Eur J Nutr [JOURNAL]
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200 papers
Pea protein preload improves postprandial glucose response in healthy adults: a randomized, double-blind, controlled pilot study.
Elbira A, Punithalayal PGG, Hernández-Álvarez AJ … +1 more , Boesch C
Eur J Nutr · 2026 Jun · PMID 42274793 · Full text
PURPOSE: Protein intake has shown benefits to mitigate postprandial hyperglycaemic excursions. In particular, whey protein has demonstrated strong potential for postprandial glucose management, and more recent findings h...
PURPOSE: Protein intake has shown benefits to mitigate postprandial hyperglycaemic excursions. In particular, whey protein has demonstrated strong potential for postprandial glucose management, and more recent findings highlighted evidence for increased efficacy of whey protein when consumed before, rather than with a carbohydrate-rich meal. Given the strong interest yet limited evidence on plant-based protein, the present study compared the potential of pea protein consumed prior to carbohydrates, on postprandial glucose as well as satiety and blood pressure (BP). METHODS: In an acute randomized cross-over trial, ten healthy adults consumed a pea protein drink either before (PrePP) or with (PP) a standard carbohydrate-rich meal, compared with a control meal (CHO). Continuous glucose monitoring, satiety levels and BP were recorded over 180 min post-meal consumption. RESULTS: Both PP and PrePP significantly reduced postprandial glucose excursion (0.46 vs. 1.125 mmol/L), compared to CHO (1.89 mmol/L). The effect was more pronounced with PrePP, exhibiting a delayed glucose response and a blunted peak beyond 60 min. Systolic BP remained unchanged, whereas both PP and PrePP significantly reduced diastolic BP compared to CHO (- 4.2 mmHg at 150 min, p < 0.05; -9.2 mmHg at 180 min, p < 0.01, respectively). PP significantly increased fullness and reduced hunger after 60 and 180 min, respectively, whereas PrePP significantly decreased hunger after 60 min of carbohydrate consumption. CONCLUSION: Given the enhanced efficacy in lowering postprandial glucose when consumed before carbohydrates, pea protein pre-meal consumption could be considered as part of a dietary strategy to manage postprandial glycaemia well comparable to whey protein.
Retraction Note: The effect of hesperidin supplementation on metabolic profiles in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial.
Yari Z, Movahedian M, Imani H … +3 more , Alavian SM, Hedayati M, Hekmatdoost A
Eur J Nutr · 2026 Jun · PMID 42268416 · Publisher ↗
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The moderating role of central adiposity, sex and age, on the association between animal- and plant-based protein intake and the 20-year cumulative incidence of type 2 diabetes: the ATTICA cohort study (2002-2022).
Kechagia I, Barkas F, Yannakoulia M … +4 more , Liberopoulos E, Sfikakis PP, Pitsavos C, Panagiotakos D
Eur J Nutr · 2026 Jun · PMID 42250107 · Full text
PURPOSE: The aim of this study was to evaluate the role of central adiposity, sex and age, on the association between total-animal and total-plant based protein and the 20-year cumulative incidence of type 2 diabetes (T2...
PURPOSE: The aim of this study was to evaluate the role of central adiposity, sex and age, on the association between total-animal and total-plant based protein and the 20-year cumulative incidence of type 2 diabetes (T2D), among apparently healthy adults participating in the ATTICA cohort study (2002-2022). METHODS: The present analysis included data from 2,000 individuals free of atherosclerotic cardiovascular disease and T2D at baseline (age 43 ± 13 years; 51% women). Total, animal-based, and plant-based protein intake were measured, through a validated food frequency questionnaire. RESULTS: The 20-year cumulative incidence of T2D was 26.3% (95%CI [24.4, 28.3%]). Total red meat intake was consistently associated with increased incidence of T2D in both sexes, with RRs ranging from 1.08 to 1.11 per 30 g/day increment (p's < 0.05), after adjustment for confounders. Among females, a higher intake of animal-based protein was significantly associated with increased incidence of T2D (RR 1.24, 95%CI [1.04, 1.48]), with no significant associations among males. The adverse association between animal-based protein intake and T2D was strongest among females with increased WHR (RR 2.06, 95%CI [1.21, 3.49]); no significant association was observed in males, regardless of WHR status. Among younger females (< 65 years) with increased WHR, the association between animal-based protein and T2D incidence was equally strong (RR 2.06, 95%CI [1.21, 3.49]), and plant-based protein intake retained a highly significant protective association (RR 0.24, 95%CI [0.08, 0.68]). CONCLUSIONS: Long-term animal protein intake, especially red meat, increases the likelihood of developing T2D, particularly in women with central obesity; plant protein appears protective in metabolically vulnerable subgroups.
Digestibility and microbiota modulation by nuts and sunflower seeds in cystic fibrosis: an in vitro approach.
Viteri-Echeverría J, Calvo-Lerma J, Heredia A … +2 more , Andrés A, Asensio-Grau A
Eur J Nutr · 2026 Jun · PMID 42250097 · Full text
PURPOSE: This study evaluated the lipid and protein digestibility and the prebiotic potential of almonds, hazelnuts, peanuts, and sunflower seeds through static in vitro gastrointestinal digestion and colonic fermentatio...
