BMJ Nutrition, Prevention and Health最新文献

{"title":"User experience and feasibility of CVD risk models: a study on clinician and patient expectations, and implementation in primary healthcare with P-CARDIAC pilot study in Hong Kong.","authors":"Celine S L Chui, Celia Jiaxi Lin, Natalie Tsie, Marco Lee, Ashley Ching Yau Kwok, Judy Lee, Bonnie Leung, Meyone Yuen Tung Ng, Alston Conrad Chiu, Emmanuel Chun Ka Wong","doi":"10.1136/bmjnph-2025-001345","DOIUrl":"10.1136/bmjnph-2025-001345","url":null,"abstract":"<p><strong>Background: </strong>A newly developed machine-learning-driven cardiovascular disease (CVD) risk prediction tool, the Personalised CARdiovascular DIsease risk Assessment for Chinese (P-CARDIAC), tailored for the Hong Kong population, has demonstrated superior predictive performance compared with existing risk prediction tool. This study aims to explore the acceptability and expectations of P-CARDIAC among clinicians and the general public, and to assess its feasibility within pharmacist-led services in local primary healthcare systems.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to investigate the awareness and expectations of risk prediction tools among clinicians and the general public. A pragmatic pilot study was carried out to implement P-CARDIAC in pharmacist-led services at local primary healthcare centres. Data analysis included descriptive statistics, univariate regression modelling and reliability assessments of validated measurement scales.</p><p><strong>Results: </strong>For the cross-sectional study, a total of 113 of the general public and 17 clinicians responded to the questionnaire. The general public demonstrated low awareness but high health-seeking behaviour related to CVD risk prediction tools. Clinicians, especially cardiologists, reported limited experience with such tools due to unavailability and limited user-friendliness. In the pilot study, 15 participants engaged with pharmacist-led services incorporating P-CARDIAC. They expressed positive perceptions of the tool, believing that it could support better medication adherence and disease management. The pharmacist-led services incorporating P-CARDIAC were well-received by participants.</p><p><strong>Conclusion: </strong>P-CARDIAC demonstrates promise as a local risk prediction tool to enhance cardiovascular care in Hong Kong. The study underscores the importance of improving awareness and adoption of such CVD risk tools.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001345"},"PeriodicalIF":2.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654450","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":"Dietary and non-dietary factors of undernutrition using Composite Index of Anthropometric Failure in children aged 6-23 months in Democratic Republic of the Congo: the 2023 National Nutrition Survey.","authors":"Richard Makaba Ma Eloko, Marcel Mubelo Aspro, Emérite Disuemi Bisita, Botomba Ntambwe Steve, Bernard-Kennedy Nkongolo, Mayavanga Jean Baptiste Bazana, Nahimana Damien Gitebo, Bindama Senge Bruno, Mapatano Mala Ali, Marie-Claire Muyer Muel","doi":"10.1136/bmjnph-2025-001393","DOIUrl":"10.1136/bmjnph-2025-001393","url":null,"abstract":"<p><strong>Introduction: </strong>Undernutrition remains a significant public health challenge in the Democratic Republic of Congo (DRC). This study aims to identify dietary and non-dietary factors associated with undernutrition among children aged 6-23 months using the Composite Index of Anthropometric Failure.</p><p><strong>Methodology: </strong>The secondary analysis was conducted using data from the 2023 National Nutrition Survey, a nationally representative cross-sectional study. The final analytical sample consisted of 5396 children, stratified into two age bands 6-11 months (n=1792) and 12-23 months (n=3604). Bivariate analysis (p<0.2), Multivariable logistic and stepwise regression models (p<0.05) were used to identify factors associated with undernutrition.</p><p><strong>Results: </strong>The overall prevalence of undernutrition was 47.4%, rising significantly from 37.4% in infants aged 6-11 months to 52.6% in children aged 12-23 months. Stepwise logistic regression identified distinct risk profiles: for the 6-11 month group, male sex (adjusted OR (aOR)=1.7; 95% CI 1.3 to 2.1) and larger households with >2 children (aOR=1.3; 95% CI 1.1 to 1.6) increased the undernutrition, while acceptable minimum meal frequency (MMF) was the primary protective factor (aOR=0.12; 95% CI 0.08 to 0.19). Among the 12-23 month, high dietary diversity (aOR=0.5; 95% CI 0.4 to 0.7), acceptable MMF (aOR=0.6; 95% CI 0.5 to 0.8) and maternal education significantly reduced undernutrition. Conversely, rural residency, recent diarrhoea (aOR=1.4; 95% CI 1.2 to 1.7) and poor hand hygiene remained major factors associated with undernutrition.</p><p><strong>Conclusion: </strong>Traditional indices significantly underestimate the true nutritional burden in the DRC. These findings underscore the need for a National Nutrition Programme to implement multisectoral interventions that prioritise maternal literacy and the integration of Water, Sanitation and Hygiene protocols to address the diverse drivers of undernutrition.