American Journal of Clinical Nutrition最新文献

{"title":"Providing multiple micronutrients through household salt","authors":"Tor A Strand","doi":"10.1016/j.ajcnut.2025.05.007","DOIUrl":"10.1016/j.ajcnut.2025.05.007","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 5-6"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522685","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":"The association of early pregnancy vitamin D and BMI status with composite adverse pregnancy outcomes: an ancillary analysis of the Vitamin D Antenatal Asthma Reduction Trial","authors":"Catherine Jung ,&nbsp;Zheng Lu ,&nbsp;Augusto A Litonjua ,&nbsp;Joseph Loscalzo ,&nbsp;Scott T Weiss ,&nbsp;Hooman Mirzakhani","doi":"10.1016/j.ajcnut.2025.04.034","DOIUrl":"10.1016/j.ajcnut.2025.04.034","url":null,"abstract":"<div><h3>Background</h3><div>Adverse pregnancy outcomes (APOs) affect ∼20% of pregnancies and pose significant health risks for mothers and fetuses. Identifying risk factors is crucial for developing prevention strategies.</div></div><div><h3>Objectives</h3><div>This study examined the association between vitamin D status, measured by 25-hydroxyvitamin D (25(OH)D) concentrations, and APO risk, and whether this association varies by pregnancy timing and body mass index (BMI) (kg/m²).</div></div><div><h3>Methods</h3><div>In this ancillary analysis of the Vitamin D Antenatal Asthma Reduction Trial, we used multivariable logistic regression models to examine the association between 25(OH)D concentrations in early (10–18 wk) and late (32–38 wk) pregnancy, and development of a composite APO outcome, including pre-eclampsia, gestational hypertension, gestational diabetes, intrauterine growth restriction, and preterm birth.</div></div><div><h3>Results</h3><div>Among 816 participants in the intention-to-treat analysis, 283 composite APO events occurred. Vitamin D supplementation did not significantly reduce APO risk. Participants who developed APOs had lower baseline 25(OH)D concentrations than those who did not (mean ± SD: 21.72 ± 10.04 vs. 23.47 ± 10.29 ng/mL; mean difference ± SE: 1.75 ± 0.78; <em>P</em> = 0.026). A significant interaction was observed between baseline 25(OH)D and BMI (interaction term, odds ratio [OR]: 1.04; 95% confidence interval [95% CI]: 1.00, 1.08; <em>P</em> = 0.041). Among participants with BMI &lt; 25 (reference group), each unit increase in baseline 25(OH)D (ng/mL) was associated with 4% lower odds of developing an APO (OR: 0.96; 95% CI: 0.93, 0.99; <em>P</em> = 0.013), whereas no association was observed among participants with BMI ≥ 25 kg/m² (OR: 1.00; 95% CI: 0.98, 1.02; <em>P</em> = 0.83). Third-trimester 25(OH)D concentrations did not differ between participants with and without APOs.</div></div><div><h3>Conclusions</h3><div>Although vitamin D supplementation did not reduce APO risk, higher early pregnancy 25(OH)D concentrations were associated with lower odds of APOs in participants with BMI &lt; 25. These findings highlight the potential importance of higher early pregnancy 25(OH)D concentrations, particularly among those with normal BMI, in reducing APO risk.</div></div><div><h3>Trial registration</h3><div>This study is an ancillary analysis from VDAART, which is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (NCT00920621: <span><span>https://clinicaltrials.gov/study/NCT00920621?term=vdaart&amp;rank=1</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 324-334"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052382","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":"One-carbon metabolism, insulin resistance, and fecundability in a Singapore prospective preconception cohort study","authors":"Chee Wai Ku ,&nbsp;Hiu Gwan Chan ,&nbsp;Alexandrea Lishan Sia ,&nbsp;Christine Huang ,&nbsp;Jessica Quek ,&nbsp;Yin Bun Cheung ,&nbsp;Karen Mei Ling Tan ,&nbsp;Jun Shi Lai ,&nbsp;Keith M Godfrey ,&nbsp;Jerry Kok Yen Chan ,&nbsp;Fabian Yap ,&nbsp;See Ling Loy","doi":"10.1016/j.ajcnut.2025.04.035","DOIUrl":"10.1016/j.ajcnut.2025.04.035","url":null,"abstract":"<div><h3>Background</h3><div>One-carbon metabolism, which consists of the folate cycle, methionine cycle, and trans-sulphuration pathway, is associated with nucleotide synthesis. However, the association between one-carbon metabolites, metabolic status, and reproductive health remains poorly understood.