Julie M Hess, Claudia PromSchmidt, Angela J Scheett, Shanon Casperson, Joanne L Slavin, Daniel G Palmer
{"title":"Dietary Guidelines for Americans with Ultra-Processed foods (DGA-UP) study protocol: impact of dietary guidelines diets containing mostly ultra-processed foods compared with less-processed foods on biomarkers of cardiometabolic disease, a randomised single-blind crossover study.","authors":"Julie M Hess, Claudia PromSchmidt, Angela J Scheett, Shanon Casperson, Joanne L Slavin, Daniel G Palmer","doi":"10.1017/S0007114526108034","DOIUrl":"10.1017/S0007114526108034","url":null,"abstract":"<p><p>Ultra-processed food (UPF) consumption has generated a great deal of concern among nutrition scientists and consumers due to its potential relationship with increased risk of adverse health impacts. Evidence from intervention studies comparing UPF-rich and less-processed diets on cardiometabolic health outcomes is limited. Clinical trials that have been published to date focus on comparing more- and less-processed diets, as defined by the Nova system, and their impact on weight-related outcomes. Only one trial compares equally healthful more- and less-processed diets. The Dietary Guidelines for Americans with Ultra-Processed foods (DGA-UP) study will be the first trial to examine whether there is a differential effect to following recommendations from the 2020-2025 Dietary Guidelines for Americans (2020 DGA) including more- or less-processed foods as defined by the Nova classification system on cardiometabolic disease risk factors. A randomised controlled crossover dietary intervention study, DGA-UP will be conducted with 4-week provision of all meals to generally healthy male and female adults at eucaloric levels. The trial will consist of two dietary arms: (1) a less-processed 2020 DGA diet and (2) an ultra-processed 2020 DGA diet. The primary outcome is change in blood pressure on each diet from baseline to week 4. Both interventions will have excellent diet quality and contain similar amounts of macronutrients and micronutrients as well as the same types of food. DGA-UP will help to fill a significant research gap regarding potential impact of UPF on cardiometabolic health markers independent of food type, diet quality and micronutrient content.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454668","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}
María José Cobo Díez, Andrea Romanos, María Olmedo López-Frías, Nerea Martin-Calvo, Miguel Angel Martínez-González, Maira Bes-Rastrollo, Estefanía Toledo
{"title":"Impact of plant-based dietary patterns on obesity-related cancers: the Seguimiento University of Navarra (SUN) prospective cohort.","authors":"María José Cobo Díez, Andrea Romanos, María Olmedo López-Frías, Nerea Martin-Calvo, Miguel Angel Martínez-González, Maira Bes-Rastrollo, Estefanía Toledo","doi":"10.1017/S0007114526107570","DOIUrl":"10.1017/S0007114526107570","url":null,"abstract":"<p><p>Evidence suggests that plant-based dietary patterns - favouring plant-based foods without being strictly vegetarian or vegan - may prevent obesity and offer health benefits. Since not all plant-based foods are equally healthy, it is essential to distinguish between healthful and unhealthful plant-based options. This study aimed to analyse the associations between different plant-based dietary patterns and the incidence of obesity-related cancers. We followed-up 16 256 participants from the 'Seguimiento Universidad de Navarra' prospective cohort. Based on a validated FFQ, we calculated adapted overall, healthful and unhealthful plant-based diet index scores. Scores were assessed at baseline and repeatedly after 10 years of follow-up. Hazard ratios (HR) and 95 % CI were estimated using multivariable-adjusted time-dependent Cox regression models. After a median follow-up of 13 years, 221 incident obesity-related cancer cases were confirmed. Overall plant-based and unhealthful plant-based dietary patterns showed no association. Contrarily, participants in the highest tertile of the healthful plant-based diet score had a lower obesity-related cancer risk (HR<sub>T3vsT1</sub> 0·67; 95 % CI, 0·47, 0·97; <i>P</i><sub>trend</sub> = 0·031). This association persisted after updating dietary information at 10-year follow-up (HR<sub>T3vsT1</sub> 0·68; 95 % CI, 0·47, 0·99; <i>P</i><sub>trend</sub> = 0·037) and was stronger for women (HR<sub>T3vsT1</sub> 0·52; 95 % CI, 0·32, 0·86; <i>p</i><sub>interaction</sub> = 0·04). In this large prospective cohort, greater alignment with a healthful plant-based dietary pattern was associated with a decreased risk of obesity-related cancer, whereas alignment with overall and unhealthful plant-based dietary patterns showed no association.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469137","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}
