Journal of the American Nutrition Association最新文献

{"title":"A Comparative Study of Iron Bioaccessibility and Antinutrient Levels in <i>Hibiscus sabdariffa</i> (Roselle) Leaves and Calyces and <i>Persea americana</i> (Avocado) Leaves and Seeds: Nutritional Implications.","authors":"Barugahara Evyline Isingoma, Kyarimpa Christine Mugumya, Buzigi Edward","doi":"10.1080/27697061.2025.2585823","DOIUrl":"10.1080/27697061.2025.2585823","url":null,"abstract":"<p><strong>Objective: </strong>To compare iron bioaccessibility (availability for absorption) and antinutrient levels in Roselle leaves and calyces and Avocado leaves and seeds in fresh and dry forms.</p><p><strong>Methods: </strong>The iron content and nutrients linked to its metabolism such as protein, vitamin C, and betacarotene and iron absorption inhibitors such as calcium and antinutrients (total phenolic compounds, phytates, oxalates, tannins, and flavonoids) were analyzed in triplicate using standard methods. Iron and calcium inhibition was predicted using molar ratios. Data were analyzed using IBM Statistical Package for Social Scientists and means compiled. Analysis of variance and differences among means was compared by Duncan's Post Hoc test at <i>p</i> < 0.05.</p><p><strong>Results: </strong>The iron content in 100 grams was 15.71 ± 0.04 and 8.16 ± 0.01 mg in fresh and dry Roselle leaves respectively, 13.47 ± 0.01 mg in fresh Avocado leaves and seeds, 10.16 ± 0.01 mg in fresh Roselle calyces, 4.47 ± 0.01 mg in dry Avocado leaves and Roselle calyces and 2.47 ± 0.01 mg in dry Avocado seeds. The highest protein content of 13.82 ± 0.13% was found in fresh Avocado leaves while fresh Roselle leaves had the highest betacarotene content of 9.30 ± 0.00 mg/100 g. Vitamin C was significantly high in fresh Avocado and Roselle leaves (>30 mg/100 g). Calcium contents in all samples were low (<80 mg/100 g) and not inhibited by phytates and oxalates. In all samples, iron was not inhibited by oxalates and only in fresh Avocado seeds was iron inhibited by phytates. Tannins, phytates and oxalate concentrations were all below the maximum tolerable levels. Though fresh Roselle leaves had the highest iron content, its total phenolic compounds were above the maximum tolerable levels, depicting toxicity.</p><p><strong>Conclusion: </strong>Only Avocado leaves, Roselle calyces and dry Roselle leaves have good amounts of bioaccessible iron with safe antinutrient levels.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"339-346"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Iron Bioavailability with Sprinkle Food Containing Steam-Blasted and Enzymatically Hydrolyzed Soybean: A Randomized Controlled Trial in Adolescent Girls.","authors":"Noer Laily, Retno Dumilah Esti Widjayanti, Jordan Kahfi, Alit Pangestu, Iim Sukarti, Fatim Illaningtyas, Hasna Rahma Aulia, Bangkit Wiguna, Wahju Eko Widodo, Maya Soraya, Ida Royanti, Wawuk Widarsih, Muhamaludin Muhamaludin, Musliha Mustary, Solehah Solehah, Sri Peni Wijayanti","doi":"10.1080/27697061.2025.2585830","DOIUrl":"10.1080/27697061.2025.2585830","url":null,"abstract":"<p><strong>Objective: </strong>This study extends prior work on soy hydrolysate by developing a sprinkle food formula and evaluating its iron bioavailability and effectiveness in improving iron status among adolescent girls over an eight-week intervention.</p><p><strong>Method: </strong>The soybean hydrolysate was produced through sequential steam blasting and enzymatic hydrolysis. It was characterized by its molecular weight distribution-predominantly <15 kDa-and amino acid composition, with high levels of glutamic acid, aspartic acid, and arginine, known for their iron-binding properties. A randomized controlled trial (RCT) was conducted involving 106 female adolescents, comparing serum ferritin levels before and after an eight-week intervention with either the hydrolysate-fortified or control sprinkle product.