 3 meals, each of which contained vegetables (starchy and non-starchy), carbohydrates (whole grains, fruits, berries), proteins (poultry, fish, seafood, eggs, legumes, dairy products) and fats (olive oil, flax seeds, tree nuts). Pts were restricted on red and processed meat, butter, milk, trans fat, sugar, white flour products, and alcohol. The dietary intervention durated 12 weeks, during which pts maintained selfreported diet records to monitor their dietary intake. No pharmaceutical interventions were employed throughout this duration. Statistical analysis were based on using paired t-test with assessment of the dynamics of clinical indicators with 95% CI and calculation of the standardized effect size based on mean comparison.

Among women after 12 weeks the mean reduction in serum low-density lipoprotein cholesterol (LDL-C) was −0.79 mmol/L (from 4.16 ± 0.85 to 3.37 ± 0.72) or -18.9%; triglycerides −0.33 mmol/L (from 1.51 ± 0.77 to 1.18 ± 0.45) or -21,85%; Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index decreased on -2,23 or -43,47% (from 5.13 ± 4.59 to 2.9 ± 2.56), insulin level dropped by 35,25% (from 17.87 ± 12.76 to 11.57 ± 7.89).

Among men the reduction in values was the following: for LDL-C -0,85 mmol/L or -18,44% (from 4.16 ± 1.08 to 3.76 ± 0.88); for triglycerides -0,68 mmol/L or 33,66% (from 2.02 ± 1.07 to 1.34 ± 0.52); for HOMA-IR index -2,03 or -38,01% (from 5.34 ± 4.34 to 3.31 ± 2.74), for insulin -8,17 or -39,78% (from 20.54 ± 15.26 to 12.37 ± 8.66).

The dynamics for these indicators are statistically significant (p < 0.05).

Dietary intervention led to significant reductions in serum LDL-C, triglycerides, HOMA-IR index, and insulin levels among both women and men, highlighting the effectiveness of dietary modification in improving lipid profiles and insulin sensitivity.

Sarcopenic obesity is associated with higher risk of falls, hospitalizations, mortality, and a wide range of poor health outcomes(1). However, its relationship with multimorbidity is less explored. This study aimed to investigate the association between sarcopenic obesity and multimorbidity across sexes.

In this cross-sectional analysis of the UK Biobank, we included 171,448 participants (53.1% women, mean age 55 years). Sarcopenic obesity, defined according to the EWGSOP2 classification(2), was analysed as the outcome. Multimorbidity was the predictor, determined by self-reported chronic conditions and categorized into none, 1, 2, 3, 4, and 5+ diseases. Poisson regression with robust error was used to estimate the risk ratio and its 95% confidence intervals (RR, 95%CI). Analyses were adjusted for sociodemographic and lifestyle factors.

The prevalence of sarcopenic obesity increased with the number of chronic diseases in both men and women but varied significantly by sex (p-interaction= 0.030). Compared to individuals without chronic diseases, those with 5+ diseases exhibited prevalences of 55.7% in men and 51.2% in women. The prevalence of sarcopenic obesity increased by 94% (95% CI: 1.89, 2.00) for each additional chronic disease in women and 117% (95% CI: 2.09, 2.25) in men. Relative to those with no chronic conditions, individuals with 5+ diseases had 41.5 and 68.7-times higher prevalence of sarcopenic obesity in women and men, respectively.

Our findings showed a robust association between sarcopenic obesity and multimorbidity, which varies by sex, further studies is needed to examine the predictive utility of using multimorbidity to identify sarcopenia.

Hyperlipidemia is known to be closely associated with diet and inflammation.(1) This study aimed to examine the relationship between predicted hsCRP score and hyperlipidemia among women in the Korea Nurses’ Health Study.

In this prospective cohort study, a total of 6,921 women aged 21-50 years were included from the Korea Nurses’ Health Study (KNHS)(2) module 1 to 11. The predicted hsCRP score was derived from demographic, lifestyle, dietary, and anthropometric factors.(3) Dietary factors were derived based on a validated food frequency questionnaire (FFQ).