</div></div><div><h3>Objectives</h3><div>We examined the association between the one-carbon cycle plasma metabolites and fecundability and determined whether it is modified by metabolic health status, as assessed by insulin resistance (IR).</div></div><div><h3>Methods</h3><div>This prospective cohort study utilized data from the Singapore PREconception Study of long-Term maternal and child Outcomes. Fasting blood samples were collected, and one-carbon cycle metabolites were measured. Fecundability was measured by time to pregnancy in menstrual cycles within a year of enrollment. We identified patterns in plasma one-carbon cycle metabolites using principal component (PC) analysis. We estimated fecundability ratios (FRs) and confidence intervals (CIs), with confounder adjustment using discrete-time proportional hazards models. IR was determined using the Homeostatic Model Assessment 2 Insulin Resistance score, classified into lower IR (&lt;0.65) and higher IR (≥0.65). The role of IR was examined through interaction tests and stratification.</div></div><div><h3>Results</h3><div>We identified 3 one-carbon cycle PCs. PC1, characterized by higher folate and lower homocysteine concentrations; PC2, characterized by higher concentrations of dimethylglycine, choline, methionine, and betaine; and PC3, characterized by higher concentrations of vitamins B2, B12, and B6. Each <em>z</em>-score increase in PC1 was associated with a 17% increase in fecundability (FR: 1.17; 95% CI: 1.03, 1.33). The association between PC1 and fecundability was more evident in women with lower IR (FR: 1.30; 95% CI: 1.08, 1.57) but was attenuated in those with higher IR (FR: 1.09; 95% CI: 0.92, 1.30), with a <em>P</em>-for-interaction of 0.127. PC2 and PC3 were not associated with fecundability.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that higher folate and lower homocysteine concentrations, which reflected the interlinked folate and methionine cycles, were associated with higher fecundability in preconception women with lower IR but less so in those with higher IR.</div><div>Clinical Trial Registration: This trial was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> as NCT03531658 (<span><span>https://www.clinicaltrials.gov/study/NCT03531658</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 335-343"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063034","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 quintuply-fortified salt on the micronutrient status of females of reproductive age in Punjab, India: a randomized, community-based trial","authors":"Yvonne E Goh ,&nbsp;Mona Duggal ,&nbsp;Reena Das ,&nbsp;Mari S Manger ,&nbsp;Manu Jamwal ,&nbsp;Bidhi L Singh ,&nbsp;Gurjinder Kaur Brar ,&nbsp;Julie M Long ,&nbsp;Jamie Westcott ,&nbsp;Lauren Thompson ,&nbsp;Charles D Arnold ,&nbsp;Nancy F Krebs ,&nbsp;Kenneth H Brown ,&nbsp;Christine M McDonald","doi":"10.1016/j.ajcnut.2025.04.009","DOIUrl":"10.1016/j.ajcnut.2025.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Innovative fortification solutions are needed to address micronutrient deficiencies, which remain highly prevalent among adult females in India.</div></div><div><h3>Objectives</h3><div>The objective of this trial was to evaluate the effects of quintuply-fortified salt (QFS) compared with iodized salt on the micronutrient status of nonpregnant females of reproductive age (NPFRA) in Punjab, India.</div></div><div><h3>Methods</h3><div>We conducted a double-blind, randomized, controlled, community-based trial. A total of 998 NPFRA were randomly assigned to receive: <em>1</em>) QFS with iron as encapsulated ferrous fumarate, zinc, vitamin B₁₂, folic acid, and iodine (eFF-QFS); <em>2</em>) QFS with the same micronutrients, but iron as encapsulated ferric pyrophosphate plus ethylenediaminetetraacetic acid (eFePP-QFS); or <em>3</em>) iodized salt. Biomarkers of micronutrient status were assessed at enrollment, 6 mo and 12 mo.