Dietary choline and betaine, suggested as neuroprotective nutrients, have not been sufficiently studied in relation to psychological disorders. This study aimed to investigate the association between dietary choline and betaine and common psychological disorders (depression, anxiety and psychological distress) among Iranian adults. Using a multistage cluster random sampling method, 533 middle-aged adults were included in this cross-sectional study. Dietary intakes were assessed using a validated semi-quantitative 168-item FFQ. Depression, anxiety and psychological distress were evaluated using the Hospital Anxiety and Depression Scale and the General Health Questionnaire, both validated for the Iranian population. Binary logistic regression was applied to explore the associations. Mean age of participants was 42·6 (sd 11·14) years; of whom 18·9, 5·1 and 33·4 % had depression, anxiety and psychological distress, respectively. In the crude model, the highest intake of choline was negatively associated with depression (OR = 0·52; 95 % CI: 0·30, 0·91), anxiety (OR = 0·38; 95 % CI: 0·14, 0·99) and distress (OR = 0·60; 95 % CI: 0·38, 0·94) compared with the lowest intake. After considering all confounders, such associations remained significant in the case of depression (OR = 0·51; 95 % CI: 0·26, 0·98) but not for anxiety and distress. Additionally, there was no significant association between betaine intake and odds of depression, anxiety or distress in both crude and adjusted models. This study suggests a protective association between choline intake and depression, while no significant relation was found in the case of anxiety and distress. Betaine intake was not related to psychological disorders. Further prospective studies are crucial to replicate these findings.

High intake of dietary advanced glycation end products (AGE) could induce oxidative stress, inflammation and the gut microbiota dysbiosis processes that play a major role in the development of functional gastrointestinal disorders (FGID). There is limited data on the association between AGE intake and FGID. Therefore, this study aimed to examine the association of AGE with FGID in Iranian adults. In a cross-sectional analysis under the framework of the Isfahan functional disorders study, data on 1892 Iranian healthy adults aged 18–65 years were examined. Participants’ dietary intakes were collected using a validated dish-based, 106-item FFQ. Dietary AGE content of seventy-two food items was measured for all participants. FGID were assessed using Rome IV criteria. In total, 38 % of subjects had one of the most prevalent upper or lower FGID. The mean of AGE intake was 14690·10 (sd 8797·25) (kU/gr). In the fully adjusted model, being in the highest v. lowest tertile of AGE intake was associated with increased odds of FGID (OR = 1·78; 95 % CI: 1·01, 3·36). In stratified analysis by sex, males in the highest tertile of AGE intake showed higher odds of FGID than those in the lowest tertile (OR = 2·15; 95 % CI: 1·04, 4·45). However, in females, the AGE intake was not significantly associated with the risk of FGID in the fully adjusted model. Higher AGE intake was significantly associated with an increased risk of FGID, particularly in men. Further prospective studies are warranted to confirm these findings.

This study aimed to explore the combined association between the dietary antioxidant quality score (DAQS) and leisure-time physical activity on sleep patterns in cancer survivors. Data of cancer survivors were extracted from the National Health and Nutrition Examination Surveys database in 2007–2014 in this cross-sectional study. Weighted multivariable logistic regression models were used to estimate OR and 95 % CI for the association of DAQS and leisure-time physical activity on sleep patterns. The combined association was also assessed in subgroups of participants based on age and use of painkillers and antidepressants. Among the eligible participants, 1133 had unhealthy sleep patterns. After adjusting for covariates, compared with low DAQS level combined with leisure-time physical activity level < 600 MET·min/week, high DAQS level combined with leisure-time physical activity ≥ 600 MET·min/week was associated with lower odds of unhealthy sleep patterns (OR = 0·41, 95 % CI: 0·23, 0·72). Additionally, the association of high DAQS level combined with high leisure-time physical activity with low odds of unhealthy sleep patterns was also significant in < 65 years old (OR = 0·30, 95 % CI: 0·13, 0·70), non-painkiller (OR = 0·39, 95 % CI: 0·22, 0·71), non-antidepressant (OR = 0·49, 95 % CI: 0·26, 0·91) and antidepressant (OR = 0·11, 95 % CI: 0·02, 0·50) subgroups. DAQS and leisure-time physical activity had a combined association on sleep patterns in cancer survivors. However, the causal associations of dietary nutrient intake and physical activity with sleep patterns in cancer survivors need further clarification.

