Yu H, Zhang J, Qian F
… +17 more, Liu J, Zhu K, Qiu Z, Li R, Li R, Li L, Wang Y, Guo T, Xu K, Wu P, Geng T, Li D, Yang K, Yu X, Liao Y, Pan A, Liu G
Am J Clin Nutr
· 2026 Jun · PMID 42230086
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BACKGROUND: Heart failure (HF) is a severe complication of type 2 diabetes (T2D), yet the association between plasma proteins and HF in individuals with T2D remains underexplored. OBJECTIVES: This study aimed to investig...BACKGROUND: Heart failure (HF) is a severe complication of type 2 diabetes (T2D), yet the association between plasma proteins and HF in individuals with T2D remains underexplored. OBJECTIVES: This study aimed to investigate the association between plasma proteomic profiles and HF, and further evaluate whether proteomic data could enhance HF prediction beyond clinical variables, polygenic risk, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP). METHODS: This cohort study included 2198 participants with T2D from the United Kingdom Biobank. Cox proportional hazards models were employed to examine associations between 2920 plasma proteins and incident HF. Clinical and protein predictors were selected using the least absolute shrinkage and selection operator method based on 10-fold cross-validation. The predictive performance of models was evaluated using Harrell's C-index, calibration slope, net reclassification improvement, integrated discrimination improvement, decision curve analysis, and calibration plots. RESULTS: During a median follow-up of 13.1 y, 298 individuals developed incident HF. A total of 455 proteins (447 positively and 8 inversely) were associated with HF, primarily involved in cell adhesion, extracellular space, signaling receptor activity, and cytokine-cytokine receptor interaction pathways. The top protein associated with increased risk of HF was whey acidic protein (WAP) 4-disulfide core domain protein 2, with a per-SD increment hazard ratio (HR) of 1.90 [95% confidence interval (CI): 1.65, 2.19)]. Conversely, the top protein inversely associated with HF risk was apolipoprotein C-I, with a per-SD increment HR of 0.75 (95% CI: 0.66, 0.85). Seventeen proteins were subsequently selected as proteomic predictors, and the resulting 17-protein risk score improved HF prediction beyond clinical variables, polygenic risk, and NT-proBNP, yielding a maximum C-index of 0.833 with an increment of 0.091. CONCLUSIONS: This study identified proteomic biomarkers for HF, highlighted potential pathways that inform biological mechanisms, and demonstrated that proteomic data enhanced HF risk prediction in individuals with T2D.
Boyd SS, Hecker J, Mirzakhani H
… +3 more, DeMeo DL, Weiss ST, Halu A
Am J Clin Nutr
· 2026 Jun · PMID 42230085
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BACKGROUND: Vitamin D-binding protein (DBP) transports vitamin D metabolites and regulates vitamin D levels in circulation. Additionally, maternal vitamin D levels during pregnancy play an important role in lung developm...BACKGROUND: Vitamin D-binding protein (DBP) transports vitamin D metabolites and regulates vitamin D levels in circulation. Additionally, maternal vitamin D levels during pregnancy play an important role in lung development and childhood asthma occurrence. OBJECTIVES: In this post hoc analysis of a randomized controlled trial, the joint associations of maternal 25-hydroxyvitamin-D (25OHD) and DBP with offspring asthma/recurrent wheeze, for both the full cohort and stratified by maternal asthma status, are analyzed. Additionally, associations between estimated maternal free 25OHD and offspring asthma/recurrent wheeze are investigated. METHODS: A total of 518 participants from the Vitamin D Antenatal Asthma Reduction Trial were included in this analysis. The primary outcome was offspring asthma/recurrent wheeze by age 3 y. Maternal plasma DBP levels were measured for 517 and 516 participants at 10-18 and 32-38 wk of gestation, respectively. Total 25OHD and DBP levels were compared across haplotypes of the group-specific component (GC) gene, which codes for DBP. Logistic regression models estimated the relationships between maternal DBP, total 25OHD, and offspring asthma/recurrent wheeze. In addition, offspring asthma/recurrent wheeze was modeled as a function of estimated maternal free 25OHD. RESULTS: Maternal DBP levels generally increased as pregnancy progressed. Maternal DBP and total 25OHD levels varied significantly across GC haplotypes. A significant positive interaction effect between maternal DBP and total 25OHD on offspring asthma/recurrent wheeze risk was observed for the subset of mothers without asthma. For the subset of mothers with asthma, we observed a significant negative association between estimated maternal free 25OHD and offspring asthma/recurrent wheeze, surpassing the effects of DBP or total 25OHD individually. CONCLUSIONS: Our study gives insight into the interplay between vitamin D metabolites during pregnancy and their associations with offspring asthma/recurrent wheeze. These results also suggest that maternal free vitamin D during pregnancy may be more biologically relevant than total vitamin D for offspring's respiratory health. This trial was registered at clinicaltrials.gov for VDAART as NCT00920621.