Marco Mensink, Meeke Ummels, Ron Wehrens, Jasper Engel, Nikkie van der Wielen, Diederik Esser, Jurriaan J Mes
{"title":"Between- and within-person variability in postprandial blood amino acid kinetics after ingestion of a good and a moderately digestible protein source: a randomised trial.","authors":"Marco Mensink, Meeke Ummels, Ron Wehrens, Jasper Engel, Nikkie van der Wielen, Diederik Esser, Jurriaan J Mes","doi":"10.1017/S0007114526108010","DOIUrl":"10.1017/S0007114526108010","url":null,"abstract":"<p><p>Protein intake and the resulting postprandial aminoacidemia are important anabolic stimuli. However, considerable individual variation in postprandial amino acid (AA) kinetics can be expected. In this study, the aim was to quantify the variability in postprandial AA kinetics within and between individuals after consumption of a moderately digestible plant protein concentrate (lucerne (alfalfa), LPC) and an easily digestible animal protein concentrate (whey, WPC). Eighteen healthy young adults consumed a 20 g protein drink on five occasions (3xLPC; 2xWPC). Plasma AA kinetics were calculated, and a mixed model was fitted to describe within- and between-individual variability and to calculate the intra-class correlation coefficient (ICC). AA kinetics showed significant variation between and within individuals, both for WPC and LPC. Between-individual variation in postprandial response for total AA (TAA) or total essential AA (TEAA) was in general larger than within-individual variation for WPC with the ICC with or without blood volume (BV) correction ranging from 0·45 to 0·77. For LPC, the within-individual variation of the TAA response was higher than the between-individual variation, and for TEAA they were more or less equal, with the ICC with or without BV correction ranging from 0·34 to 0·58 for LPC. Subjects with a high level of aminoacidemia for one protein source were not necessarily those with a high level for the other protein source. Our results indicate that between- and within-person variation in postprandial AA kinetics are substantial and should not be neglected.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444455","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 vitamin D status with immune-associated serum protein pathways in overweight French-Canadian adults with hyperinsulinaemia in the Quebec City metropolitan area, Canada.","authors":"Atena Mahdavi, Michel Lebel, Iwona Rudkowska","doi":"10.1017/S0007114526108009","DOIUrl":"10.1017/S0007114526108009","url":null,"abstract":"<p><p>Deficiency in vitamin D can increase the risk of type 2 diabetes (T2D). Yet, the association between 25-hydroxyvitamin D (25(OH)D) levels and the serum proteome in subjects at risk of T2D remains unknown. This proteomic analysis aimed to examine the correlations between serum proteins and 25(OH)D levels stratified as insufficient (< 50 nmol/l), adequate (50-74·9 nmol/l) and optimal (≥ 75 nmol/l) and (2) to identify biological pathways linked to these proteins that may reduce T2D risk. In this cross-over study, twenty-five hyperinsulinaemic French-Canadian adults from the Quebec City metropolitan area (Canada) were evaluated at four timepoints: before and after 6 weeks of either adequate dairy intake (∼2 servings/d) or high dairy intake (≥ 4 servings/d). Serum 25(OH)D concentrations were measured using an immunoassay, and serum protein profiling was performed using liquid chromatography-tandem MS. Gene ontology analysis identified biological pathways. Dairy intake did not significantly change 25(OH)D serum levels. Nevertheless, in ten subjects with optimal 25(OH)D levels, positively correlated proteins were mainly involved in Ig-mediated immune response, regulation of blood coagulation, acute-phase response and adaptive immunity. Negatively correlated proteins were enriched in classical complement activation, innate immune response, acute-phase response and proteolysis. In six subjects with adequate 25(OH)D levels, correlated proteins were associated mainly with innate immune responses. No significant biological pathway enrichment was observed in subjects with insufficient 25(OH)D. Overall, individuals with higher or optimal serum 25(OH)D levels exhibit a greater number of proteins enriched in various immune system response pathways, processes known to influence T2D development.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-13"},"PeriodicalIF":3.1,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435152","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}
Carly Drake, Amy Miskimon Goss, Barbara A Gower, Ambika Ashraf, Jessica Alvarez, Mark Bolding, Fernando Bril, Yenni Cedillo, Alexandria Luzuriaga-McPherson, Rebecca Hanson
