Journal of the Academy of Nutrition and Dietetics最新文献

{"title":"Weight Bias Internalization Statistically Mediates the Association Between Positive Body Image and Intuitive Eating: A Cross-Sectional Study","authors":"Paula M. Brochu PhD ,&nbsp;Janell L. Mensinger PhD ,&nbsp;Lauren B. Moss PsyD ,&nbsp;Stephanie L. Rothenberg MS","doi":"10.1016/j.jand.2024.12.007","DOIUrl":"10.1016/j.jand.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Two facets of positive body image, body appreciation and functionality appreciation, are positively associated with an adaptive eating style known as intuitive eating. Little is known about the mechanisms underlying the association between positive body image and intuitive eating, although it is well established that weight bias internalization is associated with unfavorable views of the self and body and interferes with health behavior engagement.</div></div><div><h3>Objective</h3><div>The present cross-sectional study examined weight bias internalization as a statistical mediator of the association between positive body image (ie, body appreciation and functionality appreciation) and intuitive eating.</div></div><div><h3>Design</h3><div>An online cross-sectional survey was conducted with a convenience sample of adults who were recruited through social media from February to April 2019.</div></div><div><h3>Participants and setting</h3><div>The final sample included 178 participants (120 women, 55 men, 2 gender nonbinary; mean age = 26.34 years, <em>SD</em> = 9.53 years) who completed the study online.</div></div><div><h3>Main outcome measures</h3><div>Participants completed the Intuitive Eating Scale-2 as the main outcome measure.</div></div><div><h3>Statistical analyses</h3><div>The PROCESS macro was used to conduct 2 mediation analyses with body appreciation and functionality appreciation as the antecedents, intuitive eating as the outcome, and weight bias internalization as the mediator.</div></div><div><h3>Results</h3><div>As expected, body appreciation (<em>b</em> = .34, <em>SE</em> = .06; <em>P</em> &lt; .001) and functionality appreciation (<em>b =</em> .13, <em>SE</em> = .06; <em>P</em> = .043) had significant positive associations with intuitive eating. Weight bias internalization statistically mediated the association between body appreciation and intuitive eating (<em>b</em> = .24, <em>SE</em> = .07, 95% CI .114 to .376), and functionality appreciation and intuitive eating (<em>b</em> = .04, <em>SE</em> = .03, 95% CI .004 to .104).</div></div><div><h3>Conclusions</h3><div>These findings contribute to better understanding the mechanisms connecting positive body image and intuitive eating. Results from this cross-sectional study indicate weight bias internalization statistically mediates the associations between body appreciation and intuitive eating and functionality appreciation and intuitive eating.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 12","pages":"Pages 1899-1906"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870917","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":"Explicit, Implicit, and Internalized Weight Bias: Relationships With Self-Perceptions of Weight and Current Dieting","authors":"Diane L. Rosenbaum PhD ,&nbsp;Meghan M. Gillen PhD ,&nbsp;Charlotte H. Markey PhD","doi":"10.1016/j.jand.2025.06.026","DOIUrl":"10.1016/j.jand.2025.06.026","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Negative attitudes regarding body size, including explicit, implicit, and internalized weight bias, are associated with deleterious outcomes, particularly for those in larger bodies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study evaluated the relation of weight bias (explicit, implicit, and internalized forms) and body mass index (BMI) to self-perceived weight and current dieting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;This was a cross-sectional study. Participants completed the AntiFat Attitudes Questionnaire, which assesses 3 domains of explicit weight bias, a weight-specific version of the Implicit Attitudes Test, and the Weight Bias Internalization-Modified Questionnaires through an online survey.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants/setting&lt;/h3&gt;&lt;div&gt;Participants (N = 392; 62.5% women; 15.8% African American/Black, 24.2% Asian American/Asian/Pacific Islander, 15.1% Latino/Hispanic, 37.0% White, 5.4% Multiracial, 2.3% Other, and 0.2% Did not disclose) were individuals of varying body size (mean BMI = 25.0 ± 5.73 kg/m&lt;sup&gt;2&lt;/sup&gt;, range = 14.08 to 50.17 kg/m&lt;sup&gt;2&lt;/sup&gt;). This study took place at a university in the Mid-Atlantic region of the United States from 2020 to 2022. Undergraduates who were aged at least 18 years, fluent in English, and enrolled in a psychology course that required subject pool participation were eligible to take part in the study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main outcome measures&lt;/h3&gt;&lt;div&gt;Participants completed the Self-Classified Weight Scale and reported dieting behavior.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Statistical analyses performed&lt;/h3&gt;&lt;div&gt;Using the PROCESS macro, regression models evaluated main effects and interactions for the different weight bias measures and BMI on self-perceived weight and current dieting, controlling for gender.