Jiang C, Zhang X, Wang X
… +3 more, Zhu H, Yang M, Wei W
Am J Clin Nutr
· 2026 May · PMID 42214494
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BACKGROUND: The structural organization of fatty acids within triacylglycerols (TAGs), particularly at the sn-2 position, determines their metabolic fate. Whether the TAG architecture in human milk, the sole nutrition fo...BACKGROUND: The structural organization of fatty acids within triacylglycerols (TAGs), particularly at the sn-2 position, determines their metabolic fate. Whether the TAG architecture in human milk, the sole nutrition for infants, is distinct from that in maternal and fetal circulation remains unclear. OBJECTIVES: We conducted a comparative lipidomic analysis to characterize the molecular and regioisomeric profiles of TAGs across human milk (at 3 lactation stages) and paired maternal/cord plasma. METHODS: TAGs from milk (colostrum, transitional, mature; n = 87) and plasma (maternal and cord; n = 58) of 29 mother-infant dyads were analyzed using ultraperformance supercritical fluid chromatography quadrupole time-of-flight mass spectrometry. Regioisomers were quantified via a validated computational model. RESULTS: Human milk TAGs exhibited a unique compositional and structural profile compared with circulatory TAGs. A key finding was the preferential positioning of docosahexaenoic acid (DHA) at the sn-2 position in major human milk TAGs (e.g., >65% in DHA/O/O), whereas in cord plasma, DHA in analogous TAGs was exclusively at the sn-1/3 positions (P < 0.001). Similarly, palmitic acid (16:0) was predominantly at sn-2 in milk TAGs (>90% in major species) but not in plasma (<35%). Cord plasma was enriched in long-chain polyunsaturated fatty acids (8.2% compared with 2.5% in maternal plasma, P < 0.05; all tests 2-sided) carried by distinct TAG species. CONCLUSIONS: Human milk shows a unique TAG architecture characterized by a conserved sn-2 enrichment of both DHA and palmitic acid, fundamentally different from the TAG regioisomer profiles in maternal-fetal circulation. This sn-2-DHA-rich structure in milk lipids may represent a tailored metabolic design to support neonatal development.