Hyperlipidemia was defined as the presence of any one of the following: 1) total cholesterol ≥240 mg/dl, 2) HDL-cholesterol <50 mg/dl, or 3) triacylglycerol ≥200mg/dl.(4) We also considered participants with a history of diagnosed hyperlipidemia or current use of hyperlipidemia medication as having hyperlipidemia. Cox proportional hazard regression analysis was used to calculate relative risk (RRs) and 95% confidence intervals (CIs) with adjustment for potential confounding factors.

During a mean follow-up of 5.81 person-years, 1,862 cases of hyperlipidemia were identified. After multivariable adjustment, the RRs (95% CIs) for hyperlipidemia comparing the highest predicted hsCRP score with the lowest predicted hsCRP score were 1.22 (1.04-1.43), 1.12 (0.96-1.32), 1.27 (1.08-1.49), and 1.61 (1.37-1.89), respectively (P for trend < 0.001).

Our results support that increasing predicted hsCRP scores were associated with increased risk of hyperlipidemia. These findings suggest that dietary and lifestyle changes aimed at reducing inflammation may help prevent hyperlipidemia.

Diabetes mellitus is a serious worldwide public health problem due to its high prevalence. In Chile, 1.7 million people have been diagnosed with diabetes mellitus, of which 90% are type 2 diabetes mellitus (T2DM) cases(1). It is well known that blood pressure (BP) control is essential to prevent future complications and to ensure a positive prognosis for this disease (2). Moreover, studies in Chile have shown a significant increase in systolic and diastolic blood pressure (SBP, DBP) levels in T2DM subjects compared to the non-diabetic Chilean population (3). Therefore, this study aimed to determine and compare SBP and DBP levels according to age group in T2DM patients of primary health care centres (PHCC) in Copiapó, Chile.

Cross-sectional study within the CODIACO cohort. Data were collected from April to August 2023 on 161 patients with T2DM from eight PHCCs of Copiapó. Patients diagnosed with T2DM, of both sexes and aged between 30 and 65 years were included. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer and severe inflammatory or infectious diseases were excluded. To estimate BP, three measurements were taken every five minutes. Three age groups were established: ≤ 50 (n = 36), 50-60 (n = 74) and ≥ 60 years old (n = 51). Blood pressure results were expressed as mean and standard deviation of mmHg unit. Normal distribution was analysed using the Kolmogorov-Smirnov test corrected for Lilliefors. In addition, the one-way ANOVA test was used to compare SBP and DBP between age groups. Bonferroni was used for post hoc testing. A P-value < 0.050 was considered statistically significant. Data were analysed using SPSS software. The study was conducted according to the ethical standards of the Declaration of Helsinki and its subsequent modifications. The CODIACO study was approved by the Scientific Research Ethics Committee of the University of Atacama. The project was funded by FONDECYT N° 11180794

The mean of systolic blood pressure (SBP) for the ≤ 50, 50-60 and ≥ 60 year groups, was 123.92 ± 14.38; 133.23 ± 18.36; 135.88 ± 15.02 mmHg (p = 0.003); respectively. Bonferroni test indicated a significant difference in SBP between the group ≤50 and 50-60 (p = 0.019) and ≥60 year groups (p = 0.003), but not between 50-60 and ≥60 year groups (p = 1.000). The ANOVA did not show a significant difference in diastolic blood pressure (DBP) between groups (p = 1.000).

The results suggest that SBP levels of T2DM patients in PHCCs of Copiapó are higher in older age groups (50-60 and ≥60y) compared to the younger age group ≤50y). No significant differences were found in DBP.

Metabolic dysfunction-associated steatotic liver disease (MASLD), considered as the hepatic component of the metabolic syndrome, is the leading cause of chronic liver disease around the world(1). The MASLD disease spectrum begins with isolated steatosis. A subset of patients will develop metabolic dysfunction-associated steatohepatitis (MASH) which is characterized by steatosis and inflammation, resulting in hepatocyte injury with or without fibrosis. MASH is regarded as a progressive phenotype, as it can advance to cirrhosis and subsequently to hepatocellular carcinoma(2). Compared with fasting measurements alone, postprandial responses to nutrient challenges offer a greater insight into the phenotypic heterogeneity that occurs across health and disease(3). To better understand the phenotypes that occur across the spectrum of MASLD, we have characterized the postprandial metabolic and inflammatory responses to different dietary challenges in healthy individuals and patients with MASLD and MASH.