</div></div><div><h3>Results</h3><div>At enrollment, the prevalence of anemia, iron deficiency, hypozincemia, vitamin B₁₂ insufficiency, and folate insufficiency among trial participants was 47.9%, 59.7%, 35.5%, 61.5%, and 69.7%, respectively. Mean household salt disappearance, measured at monthly home visits, was 6.0 g/adult female equivalent/day [95% confidence interval (CI): 5.9, 6.1] and did not vary across groups or time. At 6 mo, the odds of vitamin B₁₂ insufficiency, folate insufficiency, and hypozincemia were, respectively, 80% [odds ratio (OR): 0.20; 95% CI: 0.13, 0.31], 86% (OR: 0.14; 95% CI: 0.09, 0.21), and 38% (OR: 0.62; 95% CI: 0.41, 0.93) lower in the eFF-QFS compared with the iodized salt group. Effects on vitamin B₁₂ and folate status were sustained at 12 mo, and were comparable in the eFePP-QFS compared with the iodized salt group. There was a small, marginally significant, reduction in iron deficiency in the eFF-QFS compared with the iodized salt group at 6 (OR: 0.64; 95% CI: 0.42, 0.98; <em>P</em> = 0.08) and 12 mo (OR: 0.58; 95% CI: 0.35, 0.95; <em>P</em> = 0.06), but not in the eFePP-QFS compared with the iodized salt group. There were no groupwise differences in anemia at either time point.</div></div><div><h3>Conclusions</h3><div>Multiple micronutrient salt fortification may be an effective strategy to improve micronutrient status, especially vitamin B₁₂ and folate, among NPFRA at high risk of deficiency.</div></div><div><h3>Trial registration number</h3><div>This study was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span>, with NCT05166980 and at Clinical Trials Registry-India with CTRI/2022/02/040333.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 146-156"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522266","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":"A novel nutritional assessment tool combining the mNUTRIC Score and the GLIM criteria with prognostic value for in-hospital mortality in critically ill patients: a single-center retrospective cohort study","authors":"Hye Jin Kim ,&nbsp;Jae Chan Shim ,&nbsp;Ju Hyun Oh ,&nbsp;Sang Bong Choi ,&nbsp;Hyuk Pyo Lee ,&nbsp;Youjin Chang","doi":"10.1016/j.ajcnut.2025.05.005","DOIUrl":"10.1016/j.ajcnut.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>There is no gold standard tool for nutritional assessment in critically ill patients. The modified Nutrition Risk in Critically Ill (mNUTRIC) score assesses risk of future malnutrition, whereas the Global Leadership Initiative on Malnutrition (GLIM) criteria diagnose only current malnutrition.</div></div><div><h3>Objectives</h3><div>We aimed to evaluate the prognostic performance of a novel nutritional assessment tool that combines the mNUTRIC score and GLIM criteria for hospital outcomes among intensive care unit (ICU) patients.</div></div><div><h3>Methods</h3><div>A single-center, retrospective observational cohort study was conducted on patients admitted to the ICU between 1 August, 2018, and 7 June, 2021. The novel tool was categorized into 4 groups: group 1: low risk (0–4 points) by mNUTRIC plus no malnutrition from the GLIM; group 2: low risk plus moderate malnutrition or high risk (5–9 points) plus no malnutrition; group 3: high risk plus moderate malnutrition or low risk plus severe malnutrition; and group 4: high risk plus severe malnutrition.</div></div><div><h3>Results</h3><div>A total of 724 patients were enrolled. The in-hospital mortality rates for groups 1–4 were 3%, 16%, 32%, and 52%, respectively. A poor nutritional status by the novel nutritional assessment tool was an independent risk factor for in-hospital mortality when compared with group 1, particularly as patients progressed to group 4 (odds ratio: 2.32; 95% confidence interval: 1.84, 2.93). In the receiver operating characteristic (ROC) analysis, the novel tool demonstrated the strongest prognostic performance for in-hospital mortality (area under the ROC curve: 0.759; 95% CI: 0.723, 0.795) compared with validated severity scoring systems and other significant risk factors such as use of mechanical ventilation.