He X, Zhang Z, Johansson U
… +5 more, Tancredi DJ, Hernell O, Lönnerdal B, Lind T, Slupsky CM
Am J Clin Nutr
· 2026 Apr · PMID 41702471
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BACKGROUND: Protein intake among children in resource-rich countries often exceeds current recommendations. Higher protein consumption during infancy has been associated with an increased risk of obesity later in life. O...BACKGROUND: Protein intake among children in resource-rich countries often exceeds current recommendations. Higher protein consumption during infancy has been associated with an increased risk of obesity later in life. OBJECTIVES: We conducted a secondary analysis of a randomized controlled trial where 250 infants were randomly assigned to receive either a protein-reduced Nordic diet or a conventional Swedish complementary diet. Our aims were to examine the metabolic responses to the intervention using plasma metabolomics and to test the pathways proposed by the Early Protein Hypothesis by linking cumulative protein intake to circulating branched-chain amino acids (BCAAs), insulin-like growth factor-1 (IGF-1), and growth outcomes using structural equation modeling (SEM). METHODS: Targeted proton nuclear magnetic resonance (H-NMR) metabolomics was performed on plasma samples collected at 12 and 18 mo. Two SEM models were constructed: one modeled body weight and the other modeled BMI as growth outcomes using data collected up to age 18 mo. Model fit indices were assessed, and path diagrams were used to visualize relationships. RESULTS: The Nordic diet led to reduced-protein intake and a distinct infant plasma metabolomic profile. Circulating BCAAs and their catabolites were significantly lower in the reduced-protein Nordic diet compared with the conventional diet. Cumulative protein intake positively correlated with plasma IGF-1 concentrations {weight-based SEM: β = 0.40 [95% confidence interval (CI): 0.03, 0.48]; BMI-based SEM: β = 0.43 [95% CI: 0.05, 0.50]}. Plasma total BCAAs were positively associated with plasma IGF-1 levels [weight-based SEM: β = 0.16 (95% CI: 0.00, 0.76); BMI-based SEM: β = 0.17 (95% CI: 0.02, 0.78)]. After accounting for metabolite-mediated effects on IGF-1 and insulin, cumulative protein intake remained significantly associated with infant body weight [β=0.36 (95% CI: 0.02, 0.99)], but not BMI. CONCLUSIONS: Complementary feeding during infancy substantially shapes the plasma metabolome. Reducing protein intake from complementary feeding helps attenuate rapid infant weight gain, a well-established early-life predictor of later obesity.
Am J Clin Nutr
· 2026 Mar · PMID 41701576
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BACKGROUND: Despite benefits of prenatal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, less than half of eligible individuals receive WIC benefits during pregnancy. By exace...BACKGROUND: Despite benefits of prenatal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, less than half of eligible individuals receive WIC benefits during pregnancy. By exacerbating barriers to participating in this program, the pandemic could have reduced prenatal WIC participation especially among certain vulnerable groups. OBJECTIVES: The objective was to examine the association of the pandemic with prenatal WIC participation among eligible individuals. An additional objective is to examine this association by key demographic characteristics, including income and education, and health care access. METHODS: Using Pregnancy Risk Assessment Monitoring System 2017-2022 from 23 states, WIC-eligible pregnant individuals with data on WIC receipt were included. Those who had given birth from 2017 through February 2020 and from July 2020 through 2022 were classified as having pregnancies during prepandemic and postpandemic periods, respectively. An interrupted time series model using logistic regression examined association of pandemic with WIC participation. RESULTS: Compared with prepandemic, the postpandemic period was associated with lower odds of WIC participation in the overall sample (odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.74, 0.96). The postpandemic period also was significantly associated with lower odds of WIC participation in some subgroups, such as those with an education level of high school or less (OR: 0.77; 95% CI: 0.65, 0.92), family income of poverty ratio <1 (OR: 0.77; 95% CI: 0.61, 0.97), inadequate prenatal care (OR: 0.62; 95% CI: 0.40, 0.96), and no health insurance during pregnancy (OR: 0.28; 95% CI: 0.11, 0.72). CONCLUSIONS: Findings suggest a decline in prenatal WIC participation after the pandemic. Additionally, the association of the pandemic with lower odds of WIC participation among those from lower socioeconomic status and poorer health care access suggests exacerbation of health disparities and underscores the need to improve participation in these groups.