10 healthy individuals, 18 patients with MASLD, and 15 with MASH were recruited. Body composition was assessed using bioelectrical impedance analysis (Tanita). Liver fat and stiffness were measured by FibroScan in patients only. All participants completed a high fat mixed meal challenge containing 655kcals, 46g fat, 33g saturated fat, 50g carbohydrates, 45g sugar, and 10g protein. Patients with MASLD and MASH also completed a high-fructose challenge containing 400kcals, 75g fructose and 25g glucose. Fasting and postprandial blood samples were drawn at each challenge at 0, 30, 60, 90, 120, 180, 240 and 360-minutes. Glucose was measured in whole blood using a HemoCue Glucose 201+ analyzer. Serum insulin and plasma IL-6 and CRP will be measured by ELISA. Plasma triglycerides, non-esterified fatty acids (NEFA), and glycerol will be measured by colorimetric assay.

Bodyweight (p = 0.0247), BMI (p = 0.0448), and hip circumference (p = 0.0237) were greater in MASH vs MASLD. Healthy participants had significantly lower bodyweight, BMI, and waist and hip circumferences vs both MASLD and MASH (p<0.0001 for each variable). Liver fat was similar between MASLD and MASH, whereas liver stiffness was greater in MASH (p<0.0001). Alanine transaminase (ALT) was increased in MASH vs MASLD (p = 0.0408), while concentrations of other liver enzymes were similar between groups. Total cholesterol (p = 0.0492) and LDL-cholesterol (p = 0.0197) were also higher in MASH vs MASLD, but there was no difference in triglyceride concentrations or HDL-cholesterol. There was a significant impact of group on glucose response to the HFMM (p = 0.0321), and glucose responses varied between the 3 groups across different time points (p<0.0001).

The HFMM, which is more representative of a typical meal, revealed glucose intolerance in MASLD and MASH which was also greater in MASLD. Analysis of the full cohort will enable greater characterization of the phenotypes that occur across the spectrum of MASLD.

The global pandemic of overweight and obesity is linked to non-communicable disease (NCD) risk, incidence, and outcomes(1). Moderate weight-loss (5-10%) has considerable benefits, yet high quality diets can offer protective nutritional factors for NCD while encouraging nutritious, sustainable, and empowering dietary/lifestyle change. Evidence supports Mediterranean-style diet (MD) efficacy, yet adherence and adoption are becoming low even in countries of the Mediterranean basin(2). Obesogenic environments, ultra-processed foods, and social factors are implicated in low adoption. An adapted MD could improve adherence and adoption for UK populations(3). This systematic review aims to investigate substitutions and adaptations to MD.

The following databases were searched for articles published between inception and December 2023: the Cochrane Library, EMBASE, CINAHL, Scopus, and MEDLINE. Risk of bias was assessed using the Revised Cochrane v2 tool for randomized trials. Articles were included if they met the following criteria: (1) study type was experimental or quasi-experimental; (2) mean participant age between 18 and 65 years (3) healthy or pre-clinical population (4) modification, adaptation, or tailoring of MD to specific populations.

