Journal of Health, Population, and Nutrition最新文献

{"title":"Nutritional knowledge, sustainable food practices and food safety, in child and youth care facilities in KwaZulu-Natal, South Africa.","authors":"Mumsy Evidence Chibe, Carin Napier, Heleen Grobbelaar","doi":"10.1186/s41043-026-01343-5","DOIUrl":"10.1186/s41043-026-01343-5","url":null,"abstract":"<p><strong>Background: </strong>Child and Youth Care Centres (CYCCs) play an important role in providing nutritional support to disadvantaged children and youth. However, little is known about how food handlers apply national nutrition and food hygiene standards in resource-constrained CYCC settings in South Africa.</p><p><strong>Aim: </strong>The aim of the study was to examine food, nutrition, and hygiene practices among food handlers at CYCCs in KwaZulu-Natal Province of South Africa.</p><p><strong>Methodology: </strong>A qualitative exploratory research design was used in the study. Three online focus group discussions (FGDs) were conducted in August and September 2020, with 18 food handlers from two CYCCs participating. COVID-19 Alert Level 5 restrictions necessitated online FGDs. The discussions were audio-recorded, transcribed verbatim, and analysed thematically. Co-researchers' independent coding, peer debriefing, member checking, and safeguarding of an audit trail all assisted to assure trustworthiness.</p><p><strong>Results: </strong>The study revealed different levels of awareness about nutrition guidelines and food-based dietary guidelines, with a significant gap between knowledge and practical application. While participants exhibited a high level of awareness of food safety, hygiene, and storage practices, implementation was hindered by limited financial resources, inadequate nutrition instruction, a lack of standardised recipes, and insufficient access to hygiene supplies and personal protective equipment. Budget constraints significantly affected meal planning and dietary diversification.</p><p><strong>Conclusion: </strong>While food handlers in CYCCs have a basic understanding of food safety and cleanliness, they face systematic and structural impediments to effectively apply nutrition requirements. Strengthening practical nutrition training, improving resource allocation, and increasing institutional and policy support are critical for improving food, nutrition, and hygiene practices and promoting improved health outcomes for children in CYCCs.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between dietary carbohydrate to protein ratio and risk of cardiovascular disease, type 2 diabetes, and metabolic syndrome in Iranian adults: a cohort study.","authors":"Zahra Gaeini, Sahar Mirzaei, Parvin Mirmiran, Fereidoun Azizi","doi":"10.1186/s41043-026-01351-5","DOIUrl":"10.1186/s41043-026-01351-5","url":null,"abstract":"<p><strong>Background: </strong>The dietary balance of macronutrients may play a critical role in the development of cardio-metabolic diseases. The carbohydrate-to-protein (CHO/Pr) ratio provides an index of this balance; however, its association with long-term health outcomes in Middle Eastern populations remains unclear. We investigated the relationship between dietary CHO/Pr ratio and the incidence of cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS) among adults from the Tehran Lipid and Glucose Study (TLGS).</p><p><strong>Methods: </strong>A total of 2648 adults free of CVD, 2256 adults free of T2DM, and 1713 adults free of MetS at baseline (2006-2008) were included. Dietary intakes were assessed using a validated 168-item food frequency questionnaire. The CHO/Pr ratio was calculated and categorized into tertiles. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cardio-metabolic outcomes were estimated using Cox proportional hazards regression, adjusted for demographic, lifestyle, and dietary covariates.</p><p><strong>Results: </strong>Over median follow-up periods of 10.6, 8.5, and 7.6 years for CVD, T2DM, and MetS, respectively, 171 CVD, 241 T2DM, and 596 MetS cases occurred. Compared with the lowest tertile, participants in the second tertile of CHO/Pr ratio had a higher risk of CVD (HR = 1.48; 95% CI: 1.01-2.17), whereas no significant association was observed in the highest tertile. No significant associations were found between CHO/Pr ratio and incidence of T2DM or MetS.</p><p><strong>Conclusions: </strong>A moderate CHO/Pr ratio was associated with an increased risk of CVD, but not with T2DM or MetS. These findings highlight the potential importance of macronutrient balance in cardiovascular prevention.