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The 3 forms of weight bias had inconsistent relationships with self-perceived weight and dieting—some were significant while others were not. There were significant interactions between BMI and fear of fat (explicit weight bias) for both self-perceived weight (&lt;em&gt;P&lt;/em&gt; = .003) and dieting (&lt;em&gt;P&lt;/em&gt; = .02). A significant interaction was also found between BMI and implicit weight bias (&lt;em&gt;P&lt;/em&gt; = .01); those with higher bias had more discrepancies between actual and self-perceived weight. Believing that body size is controlled by willpower (explicit weight bias; &lt;em&gt;P&lt;/em&gt; = .005) and weight bias internalization (&lt;em&gt;P&lt;/em&gt; = .008) were positively related to dieting. Weight bias internalization was also positively associated with self-perceived weight (&lt;em&gt;P&lt;/em&gt; &lt; .001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Internalized and some domains of explicit weight bias relate to larger self-perceived weight and greater dieting likelihood. Implicit weight bias in conjunction with BMI may also contribute to perceptions about one’s own body size. Findings highlight the importance of considering weight bias in disordered eating risk.&lt;/div&gt;&lt;/","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 12","pages":"Pages 1853-1863"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281922","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":"Empirical Redundancy? What Is the Distinct Role of Self-Objectification, Thin-Ideal Internalization, and Internalized Weight Stigma on Eating Pathology?","authors":"Caitlin A. Martin-Wagar PhD ,&nbsp;Sarah E. Attaway MA ,&nbsp;Lillian King BA ,&nbsp;Oscar R. Kronenberger BA ,&nbsp;Katelyn A. Melcher MA","doi":"10.1016/j.jand.2025.02.007","DOIUrl":"10.1016/j.jand.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Sociocultural risk factors predict disordered eating and body dissatisfaction. Three internalized variables (self-objectification, thin-ideal internalization, and internalized weight stigma) have each been shown to relate to body dissatisfaction and disordered eating. Although these 3 variables have distinct conceptualizations and definitions, they show similarity in theoretical definitions, evidence of strong relationships between the 3 variables, and similarity in how they each relate to adverse health outcomes.</div></div><div><h3>Objective</h3><div>This study investigated potential construct proliferation among these 3 internalized sociocultural variables.</div></div><div><h3>Design</h3><div>Data collection was cross-sectional, with undergraduate students completing online self-report measures from January to December 2023.</div></div><div><h3>Participants</h3><div>Participants were 599 undergraduate students at a northwestern US university.</div></div><div><h3>Main outcome measures</h3><div><span>The Objectified Body Consciousness Scale body surveillance subscale, Sociocultural Attitudes Toward Appearance Questionnaire-4 thin/low body fat subscale, Modified Weight Bias Internalization Scale, and </span>Eating Disorder<span> Examination-Questionnaire-6.0 subscales and behavioral items were used to measure self-objectification, thin-ideal internalization, internalized weight stigma, and eating disorder symptoms.</span></div></div><div><h3>Statistical analyses performed</h3><div>Six multiple regression analyses were performed to examine how the 3 internalization variables related to the outcome variables: restraint, eating concern, shape concern, weight concern, binge eating, and compensatory behaviors. Given the multiple analyses performed, a Bonferroni correction adjusted alpha levels to .008.</div></div><div><h3>Results</h3><div>All 6 regression models were significant (<em>P &lt;</em> .001). Although self-objectification, thin-ideal internalization, and internalized weight stigma (IWS) each contributed uniquely to the body image variables (weight concern and shape concern), only IWS contributed uniquely to binge eating, and only thin-ideal internalization and IWS contributed uniquely to restraint, eating concerns, and compensatory behaviors.</div></div><div><h3>Conclusions</h3><div>This study provides evidence that contradicts the premise of empirical redundancy and construct proliferation for these 3 internalization variables. Findings also highlight the potential to target each of the 3 internalized variables within prevention and intervention efforts. Particularly, future research should explore IWS within eating disorder prevention and treatment, given the unique relationship of IWS with all outcome variables.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 12","pages":"Pages 1884-1891"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456382","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":"People & Events","authors":"","doi":"10.1016/j.jand.2025.10.002","DOIUrl":"10.1016/j.jand.2025.10.002","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 12","pages":"Page 1923"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145537101","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":"Parental Overvaluation of Child Weight/Shape Is Associated With Disordered Eating in Children Beyond Associations With Parental Internalized Weight Bias","authors":"Christina M. Sanzari MA ,&nbsp;Janet A. Lydecker PhD, FAED","doi":"10.1016/j.jand.2025.02.015","DOIUrl":"10.1016/j.jand.2025.02.015","url":null,"abstract":"<div><h3>Background</h3><div><span>Parental overvaluation (ie, parental identity based on their child’s weight) and parental weight bias internalization (ie, parents’ internalization of societal bias toward people living in larger bodies) are both associated with their children’s </span>disordered eating. Less is known about the extent to which these constructs overlap and how their combination may relate to pediatric disordered eating.</div></div><div><h3>Objective</h3><div>This study examined the relationship between parental overvaluation, parental internalized weight bias, and children’s disordered eating to test whether parental overvaluation was associated with disordered eating in children beyond the effects of parental internalized weight bias.