PURPOSE: This study evaluated the lipid and protein digestibility and the prebiotic potential of almonds, hazelnuts, peanuts, and sunflower seeds through static in vitro gastrointestinal digestion and colonic fermentation, comparing healthy and cystic fibrosis (CF) conditions. METHODS: The CF model included reduced pH, low bile salt concentration, and pancreatic enzyme replacement therapy. Digestibility was assessed via matrix degradation, proteolysis, and lipolysis, while microbiota composition and metabolic activity were analysed using faecal inoculum from paediatric CF donors. RESULTS: Sunflower seeds and peanuts showed the highest lipolysis under CF conditions (46%), with sunflower seeds also achieving the highest proteolysis (457 mg tyrosine/g food). Beta-diversity analyses revealed significant differences in microbiota composition after simulated colonic fermentation between the four food samples, with sunflower seeds uniquely reducing Acidaminococcus and increasing the production of linear-chain short-chain fatty acids and lactate. In contrast, almonds exhibited notably low proteolysis, potentially due to antinutritional factors. CONCLUSION: These findings highlight the differential digestibility and microbiota modulation of nuts and seeds under CF-specific conditions, with sunflower seeds emerging as a promising dietary component for children with CF.
Exploring the associations between lifestyle and dietary patterns with preclinical alzheimer's disease: findings from La Rioja cohort study.
Iñiguez M, Tobías BM, López-Álava S … +5 more , Yuste S, Manzano JI, Recio-Fernández E, Pérez-Matute P, Motilva MJ
Eur J Nutr · 2026 Jun · PMID 42250017 · Full text
PURPOSE: Modifiable lifestyle factors play an important role in maintaining brain health. This study aimed to investigate lifestyle behaviours, with a special focus on dietary patterns, associated with preclinical Alzhei...
PURPOSE: Modifiable lifestyle factors play an important role in maintaining brain health. This study aimed to investigate lifestyle behaviours, with a special focus on dietary patterns, associated with preclinical Alzheimer's disease, and to evaluate the urinary diet-polyphenol metabolites as objective biomarkers of plant-based food consumption by integration of the targeted metabolomics with self-reported dietary assessments. METHODS: We conducted a case-control study including 50 individuals diagnosed with preclinical Alzheimer's disease and 48 cognitively healthy controls (aged 55-75 years, both sexes). Demographic characteristics, cardiovascular risk factors, physical activity, cognitive and social engagement, and dietary patterns were assessed. The 24-hour urine samples were analysed by targeted ultra-high-performance liquid chromatography coupled to triple quadrupole tandem mass spectrometry (UHPLC-QqQ-MS/MS). RESULTS: Dietary patterns characterised by higher daily consumption of vegetables and nuts and lower of processed foods, consistent with the MIND diet score, were associated with better cognitive outcomes. These associations were strengthened by engagement in cognitively stimulating activities. Urinary polyphenol metabolites, including anthocyanins, stilbenes, and gut microbiota-derived metabolites of dietary flavan-3-ols such as valerolactones and phenolic acids, were positively associated with the consumption of plant-based foods. CONCLUSION: Lifestyle modifications combining plant-rich dietary patterns with cognitive stimulation may support cognitive resilience in individuals with preclinical Alzheimer's disease diagnosis. Urinary polyphenol metabolites represent objective biomarkers that can enhance the accuracy of diet-brain health assessments.
Combined fat and sugar intake reshapes the tumor microenvironment through hypoxia and lipogenic pathways in breast cancer.
Ferrero V, Mazo T, Don JA … +7 more , Barotto NN, Moreira-Espinoza MJ, Pairola MO, Rivoira MA, Rodríguez VA, Fernández-Zapico ME, Pasqualini ME
Eur J Nutr · 2026 Jun · PMID 42249987 · Publisher ↗
PURPOSE: Breast cancer is the most prevalent malignancy worldwide. Beyond genetic factors, dietary components like palmitic acid (PA) and sucrose modulate tumor progression and microenvironment dynamics. However, their c...
PURPOSE: Breast cancer is the most prevalent malignancy worldwide. Beyond genetic factors, dietary components like palmitic acid (PA) and sucrose modulate tumor progression and microenvironment dynamics. However, their combined mechanistic impacts on tumor-stroma crosstalk remain undefined. We investigated how dietary PA and sucrose affect breast cancer growth and the tumor microenvironment using a murine model. METHODS: Mice received Control, high-PA (HPOD), high-sucrose (HCD), or combined (HPCD) diets. We assessed tumor growth, metabolic parameters, membrane fatty acids, histopathology, proliferative indices, and microenvironment markers (CD8, F4/80, α-SMA, HIF-1α, FASN). In vitro assays evaluated PA and fructose effects on LM3 cells and fibroblasts. RESULTS: HCD and HPCD markedly promoted tumor growth versus Control and HPOD. HPOD increased membrane saturated fatty acids, whereas HCD elevated ω-6 PUFAs. Both HCD and HPCD increased macrophage infiltration (F4/80 +), while HPCD specifically activated cancer-associated fibroblasts (α-SMA). HIF-1α protein increased across all experimental diets without mRNA alterations, suggesting post-transcriptional stabilization. FASN protein upregulation occurred in HCD and HPCD, while Fasn mRNA increased specifically in HCD. In vitro, combining PA and fructose enhanced LM3 cell proliferation and viability while reducing apoptosis. Additionally, this co-treatment specifically increased fibroblast viability. CONCLUSIONS: Diets rich in PA and sucrose drive breast cancer progression through distinct mechanisms. Carbohydrates transcriptionally activate FASN-mediated lipogenesis, whereas their combination with PA remodels the tumor microenvironment via CAF activation and HIF-1α post-transcriptional stabilization. These findings highlight specific dietary components as critical variables in cancer progression, offering potential implications for nutritional interventions and targeted therapies.
Wild blueberry-derived polyphenol metabolites attenuate telomere shortening in an in vitro model of metabolic syndrome.