The databases identified 4,478 results. Forward citation searching returned two eligible results. A total of seventeen articles were included in the analysis. Fourteen were RCTs, one each of crossover and uncontrolled trials, and one protocol. Six studies were reported as part of the PREDIMED multicentre trials, while the protocol represented the RESMENA-S trials (hypocalorific, low glycaemic index diets). Ten were independent. PREDIMED studies supplemented MD with either extra virgin olive oil or nuts, with control group following a low-fat American Heart Association diet. Remaining interventions demonstrated heterogenicity of MD design; a ketogenic MD with phytoextract supplementation; three studies required aerobic exercise (i) daily (walk ≥30 minutes), (ii) weekly (150 minutes), or (iii)trainer-led resistance programme, with MD [ (i) MD with EVOO and pistachios, (ii) low-carbohydrate MD with walnuts (iii) hypocalorific macronutrientpercentage-adjusted MD]. A further three studies (two hypocalorific and one ketogenic) required no change to habitual physical activity levels. Five studies (PREDIMED) recorded leisure-time physical activity. Three studies [ (i) PREDIMED (ii) personalised hypocalorific MD (iii) isocaloric MD] had no activity information. Only one study [personalised low-calorie MD] applied a psychological behaviour change model. No studies specifically reported hydration levels or conviviality intervention; uncertain whether this information was included in professional-led education.

The present systematic review finds paucity of evidence in RCTs of MD customisation for specific countries in healthy or pre-clinical individuals. Interventions have largely focused on augmenting MD with extra consumption of specific foods. Other components of the MD and lifestyle such as conviviality, hydration, adequate rest, seasonal and traditional ingredients, and lack of sedentarism were not reported.

Cardiovascular diseases account for 31% of all global deaths, the majority (80%) of which are associated with hypertension.(1,2) As of 2019, hypertension is expected to affect 1 in 3 adults living in West Africa, with prevalence standing at 36.1% In Nigeria.(3,4) Poor dietary habits, including high intakes of salt, processed meat, ultra-processed foods, and unhealthy fats and oils and low intakes of vegetables, fruits, fibre, and nutrients such as potassium and omega-3 fatty acids, account for 9–17% of cases of hypertension globally, and our recent meta-analysis confirms their contribution in Nigeria and other West African countries.(1,5,6) This study aimed to develop and deliver a culturally-appropriate diet risk score for clinical practice that can (i) rapidly and accurately identify and stratify individuals at risk of hypertension and (ii) support clinicians and other healthcare professionals to provide tailored and effective personalised dietary advice.

We used a culturally-appropriate Nigerian Dietary Screening Tool (that we recently designed and validated(7,8)) to assess the dietary intake among 151 patients in a Nigerian hospital and used methods similar to Framingham and INTERHEART to: (i) construct and validate a Nigerian Dietary Risk Score (NiDRS) for hypertension, and (ii) evaluate the NiDRS against a panel of clinical biomarkers of hypertension, using multiple logistic regression models, internal validation using measures of discrimination and calibration, decision analysis curve and mediation analysis to facilitate its use in clinical practice.

Each incremental increase in the overall NiDRS was associated with a 2-fold increase in odds of overall hypertension (OR: 2.04, 95%CI: 1.16, 1.16, p = 0.01), with the highest score category associated with >18-food increased odds of hypertension, compared to lowest NiDRS (OR: 18.27, 95%CI: 1.33, 251.21, p = 0.03). The NiDRS demonstrated good discrimination with an AUC of 0.92%, high sensitivity (0.85), specificity (0.94), calibration (with a Brier score of 0.1) and a positive net benefit. In addition, via mediation analysis, total cholesterol (50%), triglycerides (47%), LDL-c (49%), VLDL-c (17%), CRP (68%), and homocysteine (71%) were mediators of the NiDRS-hypertension pathway in a positive direction.

The NiDRS is an accurate and valuable tool for clinicians to identify and stratify individuals at risk of hypertension and discuss dietary prevention strategies to address the rising prevention of hypertension and its associated cardiovascular complications in Nigeria.

It is common for individuals to seek information online when facing health and nutritional problems, particularly those with lower education level and nutritional knowledge(1). One way to access such information is through search engines, with Google being the most popular, currently used by 92% of the world’s population, with an average of 85.59 billion monthly visits(2). Google Trends is a tool provided by Google, freely accessible, allowing users to observe patterns in internet searches(3). The aim of this study is to identify patterns to predict trends related to weight loss at specific times.

