The American Journal Of Clinical Nutrition[JOURNAL]
Sun
200 papers
A genetic association study of iron absorption in adults of East Asian or Northern European ancestry from the Iron Genes in East Asian and Northern European Adults Study (FeGenes).
Barad A, Xu H, Clark AG … +4 more , Gu Z, Pressman EK, Ye K, O'Brien KO
Am J Clin Nutr · 2026 Jun · PMID 41895699 · Full text
BACKGROUND: Over 100 genetic variants are linked to iron (Fe) biomarkers in European populations, but their effects on nonheme Fe absorption remain unknown. Additionally, despite the higher body Fe burden observed in Eas...
BACKGROUND: Over 100 genetic variants are linked to iron (Fe) biomarkers in European populations, but their effects on nonheme Fe absorption remain unknown. Additionally, despite the higher body Fe burden observed in East Asian (EA) individuals, the genetic factors influencing Fe absorption in this population remain unexplored. OBJECTIVES: We aimed to examine the impact of genetic variation on Fe absorption and evaluate how it differs across individuals of genetically inferred Northern European (NE) or EA ancestry. METHODS: Participants in this genetic association study were healthy males and premenopausal females of EA (n = 253) or NE (n = 251) ancestry, aged 18-50 y. Genotyping data were obtained using the Illumina Global Diversity Array. Fe absorption was assessed using the erythrocyte Fe isotope incorporation method, normalized to a serum ferritin (SF) of 40 μg/L. We evaluated the associations of candidate variants with SF-corrected Fe absorption, tested for variant-ancestry interaction effects, and assessed a European-derived polygenic score for SF (PGS-SF). RESULTS: Seven variants nominally associated with SF-corrected Fe absorption in either EA or NE were tested for variant-ancestry interactions. Two variants remained significant after Bonferroni correction (P-interaction < 0.007), rs1672992 in hepsin and rs9423600 in urocortin 3 (UCN3), indicating ancestry-specific genetic effects on Fe absorption. The C allele of rs1672992 was associated with a 26% decrease in Fe absorption in NE (P = 0.04) but with a 62% increase in EA (P = 0.008). The G allele of rs9423600 was associated with a 27% decrease in Fe absorption in NE (P = 0.005) but with a nonsignificant 17% increase in EA (P = 0.18). The PGS-SF was significantly associated with SF-corrected Fe absorption in both groups (P < 0.05) but captured only a small proportion of its variance (NE: 1.8%, EA: 2.3%). CONCLUSIONS: Our findings underscore the need to further understand the genetic architecture of Fe metabolism across diverse populations to inform precision nutrition strategies aimed at reducing Fe-related chronic diseases. The study was registered at clinicaltrials.gov as NCT04198545.
The impact of a continuum of care intervention from prevention to treatment on child wasting compared with usual community group activities: a cluster-randomized controlled trial in Mali.
Huybregts L, Diop L, Fall T … +6 more , Barba FM, Brander RL, Toure M, Ouedraogo M, Hien A, Becquey E
Am J Clin Nutr · 2026 Jun · PMID 41895698 · Publisher ↗
BACKGROUND: Child wasting is associated with a high mortality risk and remains a persistent public health challenge. OBJECTIVES: This study aimed to evaluate the impact of an intervention strengthening the continuum of c...
BACKGROUND: Child wasting is associated with a high mortality risk and remains a persistent public health challenge. OBJECTIVES: This study aimed to evaluate the impact of an intervention strengthening the continuum of care of child wasting from prevention, screening, and referral to treatment in Mali. METHODS: A 2-arm cluster-randomized controlled trial was conducted using 2 study designs to evaluate impact and pathways: 1) a longitudinal study of children enrolled at 6 mo (n = 2324) with monthly follow-up for 3-6 mo to assess wasting prevalence (primary outcome); 2) a longitudinal study of all children 6-23 mo admitted to outpatient therapeutic programs (OTP; n = 7104) assessing recovery and adherence. Additional OTP coverage surveys were conducted at the end of the study. In both study arms, nutrition activity support groups (NASG) screened children for wasting and provided caregiver behavior change communication (BCC). The intervention arm additionally received small-quantity lipid-based nutrient supplements (SQ-LNS), child-centered BCC, family-led screening, and follow-up on referred wasting cases to support OTP admission and adherence. RESULTS: The intervention did not impact wasting prevalence but reduced the incidence of wasting [relative risk (RR): 0.80, 95% confidence interval (CI): 0.64, 0.99] and severe acute malnutrition (SAM) (RR: 0.71, 95% CI: 0.57, 0.89). The intervention significantly increased wasting screening coverage by 37 percentage points (pp) (95% CI: 31, 44) and SAM treatment coverage by 15 pp (95% CI: 0.35, 30). No impacts of the intervention on OTP recovery or adherence were found. NASGs often replaced the monthly home visits with community gatherings to deliver the intervention. NASGs also often distributed SQ-LNS to children they identified with wasting instead of referring them to the OTP. CONCLUSIONS: Strengthening the continuum of care of wasting through community groups reduced the incidence of wasting and SAM and improved screening coverage, which translated into a modest gain in SAM treatment coverage. This trial was registered at clinicaltrials.gov as NCT04872088.
The 2025-2030 dietary guidelines for Americans: a pediatric review of recommendations for children under 5 years.
Du N, Abrams SA
Am J Clin Nutr · 2026 May · PMID 41887332 · Publisher ↗
The 2025-2030 Dietary Guidelines for Americans, released in January 2026, marks a significant departure from prior editions, both in its development process and nutritional recommendations. This paper examines the guidel...
