Nutrition and health最新文献

{"title":"Nutrition and integrated healthcare knowledge, attitudes, and prospective practices among healthcare students: A theoretical model survey analysis.","authors":"Patricia Dyett, George Legall, Lesley-Ann Foster-Nicholas, Claudette Mitchell, Adana Adams-Robinson, Vanessa Jones-Oyefeso, Paula Valley-Thom, Valerie Sealey-Tobias","doi":"10.1177/02601060251390159","DOIUrl":"10.1177/02601060251390159","url":null,"abstract":"<p><p>BackgroundThe understanding, appreciation, and application of integrated healthcare by health professional students can shape future health promotion and intervention strategies. This involves blending nutrition, lifestyle, and conventional medical approaches from educational curricula to the professional practice arena.AimsTo assess targeted healthcare students from three institutions for associations between demographics and survey parameters of knowledge, attitudes, and practices regarding nutrition and integrated healthcare approaches, and to evaluate students' prospects for integrating lifestyle-based and conventional healthcare approaches, within the context of the Knowledge-Attitude-Practice (KAP) model.MethodsSurvey questions and responses based on a previously validated electronic questionnaire were used to evaluate university-level healthcare students enrolled in the nutrition (n = 92) and nursing (n = 195) disciplines. Demographic data were analyzed alongside scored items assessing knowledge, attitudes, and practices. Descriptive statistics, chi-square tests, Kruskal-Wallis tests, Dunn-Bonferroni tests, Spearman's rho, and partial correlations were conducted.ResultsMost students demonstrated high overall knowledge (74%), attitude (93%), and practice (84%) scores. However, significant differences (p < 0.05) in the knowledge scores were observed across institutions, academic levels, and disciplines. Although relatively weak, knowledge had a significant and positive relationship with attitude (rho = 0.263, < 0.001), but not with practice. The strength of relationships was moderated by controlling for socio-demographic factors such as specific degree/discipline, institutional and environmental context, race, religion, and age.ConclusionThe findings of this study highlight the benefits of using KAP-based learning outcomes for healthcare training programs and demonstrate its relevance in informing tailored educational strategies and clinical interventions and policy initiatives that support integrated healthcare approaches.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1633-1645"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choline status and related health outcomes in humans: A scoping review.","authors":"Samantha Yoo, Andrew Aoun, Azita Montazeri, Erin Collins, Julian Little","doi":"10.1177/02601060261430655","DOIUrl":"10.1177/02601060261430655","url":null,"abstract":"<p><p>BackgroundCholine is an essential nutrient involved in human health and development across the lifespan. The evidence on choline and its health effects has been growing; yet the findings are inconsistent.AimWe aimed to map the current evidence and identify gaps in knowledge.MethodsWe conducted a scoping review of the studies that examined relationships between choline exposure and any health outcomes. MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials were searched for research involving humans and published between January 2000 and May 2025. Screening and data abstraction were performed in duplicate.ResultsA total of 117 primary studies were included. Most of the studies were conducted in North America (54%) and Europe (22%). Cardiometabolic disease accounted for the largest proportion (34%), followed by offspring neurodevelopment (19%) and liver conditions (12%). The studies were predominantly observational (prospective 60%, retrospective 12%, cross-sectional 20%). The evidence regarding potential benefits and harms was reported to be insufficient or equivocal for many health outcomes. Based largely on data from small randomized controlled trials in women with prenatal exposure to alcohol or infants with fetal alcohol syndrome disorder, high maternal choline intake/status was associated with improved neurocognition and neurodevelopmental outcomes in the offspring.ConclusionPotential benefits of high maternal choline intake/status was indicated for neurodevelopment of the offspring; however, the evidence was insufficient or equivocal for most of the outcomes reviewed. A more comprehensive synthesis incorporating preclinical evidence from animal studies will improve the current understanding of choline and its health effects.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1489-1510"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring factors affecting the use of blended diets for children and young people in health, education and social care settings in the UK: The protocol for a realist mixed methods study.","authors":"Gemma Phillips, Jane Coad, Mary Hickson, Joseph C Manning","doi":"10.1177/02601060261439096","DOIUrl":"10.1177/02601060261439096","url":null,"abstract":"<p><p>BackgroundEnteral tube feeding provides supplementary or alternative nutrition for individuals who cannot meet their nutritional needs orally and remains essential for a number of children and young people with complex health needs. Commercial formula remains standard practice in the UK, although increasing numbers of children and their families are choosing a blended diet and reporting significant physical and social benefits. However, support for families in using blended diets varies across health, education and social settings in the UK.AimTo explore factors affecting the use of blended diets in health, education and social care settings.MethodsThis sequential mixed methods study uses a realist approach to understand what works for who under what circumstances and why. A point prevalence study of blended diet use in the UK will identify a stratified sample of professionals and families for interviews exploring their experiences. A Delphi study will prioritise key issues identified in the interview data.SummaryThis paper presents a novel, realist mixed methods protocol to investigate the contextual factors influencing the use of blended diets for children and young people across health, education and social care settings in the UK. Grounded in lived-experience, it addresses a critical gap in the evidence-base responding to family-identified priorities. Integrating qualitative and quantitative data enhances explanatory power and applicability to practice. Findings will inform future interventions and policy development, aiming to improve support and equity in blended diet provision. This research offers a robust foundation for advancing personalised enteral feeding approaches within multidisciplinary care.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1419-1428"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Astaxanthin supplementation mitigates oxidative stress by enhancing antioxidant capacity and restoring oxidation-antioxidant balance in Wistar rats exposed to cadmium toxicity.","authors":"Mohammed Al-Zharani, Mohammed Mubarak, Eman Almuqri, Hassan Rudayni, Shaikha A Albatli, Fahd A Nasr, Amin A Al-Doaiss, Mohammed S Al-Eissa","doi":"10.1177/02601060251380473","DOIUrl":"10.1177/02601060251380473","url":null,"abstract":"<p><p>BackgroundAstaxanthin is a carotenoid phytochemical primarily found in <i>Haematococcus pluvialis</i>, <i>Chlamydomonas nivalis</i>, and various algae and crustaceans.Aims/objectivesThis study aimed to evaluate astaxanthin's in vivo antioxidant properties and investigate its effectiveness in mitigating oxidative stress induced by cadmium exposure.Methods/methodologyEighty experimental rats were divided into four groups (<i>n</i> = 20 each): an untreated control group (Group 1), an astaxanthin-treated group (Group 2), a cadmium-exposed group (Group 3), and a cadmium-astaxanthin group (Group 4). Rats in Group 2 received daily oral doses of astaxanthin at 50 mg/kg body weight, and those in Group 3 were given an aqueous solution of cadmium chloride at a final concentration of 5 mg/kg b.w. per day. Rats in Group 4 were treated with both astaxanthin and cadmium chloride. Hematological and biochemical assays were conducted to achieve the study's objectives.Results/findingsThe hematological and biochemical profiles of the cadmium-exposed rats (Group 3) showed significant alterations compared to the untreated control. In the biochemical assessments (serum profile), the astaxanthin-treated animals (Group 2) exhibited no significant changes compared to the untreated control. Conversely, rats in Group 4 (exposed to cadmium and treated with astaxanthin) showed increased levels of total proteins and significant increases in antioxidant markers, including total thiols, glutathione, total antioxidant capacity, superoxide dismutase, glutathione peroxidase, and catalase. Additionally, this group demonstrated significant decreases in blood cadmium levels, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, creatinine, blood urea nitrogen, urea, bilirubin, and oxidative markers and malondialdehyde compared to the cadmium-only group (Group 3). Tissue homogenates from the liver and kidneys of Group 3 exhibited similar results to those revealed by serum biochemical analyses.ConclusionThe study concluded that astaxanthin possesses effective antioxidant properties that significantly help reduce the oxidative stress induced by cadmium exposure.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1539-1550"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early introduction of ultra-processed foods and their repercussions on inflammatory biomarkers in children.","authors":"Cecília Furtado Craveiro, Mariana Souza Lopes, Bruna Farias da Silva, Fernando Paiva Brandini, Erika Mayra de Almeida Barreto, Pietra Maria Pereira de Lima, Ricácia de Sousa Silva, Sávio Marcelino Gomes, Vinicius José Baccin Martins, José Luiz de Brito Alves","doi":"10.1177/02601060251397284","DOIUrl":"10.1177/02601060251397284","url":null,"abstract":"<p><p><b>Background:</b> Excessive consumption of ultra-processed foods (UPFs) has been associated with adverse health outcomes, including increased levels of inflammatory biomarkers such as C-reactive protein (C-RP), IL-6, and TNF-α. <b>Aims:</b> To investigate whether the introduction of UPFs before the age of 2 years is associated with inflammatory markers in school-aged children (7-10 years). <b>Methods:</b> This cross-sectional study included interviews with children and their mothers conducted by a trained team. Anthropometric and biochemical data (C-RP), IL-2, IL-4, IL-6, IL-10, IL-17a, IFN-γ, and TNF-α) were collected from children. Maternal reports provided information on family income, schooling, breastfeeding (exclusive up to 6 months), timing of food introduction, early exposure to UPFs (before 2 years), and birth weight. Statistical analyses included PERMANOVA and generalized estimating equations, adjusted for family income, BMI-for-age, and exclusive breastfeeding. <b>Summary:</b> The prevalence of early UPF introduction was higher among girls compared to boys (54.7% vs. 45.3%, <i>P</i> < 0.001). Children exposed to UPFs before 2 years of age had higher IL-10 levels (<i>P</i> = 0.002), but this association was not sustained after adjustments. Early UPF consumption (before 2 years of age) was not associated with alterations in inflammatory cytokines in children aged 7-10 years. Nevertheless, considering the established links between UPF intake, metabolic disorders, and neurodevelopmental outcomes, continuous monitoring and dietary guidance during childhood remain essential to promote lifelong health.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1793-1799"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and fruit and vegetable intake in people with severe mental illness: Results from a multicountry survey in India, Bangladesh, and Pakistan.","authors":"Tahsin Tasneem Tabassum, Alex Mitchell, Kavindu Appuhamy, Faiza Aslam, Olga P Garcia, Rumana Huque, Subhana Akber Khan, Krishna Prasad Muliyala, Nidhi Tilala, Silke Vereeken, Gerardo A Zavala","doi":"10.1177/02601060251394687","DOIUrl":"10.1177/02601060251394687","url":null,"abstract":"<p><p>BackgroundPeople with severe mental illness (SMI) are at higher risk of developing non-communicable diseases, leading to increased comorbidities and elevated mortality rates. Their health often declines due to poor dietary habits, such as low intake of fruits and vegetables (FV), combined with insufficient physical activity (PA).AimsWe report the prevalence of low FV intake and PA (as per WHO criteria) and their sociodemographic and clinical risk factors in people with SMI in South Asia.MethodsA cross-sectional survey was conducted between June 2019 and January 2022 across tertiary mental health institutions in Bangladesh, India, and Pakistan among adults diagnosed with SMI. We collected data on sociodemographics, body mass index, physical comorbidities, and health behaviours. PA and FV were measured too while logistic regression analysis was used to identify factors associated with low FV intake and PA.ResultsAmong 3989 participants, the prevalence of participants who met the WHO recommendations for FV intake was 4.9% (196/3989), and for PA was 45.6% (1817/3989). Older adults (55 + years) were less likely to meet PA recommendations compared to younger adults (18-24 years) (odds ratio (OR) = 0.56, 95%CI = 0.40-0.80, <i>p</i> = 0.001), and those with higher income levels had higher odds of meeting PA recommendations compared to those with lower income (OR = 2.23, 95%CI = 1.49-3.34, <i>p</i> < 0.001). Additionally, individuals who reported adequate FV intake were significantly more likely to meet PA recommendations (OR = 2.90, 95% CI = 2.02-4.16, <i>p</i> < 0.001).ConclusionA majority of people with SMI did not meet the WHO recommendations for PA and FV intake. The associated factors, including age, income, and dietary habits, emphasise the complexity of addressing health behaviours in this vulnerable population in South Asia.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1685-1702"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the validity of Diet ID™ for measuring Healthy Eating Index.","authors":"Dahlia Stott, Michael Bruneau, Jonathan M Deutsch, Jennifer A Nasser, Mara Z Vitolins, Brandy-Joe Milliron","doi":"10.1177/02601060261454260","DOIUrl":"10.1177/02601060261454260","url":null,"abstract":"<p><p>BackgroundDiet ID™ is a digital, image-based dietary assessment tool that uses pattern recognition and comparisons of meal images to estimate overall dietary intake and diet quality.ObjectiveTo examine the relative validity of Diet ID™ in measuring Healthy Eating Index-2020 (HEI-2020) total and component scores.MethodsIn this cross-sectional study, participants completed Diet ID™ and the Diet History Questionnaire II, a semiquantitative food frequency questionnaire. Spearman's rho correlations examined relative validity. Wilcoxon signed-rank tests, cross-classification, and Bland-Altman plots assessed agreement.ResultsThe HEI-2020 total scores were moderately correlated (<i>r_s</i> = 0.46, <i>p</i> < 0.001) and most components were weakly correlated (<i>r_s</i> = 0.12-0.34, <i>p</i> < 0.05). There was poor agreement between the dietary assessment methods, as evidenced by significant differences in most scores (<i>p</i> < 0.001), fewer than half of the participants being classified into the same tertile, and Bland-Altman plots.ConclusionFurther work is needed to improve Diet ID™ to measure HEI-2020 total and component scores.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1443-1447"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Satiety effects of high-fiber bread in healthy females: A randomized cross-over study.","authors":"Kalliopi Kavvalou, Vassilios Raikos","doi":"10.1177/02601060251397291","DOIUrl":"10.1177/02601060251397291","url":null,"abstract":"<p><p>BackgroundBread is an important staple food worldwide. Its nutrient composition can vary significantly depending on the grain type and the bread-making practices.AimThe purpose of this randomized cross-over study was to determine the satiating effects of a high-fiber bread in healthy volunteers.MethodsTwo different types of bread with the same calories (238 kcal) were prepared, differing in their fiber content. The fiber-enriched bread contained 2.5 times more fiber compared to the reference bread. Volunteers consumed the reference and the fiber-enriched bread during two separate visits in a randomized order. The volunteers completed questionnaires using a 10-point visual analog scale (VAS) to assess feelings of hunger, satiety, and desire to eat. The questionnaires were filled out before the consumption of each bread and at 0, 30, 60, and 120 min after bread consumption. Data from 25 female adults with mean age 35.0 years and mean body mass index 23.1 Kg/m² was analyzed.ResultsThe incremental area under the curve (iAUC₁₂₀min) obtained from the VAS scores showed minor variations in the feeling of hunger (1.7%, <i>p</i> = 0.94), feeling of fullness (-4.4%, <i>p</i> = 0.58), and desire to eat (4.2%, <i>p</i> = 0.38) between treatments. There was no statistically significant difference in the satiating effects between the two types of bread (<i>p</i> > 0.05).ConclusionThere was no indication that adding fiber to bread can substantially affect satiety. Future studies on fiber-fortified bread should analyze specific fiber types (soluble vs. insoluble) and standardize fat content between bread formulations.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1801-1810"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural comparison of factors influencing sustainable dietary behaviors among Japanese and German adults.","authors":"Yui Kawasaki, Emi Yoshii, Kahori Fujisaki, Misa Shimpo, Sayaka Nagao-Sato, Jana Boehnke, Rie Akamatsu, Petra Warschburger","doi":"10.1177/02601060251381870","DOIUrl":"10.1177/02601060251381870","url":null,"abstract":"<p><p>BackgroundThe concept of integrated sustainable dietary behaviors (SDBs) focuses on a series of dietary behaviors from food choice, storage and preservation, preparation (cooking), consumption, and disposal, as well as dietary patterns.ObjectivesThis study qualitatively describes the factors influencing the implementation of SDBs in Japanese and German adults and quantitatively compares the factors between the two cultures.MethodsThe online survey targeted 700 Japanese and 235 German adults, while the oral interview focused on 16 Japanese participants, recruited by a web-research company in 2021. Manifest content analysis, alongside chi-square and Fisher's exact tests, was used.ResultsThe participants' mean (SD) ages were 40.5 (10.9; Japanese; questionnaire), 26.2 (8.1; German; Questionnaire), and 38.1 (12.6; Japanese; interview), respectively. The 2515 codes (Japanese: 930; German: 1585) that emerged from the content analysis were divided into five main categories: (1) intrapersonal, (2) interpersonal, (3) food environment, (4) government, local governments, and research institutions, and (5) other. Compared to the Germans, the Japanese participants had a higher percentage of references to the <b>\"</b>intrapersonal\" and <b>\"</b>government, local government, and research institution\" categories. Japanese participants were more likely to cite psychological factors, portion size, and other factors, whereas German participants frequently referenced biology, skills of SDB, local access to sustainable food, and neighborhood characteristics.ConclusionCultural differences were found in the perceived factors for implementing SDBs. This study provides insight into the factors in implementing SDBs and can assist the development of promotion strategies that consider the cultural backgrounds of target populations.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1525-1537"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of maternal ketonuria with pregnancy outcome and optimal carbohydrate intake in pregnant women.","authors":"Naoki Sakane, Akiko Suganuma, Masayuki Domichi, Ikuyo Hayashi","doi":"10.1177/02601060251383015","DOIUrl":"10.1177/02601060251383015","url":null,"abstract":"<p><p>BackgroundKetonuria during pregnancy, potentially arising from inadequate carbohydrate intake or elevated energy demands, has an uncertain association with adverse outcomes, particularly preterm birth.AimsThis study aimed to examine the relationship between maternal ketonuria and pregnancy outcomes, and to identify the carbohydrate intake level that may help prevent ketonuria in pregnant women.MethodsIn this prospective study, 349 pregnant women were assessed for ketonuria using the nitroprusside method, categorized into mild, moderate, and severe. Dietary carbohydrate intake was measured via a food frequency questionnaire. Receiver operating characteristic analysis identified trimester-specific carbohydrate thresholds for moderate/severe ketonuria. Logistic regression evaluated associations between ketonuria and preterm birth, adjusting for confounders including prepregnancy body mass index (BMI), smoking, blood pressure, hemoglobin, and glucose levels.ResultsKetonuria prevalence was 12.6% (mild), 1.7% (moderate), and 2.3% (severe). Ketonuria was associated with higher prepregnancy BMI, smoking history, and increased preterm birth. First-trimester ketonuria significantly increased preterm birth risk (adjusted OR 5.76; 95% CI [1.73-19.1]; <i>p</i> = .004). Carbohydrate intake thresholds predicting moderate/severe ketonuria were 187 g (first trimester), 170 g (second), and 143 g (third).ConclusionsEarly pregnancy ketonuria is independently associated with preterm birth. Adequate trimester-specific carbohydrate intake may help prevent ketonuria, highlighting its importance in prenatal care.</p>","PeriodicalId":19352,"journal":{"name":"Nutrition and health","volume":" ","pages":"1583-1592"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}