Data were extracted from Google Trends over the past 20 years, from 2004 to 2024, using the keywords “weight loss” and “diet.” In Google Trends, users may input a keyword consisting of words or phrases that are relevant to the chosen issue or cases. The duration of time that users wish to examine can be specified. Furthermore, users can explore geographical regions or search worldwide. Figures generated represent search interest based on the highest points on the graph for specific regions and times. The popularity of search terms is relative and depends on the category: search term or topic. Data is normalised and presented on a scale from 0-100, where each point on the graph is divided by the highest point, or 100. A value of 100 indicates peak popularity, 50 indicates half popularity, and 0 indicates insufficient data for the term.

Over the past 20 years, there has been an increasing trend in searches for websites using the keyword “weight loss,” with an average interest score of 31. This differs from the keyword “diet,” which has shown a tendency towards stagnation in popularity, although it briefly peaked with a score of 100 in early 2014 and has an average interest score of 53. Both keywords exhibit similar search patterns, reaching their highest peaks each year in January and lowest points in December.

For the keyword “weight loss,” the most searches were from South Africa (100), Romania (96), and Vietnam (91), while the lowest were from Italy (4), Japan (5), and the Netherlands (9). For the keyword “diet,” the most searches were from Poland (100), Kuwait (87), and Greece (85), while the lowest were from Japan (2), Thailand (7), and France (11). Users also searched for other related topics or queries including ozempic and intermitten fasting.

Our data indicates a consistent increasing trend in searches for weight loss over the last 20 years via Google Trends. New Year resolutions may be linked to peak searches which occur in January. While this data may prove useful for researchers and policymakers, further validation of its validity and reliability is necessary.

The scientific evidence surrounding the efficacy of low-carbohydrate diets (LCDs) compared to low-fat diets (LFDs) in the secondary prevention of cardiometabolic diseases is diverse. While some studies indicate that LCDs can lead to superior cardiometabolic outcomes(1), others conclude that higher intakes of MUFA, or PUFA could have a better impact on the risk of CVD(2). However, despite inconclusive findings, only a limited number of reviews have employed precise meta-analytical methods and used the most recent scientific evidence to derive quantitative estimates of the relative effect of these two diets.

This study aims to exploit the advantages of meta-analysis to compare the efficacy of LCDs (CHO <30% of total energy intake) and LFDs (FAT <35% of total energy intake) against cardiovascular diseases (CVDs), based on the most recent scientific evidence.

A systematic review was performed by retrieving studies from 5 bibliographic databases from January 2013 to 31 May 2023. The studied population included adults at high risk for CVDs, and the outcomes covered indicators for glycemic control, adiposity, lipidemia, and inflammation. Data were extracted in a pre-defined template and a meta-analysis was performed, along with sensitivity analyses. This abstract provides a preliminary analysis of outcomes from a subset of identified studies, focusing on two specific parameters, including triacylglycerols (TGs) and Body Mass Index (BMI).

Six studies (769 subjects) were included in the meta-analysis. Overall, participants in the LCD had on average 0.30 mmol/L lower TG levels at the end of the intervention (95% CI: −0.43; −0.17) whilst for participants in the LFD the magnitude of the effect was smaller (i.e., −0.22 (−0.36; −0.08) mmol/L). However, we found no evidence of a significant impact of the LCD on TG levels against the LFD (change in mean difference (95% CI): −0.096 (−0.245; 0.053) mmol/L), whilst study heterogeneity was moderate (I2 = 56%). Moreover, participants in the LCD achieved a reduction in BMI of -2.04 kg/m2 on average (95% CI: -2.77; -1.31), whilst those in LFD achieved on average a reduction of -1.20 kg/m2 in BMI (95% CI: -1.95; −0.44), with the reduction in BMI being greater for participants in the LCD compared to the LFD (−0.47 kg/m2 (−0.91; −0.04), I2 = 12%).

The findings of this pairwise meta-analysis underscore the complex interplay between dietary composition and metabolic outcomes and will provide the best practices for the risk reduction of developing CVDs.

