American Journal of Clinical Nutrition最新文献

{"title":"Ultra processed food consumption by urbanization level among US youth and adults: Cross-Sectional Analysis of NHANES 2013-March 2020.","authors":"Nicholas Ansai, Anne Williams, Samuel D Emmerich, Kirsten A Herrick, Edwina A Wambogo, Euridice Martínez Steele, Cynthia L Ogden","doi":"10.1016/j.ajcnut.2025.10.010","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.10.010","url":null,"abstract":"<p><strong>Objective: </strong>To describe the mean contribution to total energy and total gram intakes from ultra processed foods (UPF), unprocessed or minimally processed foods (MPF), other Nova categories and subcategories by urbanization level among US youth and adults.</p><p><strong>Methods: </strong>Cross-sectional data from the National Health and Nutrition Examination Survey from 2013-March 2020 were analyzed. The mean percent of total energy and total gram intakes from Nova categories (MPF, processed culinary ingredients (PCI), processed foods (PF), and UPF) were estimated by urbanization (non-metropolitan statistical areas (non-MSAs, n=3,976), small to medium MSAs (n=9,170), and large MSAs (n=14,637)) for youth 2-19 years and adults 20 and older. Trends by urbanization were assessed using orthogonal contrasts in linear regression models adjusted for sex, age, race/Hispanic origin, and income. Day 1 dietary sample weights accounted for differential probabilities of selection, nonresponse, noncoverage and day of the week.</p><p><strong>Results: </strong>Among youth, there was no trend in MPF or UPF as a percent of energy by urbanization level. As a percent of grams, MPF increased and UPF decreased with higher urbanization level. After adjustment for sex, age, race and Hispanic origin, and income, only the trend in the percent of grams from MPF remained. Among adults, as both a percent of energy and a percent of grams, MPF increased and UPF decreased with higher urbanization level. These trends remained significant after adjustment for covariates.</p><p><strong>Conclusions: </strong>Adults in rural areas consumed more UPF and less MPF than those in urban areas in terms of both energy and grams. There were few significant differences by urbanization among youth.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Comprehensive Lifestyle Interventions on Plasma Branched-Chain Amino Acid Concentrations: A Randomized Trial.","authors":"Yu Jin Lim, Rob M van Dam","doi":"10.1016/j.ajcnut.2025.10.008","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.10.008","url":null,"abstract":"<p><strong>Background: </strong>Elevated plasma branched-chain amino acid (BCAA) concentrations are associated with a higher risk of type 2 diabetes and cardiovascular diseases. Lifestyle interventions have been proposed as a strategy to manage plasma BCAA concentrations, but evidence of their effectiveness is limited.</p><p><strong>Objective: </strong>We investigated the effects of comprehensive lifestyle interventions on plasma BCAA concentrations over six months and associations between changes in Body Mass Index (BMI), physical fitness, and dietary factors and plasma BCAA changes METHODS: The PREMIER study was a randomized trial of the effects of behavioral lifestyle interventions. The interventions included counseling on diet, exercise, and weight loss ('Established'), a similar intervention with additional guidance to follow Dietary Approaches to Stop Hypertension ('Established plus DASH'), and an advice-only control group. We analyzed data from 713 male and female adult participants during the 6-month intervention period. Data and biospecimens were obtained through the NHLBI BioLINCC repository, and plasma BCAA concentrations were measured using NMR spectroscopy. Multiple linear regression was used to assess the association between intervention groups and BCAA concentrations.</p><p><strong>Results: </strong>The Established (-7.19 μmol/L; 95% CI 17.45, 3.08) and Established plus DASH (-8.70 μmol/L; 95% CI -18.95, 1.55) interventions were associated with non-significant decreases in BCAA concentrations compared with the control group. Changes in BMI were correlated with changes in BCAA concentrations during the trial (partial Pearson r=0.24, p<0.001). Although changes in fitness and fiber intake were also significantly correlated with changes in BCAA concentrations, adjustment for BMI attenuated these correlations. Changes in the DASH and healthy plant-based diet indices and BCAA and protein intakes were not significantly correlated with plasma BCAA changes.