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between urinary arsenic and vitamin D deficiency: a cross-sectional analysis of NHANES 2011-2018.","authors":"Meiling Zhou, Yiyun Liu, Wenqi Liu, Yunwei Zhang","doi":"10.1186/s41043-025-01235-0","DOIUrl":"10.1186/s41043-025-01235-0","url":null,"abstract":"<p><p>Arsenic exposure and vitamin D deficiency independently contribute to adverse neurological and systemic outcomes, yet their interplay in the general population has not been thoroughly characterized. We investigated the association between urinary arsenic (total arsenic and dimethylarsinate [DMA]) and vitamin D deficiency and explored how this relationship varies by demographic, behavioral, laboratory, dietary, and neurological comorbidity factors. Using data from 6,148 U.S. adults aged ≥ 18 years in NHANES 2011-2018, we estimated odds ratios (ORs) for deficiency per interquartile‑range increase in each arsenic measure using survey-weighted logistic regression. After full adjustment for demographics, lifestyle, dietary, and clinical factors, the ORs for total urinary arsenic and DMA were 1.30 (95% CI 1.16, 1.45) and 1.50 (95% CI 1.27, 1.78), respectively. Associations were strongest among women; adults aged < 60 years; Non‑Hispanic, highly educated, underweight individuals; as well as current smokers and drinkers. In contrast, participants with stroke or sleep disorders exhibited inverse associations, likely due to routine clinical vitamin D supplementation. These findings demonstrate a robust, dose‑dependent association between arsenic exposure and vitamin D deficiency in U.S. adults. They suggest the importance of integrated public health strategies-combining arsenic mitigation with targeted vitamin D strategies-and highlight the need for longitudinal and interventional studies to establish causality and to determine whether optimizing vitamin D status might potentially modify the adverse health effects of arsenic.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher vegetable intake is associated with lower diabetes risk: cross-sectional evidence from the STEPS 2016 survey in Iran.","authors":"Mehran Nouri, Zainab Shateri, Shiva Faghih","doi":"10.1186/s41043-026-01327-5","DOIUrl":"10.1186/s41043-026-01327-5","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the association between dairy products, fruit, and vegetable (FV) intake and the risk of diabetes and pre-diabetes is inconsistent across populations, particularly in Middle Eastern countries. Therefore, this study examined the association between dairy products and FV intake with pre-diabetes and diabetes risk in Iranian adults.</p><p><strong>Methods: </strong>This nationwide Stepwise Approach to Surveillance (STEPS) survey conducted from April to November 2016 in 30 provinces of Iran with 30,541 participants over 18 years of age living in rural or urban Iran were selected for further investigation. Fasting blood sugar (FBS) was assessed by an autoanalyzer. Dietary intake was assessed using the world health organization (WHO) STEPwise questionnaire. Food intakes were categorized as follows: fruit and dairy product consumption: less than 1, 1, 2, and more than 2 servings; and vegetable intake: more than 3, 3, 2, and less than 2 servings/day. Multinomial logistic regression was used to evaluate associations between FV and dairy products intake with FBS levels, adjusting for body mass index, age, gender, physical activity, education, marital status, area of residency, smoking history, occupation, and wealth index.</p><p><strong>Results: </strong>In the adjusted model, the inverse relationship between vegetable intake and diabetes remained significant. Specifically: two servings/day (odds ratio (OR) = 0.46; 95% confidence interval (CI): 0.31-0.66), three servings/day (OR = 0.52; 95% CI: 0.36-0.76), more than three servings/day (OR = 0.55; 95% CI: 0.36-0.85) were each associated with significantly reduced odds of diabetes. No significant associations were observed between diabetes risk and fruit or dairy intake in the adjusted model.</p><p><strong>Conclusions: </strong>Higher vegetable consumption was inversely associated with diabetes risk in this cross-sectional study, whereas no significant associations were observed for fruit or dairy intake. These findings suggest a potential protective role of vegetable intake; however, causal inferences cannot be made, and longitudinal studies are required to confirm these associations.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics and vaccination history analysis of pertussis in Quzhou from 2005 to 2024.","authors":"Fei Zhao, Wenjie Xu, Bo Chen, Canya Fu, Canjie Zheng, Xiaojuan Lin, Zhiying Yin","doi":"10.1186/s41043-026-01340-8","DOIUrl":"10.1186/s41043-026-01340-8","url":null,"abstract":"<p><strong>Background: </strong>Despite high vaccination coverage, pertussis is reemerging in China and increasingly affecting older children. This shift challenges current immunization strategies. To inform better prevention, we aimed to investigate pertussis epidemiology in Quzhou, with a focus on analyzing factors linked to the time between vaccination and illness onset among diagnosed cases.