Journal of the Academy of Nutrition and Dietetics最新文献

{"title":"Recognizing Excellence in Nutrition and Dietetics Practice: Updates to the Center of Excellence Designation.","authors":"Emily Pacetti, Angela Lago, Tamaire Ojeda","doi":"10.1016/j.jand.2026.156888","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156888","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156888"},"PeriodicalIF":5.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029519","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":"Methodology for Adding Heme Iron and Non-Heme Iron to a Food and Nutrient Database and Dietary Analysis Software.","authors":"Bhaskarani Jasthi, Janet Pettit, Lisa Harnack","doi":"10.1016/j.jand.2026.156880","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156880","url":null,"abstract":"<p><strong>Background: </strong>Including both heme and non-heme forms of iron in food and nutrient databases is important because they differ in bioavailability and potentially have differential health impacts.</p><p><strong>Objective: </strong>The study describes the methodology used for assigning heme and non-heme iron values to foods in the University of Minnesota Nutrition Coordinating Center (NCC) Food and Nutrient Database.</p><p><strong>Design: </strong>/Methods: The NCC Database includes about 19,500 foods, and heme and non-heme iron values (mg/100g) were assigned to foods using a multi-step process: (1) Reviewed scientific literature and international food composition databases to gather analytical data; (2) Assigned values to the core foods based on the above sources and imputation rules; (3) For non-core foods, values were assigned using the NCC Food Calculation program; and (4) As a quality assurance measure, all assigned values were systematically reviewed for consistency across NCC food groups.</p><p><strong>Results: </strong>In the 2025 version of the NCC Database, heme and non-heme iron values were assigned to all foods, with no missing values. Core foods with zero total iron were assigned 0 mg for both forms of iron (14% of core foods). For eggs, dairy, and plant foods with iron content, 100% of the iron was assigned as non-heme (68% of core foods). For meats and seafoods, heme iron was calculated based on literature heme-to-total iron ratios, and non-heme iron was determined by subtraction of heme iron from total iron (18% of core foods). Imputation was required for 24% of the meat and seafood core foods.</p><p><strong>Conclusions: </strong>The methodology used to add heme and non-heme iron to the NCC Database resulted in complete data, though imputation was required for some meats and seafoods.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156880"},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015181","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":"Exploring the Dimensions and Nature of Clinical Decision Making Among Doctorally Prepared Dietitians Practicing in the Acute Care and Ambulatory Setting: A Rapid Ethnography Study.","authors":"Shelby Yaceczko, Pamela Rothpletz-Puglia, Laura D Byham-Gray, Jane Ziegler","doi":"10.1016/j.jand.2026.156878","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156878","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision making (CDM) driven by evidence-based practice promotes positive outcomes in health care. Little is known about CDM among doctorally prepared dietitians (i.e., those clinicians who practice at an advanced level), and a better understanding may lead to improvements in patient care and dietetics education.</p><p><strong>Objective: </strong>To explore the key dimensions and the nature of doctorally prepared dietitians' clinical decision making.</p><p><strong>Design: </strong>To capture the complexities of CDM throughout 10 workdays, a rapid ethnographic study was conducted using multiple data collection methods, including the critical incident technique and two validated questionnaires, the Health Sciences Reasoning Test (HSRT) and the California Critical Thinking Disposition Inventory (CCTDI). Participant Setting PARTICIPANTS: (N=10) were recruited through purposeful sampling of dietitians from a doctoral nutrition program database. They were required to have completed all components of a Doctor of Clinical Nutrition degree and work in either an acute-care or ambulatory setting for at least 20 hours per week.</p><p><strong>Analysis: </strong>Performed The critical incidents reflecting on a memorable patient care experience were analyzed using thematic analysis. Two questionnaires (HSRT and CCTDI) assessed distributions of critical thinking skills (analysis, interpretation, inference, evaluation, explanation, induction, deduction, numeracy) and dispositions (truth-seeking, open-mindedness, analyticity, systematically, confidence in reasoning, inquisitiveness, maturity of judgement).</p><p><strong>Results: </strong>Forty critical incidents were collected. Dietitians worked an average of 31.8 hours weekly with equal representation from acute-care and ambulatory care settings and have been in practice an average of 13.9 years. The critical incidents yielded four themes characterizing doctorally prepared dietitians' decision making in practice, and they included: (1) adaptive learning, (2) delivery of patient-centered care, (3) display of situational leadership, and (4) upholding of ethical practice. HSRT and CCTDI data reported positive or strong average classifications among critical thinking and disposition skills; however, there is a potential opportunity for growth in interpretation, deduction, and numeracy skills.</p><p><strong>Conclusion: </strong>Doctorally prepared dietitians develop advanced level skills and leverage evidence-based research to drive CDM in practice. Understanding the nature of dietitian decision making may help better support dietitian retention, professional development, and the necessary professional training and education required to provide effective patient care.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156878"},"PeriodicalIF":5.