British Journal of Nutrition最新文献

{"title":"2,3-diphosphoglycerate: The Forgotten Metabolic Regulator of Oxygen Affinity.","authors":"Layal S Jaafar, Christina Mary R Kourie, Carla A El-Mallah, Omar Obeid","doi":"10.1017/S0007114525105345","DOIUrl":"https://doi.org/10.1017/S0007114525105345","url":null,"abstract":"<p><p>2,3-Diphosphoglycerate (2,3-DPG), a metabolic intermediate in the Rapoport-Luebering pathway, is primarily present in red blood cells and regulates the affinity of hemoglobin (Hb) to oxygen. As the 2,3-DPG level in the erythrocyte increases, the oxygen dissociation curve shifts to the right, thus decreasing the oxygen affinity of Hb. This alteration in oxygen affinity is crucial for maintaining adequate oxygen supply to peripheral tissues, especially under hypoxic conditions such as high-altitude adaptation and anemia. Despite its crucial role in regulating oxygen affinity and its potential function as a modulator in various physiological and pathological adaptations, much of the research on 2,3-DPG is outdated and has largely been overlooked in recent years. The aim of this review is to compile the existing evidence on 2,3-DPG and highlight the gaps in our current understanding.The erythrocyte concentration of 2,3-DPG can be determined using chromatography or enzymatic methods. However, assessing 2,3-DPG poses a challenge due to its instability, which can rapidly degrade in the absence of proper storage conditions. Several factors can impact the erythrocyte concentration of 2,3-DPG, including diet, physiological conditions, and pathological conditions. Dietary intake, particularly phosphorus, can acutely influence 2,3-DPG levels in red blood cells. However, no information is available on the postprandial status of 2,3-DPG following the ingestion of meals with varied nutrient composition. Additionally, physiological factors such as age, pregnancy, and physical activity can affect 2,3-DPG levels, but its role during infancy and childhood is still not well understood. Although the levels of 2,3-DPG in various pathological conditions have been widely discussed, the underlying molecular mechanisms regulating these changes are still not well understood and require further investigations.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-41"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-packaged food targeted to gastrointestinal pathologies: are they low in FODMAP?","authors":"Sara Barreirinhas, Carla Almeida, Susana Casal, Patrícia Padrão","doi":"10.1017/S000711452510528X","DOIUrl":"https://doi.org/10.1017/S000711452510528X","url":null,"abstract":"<p><p>A diet low in fermentable carbohydrates, oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) has been described as an effective nutritional approach in Irritable Bowel Syndrome (IBS). There has been an increased demand for gluten- and lactose-free foodstuffs in the last few years, which are associated with GI symptoms and are consumed by patients with GI disease. This study aims to estimate the FODMAP content of an industrial pre-packaged food products containing the \"gluten-free\" and \"lactose-free\" claims. The ingredient lists of the foodstuffs from a Portuguese food retail chain were verified and classified according to their estimated FODMAP content as \"low\" and \"high\", using as a reference the FODMAP cutoff values and the serving sizes established by the Monash University App. Descriptive statistics and the Pearson chi-squared test were applied. From the 436 eligible products identified, most were classified as \"low\" (53.0%, n=231), 24.3% (n=106) were classified as \"high\", and 22.7% (n=99) with \"unknown\" FODMAP content. \"High FODMAP\" products accounted for 12.2% of those with 'lactose-free' claims and 31.6% of those with 'gluten-free' claims. The \"ready meals\" and \"sauces, dressings, creams and soups\" were the food categories with the highest proportion of products with high FODMAP sources. This study showed that approximately a quarter of pre-packaged industrial foods targeted to GI pathologies are high in FODMAP. The nutritional information on the label should be more specific, enabling more accurate dosing of FODMAP contents in foodstuff and the establishment of the recommended serving sizes.