American Journal of Clinical Nutrition最新文献

{"title":"The global leadership initiative on malnutrition (GLIM).","authors":"Gordon L Jensen, Charlene Compher","doi":"10.1016/j.ajcnut.2025.06.028","DOIUrl":"https://doi.org/10.1016/j.ajcnut.2025.06.028","url":null,"abstract":"<p><p>A lack of global consensus on diagnostic criteria for malnutrition in adults in diverse healthcare settings limits our ability to share meaningful data and compare promising interventions. The Global Leadership Initiative on Malnutrition (GLIM) is a collaborative global effort to address this shortcoming. A current understanding of the interplay between malnutrition, disease, and inflammation was used to create a simple diagnostic framework comprised of etiologic and phenotypic criteria. It was specifically designed to accommodate healthcare settings where skilled nutrition expertise, laboratory assessments, and high technology body composition methodologies may not be readily available. The purpose of this paper is to present controversies, limitations, and research gaps that have been recognized through our ongoing review of GLIM related research literature and procedures. We share these issues and the ongoing efforts of GLIM working groups to address them. The use of GLIM malnutrition criteria that closely resemble those found in other validated tools raises the opportunity to further standardize malnutrition language and severity cutoffs used to characterize malnutrition criteria. Clinical Trial Registry number - Not applicable.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561891","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 age and sex on the urinary elimination of a single dose of mixed flavonoids: results from a single-arm intervention in healthy United Kingdom adults","authors":"Colin D Kay ,&nbsp;Noemi Tejera ,&nbsp;Amy Jennings ,&nbsp;Sumanto Haldar ,&nbsp;Bethany C. Diment ,&nbsp;Damon Bevan ,&nbsp;Lisa C Crossman ,&nbsp;Sherly Li ,&nbsp;Aedin Cassidy ,&nbsp;Anne-Marie Minihane","doi":"10.1016/j.ajcnut.2025.05.006","DOIUrl":"10.1016/j.ajcnut.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Nutrition intervention trials demonstrate that increased flavonoid intake can have clinically meaningful impacts on disease outcomes/biomarkers; however, high variability in absorption and metabolism and large heterogeneity in biochemical and physiological responses are observed. The etiology of this variability is poorly understood.</div></div><div><h3>Objective</h3><div>The objective of this study was to explore the relationships between sex, age, and microbiota speciation on mixed flavonoid elimination over 24 h.</div></div><div><h3>Methods</h3><div>Healthy males and females (<em>n</em> = 163) prospectively recruited on the basis of age (18–30 y or 65–77 y) and sex consumed a standardized flavonoid-rich test meal providing 640-mg cocoa/chocolate flavan-3-ols, 340-mg citrus flavanones, and 390-mg blackberry anthocyanins. Urinary samples collected at baseline (−24 to 0 h), 0 to 3.5 h, &gt;3.5 h to 7 h, and &gt;7 to 24 h were analyzed for flavonoids and their metabolites by ultra-high-performance liquid chromatography-mass spectrometry (UPLC-MS/MS). Stool microbiome speciation was determined via Illumina sequencing. Linear mixed-effect models were used to assess differences in cumulative excretion across age and sex with time-by-group interaction taken as the principal analysis of effect.</div></div><div><h3>Results</h3><div>There were no group (older females, older males, younger females, and younger males) differences in total 24 h urinary metabolite recovery, but there was a trend toward a higher rate of cumulative recovery in older males versus younger males at 24 h (<em>P</em>-group at 24h = 0.06). Of 76 metabolites, 20 had significantly different times of maximum urine excretion (Tmax) by age and 9 by sex, with a later mean Tmax observed for older participants (92% of instances). Associations with age were not mediated by body mass index (BMI) or microbiome speciation. Significant differences in maximum urine excretion (Cmax) by sex were observed for only 6 metabolites and differences by age for 5 metabolites.