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001393"},"PeriodicalIF":2.6,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654416","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":"Diet diversity during complementary feeding and childhood acute respiratory infection and diarrhoea in rural China.","authors":"Qianling Zhou, Xing Lin Feng","doi":"10.1136/bmjnph-2025-001299","DOIUrl":"10.1136/bmjnph-2025-001299","url":null,"abstract":"<p><strong>Objective: </strong>Childhood acute respiratory infections (ARI) and diarrhoea are prevalent and have placed significant medical burden on the society. This study was conducted to examine the associations between maternal feeding practices and childhood ARI and diarrhoea in rural China. To allow wider comparison across studies, the most recent WHO feeding indicators were adopted.</p><p><strong>Design: </strong>A prospective cohort study (n=629).</p><p><strong>Setting: </strong>Five rural regions of China.</p><p><strong>Participants: </strong>Multi-stage stratified random cluster sampling was applied to recruit mothers who had given live birth to their child within 6 months. A baseline survey was conducted in participants' houses or village health centres between January 2014 and August 2016. A follow-up survey was conducted with all participants through telephone interviews from January 2017 to September 2018.</p><p><strong>Results: </strong>The prevalence of childhood ARI and diarrhoea during the past 2 weeks at follow-up was 14.2% and 11.4%, respectively. Poor complementary feeding practices were found, with only 33.1% and 22.3% of mothers feeding their children with sufficient diet diversity (MDD) and meeting the WHO requirement of minimal acceptable diet (MAD), respectively. Logistic regression analyses demonstrated that MDD was associated with a lower risk for childhood ARI (adjusted OR=0.39, 95% CI 0.17 to 0.93) and diarrhoea (adjusted OR=0.38, 95% CI 0.15 to 0.93). MAD was protective for childhood diarrhoea (adjusted OR=0.36, 95% CI 0.14 to 0.94).</p><p><strong>Conclusion: </strong>Interventions to ensure children's diet diversity during complementary feeding stage might be useful to prevent and reduce childhood ARI and diarrhoea in rural areas.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001299"},"PeriodicalIF":2.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654352","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":"Student-led teaching and learning initiatives in nutrition education for medical and health students: a scoping review.","authors":"Sean Yong, Lauren Ball, Jørgen Torgerstuen Johnsen, Breanna Lepre","doi":"10.1136/bmjnph-2025-001264","DOIUrl":"10.1136/bmjnph-2025-001264","url":null,"abstract":"<p><strong>Background: </strong>Unhealthy diets are a leading cause of death, yet nutrition education for medical and healthcare professionals remains inadequate internationally. Beyond 'top-down' curriculum and accreditation initiatives, student-led teaching and learning initiatives typically commence to fill curricular gaps. This scoping review aimed to synthesise evidence on student-led nutrition education initiatives for medical and health students.</p><p><strong>Methods: </strong>Following <i>JBI</i> methodology for scoping reviews, MEDLINE, Embase, CINAHL, ERIC and Web of Science were searched for studies from any country and year that related to student-led nutrition education initiatives for medical and health students. A grey literature search ensured a comprehensive overview of available literature. Data were synthesised narratively.</p><p><strong>Results: </strong>Twenty articles published between 2012 and 2024 were included, and most were from the USA (n=15). Student-led nutrition education initiatives included culinary education (n=11, 55%), placement opportunities (n=10, 50%), lecture series (n=7, 35%) and student interest groups (n=6, 30%). Twelve studies (60%) included more than one type of initiative. Initiatives mostly targeted medical students (n=13, 65%), and four were interdisciplinary (20%). Studies included students from undergraduate or preclinical years through to practising health professionals. Initiatives were delivered by students, physicians, dietitians, and other health professionals, mostly in-person (n=12, 60%) within university (n=12, 60%) or community (n=7, 35%) settings. Thirteen studies evaluated the initiative(s) using questionnaires (n=10, 50%), informal feedback (n=2, 10%) or focus groups (n=1, 5%). Of these, seven studies (54%) reported improved confidence and competence in nutrition among the students involved.</p><p><strong>Conclusions: </strong>Student-led nutrition education initiatives are likely to be well received and may improve nutrition competence. These initiatives are a promising approach to address the persistent gap in nutrition education for medical and health students.