Rendine M, Del Bo' C, Riso P … +1 more , Møller P
Eur J Nutr · 2026 Jun · PMID 42249975 · Full text
PURPOSE: Metabolic syndrome (MetS) is a multifactorial disorder characterized by metabolic alterations that increase cardiovascular risk and may accelerate telomere attrition, potentially contributing to age-related dise...
PURPOSE: Metabolic syndrome (MetS) is a multifactorial disorder characterized by metabolic alterations that increase cardiovascular risk and may accelerate telomere attrition, potentially contributing to age-related diseases. Dietary (poly)phenols (PPs), including those derived from blueberries (BB), may counteract telomere shortening through their multitarget biological effects; however, additional mechanistic studies are required. This study investigated the effects of BB-derived PP metabolites, ferulic acid (FA), isoferulic acid (IA), vanillic acid (VA), and hippuric acid (HA), on telomere length (TL) in an in vitro MetS model. METHODS: The MetS model was established using THP-1 monocytes exposed to free fatty acids and TNF-α. Metabolites were tested individually and in combination (MIX) at physiologically relevant concentrations (0.1-50 µM). Cytotoxicity, telomere length, and intracellular reactive oxygen species (ROS) were assessed. RESULTS: The MetS stimulus significantly reduced TL (mean difference - 0.61; 95% CI - 0.80 to - 0.41; p < 0.001). Pre-treatment with FA (1 µM), VA (0.5-5 µM), and MIX (6.1 µM) significantly attenuated telomere attrition, restoring TL compared to the control (mean differences 0.30-0.37; p < 0.05), whereas lower concentrations of FA, IA, and HA were ineffective. ROS modulation was context-dependent: PP metabolites did not directly affect basal ROS levels but modified the response to HO exposure, with VA (5 µM) and the MIX (6.1 µM) exacerbating HO-induced ROS generation under MetS conditions. CONCLUSION: These findings indicate that selected BB-derived PP metabolites could mitigate telomere shortening under metabolic stress independently of acute ROS modulation, supporting a potential role of dietary PPs in preserving genomic integrity under MetS-like conditions.
Effects of acute bovine colostrum supplementation on immune responses to prolonged cycling: a randomised crossover trial.
Jones AW, Thatcher R, Davison G
Eur J Nutr · 2026 Jun · PMID 42249952 · Full text
PURPOSE: The purpose of this double-blind placebo-controlled crossover trial was to assess the effects of acute bovine colostrum supplementation on exercise-induced changes in neutrophil function and mucosal immunity fol...
PURPOSE: The purpose of this double-blind placebo-controlled crossover trial was to assess the effects of acute bovine colostrum supplementation on exercise-induced changes in neutrophil function and mucosal immunity following prolonged exercise. METHODS: Sixteen healthy, recreationally active males participated in two trials in a randomised counterbalanced order. Participants either consumed doses of bovine colostrum or an isoenergetic placebo 1 h (30 g) and immediately prior (5 g) to 2.5 h of cycling at 15% Δ with a further dose midway through the exercise (5 g). Venous blood and unstimulated saliva samples were obtained at baseline, 1 h post-consumption (pre-exercise), immediately post-exercise and 1 h post-exercise. A mechanistic sub-study was performed to determine whether plasma obtained from participants following bovine colostrum consumption directly enhances neutrophil function. RESULTS: Compared to placebo, a greater fMLP-stimulated blood neutrophil oxidative burst was observed (~ 15% difference across timepoints) with bovine colostrum (trial, p < 0.05). In the sub-study, fMLP-stimulated neutrophil oxidative burst was enhanced when whole blood was pre-incubated with plasma obtained 1 h following colostrum consumption. There was greater salivary lysozyme concentration and bacterial-stimulated blood neutrophil elastase release at post-exercise and 1 h post-exercise respectively in the bovine colostrum trial (trial × time interaction, p < 0.05). There was no effect of bovine colostrum on leukocyte trafficking, PMA-stimulated neutrophil oxidative burst, salivary secretory immunoglobulin A and salivary lactoferrin. CONCLUSION: Acute bovine colostrum supplementation can modify innate immune responses to prolonged exercise, which may be due to components or metabolites of bovine colostrum that become bioavailable following consumption.
Educational disparities in the association of protein diversity and type 2 diabetes: a multi-country population-based prospective case-cohort study.
Mozaffari H, Imamura F, Murphy RA … +18 more , Sharp SJ, Forouhi NG, Wareham NJ, Jessri M, Ibsen DB, Dahm CC, Luján-Barroso L, Sánchez MJ, Chirlaque MD, Colorado-Yohar SM, Guevara M, Jakszyn P, Panico S, Ricceri F, Rolandsson O, Schulze MB, Winkvist A, Conklin AI
Eur J Nutr · 2026 Jun · PMID 42249949 · Publisher ↗
PURPOSE: To investigate socio-economic disparities in the association between dietary diversity and type 2 diabetes (T2D). METHODS: Prospective secondary analysis study of 10,363 incident cases of T2D over 12 years and a...