</div></div><div><h3>Conclusion</h3><div>Total elimination recovery of (poly)phenols was relatively consistent across age and sex groups, whereas elimination kinetics (Tmax) differed substantially being much later in older indivudals, possibly resulting from differences in intestinal transit time or kidney clearance. Assuming (poly)phenol metabolites have varying biological activities, establishing dose-response relationships and defining metabolite profiles in population subgroups is required to inform the future development of dietary flavonoid/(poly)phenol recommendations.</div><div>This trial was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT01922869</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 101-111"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081857","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":"Three decades of the Mediterranean diet pyramid: A narrative review of its history, evolution, and advances","authors":"Frank B Hu ,&nbsp;Greg Drescher ,&nbsp;Antonia Trichopoulou ,&nbsp;Walter C Willett ,&nbsp;Miguel A Martínez-González","doi":"10.1016/j.ajcnut.2025.04.036","DOIUrl":"10.1016/j.ajcnut.2025.04.036","url":null,"abstract":"<div><h3>Background</h3><div>The Mediterranean diet (MedDiet) pyramid was officially published in the <em>American Journal of Clinical Nutrition</em> in 1995. Since then, our understanding of the role of the MedDiet and its role in reducing risk of chronic diseases has grown substantially.</div></div><div><h3>Objectives</h3><div>This article aims to provide a narrative review of the historical context of the MedDiet and its environmental impact, summarize health-related evidence from the past 3 decades, and explore its practical applications and cultural adaptations.</div></div><div><h3>Methods</h3><div>Relevant studies were identified through searches of PubMed and other major databases. We prioritzed publications from the past 3 decades, while also including influential earlier studies where appropriate. Evidence was synthesized qualitatively to summarize key findings and identify gaps for future research.</div></div><div><h3>Results</h3><div>A large body of evidence from prospective cohort studies, randomized controlled trials, and mechanistic studies consistently supports the benefits of the MedDiet for the prevention of chronic diseases, particularly cardiometabolic diseases and the improvement of healthy aging. Growing evidence demonstrates that the MedDiet promotes favorable changes in circulating metabolites and gut microbiome composition, providing novel insights into biological mechanisms underlying its health benefits and informing the development of precision nutrition strategies. The MedDiet aligns with the principles of the planetary health diet recommended by the EAT-Lancet Commission, which aims to promote both human health and environmental sustainability. The development of the MedDiet pyramid 30 y ago inspired the creation of the Asian, African, and Latin-American heritage diet pyramids.</div></div><div><h3>Conclusions</h3><div>Over the past 3 decades, substantial evidence has accumulated to strongly support the benefits of the MedDiet in preventing chronic diseases and promoting healthy aging. Despite robust evidence, further studies are needed to evaluate the long-term effectiveness and adaptability of the MedDiet across diverse populations, cultural settings, and food environments.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 17-28"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081862","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 sociodemographic factors and a healthy and sustainable dietary pattern in adult population in Mexico, United States, and Canada: a cross-sectional study","authors":"Yazmin Venegas-Aviles ,&nbsp;Sonia Rodríguez-Ramírez ,&nbsp;Aaron Salinas-Rodríguez ,&nbsp;Tania G Sánchez-Pimienta","doi":"10.1016/j.ajcnut.2025.05.010","DOIUrl":"10.1016/j.ajcnut.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Evaluating diet in terms of health and environmental impact is crucial to transform current food systems to encourage a healthier and more sustainable approach.</div></div><div><h3>Objectives</h3><div>In this study, we analyzed the association between a healthy and sustainable dietary pattern and sociodemographic factors in adults from Mexico, the United States, and Canada.</div></div><div><h3>Methods</h3><div>This cross-sectional study included adults aged ≥20 y. We assessed the dietary quality on health and environment dimensions using the World Index for Sustainability and Health (WISH). Dietary information was collected using a 24-h recall from national surveys in Mexico, the United States, and Canada. Compliance with the recommendations of 13 food groups was estimated to obtain a total score of 130. Multiple linear regression models were used to estimate the association between the total score and sociodemographic factors.</div></div><div><h3>Results</h3><div>The total WISH score was low in Mexico (47.6 ± 0.78), Canada (44.2 ± 0.29), and the United States (41.3 ± 0.31). The highest scores in protective foods were whole grains (4.8 ± 0.25) in Mexico. In limiting foods, the lowest scores were: red meat (4.4 ± 0.10) and added sugars (3.0 ± 0.10) in the United States and saturated fat in Canada (5.5 ± 0.09). Being female [<em>β</em>: 2.4, 95% confidence interval (CI): 1.4, 3.5], or over 60 y old (<em>β</em>: 3.1, 95% CI: 1.8, 4.3) and having a higher educational level (<em>β</em>: 2.5, 95% CI: 1.4, 3.6) were associated with higher scores.</div></div><div><h3>Conclusions</h3><div>Mexico, the United States, and Canada have an unhealthy and high environmental impact dietary pattern. The groups with lower compliance are males, younger individuals, and those with lower educational attainment.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 137-145"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121460","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 dietary cholesterol from eggs and saturated fat on LDL cholesterol levels: a randomized cross-over study","authors":"Sharayah Carter ,&nbsp;Alison M Hill ,&nbsp;Catherine Yandell ,&nbsp;Lisa Wood ,&nbsp;Alison M Coates ,&nbsp;Jonathan D Buckley","doi":"10.1016/j.ajcnut.2025.05.001","DOIUrl":"10.1016/j.ajcnut.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) remains a leading cause of death. Although dietary cholesterol from eggs has been a focus of dietary guidelines, recent evidence suggests that saturated fat has a greater impact on LDL cholesterol.</div></div><div><h3>Objectives</h3><div>This study examined the independent effects of dietary cholesterol and saturated fat on LDL concentrations.</div></div><div><h3>Methods</h3><div>In this randomized, controlled, cross-over study (clinicaltrials.gov, NCT05267522), 61 adults (age 39 ± 12 y, BMI 25.8 ± 5.9 kg/m²) with baseline LDL cholesterol &lt;3.5 mmol/L (135.3 μg/dL) were assigned to 3 isocaloric diets for 5 wk each: high-cholesterol (600 mg/d), low-saturated fat (6%) including 2 eggs/d (EGG); low-cholesterol (300 mg/d), high-saturated fat (12%) without eggs (EGG-FREE); and a high-cholesterol (600 mg/d), high-saturated fat (12%) control diet (CON) including 1 egg/wk. Outcomes were assessed at the end of each diet phase.</div></div><div><h3>Results</h3><div>Fifty-four participants completed ≥1 diet phase, and 48 completed all diet phases. Compared with CON, EGG but not EGG-FREE reduced LDL cholesterol (CON 109.3 ± 3.1 μg/dL compared with EGG 103.6 ± 3.1 μg/dL <em>P =</em> 0.02 compared with EGG-FREE 107.7 ± 3.1 μg/dL, <em>P =</em> 0.52). Across all diets, saturated fat intake was positively correlated with LDL cholesterol (<em>β</em> = 0.35, <em>P =</em> 0.002), whereas dietary cholesterol was not (<em>β</em> = −0.006, <em>P =</em> 0.42). Compared with CON, EGG but not EGG-FREE reduced concentrations of large (EGG <em>β</em> = −48.6, <em>P =</em> 0.03; EGG-FREE <em>β</em> = −35.85, <em>P =</em> 0.12) and increased concentrations of small LDL particles (EGG <em>β</em> = 95.1, <em>P =</em> 0.004; EGG-FREE <em>β</em> = 55.82, <em>P =</em> 0.10).</div></div><div><h3>Conclusions</h3><div>Saturated fat, not dietary cholesterol, elevates LDL cholesterol. Compared with consuming a high-saturated fat diet with only 1 egg/wk, consuming 2 eggs daily as part of a low-saturated fat diet lowers LDL concentrations, which may reduce CVD risk. However, this effect on CVD risk may be mitigated, at least in part, by a reduction in less-atherogenic large LDL particles and an increase in more atherogenic small LDL particles.</div></div><div><h3>Trial registration</h3><div>This trial was registered at clinicaltrials.gov as NCT05267522 (https://clinicaltrials.gov/study/NCT05267522?term=eggs%20and%20cholesterol&amp;rank=3).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 83-91"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052378","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":"Single-cell transcriptomics reveals that human milk feeding shapes neonatal immune cell interleukin signaling pathways in a nonrandomized clinical trial","authors":"Michael L Salinas ,&nbsp;Bharath Kumar Mulakala ,&nbsp;Laurie A Davidson ,&nbsp;James J Cai ,&nbsp;Sharon M Donovan ,&nbsp;Robert S Chapkin ,&nbsp;Laxmi Yeruva","doi":"10.1016/j.ajcnut.2025.04.024","DOIUrl":"10.1016/j.ajcnut.2025.04.024","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have indicated the benefits of human milk feeding to infants however, mechanisms behind positive health outcomes have not been investigated.</div></div><div><h3>Objectives</h3><div>The study aimed to characterize circulating immune cell subpopulation gene expression in human milk-fed (HMF) compared with cow milk formula-fed (FF) infants using single-cell transcriptomics.</div></div><div><h3>Methods</h3><div>Peripheral blood mononuclear cells (PBMCs) were isolated from healthy HMF (<em>n =</em> 6), and FF (<em>n =</em> 3) infants who were 3–3.5 mo old and enrolled in a nonrandomized clinical trial. Single-cell RNA sequencing was used to generate a PBMC atlas and evaluate gene expression in immune cell subsets. Differential expression analysis was performed on each cell type independently after clustering the cells by similar marker gene expression using the scGEAToolbox. Differentially expressed genes were subjected to pathway analyses using an online functional enrichment analysis program.</div></div><div><h3>Results</h3><div>The relative abundance (%) of T and B lymphocytes, natural killer (NK) cells, and plasmacytoid dendritic cells were similar, whereas monocytes were higher in FF infants than in HMF infants (22.6 ± 10.7 compared with 8.3 ± 5.6; <em>P =</em> 0.0314). In addition, innate and adaptive immune cells from FF infants exhibited a higher activation state compared with HMF infants. We identified 16 distinct cell subsets from the major immune cell types: 3 monocyte subsets, 4 NK subsets, 2 B cell subsets, and 7 T cell subsets. Transcriptional profiles of each peripheral innate and adaptive immune cell subtype varied between HMF and FF infants. Pathway enrichment analysis of cell-specific transcriptional changes within subsets of major cell types revealed that the interleukin (IL)-4/IL-13 signaling pathways were upregulated in FF infants relative to HMF infants.</div></div><div><h3>Conclusions</h3><div>These findings suggest that human milk downregulates peripheral immune cell cytokine transcriptional signatures linked to allergic inflammation and infection relative to formula feeding.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 196-207"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057384","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 prenatal nut and seafood consumption and child neuropsychological function from 4 to 15 years of age: a population-based cohort study","authors":"Ariadna Pinar-Martí ,&nbsp;Nicolas Ayala-Aldana ,&nbsp;Marina Ruiz-Rivera ,&nbsp;Nerea Lertxundi ,&nbsp;Mikel Subiza-Pérez ,&nbsp;Llúcia González-Safont ,&nbsp;Jesús Vioque ,&nbsp;Isolina Riaño-Galán ,&nbsp;Cristina Rodríguez-Dehli ,&nbsp;Lucía Iglesias-Vázquez ,&nbsp;Victoria Arija ,&nbsp;Silvia Fernández-Barrés ,&nbsp;Dora Romaguera ,&nbsp;Vicenç Pascual-Rubio ,&nbsp;Albert Fabregat-Sanjuan ,&nbsp;Darren Healy ,&nbsp;Xavier Basagaña ,&nbsp;Martine Vrijheid ,&nbsp;Mònica Guxens ,&nbsp;Maria Foraster ,&nbsp;Jordi Julvez","doi":"10.1016/j.ajcnut.2025.04.032","DOIUrl":"10.1016/j.ajcnut.2025.04.032","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the role of maternal diet in early brain development is critical, as pregnancy represents a period of significant vulnerability and growth for the developing brain.</div></div><div><h3>Objectives</h3><div>This study aims to assess the association between maternal nuts, total seafood, and large fatty fish consumption during pregnancy and offspring neuropsychological function ≤15 y, considering the potential mediation of omega-3 fatty acids.</div></div><div><h3>Methods</h3><div>This study was part of The Spanish Childhood and Environment birth cohort, following 1737 mother–child pairs from pregnancy to age 15. Maternal diet was evaluated using a semiquantitative food frequency questionnaire, whereas children’s neuropsychological function was measured through standardized computer-based tests. Attention (hit reaction time and its variability, HRT and HRT-SE) was measured with the Conners’ Kiddie Continuous Performance Test and the Attention Network Test. Working memory (detectability in 2-back, d2′, and 3-back tasks, d3′) was evaluated using the N-back task. Fluid intelligence was assessed with Raven’s Progressive Matrices and the Test of Primary Mental Abilities. Linear mixed-effects regression models assessed the association of nuts, seafood and large fatty fish with neuropsychological outcomes, whereas generalized structural equation modeling was used for mediation analyses.</div></div><div><h3>Results</h3><div>Higher maternal nut consumption was significantly linked to improved attention [HRT-SE <em>β</em> = –0.05, 95% confidence interval (CI): –0.09, –0.00] and working memory (d2′ <em>β</em> = 0.05, 95% CI: 0.00, 0.09, and d3′ <em>β</em> = 0.06, 95% CI: 0.02, 0.11) in offspring. Greater consumption of large fatty fish was associated with better attention (HRT-SE <em>β</em> = –0.06, 95% CI: –0.10, –0.02; and HRT <em>β</em> = –0.04, 95% CI: –0.08, –0.00), and fluid intelligence (<em>β</em> = 0.08, 95% CI: 0.02, 0.13). Omega-3 fatty acids mediated 8%–14% of these effects on attention.</div></div><div><h3>Conclusions</h3><div>Maternal diet at pregnancy and omega-3 intake may support long-term cognitive development in children and adolescents.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 274-284"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062983","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 effects of the Multicultural Healthy Diet on cognitive decline and Alzheimer’s disease risk: a phase II randomized controlled trial in middle-aged adults","authors":"Yasmin Mossavar-Rahmani ,&nbsp;Noorie Hyun ,&nbsp;Jonathan G Hakun ,&nbsp;Mindy J Katz ,&nbsp;Jelena M Pavlovic ,&nbsp;Henrik Zetterberg ,&nbsp;Zheng Wang ,&nbsp;Jasper B Yang ,&nbsp;Judith Wylie-Rosett ,&nbsp;James R Hebert ,&nbsp;Martin J Sliwinski ,&nbsp;Pamela A Shaw","doi":"10.1016/j.ajcnut.2025.05.011","DOIUrl":"10.1016/j.ajcnut.2025.05.011","url":null,"abstract":"<div><h3>Background</h3><div>Anti-inflammatory dietary patterns are associated with slower cognitive decline in older adults; however, little is known about the effects of an anti-inflammatory dietary pattern in middle age.</div></div><div><h3>Objectives</h3><div>This study aims to adapt an anti-inflammatory diet to a multicultural setting and assess its impact on cognitive decline and Alzheimer’s disease risk and related dementias in healthy middle-aged adults.</div></div><div><h3>Methods</h3><div>We performed a phase II pilot randomized clinical trial in adults (40–65 y old; <em>n</em> = 290) in Bronx, New York. Participants were assigned to follow either the Multicultural Healthy Diet (MHD), an anti-inflammatory diet, or usual diet (Comparison). Diet was evaluated using the National Cancer Institute’s Automated Self-Administered 24-h food records. The primary cognitive outcome was assessed at 9 mo after randomization using a global composite score derived from 3 ambulatory cognitive assessments of visuospatial memory (Grid Memory), processing speed (Symbol Search) and short-term associative memory binding (Color Shapes). Secondary outcomes included performance on individual tests and association of dietary components with cognitive performance.</div></div><div><h3>Results</h3><div>At 9-mo follow-up, the MHD arm had a lower Dietary Inflammatory Index (DII) score based on self-reported diet, with an adjusted MHD minus Comparison difference of –0.64 [95% confidence interval (CI): –1.02, –0.27] and –0.94 (95% CI: –1.34, –0.54) for the DII and energy-adjusted DII scores, respectively, indicating intervention participants had adhered to an anti-inflammatory dietary pattern. Group session and telephone contact completion averaged 93% and 72%, respectively, for the MHD arm. No statistically significant difference between arms was found in the primary outcome—cognitive global score change—from baseline: –0.06 (95% CI: –0.15, 0.04), <em>P</em> = .259.</div></div><div><h3>Conclusions</h3><div>The MHD is feasible and acceptable in this multicultural United States cohort. Although the influence of MHD at 9 mo is nonsignificant based on the global composite cognitive score, additional research using other measures such as day-to-day variability in cognitive function and peak performance is warranted.</div><div>This study was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT03240406 (<span><span>https://clinicaltrials.gov/study/NCT03240406?term=Diet%20%26%20Cognition&amp;page=3&amp;rank=30</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 48-59"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144153","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":"Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society","authors":"Dariush Mozaffarian ,&nbsp;Monica Agarwal ,&nbsp;Monica Aggarwal ,&nbsp;Lydia Alexander ,&nbsp;Caroline M Apovian ,&nbsp;Shagun Bindlish ,&nbsp;Jonathan Bonnet ,&nbsp;W Scott Butsch ,&nbsp;Sandra Christensen ,&nbsp;Eugenia Gianos ,&nbsp;Mahima Gulati ,&nbsp;Alka Gupta ,&nbsp;Debbie Horn ,&nbsp;Ryan M Kane ,&nbsp;Jasdeep Saluja ,&nbsp;Deepa Sannidhi ,&nbsp;Fatima Cody Stanford ,&nbsp;Emily A Callahan","doi":"10.1016/j.ajcnut.2025.04.023","DOIUrl":"10.1016/j.ajcnut.2025.04.023","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Glucagon-like peptide 1 receptor agonists and combination medications (hereafter collectively referred to as GLP-1s) are shifting the treatment landscape for obesity. However, real-world challenges and limited clinician and public knowledge on nutritional and lifestyle interventions can limit GLP-1 efficacy, equitable results, and cost-effectiveness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;We aimed to identify pragmatic priorities for nutrition and other lifestyle interventions relevant to GLP-1 treatment of obesity for the practicing clinician.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;An expert group comprising multiple clinical and research disciplines appraised the scientific literature, informed by expert knowledge and clinical experience, to identify and summarize relevant topics, priorities, and emerging directions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;GLP-1s reduce body weight by 5% to 18% in trials, with modestly lower effects in real-world analyses, and multiple demonstrated clinical benefits. Challenges include side effects, especially gastrointestinal; nutritional deficiencies due to calorie reduction; muscle and bone loss; low long-term adherence with subsequent weight regain; and high costs with resulting low cost-effectiveness. Numerous practice guidelines recommend multicomponent, evidence-based nutritional and behavioral therapy for adults with obesity, but use of such therapies with GLP-1s is not widespread. Priorities to address this include: (a) patient-centered initiation of GLP-1s, including goals for weight reduction and health; (b) baseline screening, including usual dietary habits, emotional triggers, disordered eating, and relevant medical conditions; (c) comprehensive exam including muscle strength, function, and body composition assessment; (d) social determinants of health screening; (e) and lifestyle assessment including aerobic activity, strength training, sleep, mental stress, substance use, and social connections. During GLP-1 use, nutritional and medical management of gastrointestinal side effects is critical, as is navigating altered dietary preferences and intakes, preventing nutrient deficiencies, preserving muscle and bone mass through resistance training and appropriate diet, and complementary lifestyle interventions. Supportive strategies include group-based visits, registered dietitian nutritionist counseling, telehealth and digital platforms, and Food is Medicine interventions. Drug access, food and nutrition insecurity, and nutrition and culinary knowledge influence equitable obesity management with GLP-1s. Emerging areas for more study include dietary modulation of endogenous GLP-1, strategies to improve compliance, nutritional priorities for weight maintenance post-cessation, combination or staged intensive lifestyle management, and diagnostic criteria for clinical obesity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Evidence-based nutritional and lifestyle strategies play a pivota","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 344-367"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227486","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 associations between dairy intake and chronic liver disease mortality and liver cancer incidence: a prospective cohort study","authors":"Xing Liu ,&nbsp;Xinyuan Zhang ,&nbsp;Longgang Zhao ,&nbsp;Jessica L Petrick ,&nbsp;Linda M Liao ,&nbsp;Weibing Wang ,&nbsp;Na He ,&nbsp;Edward Giovannucci ,&nbsp;Zuo-Feng Zhang ,&nbsp;Katherine A McGlynn ,&nbsp;Xuehong Zhang","doi":"10.1016/j.ajcnut.2025.04.028","DOIUrl":"10.1016/j.ajcnut.2025.04.028","url":null,"abstract":"<div><h3>Background</h3><div>The incidence and prevalence of chronic liver diseases (CLD) and liver cancer are increasing worldwide.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the associations between the intake levels of high-fat and low-fat dairy products and CLD mortality and liver cancer incidence.</div></div><div><h3>Methods</h3><div>This study included eligible participants from the NIH–American Association of Retired Persons Diet and Health Study cohort established between 1995 and 1996. Epidemiological data, including dietary factors, were collected using a self-administered validated questionnaire. Portion size and frequency of intake of dairy products were recorded. Cox proportional hazard models were used to examine the associations.</div></div><div><h3>Results</h3><div>A total of 485,931 eligible participants, 59.8% male, with an average age of 61.5 y (SD = 5.4 y) at baseline were included in this analysis after excluding those with pre-existing cancer diagnoses or extreme caloric intakes. During a median follow-up of 15.5 y, 993 deaths from CLD and 940 incident liver cancer cases occurred. CLD mortality was positively associated with intake of high-fat dairy [hazard ratio (HR)_{21+ compared with 0–&lt;3.5 serv/wk} = 1.51, 95% confidence interval (CI): 1.24, 1.84, <em>P</em>_{<em>trend</em>} = 0.009] and high-fat milk (HR_{14+ compared with 0 serv/wk} = 2.03, 95% CI: 1.31, 3.14, <em>P</em>_{<em>trend</em>} &lt;0.001), and was inversely associated with low-fat dairy (HR_{21+ compared with 0–&lt;3.5 serv/wk} =0.62, 95% CI: 0.46, 0.84, <em>P</em>_{<em>trend</em>} = 0.002), low-fat milk (HR_{14+ compared with 0 serv/wk} =0.54, 95% CI: 0.41, 0.70, <em>P</em>_{<em>trend</em>} = 0.028) and yogurt (HR_{4+ compared with 0 serv/wk} = 0.60, 95% CI: 0.37, 0.97, <em>P</em>_{<em>trend</em>} = 0.057). Total dairy intake (HR_{21–&lt;28 compared with 0–&lt;7 serv/wk} = 1.26, 95% CI: 0.99, 1.59, <em>P</em>_{<em>trend</em>} = 0.040) and high-fat dairy (HR_{14–&lt;21 compared with 0–&lt;3.5 serv/wk} = 1.35, 95% CI: 1.07, 1.70, <em>P</em>_{<em>trend</em>} = 0.14) showed marginally positive association with liver cancer risk. Milk intake was positively associated with risk of hepatocellular carcinoma (HCC).</div></div><div><h3>Conclusions</h3><div>High-fat dairy intake is positively associated with CLD mortality, and low-fat dairy shows an inverse association. Total dairy intake is marginally positively associated with liver cancer, and milk intake is positively associated with HCC.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 1","pages":"Pages 263-273"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014457","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}