Inflammation and oxidative stress contribute to the progression of chronic diseases, and the volume of research in this area is rapidly expanding. Various dietary indices have been developed to determine the overall inflammatory or oxidative stress potential of a diet; however, few have been validated in cardiometabolic disease populations. This review aimed to explore the association between dietary indices and biomarkers of inflammation and oxidative stress in adults with cardiometabolic conditions. Four databases were systematically searched for literature in any language (Embase, CINAHL, CENTRAL and MEDLINE) with 12,286 deduplicated records identified. Seventeen studies of adults with metabolic syndrome, cardiovascular disease, type 2 diabetes, non-alcoholic fatty liver disease or chronic kidney disease were included. Fourteen studies were observational studies, one study was a clinical trial, and one was a randomised controlled trial. Four dietary indices were reported on with most studies (n 11) reporting on the dietary inflammatory index. The most reported biomarker was C-reactive protein. The findings were narratively synthesised. Results were inconclusive due to the heterogeneity of dietary indices and their use, disease states and biomarkers reported. Only one study reporting on the dietary inflammatory index assessed all 45 parameters. Observational studies, particularly retrospective designs (n 7), are subject to recall and selection biases, potentially presenting overestimated results. Further research is required to determine the relationship between dietary indices and biomarkers of inflammation and oxidative stress in cardiometabolic disease populations. Future research should be prospective, utilise rigorous research methods, assess the full range of index parameters, and examine biomarkers the tool was developed for.

Ultra-processed foods (UPF), defined using the Nova classification system, are associated with increased chronic disease risk. More recently, evidence suggests the UPF subgroup of whole-grain breads and cereals is in fact linked with reduced chronic disease risk. This study aimed to explore associations of cardiometabolic risk measures with Nova UPF intake v. when foods with ≥ 25 or ≥ 50 % whole grains are excluded from the definition. We considered dietary data from the Australian National Nutrition and Physical Activity Survey 2011–2012. Impacts on associations of UPF intake (quintiles) and cardiometabolic risk measures were analysed using regression models. The median proportion of UPF intake from high whole-grain foods was zero for all quintiles. Participants in the highest Nova UPF intake quintile had significantly higher weight (78·1 kg (0·6)), BMI (27·2 kg/m2 (0·2)), waist circumference (92·7 cm (0·5)) and weight-to-height ratio (0·55 (0·003)) compared with the lowest quintile (P< 0·05). Associations were the same when foods with ≥ 25 and ≥ 50 % whole grains were excluded. Adjusted R-squared values remained similar across all approaches for all outcomes. In Australia, high whole-grain foods considered UPF may not significantly contribute to deleterious cardiometabolic risk associations. Until conclusive evidence on Nova UPF is available, prioritisation should be given to the nutrient density of high whole-grain foods and their potential contribution to improving whole-grain intakes and healthful dietary patterns in Australia.

There has been concern regarding the consumption of fruit juices because of the high levels of naturally occurring sugars they contain, which could rapidly elevate glycaemic response and increase the risk of cardiometabolic diseases. We conducted two trials in which each volunteer ingested (1) white bread with 200 ml of two types of orange juice (OJ) prepared from ‘Moro’ and ‘Pera’ varieties (MOJ and POJ) – the former containing anthocyanins – and the same juices alone; and (2) 200 ml of POJ or MOJ followed by a sandwich made with white bread, plus light cheese or butter, and also the same juices alone. Capillary blood was collected over 120 min, and glucose and insulin levels were analysed. In the cross-over clinical design with healthy volunteers, we observed that both OJ does not increase blood glucose and insulin, even when co-consumed with other typical breakfast foods in Brazil. In conclusion, OJ does not elevate postprandial glycaemic responses to the meal while providing additional sugars and nutrients.

Flavonoids are a key class of polyphenols, i.e., phytochemical compounds present in foods and beverages, which have been described as having health benefits in preventing several chronic diseases. Estimating flavonoid intake has already been conducted in several countries but has yet to be performed in Portugal. This study included 5005 participants aged 3–84 years and aimed to estimate dietary flavonoid intake in the Portuguese population, using data from the National Food and Physical Activity Survey 2015–2016, providing information on intake, main food contributors and the socio-demographic factors associated with the intake. Food intake data from the survey was converted to flavonoid intake using a database built to include the most updated USDA databases on flavonoids, isoflavones and proanthocyanidins and the Phenol-Explorer database. The rationale for combining food consumption data and different flavonoid databases using the FoodEx2 classification system was established. Linear regressions assessed the associations between socio-demographic factors and dietary flavonoid intake. The total flavonoid intake of the Portuguese population was estimated to be 107·3 mg/d. Flavanols were the most representative subclass, followed by flavonols, anthocyanidins, flavanones, flavones and isoflavones. Fruits and vegetables were the primary food contributors, providing 31·5 % and 12·4 % of the total flavonoid intake. Adolescents had the lowest total flavonoid intake, and older adults had the highest. This study provides information on the Portuguese population’s dietary flavonoids, allowing for international comparisons. It can also streamline forthcoming investigations into the link between flavonoid consumption and its impact on health, contributing to the future establishment of dietary reference values.