</p><p><strong>Conclusion: </strong>Weight loss resulting from lifestyle interventions was associated with reductions in plasma BCAA concentrations. Improvements in fitness and diet composition were not associated with changes in BCAA concentrations independent of weight loss.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT00000616).</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has the golden egg lost its luster?","authors":"Christine P Stewart","doi":"10.1016/j.ajcnut.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.09.021","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between domestic water hardness and the risk of experiencing fifteen different cardiovascular events: A prospective cohort study of 324,136 UK Biobank participants.","authors":"Sicheng Li, Hanwen Zhou, Jiajin Chen, Wenpan Xian, Yuqin Zhang, Yan Wang","doi":"10.1016/j.ajcnut.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.10.004","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated domestic water hardness (DWH)-cardiovascular disease (CVD) associations, but the results are inconsistent, and investigations of specific CVD subtypes are scarce.</p><p><strong>Objective: </strong>We aimed to investigate the individual and combined associations of DWH with CVD and its subtypes.</p><p><strong>Methods: </strong>This cohort study included UK Biobank participants whose address codes were used to obtain DWH data (calcium carbonate [CaCO₃], calcium [Ca], and magnesium [Mg]) from water supply companies. Incident CVD events were identified via International Classification of Diseases-Tenth Revision codes. The individual and combined associations between DWH exposure and incident CVD events were evaluated via Cox proportional hazards regression and quantile G-computation, respectively.</p><p><strong>Results: </strong>During a median follow-up period of over 13.41 years, 5,780 CVD deaths and 60,184 CVD cases were identified among 324,136 participants (mean±standard deviation age=55.76±8.08 years; female proportion=53.95%). U-shaped associations were observed between CaCO₃ and CVD death (P-nonlinear=0.024) and between Ca and CVD (P-nonlinear=0.008). Each log-transformed Mg interquartile range increase was associated with decreased CVD risk (hazard ratio [HR]=0.978, 95% confidence interval [CI]=0.961‒0.996). DWH was linearly and nonlinearly associated with seven CVD subtypes (chronic rheumatic heart diseases, ischemic heart diseases, nonrheumatic valve disease, myocarditis and cardiomyopathy, arrhythmias, heart failure, and cerebral infarction). Combined DWH exposure was associated with increased chronic rheumatic heart disease risk (HR=1.070, 95% CI=1.011‒1.133), with Mg having the largest negative weight of 1.000 and Ca having the largest positive weight of 0.908.</p><p><strong>Conclusions: </strong>DWH was associated with cardiovascular health, including nine CVD events. Specifically, higher concentrations of Mg and moderate levels of CaCO₃ and Ca were associated with lower CVD risk. Combined DWH was associated with increased chronic rheumatic heart disease risk.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal and preschool micronutrient supplementation and behavioral outcomes in school aged children in Nepal - a cohort study.","authors":"Parul Christian, Eleonor Zavala, Kristen Hurley, Subarna K Khatry, Steven C LeClerq, Lee Shu Fune Wu, James Tielsch, Joanne Katz, Laura E Murray-Kolb","doi":"10.1016/j.ajcnut.2025.10.006","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.10.006","url":null,"abstract":"<p><strong>Background: </strong>Few studies examine behavioral difficulties among children in low-income countries or the influence of early-life nutrition interventions.</p><p><strong>Objective: </strong>We examined the effect of micronutrient supplementation done as part of two randomized trials during pregnancy or in early preschool age on behavioral outcomes among school-age children in rural Nepal.