PURPOSE: To investigate socio-economic disparities in the association between dietary diversity and type 2 diabetes (T2D). METHODS: Prospective secondary analysis study of 10,363 incident cases of T2D over 12 years and a random sub-cohort of 13,937 individuals in the EPIC-InterAct case-cohort study. We used baseline self-reported diet data (1991-1998) to construct scores for diversity between food groups (range: 0-5) and diversity within subtypes of vegetables (0-4), and plant protein sources (0-5). Prentice-weighted Cox regressions estimated multivariable-adjusted hazard ratios (HR) and 95% confidence intervals of incident T2D for each diversity score stratified by education, employment, and marital status. RESULTS: Overall group differences were evident for education in the association between plant-protein diversity and incident T2D (p for group effect = 0.04). University-educated participants consuming three plant-protein subtypes had 35% lower T2D incidence (HR 0.65 [95% CI: 0.45, 0.95]). Greater vegetable diversity (3-4 subtypes vs 0-1) was associated with 61%, 22% and 18% lower T2D incidence for, respectively, those who were single, had primary education or were employed. Total diet diversity (5 food groups versus ≤ 3) was associated with 43%, 30%, 20% and 15% lower T2D incidence for, respectively, those who were single, employed, had primary education or were married. CONCLUSION: Education modified the association between plant-protein diversity and T2D onset in European adults, and certain socioeconomic groups specifically benefited from higher diversity reducing T2D risk. Promoting diet diversity overall may support T2D prevention across populations, while tailored messages of plant-protein diversity may improve relevance and equity in nutrition and diabetes.
Quantitative comparison of food-based dietary guidelines: alignment with the Slovenian nutrition guidelines 2025 and Slovenian intake.
Kreft S, Tavčar E, Schäfer AC … +4 more , Sivec N, Fras Z, Jakše B, Mis NF
Eur J Nutr · 2026 Jun · PMID 42228199 · Full text
PURPOSE: Food-based dietary guidelines (FBDGs) are a key instrument for translating nutrition science into public health advice, yet direct comparison across guidelines is hindered by differences in food grouping, units,...
PURPOSE: Food-based dietary guidelines (FBDGs) are a key instrument for translating nutrition science into public health advice, yet direct comparison across guidelines is hindered by differences in food grouping, units, and formulation of recommendations. Slovenia has recently developed and scientifically completed the Slovenian Nutrition Guidelines 2025 (SNG2025), its updated FBDGs, which have been submitted for governmental adoption but are not yet officially adopted. The SNG2025 extend conventional FBDGs into a quantitative, plant-forward framework that integrates health and environmental sustainability. However, their quantitative position relative to contemporary international guidelines and nationally representative intake data has not yet been systematically evaluated. METHODS: We compared 13 national FBDGs (Denmark, Finland, Sweden, Norway, Germany, Austria, Spain, France, Canada, United States, China, United Kingdom and Australia) and two international frameworks (Nordic Nutrition Recommendations and EAT-Lancet) with the SNG2025. Recommendations were extracted for major food groups and mathematically converted (standardised) to a common unit (g/day) using predefined conversion factors and explicitly stated assumptions. RESULTS: The SNG2025 are largely consistent with international practice. Strong convergence was observed for fruits and vegetables, while recommendations for legumes, nuts, and whole grains closely aligned with EAT-Lancet targets and those from Spain and Austria. Slovenian upper limits for meat, dairy and eggs were comparable to those in several European and international guidelines; notably, some FBDGs suggest more stringent reductions than the SNG2025. Several guidelines allow fortified plant-based alternatives to fully replace animal-based dairy. Greater variability was observed for fish and seafood, reflecting regional dietary traditions. Significant heterogeneity in the formulation of recommendations (e.g., portion-based vs. weight-based) was identified. CONCLUSIONS: The SNG2025 are well aligned with contemporary international and national recommendations and align with widely accepted quantitative ranges for all major food groups. Differences between guidelines reflect cultural framing and quantification rather than conflicting nutritional principles. The SNG2025 demonstrate that contemporary dietary guidelines can integrate quantitative guidance, a plant-forward approach, and sustainability considerations while remaining aligned with international evidence. These findings support the use of SNG2025 as a reference framework for the development and evaluation of future dietary guidelines in comparable settings.
Effects of green tea use on the metabolic profile of postmenopausal women: systematic review and meta-analysis.
Zago IHR, Colonetti L, Balbinot EL … +4 more , Taschetto IS, Grande AJ, da Rosa MI, Colonetti T
Eur J Nutr · 2026 Jun · PMID 42228178 · Full text
PURPOSE: Among the main consequences of menopause are changes in body weight, lipid and metabolic profiles, as well as an increased risk of cardiovascular disease. This study aimed to analyze the effects of green tea con...
PURPOSE: Among the main consequences of menopause are changes in body weight, lipid and metabolic profiles, as well as an increased risk of cardiovascular disease. This study aimed to analyze the effects of green tea consumption on the metabolic profile of postmenopausal women. METHODS: This is a systematic review of randomized controlled trials (RCTs) evaluating the effects of green tea compared with placebo in postmenopausal women. The search was conducted in the following electronic databases: MEDLINE via PubMed, EMBASE via Elsevier, the Cochrane Library, LILACS via BVS, and Web of Science, using the terms "Tea," "Green tea extract," "Metabolic profile", "Menopause," and "Postmenopause" (MeSH descriptors and synonyms). The outcomes listed in the study protocol were: weight, body mass index (BMI), body composition, lipid profile, and blood glucose. RESULTS: Data were collected from seven RCTs that met the selection criteria. The meta-analysis showed that green tea reduced total cholesterol levels in postmenopausal women (mean difference [MD]: -7.03; 95% confidence interval [CI]: -13.24 to - 0.82; p = 0.03; I² = 0%; four studies; 1,109 participants; low-quality evidence). However, no statistically significant effects were observed for the other evaluated outcomes. CONCLUSION: This meta-analysis demonstrated that green tea resulted in reductions in total cholesterol levels in postmenopausal women. However, further high-quality randomized controlled trials with standardized dosage, formulation, and duration are needed to confirm these findings and support the safe clinical use of green tea as an adjunctive strategy. High-dose concentrated extracts should be used with caution, and hepatic function monitoring may be warranted.
