Journal of the Academy of Nutrition and Dietetics最新文献

{"title":"Malnutrition Universal Screening Tool is not sufficiently valid in screening for risk of malnutrition in patients with newly diagnosed esophago-gastric cancer: a validation study compared with Patient-Generated Subjective Global Assessment.","authors":"Valeria Rucco, Eva M Grace, Clare Shaw, Amyn Lalji, Kabir Mohammed, H Jervoise N Andreyev, Kevin Whelan","doi":"10.1016/j.jand.2026.156874","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156874","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is prevalent in patients with esophago-gastric cancer and is associated with poorer outcomes. Malnutrition screening tools are used to screen for risk of malnutrition and to determine whether full nutritional assessment is required. The optimal malnutrition screening tool to use in esophago-gastric cancer is unknown.</p><p><strong>Objective: </strong>To assess the validity of the Malnutrition Universal Screening Tool (MUST) in esophago-gastric cancer by measurement of its sensitivity, specificity, positive and negative predictive values for detecting risk of malnutrition.</p><p><strong>Design: </strong>A validation study comparing MUST with full malnutrition assessment using Patient-Generated Subjective Global Assessment (PG-SGA) as the reference standard.</p><p><strong>Participants: </strong>/setting. 80 patients with newly diagnosed esophago-gastric cancer awaiting radical treatment at an oncology specialist hospital (Royal Marsden NHS Foundation Trust, London, United Kingdom) were recruited between December 2011 and June 2013.</p><p><strong>Main outcome measures: </strong>Validity (accuracy) of MUST compared with PG-SGA as a reference method. Association of individual MUST features (BMI, percent weight loss) with PG-SGA score.</p><p><strong>Statistical analyses: </strong>Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MUST compared with PG-SGA. Spearman's rank correlation (ρ) between BMI and percentage weight loss with PG-SGA score.</p><p><strong>Results: </strong>MUST was found to have agreement with PG-SGA in 53/80 (66.3%) patients, misclassifying 19 (23.8%) patients as being at low risk of malnutrition when they were not and 8 (10%) at risk when they were not. MUST demonstrated a sensitivity of 61.2% (95% CI: 46.2-74.8%) and a specificity of 74.2% (95% CI: 55.4-88.1%). PPV for MUST was 78.9% (95% CI: 66.5-87.6%) and NPV was 54.8% (95% CI: 44.6-64.6%). Lower BMI was weakly associated with higher PG-SGA score (correlation -0.259, p=0.021) while greater percentage weight loss was moderately associated with higher PG-SGA score (correlation +0.653, p< 0.001).</p><p><strong>Conclusions: </strong>MUST did not meet a priori criteria (sensitivity and specificity ≥70%) for validation against PG-SGA. MUST is unlikely to be an appropriate malnutrition screening tool in patients with newly diagnosed esophago-gastric cancer.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156874"},"PeriodicalIF":5.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the Prevalence of Foods High in Saturated Fats, Sodium, and Added Sugars among U.S. adults, NHANES 2007-2018.","authors":"Gabriela Vatavuk-Serrati, Katie A Meyer, Lindsey Smith Taillie","doi":"10.1016/j.jand.2026.156834","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156834","url":null,"abstract":"<p><strong>Background: </strong>Foods and beverages high in saturated fats, sodium, and added sugars (HFSS) are often ultra-processed and linked to poor health outcomes, but few studies have investigated their intake.</p><p><strong>Objective: </strong>To describe the trends in the intake of HFSS foods and beverages between 2007 and 2018 in a nationally representative sample of U.S. adults, by sociodemographic characteristics and What We Eat in America food groups.</p><p><strong>Design: </strong>This is a secondary, cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018.</p><p><strong>Participants/setting: </strong>The final sample included 27,984 adults 19 years of age or older from NHANES with at least one complete dietary recall.</p><p><strong>Main outcome measures: </strong>The primary outcomes are the percentage of total energy intake from foods classified as HFSS according to the Pan American Health Organization (PAHO) Nutrient Profile Model.</p><p><strong>Statistical analyses performed: </strong>To estimate the percentage of energy intake from foods and beverages HFSS, linear regression models with interaction terms between cycles and covariates were used.