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-16"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma 25-hydroxyvitamin D concentrations, vitamin D deficiency, and mortality in community-dwelling Japanese adults.","authors":"Kaori Kitamura, Yumi Watanabe, Keiko Kabasawa, Toshiko Saito, Akemi Takahashi, Ryosaku Kobayashi, Rieko Oshiki, Kei Watanabe, Ribeka Takachi, Shoichiro Tsugane, Kazutoshi Nakamura","doi":"10.1017/S0007114525105308","DOIUrl":"https://doi.org/10.1017/S0007114525105308","url":null,"abstract":"<p><p>Blood 25-hydroxyvitamin D (25(OH)D) concentrations vary considerably by season and sex. The present study aimed to determine associations between vitamin D deficiency and mortality in Japanese adults and identify risk thresholds according to 25(OH)D concentrations. This was a cohort study with an 11-year follow-up. Participants were 8,285 community-dwelling Japanese adults aged 40 to 74 years. Plasma 25(OH)D concentrations were measured by chemiluminescent immunoassay at baseline, and divided into quintiles for each of the subgroups stratified by season and sex (denoted as season- and sex-stratified quintiles). The main outcome was all-cause mortality. Hazard ratios (HRs) were calculated using a Cox proportional hazards model. Mean age and 25(OH)D concentration were 59.9 years (SD=9.1) and 50.1 nmol/L (SD=18.1), respectively. Lower season- and sex-stratified quintiles were associated with higher hazards of all-cause mortality (P for trend=0.0015), with the first quintile (median=28.2 nmol/L) having a higher HR (HR=1.46, 95% CI, 1.13-1.88) than the highest quintile (reference). When crude quintiles were used, the overall association was similar (P for trend=0.0027), with the first (median=28.0 nmol/L) and second (median=39.7 nmol/L) quintiles having higher HRs (HR=1.40, 95% CI, 1.06-1.85 and 1.38, 95% CI, 1.07-1.77, respectively) than the reference. The risk threshold difference was estimated to be approximately 10 nmol/L. In conclusion, low blood 25(OH)D concentrations are associated with high mortality risk. Crude blood 25(OH)D concentration may modulate the estimated risk threshold for vitamin D deficiency associated with mortality.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-23"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arabinoxylans in piglet nutrition: A review of impacts and mechanisms on gut health and microbiota regulation.","authors":"Hongyu Yi, Youzhi Pu, Yuejiao Wang, Zhaoxi Xie, Lunjie Feng, Pan Zhou, Yong Zhang, Jingbo Liu, Hui Diao, Honglin Yan","doi":"10.1017/S0007114525105254","DOIUrl":"https://doi.org/10.1017/S0007114525105254","url":null,"abstract":"<p><p>Arabinoxylans (AXs), the primary hemicellulose found in cereals and grasses, play a crucial role in regulating immunity, metabolism, and various physiological processes underscoring their value as essential components in dietary nutrition. Considering the extensive research on AXs in piglet nutrition, this paper systematically reviews their impacts on gut health and microbiota in piglets, as well as the underlying mechanisms of action. AXs have been shown to mediate gut barrier fortification through tight junction protein upregulation and orchestrate mucosal immunity homeostasis, consequently ameliorating early-weaning-associated diarrheal pathogenesis in piglets. Additionally, AXs function as microbial ecological modulators through selective enrichment of beneficial commensal microbiota (e.g., <i>Bifidobacterium</i> spp. and <i>Lactobacillus</i> spp.), while simultaneously stimulating microbial biosynthesis of short-chain fatty acids and ferulic acid exhibiting potent antioxidant and anti-inflammatory activity, thereby maintaining the intestinal health of piglets. This review offers valuable insights into their potential as a dietary intervention to support gut health and immune function in early-weaned piglets. However, most studies focus on single-source AXs such as wheat or corn, with limited exploration of novel sources or comparative effects of source combinations. Future research should systematically investigate the molecular mechanisms of AXs action, provide data-driven guidance for selecting AXs sources in feed formulations, and establish optimal inclusion levels in practical feeding regimens. Such efforts will further solidify the precision nutrition potential of AXs in promoting sustainable and healthy growth in piglets.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-35"},"PeriodicalIF":3.