</p><p><strong>Result: </strong>A significant increase in serum ferritin levels was observed among participants with low baseline ferritin (<11 ng/mL) who consumed the soy-hydrolysate-fortified formula, indicating enhanced iron absorption. No significant improvement was detected in participants with normal ferritin but low hemoglobin levels, suggesting that the benefit of soy hydrolysate is more pronounced in individuals with depleted iron stores. Baseline dietary intake and serum profiles were similar between groups, indicating that the benefits observed were likely due to the bioactive properties of soy hydrolysate, especially its amino acid composition and molecular weight that support iron absorption.</p><p><strong>Conclusion: </strong>Fortification with hydrolyzed soybean peptides represents a promising strategy to improve iron status and reduce the risk of anemia, while the applied processing method offers an effective, value-added use of agricultural resources.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"355-366"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Ultra-Processed Food (UPF) Consumption and Weight Change and Obesity Risk Among Consumers of Plant-Based Diets: A Systematic Review.","authors":"Terpase S Gbaa, Qisi Yao, Yarisbel Melo Herrera, Maya K Vadiveloo","doi":"10.1080/27697061.2026.2660795","DOIUrl":"https://doi.org/10.1080/27697061.2026.2660795","url":null,"abstract":"<p><p>Interest in plant-based diets for health promotion continues to grow, emphasizing whole and minimally processed foods. Consistent with broader U.S. trends, plant-based consumers derive many calories from UPFs, whose impact on weight change, overweight, and obesity remains unclear. This review aimed to evaluate the association between UPF consumption and weight change, overweight, and obesity among consumers of plant-based diets. A systematic literature search was performed in Web of Science, PubMed, and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. This review analyzed twelve studies published between 2020 and 2025 involving 206,727 participants aged 18 and older across six countries. There was a mixed association between UPF consumption and weight change, overweight, and obesity among plant-based consumers, with some suggestion that higher diet quality UPFs were inversely or not associated with body weight. Among the 12 studies included, 4 specifically examined the research question, while the rest separately reported baseline UPF intake and weight-related outcomes. The quality of evidence was weak. While the four studies addressing the research question were rated fair to good quality individually, it was not possible to draw definitive conclusions, as the studies were observational and had a high risk of bias. Across the studies, there was also variability in consumption patterns and potential misclassification of plant-based consumers. Further research evaluating the quality of plant-based UPFs and UPF subcategories is warranted, as diet quality appears to be an influencing factor of the association.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"1-14"},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting Energy Expenditure is Overpredicted in Midlife Females: Examining the Accuracy of Predictive Equations and the Role of Lean Soft Tissue in Perimenopause.","authors":"Gabrielle M DelBiondo, Sam R Moore, Paul A Baker, Alex N Ladan, Morgan E Britton, Abbie E Smith-Ryan","doi":"10.1080/27697061.2026.2658497","DOIUrl":"https://doi.org/10.1080/27697061.2026.2658497","url":null,"abstract":"<p><strong>Background: </strong>Perimenopause is often accompanied by changes in metabolism and body composition, including loss of lean soft tissue (LST). The purpose of this study was to compare measured resting energy expenditure (mREE) <i>via</i> indirect calorimetry to predicted REE from common equations in perimenopausal women. The secondary purpose was to examine the effect of LST on differences between mREE and metabolic equations.</p><p><strong>Methods: </strong>REE was assessed using indirect calorimetry in 45 perimenopausal females. Estimated REE was calculated from Cunningham (C), De-Lorenzo (DL), Harris-Benedict (HB), Mifflin St. Jeor (MS), Molnar (M), and ten Haaf (TH) equations. LST (kg) was determined using dual energy x-ray absorptiometry. mREE vs estimated were compared using a mixed-model ANOVA. A linear regression was used to examine the effect of LST on predictive equations and mREE.