</div></div><div><h3>Conclusions</h3><div>This novel nutritional assessment tool has strong prognostic value in being associated with in-hospital mortality. Prospective validation with an external dataset is warranted. A comprehensive nutritional assessment of the current status and future risk at ICU admission could be the most critical factor in assessing the prognosis of critically ill patients</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 306-314"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004423","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":"Rising phytate and oxalate intake, declining calcium intake, and bone health in United States adults: 1999–2023, a serial cross-sectional analysis","authors":"Hongbing Sun ,&nbsp;Connie M Weaver","doi":"10.1016/j.ajcnut.2025.05.018","DOIUrl":"10.1016/j.ajcnut.2025.05.018","url":null,"abstract":"<div><h3>Background</h3><div>The relationship among dietary patterns, calcium bioavailability, and bone health in United States adults remains unclear.</div></div><div><h3>Objectives</h3><div>This study aims to examine associations among dietary calcium, phytate, and oxalate intake and calcium bioavailability and bone health indicators, including bone mineral density (BMD), osteoporosis prevalence, and fracture incidence.</div></div><div><h3>Methods</h3><div>A serial cross-sectional analysis was conducted using National Health and Nutrition Examination Survey (NHANES) data (1999–2023) for adults aged 18–85. Serum calcium and BMD were measured in NHANES laboratories; dietary intake, osteoporosis, and fracture history were self-reported. Primary exposures included dietary calcium, phytate, and oxalate; outcomes included estimated calcium absorption, and changes in BMD, osteoporosis, and fractures. Survey-weighted regression models were used to assess temporal changes and associations across survey cycles.</div></div><div><h3>Results</h3><div>In 2017–2020, mean phytate intake was significantly higher than in 1999–2000 (834.1 ± 26.2 mg/d compared with 593.5±23.2 mg/d), and oxalate intake increased from 241.5 ± 6.6 mg/d to 280.5 ± 6.6 mg/d. Calcium intake peaked at 1025.3 ± 9.7 mg/d in 2009–2010 but lowered to 899.9 ± 15.7 mg/d by 2021–2023. Periods of lower calcium intake and higher phytate and oxalate concentrations corresponded with reduced calcium absorption. Milk consumption, a primary source of bioavailable calcium, decreased from 0.95 ± 0.03 cup-equivalents/d in 1999–2000 to 0.56 ± 0.02 in 2017–2020. Serum calcium concentrations lowered from 9.46 ± 0.02 mg/dL in 2009–2010 to 9.29 ± 0.01 mg/dL in 2017–2020. BMD at the femur dropped from 0.982 ± 0.004 to 0.934 ± 0.005 g/cm², and at the femoral neck from 0.849 ± 0.003 to 0.775 ± 0.005 g/cm² between 2009–2010 and 2017–2020. Osteoporosis prevalence increased, and fractures at the hip, wrist, and spine were more frequently reported in 2017–2020 compared with those in 2009–2010.</div></div><div><h3>Conclusions</h3><div>Diets with greater phytate and oxalate and lower calcium and dairy intake may contribute to reduced calcium bioavailability and unfavorable bone health outcomes among United States adults.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 315-323"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133191","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":"Should the recommendations for dietary protein and amino acid intake in humans be revised?","authors":"Daniel Tomé","doi":"10.1016/j.ajcnut.2025.05.004","DOIUrl":"10.1016/j.ajcnut.2025.05.004","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 3-4"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522684","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":"Association of adherence to Mediterranean diet and changes over time with all-cause mortality in older adults: the Seniors-ENRICA cohorts","authors":"Miguel Angelo Duarte Junior ,&nbsp;Verónica Cabanas-Sánchez ,&nbsp;Salud Pintos-Carrillo ,&nbsp;Rosario Ortolá ,&nbsp;Fernando Rodríguez-Artalejo ,&nbsp;Mercedes Sotos-Prieto ,&nbsp;David Martinez-Gomez","doi":"10.1016/j.ajcnut.2025.04.027","DOIUrl":"10.1016/j.ajcnut.2025.04.027","url":null,"abstract":"<div><h3>Background</h3><div>Despite the well-recognized nutritional quality and health benefits of the Mediterranean diet (MD), its adherence appears to be declining. However, the extent of this decline and its relationship with mortality in the older population remains unclear.