</p><p><strong>Methods: </strong>Children 7-9 years of age were enrolled in a cohort follow-up study in which the Conners Rating Scale-Revised was administered to their parents and teachers. These children were offspring of participants in a cluster-randomized trial during pregnancy receiving daily iron-folic acid, iron-folic acid+ zinc or multiple micronutrients, compared with a control (all groups received vitamin A). These children between 12 and 35 months of age also received daily placebo, iron-folic acid, zinc alone, or iron-folic acid+zinc in a separate randomized trial. Factor analysis identified two attention deficit hyperactivity disorder (ADHD)-related behaviors for parent scores (hyperactivity/oppositional and inattention) and two for teacher scores (hyperactivity and inattention). Using mixed effects linear regression analysis, we analyzed the effect of early life supplementation on behavioral domains in schoolchildren (n=1255).</p><p><strong>Results: </strong>Exposure to prenatal iron-folic acid resulted in lower oppositionality/hyperactivity and inattention scores in children assessed via parental ratings in both unadjusted and adjusted analysis. Iron-folic acid with zinc reversed the positive effect seen with iron-folic acid. Multiple micronutrient supplementation resulted in a lower oppositionality and/or hyperactivity score, using parent and teacher ratings in the adjusted analysis. All three supplement groups in the preschool trial reduced child inattention when assessed by parents. Based on teacher ratings, groups that had received iron-folic acid alone or with zinc during preschool had reduced scores of hyperactivity in both unadjusted and adjusted analysis.</p><p><strong>Conclusion: </strong>Our study shows potential benefit of early life exposure to micronutrient supplementation for child related behavior outcomes in a South Asian setting where inadequate diets and nutrition deficiencies exist.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing glycemic variability in type 2 diabetes using simple dietary and culinary recommendations to modulate starch digestibility: a randomized controlled trial.","authors":"Maëliss Chisbert, Anne-Laure Castell, Laurie Van Den Berghe, Anne-Esther Breyton, Nathalie Feugier, Charlotte Cuerq, Karim Chikh, Olivier Brack, Martine Laville, Aurélie Goux, Alexandra Meynier, Sophie Vinoy, Julie-Anne Nazare","doi":"10.1016/j.ajcnut.2025.10.007","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.10.007","url":null,"abstract":"<p><strong>Background: </strong>In type 2 diabetes (T2D), postprandial glycemic excursions significantly contribute to glycemic variability (GV) and cardiovascular risk. As starch is the main carbohydrate source controlling its digestibility in the daily diet to promote a gradual glucose release, represents a promising nutritional strategy to reduce GV and improve glycemic control.</p><p><strong>Objective: </strong>We investigated the feasibility and efficiency of a 3-month dietary intervention emphasizing Slowly Digestible Starch (SDS) through commercial starchy product supply and dietary and culinary counseling, on GV, glycemic control and cardiometabolic profile in patients with T2D with suboptimal control.</p><p><strong>Methods: </strong>In a randomized, parallel, single-blind, controlled trial, 51 patients with T2D completed a 12-week high-SDS (H-SDS) or low-SDS (L-SDS) diet. Participants received commercial starchy products either high or low in SDS content, with specific dietary/culinary counseling. MAGE (Mean Amplitude of Glycemic Excursions) and other intra- and inter-day GV parameters were assessed by CGMS (Continuous Glucose Monitoring System), as well as glycemic control and cardiometabolic parameters.</p><p><strong>Results: </strong>Compared to the L-SDS diet, the H-SDS diet significantly lowered MAGE over 12 weeks (β = 30.4 [95% CI: 12.4 to 48.5]; p = 0.0025) and other intra and inter-day GV parameters (standard deviation, coefficient of variation, CONGAs (Continuous Overall Net Glycemic Action), MODD (Mean of Daily Differences) with 96% compliance throughout the study. HbA1c decreased in both groups, with a trend toward a greater reduction in the H-SDS group (β = 0.3 [95% CI: 0.05 to 0.47]; p = 0.0981]), where HbA1c fall below the 7% target. Other cardiometabolic markers were similar between diets.</p><p><strong>Conclusions: </strong>Modulating starch digestibility represents an effective and accessible strategy for enhancing GV and thus glycemic management in T2D, allowing patients with suboptimal glycemic control to reach recommended glycemic targets. This trial was registered at ClinicalTrials.gov (identifier: NCT03847701; registered on February 18, 2019): https://clinicaltrials.gov/study/NCT03847701.