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Serum Biomarkers of Fruit and Vegetable Intake and All-Cause, Cancer, and CVD Mortality among U.S. Adults.","authors":"Kijoon Kim, Seoeun Ahn, Matthew P Madore, Ock K Chun","doi":"10.1017/S000711452510531X","DOIUrl":"https://doi.org/10.1017/S000711452510531X","url":null,"abstract":"<p><p>Using serum biomarkers that reflect fruit and vegetable (FV) intake offers a significant advantage over traditional dietary assessments by providing a more objective, accurate measure, meaningfully minimizing recall bias and misreporting common in self-reported dietary data. This study investigated the relationship between these serum biomarkers and mortality risk using data from 19,168 adults aged 30 and older who participated in the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2006. Mortality follow-up was determined by linkage to the National Death Index through December 31, 2019, and diet by 24-h recalls. Cox proportional hazards models were employed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes by tertiles of serum biomarkers of FV intake. Higher serum concentrations of total carotenoids were associated with a reduced risk of all-cause (Tertile 3 vs. Tertile 1 HR=0.69, 95% CI=0.61-0.78) and cancer mortality (HR=0.53, 95% CI=0.39-0.71). Greater serum concentrations of individual carotenoids, such as α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin, were also linked to lower risks of all-cause and cancer mortality. Higher serum potassium concentrations showed a trend toward an association with a greater risk of all-cause mortality. No significant associations were found between serum vitamin C concentrations and mortality outcomes in the overall analysis; however, in sex-stratified analyses, higher vitamin C concentrations were associated with reduced risk of all-cause and cancer mortality in women. These findings suggest that specific serum biomarkers of FV intake, particularly carotenoids and vitamin C, may serve as indicators of reduced mortality risk.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-32"},"PeriodicalIF":3.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SERUM THYROGLOBULIN LEVELS ARE PREDICTIVE OF URINARY IODINE CONCENTRATION THRESHOLDS FOR DEFINING POPULATION IODINE STATUS.","authors":"Kasthuri Sivalogan, Rafael Flores-Ayala, Roelinda Jongstra, Carolina Martinez, Roberto Mendoza, Mireya Palmieri, Karla Mesarini, Maria Elena Jefferds, O Yaw Addo","doi":"10.1017/S0007114525105205","DOIUrl":"https://doi.org/10.1017/S0007114525105205","url":null,"abstract":"<p><p>Thyroglobulin (Tg) has been considered a measure of iodine status but there is no global guidance. This analysis examines relationship between serum Tg and spot urinary iodine concentration (UIC) data from Guatemala's 2018-2019 Epidemiological Health and Nutritional Surveillance System and identify Tg concentrations that correspond to current WHO thresholds for population iodine status among women ages 15-49 years. We analyzed data from non-pregnant Guatemalan women aged 15-49 years who had both UIC and Tg measurements. Correlations were examined. Bootstrap stratified finite sampling with replacement was used to generate cluster <i>k-medians</i> of UIC (mUIC) and Tg (mTg) that served as population unit of analyses. Non-linear restricted cubic spline regression dose-response curve functions and ordinary differential equations were then used to derive Tg threshold corresponding to WHO definitions for UIC. Serum Tg and UIC data were available for 730 non-pregnant women. Mean age was 30.2 ± 9.3 years. mTg was 10.4 ng/mL (9.9, 10.8) and mUIC was 148.7 μg/L (139.1, 161.0). Correlations between spot UIC and Tg were not significant at individual-level, but correlations based on population <i>k-medians</i> were significant (Spearman r = -0.21 to -0.06 each p<0.0001) and demonstrated U-shaped relationship according to WHO categories. Derived mTg cut-offs were 14.2 ng/mL predictive of UIC insufficiency, 10.2 ng/mL for UIC adequacy, 8.5 ng/mL for UIC above adequate and 10.8 ng/mL for UIC excess. The significant and graded mUIC-mTg correlations suggests that Tg concentrations predictive of UIC categories are obtainable for non-pregnant Guatemalan women aged 15-49 years. The newly derived mTg cut-off may be more discriminant at lower spectrum of UIC in terms of identifying iodine deficient women more so than those in the UIC excess category. Further studies could inform if Tg could be a potentially viable biomarker for assessing population iodine status in women.