</div></div><div><h3>Design</h3><div>Cross-sectional data were collected from parents in the United States recruited online through Mechanical Turk from March 2021 through January 2022.</div></div><div><h3>Participants/setting</h3><div>Participants included 196 parents (mean age = 38.2 years). Participants were excluded if they were younger than 21 years, lived with their child less than one-half the time, or failed to meet attention and validity checks embedded throughout assessments.</div></div><div><h3>Main outcome measures</h3><div>Disordered eating in children behaviors (eg, overeating, binge eating, purging, and secretive eating) were evaluated.</div></div><div><h3>Statistical analyses performed</h3><div>Correlations compared parental overvaluation and internalized weight bias. Hierarchical logistical regressions tested the association of internalized weight bias with disordered eating in children behaviors and then whether parental overvaluation significantly contributed to the variance in disordered eating in children eating behaviors beyond the effect of internalized weight bias.</div></div><div><h3>Results</h3><div>Across all disordered eating in children behaviors, parental internalized weight bias was significant in the first step of the logistic regression when it was the sole variable (all, <em>P</em> &lt; .005). When both variables were included in models, parental overvaluation, but not weight bias, was significantly associated with all disordered eating in children behaviors (all, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>The extent to which a parent evaluates their worth as a parent based on their child’s weight/shape is more strongly associated with disordered eating behaviors in children than with internalized weight bias. More research is needed to determine whether parent-focused treatment for pediatric eating disorders could benefit from strategies aimed at shifting the valued aspects of parental identity away from child weight/shape.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 12","pages":"Pages 1877-1883"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584135","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":"2025 Academy of Nutrition and Dietetics Honorary Memberships","authors":"","doi":"10.1016/j.jand.2025.10.007","DOIUrl":"10.1016/j.jand.2025.10.007","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 12","pages":"Page 1914"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536886","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":"2025 Outstanding Nutrition and Dietetics Technician, Registered Award","authors":"","doi":"10.1016/j.jand.2025.10.001","DOIUrl":"10.1016/j.jand.2025.10.001","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 12","pages":"Page 1919"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145537103","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":"Nutrition-Related Experiences and Perceptions of Pacific Islanders With Diabetes in the United States: A Qualitative Analysis","authors":"Dailyn K. Tufuga MS ,&nbsp;Autumn Vaitohi ,&nbsp;Emily Patten PhD, RDN ,&nbsp;Pitovao Gerratt ,&nbsp;Sarah Bellini PhD, RD","doi":"10.1016/j.jand.2025.07.006","DOIUrl":"10.1016/j.jand.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Pacific Islanders (PI) have a greater risk of developing type 2 diabetes compared with the non-Hispanic White population. Little is known about PIs’ culture, experiences, and perceptions related to diabetes, especially regarding nutritional health care.</div></div><div><h3>Objective</h3><div>The primary purpose of this study was to explore the experience and perceptions of PIs living in the mainland United States regarding diabetes, diabetes management, and nutrition interventions.</div></div><div><h3>Design</h3><div>Researchers conducted a qualitative study using semistructured interviews to gain cultural knowledge about the mainland PI population based on Campinha-Bacote’s framework of cultural competence. Researchers analyzed data using reflexive thematic analysis.</div></div><div><h3>Participants/setting</h3><div>PIs with prediabetes or type 2 diabetes living in the mainland United States were recruited through email and social media in Utah, California, and the Pacific Northwest.</div></div><div><h3>Results</h3><div>Most of the participants (24 out of 26) lived in the United States for more than 10 years. Although 9 participants were not born in the United States, all lived in the United States for 6 years or more. Most of the participants were Tongan (11 out of 24) or Samoan (10 out of 24). Slightly more participants were aged 18 to 49 years (n = 14) and were men (n = 14), compared with participants older than 50 years (n = 12) and women (n = 12). Researchers identified 4 main themes: eating approaches, responses to diabetes diagnosis, perspectives on diabetes education, and navigating health care services. Price, convenience, family food practices, and taste influenced day-to-day food choices. Participants reported a tug-of-war trying to adopt a new culture, manage their diabetes, and retain their PI culture. Education for participants lacked cultural awareness and could be improved by focusing on PI communities and families rather than PI individuals. The health care system was difficult to navigate, and there were cultural and language barriers.</div></div><div><h3>Conclusions</h3><div>These study results provide an opportunity for registered dietitian nutritionists and other health care practitioners to gain knowledge about PI experiences and be better equipped to provide culturally sensitive care to individuals with prediabetes or type 2 diabetes.