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001264"},"PeriodicalIF":2.6,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654469","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":"Optimising enteral feeding prevents postnatal growth faltering in preterm infants: a retrospective cohort study.","authors":"Gabriella Esperanza Gegel, Rachel Jacob, Cynthia Blanco, Alvaro Moreira","doi":"10.1136/bmjnph-2025-001425","DOIUrl":"10.1136/bmjnph-2025-001425","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in neonatal care, many preterm infants continue to experience growth faltering, with long-term consequences. We aimed to identify early, modifiable feeding-related risk factors and develop machine learning models to predict growth faltering at discharge.</p><p><strong>Methods: </strong>We retrospectively analysed 700 preterm infants (≤34 weeks gestational age (GA), ≤1800 g birth weight (BW)) admitted to a single level IV neonatal intensive care unit between 2014 and 2022, representing a relatively homogeneous population with standardised feeding practices. Over 100 demographic, clinical and nutritional variables, including parenteral and enteral intake during the first 28 days, were evaluated. Growth faltering was defined as a longitudinal decline in weight z-score of ≥1.2 SD from birth to 36 weeks postmenstrual age, rather than an absolute cross-sectional threshold. Supervised machine-learning models were trained using a 70% training and 30% testing split.</p><p><strong>Results: </strong>Growth faltering occurred in 17.7% (n=124). Affected infants had lower GA, lower BW and greater oxygen dependence at day of life 28 (all p<0.001). Although both enteral feeding volume and caloric intake were lower among infants with growth faltering, differences in enteral volume emerged earlier and persisted more strongly over time. The final predictive model demonstrated good discrimination (area under the curve=0.85). In adjusted models evaluating individual nutritional exposures, both enteral feeding volume and caloric intake were significantly associated with reduced odds of growth faltering. However, enteral volume demonstrated earlier divergence and a greater consistency across time points.</p><p><strong>Conclusions: </strong>Although both volume and caloric intake were significant when modelled independently, enteral feeding volume emerged as the more robust and clinically informative predictor, likely reflecting feeding tolerance and advancement decisions. Combining dynamic nutritional monitoring with artificial intelligence-based prediction tools may enable earlier identification of at-risk infants and guide individualised nutrition strategies.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001425"},"PeriodicalIF":2.6,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654513","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":"Influence of milk and dairy products on wound healing after wisdom teeth removal: a prospective clinical study.","authors":"Antigona Aliu, Norbert R Kübler, Rita Depprich, Andre Zimmermann, Julian Lommen, Felix Schrader, Max Wilkat","doi":"10.1136/bmjnph-2025-001432","DOIUrl":"10.1136/bmjnph-2025-001432","url":null,"abstract":"<p><p>The oral cavity poses a challenging surgical site due to physiologically high bacterial load and limited disinfection efficacy, attributed to biofilm-promoting surfaces of teeth and saliva. To minimise postoperative wound healing complications, clinicians in German-speaking countries traditionally advise against the consumption of milk and dairy products following dental, oral and maxillofacial (OMF) surgery. Although primarily rooted in historical tradition, the belief that milk impairs wound healing remains prevalent. Therefore, this study aims to evaluate the impact of milk and dairy product consumption on intraoral wound healing following elective surgical removal of impacted third molars. This prospective, controlled, single-blinded clinical trial analysed data from 157 healthy patients who underwent surgical removal of impacted third molars. Participants were randomised to either consume milk and dairy products at least three times per day (experimental group; n=77) or completely avoid dairy (control group; n=80) during a 7-day postoperative period. Wound healing was assessed using the adapted ASEPSA (Additional treatment, Serous exudate, Erythema, Purulent exudate, Separation of deep tissue, Admission to the hospital) wound scoring system. The total follow-up period was 3 months to monitor for late wound healing complications. The majority of patients (90,4%; n=142), regardless of group allocation, achieved an ASEPSA score of 0, indicating undisturbed wound healing. The overall postoperative complication rate was 7.0% (n=11), with a higher incidence observed in the control group (n=8) compared with the dairy group (n=3) (p>0.05). Specifically, the rate of infectious complications was 2.5% (n=4), with no evidence of an increased infection risk associated with dairy consumption. These findings do not support the assumption that milk consumption impairs wound healing. Postoperative intake of milk and dairy products was not associated with an increased rate of wound healing disturbances or infectious complications. Moreover, the dairy-containing diet was perceived as less restrictive and contributed to greater patient comfort. Consequently, the recommendation to avoid milk following oral surgery can no longer be justified.