</p><p><strong>Results: </strong>Significant differences were seen between mREE vs estimated REE for C (mean difference ± standard error [mREE-C]: -157.8 ± 28.7 kcals, <i>p</i> = 0.001), DL ([mREE-DL]: -381.9 ± 32.8 kcals, <i>p</i> < 0.001), HB ([mREE-HB]: -100.5 ± 30.5 kcals, <i>p</i> = 0.033), and TH ([mREE-TH]: -142.2 ± 33.1 kcals, <i>p</i> = 0.003). MS ([mREE-MS]: -18.5 ± 31.7 kcals, <i>p</i> = 0.99) and M (29.9 ± 34.0 kcals, <i>p</i> = 0.99) equations most closely predicted REE. LST accounted for 1.1-2.2% range of variance in REE.</p><p><strong>Conclusions: </strong>Estimated REE significantly overestimated caloric expenditure compared to mREE by an average of ∼215 kcals/day, with some equations (MS, M) more accurately estimating REE in perimenopausal women. The MS equation may be most beneficial for REE estimates in midlife women. LST may not be driving differences between mREE and predictive equations.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing Herbal Power: A Systematic Review of Phytopharmaceuticals in Type 2 Diabetes Management.","authors":"Kamalika Chattopadhyay, Pankaj Kumar, Ravishankar Ram Mani, Kushagra Khanna, Binar Asrining Dhiani, Mogana Rajagopal","doi":"10.1080/27697061.2026.2650457","DOIUrl":"https://doi.org/10.1080/27697061.2026.2650457","url":null,"abstract":"<p><strong>Objective: </strong>The Type 2 diabetes mellitus (T2DM) is one of the key health crises facing the world, with the prevalence expected to surpass 783 million adults by the year 2045. It causes premature disability, death and enormous social and economic costs. It is believed that the number of diabetes mellitus (DM) may increase to 592 million in 2035. Although there are conventional therapies, they are very expensive and limited. Despite the fact drugs that are produced synthetically are effective in controlling the disease, there are some side effects that are related with their long-term use. Consequently, the role of the traditional medicine such as plant extracts and pharmacological compounds derived out of plants is becoming very popular. The purpose of this review is to bring together the existing research on the effectiveness of herbal medicine in treating T2DM and especially phytochemicals based on <i>in vitro</i>, <i>in vivo</i> and clinical studies.</p><p><strong>Methods: </strong>This review is the first to put a list of mechanisms into seven functional domains (1): insulin secretion and 2 -cell protection (2), insulin signaling facilitation (PI3K/Akt, AMPK, GLUT4) (3), carbohydrate digestion inhibition (alpha -amylase, 3 -glucosidase) (4), lipid metabolism control (5), carbohydrate oxidative stress (6), 3 -cell inflammation, and (7) gut microbiota control. It addresses also a wide range of herbal extracts and commercial products in order to estimate their capacity in the symptoms and complications of T2DM alleviation.</p><p><strong>Results: </strong>Some of the plant-derived metabolites, including antidiabetic properties expressed in their antioxidant, alkaloids and polysaccharides, are discussed. Growing evidence shows that phytochemicals control the secretion and activity of glucagon-like peptide-1 (GLP-1) receptor and is another natural way of using incretin-based therapy.</p><p><strong>Conclusion: </strong>The results of the researches suggest that plant-based compounds are effective in the management of T2DM due to different biochemical processes such as restoration of the pancreatic β-cells functions, insulin sensitization, the stimulation of insulin secretion, the inhibition of hepatic gluconeogenesis, enhancement of glucose absorption, and the suppression of G-6-phosphatase, α-amylase, and α-glucosidase activity.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"1-24"},"PeriodicalIF":2.