Cardiovascular diseases (CVDs), including ischemic heart diseases (IHD) and stroke, are a leading cause of death globally and significantly impact quality of life(1). Current guidance suggests increasing the consumption of pulses rich in fibre and iron, to reduce CVD risk(2). However, longterm observational studies investigating pulse consumption and CVD incidence are limited(3). In the current analysis, the UK Biobank, a prospective cohort study of over 500,000 UK adults was used to investigate the association between pulse consumption and CVD incidence(4).

A total of 119,914 (males: 51,540 and females: 68,374) participants with ≥ two 24-hour dietary recalls, not pregnant and free from CVD at baseline were included. Total CVD was defined as IHD and cerebrovascular diseases. Multivariable-adjusted Cox proportional hazard regression models were used to estimate the incidence of CVD by pulse consumption, reported as hazard ratios (HR) and 95% confidence intervals (CI). Pulse consumption was modelled as a categorical variable with non-consumers (0g/day, n = 76,531) and 3 tertiles (T) of pulse intake T1 (1-20.4g/day, n = 14,785); T2 (20.5-40g/day, n = 14,015); T3 (40.5-360g/day, n = 14,583). The fully adjusted model was controlled for sex, age, dietary energy, region, ethnicity, smoking status, physical activity level, education, income, employment, body mass index (BMI), alcohol intake, supplement use, processed red meat intake, sodium intake and trans-fatty acids intake, family history of stroke, heart disease and diabetes, insulin use, blood pressure or cholesterol-lowering medication use. The analysis was performed in STATA 18.

The cohort had a mean ± SD age of 55.9 ± 7.8 years, BMI of 26.6 ± 4.5 kg/m2 and pulse intake of 13.2 ± 24.3 g/day. There were 8,937 incidences of CVD after a mean follow-up of 12.4 years. Compared with non-consumers, pulse intake was not significantly associated with the incidence of total CVD, T1 (HR: 0.95, CI: 0.89–1.01),T2 (HR: 0.98, CI: 0.92–1.05), T3 (HR: 0.97; CI: 0.91–1.04).

In conclusion, pulse-rich diets were not significantly associated with a lower total CVD incidence in middle-aged adults participating in the UK Biobank compared to non-consumers. Further work will model the replacement of red and processed meat with pulses on CVD incidence and mortality.

Funding was received from BBSRC (BB/W017946) for the project “Raising the Pulse: Systems analysis of the environmental, nutritional and health balance of staple foods”. This research has been conducted using the UK Biobank Resource under application number [101928].

Low energy availability (LEA) is a state in which the body lacks sufficient energy to support normal bodily functions required to maintain health1. While LEA is frequently associated with a plethora of cardiovascular abnormalities, supporting research is limited and largely comprised of studies that are small and preliminary in nature2. To date, there has been no comprehensive synthesis of the evidence regarding the cardiovascular implications of LEA in female athletes and our review aims to address this.

This review followed the Cochrane Collaboration PRISMA protocol3. Various online databases (PubMed, One Search, Web of Science, Google Scholar) and manual searches were used, with a cut-off publication date set at November 2023. Search keywords were devised using the PICO framework3. Medical Subject Headings (MeSH) terms were used in PubMed. Boolean logic was applied to filter relevant results. Eligibility criteria included physically active to elite-trained female athletes, LEA risk determination, and cardiovascular measures (including cardiovascular disease (CVD) risk, biomarkers and/or non-invasive measures). Articles were screened, extracted, and quality assessed using the NIH Quality Assessment Tool. Three researchers were blinded to each other’s decisions to reduce potential biases and queries were resolved through reviewer discussion.

A total of nine studies were included. After evaluating the studies using the quality assessment tool, five studies were found to be moderate quality and four low-quality, due to factors including the inability to blind subjects or testers. The studies examined multiple cardiovascular health indicators and had mixed findings regarding the connection between LEA and potentially increased cardiovascular risks, aligning with previous research. Two studies suggested LEA leads to unfavourable blood lipid profiles which are known to lead to an increased risk of CVD4, while three others found no significant difference in blood lipids due to LEA. One study identified twenty detrimental associations between lipids and clinical markers of hormone imbalance, dyslipidemia, and altered body composition, which are characteristic issues of LEA. These associations reflect the underlying metabolic disruptions caused by LEA typically involved with cardiovascular issues. Regarding autonomic control, vascular function and morphology, two research studies showed no significant association in heart rate variability, brachial flow-mediated dilation, pulse wave velocity, carotid artery reactivity, carotid-intima media thickness, or biomarkers reflecting endothelial activation with LEA. Although one study indicated abnormalities in flow-mediated dilation among those with LEA. Additionally, one study determined female athletes with LEA were more than 2.5 times more likely to experience cardiovascular issues (e.g., arrhythmias, valvular heart disease, coronary artery disease, and cardiomyopathy) as determined by the preparticipation examination.