BACKGROUND: Few studies on diet and chronic kidney disease (CKD) have evaluated the role of overall dietary patterns, particularly in European populations. OBJECTIVE: To examine the association between several diet quali...BACKGROUND: Few studies on diet and chronic kidney disease (CKD) have evaluated the role of overall dietary patterns, particularly in European populations. OBJECTIVE: To examine the association between several diet quality indices-Alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH), Alternative Healthy Eating Index-2010 (AHEI-2010), Planetary Health Diet Index (PHDI), and Dietary Inflammatory Index (DII)-and all-cause mortality among British adults with CKD. METHODS: We analyzed data from 4102 United Kingdom Biobank participants, who were followed from February 2011 to July 2024. CKD was determined using clinical diagnoses and estimated glomerular filtration rates. Dietary indices were calculated from at least two 24-h dietary assessments, and mortality records were obtained from national death registers. Multivariable proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between dietary patterns and mortality. RESULTS: Baseline mean age of participants was 60.6 y (women, 53.2%). Over a median follow-up of 12 y, 696 participants died (16.97%). Comparing the highest to the lowest adherence tertile of the 5 dietary patterns, the fully-adjusted HRs for all-cause mortality was 0.73 (95% CI: 0.59, 0.90) for the aMED, 0.68 (95% CI: 0.56, 0.84) for the DASH, 0.77 (0.63, 0.93) for the AHEI-2010, 0.87 (95% CI: 0.72, 1.06) for the PHDI, and 1.30 (95% CI: 1.05, 1.59) for the DII. Major dietary components driving the associations included nuts [aMED 0.84 (95% CI: 0.72, 0.99); PHDI 0.95 (95% CI: 0.91, 0.99)], legumes and nuts [DASH 0.93 (95% CI: 0.88, 0.98); AHEI-2010 0.97 (95% CI: 0.95, 1.00)], and sodium [DASH 0.92 (95% CI: 0.86, 0.99); AHEI-2010 0.96 (95% CI: 0.93, 0.99)]. Sensitivity analyses yielded consistent results. CONCLUSIONS: In this cohort study of middle-aged and older adults with CKD, higher adherence to healthy dietary patterns, including aMED, DASH, and AHEI-2010, was associated with significantly lower all-cause mortality, whereas higher DII scores were linked to higher mortality. These findings highlight diet quality as a modifiable protective factor in individuals with CKD.
Trujillo-Gonzalez I, Horita DA, Stegall J
… +9 more, Coble R, Paules EM, Lulla AA, Baah E, Bottiglieri T, Sha W, Kohlmeier M, Friday WB, Zeisel SH
Am J Clin Nutr
· 2026 Apr · PMID 41687879
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BACKGROUND: Choline is an essential nutrient, and insufficient intake negatively affects the liver, brain, and muscles. In the United States, habitual choline intake remains below the adequate intake (AI). To date, no ci...BACKGROUND: Choline is an essential nutrient, and insufficient intake negatively affects the liver, brain, and muscles. In the United States, habitual choline intake remains below the adequate intake (AI). To date, no circulating metabolites have been validated to distinguish between low and adequate choline intake. OBJECTIVES: We tested whether plasma concentrations of choline and its metabolites could discriminate adequate compared with low dietary choline intake and whether liver elastography (FibroScan) could detect diet-induced changes in liver fat. METHODS: In a double-blind, randomized, crossover feeding study, participants followed three 15-d dietary arms providing ∼100%, 50%, and 25% of the choline AI in the form of choline chloride. On day 12 of each dietary arm, participants consumed a single bolus of 2.2 mmol trimethyl-d-choline. Targeted assays quantified plasma choline, betaine, phosphatidylcholine (PtdCho), and total homocysteine (tHcy) concentrations. Liver fat content was measured using FibroScan. RESULTS: Plasma concentrations of d-choline, betaine, and their isotopic enrichment ratio (IER) varied with dietary intake (q < 0.0001), and PtdCho IER also differed significantly (q = 0.001). In targeted analysis, choline and betaine concentrations were highly responsive to dietary choline intake, whereas PtdCho and tHcy were not. Compared with the 100% AI arm, plasma choline was lower in the 25% AI arm [β= -2.20, 95% confidence interval (CI): -2.72, -1.68]. Receiver operator characteristic analysis showed strong discrimination for plasma choline [area under the curve (AUC) = 0.81, 95% CI: 0.74, 0.88], and betaine (AUC = 0.80, 95% CI: 0.73, 0.88), with improved discrimination when combined (AUC = 0.85, 95% CI: 0.79, 0.91). Fibroscan identified a subset of participants with increased liver fat in response to the 25% AI compared with 100% AI choline diet, though patterns varied among individuals. CONCLUSIONS: Plasma choline and betaine concentrations discriminate low compared with AI under controlled feeding. These findings support targeted metabolite profiling to improve choline intake assessment and reveal individual differences in liver response to low choline intake. This study was registered at Choline Nutritional Status: Development of a Biomarker Panel as NCT03726671 (www. CLINICALTRIALS: gov) registered 31 October, 2018.