Demaré N, Bridier-Nahmias A, Carbonnelle E
… +9 more, Magnan M, Bellicha A, Marin J, Arnault N, Benallaoua M, Omar AA, AAS-Lynch study group 2024, Benamouzig R, Deschasaux-Tanguy M
Am J Clin Nutr
· 2026 May · PMID 42214493
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BACKGROUND: People with Lynch syndrome (LS) have a high probability of early onset of several cancers, mainly colorectal cancer (CRC), due to genetic alterations. Gut microbiota alteration has been associated with the de...BACKGROUND: People with Lynch syndrome (LS) have a high probability of early onset of several cancers, mainly colorectal cancer (CRC), due to genetic alterations. Gut microbiota alteration has been associated with the development of CRC. In general populations, the gut microbiota appears to be influenced by genetic and environmental factors, including diet. OBJECTIVES: The aim of this exploratory study was to characterize the profile of the fecal microbiota in relation to dietary intakes in individuals with LS, with or without a history of CRC. METHODS: In this cross-sectional study, fecal samples, dietary intakes, as well as sociodemographic and clinical features were collected at inclusion in the French AAS-Lynch clinical trial (2017-2022). Fecal microbiota profiles (α- and β-diversity, taxa abundance, and enterotypes) were derived from 16S ribosomal RNA sequencing. Dietary intakes were estimated using a validated food frequency questionnaire. Associations between dietary intakes and fecal microbiota were assessed using linear regression, and (permutational) analysis of variance (PERMANOVA and ANOVA) models adjusted for confounding factors. RESULTS: Our analysis of 95 people with LS revealed that α-diversity (Shannon and Simpson indices) was negatively associated with Western dietary pattern, red meat consumption, and higher intakes of SFA, cholesterol, and animal proteins and positively associated with plant proteins and the ratio of plant to animal proteins. Western dietary pattern, consumption of fruits, cake and biscuits, breakfast cereals, and red meat were the top dietary factors explaining the dissimilarities in microbiota composition between individuals. An association was observed between plant protein intake and the relative abundance of Lachnospiraceae NK3A20 group. CONCLUSIONS: This study explored for the first time, to our knowledge, associations between dietary intakes and fecal microbiota profiles in individuals with LS. Further studies are needed to confirm these results and to assess the potential impact of these associations on the risk to develop CRC in this particular population. The study was registered at clinicaltrials.gov as NCT04791644.
Zupančič Ž, Barnes TM, Deutz MT
… +8 more, Irwin G, Zimring JE, Chen C, Askow AT, Ulanov AV, Willard JW, van Loon LJ, Burd NA
Am J Clin Nutr
· 2026 May · PMID 42214492
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BACKGROUND: Combining plant proteins is a strategy to improve overall amino acid balance; however, the impact of this pairing on postexercise myofibrillar protein synthesis (MPS) remains unclear. OBJECTIVES: We compared...BACKGROUND: Combining plant proteins is a strategy to improve overall amino acid balance; however, the impact of this pairing on postexercise myofibrillar protein synthesis (MPS) remains unclear. OBJECTIVES: We compared postexercise MPS after ingestion of beans and rice [complementary pairing of rice and black beans (COMP)] compared with a nutrient-matched mixture of isolated nutrients [isolated mixture of crystallized amino acids, maltodextrin, cellulose, pectin, and soy oil (ISO)]. METHODS: In this randomized, crossover trial, 11 physically active adults (24 ± 4 y; 25.0 ± 3 kg/m; 10 M, 1 F) were randomly assigned (1:1 allocation) to 1 of 2 treatment sequences (COMP-ISO or ISO-COMP). Each trial was separated by ∼1-wk recovery period to allow for muscle biopsy site healing. During primed-constant infusions of L-[ring-C]phenylalanine, participants consumed either COMP (548 kcal; 20 g protein, 114 g carbohydrate, 0.8 g fat) or ISO immediately after resistance exercise. Blood and muscle samples were collected at rest and during the 0 to 5 h recovery period to assess outcomes. The primary outcome was MPS. Data were analyzed using linear mixed-effects models. RESULTS: A total of 10 randomly assigned participants completed both arms of the study, whereas 1 participant completed only 1 arm. All participants were included in the final analysis. Postexercise aminoacidemia and net amino acid exposure (incremental AUC) decreased over the 0 to 5 h recovery period regardless of condition (all, P < 0.05). Phosphorylation of AKT, 4E-BP1, rpS6, and p706k significantly increased at 5 h postexercise in both groups (all P < 0.05). MPS increased from rest but did not differ between COMP (0.057 ± 0.013 %/h) and ISO (0.052 ± 0.013 %/h; P = 0.260; d = 0.4). In an exploratory, cross-trial comparison, MEAT (ground pork) elicited a significantly greater postprandial MPS compared with ISO, COMP, or carbohydrate alone (all, P < 0.05). CONCLUSIONS: Post exercise, MPS does not differ after the ingestion of 20 g protein provided as a blend of beans and rice or as a nutrient-matched mix of crystalline amino acids, maltodextrin, soy oil, and fiber in healthy young adults. This study was registered at clinicaltrials.gov as NCT06781723 (https://clinicaltrials.gov/study/NCT06781723).