</div></div><div><h3>Objectives</h3><div>This study aims to analyze the associations between adherence to MD and its changes over time with all-cause mortality in older adults.</div></div><div><h3>Methods</h3><div>We used data from 3518 and 3273 older adults, aged 60–96 y at baseline, participating in the Seniors-ENRICA-1 and 2 cohorts, respectively. Adherence to MD was assessed by the 14-item Mediterranean Diet Adherence Screener (MEDAS) and classified as low (&lt;7 points), moderate (7–8 points), and high (≥9 points). All-cause mortality was ascertained up to 31 January, 2024. Analyses were performed using Cox regression models adjusted by main confounders.</div></div><div><h3>Results</h3><div>Baseline [<em>n</em> = 6083; follow-up of 7.9 y; per 1-point: hazard ratio (HR) = 0.92; 95% confidence interval (CI): 0.89, 0.95] and changes (<em>n</em> = 2070; follow-up of 11.2 y; per 1-point increase: HR = 0.91; 95% CI: 0.86, 0.97) in MEDAS were associated with a lower mortality. At baseline, moderate (HR = 0.87; 95% CI: 0.77, 0.99) and high (HR = 0.70; 95% CI: 0.59, 0.82) adherence to MD were associated with lower mortality, compared with low adherence. In addition, participants who maintained high adherence to MD in both examinations had the lowest mortality compared with consistently low adherence (HR = 0.54; 95% CI: 0.38, 0.76). Baseline and maintained adherence in items of carbonated sweetened beverages (&lt;1 serving/d), fish/seafood (≥3 servings/wk), commercial pastry (&lt;2 servings/wk), and nuts (≥3 servings/wk) was associated with lower mortality.</div></div><div><h3>Conclusions</h3><div>Initial adherence to MD, as well as subsequent maintained or increased adherence, is associated with lower all-cause mortality in older adults, with some foods as the main drivers.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 255-262"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052377","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":"Maternal multiple micronutrient supplementation in rural Pakistan increased some milk micronutrient concentrations, but not infant growth, at three-months postpartum: a randomized controlled trial substudy","authors":"Jo-Anna B Baxter ,&nbsp;Yaqub Wasan ,&nbsp;Allison I Daniel ,&nbsp;Kehkashan Begum ,&nbsp;Amjad Hussain ,&nbsp;Junaid Iqbal ,&nbsp;Susanne Aufreiter ,&nbsp;Megan R Beggs ,&nbsp;Lauren Duan ,&nbsp;Adrianna Greco ,&nbsp;Carolina Huang ,&nbsp;Sajid Soofi ,&nbsp;Robert HJ Bandsma ,&nbsp;Zulfiqar A Bhutta ,&nbsp;Deborah L O’Connor","doi":"10.1016/j.ajcnut.2025.05.019","DOIUrl":"10.1016/j.ajcnut.2025.05.019","url":null,"abstract":"<div><h3>Background</h3><div>In Pakistan, maternal micronutrient deficiencies are highly prevalent, and stunting affects 43% of infants by 6-mo postpartum. Human milk composition for some micronutrients can be negatively affected by suboptimal maternal nutrition; however, it is unknown whether this affects infant growth.</div></div><div><h3>Objectives</h3><div>We aimed to determine whether mothers receiving multiple micronutrient supplements (MMSs) compared with standard of care had <em>1)</em> greater concentrations of iodine, vitamins A, E, and B12, and folate in their milk at 3-mo postpartum; and <em>2)</em> improved growth of their offspring. Associations between milk micronutrients and infant growth were also explored.</div></div><div><h3>Methods</h3><div>This substudy was nested within a district-based, cluster-randomized, controlled trial (MaPPS Trial; 25,477 females) with the primary aim of evaluating whether maternal MMS (preconception: twice-weekly, pregnancy and postpartum: daily, to 6-mo postpartum) compared with the standard of care (preconception: no intervention; pregnancy and postpartum: daily iron and folic acid supplementation, to 6-mo postpartum) in rural Pakistan improved infant birthweight. Substudy mother-infant dyads (<em>n</em> = 186) were recruited if infants were term-born and predominantly or exclusively breastfed. Milk micronutrient concentrations were compared to reference values derived from mother’s milk [mother’s milk adequacy estimates (MAEs)].