Furst AJ, Johnson KE, Nagel EM
… +12 more, Yerabandi N, Kats AM, Gallagher TT, Gale CA, Palmsten K, Pierce S, Hoffman S, Jacobs K, Fields DA, Isganaitis EM, Bode L, Demerath EW
Am J Clin Nutr
· 2026 Apr · PMID 41672407
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BACKGROUND: Gestational diabetes mellitus (GDM) increases offspring obesity risk, but whether this occurs via changes in human milk composition, including alterations in human milk oligosaccharides (HMOs), is unknown. OB...BACKGROUND: Gestational diabetes mellitus (GDM) increases offspring obesity risk, but whether this occurs via changes in human milk composition, including alterations in human milk oligosaccharides (HMOs), is unknown. OBJECTIVES: This study aimed to identify differences in HMO concentrations in mothers with and without GDM and test whether GDM-associated HMOs are associated with infant growth, body composition, and fecal microbiome characteristics over the first 6-mo of life. METHODS: Human milk was collected at 1-mo postpartum from 337 females (49 with GDM) who fed their infants breastmilk exclusively. HMOs were quantified by high-performance liquid chromatography and multivariate regression models were used to test differences in HMO concentrations by GDM status (false discovery rate adjustment for multiple testing set at q < 0.05). HMOs associated with GDM were then tested for associations with infant growth, body composition, and 1 and 6-mo infant fecal microbial abundances measured by metagenomic whole-genome sequencing. RESULTS: Participants with GDM had ∼1 SD higher milk 6'sialyllactose (6'SL) {[β (95% confidence interval): 0.58 (0.20, 0.96)] and lacto-N-fucopentaose III (LNFP III) III [95% CI: 0.55 (0.16, 0.94)]} compared with those without GDM and 6'SL concentration was also positively associated with weight and length gain. Although infants of mothers with GDM had lower 1-mo fecal α-diversity and altered abundances of 6 of 56 microbial species detected compared with those without GDM, microbial features were not associated with the concentration of either 6'SL or LNFP III and evidence for mediation of GDM-growth and GDM-microbiome by HMOs was not found. CONCLUSIONS: Mothers with a GDM diagnosis had higher milk concentrations of LNFP III and 6'SL, and 6'SL was in turn associated with increased infant growth rate, but neither HMO was associated with differential infant gut microbial abundances. The results suggest that the link between 6'SL and faster infant growth, if causal, occurs via mechanisms independent of the infant gut microbiome. This study was registered at clinicaltrials.gov as NCT03301753.