</p><p><strong>Results: </strong>The overall intake of foods and beverages HFSS did not change, representing over 60% of the total energy intake between 2007-2010 and 2015-2018. The intake of foods and beverages high in sodium increased by 2.0 percentage points (95% CI: 0.5, 3.5) and 3.5 percentage points (95% CI: 1.1, 5.8), respectively. The intake of foods and beverages high in saturated fats increased by 6.1 percentage points (95% CI: 4.5, 7.6) and 6.1 percentage points (95% CI: 3.9, 8.2), respectively. The intake of foods and beverages high in added sugars did not change.</p><p><strong>Conclusion: </strong>In the U.S., intake of HFSS foods and beverages is high. Future research should focus on whether public health interventions and policies might reduce the intake of foods high in nutrients of concern.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156834"},"PeriodicalIF":5.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Nutrition Intake Adequacy with Clinical Outcomes in Hospitalized Hematopoietic Cell Transplant Patients: A Retrospective Cohort Study.","authors":"Travis Swiatlo, Nusheen Orandi Garrison, Janette Bedoyan","doi":"10.1016/j.jand.2026.156841","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156841","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing hematopoietic cell transplantation (HCT) face nutrition-impacting symptoms that compromise oral intake and increase malnutrition risk. The independent relationship between nutrition intake adequacy and clinical outcomes in this population remains incompletely characterized.</p><p><strong>Objective: </strong>To determine whether adequate intake (≥75% of estimated needs) during HCT admission is independently associated with hospital length of stay (LOS), 30-day readmission, and acute graft-versus-host disease (GVHD).</p><p><strong>Design: </strong>Twelve-month retrospective cohort study using electronic medical records between June 15, 2022 - June 15, 2023. Nutrition intake was averaged across admission from registered dietitian assessments and categorized as adequate (≥75%) or inadequate (<75%).</p><p><strong>Participants: </strong>/Setting: 283 adults (85 autologous, 198 allogeneic) aged ≥18 years admitted to Stanford Health Care for HCT with a length of stay ≥7 days.</p><p><strong>Main outcome measures: </strong>Hospital LOS, 30-day readmission, and acute GVHD within 100 days.</p><p><strong>Statistical analyses performed: </strong>Multivariable linear regression for LOS and logistic regression for readmission and GVHD, each adjusted for age, gender, race/ethnicity, and BMI.</p><p><strong>Results: </strong>In autologous HCT patients, adequate intake was independently associated with shorter LOS (β = -1.91 days, 95% CI -3.33 to -0.48; P = 0.009), and malnutrition at discharge with longer LOS (β = 1.43 days, 95% CI 0.02 to 2.91; P = 0.04). Sensitivity analyses for autologous HCT patients with adequate intake, excluding patients who received enteral or parenteral nutrition support, did not alter these findings (β = -1.51 days, 95% CI -2.99 to -0.03; P = 0.048). In allogeneic patients, no significant associations were found between intake and LOS after adjustment. Intake was not associated with 30-day readmission or acute GVHD in either group.</p><p><strong>Conclusions: </strong>Among autologous HCT patients, adequate intake was associated with shorter LOS and discharge malnutrition with longer LOS. Optimizing nutritional status may help improve outcomes and reduce hospitalization in this population.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156841"},"PeriodicalIF":5.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Ultra-Processed Foods and Clinical Relapse in Crohn's Disease: A Systematic Review and Meta-Analysis.","authors":"Sunil Samnani, Hiu-Ki Rachel Tran, Kathy Vagianos, Charles N Bernstein, John K Marshall, Neeraj Narula","doi":"10.1016/j.jand.2026.156838","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156838","url":null,"abstract":"<p><strong>Background: </strong>Higher consumption of ultra-processed foods (UPFs) has been linked to an increased risk of developing Crohn's Disease (CD) and is hypothesized to worsen activity of CD through mechanisms such as gut microbiome alterations and increased intestinal permeability.</p><p><strong>Objective: </strong>To assess the association between dietary intake of UPFs and clinical relapse in patients with CD.