This review highlights LEA’s potential to elevate CV risks in female athletes. To validate these implications, further future larger-scale longitudinal studies with robust study designs are necessary to confirm the cardiovascular implications of LEA in female athletes.

Chile has the third highest prevalence of diabetes mellitus America, with 12.7% of the population aged 20-79 years, whose 90% have type 2 diabetes mellitus(T2DM)(1). Diet plays an important role in the management of this disease(2). According to the 2016-17 National Health Survey in Chile, only 9.2% of the population consume fish and seafood (9.5% women and 8.8% men)(3). However, no studies have investigated the frequency of fish and seafood consumption in T2DM population from Chile, or whether consumption differs between normal weight, overweight, and obese subjects. This study aims to compare the frequency of fish and seafood consumption in normal weight, overweight, and obese subjects with T2DM in primary health care centres (PHCC) in CopiapóChile.

A descriptive cross-sectional study was conducted in patients with T2DM, of both sexes, aged 3065 years, from the CODIACO cohort, recruited in PHCCs, during 2023. Pregnant and lactating women, diabetic neuropathy or nephropathy, cancer, and severe inflammatory or infectious diseases patients were excluded. Participants were administered a food consumption frequency questionnaire (never/rarely, occasionally and usually) of oily and white fish, and seafood. The nutritional status (normal-weight, overweight, and obese) was defined based on WHO criteria(4). The results on the frequency of food consumption were expressed as percentages and the age of the participants as mean and standard deviation. Chi-square test was used to study the relationship between the frequency of fish and seafood consumption and nutritional status. A Pvalue less than 0.05 was considered statistically significant. The CODIACO project was approved by the Scientific Research Ethics Committee of the Universidad de Atacama. Project funded by FONDECYT N°11180794.

The mean age of the 153 participants, 106 women and 47 men, was 55.45±7.56 years. Of the participants 9.8% were normal-weight, 32.0% were overweight and 58.2% were obese. Those who reported an usually consumption of oily fish according normal-weight (53.3%), overweight (28.6%) and obese patients (29.2%), were significant (P=0.021). From the total number of subjects who never/rarely consumed oily fish, 2.2 % were normal-weight, 26.1% were overweight and 71.7% were obese. Regarding white fish, it was usually consumed by 46.7% of normal-weight, 32.7% of overweight and 29.2% of obese patients, but not significant (P=0.059). Furthermore, white fish was never/rarely consumed by 5.1% of normal-weight, 23.1% of overweight and 71.8 % of obese subjects. Finally, seafood consumption reported was not significant (P = 0.571). Those who declare a never/rarely seafood consumption, 6.0% had a normal-weight, 30% were overweight and 64% were obese subjects.

The results suggest that obese patients with T2DM in the PHCCs of Copiapó consume significantly less fish, especially oily fish, than normal-weight and overweight diabetic patients. A better oily fish consumption could be a protector factor to prevent obsesity in T2DM.

Incarcerated individuals are vulnerable and might face more health challenges as their dietary intake and physical activity are limited to what their national or institutional policies offer or allow. Excess weight might increase the risk of metabolic disorders, affecting the overall health status and increasing the financial burden on medical care within prisons and the community once incarcerated individuals are released after incarceration.(1) Some reports show a high prevalence of overweight and obesity among incarcerated individuals in developed countries.(2) However, evidence from developing countries is underreported.(3) The aim of this systematic review and meta-analysis was to assess the nutritional status of incarcerated populations in developing and developed countries.