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Link between the Intestinal Microbiome and Th17/Treg Dysregulation in Hashimoto's Thyroiditis, and the Therapeutic Potential of Vitamin D.","authors":"Samantha Flower, Anna Gruvstad Melén, Karin Seidler","doi":"10.1080/27697061.2026.2644894","DOIUrl":"https://doi.org/10.1080/27697061.2026.2644894","url":null,"abstract":"<p><p><b>Objective:</b>Autoimmune disease (AD) has become a leading cause of illness in the twenty-first century, with autoimmune thyroid disease at the forefront of these conditions. Hashimoto's thyroiditis (HT) shares many features with other ADs, including associations with gastrointestinal symptoms linked to intestinal dysbiosis (ID). However, the pathogenesis of HT remains incompletely understood, particularly the role of specific T cell lymphocyte activity. The primary objective of this review was to investigate links between ID and HT pathogenesis, focusing on the relationship between a specific cluster of differentiation 4 (CD4) T cell subsets including T helper 17 (Th17) and regulatory T cells (Treg). A secondary aim was to explore whether vitamin D supplementation may serve as a viable intervention in managing HT, given existing research demonstrating links between Vitamin D status, HT pathogenesis and ID.</p><p><p><b>Methods:</b>A systematic literature search was conducted in PubMed using predefined inclusion/exclusion criteria across three tranches. A search of the review literature pertaining to thyroid autoimmunity, HT and the intestinal microbiome identified 21 papers for inclusion. A mechanistic literature search covering animal, <i>in vitro</i> and human studies on HT, autoimmunity, ID, intestinal microbiota, intestinal permeability (IP) and Th17 yielded 43 papers. A final search of human studies examining vitamin D status or supplementation in relation to ID, IP, Th17 and interleukin (IL)-17 identified 45 relevant papers. Accepted studies were critically appraised and synthesized in a narrative analysis.<b>Results:</b>Evidence across the included studies suggests an association between ID and pathogenesis of HT. Increased IP and alterations in Th17/Treg balance emerged as key contributing mechanisms. Vitamin D status was also associated with immune modulation, particularly involving Th17 activity, and was strongly linked to both ID and HT pathogenesis.<b>Conclusions:</b>ID may play a contributory role in HT pathogenesis through immune modulation involving CD4+ T cell subsets. Vitamin D supplementation demonstrates potential as an adjunctive strategy; however, further targeted human studies are required to clarify causality and therapeutic efficacy.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"1-19"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food Choice Motive Profiles and Nutrition Claims in Brazil: Perceived Healthiness and Substitution Intentions in a Weight-Loss Context.","authors":"Camila de Mello Marsola, Joana Pereira de Carvalho-Ferreira, Natália d'Ottaviano Medina, Diogo Thimoteo da Cunha","doi":"10.1080/27697061.2026.2648561","DOIUrl":"https://doi.org/10.1080/27697061.2026.2648561","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify consumer profiles based on their food choice motivations and their perceptions toward foods with nutrition claims (NCs).</p><p><strong>Methods: </strong>The final sample consisted of 412 Brazilian consumers who answered to an online questionnaire. To measure food choice motives, The Eating Motivation Survey (TEMS) was used. The Three Factor Eating Questionnaire-R21 (TFEQ-R21) was employed to assess cognitive restraint, uncontrolled eating and emotional eating. Participants evaluated pairs of conventional foods and versions with nutrition claims (e.g. chocolate vs sugar-free chocolate, bread vs gluten-free bread, <i>requeijã</i>o (cream-cheese) vs light <i>requeijão</i>, yogurt vs high-protein yogurt, milk vs lactose-free milk) in terms of perceived healthiness and likelihood of substitution in a weight-loss context.