Am J Clin Nutr
· 2026 Apr · PMID 41655703
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BACKGROUND: In Canada, by 2026, prepackaged foods high in saturated fat, sodium, or sugar require a front-of-package warning symbol (FOPS). However, evidence on ultraprocessed foods (UPFs) raises concerns about whether t...BACKGROUND: In Canada, by 2026, prepackaged foods high in saturated fat, sodium, or sugar require a front-of-package warning symbol (FOPS). However, evidence on ultraprocessed foods (UPFs) raises concerns about whether this approach fully captures all foods of concern-particularly for individuals with hypertension or hypercholesterolemia, for whom dietary changes are crucial. It is also important to assess whether medication use diminishes the benefits of limiting such foods. OBJECTIVES: We examined the joint association of consuming foods of concern-defined as UPFs or foods with FOPS-medication use, and cardiovascular disease (CVD) risk in adults with hypertension and/or hypercholesterolemia from the CARTaGENE cohort. METHODS: This prospective cohort study included 2123 participants free of CVD but with hypertension and/or hypercholesterolemia at baseline (2009-2010). Using food frequency questionnaire (FFQ) data (2012), UPFs were identified using Nova, and foods with FOPS using Health Canada criteria. Cholesterol- and blood pressure-lowering medication use was self-reported. Incident CVDs were identified using administrative databases, from FFQ completion to 31 December, 2021. Associations between intake of foods of concern, medication use, and CVD risk were assessed using multivariable-adjusted Cox proportional hazards models. RESULTS: In multivariable-adjusted analyses-including medication use, energy intake, and BMI-the hazard ratio (HR) for CVD risk associated with a 10% lower difference in UPF consumption-accompanied by a proportional higher difference in non-UPF-was 0.87 [95% confidence interval (CI): 0.78, 0.97]. For foods with FOPS, the corresponding HR was 0.80 (95% CI: 0.70, 0.93), with no evidence that this estimate differed significantly from that for UPF (P = 0.42). There was no evidence of departure from additivity between medication use and the consumption of foods of concern relative to CVD risk. CONCLUSIONS: In individuals with hypertension or hypercholesterolemia, lower consumption of UPFs or foods with FOPS was similarly associated with lower CVD risk, independent of concomitant medication use.
BACKGROUND: The influence of plasma DHA and overall omega-3 (n-3) long-chain PUFA (LC-PUFA) on child cognitive development is unclear. OBJECTIVES: We examined if plasma LC-PUFA concentrations are prospectively associated...BACKGROUND: The influence of plasma DHA and overall omega-3 (n-3) long-chain PUFA (LC-PUFA) on child cognitive development is unclear. OBJECTIVES: We examined if plasma LC-PUFA concentrations are prospectively associated with academic performance in primary school children and if diet patterns modulate the relationship. METHODS: Children were from the Growing Up in Singapore Toward healthy Outcomes cohort. Fasting LC-PUFA concentrations were measured using nuclear magnetic resonance spectroscopy at age 8 y (n = 557). Dietary patterns were derived using principal component analysis from a validated food frequency questionnaire at age 7 y. Academic performance was assessed using the Wechsler Individual Achievement Test-III at age 9 y (n = 288) and the primary school leaving examination (PSLE) at age 12 y (n = 408). The relationships of LC-PUFAs to academic performance scores were examined using multivariable linear regression models. RESULTS: Percent DHA at age 8 y was associated with higher reading fluency {β [95% confidence interval (CI)] = 3.54 (0.52, 6.56), P = 0.022} and spelling scores [4.49 (0.02, 8.95); P = 0.021] at age 9 y, and lower PSLE scores [β (95% CI) =-1.43 (-2.68, -0.618); P = 0.025] (indicating better performance) at age 12 y. However, these associations were attenuated after adjusting for an unhealthy dietary pattern. Total n-3 LC-PUFA at age 8 y was associated with higher reading fluency [β (95% CI) =1.55 (0.03, 3.07); P = 0.046] scores at age 9 y, and lower PSLE scores [β (95% CI) =-0.83 (-1.42, -0.24); P = 0.006] at age 12 y. The association with PSLE scores remained significant even after adjusting for healthy or unhealthy dietary patterns [β (95% CI) =-0.68 (-1.29, -0.08); P = 0.028]. CONCLUSIONS: Higher plasma total n-3 LC-PUFA and DHA were prospectively associated with better academic performance in primary school children, but the relationship with DHA was modulated by an unhealthy dietary pattern. The results suggest that beyond DHA, total n-3 LC-PUFA status plays a significant role in the cognitive development of children.