The 2025-2030 Dietary Guidelines for Americans, released in January 2026, marks a significant departure from prior editions, both in its development process and nutritional recommendations. This paper examines the guidelines for children in the first 5 y of life. We highlight both advances and areas that may require additional guidance by future advisory panels. Notable changes for this age group include a recognition of the potential risks of highly processed foods and strengthened guidance on added sugars through 10 y of age. We question whether the recommendation to avoid nearly all added sugars may be unrealistic and undermine adherence to other valuable guidance. The guidelines also omitted key themes from prior iterations. This included the removal of guidance on usage of infant cereals for complementary food introduction, despite its importance for iron and other micronutrient fortification during a critical developmental period. Specific warnings against unpasteurized dairy products are not present, and the guidance had inconsistencies around the handling of allergenic foods. Moving forward, guideline development for small children should be undertaken with a high level of transparency and involvement of pediatricians and should fully incorporate key aspects of the Dietary Guidelines Advisory Committee's scientific work reviewing early childhood nutrition.
Methodological standards for body composition assessment-an expert-endorsed guide for research and clinical applications: bioimpedance, dual-energy X-ray absorptiometry, computerized tomography, and ultrasound methods.
Prado CM, Gonzalez MC, Norman K … +26 more , Orsso CE, Barazzoni R, Cederholm T, Compher C, Jensen GL, Abe T, Barbosa-Silva TG, Bennett JP, Carmichael OT, Earthman CP, Evans WJ, Fields DA, Genton L, Hu HH, Kara M, Miles-Chan JL, Mourtzakis M, Paris MT, Perkisas S, Sardinha LB, Shepherd JA, Siervo M, Strauss BJ, Yamada Y, Zhu S, Heymsfield SB
Am J Clin Nutr · 2026 May · PMID 41864542 · Full text
The assessment of body composition has long been a fundamental component of research and is gaining increasing adoption in clinical practice. This growing interest has drawn new professionals to the field and increased e...
The assessment of body composition has long been a fundamental component of research and is gaining increasing adoption in clinical practice. This growing interest has drawn new professionals to the field and increased emphasis on its clinical relevance and applications. However, the diversity of assessment techniques and inconsistent terminology create challenges, highlighting the urgent need for harmonized approaches across research and healthcare settings. Commonly employed methods include bioelectrical impedance approaches, dual-energy X-ray absorptiometry, and computerized tomography, with ultrasound emerging as an increasingly prominent tool. These methods are featured in guidelines for diagnosing conditions such as low muscle mass, malnutrition, sarcopenia, and sarcopenic obesity, among others. This second narrative review in a series, developed by an international panel of experts, focuses on these widely accessible assessment tools that align with clinical recommendations. It presents foundational knowledge, discusses validity and reliability considerations, and offers practical advice on terminology, measurement protocols, data interpretation, and longitudinal monitoring. The report also addresses current limitations and identifies areas needing further research. Our goal is to provide clear, evidence-based guidance that is useful for both experienced practitioners and those newly engaging with body composition assessment. We urge organizations, journals, and stakeholders across the body composition field to adopt the proposed principles and standards to support consistency, transparency, and scientific rigor in both research and clinical care.
Diabetes modifies the association between magnesium and insomnia, but not depressive symptomatology, in Puerto Rican adults: a prospective cohort study.
Chen F, Mangano KM, Scott TM … +5 more , Li W, Falcón LM, Gao X, Garelnabi M, Tucker KL
Am J Clin Nutr · 2026 May · PMID 41862003 · Full text
BACKGROUND: Evidence on magnesium (Mg), depression, and sleep quality has been controversial. OBJECTIVES: We aimed to examine associations of serum and dietary Mg with depressive and insomnia symptoms in a prospective lo...
BACKGROUND: Evidence on magnesium (Mg), depression, and sleep quality has been controversial. OBJECTIVES: We aimed to examine associations of serum and dietary Mg with depressive and insomnia symptoms in a prospective longitudinal cohort. METHODS: Adults from the Boston Puerto Rican Health Study who completed the Centre for Epidemiologic Studies Depression Scale (CES-D) assessment at any visit from baseline to the third visit (∼6-y follow-up) were included in analyses on Mg and depressive symptomatology (n = 1465 with Mg intake; n = 1116 with serum Mg). Linear mixed-effects models were used to estimate β coefficients and 95% confidence intervals (CI). Mg measures at visit 2 were used to predict incident insomnia symptoms at visit 3 (n = 613 with Mg intake; n = 587 with serum Mg; median follow-up: ∼4 y). Logistic regression was used to estimate odds ratios (ORs). Diabetes, sex, baseline Mg status, and calcium:Mg intake ratio were evaluated as modifiers. RESULTS: No clear association was observed between Mg and CES-D score after adjustment for confounders. However, higher Mg intake from food was associated with less low positive affect, a dimension of CES-D [β (95% CI): -0.28 (-0.45, -0.11)]. Mg was not associated with insomnia in the full sample. However, higher Mg intake and supplement use were associated with lower odds of insomnia in participants without diabetes [per 100 mg/d total Mg: OR (95% CI): 0.42 (0.23, 0.79); per 100 mg/d Mg from food: 0.41 (0.21, 0.79); Mg supplement users compared with nonusers: 0.37 (0.17, 0.81)], which was not found in participants with diabetes (P-interaction < 0.05). Serum Mg was not associated with either outcome. Limited interaction was detected for other potential modifiers, despite some subgroup variation in association direction or magnitude. CONCLUSIONS: Higher Mg intake was associated with lower odds of insomnia symptoms in Puerto Rican adults without diabetes. Further research is needed to investigate the role of diabetes in the Mg-sleep association.
Baseline body mass index modifies the effects of digital health interventions compared with usual care on cardiovascular disease risk in people with type 2 diabetes: a secondary analysis of the SMARTDiabetes trial.
Ren J, Sun X, Zhang Z … +10 more , Zhang Y, Xiong S, Tao X, Sun K, Zhang C, Yin B, Zhang X, Peiris D, Zhang P, Ma Y
Am J Clin Nutr · 2026 May · PMID 41862002 · Publisher ↗
BACKGROUND: Body weight is a critical determinant of cardiovascular disease (CVD) risk among people with type 2 diabetes mellitus (T2DM), substantially contributing to the incidence of and outcomes from CVD. However, the...