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001432"},"PeriodicalIF":2.6,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654397","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":"Vitamin E intake and all-cause mortality: associations modified by smoking cessation duration in a US national cohort.","authors":"Eunjin Bae, Kyungho Ha, Yaerim Kim, Jeonghwan Lee, Seun Hyun Han, Dong Ki Kim, Chun Soo Lim, Jung Pyo Lee","doi":"10.1136/bmjnph-2025-001435","DOIUrl":"10.1136/bmjnph-2025-001435","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the association between vitamin E intake, its serum levels and all-cause mortality by smoking status.</p><p><strong>Participants: </strong>This study included 30280 adults from National Health and Nutrition Examination Survey (NHANES) 1999-2014. We categorised participants into current smokers, former smokers and non-smokers.</p><p><strong>Measurements: </strong>Vitamin E intake was assessed via a 24-hour dietary recall and categorised into tertiles. Serum vitamin E levels (alpha-tocopherol) were measured using high-performance liquid chromatography. Mortality data were obtained through linkage to the National Death Index.</p><p><strong>Results: </strong>During a median follow-up of 119.7 months, 15.4% of participants experienced all-cause mortality. The former smokers were the oldest and had the highest proportions of men, hypertension, diabetes mellitus and chronic kidney disease. This group had the highest Body Mass Index, serum cholesterol, uric acid and urinary albumin creatinine ratio. The proportion of participants who met the recommended dietary allowance (RDA) of vitamin E was only 2491 (8.3%), and the RDA meeting rate was highest in the order of non-smokers, former smokers and current smokers. Cox regression analysis revealed that higher vitamin E intake was associated with lower mortality risks in former smokers and non-smokers, but not in current smokers. The association between vitamin E intake and mortality in former smokers was observed, particularly those who had quit smoking for more than 20 years. Serum vitamin E levels were associated with mortality only in non-smokers.</p><p><strong>Conclusions: </strong>Vitamin E intake was not associated with a lower mortality risk in current smokers but was associated with lower mortality risk in former smokers and non-smokers. This finding suggests the importance of smoking cessation and the potential benefits of antioxidant vitamin E in former smokers.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001435"},"PeriodicalIF":2.6,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654571","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":"Predicting pre-diabetes progression: a systematic review and meta-analysis.","authors":"Kate Meads, Pranav Machiraju, Yumeng Shi, Stephen Colagiuri","doi":"10.1136/bmjnph-2024-000877","DOIUrl":"10.1136/bmjnph-2024-000877","url":null,"abstract":"<p><strong>Background: </strong>Pre-diabetes is a well-known risk factor for diabetes, a major contributor to morbidity and mortality globally. Identifying patients at highest risk of developing diabetes facilitates early intervention. There is no consensus on diagnostic criteria, with no single modality or range shown to be most predictive of progression to diabetes.</p><p><strong>Purpose: </strong>This systematic review and meta-analysis aimed to determine which single or combination biochemical test(s) and definition of pre-diabetes best predict progression to diabetes.</p><p><strong>Methods: </strong>Following primary screening of 11 980 papers from MEDLINE, Embase and Global Health, 40 original studies published between 2006 and 2024 looking at adults with pre-diabetes were included. Children, pregnant patient populations and groups with significant morbidity were excluded. Risk of bias was assessed with the JBI Critical Appraisal Checklist.</p><p><strong>Results: </strong>Our meta-analysis demonstrated the highest risk of progression to diabetes in the impaired fasting glucose (IFG) 6.1-6.9 mmol/L group, with an HR of 9.0 (4.6 to 13.5). Descriptive statistics identified the combination of IFG 6.1-6.9 mmol/L + impaired glucose tolerance + HbA1c 6.0%-6.4% had the highest percent incidence of diabetes per year, at 15.2%. Generally, combination tests were associated with higher progression rates.</p><p><strong>Conclusions: </strong>Certain single and combination biochemical test combinations may allow better identification of patients with pre-diabetes likely to progress to diabetes. To our knowledge, this is the first systematic review evaluating all testing combinations of these categories in progression and comparing pre-diabetes states as defined by multiple guidelines. This study (PROSPERO CRD42022312640) did not receive funding.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e000877"},"PeriodicalIF":2.6,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654430","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":"Hydration and primary headaches in children and adolescents: a prospective interventional study.","authors":"Patricija Kunstek, Neli Bizjak, Damjan Osredkar, Uroš Godnov, Mary Fewtrell, Evgen Benedik","doi":"10.1136/bmjnph-2025-001341","DOIUrl":"10.1136/bmjnph-2025-001341","url":null,"abstract":"<p><strong>Objective: </strong>Primary headaches are a prevalent health concern among children and adolescents, often affecting their quality of life. Emerging evidence suggests that hydration status may play a role in primary headache occurrence and severity. This study aimed to evaluate the impact of hydration on headache characteristics in children and adolescents with primary headaches.