</p><p><strong>Results and discussion: </strong>Five clusters were identified, characterized by focus on: a) hedonic aspects, b) overall aspects, c) context, d) health and weight control, e) no concerns. Differences in perceived healthiness between clusters for NC foods were found only for <i>high-protein yogurt</i> and <i>light cream-cheese</i>. No differences were observed between clusters in the likelihood of substituting any conventional food with its NC version in a weight-loss diet context. It was noted that the positive effect of NCs on perceived healthiness influenced all consumer profiles in a similar way.</p><p><strong>Conclusion: </strong>These findings highlight the urgent need to improve public understanding of what NC actually mean and in which dietary contexts substituting conventional foods with claimed alternatives is appropriate. They also reinforce the importance of stricter regulation of NC on ultra-processed foods, so that these messages do not undermine healthy eating and weight-management efforts.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Nutritional Management of Menopausal Symptoms: A Pathophysiological Reasoning Approach to Personalized Nutrition Practice.","authors":"Eleanor Reid, Michelle Barrow, Bea Cutler","doi":"10.1080/27697061.2026.2632580","DOIUrl":"https://doi.org/10.1080/27697061.2026.2632580","url":null,"abstract":"<p><strong>Introduction: </strong>This case report presents the methodology and the outcomes of a Personalized Nutrition intervention with a menopausal female over seven weeks and two online consultations. The report details the pathophysiological reasoning approach to the patient assessment and the recommendation of interventions with the supporting clinical evidence and learnings.</p><p><strong>Case: </strong>A 47 year old working mother (Patient A) with maternal family history (FH) of osteoporosis (OP), a body mass index (BMI) of 24.2 kg/m² and a waist-to-hip ratio (WHR) of 0.86. Patient A had seen her medical practitioner (MP) regarding fatigue, lack of concentration and low mood and was prescribed hormone replacement therapy (HRT). Patient A's sleep and mood remained unstable, and she presented with late afternoon fatigue, lower belly bloating and mild headaches. A chiropractor had diagnosed scoliosis. Patient A was seeking support for energy and bone health. Analysis of dietary recall and frequency data indicated that her current macronutrient intake was contributing to blood sugar imbalance, influencing energy levels and impacting hypothalamic-pituitary-adrenal (HPA) axis function, potentially exacerbated by a change in estrogen levels. A FH of OP encouraged the practitioner to promote bone health. Adjusted macronutrient intake was recommended to support blood sugar balance, increase and sustain energy and promote muscle synthesis. A supplementation plan with regular weight-bearing exercise aimed to support bone mineral density. Caffeine reduction, yoga and meditation to help rebalance the HPA axis. Patient A reported an increase in energy, a reduction in snacking and improved sleep. There was no change to her mood and bloating persisted. Her headaches worsened and the MP prescribed amitriptyline (10 mg) toward the end of the therapy period. Her bone health was not measured.</p><p><strong>Conclusions: </strong>This case provides observational evidence of the potential efficacy of personalized nutrition utilizing pathophysiological reasoning to assess health status, an evidence-based approach to support intervention decisions and coaching skills to embed dietary change.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy Eating Index-2020 and Trabecular Bone Score in US Adults: A Cross-Sectional Analysis of NHANES 2005-2008.","authors":"Huang Yu, Yuting Liu","doi":"10.1080/27697061.2026.2636544","DOIUrl":"https://doi.org/10.1080/27697061.2026.2636544","url":null,"abstract":"<p><strong>Objective: </strong>Osteoporosis is a growing public health burden. Trabecular bone score (TBS) from dual-energy X-ray absorptiometry (DXA) reflects trabecular microarchitecture and predicts fractures beyond bone mineral density (BMD). The relationship between Healthy Eating Index 2020 (HEI-2020) and TBS is unknown.</p><p><strong>Methods: </strong>We modeled the HEI-2020 in relation to TBS in a cross-sectional sample from the National Health and Nutrition Examination Survey (NHANES) 2005-2008 (<i>n</i> = 7,007), using multivariable linear regression, restricted cubic splines for nonlinearity, stratified and interaction analyses for effect modification, and mixture and clustering analyses.