Am J Clin Nutr
· 2026 Apr · PMID 41643855
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BACKGROUND: The ingestion of protein-rich whole-foods may stimulate (post exercise) whole body (WB) and myofibrillar protein synthesis (MyoPS) rates to a greater extent than more isolated protein sources. OBJECTIVES: We...BACKGROUND: The ingestion of protein-rich whole-foods may stimulate (post exercise) whole body (WB) and myofibrillar protein synthesis (MyoPS) rates to a greater extent than more isolated protein sources. OBJECTIVES: We assessed WB protein turnover and MyoPS rates after a bout of resistance exercise and ingestion of a variety of protein-rich whole-foods (animal and nonanimal) and egg whites (more isolated protein source) in resistance-trained young adults. METHODS: In a randomized parallel group design, 65 healthy individuals received primed, continuous infusions of L-[ring-H]phenylalanine and L-[3,3-H]tyrosine and completed a bout of lower-body resistance exercise before ingesting 0.25 g protein per kg body mass (bm) from: egg whites (n = 11), egg (n = 11), salmon (n = 10), pork (n = 11) lentils (n = 11) or mycoprotein (n = 11). Blood and muscle samples were taken pre- and (120 and 300 min) post exercise/food ingestion to determine WB phenylalanine kinetics and MyoPS rates. Calculated WB phenylalanine kinetics and fractional synthesis rates were analyzed using 2-way (group × time) analysis of variance. RESULTS: WB protein synthesis and breakdown rates increased and decreased, respectively, post exercise/food ingestion in all groups; though a greater positive WB net protein balance was achieved (primarily via greater suppression of breakdown) after egg white ingestion, despite similar insulinemia across all groups [postprandial net balance (0-300 min); egg whites, 256.6 ± 15.4 compared with.; egg, 161.0 ± 6.1; pork, 166.8 ± 7.2; salmon, 195.4 ± 7.1; lentils, 175.8 ± 8.1; mycoprotein, 189.7 ± 8.4 μmol/kg/min (P < 0.0001, all)]. MyoPS rates increased after exercise/food ingestion with no (temporal) differences between groups despite divergent plasma amino acid responses [Δ change in fractional synthesis rates (0-300 min); egg whites, 0.050 ± 0.013; egg, 0.051 ± 0.009; pork, 0.008 ± 0.008; salmon, 0.021 ± 0.014; lentils, 0.029 ± 0.012; mycoprotein, 0.041 ± 0.012% per hour (P = 0.077)]. CONCLUSIONS: The ingestion of a variety of protein-rich whole-foods or a more isolated protein source (egg whites) after lower-body exercise results in comparable MyoPS rates, though a greater WB net protein anabolism was achieved with egg whites. The trial was registered at clinicaltrials.gov (NCT04794153). Date of Registration: 2021-03-04. https://clinicaltrials.gov/study/NCT04794153?term=NCT04794153&rank=1 Clinical Trial Register No. (clinicaltrials.gov): NCT04794153.
Xia J, Ge Z, Qian F
… +17 more, Li S, Guasch-Ferré M, Yao P, Franco OH, Zheng M, Lee DH, Geng T, Malik V, Wei Y, Misra A, Chen W, Koh WP, Salas-Salvadó J, Pan A, Manson JE, Willett WC, Liu G
Medical nutritional therapy, an evidence-based application of the nutrition care process guided by a registered dietitian nutritionist, is an integral part of diabetes management, with emerging evidence suggesting distin...Medical nutritional therapy, an evidence-based application of the nutrition care process guided by a registered dietitian nutritionist, is an integral part of diabetes management, with emerging evidence suggesting distinct nutritional requirements in this population. A thorough review of the existing literature reveals an imperative to address the specific requirements for vitamins and minerals in this population. Current guidelines have given limited attention to micronutrients, despite the higher prevalence of deficiencies and the altered patterns of association between serum micronutrient concentrations and multiple health outcomes among individuals with type 2 diabetes (T2D). To enhance diabetes management, an international multidisciplinary panel of 20 experts from 12 countries participated in a modified Delphi process, which was informed by a narrative review conducted by the research team, to reach consensus on 18 statements, encompassing 11 nutrient-specific recommendations and 7 statements outlining future directions in diabetes nutrition therapy research. The plan for this consensus has been registered on the Practice Guideline Registration for Transparency (registration number: PREPARE-2025CN1178). The expert panel proposed potential target serum concentrations, screening strategies, and micronutrient supplementation for people with T2D and that personalized nutritional strategies integrating individual characteristics, genetic information, and gut microbiota represent key areas for future research.