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond serum phosphorus: metabolic balance studies offer insight on effects of phosphate binders in dialysis patients.","authors":"Kathleen M Hill Gallant","doi":"10.1016/j.ajcnut.2025.09.030","DOIUrl":"10.1016/j.ajcnut.2025.09.030","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative plasma short- and branched-chain fatty acids in relation to risk of complications after colorectal cancer surgery: a prospective cohort study.","authors":"Niels Klaassen-Dekker, Erwin G Zoetendal, Edoardo Capuano, Renate M Winkels, Fränzel J B van Duijnhoven, N Tjarda van Heek, Flip M Kruyt, Arve Ulvik, Adrian McCann, Per Magne Ueland, Johannes H W de Wilt, Ellen Kampman, Dieuwertje E Kok","doi":"10.1016/j.ajcnut.2025.10.001","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.10.001","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence suggests that nutritional prehabilitation reduces risk of complications after colorectal cancer (CRC) surgery. The gut microbiota and its metabolic activity potentially link preoperative diet to postoperative outcomes.</p><p><strong>Objective: </strong>Investigate associations between preoperative plasma levels of microbial-derived metabolites and postoperative complications in CRC patients.</p><p><strong>Methods: </strong>We used data from a prospective cohort study among 1220 patients with non-metastatic CRC. The short-chain fatty acids (SCFAs) acetate, propionate, butyrate, and valerate, as well as the branched-chain fatty acids (BCFAs) isovalerate, isobutyrate and α-methylbutyrate were measured in plasma collected at diagnosis. Prevalence ratios (PR) were calculated using regression models adjusted for age, sex, tumor location, smoking status, and physical health status.</p><p><strong>Results: </strong>Acetate levels of 40.0 μmol/L were associated with a lower risk of any postoperative complications compared to the reference of 20.0 μmol/L (PR 0.76; 95%CI 0.62, 0.93). Higher levels of propionate (per 1 μmol/L) were associated with a lower risk of any complications (PR 0.84; 95%CI 0.73, 0.96). Similar associations were found for acetate (per 20 μmol/L) and propionate (per 1 μmol/L) in relation to surgical complications (PR 0.75; 95%CI 0.60, 0.93; and PR 0.83; 95%CI 0.69, 1.00; respectively). No associations were found for BCFAs in relation to complications. Low (below median) total SCFA levels combined with high (above median) total BCFA levels were least favorable in terms of complication risk (PR 1.35; 95%CI 1.02, 1.80) when compared to a low SCFA/low BCFA profile.</p><p><strong>Conclusions: </strong>Our findings suggest that microbial fermentation processes, mainly those resulting in higher SCFA levels, may be linked to postoperative recovery. These findings provide leads for future studies investigating the role of preoperative diet, especially the balance between fiber and protein intake, and microbial metabolism in relation to postoperative recovery of patients with CRC.</p><p><strong>Clinical trial details: </strong>This study was registered at clinicaltrials.gov with registration number NCT03191110.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediterranean diet, metabolic signature, genetic predisposition, and risk of rheumatoid arthritis: a large-scale population-based prospective cohort study.","authors":"Xin Song, Xiaofeng Ma, Bin Yang, Di Zhang, Yanqiu Zou, Bowen Lei, Rong Xiang, Xunying Zhao, Yang Qu, Sirui Zheng, Ting Yu, Jinyu Zhou, Tao Han, Yangdan Zhong, Maoyao Xia, Lars Alfredsson, Karin Leander, Mengyu Fan, Xia Jiang","doi":"10.1016/j.ajcnut.2025.09.051","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.09.051","url":null,"abstract":"<p><strong>Background: </strong>While the Mediterranean (MED) diet has been associated with reduced rheumatoid arthritis (RA) risk, the underlying metabolic mechanisms and the role of genetic susceptibility in this relationship remain unknown.</p><p><strong>Objectives: </strong>To identify a metabolic signature linked to the MED diet and examine its association with the risk of RA, while accounting for genetic predispositions.