BACKGROUND: Recent personalized nutrition research has reported large interindividual differences in postprandial glucose responses to identical foods, raising questions about whether these differences reflect food-speci...BACKGROUND: Recent personalized nutrition research has reported large interindividual differences in postprandial glucose responses to identical foods, raising questions about whether these differences reflect food-specific personal effects or normal day-to-day variability in glucose tolerance. OBJECTIVES: This study aimed to quantify the relative contributions of measurement variability compared with person-specific effects to interindividual glycemic variation, and to define substitution thresholds for when glycemic index (GI) differences produce distinct physiological effects. METHODS: In this secondary analysis with simulated validation, data from 382 healthy adults (1022 glucose reference tests, 1116 food tests across 9 carbohydrate-rich foods) were analyzed using a direct comparison scaling model, in which an individual's food response equals their glucose reference response scaled by the food's mean GI. Sensitivity analyses included single-reference predictions, restriction to participants with ≥3 reference tests, and exclusion of a protocol-deviating food. RESULTS: Predicted errors did not exceed the observed glucose reference test-retest variability [mean root mean square deviation: 0.78 compared with 1.02 mmol/L; Cohen's d = 0.54 (0.45, 0.63)], with ∼90% of predictions falling within each participant's own test-retest range. Bland-Altman analysis confirmed negligible systematic bias (-0.01 mmol/L). Synthetic datasets generated from glucose variability and mean GI values reproduced observed response distributions without person-specific parameters. GI differences of ≥15 units produced reliably distinguishable responses in a given individual. All sensitivity analyses yielded equal or stronger effect sizes. CONCLUSIONS: In healthy adults under standardized conditions, interindividual variation in glycemic responses predominantly accounts for by variability in day-to-day glucose tolerance, propagating through the GI ratio. The GI concept performs within the reproducibility limits of input data.
When randomized trials in nutrition are not feasible, timely, or ethical, observational studies serve as important pillars of evidence-informed clinical decision-making and public health guidelines. Given that diet is dy...When randomized trials in nutrition are not feasible, timely, or ethical, observational studies serve as important pillars of evidence-informed clinical decision-making and public health guidelines. Given that diet is dynamic, multidimensional, and multifactorial, causal questions of dietary exposures are often complex. Consequently, research questions are often poorly defined, making study findings difficult to interpret and implement in the real world. Conceptualizing the design and analysis of observational data like a hypothetical pragmatic randomized trial, a target trial, is one approach to improve the specificity and interpretation of causal questions. Protocol components, including eligibility criteria, treatment strategies, and assignment procedure, outcome and follow-up, causal contrast, and statistical analysis plan, are clearly specified and subsequently implemented using available observational data. In this paper, we explain the target trial framework approach, describe examples from nutrition research, demonstrate the practical steps of performing a target trial study, and discuss the methodological challenges and opportunities of applying the framework to nutrition research.