</div></div><div><h3>Results</h3><div>MMS increased milk iodine and vitamin A concentrations, but not vitamins B12 or E, nor folate. Importantly, few milk sample micronutrients in either arm were above existing MAEs. MMS compared to standard of care did not improve infant growth. Independent of allocation, having all 5 milk micronutrients below MAEs was associated with decreased infant length-for-age z-score (β: –0.39, 95% CI: –0.73, –0.04; <em>P</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>In a population with maternal micronutrient deficiencies, providing maternal MMS was not associated with milk micronutrient concentrations above MAEs; however, infants born to mothers with milk below MAEs for all investigated micronutrients appeared to experience poorer growth. Further research is needed to understand longer-term implications, if any.</div></div><div><h3>Clinical Trial Registry number and website</h3><div>ClinlicalTrials.gov: NCT04451395 (<span><span>https://clinicaltrials.gov/study/NCT04451395</span><svg><path></path></svg></span>) and NCT03287882 (<span><span>https://clinicaltrials.gov/study/NCT03287882</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 174-184"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133144","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":"Vitamin D3 and marine ω-3 fatty acids supplementation and leukocyte telomere length: 4-year findings from the VITamin D and OmegA-3 TriaL (VITAL) randomized controlled trial","authors":"Haidong Zhu ,&nbsp;JoAnn E Manson ,&nbsp;Nancy R Cook ,&nbsp;Bayu B Bekele ,&nbsp;Li Chen ,&nbsp;Kevin J Kane ,&nbsp;Ying Huang ,&nbsp;Wenjun Li ,&nbsp;William Christen ,&nbsp;I-Min Lee ,&nbsp;Yanbin Dong","doi":"10.1016/j.ajcnut.2025.05.003","DOIUrl":"10.1016/j.ajcnut.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Limited studies suggest that vitamin D or omega 3 fatty acids (n-3 FAs) supplementation may be beneficial for telomere maintenance, however, evidence from large randomized clinical trial is lacking.</div></div><div><h3>Objective</h3><div>We aimed to determine whether vitamin D or n-3 FAs supplementation reduce leukocyte telomere length (LTL) attrition over time by leveraging the VITamin D and OmegA-3 TriaL (VITAL) trial.</div></div><div><h3>Methods</h3><div>VITAL is a large, randomized, double-blind, placebo-controlled tr ial with a 2 x 2 factorial design of vitamin D3 (2,000 IU/day) and marine n-3 FAs (1 g/day) supplements for 5 years among a representative sample of 25,871 US females ≥55 and males ≥50 years of age. The VITAL Telomere study (NCT04386577) included 1054 participants who were evaluated in person at the Harvard Clinical and Translational Science Center. LTL was determined by the Absolute Human Telomere Length Quantification quantitative Polymerase Chain Reaction (PCR) method at baseline, Year 2, and Year 4. The pre-specified primary outcome measures were changes in LTL between baseline, Year 2 and Year 4. Analyses of intervention effect used mixed-effects linear regression models.</div></div><div><h3>Results</h3><div>LTL was measured in a total of 2,571 samples from the 1031 participants at baseline, year 2, and year 4. Compared to placebo, vitamin D3 supplementation significantly decreased LTL attrition by 0.14 kilo base pairs (kb) (95%CI: 0.007, 0.27) over 4 years (p = 0.039). Overall trend analysis showed that the vitamin D3 supplementation group had LTLs that were about 0.035 kb higher per year of follow-up compared to placebo group (95%CI: 0.002, 0.07, p=0.037). Marine n-3 FAs supplementation had no significant effect on LTL at either year 2 or year 4.</div></div><div><h3>Conclusion</h3><div>4-years of supplementation with 2000 IU/day vitamin D₃ reduced telomere attrition by 140 bp, suggesting that vitamin D₃ daily supplementation with or without n-3 FAs might have a role in counteracting telomere erosion or cell senescence.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 39-47"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133216","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}