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-22"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle patterns and their associations with overweight and obesity among children aged 4-9 years in the United Arab Emirates.","authors":"Farah Naja, Nada Abbas, Katia Abu Shihab, Fatima Al Zahraa Chokor, Leila Cheikh Ismail, Ayesha S Al Dhaheri, Lynda O'Neill, Habiba Ali, Maysm N Mohamad, Nahla Hwalla, Lara Nasreddine","doi":"10.1017/S0007114525105242","DOIUrl":"https://doi.org/10.1017/S0007114525105242","url":null,"abstract":"<p><p>An integrative approach addressing diet as well as other lifestyle factors is warranted in studying obesity and its related diseases. The objective of this study is to examine the associations of lifestyle patterns with overweight/obesity among children in the United Arab Emirates (UAE). Data were derived from a cross-sectional survey of children aged 4 to 9 years living in Dubai, Sharjah, and Abu Dhabi (n=426). Dietary intake was collected using a 24-hour dietary recall (24-HR) and evaluated with the Healthy Eating Index (HEI). The Youth Physical Activity Questionnaire (Y-PAQ) assessed physical activity, while other lifestyle factors included presence of a live-in household helper, number of electronic devices in the child's bedroom, eating while watching TV, family dinner frequency, fast food and breakfast consumption, and hours of sleep. Factor analysis was used to identify the lifestyle patterns. Two lifestyle patterns emerged: an unhealthy pattern marked by higher fast-food intake, eating while watching TV, having a live-in household helper, and lower family dinners; and a healthy pattern with higher physical activity, better HEI, more sleep, micronutrient supplements, and breakfast consumption. The healthy lifestyle pattern was linked to a 30% reduction in overweight/obesity odds (OR= 0.7, 95% CI: 0.53-0.93). A healthy lifestyle pattern, characterized by higher physical activity, better dietary quality, adequate sleep, and breakfast consumption, is associated with lower odds of overweight/obesity among children in the UAE. These findings highlight the importance of promoting comprehensive lifestyle interventions to effectively address childhood obesity in this population.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-34"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a screener to assess ultra-processed food consumption in the adult Indian population: The Nova-UPF Screener (for India).","authors":"Suparna Ghosh-Jerath, Srishti Mediratta, Gaurika Kumar, Sahiba Kohli, Fernanda H Marrocos-Leite, Neha Khandpur, K Srinath Reddy","doi":"10.1017/S0007114525105230","DOIUrl":"https://doi.org/10.1017/S0007114525105230","url":null,"abstract":"<p><p>Increasing prevalence of diet-related non-communicable diseases in India is attributed to overconsumption of energy-dense, nutrient-poor diets and ultra processed foods (UPFs) may potentially contribute to this consumption pattern. Applying standard UPF definition and developing appropriate tools can better capture its consumption among Indians. This cross-sectional study aimed to validate the 'Nova-UPF Screener (for India)' and explore its potential to objectively capture UPF consumption among Indian adults. The screener, adapted in prior formative research study from a tool for Brazilian population, was subjected to content, face, and concurrent criterion validation. Subject matter experts (n=74) participated in online consultations to determine its content validity. Adults (18-60 years) from different geographical regions of India were included for face (n=70) and concurrent criterion (n=304) validations. The screener comprised 24 UPF categories specific to Indian food environment. Critical inputs from experts on screener's appropriateness were incorporated to enhance its content. For face validation, overall percentage agreement of 99.4% for all questions indicated a strong agreement for retaining screener attributes in each question. Half the participants (49.4%) who were administered the finalized screener had Nova-UPF scores between 2 to 4 out of 24. There was almost perfect agreement (Pabak index = 0.85) between distribution of participants based on Nova-UPF scores and fifths of dietary share of UPFs (as energy %) assessed by 24-hour dietary recall. Nova-UPF Screener (for India) is a valid tool to capture UPF consumption in India that can be used for rapid assessment of UPF consumption and informing policies to improve Indian diets.