Systematic searches were conducted in Embase, Medline and Cochrane databases for crosssectional studies or baseline data from longitudinal or intervention studies of adults who were incarcerated. Studies that reported on nutritional status (body weight, body height, or BMI), as well as the prevalence of overweight or obesity, were included. Overweight and obesity proportions within studies were pooled into a meta-analysis and compared with national prevalence rates. First, the proportion of overweight and obesity within prisons in each study sample and the 95% confidence intervals (CI) were estimated by sex and stratified according to each country’s income categories (World Bank 2023 fiscal year income(4)). Then, national overweight and obesity prevalence data were retrieved from the World Obesity Federation Global Obesity

Observatory(5) for each country and adjusted for sex and year of data collection of the studies included in the meta-analyses. The proportion of incarcerated individuals with overweight and obesity was then compared with that of the general population using national data through a risk difference (RD) meta-analysis. The heterogeneity of studies included in the meta-analyses was assessed through I2, and a random or fixed-effect model was fitted accordingly.

Overall, 71 studies met the inclusion criteria, and 38 were included in the meta-analysis. Studies in high-income countries reported higher proportions of overweight and obesity (73.3%, CI 73.1, 73.5) compared to upper-middle-income countries (65.9%, CI 64.1, 67.7) and lower-middle-income countries (52.8%, CI 47.1, 58.1). The prevalence of overweight and obesity in female incarcerated individuals was higher than that in the general population (RD 11.7%, CI 9.1, 14.3), especially in low and middle-income countries (RD 35.1%, CI 29.4, 40.7). The prevalence of overweight and obesity in male incarcerated individuals was lower than that in the general population in all income categories (RD -10.8%, CI -13.2, -8.4).

Thus, the prevalence of overweight and obesity in incarcerated populations differed between developed and developing countries. Future research on managing overweight and obesity should consider female incarcerated individuals, especially in lower-middle-income countries.

PROSPERO registration no CRD42022320861

Low-carbohydrate diets (LCDs) can be effective in inducing Type 2 diabetes (T2DM) remission(1). Although there are large interventional studies conducted on quantitative outcomes for remission, qualitative aspects -primarily patient experiences- are less likely to be explored. This study aimed to investigate experiences of participants who recently induced remission using a LCD in primary care.

Participants were recruited from two GP practices in England after receiving advice to follow a LCD by their GP and recently achieved T2DM remission. Semi-structured interviews were performed virtually, audio recorded and transcribed. The interview questions focussed on barriers and facilitators when adopting a new diet and lifestyle for inducing remission. Verbatim transcripts were analysed using Braun&Clarke’s(2) guide. Ethical approval was granted from Edge Hill University and the NHS (ETH2122-0228 and 22/SC/0451, respectively).

Twelve participants (4 female/8 male) completed the study. Mean ( ±SD) age of participants was 69±8 years. Duration of T2DM prior to remission was 66±54 months. Mean ( ±SD) HbA1c was 44±2 mmol/mol. Thematic analysis yielded four overarching themes: 1) motivation, 2) empowerment and autonomy,3) challenges and 4) integrating LCD into daily life.

The analysis indicated that a behaviour change in participants was observed as evidenced by theme 4 integrating LCD into daily lives. In this theme, participants mentioned they built new habits such as reading food labels and cooking fresh meals, with new and more mindful attitudes towards food. Especially on days where they deviated from LCD, usually due to social events, they strived for balance and continued to follow LCD the next day.

The findings aligned with a UK study(3) where participants who followed LCD found enjoyment in their food and they viewed LCD as a lifestyle change rather than a short-term fix, as well as allowing for some flexibility (striving for balance) within LCD. These factors were similarly observed in our study, and this facilitated adherence to LCD.

This study suggests that LCD advice by GPs was well-received by patients and was associated with positive lifestyle changes. Participants report that having some flexibility with LCD, such as taking breaks for special occasions, aided long term compliance. Initiatives that aim to encourage long-term compliance need to consider the importance of flexible management allowing participants to plan and recover from relapse.