Understanding the determinants of malnutrition is pivotal for public health interventions. This study aimed to identify socio-economic, demographic, dietary and maternal determinants of wasting and overweight among Brazilian children between 6 and 59 months. Data from the Brazilian National Survey on Child Nutrition were analysed (n 11 789). Children’s weight-for-height Z-scores were calculated according to the WHO growth standard and classified as wasting (Z < −2), normal weight (–2 ≤ Z ≤ 1), overweight risk (1 < Z ≤ 2) and overweight (Z > 2). Socio-economic, demographic, dietary and maternal covariables were considered. Adjusted multinomial logistic regression (OR and 95 % CI) was employed. The prevalence of overweight and wasting was 9·5 and 2·6 %, respectively. In the adjusted model, younger age (6–23 months: OR: 1·7; 95 % CI: 1·3, 2·2), consumption of ≥ 5 ultra-processed food groups (OR: 1·8; 95 % CI: 1·1, 3·1), maternal underweight (OR: 0·4; 95 % CI: 0·2, 0·9), overweight (OR: 1·5; 95 % CI: 1·2, 1·9) and mild food insecurity (OR: 0·8; 95 % CI: 0·6, 1·0) were associated with child overweight. The Brazilian Northeast (OR: 4·9; 95 % CI: 2·1, 11·3), Southeast (OR: 7·1; 95 % CI: 3·0, 16·6), South (OR: 4·7; 95 % CI: 1·8, 12·1), Midwest regions (OR: 2·7; 95 % CI: 1·2, 6·2) and maternal underweight (OR: 5·4; 95 % CI: 2·7, 10·7) were associated with wasting. Overweight in Brazil is prevalent among children between 6 and 59 months, while wasting is not a major public health problem. The main determinants of these Brazilian children’s nutritional status were age, ultra-processed food consumption and maternal nutritional status.

The purpose of this study was to measure meal quality in representative samples of schoolchildren in three cities located in different Brazilian regions using the Meal and Snack Assessment Quality (MESA) scale and examine association with weight status, socio-demographic characteristics and behavioural variables. This cross-sectional study analysed data on 5612 schoolchildren aged 7–12 years who resided in cities in Southern, Southeastern and Northeastern Brazil. Dietary intake was evaluated using the WebCAAFE questionnaire. Body weight and height were measured to calculate the BMI. Weight status was classified based on age- and sex-specific Z-scores. Meal quality was measured using the MESA scale. Associations of meal quality with weight status and socio-demographic and behavioural variables were investigated using multinomial regression analysis. Schoolchildren in Feira de Santana, São Paulo and Florianópolis had a predominance of healthy (41·8 %), mixed (44·4 %) and unhealthy (42·7 %) meal quality, respectively. There was no association with weight status. Schoolchildren living in Feira de Santana, those who reported weekday dietary intakes, and those with lower physical activity and screen activity scores showed higher meal quality. Schoolchildren aged 10–12 years, those who reported dietary intakes relative to weekend days, and those with higher screen activity scores exhibited lower meal quality.

Epidemiologic evidence on the association between dietary choline, betaine and mortality risk remains limited, particularly among non-Western populations. We examined the association of dietary choline and betaine with all-cause mortality in Chinese adults using data from the China Health and Nutrition Survey 1991–2015. We included 9027 men and 8828 women without CVD and cancer at baseline. Dietary intake was assessed using 3-day 24-hour dietary recalls and household food inventories. Death was ascertained through household surveys in each wave. Time-dependent Cox proportional hazards regression models estimated multivariable-adjusted hazard ratios (HRs) and 95 % CIs. During a median follow-up of 9·1 years, 891 men and 687 women were deceased. Higher total choline intake was associated with lower all-cause mortality in both men (HRQ5 v. Q1 = 0·58 (95 % CI: 0·45, 0·74)) and women (HRQ5 v. Q1 = 0·59 (95 % CI: 0·44, 0·78)). The dose–response curve were reverse J-shaped in men and L-shaped in women (both P-nonlinear ≤ 0·005). Similarly, fat-soluble choline intake was inversely associated with mortality in both men (HRQ5 v. Q1 = 0·59 (95 % CI: 0·46, 0·75)) and women (HRQ5 v. Q1 = 0·53 (95 % CI: 0·40, 0·70)), showing reverse J-shaped patterns (both P-nonlinear < 0·001). A J-shaped association between water-soluble choline and mortality was observed in women (P-nonlinear < 0·001), but a null association was found in men. Betaine intake was not associated with all-cause mortality in either sex. Our findings suggest that adequate choline intake is linked to reduced all-cause mortality in Chinese adults with predominantly plant-based diets.