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987517","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":"Barriers and Facilitators of Implementing an Online Weight Loss Program and App with Patients: A Qualitative Study of Registered Dietitian Nutritionists' Perspectives.","authors":"Ashleigh Oliveira, Manabu Nakamura","doi":"10.1016/j.jand.2026.156879","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156879","url":null,"abstract":"<p><strong>Background: </strong>Registered dietitian nutritionists (RDNs) play a pivotal role in providing dietary education to patients seeking weight loss. Technology such as apps and online education may support RDNs and patients by providing platforms for enhanced communication and tracking.</p><p><strong>Objective: </strong>To explore RDNs' perceptions of using an online weight management program and app in dietetic practice, including perceived barriers and facilitators to implementation.</p><p><strong>Design: </strong>Qualitative study using semi-structured individual interviews.</p><p><strong>Participants: </strong>Participants (n=22) were credentialed RDNs currently working in weight loss practice with at least one year of experience. RDNs were purposively recruited to represent a range of years in practice, regions of the United States, and employer types INTERVENTION: Participant RDNs completed an eight-week study reviewing a newly developed online weight management program and companion web application. Activities included reviewing online educational sessions and testing the web application from patient and professional perspectives before participating in interviews.</p><p><strong>Data analysis: </strong>Interview data were analyzed using reflexive thematic analysis within a constructivist research paradigm. Atlas.ti (Version 9.1.4) software was used to support data organization, coding, and management.</p><p><strong>Results: </strong>Perceived barriers included patients' lack of time, self-motivation, and lower education level. Institutional barriers included a lack of insurance coverage and rigid workplace processes. Facilitators included patient preference for digital tools and improved accountability and self-monitoring. RDNs also described potential time savings by providing these materials to patients.</p><p><strong>Conclusions: </strong>Broader integration of digital platforms into nutrition care may benefit from streamlined workflows, institutional support, and reimbursement structures that facilitate technology-assisted practice. As demand for weight management services increases, RDNs are well positioned to lead implementation of evidence-based digital interventions that expand access, support long-term adherence, and promote equitable nutrition care.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156879"},"PeriodicalIF":5.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987511","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":"Reductions in sugar-sweetened beverage intake and weight are maintained following a digital health intervention: findings from a randomized-controlled trial.","authors":"Jamie Zoellner, Wen You, Kathleen Porter, Annie L Reid, Donna-Jean P Brock, Theresa Markwalter, Deborah F Tate, Lee Ritterband","doi":"10.1016/j.jand.2026.156877","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156877","url":null,"abstract":"<p><strong>Background: </strong>Reducing sugar-sweetened beverage (SSB) intake is a global public health priority, but little is known about the long-term maintenance of SSB behaviors after an intervention.</p><p><strong>Objective: </strong>The objective of this study was to examine 18-month post-intervention maintenance effects on SSB and weight outcomes and to explore the mediation of SSB changes on weight changes.</p><p><strong>Design: </strong>This study used a two-group randomized controlled trial (RCT) [iSIPsmarter versus patient education (PE)] with assessments conducted at 4-time points (baseline, 9-weeks, and 6-months and 18-months post-intervention) during 2021-2024.</p><p><strong>Participants/setting: </strong>Of 249 enrolled adult participants, 211 (85%) were retained at 18-months post-intervention. Recruited from Appalachia and surrounding counties, participants were 89% White, 83% female, 50% with incomes <$55,000/year, 86% from more rural counties, and 82% with overweight or obesity.</p><p><strong>Interventions: </strong>Guided by the Theory of Planned Behavior and health literacy concepts, iSIPsmarter is a highly interactive, structured, digital health intervention comprised of six Cores, behavioral tracking, and personalized action planning. The PE condition was a static self-guided website without personalized information.</p><p><strong>Main outcome measures: </strong>Self-reported SSB intake and objective weight were measured with the validated Beverage Intake Questionnaire and a cellular-enabled scale, respectively.</p><p><strong>Statistical analyses performed: </strong>Statistical analyses included generalized linear models and mediation models.</p><p><strong>Results: </strong>At 18-months post-intervention iSIPsmarter participants (n=102) showed significantly greater reductions in SSB [-30.1 ounces/day (95% CI = -35.3, -24.9; p<0.001)] than PE participants (n=109) [-20.9 ounces/day (95% CI= -25.7, -16.1; p<0.001)](effect size=0.34; p=0.011). Similarly, iSIPsmarter participants experienced a significantly greater percentage weight change [-3.0% (95% CI = -1.5, -4.8; p<0.001)] than PE participants [<-0.01% (95% CI = 0.00, 0.00; p=0.570)](effect size=0.58; p<0.001). The total iSIPsmarter treatment effect on 18-month post-intervention percent weight change was -3.02% (p=0.028), comprising a concurrent indirect effect through SSB intake (-0.94%; p=0.050) and a direct effect (-2.08%; p=0.119).</p><p><strong>Conclusions: </strong>A digital behavioral intervention, iSIPsmarter, supported long-term improvements in SSB intake and modest, meaningful weight loss. Its digital format suggests scalability to other high-risk populations.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156877"},"PeriodicalIF":5.