BACKGROUND: Body weight is a critical determinant of cardiovascular disease (CVD) risk among people with type 2 diabetes mellitus (T2DM), substantially contributing to the incidence of and outcomes from CVD. However, the impact of body weight on the effectiveness of digital health interventions, an increasingly used innovation to improve care outcomes, remains uncertain. OBJECTIVES: This study aimed to examine the effectiveness of digital health interventions in improving CVD risks and whether baseline body mass index (BMI) modified these effects in people with T2DM. METHODS: SMARTDiabetes was an open-label, parallel, cluster randomized controlled trial examining the effects of digital health interventions compared with usual care on T2DM management over 24 mo. In this secondary analysis, we compared 10-y CVD risk scores between intervention and usual care groups and examined the heterogeneity of intervention effects across different BMI subgroups. RESULTS: The study included 2072 patients with T2DM, of whom 714 were in the normal BMI range (<25 kg/m), 996 were overweight (25 to <30 kg/m), and 362 were obese (≥30 kg/m) at baseline. There was no difference in mean 10-y CVD risk between intervention and usual care groups from baseline to 24 mo [between-group difference: -0.201%; 95% confidence interval (CI): -0.788, 1.190; P = 0.691]. However, there was significant heterogeneity by BMI subgroup (P-interaction = 0.009). Among individuals with normal BMI, the intervention was associated with a significant reduction in mean 10-y CVD risk [-1.108%; (95% CI -1.831, -0.386; P = 0.003)], whereas no significant benefit was observed in individuals with overweight or obesity. A similar heterogeneity of intervention effects was observed for change in body weight and systolic blood pressure (P-interaction < 0.1 for all comparisons). CONCLUSIONS: Digital health interventions had heterogeneous effects on reducing CVD risk and were only effective among people with a normal baseline BMI. Digital health interventions should be tailored to better suit the needs of people with T2DM and elevated BMI. The SMARTDiabetes trial is registered at clinicaltrials.gov as NCT02726100.
Comparative efficacy of biweekly preventive supplementation, with multiple micronutrients and iron folic acid or iron folic acid alone, on hemoglobin concentrations and anemia prevalence in children aged 6-59 months: a randomized controlled trial in rural India.
Upadhyay RP, Chowdhury R, Mundra S … +5 more , Taneja S, Jacob M, Kapil U, Bavdekar A, Bhandari N
Am J Clin Nutr · 2026 May · PMID 41862001 · Publisher ↗
BACKGROUND: Anemia affects more than two-thirds of children aged <5 y in India, despite biweekly iron folic acid (IFA) supplementation under the Anemia Mukt Bharat national program. Multiple micronutrient (MMN) deficienc...
BACKGROUND: Anemia affects more than two-thirds of children aged <5 y in India, despite biweekly iron folic acid (IFA) supplementation under the Anemia Mukt Bharat national program. Multiple micronutrient (MMN) deficiencies may also contribute to the presence of anemia, but the incremental benefit of MMN supplementation in addition to IFA remains unclear. OBJECTIVES: We aimed to compare the efficacy of biweekly preventive supplementation with MMNs plus IFA compared with IFA alone on hemoglobin concentrations and prevalence of anemia in children aged 6-59 mo. METHODS: In this individually randomized, open-label trial, eligible children received biweekly supplementation with either MMN plus IFA (intervention) or IFA alone (control) for 100 doses over 50 wk. Primary outcomes were mean hemoglobin concentration and anemia prevalence. Secondary outcomes included serum ferritin, soluble transferrin receptor, vitamin B, folate, and zinc. RESULTS: Among 1300 children enrolled (648 intervention and 652 control), supplementation compliance exceeded 75%. At the endline, the mean hemoglobin was slightly higher in the intervention group [adjusted mean difference, 0.12 g/dL; 95% confidence interval (CI): 0.00, 0.25]. The prevalence of anemia was 17.6% in the intervention group and 24.0% in the control group (adjusted relative risk, 0.72; 95% CI: 0.58, 0.90). No significant differences were observed in serum biomarkers of iron status or other micronutrients. CONCLUSIONS: Biweekly supplementation with MMN plus IFA resulted in a modest increase in hemoglobin concentrations and a relative reduction in anemia prevalence compared with IFA alone, particularly in older children. Lack of improvement in biochemical markers and a small rise in hemoglobin concentrations suggest that a reduction in the prevalence of anemia may be driven by shifts near diagnostic thresholds, rather than meaningful physiological benefits. MMN adds minimal value where IFA adherence is already high. The study was registered at Clinical Trial Registry of India as #CTRI/2020/10/028299 (https://ctri.nic.in/Clinicaltrials/login.php).
Consumption of organic compared with conventional fruits and vegetables in relation to cancer risk: findings from the NutriNet-Santé cohort study.
Berlivet J, Meyer E, Allès B … +6 more , Lairon D, Hercberg S, Touvier M, Srour B, Baudry J, Kesse-Guyot E
Am J Clin Nutr · 2026 May · PMID 41862000 · Publisher ↗
BACKGROUND: Regular fruits and vegetables (F&V) consumption is linked to a lower risk of certain cancers. However, F&V can contain pesticides, some of which may have carcinogenic properties. Organic foods are thought to...
BACKGROUND: Regular fruits and vegetables (F&V) consumption is linked to a lower risk of certain cancers. However, F&V can contain pesticides, some of which may have carcinogenic properties. Organic foods are thought to reduce pesticide residue exposure, but the relationship between organic consumption and cancer risk is inconsistent. Notably, to our knowledge, no study has explored substituting conventional with organic F&V. OBJECTIVES: This study examined the association between substituting conventional with organic F&V and cancer risk in the NutriNet-Santé cohort (∼31,000 French adults), using detailed data from a food frequency questionnaire distinguishing between conventional and organic products. METHODS: Substitution of conventional F&V with organic F&V, at fixed total F&V consumption, was examined with multivariable Cox proportional hazards models per 100 g/d increment of substitution and by quintiles. Sensitivity analyses as well as marginal structural models were also implemented to improve causal inference. RESULTS: A total of 31,179 participants, 75% of whom were females, were included in the analyses. During follow-up {mean = 7.3 y [standard deviation = 3.1]}, 1718 cancer cases (284 cases of postmenopausal breast cancer) were registered >227,660 person-years. Substituting conventional with organic F&V was associated with a lower risk of overall cancer {hazard ratio (HR) [95% confidence interval (CI)] for a 100 g/d substitution = 0.98 (0.95, 1.00)} and a lower risk of postmenopausal breast cancer [HR (95% CI) for a 100 g/d substitution = 0.90 (0.85, 0.96)], whereas no association was detected for other cancer locations. When modeled by quintiles, an inverse association was found for postmenopausal breast cancer but not for overall cancer or other locations. When running marginal structural models and testing for additional adjustments, findings remained significant for postmenopausal breast cancer. CONCLUSIONS: In the present work, substituting conventional F&V with organic ones was associated with a reduced risk of postmenopausal cancer. The specific role of organic F&V compared with conventional F&V needs further investigation in other contexts. The NutriNet-Santé cohort is registered at clinicaltrials.gov as NCT03335644 (https://clinicaltrials.gov/study/NCT03335644).