</p><p><strong>Methods: </strong>A total of 60 children and adolescents diagnosed with primary headaches were enrolled from the outpatient Headache Clinic of the Department of Paediatric Neurology at the University Children's Hospital, University Medical Centre Ljubljana, Slovenia, between May and September 2023. Participants received personalised hydration recommendations based on established Slovenian dietary guidelines and guidance on appropriate fluid choices. The primary outcome was headache frequency, intensity, and duration, measured at baseline and after the four-month intervention using a headache questionnaire. Fluid intake was assessed using a Food Frequency Questionnaire, while hydration status was evaluated in a sub-group (n=28) using bioelectrical impedance analysis.</p><p><strong>Results: </strong>Following the four-month intervention, participants demonstrated a significant increase in daily fluid intake from 5-8 glasses/day (one glass=200 mL) to 8-10 glasses/day (p<0.001), which was associated with a reduction in primary headache frequency (1-2 times/week to 3 times/month; p<0.001) and headache intensity (7/10-5/10; p<0.001). However, no significant effect was observed on headache duration (3 hours/headache to 2 hours/headache; p=0.19). Following the intervention, hydration status improved, as evidenced by significant increases in median total body water and extracellular water (p<0.001 and p=0.007, respectively), while the total body water to extracellular water ratio remained unchanged.</p><p><strong>Conclusions: </strong>This study provides novel evidence supporting adequate fluid intake and hydration as a non-pharmacological intervention for reducing primary headache frequency and intensity in paediatric populations.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001341"},"PeriodicalIF":2.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654368","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":"Effect of a low-carbohydrate diet on glycaemic control and disease management in type 2 diabetes: results from a prospective free-living trial.","authors":"Sineaid Collins, Jane Ogden, Denise Robertson, Martin Whyte","doi":"10.1136/bmjnph-2025-001353","DOIUrl":"10.1136/bmjnph-2025-001353","url":null,"abstract":"<p><strong>Background: </strong>Low-carbohydrate diets (LCD) improve glycaemic control (HbA1c) and weight in individuals with type 2 diabetes (T2D). Few studies have explored both the quantitative effects and qualitative experiences of individuals following LCD.</p><p><strong>Methods: </strong>Single-arm, prospective, observational study of a carbohydrate-reduced diet (CRD) on HbA1c, weight and the acceptability in people with T2D and HbA1c ≥6.5% (48 mmol/mol). Participants were recruited from general practitioner surgeries and enrolled in an eight-session CRD health coaching programme delivered by The Lifestyle Club, with follow-up over 6 months. Blood samples, anthropometric data and dietary adherence were measured at baseline and at 6 months. Participants were informed about the semi-structured interviews at consent and invited after visit 2.</p><p><strong>Results: </strong>Forty-eight participants were included (mean age 67±10 years; 55% male). Carbohydrate intake decreased from 226.0 g/day at baseline to 126.3 g/day at 6 months (p<0.001) and the proportion of energy from carbohydrates decreased from 42.6% to 29.7% (p<0.001). HbA1c decreased from 60.0±12.9 mmol/mol to 49.7±9.0 mmol/mol at 6 months (p<0.001). Mean body weight decreased by 5.2±4.4 kg (p<0.001), and body mass index decreased from 30.6±6.5 kg/m² to 28.8±5.7 kg/m² (p<0.001). No significant changes were observed in lipids or blood pressure. Regression analyses showed an association between weight loss and HbA1c normalisation (OR 1.413, p=0.002), but no relationship was found between carbohydrate intake and changes in HbA1c. Qualitative interviews revealed that motivation and empowerment were central to adherence; participants cited health improvements and reduced medication as key motivators. Challenges included social dynamics and domestic routines; older participants and those with significant comorbidities reported greater difficulties in maintaining the diet.</p><p><strong>Conclusions: </strong>CRD was associated with reduced HbA1c and weight. Weight loss was associated with HbA1c normalisation; however, no independent statistical relationship was observed between carbohydrate reduction and glycaemic outcomes. HbA1c normalisation often occurred with LCD, suggesting it is a viable option for individualised care alongside other dietary approaches in T2D.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"9 1","pages":"e001353"},"PeriodicalIF":2.6,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654343","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}