</p><p><strong>Methods: </strong>A comprehensive search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from database inception to March 18, 2025. At the time of the search, records in the Cochrane Central Register of Controlled Trials were available through February 28, 2025. The study included prospective cohort studies and randomized controlled trials enrolling adults with CD in clinical remission, comparing higher versus lower UPF intake or no UPF, with a minimum follow-up of 6 months. Studies not meeting these criteria, including retrospective designs and non-English publications, were excluded. The primary outcome was clinical relapse within one year. Study quality was assessed using the Newcastle-Ottawa Scale, and overall certainty of evidence was evaluated using the GRADE framework. Pooled odd ratios (ORs) and 95% confidence intervals (CIs) were calculated using DerSimonian-Laird random-effects meta-analysis based on estimates and standard errors. Heterogeneity was assessed using the I² statistic. The publication bias was planned to assess using funnel plots and statistical tests if sufficient studies were available.</p><p><strong>Results: </strong>1945 studies were identified through the search. After removing duplicates, and abstract screening, 13 studies were selected for full-text review and 3 prospective cohort studies involving 276 patients with CD were included in the analysis. Pooled analysis demonstrated a significant association between UPF intake and relapse in patients with CD. Patients with higher versus lower UPF intake had increased odds for clinical relapse (OR 2.27, 95% CI 1.01-5.13, p = 0.048; I² = 20.95%), although the certainty of the evidence was rated as very low according to the GRADE framework.</p><p><strong>Conclusion: </strong>This study suggests that higher UPF intake is associated with increased odds of clinical relapse in patients with Crohn's disease in remission. However, the certainty of evidence is very low, and additional well-designed prospective studies and randomized trials are required before firm dietary recommendations can be made.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156838"},"PeriodicalIF":5.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feeding practices, behaviours and disorders in infants and children with cystic fibrosis: A scoping review.","authors":"Caitlin N Miles, Kristyn E Ford, Cassandra E Gorton, Gillian M Nixon, Zoe E Davidson","doi":"10.1016/j.jand.2026.156836","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156836","url":null,"abstract":"<p><strong>Background: </strong>Feeding practices and behaviours in children with cystic fibrosis (cwCF) are thought to be atypical, with evidence pertaining to lower breastfeeding rates and higher problematic mealtime behaviours compared to the general population. To date, there has been no systematic approach to synthesising this evidence.</p><p><strong>Objective: </strong>This review aims to map the available literature on feeding practices, feeding behaviours and feeding disorders in infants and cwCF.</p><p><strong>Methods: </strong>Six electronic databases (MEDLINE, Embase, Emcare, PsycINFO, Cochrane and CINAHL) were searched on September 13^th, 2024 and last updated on June 16^th, 2026. Studies exploring feeding practices, behaviours and feeding in cwCF 0-12 years, or their parents, were included. The search was limited to English-language and published empirical studies. Two authors independently screened studies for inclusion in a two-staged process and charting followed standardised JBI methodology. Quality appraisal was performed using Critical Appraisal Skills Programme and JBI checklists.</p><p><strong>Results: </strong>The search yielded 6116 articles; 279 full-text studies were screened and 38 were included in the final synthesis. Twenty-two studies described breastfeeding practices, 15 studies described feeding behaviours and 1 study explored feeding disorders in cwCF. Eighty-two percent (31 of 38) were observational studies, 71% (27 of 38) were conducted in the United States. Exclusive breastfeeding rates at 3 months were 14-25%, reducing to 10-16% by 6 months. Problematic mealtime behaviours were twice as common in cwCF, compared to healthy counterparts; 40-43% compared to 21-22%, respectively. Problematic mealtime behaviours were associated with parental stress and authoritarian parenting styles. There were no studies exploring the impact of CF transmembrane conductance regulator modulator (CFTRm) therapy on feeding practices, behaviours or disorders in cwCF.