Longitudinal micronutrient exposure reveals country-specific associations with risk of celiac disease in genetically susceptible children: the prospective TEDDY cohort.
Yang J, Mramba LK, Hård Af Segerstad EM … +14 more , Kurppa K, Uusitalo U, Aronsson CA, Rewers MJ, McIndoe RA, Toppari J, Ziegler AG, Hagopian WA, Akolkar B, Krischer JP, Norris JM, Virtanen SM, Agardh D, TEDDY Study Group
Am J Clin Nutr · 2026 May · PMID 41850488 · Full text
BACKGROUND: The role of nutrient intake in celiac disease pathogenesis is poorly understood. OBJECTIVES: This study aims to examine whether longitudinal childhood intake of selected vitamins and minerals is associated wi...
BACKGROUND: The role of nutrient intake in celiac disease pathogenesis is poorly understood. OBJECTIVES: This study aims to examine whether longitudinal childhood intake of selected vitamins and minerals is associated with celiac disease autoimmunity (CDA, primary outcome) and celiac disease (secondary outcome) in genetically at-risk children. METHODS: A total of 6520 human leukocyte antigens-conferred at-risk children in the observational The Environmental Determinants of Diabetes in the Young (TEDDY) study were prospectively screened for tissue transglutaminase autoantibodies (tTGA) annually from ages 2 to 13 y. CDA was defined as persistent tTGA positivity in 2 samples ≥3 mo apart. Celiac disease was defined by biopsy-confirmed Marsh score ≥2 or mean tTGA ≥100 U/mL in 2 consecutive samples. Micronutrient intake was assessed via repeated 3-d food records, and adjusted hazard ratios (HRs) were estimated using time-dependent Cox proportional hazards and Bayesian joint models. RESULTS: Out of 6520 children, 1268 (19%) developed CDA and 479 (7.8%) were diagnosed with celiac disease. Results from both models suggested heterogeneity in associations by country as nutrients such as folate showed sporadic associations in the same or opposite direction across ages. Higher vitamin D intake (every 5 μg/1000 kcal) at multiple ages was associated with increased risk of CDA and celiac disease in Sweden, with the strongest at age 5 y for CDA [HR: 1.23, 95% confidence interval (CI): 1.11, 1.37; P < 0.001] and at age 4 y for celiac disease (HR: 1.20; 95% CI: 1.03, 1.40; P = 0.021). Higher iron intake (every 5 mg/1000 kcal) was also associated with increased risks of CDA and celiac disease in Sweden, with the highest observed up to age 5 y (HR: 1.70; 95% CI: 1.39, 2.08; P < 0.001 for CDA and HR:1.80; 95% CI: 1.37, 2.36; P < 0.001 for celiac disease). CONCLUSIONS: Modest country-specific associations were found between childhood micronutrient intake with risk of CDA and celiac disease, potentially reflecting the influence from regional dietary practices, fortification policies, and host factors in disease pathogenesis.
Efficacy of dietary interventions for functional constipation: a systematic review and network meta-analysis.
Mou J, Zeng L, Li Y … +3 more , He S, Hu K, Wang Q
Am J Clin Nutr · 2026 May · PMID 41850487 · Publisher ↗
BACKGROUND: The efficacy of dietary intervention in the treatment of functional constipation (FC) varies substantially across different studies. OBJECTIVES: This study aimed to compare the relative efficacy of various di...
BACKGROUND: The efficacy of dietary intervention in the treatment of functional constipation (FC) varies substantially across different studies. OBJECTIVES: This study aimed to compare the relative efficacy of various dietary interventions in patients with FC through network meta-analysis (NMA). METHODS: From the inception of the database until 20 August 2025, a systematic search was conducted in PubMed, Embase, Cochrane Library, and Web of Science. Randomized controlled trials (RCTs) were included to evaluate the efficacy of different dietary interventions on FC. A Bayesian framework was used for NMA, and surface under the cumulative ranking curve was employed for cumulative ranking; additionally, network regression, sensitivity, and subgroup analyses were conducted to explore the sources of between-study heterogeneity. RESULTS: A total of 19 RCTs were included, with 73.7% of the studies having low risk of bias. For defecation frequency, fruit-based foods (category 1) were better than fiber supplements (moderate certainty), mineral water (low certainty), and placebo (moderate certainty). Multicomponent foods (category 1) were better than fiber supplements (low certainty), medicine (moderate certainty), and placebo (low certainty). Subgroup analyses suggested that mineral water may show relatively greater efficacy in studies with longer intervention duration. In terms of improving stool consistency, multicomponent foods (category 1) were superior to medicine (high certainty), vegetables with whole grains (moderate certainty), fiber supplements (moderate certainty), and placebo (high certainty). Fruit-based foods (category 1) were superior to vegetables with whole grains (moderate certainty) and placebo (high certainty). Regarding the severity of constipation, fruit-based foods (category 1) ranked first, superior to fiber supplements (moderate certainty) and placebo (moderate certainty). CONCLUSIONS: Multicomponent foods and fruit-based foods appear to be among the more effective dietary intervention options for managing FC. Intervention duration may influence observed treatment effects. Future studies need to further integrate objective mechanistic biomarkers, in addition to standard clinical outcomes, to explore the potential mechanisms of dietary interventions for FC. This study was registered at PROSPERO as CRD420251134853.