Denno DM, Ahmed S, Ahmed T
… +12 more, Ali SA, Amadi B, Kelly P, Lawrence S, Mahfuz M, Marie C, Moore SR, Nataro JP, Petri WA, Sullivan PB, Tarr PI, EEDBI Consortium
BACKGROUND: Aging is characterized by cognitive decline, including episodic and working memory impairments, which can lead to loss of autonomy. Among older adults, one quarter, referred to here as "decliners," show great...BACKGROUND: Aging is characterized by cognitive decline, including episodic and working memory impairments, which can lead to loss of autonomy. Among older adults, one quarter, referred to here as "decliners," show greater-than-average cognitive decline for their age group without reporting memory complaints. To prevent or slow this accelerated decline and maintain a good quality of life in seniors, nutrition represents a promising approach. OBJECTIVES: This study evaluates the effect of a 3-mo fish hydrolysate (FH) supplementation on memory performance in healthy older adults identified as decliners. The primary outcome of this study was the Paired Associates Learning Total Error Adjusted (PALTEA) score, assessing episodic memory. METHODS: In this double-blind, randomized, placebo-controlled trial, 53 healthy older adults (60-73 y; Mini-Mental State Examination >27; PALTEA ≥41) received either FH [1 g of low-molecular-weight peptides and 30 mg n-3 (ω-3) long-chain polyunsaturated fatty acids (PUFAs)] or placebo daily for 3 mo. Cognitive performance was assessed using the Cambridge Neuropsychological Test Automated Battery. Statistical analyses were performed using analysis of covariance, adjusting for baseline values, age, and education level, with significance set at P < 0.05. RESULTS: FH supplementation significantly improved PALTEA scores compared with placebo [P = 0.003; β = -11.75; confidence interval (CI): -19.30, -4.19], with more patterns completed (P < 0.001; β = 1.34; CI: 0.58, 2.09) and fewer errors at higher levels (6 and 8 patterns; P = 0.040; β = -3.66; CI: -7.15, -0.17, and P = 0.004; β = -5.74; CI: -9.60, -1.89). Working memory showed partial improvement, notably the spatial working memory strategy score (P = 0.018; β = -1.26; CI: -2.31, -0.22). Verbal recognition did not differ between groups. FH supplementation increased erythrocyte n-3 PUFA levels (P = 0.036; β = 0.80; CI: 0.05, 1.54), and reduced serum C-reactive protein levels (P = 0.038; β = -0.33; CI: -0.63, -0.02) and inflammation status score (P = 0.046; β = -0.35; CI: -0.69, -0.01). CONCLUSIONS: Three months of FH supplementation improved episodic memory and working memory in older adults with accelerated cognitive decline, alongside a better n-3 PUFA profile and reduced inflammation, supporting FH as a promising strategy to promote healthy cognitive aging. This trial was registered at clinicaltrials.gov as NCT04910399.
BACKGROUND: Older adults may have reduced amino acid (AA) digestibility due to physiological changes in the digestive tract, but quantification of reduced AA digestibility in humans is lacking. OBJECTIVES: This randomize...BACKGROUND: Older adults may have reduced amino acid (AA) digestibility due to physiological changes in the digestive tract, but quantification of reduced AA digestibility in humans is lacking. OBJECTIVES: This randomized crossover study investigated differences in indispensable AA digestibility, primarily focusing on threonine and lysine, between young and older adults for milk, sorghum, and black beans using the dual tracer method. METHODS: Ten young (21.8 ± 1.7 y) and 10 older (72.8 ± 3.8 y) adults ingested 20 g H-labeled protein from either milk, sorghum, or black beans, mixed with 400 mg of a C-labeled AA mixture, in a plateau feeding protocol on 3 separate test days. Blood was sampled before and at regular intervals over an 8-h period after meal consumption. The H- and C- enrichments of AAs in plasma samples were determined at steady state (5.5-8.0 h). The ratio of the H/C-ratio between blood plasma and test meals was calculated. For lysine and threonine, this ratio was compared statistically between age groups and protein sources using linear mixed model analysis. RESULTS: The isotope plasma-to-meal ratio for lysine and threonine was 19% lower in older adults compared with young adults for sorghum (P = 0.041), whereas it was not significantly different for milk (P = 0.277) and black beans (P = 0.849). CONCLUSIONS: Lysine and threonine digestion might be lower in older compared with young adults, but the effect differed among protein sources. Furthermore, research on how aging affects protein digestibility across protein sources is needed to optimize dietary protein recommendations for older adults. This study was registered at clinicaltrials.gov as NCT05534464.
Esaian S, Smith BA, Oh J
… +3 more, Espinoza JC, Vidmar AP, Goran MI
Am J Clin Nutr
· 2026 Jul · PMID 42155589
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BACKGROUND: Infant formulas vary widely in carbohydrate composition, yet associations between exposure to nonlactose carbohydrates and glycemic patterns in early infancy remain poorly characterized. OBJECTIVES: We assess...BACKGROUND: Infant formulas vary widely in carbohydrate composition, yet associations between exposure to nonlactose carbohydrates and glycemic patterns in early infancy remain poorly characterized. OBJECTIVES: We assessed associations between infant feeding strategy and continuous glucose monitor (CGM)-derived measures of glycemic variability in a cross-sectional observational cohort of infants at 6 mo of age. METHODS: Forty-five infants (28.0 ± 1.2 wk; 47% female) wore CGMs recording interstitial glucose every 15 min for 3 to 8 d. Feeding strategy was categorized as exclusive human milk, formula containing lactose or corn syrup solids (CSS), or mixed human milk/lactose-based formula. Twenty-eight CGM-derived metrics were computed using the R package iglu. Group differences were tested using Freedman-Lane analysis of covariance with permutation-based post hoc tests; effect sizes (η) and 95% bootstrap confidence intervals (BCI) were reported for all key comparisons. Exploratory hierarchical clustering (Ward's D2) examined glycemic variability subgroups independent of feeding strategy. RESULTS: Approximately 46% of CGM-derived metrics differed significantly across feeding strategies, all reflecting contrasts between CSS-based formula and other groups; no metrics differed among human milk, lactose-based formula, or mixed feeding. Compared with human milk, CSS-fed infants were associated with greater glycemic variability and large effect sizes (though the study was powered only to detect large effects), including greater time in hyperglycemia (η = 0.21; 95% BCI = -2.59,2.49), glycemic risk assessment diabetes equation (η = 0.31; 95% BCI = -0.25,0.24), J index (η = 0.24; 95% BCI = -1.07,1.08), and mean amplitude of glycemic excursions (η = 0.40; 95% BCI = -6.14,6.03). Exploratory clustering identified 4 glycemic variability subgroups. One subgroup exhibited broadly elevated glucose variability and included ∼36% of CSS-fed infants, with no representation from other feeding strategies. CONCLUSIONS: Infant feeding strategy is associated with differences in CGM-derived glycemic variability at 6 mo, driven by greater glucose variability among CSS-fed infants. Human milk and lactose-based formula feeding do not differ. Exploratory analyses identify a subgroup with pronounced glycemic variability that includes a subset of CSS-fed infants, highlighting interindividual variability in glycemic response.
BACKGROUND: Diet quality is pivotal to both human health and environmental sustainability; however, the comprehensive environmental impacts and socioeconomic disparities associated with longitudinal shifts in diet qualit...BACKGROUND: Diet quality is pivotal to both human health and environmental sustainability; however, the comprehensive environmental impacts and socioeconomic disparities associated with longitudinal shifts in diet quality in the United States remain incompletely characterized. OBJECTIVES: To evaluate longitudinal trends in diet quality and associated comprehensive environmental impacts, and examine their interrelationships among United States adults over an 18-y period. METHODS: This serial cross-sectional study analyzed data from 25,678 United States adults aged ≥20 y across the 9 consecutives NHANES cycles (2001-2018). We assessed 6 validated diet quality indices and 4 core environmental indicators, with analyses performed via Mann-Kendall tests, multivariable linear regression, and Shapley value variance decomposition. RESULTS: From 2001 to 2018, United States diet quality improved significantly across most health-focused indices (P < 0.001), with the largest gain observed for the Dietary Approaches to Stop Hypertension score (standardized Sen's slope = 1.22 per 2-y cycle). Diet-related greenhouse gas emissions (Sen's slope = -0.36 per 2-y cycle, P < 0.001), cumulative energy demand (Sen's slope = -1.32 per cycle, P < 0.001), and land use (Sen's slope = -0.30 per cycle, P < 0.001) declined significantly (all P < 0.001), whereas water use increased markedly (+51.64 L/cycle, P < 0.001). The Planetary Health Diet Index showed the strongest inverse environmental associations, was the only index linked to reduced water use, and explained 38.2% [95% confidence interval: 31.2%, 39.0%] of greenhouse gas emission variance and 35.8% (95% confidence interval: 30.6%, 39.0%) of land-use variance. Improvements were concentrated among higher-education and higher-income groups. CONCLUSIONS: Over 18 y, United States diet quality evolved toward healthier and more environmentally sustainable trajectories, demonstrating clear health-environment synergies. Nevertheless, rising water use and uneven progress across socioeconomic groups highlight critical tradeoffs. The Planetary Health Diet Index effectively captures these comprehensive environmental benefits. Achieving truly sustainable food systems requires integrating comprehensive environmental metrics into dietary guidelines and enacting targeted policies to ensure equitable improvements in diet quality.
BACKGROUND: Previous studies have focused on double burden of malnutrition (DBM), involving overweight/obesity (OWOB) and undernutrition, primarily at individual or household levels. OBJECTIVES: This study aimed to asses...BACKGROUND: Previous studies have focused on double burden of malnutrition (DBM), involving overweight/obesity (OWOB) and undernutrition, primarily at individual or household levels. OBJECTIVES: This study aimed to assess evolving patterns and inequalities in DBM and triple burden of malnutrition (TBM) across 1995-2019 at both individual and population levels among Chinese children and adolescents. METHODS: Data were from the Chinese National Survey on Students' Constitution and Health, including 1,290,214 participants aged 7 to 18 y. OWOB, undernutrition, and anemia were assessed according to World Health Organization criteria. DBM and TBM were categorized into 4 patterns at both levels. Population-level DBM and TBM were defined as the coexistence of malnutrition forms within the same population rather than within individuals. Temporal trends were assessed using annual percent change (APC) estimated by Joinpoint regression for 1995 to 2010, 2010 to 2019, and 1995 to 2019. RESULTS: During 1995 to 2010, OWOB increased, whereas undernutrition and anemia declined; during 2010 to 2019, OWOB rose rapidly, undernutrition continued to decline, and anemia plateaued. At the individual level, OWOB + undernutrition increased after 2010 [APC = 2.87%, 95% confidence interval (CI): 1.03%, 4.85%], and OWOB + anemia increased steadily across 1995 to 2019 (APC = 4.83%, 95% CI: 3.64%, 6.44%). At the population level, OWOB + undernutrition and OWOB + anemia increased more rapidly during 2010 to 2019 than during 1995 to 2010. Although the prevalence of individual-level TBM remained rare (<0.05%), the combined prevalence of TBM declined from 38.59% (1995) to 34.16% (2005), then increased to 39.91% (2019), with an APC of 1.11% (95% CI: 0.67%, 1.58%) during 2010 to 2019. OWOB-related DBM and TBM were more prevalent among younger and urban boys, whereas rural boys experienced steeper increases after 2010. Northeastern and western provinces bore the heaviest DBM and TBM, linked to lower socioeconomic development. CONCLUSIONS: The post-2010 period marked a critical nutrition transition in China, characterized by rapidly rising OWOB + anemia at both levels and increasing population-level TBM. Reducing malnutrition burden requires nutrition-sensitive, equity-focused strategies that tackle undernutrition, OWOB, and micronutrient deficiency together.