Se is particularly necessary in infants because of their rapid physical growth period in addition to being indispensable for neurodevelopment. Severe deficiency can lead to cardiomyopathy, hypothyroidism and faltering growth. However, Se can be toxic at high doses. In the paediatric age group, plasma/serum and erythrocyte Se levels seem to increase with age, except in the first year of life. Understanding the variability in Se status during this period can help to identify infants at risk of deficiency and develop strategies for controlling and preventing its consequences. This review aimed to identify the extent and characteristics of the variability of Se status during the first year of life. A search was conducted across five databases to find articles published until 30 July 2024, with no limitations on the language or date of publication. Articles were screened, data were extracted independently by two reviewers, and any disagreement was resolved by a third reviewer. A total of 22 studies comprising 1288 participants were included in this review, 21 of which assessed plasma/serum Se and 12 assessed erythrocyte Se. In the first 4 months of age, serum/plasma Se decreased, remained stable or increased depending on feeding, with an increase in supplemented formula-fed infants and breastfed infants of supplemented mothers. Erythrocyte Se levels showed a declining trend, except in infants fed supplemented formula or breastfed by supplemented mothers. Variability of serum/plasma and erythrocyte Se levels in the first year was associated with maternal Se intake/supplementation and the Se content of the infant’s diet.

The effect of diminished ovarian reserves after undergoing hysterectomies with bilateral salpingectomies is one of the health concerns among reproductive-age women with benign gynecological diseases. Coenzyme Q10 (CoQ10), an antioxidant, is crucial in mitochondrial energy production, improving oocyte quality and quantity. This study compares the benefit of a 14-d preoperative (CoQ10) v. placebo on ovarian reserve by measuring anti-Müllerian hormone (AMH) in women undergoing hysterectomy with bilateral salpingectomy. A double-blinded, randomised, placebo-controlled trial was conducted. Forty-four women with benign gynecological diseases were randomised to receive either oral CoQ10 300 mg per d or placebo for 14 d before undergoing hysterectomy with bilateral salpingectomy. Serum AMH levels were collected for analysis before taking CoQ10 and 6 weeks postoperatively in each group. The baseline demographic, clinical characteristics and baseline AMH levels were comparable between the groups (1·47 (0·45, 2·49) v. 1·29 (0·47, 2·11), P = 0·763). The serum AMH levels after the surgery were significantly decreased from preoperative levels (median 0·99 (0·37, 1·63) v. 1·34 (0·57, 2·30)), P = 0·001. However, there was no significant difference in the AMH change between the CoQ10 group and the placebo group (AMH per cent change −28·2 % (64·09, −4·81) v. −20·07 % (–61·51, −2·92)), P = 0·99, respectively. Age, gynecological disease, operative time and blood loss were not significantly associated with the AMH change. There were no significant side effects or adverse operative outcomes among CoQ10 users. In conclusion, hysterectomy with bilateral salpingectomy led to a significantly decreased AMH level. However, pretreatment with CoQ10 for 2 weeks was ineffective in protecting an ovarian reserve.

Irritable bowel syndrome (IBS) is a common gut–brain interaction disorder. The aetiology of IBS is not entirely elucidated; however, among the risk factors, dietary factors are regarded as crucial. Previous studies have primarily investigated the association of single nutrients and food groups with the odds of IBS, rather than diet quality, which considers the interaction of food groups in the odds of disease. Thus, this study sought to investigate the association between dietary quality index international (DQI-I) and the odds of IBS in Iranian adults. In this case–control study, dietary intakes of 100 IBS cases and 310 healthy controls were examined using a validated dish-based semi-quantitative FFQ (DB-FFQ). DQI-I score was then calculated based and categorised into tertiles. The Persian version of the Rome IV questionnaire was utilised to assess IBS. Multivariable logistic regression was used to assess the association between DQI-I score and the odds of IBS. After controlling for potential confounders, no significant association was shown between DQI-I scores and IBS odds among whole and gender-stratified groups. Although DQI-I represents a healthy diet, the results of the current case–control study demonstrated that a higher DQI-I score was not associated with reduced odds of IBS in fully adjusted regression models. Considering inherent limitations as well as the scarce evidence regarding the association between DQI-I and odds of IBS, further large-scale, prospective studies are required to confirm our findings.