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 11","pages":"Pages 1643-1651.e4"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717209","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":"Provision and Access to Nutrition Care for the Prevention and Treatment of Malnutrition in Older Adults Within Long-Term Care and Community Settings: A Consensus Statement of the Academy of Nutrition and Dietetics","authors":"Judy R. Simon MS, RD, LDN ,&nbsp;Nancy Munoz MHA, DCN, RDN, FAND ,&nbsp;Shirley Y. Chao PhD, RDN, LDN, FAND ,&nbsp;Mary Litchford PhD, RDN, LDN ,&nbsp;Lisa Moloney PhD, RDN","doi":"10.1016/j.jand.2025.05.023","DOIUrl":"10.1016/j.jand.2025.05.023","url":null,"abstract":"<div><div>It is the consensus of the Academy of Nutrition and Dietetics that equitable access to nutrition care, including medical nutrition therapy provided or facilitated by registered dietitian nutritionists (RDNs), can improve nutrition and health outcomes for older adults in long-term care and community settings. The target audience includes RDNs, policymakers, insurance providers, and other interested parties. The consensus statement is based on the Evidence Analysis Center’s malnutrition in older adults systematic reviews that evaluated nutrition assessment and nutrition interventions, and the expertise of content experts. Strategies to improve access to nutrition care within a regulatory and systemic context are presented. The consensus statement identifies key barriers to nutrition care, including fragmented health care systems, insufficient research, and limited reimbursement for nutrition services. Several strategies are proposed, including policies to ensure comprehensive screening and referral, evidence-based individualized nutrition care, expanded reimbursement for nutrition services, adequate RDN staffing, increased research, and coordination with available community nutrition programs. Improved access to nutrition care is essential to reducing malnutrition and improving the overall health of older adults.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 11","pages":"Pages 1755-1768"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537624","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":"Machine Learning With Ingredient-Level Food Trees Reveals Contributors to Systemic Inflammation Among Adults in the National Health and Nutrition Examination Survey, 2001-2010 and 2015-2018","authors":"Jules A. Larke PhD ,&nbsp;Danielle G. Lemay PhD","doi":"10.1016/j.jand.2025.05.012","DOIUrl":"10.1016/j.jand.2025.05.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Methods for modeling the relationship between self-reported 24-hour dietary recalls and health outcomes are traditionally based on nutrients and/or dietary patterns. Machine learning (ML), combined with hierarchical representations of diet, may help improve estimates of health and identify specific foods associated with diet-induced inflammation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this study was to assess the accuracy of estimating systemic inflammation from hierarchically arranged ingredient-level diets in a large US cohort.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;This was a cross-sectional analysis using data on US adults from the National Health and Nutrition Examination Survey 2001-2010 and 2015-2018 cycles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants and setting&lt;/h3&gt;&lt;div&gt;The continuous National Health and Nutrition Examination Survey data representing adult men and women who completed 1 or more 24-hour dietary recalls with an energy intake between 500 and 4500 kcal/day had no active infection or acute phase response, and measurement of serum C-reactive protein (CRP) level (N = 19 460).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main outcome measures&lt;/h3&gt;&lt;div&gt;The main outcome measure was classification accuracy for predicting high and low inflammation based on the top and bottom tertiles of CRP level.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Statistical analyses performed&lt;/h3&gt;&lt;div&gt;Mixed meal disaggregation was performed to generate an ingredient-level representation of diet that was further annotated to produce a hierarchical data structure, or food tree. Hierarchical feature engineering selected the most informative food tree features for predicting systemic inflammation (ie, CRP level). ML models were used to assess the accuracy of predicting CRP level from the food tree features compared with the Dietary Inflammatory Index (DII) score. Logistic regression was used to calculate the marginal effects of ingredients identified from ML models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Representation of diet as an ingredient-level food tree reduced dietary features from 6412 unique foods to 566 unique ingredients. ML classifiers trained on food tree data predicted high vs low systemic inflammation (CRP level tertile) with similar accuracy (0.761) on never-seen data compared with models trained using DII scores (0.757) (McNemar test &lt;em&gt;P&lt;/em&gt; = .5). Individual dietary components revealed contributions toward increased inflammation, including fruit punch, soda, and high-fat milk (marginal effects: 0.001 to 0.005; &lt;em&gt;P&lt;/em&gt; &lt; .05), and foods associated with decreased inflammation such as herbal tea, brewed espresso, decaf coffee, brown rice, and dry pasta (marginal effects: –0.08 to –0.001; &lt;em&gt;P&lt;/em&gt; &lt; .05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Specific ingredients, selected from a food tree, performed as well as the DII in predicting systemic inflammation. Choice of common foods and beverages associated with inflammation varied in magnitude and direction","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 11","pages":"Pages 1664-1677.e7"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186157","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}