Asia Pacific journal of clinical nutrition最新文献

{"title":"Free sugar intake and dietary sources in rural Japanese infants aged 18-23 months.","authors":"Yohei Horikawa, Shuichi Yatsuga, Yuki Okamatsu","doi":"10.6133/apjcn.202610_35(5).0010","DOIUrl":"https://doi.org/10.6133/apjcn.202610_35(5).0010","url":null,"abstract":"<p><strong>Background and objectives: </strong>Optimizing sugar intake during early childhood is critical for preventing non-communicable diseases. Although international guidelines recommend limiting free sugar intake, Japan is yet to consolidate data on free sugar intake among children under 2 years of age. This study examined free sugar intake, dietary sources, and associated factors among Japanese children aged 18-23 months.</p><p><strong>Methods and study design: </strong>A cross-sectional study was conducted among children attending infant health checkups in Kama City, Japan. Caregivers recorded two non-weighed dietary records (one weekday and one Sunday). Free sugar intake, dietary sources, and related factors were analyzed.</p><p><strong>Results: </strong>Among 84 participants, the mean free sugar intake was 13.3 g/day, corresponding to 5.7% of estimated energy requirements. Overall, 44.0% of children exceeded the World Health Organization recommended level of <5% of energy from free sugar, and 16.7% exceeded the <10% threshold. Major sources included confectioneries (43.2%), fruits including 100% fruit juice (27.3%), dairy products (23.3%), and sweetened beverages (4.6%). Free sugar intake was 37% higher on Sundays than on weekdays. Multivariable analyses showed no significant associations between excessive free sugar intake and demographic or lifestyle characteristics.</p><p><strong>Conclusions: </strong>A substantial proportion of Japanese infants aged 18-23 months consumed free sugar in excess of World Health Organization recommendations. These findings highlight the need to improve caregiver awareness of major free sugar sources, particularly 100% fruit juice, and support the development of age-specific dietary guidance and pediatric nutrition counseling in Japan.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 3","pages":"844-855"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines on the use of Artificial Intelligence for authors, reviewers, and editors of APJCN.","authors":"","doi":"10.6133/apjcn.202608_35(4).0002","DOIUrl":"10.6133/apjcn.202608_35(4).0002","url":null,"abstract":"<p><p>Generative artificial intelligence (AI) is an emerging technology with substantial potential to support scientific research. Scientific communities across various disciplines are actively exploring its capabilities, including its application in scientific writing, peer review, and editorial processes. However, the inappropriate use of AI may lead to academic misconduct and compromise research integrity. To promote the responsible and ethical use of AI by authors, reviewers, and editors, APJCN has developed these guidelines. The guidelines are based on widely accepted ethical principles within the scientific publishing community. Given the rapid evolution of generative AI technologies, these guidelines may be updated and revised as necessary.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 4","pages":"573-576"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistant starch as a dietary strategy for metabolic and gut health: Implications for Asia-Pacific populations.","authors":"Kate Phuong-Nguyen, Leni R Rivera, Jessica R Biesiekierski","doi":"10.6133/apjcn.202608_35(4).0003","DOIUrl":"10.6133/apjcn.202608_35(4).0003","url":null,"abstract":"<p><strong>Background and objectives: </strong>Metabolic diseases are rising rapidly across the Asia-Pacific region as traditional diets are displaced by refined, low-fibre foods. Resistant starch (RS) is a fermentable dietary component that modulates gut microbial activity and short-chain fatty acid (SCFA) production, representing a promising strategy for metabolic and gut health. However, responses to RS vary according to dose, RS type, and individual context.</p><p><strong>Methods and study design: </strong>This narrative review synthesised evidence from animal and human studies on RS classification, food sources, microbial interactions, and metabolic regulation. We evaluated how responses differ by dose, RS type, baseline microbiome composition, metabolic phenotype, and habitual diet, with particular attention to traditional Asia-Pacific staple foods and ongoing dietary transitions.</p><p><strong>Results: </strong>Across studies, RS supplementation at moderate-to-high doses improves insulin sensitivity, hepatic lipid accumulation, and markers of gut barrier function, primarily through SCFA-mediated and gut hormone pathways. However, responses are highly context-dependent, varying with baseline metabolic status, micro-biome composition, habitual fibre intake and RS type. Individuals with metabolic disturbances or low fibre intake tend to show greater metabolic and microbial shifts.</p><p><strong>Conclusions: </strong>RS is a promising strategy for supporting metabolic and gut health in Asia-Pacific populations undergoing rapid nutritional transition. Culturally familiar RS-rich foods offer practical, regionally tailored intervention opportunities. Standardised characterisation, microbiome-stratified analyses and long-term human studies are needed to clarify who benefits most, under which conditions and through which mechanisms.