</p><p><strong>Methods: </strong>We analyzed data from 109,565 participants in the UK Biobank. Elastic net regression was applied to generate a MED-related metabolic signature. Cox proportional hazards models were used to assess the associations between MED diet score, its derived metabolic signature, and incident RA. A polygenic risk score (PRS) for RA was incorporated to evaluate joint associations and potential interactions between genetic susceptibility and MED diet score or its metabolic signature in relation to RA risk. Mediation analysis was conducted to estimate the extent to which metabolic signature mediates the MED diet-RA association.</p><p><strong>Results: </strong>Over a median follow-up of 11.6 years, 1,123 participants developed RA. We identified a MED diet-related metabolic signature comprising 66 metabolites. Both MED diet score and metabolic signature were inversely associated with RA risk - comparing the 90^th to the 10^th percentiles, hazard ratios (HRs) for RA were 0.73 (95%CI: 0.63, 0.84) for MED diet score and 0.60 (95%CI: 0.50, 0.70) for metabolic signature. These associations remained consistent across all strata of genetic risk. Joint analyses indicated that favorable metabolic profiles may attenuate genetic predisposition to RA. Mediation analysis showed that the metabolic signature explained 22.4% (95%CI: 11.8%, 44.8%) of the MED diet-RA association.</p><p><strong>Conclusions: </strong>We identified a robust metabolic signature reflecting the metabolic response to the MED diet. This signature was inversely associated with RA risk and partially mitigated the genetic susceptibility to RA. These findings highlight the potential of metabolic signature for enhancing dietary assessment and guiding personalized nutritional intervention.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of saffron extract supplementation on mood in healthy adults with subclinical symptoms of depression: A randomized, double-blind placebo-controlled study.","authors":"Camille Amadieu, Quentin Leyrolle, Milena Farneti, Andrea Anesi, Eva Bruchet, Juliette Montet, Sandra Dexpert, David Gaudout, Fulvio Mattivi, Line Pourtau, Nathalie Castanon, Lucile Capuron","doi":"10.1016/j.ajcnut.2025.09.050","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.09.050","url":null,"abstract":"<p><strong>Background: </strong>Subclinical depressive symptoms, including low mood, fatigue and anxiety, refer to clinically relevant depressive manifestations that do not meet the criteria for major depressive disorder. These symptoms affect quality of life and can lead to chronic mental health issues. Nutritional interventions, such as saffron extract supplementation, may help modulate mood and inflammation, potentially alleviating these symptoms.</p><p><strong>Objective: </strong>This study aims to evaluate the efficacy of a 6-week saffron extract supplementation on mood in healthy individuals with subclinical neuropsychiatric symptoms and explored the underlying mechanisms.</p><p><strong>Methods: </strong>This randomized, double-blind, placebo-controlled study involved 51 adult healthy individuals who received oral administration of either saffron extract or a placebo for 6 weeks. The primary outcome was a composite z-score averaging standardized scores of depression (BDI-II), anxiety (STAI-YA), and fatigue (MFI-20). Secondary outcomes included neuropsychiatric scores, quality of life, inflammatory markers and hypothalamic-pituitary-adrenal (HPA) axis reactivity. Amino acid derivatives were analysed in blood samples.</p><p><strong>Results: </strong>Saffron extract did not significantly affect the primary outcome of combined depressive, anxiety, and fatigue symptoms (z-score) nor individual symptoms. However, it improved auto-perceived mental health, as reflected in increased mental health scores over time on the Medical Outcome Study Short Form 12 questionnaire, compared to placebo (mean at 6 weeks=53.8 ± 12.7 vs 44.6 ± 11.4 for placebo and saffron group respectively, Time x Treatment=0.04). There were no significant effects on inflammatory parameters or HPA axis reactivity. Metabolomic analysis revealed that saffron extract significantly modulated N-acetyl-phenylalanine.</p><p><strong>Conclusion: </strong>Saffron extract supplementation did not affect subclinical depressive symptoms, either measured as a composite score or individual symptom categories. A potential effect on improved mental health outcomes cannot be excluded but requires further replication in future well-powered trials. Saffromfood study, clinicaltrial.gov: NCT05690126. https://clinicaltrials.gov/study/NCT05690126?term=NCT05690126&rank=1.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}