The relationship between maternal glucose concentrations, gestational diabetes mellitus, and adverse fetal growth and gestational age outcomes: a retrospective cohort study.
Arcot A, Gallagher K, Goldstein JA … +1 more , Gernand AD
Am J Clin Nutr · 2026 May · PMID 41850486 · Full text
BACKGROUND: Gestational diabetes mellitus (GDM) is defined as hyperglycemia or glucose intolerance in pregnancy and no history of diagnosed type 1 or type 2 diabetes mellitus. The relationship between elevated glucose wi...
BACKGROUND: Gestational diabetes mellitus (GDM) is defined as hyperglycemia or glucose intolerance in pregnancy and no history of diagnosed type 1 or type 2 diabetes mellitus. The relationship between elevated glucose without GDM and pregnancy outcomes is not well understood. OBJECTIVES: To examine the relationships between glucose challenge test (GCT) concentrations and GDM with fetal growth and gestational age at birth. METHODS: We conducted a retrospective cohort study using secondary medical record data from Northwestern Memorial Hospital (n = 10,899). The data were from pregnancies where the placenta was sent for pathology. We examined birth weight z-score, gestational age at birth, birth weight to placental weight ratio, small for gestational age, large for gestational age (LGA), and preterm birth. We categorized glucose groups: pass GCT/no GDM (control), fail GCT/no GDM, and GDM. We adjusted linear and log-binomial regression models for maternal age, race, parity, gestational age at birth, and infant sex. RESULTS: Of the placentas sent to pathology, 5% were from pregnancies diagnosed with GDM. Birth weight z-score was marginally higher in the fail GCT/no GDM (adjusted mean difference: 0.14; 95% confidence interval (CI): 0.09, 0.19) and the GDM group (0.19; 95% CI: 0.11, 0.29), compared with the control. The GDM group had a nearly 3-day mean difference in gestational age (‒2.88; 95% CI: ‒4.00, ‒1.77). Patients in the fail GCT/no GDM group had a higher risk of LGA and preterm birth, by 41% (95% CI: 22%, 63%) and 27% (95% CI: 12%, 44%), respectively. Patients in the GDM group had a 71% (95% CI: 34%, 216%) higher risk of LGA, but preterm birth risk was not significantly different. CONCLUSIONS: GDM was associated with the highest mean birthweight z-score, the shortest mean gestational age, and a higher risk of LGA. Higher glucose concentrations and failed GCT without GDM were associated with a higher risk of preterm birth and LGA.
Longitudinal association between human milk macronutrient intake and infant growth throughout the first 8.5 months of life: a multicenter cohort study.
Figueiredo AC, Campos ADS, Silva GT … +11 more , Paula DP, Schneider BC, Mucci DB, Islam MM, Michaelsen KF, Mølgaard C, Christensen SH, Hampel D, Allen LH, Moore SE, Kac G
Am J Clin Nutr · 2026 May · PMID 41850485 · Full text
BACKGROUND: Human milk (HM) contains essential components that support infant growth and development; however, evidence linking HM macronutrient intake to infant growth remains minimal. OBJECTIVES: This study aimed to ev...
BACKGROUND: Human milk (HM) contains essential components that support infant growth and development; however, evidence linking HM macronutrient intake to infant growth remains minimal. OBJECTIVES: This study aimed to evaluate the longitudinal association between HM macronutrient intake and infant growth. METHODS: This study includes 833 mother-infant pairs from the 4-site Mothers, Infants and Lactation Quality study (Bangladesh, Brazil, Denmark, and The Gambia) who were followed at 1-3.49 mo (M1), 3.5-5.99 mo (M2), and 6-8.5 mo (M3). HM macronutrients were measured by near-infrared spectroscopy at M1. HM volume intake was assessed at M1 on a subset of 533 participants using the stable isotope "dose-to-mother" method, except in Denmark, where test-weighing was used. HM macronutrient intake was estimated as the product of each macronutrient concentration and HM intake. Weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), and BMI-for-age (BAZ) z-scores were calculated at M1, M2, and M3, and analyzed according to WHO Growth Standards. Statistical analyses included linear mixed-effects models adjusted for site, maternal age, and BMI, infant birth weight, and sex. Interaction terms for site and Benjamini-Hochberg multiple testing comparisons were included. RESULTS: Positive longitudinal associations were observed between HM protein intake (g/d) at M1 and WAZ (β = 0.084), LAZ (β = 0.044), WLZ (β = 0.082), and BAZ (β = 0.092) between 1 and 8.5 mo. HM carbohydrate intake (g/d) at M1 was associated with higher WAZ (β = 0.034), LAZ (β = 0.016), WLZ (β = 0.036), and BAZ (β = 0.039) between 1 and 8.5 mo. Positive associations were also observed between HM lipid intake (g/d) and WAZ (β = 0.014), WLZ (β = 0.017), and BAZ (β = 0.018). Significant interactions with study site were observed for the associations between HM protein intake and LAZ in Brazil (β = 0.115) and between HM carbohydrate intake and WAZ in Bangladesh (β = 0.018), compared with The Gambia. CONCLUSIONS: These results reveal that HM macronutrient intake is positively associated with infant growth, and some associations may also be modified by site. This study was registered at clinicaltrials.gov as NCT03254329.
Long-chain polyunsaturated fatty acids and school achievement: tales of a tangled web.
Colombo J, Carlson SE
Am J Clin Nutr · 2026 May · PMID 41833908 · Full text
Abstract loading — click title to view on PubMed.
Exposure to low-sweet snacks and caregiver nutritional and dental health education lowered children's added sugar intake: a randomized controlled trial.
Mennella JA, Coffman DL, Merchan MT … +3 more , Croce CM, Smethers AD, Fisher JO
Am J Clin Nutr · 2026 Jul · PMID 41833907 · Publisher ↗
BACKGROUND: Children consume more added sugar than recommended, with snacks a major source. OBJECTIVES: To determine the effects of repeated exposure to lower-sugar snacks, combined with caregiver education, on children'...