Prior observational studies have reported the potential protective effect of n-3 fatty acids on the prognosis of acute pancreatitis (AP). However, the causal impact of n-3 fatty acids on AP is unclear. We aimed to investigate further the association of n-3 fatty acids with AP. We performed a meta-analysis and Mendelian randomisation (MR) to explore the association between n-3 fatty acids and the prognosis of AP from clinical observation and genetics perspectives, respectively. Nine randomised controlled trials were included in this study. The result meta-analysis showed that complementary therapy of n-3 fatty acids significantly decreased mortality (Relative Risk (RR): 0·30; 95 % CI 0·14, 0·65, P < 0·05) and infectious complications in AP (RR: 0·45; 95 % CI 0·27, 0·77, P < 0·05). Compared with the control groups, the hospital stays (MD: −1·02; 95 % CI −1·85, −0·20, P < 0·05) in AP patients with n-3 fatty acids treatment were statistically reduced. However, the ICU stay (MD: −0·49; 95 % CI −1·29, −0·31, P > 0·05) between control groups and AP patients with n-3 fatty acids treatment was insignificant. Utilising genetic susceptibility analysis in the MR approach, the MR showed n-3 fatty acids have a significant causal effect on the AP risk (OR, 0·887; 95 % CI 0·797, 0·986, P = 0·027, fixed-effect; OR, 0·887; 95 % CI 0·792, 0·993, P = 0·037, random-effect). n-3 fatty acids complementary therapy may improve the prognosis of AP. Furthermore, genetically predicted serum levels of n-3 fatty acids can significantly lower AP risk.

This study aimed to investigate the intake of dairy products during pregnancy in women with gestational diabetes mellitus (GDM) and its impacts on neonatal birth weight and pregnancy outcomes. A total of 386 women with GDM during the second trimester pregnancy participated in this prospective cohort study. We evaluated dairy products intake through the FFQ. Pregnancy outcomes were obtained from the delivery data. Participants were divided into insufficient and sufficient intake of milk and dairy products groups (< 300 g/d and ≥ 300 g/d, respectively). The average intake of dairy products during the second trimester pregnancy in women with GDM was 317·8 ± 179·5 g/d, and the total energy intake was 1635·4 ± 708·7 kcal/d. However, 76·68 % of them did not meet the recommended total energy intake of women with GDM. After adjusting for confounding factors, women with GDM who consumed ≥ 300 g/d of dairy products had an average reduction in birth weight of 93·1 g compared with women who consumed < 300 g/d of dairy products (95 % CI −171·343, −14·927). Women with GDM in sufficient intake group was also associated with lower risk of macrosomia (95 % CI 0·043, 0·695) and caesarean section (95 % CI 0·387, 0·933) and not related to low birth weight infant (95 % CI 0·617, 14·502) and preterm birth (95 % CI 0·186, 1·510) when compared with participants in insufficient intake group. Under the premise of insufficient total energy intake, the intake of dairy products during the second trimester pregnancy in women with GDM might be related to the decrease of neonatal birth weight.

Despite previous observational studies suggesting that malnutrition could be involved in venous thromboembolism (VTE), definitive causality still lacks high-quality research evidence. This study aims to explore the genetic causal association between malnutrition and VTE. The study was performed using summary statistics from genome-wide association studies for VTE (cases = 23 367; controls = 430 366). SNP associated with exposure was selected based on quality control steps. The primary analysis employed the inverse variance weighted (IVW) method, with additional support from Mendelian randomisation (MR)-Egger, weighted median and weighted mode approaches. MR-Egger, leave-one-SNP-out analysis and MR pleiotropy residual sum and outlier (MR-PRESSO) were used for sensitivity analysis. Cochran’s Q test was used to assess heterogeneity between instrumental variables (IV). IVW suggested that overweight has a positive genetic causal effect on VTE (OR = 1·1344, 95 % CI = 1·056, 1·2186, P < 0·001). No genetic causal effect of malnutrition (IVW: OR = 0·9983, 95 % CI = 0·9593, 1·0388, P = 0·9333) was found on VTE. Cochran’s Q test suggests no possible heterogeneity in both related exposures. The results of the MR-Egger regression suggest that the analysis is not affected by horizontal pleiotropy. The results of the MR-PRESSO suggest that there are no outliers. The results revealed a statistical genetic association where overweight correlates with an increased risk of VTE. Meanwhile, no genetic causal link was observed between malnutrition and VTE. Further research is warranted to deepen our understanding of these associations.