</p><p><strong>Conclusions: </strong>Future research should include breastfeeding exclusivity, duration, support and associated child and maternal health outcomes; strategies for improving the bidirectional relationship between parent and child during feeding and mealtimes; and the impact of early life CFTRm therapy on feeding practices and behaviours in cwCF.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156836"},"PeriodicalIF":5.2,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthfulness of foods and beverages displayed at store checkouts in Southern California, 2023.","authors":"Yuru Huang, Ethan C Wolf, Kris J Matas, Brittany Lemmon, Alejandra Marquez, Lisa M Powell, Rebecca M Schermbeck, Jennifer Falbe","doi":"10.1016/j.jand.2026.156839","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156839","url":null,"abstract":"<p><strong>Background: </strong>Store checkouts are key retail locations that promote impulse purchases of unhealthy foods and beverages. Perris, California, became the second U.S. jurisdiction-following Berkeley, California-to adopt a healthy checkout policy to improve the nutritional quality of items displayed at checkout.</p><p><strong>Objectives: </strong>To assess the healthfulness of food and beverage facings at retail store checkouts in Perris and three neighboring Southern California cities, prior to the implementation of the policy.</p><p><strong>Design: </strong>Cross-sectional observational study using in-store audits on all checkout product facings at sampled checkouts.</p><p><strong>Setting: </strong>Product-level data at checkouts were collected in June 2023 from 19 stores in Perris and 69 matched stores in Moreno Valley, Rialto, and Riverside, California. Stores included chain supermarkets, chain drugstores, chain convenience stores, chain dollar stores, chain mass merchandisers, and independent grocery stores. A total of 42,294 product facings were included in the analysis.</p><p><strong>Main outcome measures: </strong>The main outcome was the proportion of food and beverage facings at checkout in Southern California that met the nutritional standards of Perris' healthy checkout ordinance (HCO). For comparison, the analysis also examined this proportion using Berkeley's HCO standards.</p><p><strong>Statistical analyses performed: </strong>Descriptive analyses and log-binomial regression with robust standard errors clustered by store and checkout location were used to estimate the proportion of healthy food and beverage facings and compare differences by location, store type, and checkout staffing.</p><p><strong>Results: </strong>Only 33% of food and beverage checkout facings were considered healthy under Perris' standards, and only 22% under Berkeley's. The most common food and beverage categories at checkouts were candy (35%), gum (14%), salty snacks (13%), sugar-sweetened beverages (12%), and mints (6%). Water accounted for 2%, and fruits and vegetables for less than 1%. The percentage of checkout foods and beverages meeting Perris' standards was lowest at checkout endcaps and independent grocery stores.</p><p><strong>Conclusions: </strong>Most checkout foods and beverages were unhealthy before the implementation of a healthy checkout policy. To improve checkouts, healthy checkout policies should include the entire checkout (e.g., including endcaps where most SSBs are located) and cogent nutritional standards such as those in Berkeley's HCO.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156839"},"PeriodicalIF":5.2,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary assessment tools and food databases are needed to support research on the health effects of ultra-processed foods and food additives.","authors":"Lisa J Harnack","doi":"10.1016/j.jand.2026.156840","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156840","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156840"},"PeriodicalIF":5.2,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed food consumption and pro-inflammatory potential of the diet: a cross-sectional analysis of the NutriNet-Brasil study, 2020-2025.","authors":"Luciano Pedro da Silva, Eurídice Martinez Steele, Maria Alvim Leite, Thais da Silva Marques, Evelyn Oliveira da Silva Frade, Maria Laura da Costa Louzada, Renata Bertazzi Levy","doi":"10.1016/j.jand.2026.156837","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156837","url":null,"abstract":"<p><strong>Background: </strong>The consumption of ultra-processed foods (UPF) has been associated with diseases in which inflammation plays a key role. The Dietary Inflammatory Index (DII) was developed as a tool to estimate the inflammatory potential of the diet; however, the association between UPF consumption and higher DII scores remains insufficiently explored.