{"title":"Effects of a low-glycaemic, moderately carbohydrate-restricted diet on hepatic lipid content and insulin sensitivity in adolescents with metabolic dysfunction-associated steatotic liver disease: protocol of a 6-month family-based, randomised controlled trial.","authors":"Carly Drake, Amy Miskimon Goss, Barbara A Gower, Ambika Ashraf, Jessica Alvarez, Mark Bolding, Fernando Bril, Yenni Cedillo, Alexandria Luzuriaga-McPherson, Rebecca Hanson","doi":"10.1017/S0007114526108058","DOIUrl":"10.1017/S0007114526108058","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most prevalent liver disease among children and is closely associated with insulin resistance and increased risk of developing type 2 diabetes. Early intervention in children with MASLD is essential to prevent progression to advanced liver disease and other metabolic disorders. The goal of this ongoing trial is to determine the effect of a weight-maintaining low glycaemic, moderately carbohydrate-restricted diet (CRD) <i>v</i>. fat-restricted diet (FRD) on changes in hepatic lipid content, insulin sensitivity and metabolomic profile over a 6-month period in adolescents with MASLD. Eligible participants will be children aged 10-17 years with a BMI > 75th percentile and a clinical diagnosis of MASLD. This randomised control trial consists of two 12-week phases: a controlled feeding phase, during which food will be provided to the family, and a free-living phase. The CRD has a macronutrient composition of < 25 % carbohydrate (CHO), 25 % protein and > 50 % fat, while the FRD is composed of 55 % CHO, 25 % protein and 20 % fat. Primary outcomes include change in hepatic lipid measured by MRI and magnetic resonance spectroscopy (MRS); insulin sensitivity measured via euglycaemic clamp; and metabolomic profiling measured from fasting blood. Diet tolerance, body weight and compliance were measured weekly by a Registered Dietitian during the controlled feeding phase and then monthly in the free-living phase. Changes in study endpoints will be assessed between intervention groups and across study time points, assessing for effects by group, time and the group-by-time interaction.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429762","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":"Mid-upper arm circumference as a screening tool for maternal overweight and obesity among pregnant women in Eastern Ethiopia.","authors":"Assefa Tola, Tesfaye Gobena, Lemessa Oljira, Tadesse Gure, Nega Assefa","doi":"10.1017/S0007114526107880","DOIUrl":"10.1017/S0007114526107880","url":null,"abstract":"<p><p>Currently, no globally agreed mid-upper arm circumference (MUAC) cut-offs exist to identify obesity in pregnant women. This study aimed to validate MUAC as an alternative to BMI for detecting maternal overweight/obesity and establish optimal cut-offs. An ambispective cohort study was conducted in six Eastern Ethiopian hospitals, involving 2502 singleton pregnant women enrolled before 16 weeks of gestation. Maternal weight and MUAC were measured twice (early and late pregnancy). Using early-pregnancy BMI as the gold standard, MUAC's diagnostic accuracy was evaluated via linear regression and receiver operating characteristic (ROC) curves. Optimal MUAC cut-off points were determined using Youden's index, and diagnostics were calculated to evaluate MUAC performance. A significant positive correlation was observed between BMI and MUAC (early pregnancy: <i>r</i> 0·69; late pregnancy: <i>r</i> 0·72). Optimal MUAC cut-offs for overweight were 25·95 cm (early) and 27·05 cm (late); for obesity, 27·75 cm (early) and 28·85 cm (late), with high sensitivity, specificity and predictive values. The regression equations were as follows: BMI during early pregnancy = 1·09 + 0·89 × MUAC (95 % CI 0·85, 0·93; <i>P</i> < 0·001) and late-pregnancy BMI = -1·69 + 0·94 × MUAC (95 % CI 0·90, 0·98; <i>P</i> < 0·001). The MUAC values ≥ 26 cm for maternal overweight and ≥ 28 for maternal obesity demonstrated good discriminatory performance and may serve as practical screening thresholds in resource-limited settings. Broader validation across diverse populations could facilitate the integration of MUAC into routine antenatal screening programmes, strengthening early identification and management of maternal overweight/obesity.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429744","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}
Solange Parra-Soto, Jana J Anderson, Jirapitcha Boonpor, Carolina Araya-Bastias, Donald M Lyall, Frederick K Ho, Paul Welsh, Jill P Pell, Naveed Sattar, Jason M Gill, John C Mathers, Carlos Celis-Morales