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-31"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of caffeine, green tea, and coffee consumption with mortality and disability among older adults.","authors":"Daiki Watanabe, Tsukasa Yoshida, Hinako Nanri, Yuya Watanabe, Yosuke Yamada, Misaka Kimura","doi":"10.1017/S0007114525105278","DOIUrl":"https://doi.org/10.1017/S0007114525105278","url":null,"abstract":"<p><p>Several epidemiological studies have shown that consumption of coffee and green tea is inversely associated with risks of death and disability; however, the relationship between caffeine consumption and these outcomes remains unclear. We examined these associations in Japanese older adults. This was a prospective study of 7,708 adults (aged ≥65 years) recruited from the Kyoto-Kameoka study. Dietary intake was estimated using a validated food frequency questionnaire. Caffeine consumption was classified into four categories. Disability and mortality data were collected between 15 February 2012 and 30 November 2016. Hazard ratios (HRs) and 95% confidence intervals (CIs) of outcomes were calculated using multivariable Cox proportional hazard models. During the median 4.75-year follow-up period, a total of 593 deaths and 1,379 disability incidents were recorded. After adjusting for confounders, caffeine consumption was inversely associated with the incidence of disability (<100 mg/day: reference; 100-149 mg/day: HR, 0.91 [95% CI, 0.80-1.04]; 150-199 mg/day: HR, 0.84 [95% CI, 0.72-0.99]; ≥200 mg/day: HR, 0.75 [95% CI, 0.63-0.89], p for trend = 0.001) but not all-cause mortality. High coffee consumption was inversely associated with mortality (≥3 cups/day: HR, 0.62 [95% CI, 0.43-0.88]) and disability (≥3 cups/day: HR, 0.81 [95% CI, 0.65-0.99]) compared with non-consumption. However, green tea consumption was not associated with mortality or disability. Caffeine and coffee consumption was inversely associated with disability and/or mortality. Further research is needed to clarify whether high caffeine intake is safe and effective for older adults.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-26"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Food Rejection Behaviors in Preschool Children with Compliance to the Mediterranean Diet and Their Quality of Life: A Cross-Sectional Analysis.","authors":"Gulperi Demir, Meltem Kudret, Rabia Sena Demir, Sumeyya Bagci, Elif Yildirim","doi":"10.1017/S0007114525105199","DOIUrl":"https://doi.org/10.1017/S0007114525105199","url":null,"abstract":"<p><p>Food refusal behaviors in preschool children can significantly impact their nutritional status and overall quality of life. This study investigated the relationship between food refusal behaviors, compliance with the Mediterranean Diet, and quality of life in preschool children. Conducted as a cross-sectional study, it included 400 children aged 4-6 and their parents. The Child Food Rejection Scale measured food refusal behaviors, KIDMED assessed compliance with the Mediterranean Diet, and the Kiddy-KINDL scale evaluated quality of life. The mean age of the children was 4.80±0.71 years. According to age-based Body Mass Index-Z scores, 71.0% were normal, 15.5% underweight, 9.0% slightly overweight, and 4.5% obese. Parents' average age was 34.65±5.35 years; 96.8% were married, 88.8% had a nuclear family structure, 58.0% were university graduates, and 69.8% rated their income level as moderate. Girls had higher food refusal scores than boys(p<0.05). Children who frequently fell ill also scored higher in food refusal(p<0.05). Food refusal decreased with higher family income, larger family size, and older parental age(p<0.05). Parental nutrition education significantly reduced food refusal scores(p<0.05). Higher KIDMED scores were associated with lower food refusal(p<0.01), and children with low Kiddy-KINDL scores exhibited higher food refusal behaviors(p<0.01). A positive correlation was found between KIDMED and Kiddy-KINDL scores(p<0.01). No significant associations were detected between BMI Z scores and food rejection and its subscales. The findings suggest that compliance with the Mediterranean Diet reduces food refusal behaviors in preschool children and increases quality of life, while low quality of life is associated with increased food refusal behaviors.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-26"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}