</p><p><strong>Objective: </strong>To investigate the association between UPF consumption and the DII.</p><p><strong>Design: </strong>This was a cross-sectional study.</p><p><strong>Participants: </strong>/Setting: Data from 36,669 adults enrolled in the NutriNet-Brasil cohort between 2020 and 2025 were analyzed.</p><p><strong>Main outcome measures: </strong>The outcome was the DII, calculated as proposed in previous studies, based on dietary components such as macronutrients, vitamins, minerals, and bioactive compounds STATISTICAL ANALYSES: UPF contribution to energy intake was estimated using the mean of 2-3 24-hour recalls (Nova24h). Associations between UPF consumption (percentage of energy, in quintiles and as a continuous variable) and the DII were analyzed using multiple linear regression models.</p><p><strong>Results: </strong>The mean DII was 1.31 (95% CI: 1.28-1.33) and mean UPF contribution was 22.7%, ranging from an average of 7.50% (Q1) to 41.14% (Q5). In adjusted models, the DII increased linearly across quintiles of UPF intake (p for linear trend < 0.001). The estimated DII score in the highest quintile (Q5: 2.57) was eleven times higher than in the lowest quintile (Q1: 0.22), demonstrating a strong positive association between UPF consumption and the pro-inflammatory potential of the diet. As a continuous variable, each 10% increase in UPF energy was associated with a 0.70-point higher DII (p <0.001).</p><p><strong>Conclusions: </strong>Higher UPF consumption was associated with a more pro-inflammatory dietary pattern. These findings highlight the potential role of UPF consumption in shaping the inflammatory potential of the diet and support further research on its implications for diet-related health outcomes.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156837"},"PeriodicalIF":5.2,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dietary Inflammatory Index is Lower Among Healthy Older Adults Consuming a Walnut-Supplemented Diet. Ancillary Results from the Walnuts and Healthy Aging Randomized Controlled Trial.","authors":"Lynnley Huey Stern, Jayme Brisco, Karen Jaceldo-Siegl, David Shavlik, Joan Sabate, Mercè Serra-Mir, Montserrat Cofán, Aleix Sala-Vila, Emilio Ros, Michael D Wirth, James R Hebert, Sujatha Rajaram","doi":"10.1016/j.jand.2026.156835","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156835","url":null,"abstract":"<p><strong>Background: </strong>Walnuts may lower diet-related inflammation by providing anti-inflammatory compounds and displacing pro-inflammatory nutrients.</p><p><strong>Objective: </strong>To explore the association between daily walnut consumption or abstention for 2 years and the Dietary Inflammatory Index (DII®).</p><p><strong>Design: </strong>The Walnuts and Healthy Aging (WAHA) study is a dual-center (Loma Linda, California, USA and Barcelona, Spain), randomized trial, comparing a walnut-rich diet with a control diet over 2 years between May 2012 to May 2016, for age-related outcomes in healthy, free-living older adults aged 63-79 y. This ancillary study concerned only the Loma Linda cohort.</p><p><strong>Participants/setting: </strong>A total of 319 older adults (mean age 69 y, 66% women) from Loma Linda, Ca were randomly assigned to walnut (n = 166) or control (n = 153) diets.</p><p><strong>Intervention: </strong>The walnut group consumed 1-2 oz walnuts/day (30-60 g/day, ∼15% of energy), while the control group abstained from walnuts and limited other nuts to <2 servings/week. Both groups followed their usual background diet.</p><p><strong>Main outcome measures: </strong>DII scores were calculated from five 24-hour dietary recalls taken at random during the 2-year period.</p><p><strong>Statistical analyses performed: </strong>Linear mixed models tested DII differences between the walnut and control groups, adjusting for sex, age, BMI, race, energy intake, smoking status, physical activity, and educational attainment.