BACKGROUND: Children consume more added sugar than recommended, with snacks a major source. OBJECTIVES: To determine the effects of repeated exposure to lower-sugar snacks, combined with caregiver education, on children's added sugar intake, acceptance of lower-sweetness foods, and sweet preferences. METHODS: In a 4-month randomized trial with 1-month follow-up, 70 preschooler-caregiver dyads were assigned to a control group receiving daily snacks typical for children and general health lessons for caregivers or an intervention group receiving lower-sugar, lower-sweetness snacks and caregiver lessons on nutrition and dental health, including guidance to limit sugary foods and remove sugar-sweetened beverages (SSBs) from the home. Primary outcomes were changes in children's added sugar and SSB intakes, acceptance of low-sweetness snacks, and taste preferences. RESULTS: At 4 months, intervention children ingested less added sugar [-10.1 tsp/d; 95% confidence interval) CI: -14.0, -6.2; P < 0.001] and SSB (-103.3 kcal/d; 95% CI: -159.2, -47.5; P < 0.001) than controls; decreases were evident by mid-trial. The intervention did not alter their liking or intake of 4 selected lower-sugar snacks or shift their most preferred sucrose concentration. However, there was significant group × time interaction for salt preferences (P = 0.045); intervention children most preferred higher salt concentrations (0.52 ± 0.04 Molarity [M]) than did controls (0.32 ± 0.04 M; P = 0.002). By mid-trial, intervention caregivers also consumed less added sugar (-17.6 tsp/d; 95% CI: -24.5, -10.7; P < 0.001) and SSBs (-255 kcal/d; 95% CI: -329, -122; P = 0.01) than controls. CONCLUSIONS: Providing lower-sugar snacks daily and caregiver education for 4 months effectively reduced daily added sugar and SSB intakes among children and their caregivers without shifting the most preferred level of sweetness. Although sodium intake was unchanged, increased salt preference among intervention children suggests a potential trade-off between added sugar and sodium content of children's snacks that warrants further investigation. "Snacks, Smiles and Taste Preferences," https://clinicaltrials.gov/study/NCT03631992?cond=sweet%20biomarkers&checkSpell=&rank=2; registration date: 08/13/2018).
Adherence to the EAT-Lancet diet, genetic predisposition, and risk of kidney stone disease: a population-based prospective cohort study.
Xu K, Wu F, Na L … +4 more , Liu J, Wang P, Liu Y, Bai S
Am J Clin Nutr · 2026 May · PMID 41833906 · Publisher ↗
BACKGROUND: The EAT-Lancet diet was developed to promote both human health and environmental sustainability. However, the association between the EAT-Lancet diet and kidney stone disease (KSD) risk remains unclear. OBJEC...
BACKGROUND: The EAT-Lancet diet was developed to promote both human health and environmental sustainability. However, the association between the EAT-Lancet diet and kidney stone disease (KSD) risk remains unclear. OBJECTIVES: We aimed to investigate the association between adherence to the EAT-Lancet diet and KSD risk, evaluate the mediating role of body mass index (BMI), and explore whether genetic predisposition modifies these associations. METHODS: This prospective cohort study included 197,759 adults who completed at least one 24-h dietary recall and were free of KSD from the UK Biobank. The EAT-Lancet Diet Index (ELD-I) was calculated using these recall data to assess the adherence to the EAT-Lancet diet. A polygenic risk score was constructed using 20 single-nucleotide polymorphisms to evaluate genetic predisposition. Cox proportional hazards regression models were used to assess the associations between ELD-I, genetic predisposition, and KSD risk. The mediating role of BMI was also investigated. RESULTS: After 2,286,927 person-years of follow-up, 1708 incident KSD cases were identified. In the multivariable-adjusted model, compared with participants with the lowest ELD-I, the hazard ratio (HR) for participants with the highest ELD-I was 0.81 [95% confidence interval (CI) 0.69, 0.95]. Mediation analysis indicated that BMI mediated 14.94% of the association between ELD-I and KSD risk. Moreover, no significant interaction between the genetic predisposition for KSD and ELD-I was observed. Joint analyses showed that, compared with participants with the lowest ELD-I and higher genetic predisposition, the HR of those with the highest ELD-I and lower genetic predisposition was 0.61 (95% CI: 0.49, 0.76). CONCLUSIONS: Higher adherence to the EAT-Lancet diet was inversely associated with KSD among people with different genetic predispositions, and the association was partly mediated by BMI.
Preconception micronutrient supplementation positively affects offspring perceptual reasoning at 10-11 years of age: follow-up of a randomized controlled trial in Vietnam.
Nguyen PH, Tran LM, Khuong LQ … +7 more , Nguyen PT, Van Nguyen B, Be TH, Young MF, DiGirolamo AM, Martorell R, Ramakrishnan U
Am J Clin Nutr · 2026 May · PMID 41831611 · Publisher ↗
BACKGROUND: Maternal periconceptional nutrition is important for birth outcomes, but few studies examine long-term effects on offspring growth and development. OBJECTIVES: We assessed the impact of weekly preconception m...