Yu L, Amaliyati S, Sun H
… +5 more, Dai J, Jiang Y, Li Z, Dong Z, Zhao L
Am J Clin Nutr
· 2026 Mar · PMID 41619973
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BACKGROUND: Anthocyanin supplementation is a promising nutritional intervention for prediabetes, whereas the efficacy varies due to the heterogeneity of diseases. Efficacy of the anthocyanin supplementation in impaired g...BACKGROUND: Anthocyanin supplementation is a promising nutritional intervention for prediabetes, whereas the efficacy varies due to the heterogeneity of diseases. Efficacy of the anthocyanin supplementation in impaired glucose tolerance (IGT) is evaluated and possible mechanisms are further explored. OBJECTIVES: This study aimed to investigate the effect of anthocyanin supplementation on pancreatic islet function in individuals with IGT. METHODS: A 12-wk randomized, double-blind, placebo-controlled (anthocyanin 160 mg/d or placebo) trial was conducted with routine lifestyle guidance involving 68 IGT participants. The primary outcome was β-cell function: disposition index (DI). Secondary outcomes included other oral glucose tolerance test (OGTT)-derived indices, insulin sensitivity, anthropometric measures, and levels of skin advanced glycation end products (AGEs) measured by skin autofluorescence. Analyses followed intention-to-treat principle. RESULTS: For the primary outcome, there were no significant between-group differences in DI, with the adjusted mean differences of 61.3 [95% confidence interval (CI): -27.4, 150.0; P = 0.174]. The IGT reversion rate (defined as 2-h OGTT glucose <7.8 mmol/L) was significantly higher in the anthocyanin group than in the placebo group (55.9% compared with 29.4%, P = 0.013). In parallel with a greater improvement in Matsuda index, with an adjusted difference of 4.6 (95% CI: 2.5, 6.7; P = 0.003). Additionally, skin AGEs decreased significantly only in the anthocyanin group. The reduction in skin AGEs was positively correlated with the decrease in postprandial glucose AUC (r = 0.302, P = 0.001) and negatively with improved Matsuda index (r = -0.344, P < 0.001). CONCLUSIONS: Anthocyanin supplementation could significantly reverse IGT by improving insulin sensitivity. The reduction of skin AGEs by anthocyanins might play a critical role in the dietary management of IGT. This trial was registered at chictr.org.cn as ChiCTR2400079566 (https://www.chictr.org.cn/showproj.aspx?proj=210725).
Am J Clin Nutr
· 2026 Apr · PMID 41617091
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BACKGROUND: There have been multiple attempts to identify biological factors that predict long-term weight change. Previous investigators have theorized that variations in how humans metabolize dietary macronutrients (st...BACKGROUND: There have been multiple attempts to identify biological factors that predict long-term weight change. Previous investigators have theorized that variations in how humans metabolize dietary macronutrients (storage as opposed to oxidation) might be one of these characteristics, but to date, there has been no effort to address this hypothesis. OBJECTIVES: We used a retrospective cohort study design to test the hypothesis that greater meal fat storage in subcutaneous adipose tissue would be associated with greater future weight gain. METHODS: Body composition, demographic, and meal fatty acid metabolism data were collated from 154 nonobese research volunteers who participated in studies conducted at Mayo Clinic between 1997 and 2012 that used either C- or H-triolein. At the time of the original studies, the participants were healthy, weight stable, free of acute illnesses, and not taking any drugs that could affect the study outcomes. Using an electronic medical record search strategy, we identified satisfactory poststudy weight data for 107 volunteers (54 males), over a mean follow-up of 18 y. Regression analysis was used to test for relationships between adipose tissue meal fatty acid storage (and oxidation) and annualized weight change. RESULTS: The long-term (19 ± 7) y weight change for females was correlated with meal fat storage (P = 0.003, r = 0.38) and meal fat oxidation measured using C-triolein (43 females, P = 0.03, r = -0.33). There was no significant relationship between meal fatty acid storage or oxidation and weight change for males. CONCLUSIONS: The finding that weight change is correlated with dietary fatty acid metabolism for adult, nonobese females suggests that interindividual variations in how females process dietary fat can influence long-term energy balance. CLINICAL TRIAL REGISTRATION: NCT00254371; the other protocols were not considered clinical trials at the time they were conducted. https://clinicaltrials.gov/study/NCT00254371?term=testosterone&cond=%22Sarcopenia%22&viewType=Table&rank=9.