</p><p><strong>Results: </strong>The mean DII (SE) score was -0.025 (0.14) in the walnut group and 0.615 (0.14) in the control diet group (p<0.01). At the nutrient level, n-3 PUFAs (ß=-0.291; 95%CI: -0.450, -0.132; p<0.01), magnesium (ß=-0.014; 95%CI: -0.015, -0.013; p<0.01), carbohydrate (ß=-0.009; 95%CI: -0.014, -0.005; p<0.01), fiber (ß=-0.120; 95%CI: -0.133, -0.106; p=0.05), and protein (ß=-0.020; 95% CI: -0.031, -0.008; p<0.01), were associated with a more anti-inflammatory DII score, while intake of total and saturated fat were associated with a higher, more proinflammatory, DII score (ß=0.033; 95%CI: 0.020, 0.045; p<0.01 and ß=0.102; 95%CI: 0.080, 0.125; p<0.01 respectively).</p><p><strong>Conclusion: </strong>Incorporating walnuts into the habitual diet was associated with more anti-inflammatory DII scores compared with a walnut-free control diet. These findings suggest that adding a single whole food may be a feasible complementary strategy for favorably improving the inflammatory potential of a diet.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156835"},"PeriodicalIF":5.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life Course Dietary Insulinemic and Inflammatory Potential and Risk of Type 2 Diabetes in U.S. Women: A Prospective Cohort Study.","authors":"Yin Zhang, Mingyang Song, Molin Wang, Emily Riseberg, Dong D Wang, Deirdre K Tobias, Fred K Tabung, A Heather Eliassen, Stephanie A Smith-Warner, Qi Sun, Eric B Rimm, Meir J Stampfer, Walter C Willett, Frank B Hu, Edward L Giovannucci","doi":"10.1016/j.jand.2026.156831","DOIUrl":"10.1016/j.jand.2026.156831","url":null,"abstract":"<p><strong>Background: </strong>The timing of exposure to diet across the lifespan may be critical in the development of T2D. However, no previous study has deciphered the influence of dietary insulinemic and inflammatory potential on the risk of T2D across the lifespan from a life course perspective.</p><p><strong>Objective: </strong>This study aimed to evaluate the associations of dietary insulinemic and inflammatory potential with the risk of T2D from a life course perspective.</p><p><strong>Design: </strong>This was a prospective cohort study.</p><p><strong>Participants and setting: </strong>Data from 40,135 eligible, female participants in the Nurses' Health Study II were analyzed. Adulthood diet was assessed quadrennially since 1991 using 131-item food frequency questionnaires (FFQ), and adolescent diet was recalled in 1997 using a 124-item high-school FFQ. The main exposures were empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) scores across different life stages (adolescence, premenopausal adulthood, postmenopausal adulthood) and changes and cumulatively over the lifetime.</p><p><strong>Main outcome measures: </strong>The main outcome was incident T2D.</p><p><strong>Statistical analyses performed: </strong>Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Higher EDIH and EDIP scores (highest vs lowest quintiles) were associated with increased lifetime risk of T2D as a lifetime average (HR, 95%CI: 2.72, 2.38-3.11 and 2.04, 1.81-2.30), during premenopausal adulthood (3.18, 2.52-4.01 and 2.31, 1.88-2.82), and postmenopausal adulthood (2.67, 2.15-3.33 and 1.70, 1.41-2.05), but not during adolescence (1.07, 0.95-1.20 and 1.10, 0.98-1.24). The HR, 95%CI associated with higher lifetime averages for both EDIH and EDIP (vs. low lifetime averages for both, based on tertiles) was 2.64 (2.32-3.01). Individuals with high adulthood EDIH or EDIP had similar magnitudes of lifetime risk elevation, regardless of their adolescent EDIH and EDIP status. Adolescent EDIH and EDIP were associated with a slightly increased premenopausal T2D risk (1.24, 1.02-1.51, and 1.24, 1.02-1.50). In additional analyses estimating the time window during which adulthood dietary insulinemic and inflammatory potential influences T2D risk, higher adulthood EDIH or EDIP was associated with an increased risk of T2D with a very short time lag.</p><p><strong>Conclusions: </strong>Over the life course in women, high dietary insulinemic and inflammatory potential in both premenopausal and postmenopausal adulthood were independently associated with a substantially increased lifetime risk of T2D. Adulthood offers the most critical time window for dietary interventions to reduce lifetime T2D risk, though adolescent diet may influence the risk of premenopausal T2D.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156831"},"PeriodicalIF":5.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}