BACKGROUND: Maternal periconceptional nutrition is important for birth outcomes, but few studies examine long-term effects on offspring growth and development. OBJECTIVES: We assessed the impact of weekly preconception multiple micronutrients (MM) or iron and folic acid (IFA) supplements compared to folic acid (FA) alone, on cognitive function and nutritional status at 10-11 y. We also examined associations with early-life biological and socioenvironmental factors. METHODS: We conducted a follow-up study of 1599 children from a preconception randomized trial in Vietnam, in which females received weekly FA, IFA, or MM before conception and daily IFA during pregnancy. We assessed cognitive function, academic achievement, and nutritional status at ages 10-11 y. Early biological factors included maternal nutritional status, birth characteristics, and postnatal linear growth; socioenvironmental variables were maternal schooling, ethnicity, depression, infant feeding, socioeconomic status (SES), and home environment. Analyses used intention-to-treat and per protocol comparisons with inverse-probability-of-censoring weights to account for loss to follow-up. RESULTS: Offspring in the MM and IFA groups had higher perceptual reasoning scores than the FA group {mean difference [95% confidence interval (CI): MM: 1.68 (0.01, 3.35); IFA: 2.04 (0.33, 3.74)]}. The IFA groups also had higher reading scores [0.78 (0.11, 1.44)] and lower anemia prevalence [-4.26 (-7.60, -0.91)]. No differences were observed in full-scale intelligence quotient (FSIQ) or anthropometric measures. Maternal underweight was negatively associated with FSIQ [β (95% CI): -1.62 (-3.06, -0.18)] and reading scores [-0.59 (-1.12, -0.06)] whereas postnatal linear growth was positively associated with FSIQ [1.67 (0.91, 2.43)], mathematics [0.36 (0.12, 0.61)], and reading scores [0.47 (0.21, 0.74)]. Maternal schooling, home environment, SES, were also linked to improved cognitive and academic outcomes [β range: 0.64 (0.01, 1.27) to 8.89 (5.20, 12.58)], and exclusive breastfeeding was linked with higher mathematics scores [0.73 (0.27, 1.19)]. CONCLUSIONS: Preconception MM and IFA supplementation improved certain aspects of cognitive functioning at 10-11 y compared with FA alone, whereas early-life biological and socioenvironmental factors were positively associated with cognitive and academic outcomes. This study was registered at clinicaltrials.gov as NCT01665378 (https://clinicaltrials.gov/ct2/show/NCT01665378).
Dietary fat consumption and cancer outcomes: an umbrella review of systematic reviews and meta-analyses.
Fan B, Zhang Z, Zhang Y … +6 more , Pang L, Guo Q, Chen P, Jian L, Wu Y, Wang S
Am J Clin Nutr · 2026 May · PMID 41825531 · Publisher ↗
BACKGROUND: Dietary fats may influence carcinogenesis through pathways involving lipid metabolism, oxidative stress, and inflammation. However, existing evidence from meta-analyses (MAs) remains inconsistent across cance...
BACKGROUND: Dietary fats may influence carcinogenesis through pathways involving lipid metabolism, oxidative stress, and inflammation. However, existing evidence from meta-analyses (MAs) remains inconsistent across cancer types. OBJECTIVES: We conducted an umbrella review and updated the MA to evaluate the associations between intakes of total fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), and polyunsaturated fatty acid (PUFA) and the risk of multiple cancers. METHODS: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from inception to September 2025 for systematic reviews and MAs of observational or interventional studies assessing dietary fat intake in relation to cancer incidence. Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), and the certainty of evidence was graded with GRADE. RESULTS: Twenty-three systematic reviews and MAs were included. Higher total fat intake was associated with increased risks of bladder [relative risk (RR): 1.28; 95% confidence interval (CI): 1.04, 1.58)], breast (RR: 1.10; 95% CI: 1.05, 1.16), gastric (RR: 1.18; 95% CI: 1.00, 1.39), and esophageal cancer (RR: 1.31; 95% CI: 1.13, 1.49) and non-Hodgkin lymphoma (RR: 1.26; 95% CI: 1.12, 1.42). SFA intake was associated with higher risks of breast (RR: 1.10; 95% CI: 1.03, 1.17), gastric (RR: 1.31; 95% CI: 1.09, 1.58), liver (RR: 1.34; 95% CI: 1.06, 1.69), and esophageal cancer (RR: 1.88; 95% CI: 1.28, 2.77). MUFA intake was positively associated with esophageal (RR: 1.70; 95% CI: 1.01, 2.84) and breast cancer (RR: 1.08; 95% CI: 1.01, 1.16) but inversely associated with skin cancer (RR: 0.90; 95% CI: 0.85, 0.96). PUFA intake was inversely associated with gastric cancer (RR: 0.77; 95% CI: 0.65, 0.92). CONCLUSIONS: Higher intake of total and saturated fats was associated with increased risks of several site-specific cancers, whereas polyunsaturated fats may have protective effects. This trial was registered at PROSPERO CRD420251236506.
Dietary Choline and Betaine Intake and 2-year Changes in Cognitive Function in Older Adults With Overweight or Obesity and Metabolic Syndrome: A Prospective Cohort Analysis.
Vázquez-Lorente H, Manzanares-Errazu JM, Babio N … +45 more , Ruiz-Canela M, Corella D, Hernando J, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Urbano-Fernández V, Serra-Majem L, Cano-Ibáñez N, Tur JA, Sánchez VM, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Vázquez C, Ros E, Fernández-Aranda F, Toledo E, Gutiérrez-Carrasquilla L, Sorlí JV, Zomeño MD, Garcia-Rios A, Oncina-Canovas A, Cueto-Galán R, Zulet MA, Prohens L, Casas R, Durán-Luque M, Tojal-Sierra L, Simón-Frapolli V, Vázquez-Ruiz Z, Fernández-Carrión R, Castañer O, Rodriguez-Mancheño AL, Asencio A, García-Arellano A, Fitó M, Daimiel L, Salas-Salvadó J
Am J Clin Nutr · 2026 May · PMID 41825530 · Full text
BACKGROUND: Dietary choline and betaine may protect against cognitive decline. OBJECTIVES: To examine longitudinal associations between dietary choline and betaine intake and 2-y cognitive changes in older adults. METHOD...