BACKGROUND: Omega-3 fatty acids (ω-3 FAs), particularly EPA and DHA, are recognized for their health benefits. However, their circulating levels after supplementation may be modulated by several factors, including sex, c...BACKGROUND: Omega-3 fatty acids (ω-3 FAs), particularly EPA and DHA, are recognized for their health benefits. However, their circulating levels after supplementation may be modulated by several factors, including sex, carriage of the apolipoprotein E ε4 (APOE4) allele, and the chemical form of the supplement. Krill oil delivers ω-3 FAs primarily as phospholipids, whereas fish oil provides them as triglycerides. OBJECTIVES: This study aimed to compare EPA and DHA concentrations after supplementation with krill oil and fish oil and assess whether sex and APOE4 genotype modify responses to supplementation. METHODS: This double-blind, randomized clinical trial included 72 healthy adults (53 females, 19 males) matched for age and BMI. Participants received 1.1 g/d ω-3 FAs through either krill oil (n = 36) or fish oil (n = 36) for 12 wk. Plasma FAs were measured at baseline and at weeks 1, 2, 4, and 12 by GC-flame ionization detection. Differences in plasma ω-3 FAs concentrations by treatment, sex, and APOE4 status were analyzed. RESULTS: Time-by-treatment interactions were significant for plasma delta over baseline concentrations of EPA (P = 0.0001) and DHA (P = 0.005), with krill oil resulting in ∼1.5-fold higher Δ EPA and Δ DHA compared with fish oil. The time-by-sex interaction was significant only for EPA (P = 0.026), with females having a 1.5-fold greater increase than males at 12 wk. After supplementation with either krill oil or fish oil, APOE4 carriers had 3-fold and 1.6-fold higher EPA and DHA, respectively, compared with baseline; however, these increases were not significantly different from those found in noncarriers. CONCLUSIONS: Krill oil increased plasma ω-3 FAs more than fish oil, regardless of APOE4 genotype. Individuals with higher ω-3 FA requirements may achieve adequate enrichment with lower doses of krill oil compared with fish oil supplementation. This trial was registered at clinicaltrials.gov as NCT04279743.
BACKGROUND: Although muscle protein turnover rates have been well established, little is known regarding the turnover of other musculoskeletal tissues. Furthermore, their response to protein supplementation has not yet b...BACKGROUND: Although muscle protein turnover rates have been well established, little is known regarding the turnover of other musculoskeletal tissues. Furthermore, their response to protein supplementation has not yet been assessed. OBJECTIVES: To assess skeletal muscle, bone, cartilage, tendon, ligament, meniscus, and periarticular soft tissue protein synthesis rates over a 2-wk period with or without additional protein supplementation in vivo in older adults. METHODS: Twenty-four otherwise healthy older adults (12M/12F; age: 68 ± 7 y; body mass index: 29 ± 5 kg/m) undergoing total knee arthroplasty participated in this exploratory randomized controlled trial. Participants were randomly allocated to maintain their habitual diet with (n = 12) or without (n = 12) an additional daily bolus of 40 g whey protein for 14 d prior to surgery. Deuterium oxide (HO) was administered throughout the 14-d preoperative period, and all musculoskeletal tissues were collected during subsequent surgery to assess tissue protein synthesis rates. Data are presented as means ± standard deviation. RESULTS: Daily fractional protein synthesis rates (FSRs) in muscle, synovium, and Hoffa's fat pad averaged 1.17 ± 0.23, 0.79 ± 0.46, and 0.53 ± 0.29%/d, respectively. Fibrous tissues, including anterior and posterior cruciate ligament, patellar tendon, lateral and medial meniscus, and femoral cartilage FSRs averaged 0.45 ± 0.27, 0.46 ± 0.32, 0.20 ± 0.10, 0.21 ± 0.15, 0.18 ± 0.14, and 0.19 ± 0.11%/d, respectively. Finally, FSRs of bone obtained from the distal femur, notch, trochlea, tibia, and patella were 0.18 ± 0.13, 0.21 ± 0.14, 0.13 ± 0.10, 0.12 ± 0.05, and 0.16 ± 0.10%/d, respectively. FSR differed significantly between tissue groups (P-tissue group < 0.001), with the highest FSR in muscle, followed by periarticular soft tissues, fibrous tissues, and bone (pairwise comparisons, all P < 0.001). Musculoskeletal tissue FSR did not differ between the control and protein supplemented group (P-treatment = 0.27, P-treatment∗tissue type = 0.14). CONCLUSIONS: Muscle, bone, cartilage, tendon, ligament, meniscus, and periarticular soft tissue protein synthesis rates range between 0.12 and 1.17% per day in vivo in older adults. Two weeks of protein supplementation does not seem to increase daily musculoskeletal tissue turnover. This trial was registered at www. CLINICALTRIALS: gov as NCT03037294.