</p><p><strong>Results: </strong>Higher HEI-2020 scores were positively associated with TBS. Per 10-point increase: <i>β</i> = 0.0052 (95% CI 0.0026-0.0079). The highest versus lowest tertile had higher TBS (<i>β</i> = 0.0133, 95% CI 0.0063-0.0204; P for trend = 0.0242). The dose-response was linear. Associations were stronger in males and individuals with obesity, with significant interaction by sex (<i>p</i> = 0.0262) and body mass index (BMI; <i>p</i> < 0.0001). Mixture and clustering analyses supported positive dietary pattern effects, with the high-quality dietary cluster showing higher TBS (<i>β</i> = 0.0133, 95% CI 0.0053-0.0212). Sensitivity analyses confirmed robustness.</p><p><strong>Conclusion: </strong>Higher HEI-2020 scores were linearly associated with higher TBS, with effect modification by sex and BMI. While these cross-sectional findings suggest better diet quality may benefit trabecular bone microarchitecture, longitudinal studies are needed to establish causality.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"1-12"},"PeriodicalIF":2.6,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of 31-Day Exogenous Ketone Consumption on Running Performance, Cognitive Function, Metabolism, Body Composition, Hemodynamics, and Mood in Recreational Runners: A Randomized-Control Trial.","authors":"Philip J Prins, Alex Buga, Kristi Storoschuk, Jeffrey D Buxton, Anna K Jenkins, Christofor S Eklund, Victoria C Dacey, Samuel E Belitz, Rachel J Sullivan, Hayden D Gerhart, Dominic P D'Agostino, Jeff S Volek, Andrew P Koutnik","doi":"10.1080/27697061.2026.2636551","DOIUrl":"https://doi.org/10.1080/27697061.2026.2636551","url":null,"abstract":"<p><strong>Background: </strong>Exogenous ketone supplementation acutely elevates circulating beta-hydroxybutyrate (<i>R</i>-BHB), but the impact of chronic repeated dosing on exercise performance, cognition, mood, and cardiometabolic health remains unclear.</p><p><strong>Purpose: </strong>To evaluate the effects of 31 days of thrice-daily ketone monoester (KME) supplementation (90 g/day; high-dose) on exercise performance, executive function, mood, metabolism, body composition, blood pressure, and tolerability in recreational runners.</p><p><strong>Methods: </strong>In a single-blind, randomized-controlled trial, 18 runners consumed either (<i>R</i>)-3-hydroxybutyl (<i>R</i>)-3-hydroxybutyrate (KME; 30 g/dose; <i>n</i> = 9) or an isocaloric, flavor-matched placebo (PLA; 30 g/dose; <i>n</i> = 9) three times daily for 31 days. Outcomes included 5-km time trial (5KTT) performance, cognitive function, mood, body composition, blood pressure, and tolerability. Metabolism and substrate oxidation (rest and graded exercise) were performed after 31-d supplementation was completed to assess metabolic responses following 31 days of repeated exogenous ketone exposure.</p><p><strong>Results: </strong>31-day KME did not alter 5KTT performance, but improved cognitive function, as evidenced by faster Stroop Incongruent (<i>p</i> = 0.015) and Switching task responses (<i>p</i> = 0.038). Mood and quality of life scores were unchanged. Metabolically, the KME reliably elevated post-ingestion R-BHB (∼3.0 mM; <i>p</i> < 0.001) and lowered glycemia by 15% (<i>p</i> < 0.001). After the 31-day KME supplementation stopped, KME-treatment preserved mean absolute VO₂ during graded exercise testing (<i>p</i> = 0.029), without accompanying improvements in running performance.</p><p><strong>Conclusion: </strong>High-dose KME administration for 31-days did not alter running performance, but increased cognitive function and oxygen uptake during maximal graded exercise even after ketone administration stopped, indicating that selected physiological measures differed between groups when assessed after the supplementation period.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":" ","pages":"1-16"},"PeriodicalIF":2.6,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}