Du S, Yang J, Sullivan VK
… +4 more, He JH, Fang M, Appel LJ, Rebholz CM
Am J Clin Nutr
· 2026 Apr · PMID 41617090
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BACKGROUND: Food processing has become an important focus in nutrition science due to its link to adverse health outcomes. Evaluating different classification systems provides valuable insights into how food processing i...BACKGROUND: Food processing has become an important focus in nutrition science due to its link to adverse health outcomes. Evaluating different classification systems provides valuable insights into how food processing is defined and its implications for nutrition research, cardiometabolic health, and food policy. OBJECTIVES: We aim to compare the NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC), and University of North Carolina classification systems by evaluating their characteristics, reliability, and associations with nutrient intake and cardiometabolic risk factors. METHODS: Using data from 4392 adult participants in the 2017 to 2018 NHANES cycle, we categorized 4605 food and beverage items according to 4 classification systems and harmonized processing levels into 3 categories: minimally processed, processed, and highly processed/formulated foods. Sociodemographic characteristics, nutrient profiles, and associations with cardiometabolic risk factors were analyzed using linear regression models that accounted for survey weights. RESULTS: The mean age of the population was 47 y, 52% were female, and 63% were white. Inter-rater agreement between 2 coders ranged from 68% to 86%. IARC classified the largest proportion of food and beverage items as highly processed/formulated, whereas IFIC classified the lowest. Across all systems, the top contributors to highly processed/formulated food intake were grain products; meat, poultry, fish, and mixtures; and sugars, sweets, and beverages. Greater intake of highly processed/formulated foods was consistently associated with younger age, White and Black race, lower education, and lower intake of protein, fiber, and several micronutrients. All systems linked greater highly processed/formulated food consumption to higher body mass index and elevated levels of log-transformed high-sensitivity C-reactive protein. CONCLUSIONS: Despite differences in classification criteria across systems, associations with nutrients, sociodemographic, and cardiometabolic parameters were consistent. A standardized classification system is needed to ensure a unified understanding of ultraprocessed food and its health implications.
BACKGROUND: Although previous studies have shown that heavy metal exposure and antioxidant micronutrient insufficiency are associated with cognitive impairment, their combined influence on cognitive function remains uncl...BACKGROUND: Although previous studies have shown that heavy metal exposure and antioxidant micronutrient insufficiency are associated with cognitive impairment, their combined influence on cognitive function remains unclear. OBJECTIVES: This study investigated the associations between blood concentrations of lead, cadmium, selenium, erythrocyte folate, and serum 25-hydroxyvitamin D [25(OH)D] and cognitive performance and the interactions between heavy metals and micronutrients in a United States cross-sectional study. METHODS: Data from 2858 participants aged ≥60 y in the National Health and Nutrition Examination Survey 2011-2014 were analyzed. Multivariable linear and logistic regression models were constructed to evaluate the main effects of heavy metals and micronutrients and their additive and multiplicative interactions on cognitive function. RESULTS: After adjustment for confounders, blood lead (β: -1.67; 95% CI: -3.32, -0.03) and cadmium (β: -2.02; 95% CI: -3.19, -0.85) were inversely associated and serum 25(OH)D (β: 2.23; 95% CI: 0.88, 3.59) was positively associated with the Digit Symbol Substitution Test (DSST) score (a higher score indicating better cognitive function). Significant additive and multiplicative interactions between blood lead and erythrocyte folate, between blood lead and serum 25(OH)D, and between blood cadmium and erythrocyte folate and low DSST score were detected. Compared with individuals in the first quartile of a weighted composite score of risk factors (defined as greater than or equal to the median for 2 metals or less than the median for 3 micronutrients), those in the quartiles 2 through 4 demonstrated a progressively higher risk of low cognitive function assessed by the DSST score (OR: 1.58; 95% CI: 0.95, 2.61; OR: 2.00; 95% CI: 1.18, 3.39; and OR: 2.45; 95% CI: 1.44, 4.17, respectively; P-trend: 0.00083). CONCLUSIONS: This study revealed that the neurodegenerative influence of heavy metals is more pronounced in individuals with lower micronutrient status. If the results of the present study are confirmed by future studies, reducing heavy metal exposure and improving micronutrient status may offer a novel and practical strategy for preventing cognitive decline and dementia.