High nutritional knowledge during adolescence is associated with healthier dietary habits in adulthood: a longitudinal cohort study.
Béghin L, Morcel J, Michels N … +8 more , Leroy M, Ternynck C, Labreuche J, De Henauwn S, Miguel-Berges ML, Polito A, Moreno LA, Gottrand F
Eur J Nutr · 2026 Jun · PMID 42228155 · Full text
PURPOSE: Cardiovascular disease is the leading cause of mortality worldwide and is driven by atherosclerosis, which develops from a young age. Several lifestyle factors, including diet, physical activity, physical fitnes...
PURPOSE: Cardiovascular disease is the leading cause of mortality worldwide and is driven by atherosclerosis, which develops from a young age. Several lifestyle factors, including diet, physical activity, physical fitness, and sleep quality, influence cardiovascular health. However, limited research has investigated the association of nutritional knowledge with long-term health outcomes. This study assessed the association between adolescents' nutritional knowledge and adulthood dietary habits, physical fitness, and cardiovascular risk factors. METHODS: This longitudinal cohort study included 143 adolescents aged 12.5-17.5 years who were reevaluated as young adults (22-31 years) after a follow-up period of 10-14 years. The study was conducted in four European centers: Ghent (Belgium), Lille (France), Rome (Italy), and Zaragoza (Spain). Nutritional knowledge was assessed during adolescence and adulthood using the Nutritional Knowledge Test. Cardiovascular health was evaluated based on HDL and non-HDL cholesterol levels, blood pressure, body mass index, glycemia, and calculation of modified Pathobiological Determinants for Atherosclerosis in Youth (mPDAY) cardiovascular risk scores. Diet Quality Index (DQI), Planetary Health Diet Index (PHDI), ultra-processed food consumption, cardiorespiratory fitness (CRF) and upper-body muscular strength were also assessed. Spearman correlational analysis was used to identify associations between adolescents' nutritional knowledge and cardiovascular, dietary, and physical fitness parameters in adulthood. RESULTS: Correlation analysis showed that greater nutritional knowledge during adolescence was associated with a better dietary quality in adulthood, as reflected by a higher DQI (p = 0.004; r = 0.25; 95% CI [0.08-0.40]). Nutritional knowledge during adolescence correlated inversely with the mPDAY cardiovascular risk score in adulthood. Cross-sectional analysis in adolescence and adulthood showed that nutritional knowledge in adolescence was not associated with cardiovascular parameters, physical fitness, or dietary quality indices during adolescence. Nutritional knowledge in adulthood was associated only with a better CRF (p = 0.003; r = 0.37 [0.13-0.58]) in adulthood. CONCLUSION: Nutritional knowledge during adolescence is associated with a dietary quality in adulthood, as measured by the DQI. These findings suggest that assessment of nutritional knowledge during adolescence might serve as a simple and effective tool for early identification of individuals at risk of poor dietary habits and increased cardiovascular risk. These findings also highlight the potential value of school-based interventions involving nutritional knowledge in promoting long-term cardiovascular health. NCT number: NCT02899416.
Microencapsulated docosahexaenoic acid increases the Omega-3 Index and attenuates the physiological impact of eccentric exercise in physically trained adults: a 12-week double-blind placebo-controlled trial.
Anthony R, Macartney MJ, McLennan PL … +5 more , Elhage A, Sluyter R, Sampson JA, Mitchell TW, Peoples GE
Eur J Nutr · 2026 May · PMID 42213158 · Full text
PURPOSE: This study investigated the effects of docosahexaenoic acid (DHA) supplementation on delayed onset muscle soreness (DOMS), physical function, and inflammation following eccentric exercise-induced muscle damage i...
PURPOSE: This study investigated the effects of docosahexaenoic acid (DHA) supplementation on delayed onset muscle soreness (DOMS), physical function, and inflammation following eccentric exercise-induced muscle damage in physically trained male and female adults (training ≥ 5d/wk). METHODS: Thirty-eight participants (12 Control, 26 DHA) completed a 12-week double-blind, placebo-controlled matched-pair trial. The Control group received high-oleic acid tablets. The DHA group received 715 mg/d of microencapsulated DHA tablets. Participants performed eccentric cycling at weeks 0 and 12, with assessments conducted pre-exercise, 0-h, 24-h, and 48-h post-exercise. The primary outcomes were DOMS (visual analogue scale) and the Omega-3 Index (O3I) (estimated by finger-stick dry blood spot). Secondary outcomes included neuromuscular function and inflammatory cytokines. RESULTS: O3I was not different between groups at week 0 but was elevated in the DHA group (∆2.43%, [95% CI; 2.10, 2.77], P < 0.001) and between Control at week 12 (P < 0.001). DOMS was lower at 24-h and 48-h post-exercise in the DHA group and between Control at week 12 (P < 0.01). At week 12, jump height and peak vertical force improved at 48-h post-exercise in the DHA group (P < 0.05), resulting in moderate (d = 0.60) and small (d = 0.32) effect sizes for 48-h post-exercise area under the curve (AUC) between groups, respectively. There were interaction effects for 48-h post-exercise AUC of IL-6 (P = 0.049), TNF-α (P = 0.010), and IL-10 (P = 0.026). CONCLUSION: A dietary achievable dose of DHA elevated the O3I and reduced DOMS in physically trained adults. These outcomes support protracted intake of DHA to attenuate the physiological impact of eccentric exercise and promote recovery.
Associations between dietary patterns and cardiovascular, kidney and metabolic risk markers in the Cooperative Health Research in South Tyrol study.
Hantikainen E, Berger S, Barbieri G … +6 more , Pramstaller PP, Garcia-Larsen V, Gögele M, Pattaro C, Lundin R, Domingues FS
Eur J Nutr · 2026 May · PMID 42213156 · Full text
PURPOSE: Cardiovascular-kidney metabolic syndrome (CKM) represents an increasingly prevalent public health concern. Optimal strategies to prevent CKM-related outcomes are greatly needed. We assessed the association betwe...
PURPOSE: Cardiovascular-kidney metabolic syndrome (CKM) represents an increasingly prevalent public health concern. Optimal strategies to prevent CKM-related outcomes are greatly needed. We assessed the association between various dietary patterns and CKM biomarkers in a general population study. METHODS: We used cross-sectional data from 8066 adult participants of the Cooperative Health Research in South Tyrol (CHRIS) study. Self-reported dietary intake was assessed through the semi-quantitative GALEN Food Frequency questionnaire. We derived six established dietary pattern indices, and population-specific dietary patterns through principal component analysis. CKM biomarkers included: systolic and diastolic blood pressure, glycated haemoglobin, visceral fat, HDL, LDL and total cholesterol, triglycerides, creatinine-based estimated glomerular filtration rate, and urinary albumin-to-creatinine ratio. We investigated associations between each dietary index and CKM risk marker using multivariable linear regression models. We further examined potential effect modification by sex, body mass index, physical activity and smoking habit. RESULTS: Higher adherence to healthy dietary patterns rich in fruits, vegetables, whole grains, and low in saturated fats was associated with more favorable CKM marker levels. E.g, when comparing the fourth to the first quartile the healthy plant-based dietary index was associated with lower total and LDL cholesterol (β ≈ - 5.0 mg/dL, p < 0.001), lower blood pressure (β= - 1.24 mmHg, p = 0.001) and higher eGFR (β = 1.24 ml/min/1.73m, p = 0.001). In contrast, the unhealthy plant based and a Western style diet were associated with higher SBP (β = 1.23-1.89 mmHg, p < 0.01), amongst others. For some markers, associations tended to be stronger in men, individuals with overweight or obesity, those with lower physical activity, and smokers (P< 0.05). CONCLUSIONS: Adhering to a healthy plant rich diet low in saturated fats, added sugars and processed foods was associated with more favorable levels of CKM biomarkers, including blood lipids, blood pressure, glycated hemoglobin and eGFR.
Planetary health diet: dissecting the link between diet, mortality risk and heart age from a 16-year follow-up of the Guangzhou Biobank Cohort Study.
Lu TY, Wang J, Huang YY … +5 more , Tian WB, Jin YL, Lam TH, Zhang WS, Xu L
Eur J Nutr · 2026 May · PMID 42192022 · Full text
PURPOSE: To examine the associations of planetary health diet (PHD) with all-cause and cause specific mortality, alongside heart age based on the Guangzhou Biobank Cohort Study (GBCS) and conduct mediation analysis. METH...
PURPOSE: To examine the associations of planetary health diet (PHD) with all-cause and cause specific mortality, alongside heart age based on the Guangzhou Biobank Cohort Study (GBCS) and conduct mediation analysis. METHODS: Participants were recruited from the GBCS and were aged ≥ 50 years. Dietary information was collected using a validated Food Frequency Questionnaire. Participants were assigned PHD scores between 0 (no adherence to PHD) and 140 (complete adherence to PHD). Primary outcomes were all-cause, cardiovascular disease (CVD) and cancer mortality. Causes of death were identified through death registry. Secondary outcome, heart age, was calculated using sex-specific 10-year CVD risk prediction models previously developed and validated in the GBCS. Cox proportional hazards regression and linear regression were used to analyze the associations of PHD scores with mortality and heart age. Mediation analyses were conducted using the difference method implemented by the "mediate" SAS macro. RESULTS: Of 25,550 participants aged 50+ years, during 417,590 person-years of follow-up, higher PHD scores was linearly associated with lower all-cause and CVD but not cancer mortality (hazard ratio (HR) (95% confidence interval (CI)) per 10-point increment: 0.94 (0.92-0.97), 0.92 (0.89-0.95) and 0.97 (0.93-1.01)). The association with all-cause mortality was mediated by white blood cell count (WBC), waist-to-hip ratio and waist-to-hip-to-height ratio (mediation proportion (95% CI): 6.2% (3.2-11.7%), 2.6% (0.9-7.2%) and 5.4% (2.8-9.9%)), whereas the association with CVD mortality was mediated by WBC and waist-to-hip-to-height ratio (7.9% (4.1-14.9%) and 7.4% (3.0-17.0%)). A negative association between PHD scores and heart age was observed in women but not in men (β (95% CI) per 10-point increment: - 0.13 (- 0.24, -0.01) and 0.05 (- 0.15, 0.25) years, P < 0.001). CONCLUSION: Higher adherence to PHD was linearly associated with lower all-cause and CVD but not cancer mortality in Chinese aged 50+ years, and with lower heart age in women only. Our findings advocate for PHD in middle-aged to older Chinese, particularly women to improve cardiovascular health.
Validation and reproducibility of a novel flavonoid food frequency dietary assessment tool (Flav-Q) against multiple 24-h recalls across 12 months.
Lorzadeh E, Charlton K, McCaffrey TA … +3 more , Weston-Green K, Batterham M, Kent K
Eur J Nutr · 2026 May · PMID 42191993 · Full text
PURPOSE: Measurement of dietary flavonoid intake requires a reliable tool. This study validated and evaluated the reproducibility of a 23-item shortened flavonoid food frequency questionnaire (FLAV-Q), derived from the 9...
PURPOSE: Measurement of dietary flavonoid intake requires a reliable tool. This study validated and evaluated the reproducibility of a 23-item shortened flavonoid food frequency questionnaire (FLAV-Q), derived from the 96-item Kent & Charlton Flavonoid specific-FFQ. METHODS: The FLAV-Q was validated against an average of repeated 24-h dietary recalls using Intake-24 completed quarterly over the period of a year that were adjusted to represent habitual intake by applying the multiple source method (MSM) in 80 Australian adults. FLAV-Q validity was estimated using the Wilcoxon signed-rank test, Spearman's correlation coefficient, Bland-Altman plots, and Cohen's kappa (κ). Reproducibility was assessed by comparing the FLAV-Qs at four timepoints. RESULTS: FLAV-Q overestimated total flavonoid intake against habitual intake (443.2 mg/day versus 234.4 mg/day, p < 0.001) and all subclasses except for flavanones. Moderate agreement was detected for total flavonoids (r = 0.66, p < 0.001; κ = 0.45, p < 0.001), flavan-3-ols (r = 0.72, p < 0.001; κ = 0.53, p < 0.001), flavonols (r = 0.55, p < 0.001; κ = 0.40, p < 0.001), flavanones (r = 0.50, p < 0.001; κ = 0.30, p = 0.007) and fair but non-significant agreement for anthocyanins (r = 0.38, p < 0.001; κ = 0.15, p = 0.18) and flavones (r = 0.34, p < 0.001; κ = 0.20, p = 0.07). Bland-Altman plots showed a large bias (Bland-Altman index: 7.5%) for total flavonoid intake. FLAV-Q demonstrated moderate reproducibility across timepoints with mean percentage differences for total flavonoid intake ranging from 22% to 37%. Bland-Altman plots indicated moderate to small bias for reproducibility (Bland-Altman index: 2.5-3.8%). CONCLUSIONS: FLAV-Q demonstrates moderate to low validity and reproducibility for total flavonoids and the subclasses. Further validation for absolute intake values is necessary to understand and address the overestimation.
Plant-based dietary indices and mental health: a cross-sectional study of a middle- to older-aged population.
Millar SR, Perry IJ, Phillips CM
Eur J Nutr · 2026 May · PMID 42191962 · Full text
PURPOSE: Plant-based diets (PBDs) have been linked with favourable cardiometabolic health outcomes. However, there has been limited investigation of PBD indices (PDIs) and mental health outcomes. Addressing this gap, we...
PURPOSE: Plant-based diets (PBDs) have been linked with favourable cardiometabolic health outcomes. However, there has been limited investigation of PBD indices (PDIs) and mental health outcomes. Addressing this gap, we examined an overall PDI (oPDI), healthy PDI (hPDI) and unhealthy PDI (uPDI) associations with depressive symptoms, anxiety and well-being. METHODS: This cross-sectional study includes 1,949 middle- to older-aged men and women from the Mitchelstown Cohort. PDIs were calculated from validated food frequency questionnaires. Depressive symptoms, anxiety and well-being were assessed using the 20-item Center for Epidemiologic Studies Depression (CES-D) Scale, the anxiety sub-scale of the Hospital Anxiety and Depression Scale and the World Health Organization-Five Well-Being Index. Regression analyses investigated PDI relationships with mental health scores, adjusted for potential confounders. RESULTS: In age and sex-adjusted models, the oPDI and hPDI were negatively associated with depressive symptoms (β = -0.095, 95% CI: -0.154, -0.036; p = 0.002 and β = -0.086, 95% CI: -0.136, -0.035; p = 0.001, for oPDI and hPDI scores respectively), and positively associated with greater well-being (β = 0.045, 95% CI: 0.006, 0.084; p = 0.025 and β = 0.037, 95% CI: 0.003, 0.071; p = 0.032, for oPDI and hPDI scores respectively). Additionally, the oPDI was inversely associated with anxiety (β = -0.027, 95% CI: -0.053, -0.002; p = 0.038). Higher oPDI and hPDI score associations with fewer depressive symptoms, and oPDI score associations with anxiety, persisted upon full adjustment, with PDI quartiles demonstrating significant dose-response relationships with CES-D scores (p trend < 0.05). CONCLUSIONS: Greater adherence to an overall PBD, and more healthful PBD, is associated with fewer depressive symptoms and greater well-being among middle- to older-aged adults. Future longitudinal studies which explore causal relationships between PDIs and psychological outcomes are warranted.
Effect of breastfeeding on dietary patterns in early childhood: the CoAlHaS study.
Ferro-Larroy S, Gomez-Acebo I, Alonso-Molero J … +6 more , Llorente-Pelayo S, Valero-Dominguez S, Lechosa-Muñiz C, Paz-Zulueta M, Cabero-Perez M, Dierssen-Sotos T
Eur J Nutr · 2026 May · PMID 42191954 · Full text
PURPOSE: This study assessed the association between breastfeeding practices during the first year of life and later diet quality at ages 4 and 6 years, focusing on unprocessed/minimally processed foods (MPFs) and ultra-...
PURPOSE: This study assessed the association between breastfeeding practices during the first year of life and later diet quality at ages 4 and 6 years, focusing on unprocessed/minimally processed foods (MPFs) and ultra-processed foods (UPFs). METHODS: We analyzed data from 574 children participating in the CoAlHaS study, a prospective birth cohort conducted in Santander, Spain. Breastfeeding status was recorded at 6 months (exclusive, mixed or infant formula), and at 12 months (continued breastfeeding or infant formula). Dietary intake at ages 4 and 6 years was assessed using the Food Propensity Questionnaire from the ENALIA study, developed for the Spanish population of children and adolescents. Foods were classified according to the NOVA system. Logistic regression estimated odds ratios (OR) for high MPFs and UPFs intake (highest vs. lower tertiles), adjusting for sociodemographic, anthropometric, lifestyle variables, and total energy intake. RESULTS: Exclusive breastfeeding at 6 months was associated with higher odds of high MPFs intake at age 4 (OR 2.2; 95% CI 1.14-4.34), but this was not significant at age 6 after adjustment. Conversely, exclusive breastfeeding consistently protected against high UPFs intake, remaining significant at age 6 (OR 0.46; 95% CI 0.23-0.91) in fully adjusted models. Continued breastfeeding at 12 months showed a slightly weaker protective association at age 6 (OR 0.55; 95% CI 0.31-0.97). CONCLUSION: Exclusive breastfeeding for 6 months may contribute to healthier dietary patterns in early childhood, particularly by reducing ultra-processed food consumption, with protective effects persisting until school age.
Differential associations of diet with hepatic and muscle insulin resistance: insights from an dietary pattern analysis in the PERSON study.
Hoge A, Donneau AF, Dardenne N … +5 more , Guillaume M, Afman LA, Feskens EJM, Goossens GH, Blaak EE
Eur J Nutr · 2026 May · PMID 42191942 · Full text
PURPOSE: The relationship between dietary patterns (DPs) and type 2 diabetes is well established, but the potential role of tissue-specific insulin resistance (IR) in this association remains unclear. This study aimed to...
PURPOSE: The relationship between dietary patterns (DPs) and type 2 diabetes is well established, but the potential role of tissue-specific insulin resistance (IR) in this association remains unclear. This study aimed to derive DPs using reduced rank regression (RRR), incorporating hepatic IR index (HIRI) and muscle insulin sensitivity index (MISI) as response variables. We also examined whether these patterns are associated with insulin sensitivity and pancreatic β-cell function. METHODS: We conducted a cross-sectional analysis of 700 adults with overweight or obesity participating in the screening phase of the PERSON study. Dietary intakes were assessed using a food frequency questionnaire. RRR was used to derive DPs based on HIRI and MISI. Associations with HOMA-IR, HOMA-β, Matsuda index and Disposition index were tested using multiple regression models adjusted for socio-demographic and lifestyle factors. RESULTS: One DP was retained, explaining 13.7% of the variation in HIRI, 2.8% in MISI, and 8.2% of the combined variation. This DP was characterized by high intakes of unprocessed red meat, processed meat, fresh cream and whipped cream, and low intakes of fruits, vegetables, and tea. It was significantly associated with higher HOMA-IR (β-coefficient ± SE: 0.04 ± 0.02) and HOMA-β (0.05 ± 0.01), and lower Matsuda index (- 0.08 ± 0.02). CONCLUSION: The identified DP was more strongly associated with hepatic than muscle IR. This finding highlights differential associations between diet and tissue-specific IR, and supports the relevance of considering tissue-specific insulin resistance phenotypes when investigating the relationship between diet, insulin resistance and type 2 diabetes risk. Trial registration The trial was registered at https://clinicaltrials.gov/study/NCT03708419 (identifier NCT03708419).
Comparison of mediterranean and healthy eating guideline interventions on the dietary inflammatory index in rheumatoid arthritis: results from a dietary randomised controlled intervention trial.
Curran M, Canning N, Wrenne A … +4 more , Raad T, Herbert JR, Shivappa N, Tierney A
Eur J Nutr · 2026 May · PMID 42191934 · Full text
PURPOSE: Anti-inflammatory diets, such as the Mediterranean Diet (MedDiet) have shown positive effects on disease activity in Rheumatoid Arthritis (RA). The Dietary Inflammatory Index (DII) has been associated with RA ri...
PURPOSE: Anti-inflammatory diets, such as the Mediterranean Diet (MedDiet) have shown positive effects on disease activity in Rheumatoid Arthritis (RA). The Dietary Inflammatory Index (DII) has been associated with RA risk. However, the effect of improving diet quality with a MedDiet and impact on the DII and patient-reported outcome measures (PROMs) has not been investigated. OBJECTIVES: To assess the effects of a MedDiet and adherence to the Irish Healthy Eating Guidelines (HEG) on change in DII and to determine whether change in DII and energy-adjusted DII (e-DII) scores is associated with improvements in PROMs in adults with RA in Ireland. METHODS: 40 Participants were randomised to a MedDiet (n = 20) or a HEG intervention (n = 20) for 12 weeks. DII was calculated based on food diaries collected. Between and within group data was analysed in SPSS. RESULTS: Baseline e-DII was 0.99 ± 2.37, 0.79 ± 2.60, 1.20 ± 2.16 for total cohort (n = 40), MedDiet, and HEG groups, respectively (p = 0.588). e-DII significantly improved for the cohort following the MedDiet (p = 0.022) and HEG (p = 0.004) groups. Differences in PROMs across tertiles of e-DII change were not statistically significant, irrespective of diet assignment. Participants in the most anti-inflammatory e-DII tertile group had significantly greater intakes of omega-3 fatty acids, dietary fibre, vitamin A, vitamin E, folic acid, and beta-carotene compared to those in the pro-inflammatory tertile group (p < 0.05). CONCLUSIONS: Improving dietary quality with either a MedDiet or the Irish HEG improved e-DII scores in a cohort of people living with RA, however, no statistically significant change in PROMs were observed.
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