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917883","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":"Social Support and Perceived Dietary Barriers Mediate Weight Loss in the AMPLIFY Web-Based Diet Intervention.","authors":"Harleen Kaur, Dori W Pekmezi, Maria Pisu, Laura Q Rogers, Kelly Kenzik, Tracy E Crane, Gregory Pavela, R Drew Sayer, Holly R Wyatt, Wendy Demark-Wahnefried","doi":"10.1016/j.jand.2026.156875","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156875","url":null,"abstract":"<p><strong>Background: </strong>Web-based interventions that promote healthy diet and weight loss among cancer survivors are growing, but theoretical constructs driving their success remain unclear.</p><p><strong>Objective: </strong>This study explores whether Social Cognitive Theory (SCT) constructs (self-efficacy, social support, perceived barriers) mediate the effects of the AMPLIFY-Diet intervention on energy intake, diet quality, and body weight.</p><p><strong>Design: </strong>This mediation analysis used data from the AMPLIFY-Diet randomized controlled trial (RCT).</p><p><strong>Participants/settings: </strong>Data collected from March 2020 to March 2024 at baseline, 3 months, and 6 months were analyzed from 346 overweight-or-obese cancer survivors enrolled nationwide.</p><p><strong>Intervention: </strong>Cancer survivors received a serialized, theoretically-grounded, 24-week, web-based intervention to improve diet quality and weight loss.</p><p><strong>Main outcome measures: </strong>Energy intake and diet quality were measured using two non-consecutive 24-hour dietary recalls, and body weight was measured using digital scales at baseline and 6 months. SCT mediators were assessed using self-reported instruments at baseline, 3 months, and 6 months.</p><p><strong>Statistical analyses: </strong>Mediation analyses were conducted to estimate indirect effects.</p><p><strong>Results: </strong>At 3-months, the effect of the AMPLIFY-Diet intervention on weight was significantly mediated through improvements in social support from baseline (unstandardized indirect effect estimate=-0.42 (SE=0.21); 95% CI [-0.894, -0.084]); whereas, at 6-months, the effect was significantly mediated through reductions in perceived dietary barriers from baseline (unstandardized indirect effect estimate=-0.45 (SE=0.21); 95% CI [-0.928,-0.103]). Self-efficacy, social support, and perceived dietary barriers did not emerge as significant mediators for energy intake or diet quality models.</p><p><strong>Conclusions: </strong>Findings suggest that the AMPLIFY-Diet intervention achieved weight loss among cancer survivors through time-dependent mechanisms, improving social support earlier in the intervention and reducing perceived dietary barriers later on. However, these constructs did not explain changes in models for dietary intake. Future web-based dietary interventions should measure and examine additional theoretical constructs to better understand the mechanisms underlying dietary change.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156875"},"PeriodicalIF":5.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917901","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":"Usual micronutrient intake and food selectivity among Brazilian children and adolescents with autism spectrum disorder: a cross-sectional study.","authors":"Eduarda Silva, Laura Vargas Hoffmann, Kamila Castro, Sandra Costa Valle, Juliana Dos Santos Vaz","doi":"10.1016/j.jand.2026.156876","DOIUrl":"https://doi.org/10.1016/j.jand.2026.156876","url":null,"abstract":"<p><strong>Background: </strong>Feeding difficulties, particularly food selectivity, are commonly reported in individuals with autism spectrum disorder (ASD), raising the possibility that these aspects may affect dietary intake, including essential micronutrients. Many studies on this topic fail to adequately adjust for within-person variability, potentially misrepresenting usual nutrient intake.</p><p><strong>Objective: </strong>This study evaluates micronutrient adequacy among children and adolescents with ASD with and without food selectivity, based on usual intake estimations.</p><p><strong>Design: </strong>This study used a cross-sectional design and included data collected between July 2021 and April 2025.</p><p><strong>Participants/setting: </strong>Data were obtained from 303 participants aged between 2 and 18 years attending the public neuropediatric outpatient clinic of the Federal University of Pelotas, southern Brazil.</p><p><strong>Main outcome measures: </strong>Food consumption was obtained from three non-consecutive days of a 24-hour dietary recall, and food selectivity was assessed based on the consumption of food group items and item 10 of the Brief Autism Mealtime Behavior Inventory.</p><p><strong>Statistical analyses performed: </strong>The distribution of usual micronutrient intake was estimated using the Multiple Source Method® (version 1.0.1), and the resulting values were compared with the corresponding dietary reference intakes.</p><p><strong>Results: </strong>Food selectivity was observed in 77% of the participants. When comparing individuals with and without food selectivity, a high frequency of inadequacy was observed in both groups for copper, potassium, calcium, and retinol, while sodium intake was excessive. Significant differences in usual micronutrient adequacy between the groups were observed only for vitamin C and phosphorus.</p><p><strong>Conclusion: </strong>Food selectivity did not substantially differentiate micronutrient adequacy in this sample, and both groups showed relevant inadequacies. These findings highlight the need for routine nutritional screening for all individuals with ASD, regardless of food selectivity status, to ensure accurate evaluation of nutrient intake and better inform nutritional interventions.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156876"},"PeriodicalIF":5.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917928","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640023/pdf/","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":"OA","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}