</p><p><strong>Methods: </strong>We analyzed pertussis cases from the China Information System for Disease Control and Prevention (CISDCP) in Quzhou City (2005-2024) and linked them to vaccination records from the Zhejiang Immunization Program Smart Service Information System. The outcome variable was the time from the last vaccine dose to pertussis diagnosis.</p><p><strong>Results: </strong>During 2005-2024, Quzhou reported 2,045 pertussis cases, with 93.25% concentrated in 2024. Case distribution shifted from 0 to 4 to ≥ 5 years (P < 0.001). Age‑specific incidence rose markedly in all groups in 2024 (all P < 0.001), with the highest rate observed among 5-9‑year‑olds (878.99/100,000). Among cases with known vaccination history, 83.86% had received at least one dose. Multivariable Cox regression showed that vaccination status and vaccine type were significantly associated with pertussis risk. Pertussis risk was 45% lower after the fourth dose than before it (P = 0.017). For vaccine type comparisons versus DTaP, the hazard ratio for pertussis was 0.11 for DTwP, 2.09 for DTaP-Hib, and 3.28 for DTaP-IPV/Hib (all P < 0.001).</p><p><strong>Conclusions: </strong>The 2024 pertussis outbreak in Quzhou showed a marked age shift toward school-aged children, with the highest incidence in 5-9-year-olds. Our findings support adding a booster dose at 6 years of age and reconsidering multivalent DTaP-containing vaccines.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Household socioeconomic status, dietary diversity, and risk of stunting among South African primary school children.","authors":"Johanna Beckmann, Christin Lang, Rosa du Randt, Annelie Gresse, Kurt Z Long, Ivan Müller, Madeleine Nienaber, Siphesihle Nqweniso, Uwe Pühse, Jürg Utzinger, Cheryl Walter, Markus Gerber","doi":"10.1186/s41043-026-01335-5","DOIUrl":"10.1186/s41043-026-01335-5","url":null,"abstract":"<p><strong>Background: </strong>Children in low- and middle-income countries are disproportionately affected by socioeconomic disparities, which might influence access to diverse and nutritious foods, increasing the risk of food insecurity and low dietary quality. Hence, monitoring of these conditions is crucial. This study examined whether children from households with different wealth status vary concerning food insecurity, dietary diversity, consumption of specific food groups, and risk of stunting.</p><p><strong>Methods: </strong>Baseline data were utilized from a multi-country randomized intervention trial. Primary school children (M_age= 8.3±1.4 years; 416 girls and 423 boys) from four schools in a marginalized, peri-urban area (government-defined wealth index quintile 3) in Gqeberha, South Africa, participated. Parents/guardians provided information about household socioeconomic factors and completed a 24-hour food item checklist and a food security questionnaire. Stunted children were defined as <-2 SD height-for-age compared to current World Health Organization child growth standards. Analyses of variance and χ²-tests were employed to compare children classified into five wealth quintiles.</p><p><strong>Results: </strong>On average, children consumed food items from 5.8±2.0 healthy food groups. One out of 12 children (8.4%) were stunted. Contrast analyses showed that children from low-resourced families were exposed to more food insecurity, consumed fewer different food items, and were more likely to be stunted than children from the highest socioeconomic categories (p < 0.05). The latter were more likely to consume cereals, roots, vitamin A rich vegetables, oil, sweets, and sweet beverages. Although stunting still exists in marginalized areas of South Africa, our findings confirm that children with higher wealth status are less likely to be stunted, but consume more food items from unhealthy food groups.</p><p><strong>Conclusion: </strong>Our findings reiterate the need for improving awareness of healthy food consumption in low- resourced areas. Addressing upstream determinants such as food insecurity, poverty, and access to affordable, healthy foods is essential to reduce socioeconomic differentials in food consumption. School-based nutrition programs should be framed as complementary measures within broader government-led actions, including school feeding policies and teacher-focused nutrition education, to improve inadequate dietary quality among school-age children and address socioeconomic inequalities in stunting risk.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with malnutrition among under five children in Bangladesh: a multivariate analysis.","authors":"Md Tahidur Rahman, Md Lotifur Rohman, Md Jahangir Alam, Dulal Chandra Roy, Papia Sultana","doi":"10.1186/s41043-026-01347-1","DOIUrl":"10.1186/s41043-026-01347-1","url":null,"abstract":"<p><strong>Background: </strong>Child malnutrition remains a major global public health concern, with a disproportionately higher burden in developing countries such as Bangladesh. It is a leading contributor to childhood morbidity and mortality and has long-term consequences for physical growth, cognitive development, educational attainment, and adult productivity. Multiple socioeconomic and demographic factors are responsible for this condition. Therefore, this study aims to identify the factors associated with child malnutrition in Bangladesh using multivariate analytical approaches.