BACKGROUND: Dietary choline and betaine may protect against cognitive decline. OBJECTIVES: To examine longitudinal associations between dietary choline and betaine intake and 2-y cognitive changes in older adults. METHODS: This prospective cohort study is a secondary analysis nested within the PREDIMED-Plus trial. Participants included 6610 older adults aged 55-75 y with metabolic syndrome. Dietary choline and betaine intake were estimated at baseline, 1, and 2 y using a validated 143-item food frequency questionnaire. Cumulative averages were calculated. Cognitive function was assessed at baseline and 2 y using 5 composite scores based on 8 neuropsychological tests covering global cognition, general cognition, attention, executive function, and language. Multivariable-adjusted linear regression models evaluated associations between energy-adjusted cumulative average intakes and 2-y cognitive changes. RESULTS: Over a median follow-up of 2 y (interquartile range: 1.95-2.05), each 1 mg/d higher energy-adjusted cumulative average dietary choline intake was associated with slower decline in attention [β = 5.20 × 10; 95% confidence interval (CI): 1.61 × 10, 8.79 × 10; P = 0.005] and beneficial changes in language (β = 3.79 × 10; 95% CI: 0.62 × 10, 6.95 × 10; P = 0.019). Participants in the highest choline tertile showed greater 2-y improvements in attention (β = 7.50 × 10; 95% CI: 2.12 × 10, 12.88 × 10; P-trend = 0.006) and language (β = 5.82 × 10; 95% CI: 1.04 × 10, 10.59 × 10; P-trend = 0.016) compared with the lowest tertile. Similarly, each 1 mg/d higher betaine intake was associated with more favorable changes in executive function (β = 7.48 × 10; 95% CI: 1.71 × 10, 13.20 × 10; P = 0.011) and language (β = 9.13 × 10; 95% CI: 2.96 × 10, 15.31 × 10; P = 0.004). Participants in the highest betaine tertile also exhibited greater 2-y improvements in language (β = 4.71 × 10; 95% CI: 0.25 × 10, 9.17 × 10; P-trend = 0.036) compared with the lowest tertile. CONCLUSIONS: Higher dietary choline and betaine intake were associated with modest short-term improvements in cognitive performance over 2 y in older adults. Longer-term studies are warranted. This trial was registered at www.isrctn.com as ISRCTN89898870.
Relevance of more stringent discharge standards for acute malnutrition treatment: a pooled analysis of posttreatment relapse in 21 studies.
Guesdon B, Rattigan SM, Grellety E … +3 more , Bliznashka L, Donnen P, Bilukha O
Am J Clin Nutr · 2026 May · PMID 41825529 · Publisher ↗
BACKGROUND: The World Health Organization recently recommended that both weight-for-height Z-score (WHZ) and mid-upper-arm-circumference (MUAC) exceed moderate acute malnutrition (MAM) thresholds before a child with seve...
BACKGROUND: The World Health Organization recently recommended that both weight-for-height Z-score (WHZ) and mid-upper-arm-circumference (MUAC) exceed moderate acute malnutrition (MAM) thresholds before a child with severe acute malnutrition (SAM) is safely discharged from treatment. However, this recommendation is based on very low certainty evidence. OBJECTIVES: We aimed at estimating risk of relapse to SAM in children with anthropometric profiles below MAM case definition thresholds on discharge, compared with those with full recovery. METHODS: We performed a pooled analysis of studies that followed acutely malnourished children discharged as cured from treatment, until 6 mo after discharge. Data from 21 studies conducted in 13 countries, including 15,394 children admitted to treatment with SAM or MAM, discharged as cured free of SAM, and with nonmissing information for both MUAC and WHZ on discharge, contributed to the analysis. Inverse-variance random-effects Cox models were used. RESULTS: Overall, 32.1% of the pooled cohort had MAM defined by WHZ < -2 and/or MUAC < 12.5 cm at discharge from treatment. During follow-up, 1243 children (8.1%) relapsed to SAM. Relapse was 2-3-fold higher in children with MAM at discharge: 14.2% (13.2, 15.2) compared with 5.2% (4.8, 5.6) in those without MAM. Children with MAM by WHZ at discharge had twice higher cumulative incidence of relapse to SAM compared with children with MAM by MUAC at discharge: 19.2% (17.4, 21.0) compared with 9.4% (8.2, 10.6). Of note, a MUAC-only definition of SAM would have missed >60% of relapse cases. CONCLUSIONS: Both MUAC and WHZ should reach levels above MAM cut-offs before children with SAM or MAM safely exit from nutritional treatment. Furthermore, studies with adequately defined outcomes should investigate optimal discharge criteria for maximizing effectiveness as well as sustainability and acceptability of mediconutritional services.
NIH-FDA Nutrition Regulatory Science Workshop: advancing research and policy.
Bremer AA, Adas S, Brown AG … +10 more , Casavale KO, Hermansky S, Herrick K, Kavanaugh CJ, Nicastro HL, Schully SD, Reedy J, Vargas AJ, Zanetti KA, McKinnon RA
Am J Clin Nutr · 2026 May · PMID 41819266 · Full text
BACKGROUND: Nutrition plays a pivotal role in health, yet poor dietary habits are now the leading risk factor for illness and death. In the United States, diet-related conditions such as heart disease, cancer, diabetes,...
BACKGROUND: Nutrition plays a pivotal role in health, yet poor dietary habits are now the leading risk factor for illness and death. In the United States, diet-related conditions such as heart disease, cancer, diabetes, and obesity cause >1 million deaths per year and are leading contributors to the nation's $4.5 trillion in healthcare spending. OBJECTIVES: Addressing these issues requires coordinated efforts across multiple sectors and government agencies. The National Institutes of Health (NIH) and the United States Food and Drug Administration (FDA) are essential partners in this endeavor. A strong foundation of scientific research, coupled with effective, practical, and real-world regulatory activities, is critical to inform consumers and support a healthier food environment. METHODS: In December 2024, NIH and FDA convened a workshop to advance nutrition science for food-related policy decision making. A diverse group of researchers, policymakers, and other experts participated in the event to identify research gaps, explore strategies for enhanced NIH-FDA collaboration, and highlight emerging technologies in nutrition science, with a particular focus on the topic of ultra-processed foods. RESULTS: The workshop was designed to do the following: 1) identify critical research gaps and priorities in nutrition regulatory science; 2) enhance scientific collaboration between NIH and FDA; 3) explore how scientific evidence informs food-related policies and regulations; and 4) highlight emerging technologies and data resource needs for nutrition research. CONCLUSION: This article summarizes the workshop proceedings and describes priority research gaps, opportunities, and suggested next steps that emerged from the discussions.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe