American Journal of Clinical Nutrition最新文献

{"title":"Heterogeneity in the association between a dietary pattern high in fat, sugar, and sodium and adverse pregnancy outcomes by maternal characteristics: a United States pregnancy cohort study","authors":"Lisa M Bodnar ,&nbsp;Sharon I Kirkpatrick ,&nbsp;Ya-Hui Yu ,&nbsp;Edward Kennedy ,&nbsp;Sara M Parisi ,&nbsp;Ashley I Naimi","doi":"10.1016/j.ajcnut.2025.07.005","DOIUrl":"10.1016/j.ajcnut.2025.07.005","url":null,"abstract":"<div><h3>Background</h3><div>“Precision nutrition” aims to recognize variation in response to dietary patterns to inform tailored advice based on behavioral, social, environmental, genetic, and metabolic factors.</div></div><div><h3>Objectives</h3><div>We sought to identify characteristics of pregnant individuals that modify the associations between a high fat, sugar, and sodium diet and poor perinatal outcomes.</div></div><div><h3>Methods</h3><div>We used data from 8054 participants in the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be (8 United States medical centers, 2010‒2013), a prospective cohort study. Usual periconceptional dietary intake was assessed at 6‒13 wk of gestation using a food frequency questionnaire. The exposure was a high fat, sugar, and sodium dietary pattern compared with all other diet patterns. The outcome was a composite of 1 or more perinatal outcomes: preeclampsia, gestational diabetes, preterm birth, or small-for-gestational-age birth. We used the doubly robust learner, which enables the use of machine learning to identify maternal characteristics that modify the effect of the dietary pattern on the composite outcome.</div></div><div><h3>Results</h3><div>Approximately 29% had a dietary pattern that was high in fat, sugar, and sodium. One quarter had any adverse pregnancy outcome. The confounder-adjusted association between a high fat, sugar, and sodium dietary pattern and risk of the adverse composite pregnancy outcome was stronger among certain subgroups of the cohort than others, including individuals with a higher BMI, lower socioeconomic status, and non-Hispanic Black race/ethnicity. For instance, compared with other diet patterns, intake of a diet high in fat, sugar, and sodium was associated with 5.9 excess cases per 100 pregnancies {adjusted risk difference 0.059 [95% confidence interval (CI): 0.012, 0.11]} among individuals living in a high-poverty neighborhood, but 2.3 excess cases per 100 pregnancies (0.023; 95% CI: –0.011, 0.057) among those residing in a low-poverty neighborhood.</div></div><div><h3>Conclusions</h3><div>This work may provide clues that contribute to a deeper understanding of the heterogeneity in dietary responses in pregnancy.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 1103-1110"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627671","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":"Effects of Mediterranean diet or Mindfulness-Based Stress Reduction during pregnancy on maternal gut and vaginal microbiota: a subanalysis of the Improving Mothers for a better PrenAtal Care Trial BarCeloNa (IMPACT BCN) trial","authors":"Marta Selma-Royo ,&nbsp;Fàtima Crispi ,&nbsp;Sara Castro-Barquero ,&nbsp;Irene Casas ,&nbsp;Marta Larroya ,&nbsp;Mariona Genero ,&nbsp;Cristina Paules ,&nbsp;Leticia Benitez ,&nbsp;Lina Youssef ,&nbsp;Rosalia Pascal ,&nbsp;Noelia Encabo ,&nbsp;Ayako Nakaki ,&nbsp;Andrés Martín-Asuero ,&nbsp;M Teresa Oller-Guzmán ,&nbsp;Angela Arranz ,&nbsp;Eduard Vieta ,&nbsp;Rosa Casas ,&nbsp;Ramon Estruch ,&nbsp;Eduard Gratacos ,&nbsp;Maria Carmen Collado ,&nbsp;Francesca Crovetto","doi":"10.1016/j.ajcnut.2025.07.030","DOIUrl":"10.1016/j.ajcnut.2025.07.030","url":null,"abstract":"<div><h3>Background</h3><div>Despite the importance of gestation period for human health, studies addressing the impact of maternal microbiota on its progression and its modulation by maternal lifestyle are scarce. Although most of the evidence in the field comes from observational studies, we recently described how some lifestyle interventions during pregnancy reduced the small-for-gestational-age (SGA) incidence. We hypothesized the pregnant individual’s microbiome modulation as potential mechanism by which lifestyle interventions could impact gestation progression.</div></div><div><h3>Objectives</h3><div>The objectives of this study was to investigate the effect of pregnancy lifestyle interventions, based on a Mediterranean dietary pattern (MD) or Stress Reduction program (SR) that proved to be beneficial in reducing the SGA incidence, on the pregnant individuals’ gut and vaginal microbiota as exploratory outcomes.</div></div><div><h3>Methods</h3><div>In a random subsample (<em>n</em> = 351) from a trial including pregnancies randomly allocated into an MD intervention, an SR program, or non-intervention, maternal fecal/vaginal samples were collected at the end of the interventions, and in a subset (<em>n</em> = 85) also at recruitment. Microbiota was profiled by 16S rRNA gene sequencing. Multivariate models evaluated the associations of microbiota with the interventions.</div></div><div><h3>Results</h3><div>Mothers included in the study presented a similar gut microbiota profile before the intervention; pregnancy MD intervention influenced the overall structure of gut microbiota, (R2 = 0.008, F = 1.885, <em>P</em> = 0.002), which resulted in enrichment in Firmicutes phylum (Coeff = 0.06, 95% confidence interval [CI]: 0.002, 0.118), related to the increment in health-associated taxa (Lachnospiraceae/Ruminococcaceae families) and other SCFA producers; and diminishment in <em>Campylobacter</em> genus (Coeff = −0.91, 95% CI: −1.361, −0.459). The link of the SR program with gut microbiota was more limited; however, some key components from these families were also affected. Microbial diversity of gut microbiota decreased as pregnancy progressed, with this effect more observable in the mothers that followed the interventions. The interventions have a negligible association with the vaginal microbiota.</div></div><div><h3>Conclusions</h3><div>Pregnancy lifestyle interventions influence maternal gut microbiota.</div><div>The trial was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> Identifier as NCT03166332.</div></div><div><h3>Clinical Trial Information</h3><div>Date of Institutional Review Board approval and registration: 16 December 2016; 19 April 2017; Date of initial participant enrollment and date of first outcome (i.e., delivery of the pregnant individual enrolled): 1 February 2017; 10 May 2017.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 1121-1133"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785898","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":"Low-fat and whole milk consumption in relation to cardiovascular disease–related and all-cause mortality: a prospective cohort study in 3 Norwegian counties","authors":"Erik Kristoffer Arnesen ,&nbsp;Jacob Juel Christensen ,&nbsp;Ida Laake ,&nbsp;Monica H Carlsen ,&nbsp;Marit B Veierød ,&nbsp;Kjetil Retterstøl","doi":"10.1016/j.ajcnut.2025.07.035","DOIUrl":"10.1016/j.ajcnut.2025.07.035","url":null,"abstract":"<div><h3>Background</h3><div>The impact of milk consumption on cardiovascular disease (CVD) risk or mortality is unclear, and specific comparisons between types of milk are scarce.</div></div><div><h3>Objectives</h3><div>We aimed to investigate the associations between milk consumption, measured in a large Norwegian cohort in 3 counties during 1974–1988, and CVD–related mortality and all-cause mortality and to compare the associations between whole (full-fat) and low-fat milk.</div></div><div><h3>Methods</h3><div>This population-based, prospective cohort study included adults invited to repeated health screenings in the Norwegian Counties Study (&gt;80% attendance). Dietary intake was assessed from food frequency questionnaires at each screening in 1974–1988. Cox regression analysis was used to estimate hazard ratios (HRs) with 95% CIs for the associations between milk intake (assessed as cumulative mean intake from repeated questionnaires) and risk of death from all CVD, ischemic heart disease (IHD), acute myocardial infarction (AMI), and all causes.</div></div><div><h3>Results</h3><div>Among 73,860 participants included in this study (mean age: 41.2 years at baseline; 49% females), 26,393 deaths occurred (8590 from CVD, 4372 from IHD, and 3047 from AMI) during a median follow-up of 33 y. Comparing the highest with the lowest quintile of overall milk intake, the HR was 1.12 (95% CI: 1.03, 1.21) for CVD-related mortality and 1.22 (95% CI: 1.16, 1.28) for all-cause mortality. For whole milk, high compared with no intake was positively associated with CVD (HR: 1.07; 95% CI: 0.99, 1.16), IHD (HR: 1.13; 95% CI: 1.01, 1.27), and all-cause mortality (HR: 1.15; 95% CI: 1.10, 1.21). Compared with whole milk, low-fat milk intake was associated with lower CVD-related, IHD-related, AMI-related, and all-cause mortality. The associations were attenuated in analyses considering only baseline intakes.</div></div><div><h3>Conclusions</h3><div>In this cohort with high milk consumption, whole milk is associated with higher CVD and all-cause mortality, whereas low-fat milk is not. Low-fat milk may be associated with lower risks than whole milk.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 1075-1085"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785899","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":"Corrigendum to “Corrigendum to: Efficacy of rice bran extract for alleviating depressive symptoms in adults: a randomized, double-blind, placebo-controlled trial” Am J Clin Nutr 122 (2025) 112-121","authors":"Sung-Young Huh ,&nbsp;Ye Li Lee ,&nbsp;Su Hui Kim ,&nbsp;Sang Yeoup Lee","doi":"10.1016/j.ajcnut.2025.08.014","DOIUrl":"10.1016/j.ajcnut.2025.08.014","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Page 1136"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006745","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":"Sustainable diets reduce diet-related greenhouse gas emissions and improve diet quality: results from the MyPlanetDiet randomized controlled trial","authors":"Katie P Davies ,&nbsp;Eileen R Gibney ,&nbsp;Ursula M Leonard ,&nbsp;Leona Lindberg ,&nbsp;Jayne V Woodside ,&nbsp;Mairead E Kiely ,&nbsp;Anne P Nugent ,&nbsp;Elena Arranz ,&nbsp;Marie C Conway ,&nbsp;Sinead N McCarthy ,&nbsp;Aifric M O’Sullivan","doi":"10.1016/j.ajcnut.2025.05.015","DOIUrl":"10.1016/j.ajcnut.2025.05.015","url":null,"abstract":"<div><h3>Background</h3><div>Diet-related environmental impacts must be reduced to mitigate climate change. Although many sustainable diets have been proposed, the human and planetary impacts of following such diets have not been tested.</div></div><div><h3>Objective</h3><div>The aim of this study was to assess health and environmental outcomes related to following whole-diet sustainable dietary advice.</div></div><div><h3>Methods</h3><div>The MyPlanetDiet RCT was a 12-week single-blinded, parallel study testing the impacts of a more sustainable diet. Participants were randomly assigned to receive personalized advice based on a sustainable diet (intervention) or based on current healthy eating guidelines (control). Dietary assessments, fasted anthropometry, and fasted serum samples were collected at baseline and end point. The primary outcome was change in diet-related greenhouse gas emissions (GHGE) measured in kilograms carbon dioxide equivalents per day (kgCO₂-eq/d). Secondary outcomes included changes in diet quality, macronutrient and food group intakes, diet-related water footprint, and health biomarkers. Data were analyzed using 2-way mixed analysis of covariance.</div></div><div><h3>Results</h3><div>Study participants (<em>n</em> = 292) decreased diet-related GHGE over time (<em>P</em> &lt; 0.001) with a significant time × group interaction between control (from 6.5 ± 0.2 to 5.7 ± 0.2 kgCO₂-eq/d) and intervention groups (7.1 ± 0.2 to 4.8 ± 0.1 kgCO₂-eq/d; <em>P</em> &lt; 0.001). Diet quality increased in control (from 44.2 ± 0.8 to 52.9 ± 0.9) and intervention (from 44.7 ± 0.8 to 53.0 ± 0.9) groups (<em>P</em> &lt; 0.001). Participants decreased red meat intakes (control: from 34.2 ± 2.9 to 25.7 ± 2.4 g/d; intervention: from 42.7 ± 3.4 to 12.8 ± 1.9 g/d; <em>P</em> &lt; 0.001) and increased plant-based food intakes including beans, peas, and lentils (control: from 15.4 ± 1.9 to 18.3 ± 2.1 g/d; intervention: from 18.4 ± 2.1 to 49.2 ± 4.3 g/d; <em>P</em> &lt; 0.001), fruit (control: from 164.8 ± 12.3 to 264.5 ± 13.9 g/d; intervention: from 188.5 ± 14.2 to 233.7 ± 13.5 g/d; <em>P</em> &lt; 0.001), and vegetables (control: from 148.1 ± 6.5 to 163.1 ± 7.3 g/d; intervention: from 161.3 ± 5.9 to 201.9 ± 8.0 g/d; <em>P</em> &lt; 0.001). No changes in anthropometry, serum biochemistry, or diet-related water footprint were observed.</div></div><div><h3>Conclusions</h3><div>Personalized sustainable dietary advice led to healthier diets and lower diet-related GHGE with no short-term negative health effects.</div><div>This trial was registered with <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT05253547 (<span><span>https://clinicaltrials.gov/study/NCT05253547</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 962-971"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196020","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":"Protecting infants from environmental contaminants in milk and formula: addressing assessment gaps and advancing next steps","authors":"Jose L Domingo","doi":"10.1016/j.ajcnut.2025.08.009","DOIUrl":"10.1016/j.ajcnut.2025.08.009","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 911-912"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195778","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":"Fewer bites of beef to make an impact: even small changes toward a more sustainable diet and lifestyle can meet personal and public health goals while addressing planetary health","authors":"John L Sievenpiper ,&nbsp;David JA Jenkins ,&nbsp;Laura Chiavaroli","doi":"10.1016/j.ajcnut.2025.07.022","DOIUrl":"10.1016/j.ajcnut.2025.07.022","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 903-906"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195866","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":"Modeled impacts of substituting meat and dairy with plant-based substitutes on risk of nutrient deficiency and chronic disease–related mortality: a microsimulation study in French adults","authors":"Marion Salomé ,&nbsp;Pascal Leroy ,&nbsp;Jean-François Huneau ,&nbsp;Hélène Fouillet ,&nbsp;Emmanuelle Kesse-Guyot ,&nbsp;Louis-Georges Soler ,&nbsp;François Mariotti","doi":"10.1016/j.ajcnut.2025.07.016","DOIUrl":"10.1016/j.ajcnut.2025.07.016","url":null,"abstract":"<div><h3>Background</h3><div>Meat and dairy substitutes are gaining popularity, but their expected overall impact on health remains unclear.</div></div><div><h3>Objectives</h3><div>We aimed to simulate the complete substitution of meat, milk, and dairy desserts with plant-based substitutes (PBSs) to assess the impact on nutrient deficiency risk and chronic disease–related mortality.</div></div><div><h3>Methods</h3><div>Using individual baseline dietary data from adults in the latest French national survey (<em>N</em> = 2121; INCA3), we simulated isoenergetic diets where all meat, milk, and dairy desserts were replaced by an equivalent amount of PBSs. We constructed mean PBS profiles of varying nutritional quality (high, average, and low) based on the nutrient compositions of 96 PBSs and legumes. Intermediate scenarios (meat-only or dairy-only substitution) were also analyzed. Deficiency risk was assessed using the nutrient security of the diet (SecDiet) probabilistic system, and the number of deaths averted was projected using the Preventable Risk Integrated ModEl.</div></div><div><h3>Results</h3><div>On average, PBS did not increase overall risk of deficiency (SecDiet score: 0.90 ± 0.11 to 0.91 ± 0.11, compared with 0.91 ± 0.11 in the observed diet). However, replacing meat and dairy products increased risk of riboflavin and vitamin B-12 deficiency. Using meat PBS—with reduced consumption of red and processed meat, increased fiber, and improved fatty acid intake—would be the most effective in reducing premature deaths from cardiometabolic diseases and cancer. However, meat PBS led to higher sodium intake, which would slightly offset these benefits. Overall, replacing meat and dairy with PBS would avert between 3721 (95% uncertainty interval: 2712, 4713) and 6671 (95% uncertainty interval: 5527, 7778) deaths from chronic diseases annually, depending on the quality of the PBS (nutrient content and energy density).</div></div><div><h3>Conclusions</h3><div>As modeled, full substitution of animal products with PBS can result in limited increases in deficiency risk, and decreases in chronic disease–related mortality, with meat replacement providing most of the benefits. Expected effects vary widely depending on the nutritional quality of the substitutes.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 1052-1060"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735079","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 cross-sectional and long-term food insecurity with dietary quality among middle-aged and older United Study adults: A Cohort Study from the Health and Retirement Study","authors":"Heejin Lee ,&nbsp;Elizabeth Ludwig-Borycz ,&nbsp;Claire T McEvoy ,&nbsp;Steven G Heeringa ,&nbsp;Julia A Wolfson ,&nbsp;Cindy W Leung","doi":"10.1016/j.ajcnut.2025.07.029","DOIUrl":"10.1016/j.ajcnut.2025.07.029","url":null,"abstract":"<div><h3>Background</h3><div>Food insecurity impedes healthy diet adherence, but few studies, particularly longitudinal studies, have examined these associations in middle-aged and older adults.</div></div><div><h3>Objectives</h3><div>Using the longitudinal Health and Retirement Study (HRS), we examined the associations between cross-sectional and long-term food insecurity and diet quality among United States middle-aged and older adults.</div></div><div><h3>Methods</h3><div>Participants aged ≥50 at the time of initial food insecurity assessment and who completed the 2013 Health Care and Nutrition Study (HCNS) were included (cross-sectional food insecurity: <em>n</em> = 6783; long-term food insecurity: <em>n</em> = 4923). Food insecurity was assessed using the 6-item United States Department of Agriculture Food Security Survey Module in 2013. Long-term food insecurity was estimated by averaging 2 items from the 18-item Household Food Security Survey Module assessed biennially (2002–2012). Dietary intake was assessed using a food frequency questionnaire in 2013 to create 5 diet quality indices: the plant-based diet index (PDI), healthful PDI, unhealthful PDI (uPDI), Mediterranean diet index, and Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegeneration Delay (MIND) diet index. Weighted multivariate linear regression models examined the associations between food insecurity and diet quality indices.</div></div><div><h3>Results</h3><div>In cross-sectional analyses, very low food security was associated with higher scores on the uPDI (1.46; 95% CI: 0.45, 2.48) and low food security was associated with lower Mediterranean diet index scores (−0.69; 95% CI: −1.30, −0.09). In long-term analyses, very low food security was associated with lower scores on overall PDI (−1.15; 95% CI: −2.37, 0.08; <em>P</em>-trend = 0.03), Mediterranean diet index (MIND diet index) (−1.33; 95% CI: −2.24, −0.42; <em>P</em>-trend &lt; 0.01), and Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegeneration Delay diet index (−0.58; 95% CI: −1.00, −0.17; <em>P</em>-trend &lt; 0.01), and higher scores on the uPDI (1.92; 95% CI: 0.15, 3.69; <em>P</em>-trend = 0.01). Associations with health PDI (hPDI) were not significant.</div></div><div><h3>Conclusions</h3><div>Among adults aged 50 y or older, food insecurity, especially long-term very low food security, is adversely associated with diet quality, highlighting the need for policies to reduce food insecurity and facilitate healthy eating habits.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 932-941"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785886","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":"Heme iron compared with ferrous iron salts to treat iron deficiency anemia in Gambian children: a randomized controlled trial","authors":"Mamadou Bah ,&nbsp;Hans Verhoef ,&nbsp;Emmanuel Okoh ,&nbsp;Abdoulie Bah ,&nbsp;Alhasan Colley ,&nbsp;Alasana Saidykhan ,&nbsp;Andrew M Prentice ,&nbsp;Carla Cerami","doi":"10.1016/j.ajcnut.2025.07.037","DOIUrl":"10.1016/j.ajcnut.2025.07.037","url":null,"abstract":"<div><h3>Background</h3><div>Supplementation with conventional ferrous salts has limited efficacy in controlling anemia and improving iron status in children at high risk of inflammation. We assessed whether heme iron polypeptide (HIP), an alternative form of supplemental iron with a distinct absorption pathway, might improve outcomes.</div></div><div><h3>Objectives</h3><div>We compared hemoglobin and ferritin concentrations in anemic Gambian infants aged 6–12 mo after supervised daily oral supplementation with HIP or ferrous sulfate.</div></div><div><h3>Methods</h3><div>Between March 2023 and February 2024, 208 anemic infants, aged 6–12 mo (hemoglobin, 7.0 to &lt;11.0 g/dL) were randomly assigned to 84 d of directly observed daily supplementation with 10 mg elemental iron as HIP or ferrous sulfate. Primary outcomes were hemoglobin and ferritin concentrations at end of intervention. Analysis was by intention-to-treat with multiple imputations to replace missing data.</div></div><div><h3>Results</h3><div>Adherence to treatments was ∼90%. The primary end points of hemoglobin and ferritin concentrations both improved by day 84 with no difference between treatments. For the secondary end point of anemia, the prevalence went from 83.7% to 46.2% in the ferrous sulfate group and from 84.6% to 47.1% in the HIP group. Infants who received HIP had higher serum iron concentration (by 48.4%; 95% CI: 15.4%, 91.0%), higher transferrin saturation (by 52.3%; 95% CI: 17.9%, 96.7%), lower soluble transferrin receptor concentrations (by −9.7%; 95% CI: −16.3%, −2.6%) and lower unsaturated iron-binding capacity (by −7.8%; 95% CI: −13.4%, −1.7%). In a post hoc analysis, HIP had a greater effect on inflammation-adjusted serum ferritin concentrations (by 22.9%; 95% CI: 5.6%, 43.1%). No group differences were found in the frequency of adverse events.</div></div><div><h3>Conclusions</h3><div>There is no benefit of HIP on the primary end points of hemoglobin and ferritin. However, HIP is superior to ferrous sulfate for 5 secondary measures of iron status and might therefore improve iron supply to rapidly developing organs.</div><div>This trial is registered with the Pan African Clinical Trial Registry as PACTR202210523178727 (<span><span>https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=23910</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 4","pages":"Pages 997-1005"},"PeriodicalIF":6.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849509","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}