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 4","pages":"577-588"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between mid-to-late pregnancy gestational weight gain and adverse birth outcomes among women with gestational diabetes mellitus.","authors":"Xiaohan Guo, Xiaomin Wang, Xiaofeng Weng, Yuanqing Fu, Jun Tang, Wensheng Hu","doi":"10.6133/apjcn.202608_35(4).0015","DOIUrl":"10.6133/apjcn.202608_35(4).0015","url":null,"abstract":"<p><strong>Background and objectives: </strong>The gestational weight gain (GWG) range during mid-to-late pregnancy associated with the lowest combined risk of adverse birth outcomes in women with gestational diabetes mellitus (GDM) remains unclear. This study aims to examine the associations between GWG and adverse birth out-comes among women with GDM.</p><p><strong>Methods and study design: </strong>This study included a cohort of 1,673 pregnant women with GDM. GWG was defined as weight gain from pre-pregnancy to a measurement between 24 and 32 gestational weeks, residualized for gestational age and standardized as z-scores. Multivariable logistic regression models were used to assess associations between GWG z-scores (per 1-SD increase and categories: <-1, -1 to 1 [reference], and ≥1) and small for gestational age (SGA), large for gestational age (LGA), and preterm birth. Restricted cubic splines were fitted to explore nonlinear associations.</p><p><strong>Results: </strong>Each 1-SD higher in GWG z-score was associated with lower odds of SGA (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.43-0.71) and higher odds of LGA (1.48; 1.29-1.70). Compared with the reference group, women with GWG z-scores <-1 had higher odds of SGA and lower odds of LGA, whereas those with z-scores ≥1 showed the opposite pattern. No significant association was observed with preterm birth. Spline analyses indicated that a GWG z-score of approximately -0.07 (equal to 8.2 kg at 28 weeks) was associated with the lowest combined odds of SGA and LGA.</p><p><strong>Conclusions: </strong>Among women with GDM, both insufficient and excessive mid-to-late pregnancy GWG were associated with adverse size-for-gestational-age outcomes.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 4","pages":"714-722"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of combined nutrition, exercise and psychological interventions in patients with malignancy: A randomized controlled trial.","authors":"Shiming Song, Hongzhen Du, Caiyan Zhang, Hongmei Xue, Zengning Li","doi":"10.6133/apjcn.202608_35(4).0008","DOIUrl":"10.6133/apjcn.202608_35(4).0008","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients with malignancy often have a poor prognosis and dismal quality of life. This study aimed to evaluate whether a combined nutrition, exercise, and psychological intervention could improve these outcomes.</p><p><strong>Methods and study design: </strong>In an open-label, randomized controlled trial at the First Hospital of Hebei Medical University (Oct 2021-Jun 2022), 90 patients were assigned (1:1) to a treatment group receiving 6-month cyclic combined assessments and interventions, or a control group receiving assessments only. Body composition, hand grip strength (HGS), 6-minute walk test (6MWT), Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire-9 (PHQ-9), and quality of life were compared at baseline and 6 months. Data were analyzed using SPSS 21.0, with p <0.05 considered significant.</p><p><strong>Results: </strong>90 people were enrolled, and 80 people have completed the study. Compared to controls, the intervention group showed significantly lower nutritional risk (10.0 % vs. 100 %, p <0.001) and malnutrition rates (22.5 % vs. 100 %, p <0.001). Significant improvements were observed in BMI, muscle mass, phase angle, HGS, and 6MWT distance (all p <0.001). HADS and PHQ-9 scores decreased (p <0.001). Quality-of-life scores (physical, role, emotional, social function, overall health) improved, while symptom scores (fatigue, pain, nausea/vomiting, etc.) decreased markedly (p <0.05). The control group exhibited opposite trends.</p><p><strong>Conclusions: </strong>Combined nutrition, exercise, and psychological interventions effectively improve nutritional status, physical and psychological well-being, and quality of life in patients with malignancy, potentially enhancing treatment tolerance and promoting rehabilitation.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 4","pages":"644-655"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-life high-dose omega-3 polyunsaturated fatty acid supplementation reduces risk of childhood asthma/wheezing: A meta-analysis of randomized controlled trials.","authors":"Sisi Cai, Xinyue Ji, Yang He, Ying Zhou, Sangwangjiu Ge, Mengting Gu, Yujia Shang, Shihan Wang, Danyue Yu, Simeng Ren, Dezheng Zhou, Xiaohong Zhang","doi":"10.6133/apjcn.202608_35(4).0006","DOIUrl":"10.6133/apjcn.202608_35(4).0006","url":null,"abstract":"<p><strong>Background and objectives: </strong>Asthma, a chronic inflammatory airway disease characterized by wheezing, imposes a substantial global health burden on children. Given the potential of early-life omega-3 polyunsaturated fatty acid (omega-3 PUFA) supplementation as an anti-inflammatory intervention to prevent childhood asthma and wheezing, this meta-analysis aims to clarify its efficacy and investigate dose-dependency.</p><p><strong>Methods and study design: </strong>This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three reviewers independently evaluated the studies, extracted data, and assessed bias using the Jadad scale. The outcomes included the risk of asthma/wheezing: pooled odds ratios (ORs) were calculated using fixed-effects models, along with sensitivity/subgroup analyses and dose-response meta-regression.</p><p><strong>Results: </strong>Twelve randomized controlled trials (RCTs) involving 4,156 participants showed no overall association between omega-3 PUFA and a reduced risk of asthma/wheezing (odds ratio [OR]: 1.00; 95% confidence interval [CI]: 0.84-1.18). However, high-dose supplementation (≥1,200 mg/day) significantly decreased the risk (OR: 0.66; 95% CI: 0.46-0.94). Similarly, high-dose eicosapentaenoic acid (EPA≥1,000 mg/day) also significantly reduced the risk (OR: 0.67; 95% CI: 0.46-0.97). Dose-response analysis confirmed a linear relationship (p=0.002), indicating a 26.6% reduction in risk for every 1,000 mg/day increase in dose (OR: 0.734; 95% CI: 0.602-0.896). Subgroup analyses revealed no heterogeneity with respect to study location, allergy risk, or follow-up duration.</p><p><strong>Conclusions: </strong>Early-life omega-3 PUFA supplementation reduces childhood asthma/wheezing risk in a dose-dependent manner. High-dose regimens, particularly those involving EPA, provide substantial protection, suggesting a potential clinical strategy for prevention, although further validation is required.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 4","pages":"623-630"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a nomogram prediction model for opportunistic sarcopenia in patients with malignant tumors.","authors":"Liting Li, Ying Wang, Chunhua Bian, Hongmei Xue, Cong Wang, Jialu Hao, Zengning Li","doi":"10.6133/apjcn.202608_35(4).0012","DOIUrl":"10.6133/apjcn.202608_35(4).0012","url":null,"abstract":"<p><strong>Background and objectives: </strong>The aim of this study was to establish a predictive model for opportunistic sarcopenia applicable to Chinese cancer patients, so as to quickly detect the occurrence of this condition and provide a basis for early clinical intervention.</p><p><strong>Methods and study design: </strong>A total of 522 malignant tumor patients admitted to the First Hospital of Hebei Medical University from October 2017 to March 2022 were retrospectively analyzed. Opportunistic sarcopenia was diagnosed by L3 SMI. Twelve variables were collected; risk factors were screened and modeled via univariate and multivariate regression in R Studio, and con-tinuous variable cutoff points were determined by SPSS. A nomogram was constructed and validated with clinical decision and calibration curves.</p><p><strong>Results: </strong>The prevalence of opportunistic sarcopenia in the study population was 66.1% (345/522). The final predictive model included six key variables: gender, body mass index (BMI), C-reactive protein (CRP) level, systemic immune-inflammation index (SII), prognostic nutritional index (PNI), and SII-PNI. The area under the curve (AUC) of the model was 0.890 (95% CI: 0.854-0.926), indicating high discriminative ability. The calibration curve showed good consistency between the model's predictions and the actual diagnostic results. Clinical net benefit analysis showed that when the threshold range was greater than 0.6, the clinical benefit rate of the predictive model was higher than those of relative appendicular skeletal muscle mass (RASM) and appendicular skeletal muscle mass index (ASMI).</p><p><strong>Conclusions: </strong>The constructed nomogram model can accurately estimate the probability of opportunistic sarcopenia in cancer patients, facilitating its early screening and targeted prevention.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 4","pages":"688-695"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public health perspectives on out-of-home food consumption in Thailand.","authors":"Chanchira Phosat, Rewadee Chongsuwat","doi":"10.6133/apjcn.202607_35(Suppl1).0003","DOIUrl":"10.6133/apjcn.202607_35(Suppl1).0003","url":null,"abstract":"<p><p>Out-of-home food consumption in Thailand has risen markedly in recent decades, driven by urbanization, changing family structures, increased participation of women in the labour force, and expansion of digital food delivery platforms. This shift reflects broader transformations in the national food environment, in which convenience, accessibility, and cultural norms strongly influence dietary behaviours. Although eating outside the home is deeply embedded in Thai social life and contributes significantly to both informal and formal economies, meals prepared away from home are frequently energy-dense and nutritionally imbalanced. Evidence from national surveys and empirical studies consistently links frequent consumption of street food, restaurant meals, and delivery items with poorer dietary quality and an elevated risk of non-communicable diseases. In response, the Thai government has implemented multiple strategies to improve nutritional standards and consumer awareness. However, enforcement challenges, especially within the informal street food sector, and limited public understanding of nutrition hinder progress. Opportunities exist to strengthen the food environment through recipe reformulation, expanded menu labelling, vendor training, healthier cooking practices, and integration of digital nutrition tools. As Thailand's food landscape evolves, culturally responsive and multisectoral strategies will be essential to promote healthier out-of-home eating. Enhancing the nutritional quality, safety, and transparency of meals consumed outside the home will be critical to advancing national public health objectives and mitigating the growing burden of diet-related diseases.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 Suppl 1","pages":"S19-S29"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Japan's nutrient profile model for dishes: A culturally sensitive approach to nutrient profiling.","authors":"Hidemi Takimoto, Yuko Tousen, Jun Takebayashi, Chika Okada","doi":"10.6133/apjcn.202607_35(Suppl1).0006","DOIUrl":"10.6133/apjcn.202607_35(Suppl1).0006","url":null,"abstract":"<p><strong>Background and objectives: </strong>Excessive sodium intake remains a major public health issue in Japan, contributing to the burden of non-communicable diseases, such as hypertension. To address this, these authors developed two nutrient profiling models, one for processed foods and another for dishes, to guide food reformulation and promote healthier eating. This article focuses on the dish model, which can be applied to other regions where ready-to-eat meals are highly available.</p><p><strong>Methods and study design: </strong>The Nutrient Profile Model for Dishes in Japan (NPM-DJ) was developed using data from the Japanese Food Guide Spinning Top and Japan's National Health and Nutrition Survey. Dishes were categorised to align with the traditional food culture and scored based on nutrient content per serving, including both nutrients to limit and nutrients to encourage.</p><p><strong>Results: </strong>The NPM-DJ evaluates dishes holistically per serving, accounting for seasonings and oils. A scoring system subtracts positive nutrient points (fruits, vegetables, nuts/seeds, legumes, mushrooms, seaweed, protein, dietary fibre) from baseline points (energy, saturated fat, sugars, sodium). Example calculations demonstrate its utility in ranking the typical 105 Japanese dishes as shown in the Japanese Food Guide Spinning Top.</p><p><strong>Conclusions: </strong>The NPM-DJ offers a culturally relevant framework for improving dietary habits and guiding food reformulation. It supports public health initiatives and empowers consumers to make informed choices.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 Suppl1","pages":"S47-S50"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a nutrient profiling scoring system for Thai meals: a prototype for healthier meal choices in Thailand.","authors":"Pakpadsorn Sarachantapong, Pimnapanut Sridonpai, Orada Chansa, Pornnutcha Sopawong, Wantanee Kriengsinyos","doi":"10.6133/apjcn.202607_35(Suppl1).0005","DOIUrl":"10.6133/apjcn.202607_35(Suppl1).0005","url":null,"abstract":"<p><strong>Background and objectives: </strong>In Thailand, meals are commonly consumed as combinations of multiple dishes, yet no established nutritional criteria exist to evaluate the healthfulness of meals. This study aimed to develop healthy meal criteria for Thai diets using a nutrient profile model.</p><p><strong>Methods and study design: </strong>The Nutrient Profiling System for Meals (NPS-M) was developed with six nutritional components: energy, protein, vegetables, total fat, added sugar, and sodium. A scoring algorithm was created. Meal combinations were considered healthier if they achieved scores ≥70%, with no zero score in any one component. A total of 72,149 meals were constructed and evaluated. Criterion validity was assessed by comparing NPS-M with the Nutrient-Rich Foods Index 6.3 (NRF6.3), Health Star Rating (HSR), and Thailand's Healthier Choice logo for ready-to-eat foods (HCL-RTE) using Spearman's rank correlation.</p><p><strong>Results: </strong>The median NPS-M score of all meal combinations was 58 (interquartile range: 45.0-72.0). After excluding meals with zero scores in any component, 10,148 meals (14.1% of total) remained. Among these, 7,252 meals (10.1% of total) achieved scores ≥70%. Sodium was a predominant limiting factor, disqualifying 80% of meals. Criterion validity test-ing showed moderate correlation with NRF6.3 (ρ = 0.566, p <0.001), moderate reverse correlation with HSR (ρ = -0.527, p <0.001), and strong correlation with HCL-RTE (ρ = 0.796, p <0.001).</p><p><strong>Conclusions: </strong>The NPS-M provides a practical framework for evaluating meal healthfulness in the Thai context. The model has potential for use in restaurants, canteens, and public health programs to improve meal quality and support healthier diets in Thailand.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"35 Suppl 1","pages":"S37-S46"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}