</p><p><strong>Methods: </strong>In this study, malnutrition-related data from the Bangladesh Demographic and Health Survey (BDHS) 2022 were used. Multivariate analysis of variance (MANOVA) and multivariate linear regression models were performed to identify significant factors of child malnutrition in Bangladesh (p[Formula: see text]).</p><p><strong>Results: </strong>Multivariate linear regression analysis showed that the Z-scores for height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WAH) among children aged 12-23 months were significantly lower compared to those aged < 12 months, with reductions of 32.63, 24.01, and 16.40 units, respectively (p < 0.001). Maternal underweight was negatively associated with all three anthropometric outcomes, whereas higher maternal education and better household wealth status were positively associated with improved nutritional outcomes.</p><p><strong>Conclusion: </strong>The findings of this study suggest that both governmental and non-governmental organizations should prioritize improving maternal education and nutritional status, enhancing household income-generating activities among disadvantaged populations, and promoting adequate birth spacing.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cancer screening among HIV-positive women in conflict-affected and resource limited settings: the case of Tigray region, Ethiopia.","authors":"Haftom Gebrehiwot Woldearegay, Gebreamlak Gidey Abebe, Solomon Weldemariam, Feven Gebregziabher Tesfay, Mulugeta Gebregziabher","doi":"10.1186/s41043-026-01331-9","DOIUrl":"10.1186/s41043-026-01331-9","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer remains a significant public health concern, particularly among women living with HIV/AIDS, who are at increased risk due to compromised immunity. Despite the high burden of cervical cancer in sub-Saharan Africa, including Tigray, Ethiopia, the magnitude of cervical lesions within screening programs and its associated determinants remain inadequately addressed. This study assesses the magnitude and risk factors of precancerous cervical lesion among HIV-infected women in conflict-prone and resource- limited settings of Tigray, Ethiopia.</p><p><strong>Methods: </strong>We conducted a facility-based cross-sectional study involving 2004 women attending antiretroviral therapy clinics. As part of the routine standard of care for cervical cancer screening in Ethiopia, participants underwent Visual Inspection with 5% Acetic Acid (VIA) at five sites of Mekelle public health institutions between June, 21, 2023, to May 30, 2024. Data were collected through structured interviews using Kobo toolbox and analyzed using SPSS version 23 with the use of logistic regression to examine associations between VIA positivity, demographics, and other risk factors.</p><p><strong>Results: </strong>Of 2004 clients with HIV/AIDS who received cervical cancer screening, 378 (18.9%) had a VIA+ result. The odds of being VIA+ were 2.39 times higher among women with a history of sexually transmitted infections (AOR = 2.39; 95% CI: 1.72-3.31). Women who had multiple life time sexual partners had 1.94 times higher odds of being VIA+ (AOR = 1.94; 95% CI: 1.45-2.58). Similarly, women whose spouse with unknown life time number of sexual partners had 1.7 times higher odds of being VIA + as compared with monogamous [AOR = 1.71, 95% CI = 1.09, 2.68].The odds were also higher among women with increased parity (AOR = 2.06; 95% CI: 1.28-3.30) and those who initiated sexual activity before the age of 18 (AOR = 1.57; 95% CI: 1.23-2.01).</p><p><strong>Conclusions: </strong>This study showed a high magnitude of precancerous cervical lesions, affecting nearly to one- fifth of women living with HIV. Key risk factors identified multiple sexual partners, history of sexually transmitted infections (STIs), parity, and early sexual debut. This study demonstrates the need to support implementation efforts that prioritize and facilitate STIs prevention and safer sexual practices.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary inflammatory index and quality of life in patients with breast cancer: a cross-sectional study.","authors":"Bahar Darouei, Penias Tembo, Sherry Price, Reza Amani-Beni, Ibrahim Abdollahpour, Maryam Yazdi, Shaghayegh Haghjooy Javanmard, Kazem Zendehdel, James R Hebert","doi":"10.1186/s41043-026-01345-3","DOIUrl":"10.1186/s41043-026-01345-3","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivorship is frequently accompanied by impaired quality of life (QoL). Diet-related systemic inflammation may influence physical, emotional, and psychological well-being, yet evidence linking the inflammatory potential of diet to QoL in women with breast cancer remains limited.</p><p><strong>Methods: </strong>In this cross-sectional study, 600 women with confirmed breast cancer were recruited from the Isfahan Breast Cancer Registry between 2021 and 2023. Dietary intake and lifestyle characteristics were collected through structured telephone interviews. The Dietary Inflammatory Index (DII^®) and energy-adjusted DII (E-DII™) were calculated, and QoL was assessed using a five-point Likert scale. Associations of DII and E-DII with QoL were examined using multivariable linear regression with adjustment for potential confounders. Quartile-based analyses and tests for linear trend were also performed.</p><p><strong>Results: </strong>Higher DII scores were associated with lower QoL in adjusted models (β = -0.12; 95% CI: -0.16 to - 0.08; p < 0.001), with a clear linear decline in QoL across increasing DII quartiles (p for trend < 0.001). E-DII was similarly inversely associated with QoL (β = -0.06; 95% CI: -0.11 to - 0.02; p = 0.007), and a consistent trend across E-DII quartiles was observed (p for trend = 0.01).</p><p><strong>Discussion: </strong>Diets with greater pro-inflammatory potential were associated with poorer QoL among women with breast cancer. Although the cross-sectional design precludes causal inference, these findings support the hypothesis that anti-inflammatory dietary strategies may be a relevant target in survivorship care and justify longitudinal and interventional studies to clarify directionality and clinical impact.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction of Dietary Patterns and Physical Activity with Low Back Pain in Pre- to Post-Menopause: A Cross-Sectional Study.","authors":"Jing Zhao, Haiwen Lu, Sheng Wang, Rixin Niu, Xinyan Wang, Pengpu Wang, Hailin Li, Yanling Wang, Huiqiu Zheng, Yanling Li, Xin Liu, Yingjie Tian, Qianqian Du, Bowen Zhou, Jingxia Fan, Xuemei Wang","doi":"10.1186/s41043-026-01309-7","DOIUrl":"10.1186/s41043-026-01309-7","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) in perimenopause and postmenopausal women is an important public health concern because of its high prevalence and associated social and economic burden. Dietary patterns and physical activity have attracted increasing attention as modifiable determinants of LBP, but the impact of their interaction, particularly across menopausal stages, has not been well characterized.</p><p><strong>Methods: </strong>This cross-sectional analysis included 1530 adult women from the Ordos Resident Health White Paper Program. Dietary patterns were derived using principal components analysis of food frequency questionnaire data. Physical activity was assessed using the International Physical Activity Questionnair. LBP was defined as self-reported pain, ache or discomfort in the lumbosacral region (Verbal Rating Scale score 1-3). Logistic regression models were used to examine associations between dietary patterns, physical activity and LBP. Interaction between dietary patterns and physical activity was assessed overall and stratified by menopausal status.</p><p><strong>Results: </strong>The prevalence of LBP was 12.6%. Three major dietary patterns were identified: a plant-based dietary pattern (PBDP), a northern pastoral dietary pattern (NPDP) and a northern traditional dietary pattern (NTDP). Only PBDP was significantly associated with LBP. Compared with women in the highest quartile of adherence to PBDP (Q4), those in the lowest quartile (Q1) had higher odds of LBP (adjusted OR = 2.879, 95% CI: 1.749-4.739). No significant association with LBP was observed for NPDP. In joint analyses, the highest odds of LBP were observed among women with higher-intensity physical activity and non-adherence to PBDP (Q1) (adjusted OR = 3.777, 95% CI: 1.991-7.166). In analyses stratified by menopausal status, the risk associated with higher-intensity physical activity and non-adherence to PBDP increased from perimenopausal to postmenopausal women, with adjusted ORs of 3.600 (95% CI: 1.029-12.592) and 5.752 (95% CI: 2.189-15.114), respectively.</p><p><strong>Conclusions: </strong>In this population of midlife women, higher-intensity physical activity was associated with increased risk of LBP, and this risk rose from perimenopause to postmenopause. Adherence to PBDP attenuated the LBP risk associated with higher-intensity physical activity, with the beneficial effect becoming more pronounced after menopause. These findings suggest that menopause-specific combinations of dietary improvement and appropriate physical activity may help mitigate the burden of LBP in perimenopausal and postmenopausal women.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}