{"title":"Associations between liking patterns for foods characterised by high/low-fat content and sweet/savoury profiles and health outcomes: findings from the UK Biobank prospective cohort study.","authors":"Solange Parra-Soto, Jana J Anderson, Jirapitcha Boonpor, Carolina Araya-Bastias, Donald M Lyall, Frederick K Ho, Paul Welsh, Jill P Pell, Naveed Sattar, Jason M Gill, John C Mathers, Carlos Celis-Morales","doi":"10.1017/S0007114526108022","DOIUrl":"10.1017/S0007114526108022","url":null,"abstract":"<p><p>We investigated associations between food liking and risk of health outcomes in a prospective cohort and explored if associations were potentially explained by BMI. We included 182 181 participants from UK Biobank. Food liking was measured using a nine-point hedonic scale, covering liking (points 6-9)/disliking (points 1-5) for high-fat savoury (HFSa), high-fat sweet (HFSw), vegetable, low-fat savoury (LFSa) and fruit-based, low-fat sweet (LFSw) foods. Cox proportional hazard models assessed associations with health outcomes, as hazard ratios (HR) with 95 % CI, adjusted for relevant confounders. Compared with disliking, liking HFSa was associated with higher risks of type-2-diabetes (T2D) (HR 1·14; 95 % CI: 1·09-1·19) and lung cancer (HR 1·10; 95 % CI: 1·01-1·20). Liking HFSw was associated with higher risks of all-cause mortality and cancer (HR range 1·03-1·07; 95 % CI range: 1·00-1·14). Liking LFSa was associated with lower risks of all-cause mortality, T2D, CVD, all-cause cancer and colorectal cancer (HR range 0·85-0·97; 95 % CI range: 0·79-0·99). Liking LFSw was associated with lower risks of T2D, CVD and colorectal cancer (HR range 0·91-0·96; 95 % CI range: 0·86-1·00). Associations between food liking and health outcomes differed between food groups, with most appearing not to be attenuated after adjusting for BMI. The key findings were that associations with adverse health outcomes were strongest for higher-fat containing food preference patterns, while sweet preference alone was not associated with increased risk. Our study highlighted the potential role of food liking in designing and targeting health promotion interventions.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-11"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429757","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}
Julie M Petersen, Lisa M Bodnar, Sharon I Kirkpatrick, Ashley I Naimi
{"title":"From single conventional regression to ensemble modelling: relative importance of the Healthy Eating Index-2015 components in relation to adverse pregnancy outcomes - CORRIGENDUM.","authors":"Julie M Petersen, Lisa M Bodnar, Sharon I Kirkpatrick, Ashley I Naimi","doi":"10.1017/S0007114526107946","DOIUrl":"10.1017/S0007114526107946","url":null,"abstract":"","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419059","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}
Elisa R Silva, Nathalie Kliemann, Lilian C Vieira, Jaqueline S de Souza, Cândice L K Copetti, Luiza K Reitz, Francilene K Vieira, Patricia F Di Pietro
{"title":"Intake of polyphenols, phenolic acids and lignans associated with lower mortality in women diagnosed with breast cancer.","authors":"Elisa R Silva, Nathalie Kliemann, Lilian C Vieira, Jaqueline S de Souza, Cândice L K Copetti, Luiza K Reitz, Francilene K Vieira, Patricia F Di Pietro","doi":"10.1017/S0007114526107909","DOIUrl":"10.1017/S0007114526107909","url":null,"abstract":"<p><p>Breast cancer represents one of the main causes of mortality among women, and the consumption of bioactive compounds seems to contribute to improving the prognosis of the disease. However, the relationship between polyphenol intake and breast cancer has not yet been fully elucidated. The objective of this study was to investigate the association between polyphenol intake and breast cancer mortality, survival and recurrence. This is an observational study with a prospective sample of ninety-five women, followed up for an average of 11·5 years. Intake of polyphenols was assessed using an FFQ and estimated using the Phenol-Explorer® database. Cox proportional hazard models were used to investigate the associations. Survival curves were calculated using Kaplan-Meier analysis. An inverse association was found between the intake of total polyphenols, phenolic acids and lignans and the risk of breast cancer-specific mortality (hazard ratio (HR) = 0·20, 95 % CI (0·05, 0·80); HR = 0·09, 95 % CI (0·01, 0·50); HR = 0·15, 95 % CI (0·04, 0·63), respectively). Phenolic acids also showed an inverse association with breast cancer recurrence (HR = 0·35, 95 % CI (0·13, 0·98)) and all-cause mortality (HR = 0·23, 95 % CI (0·07, 0·77)). Coffee was the major contributor to total polyphenol, phenolic acid and lignan intake. Total polyphenol intake was associated with longer survival when breast cancer mortality was considered (P = 0·048). In conclusion, higher intake of polyphenols was associated with lower breast cancer-specific mortality. In addition, phenolic acids were associated with lower all-cause mortality and breast cancer recurrence. Further studies are needed to confirm these associations.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419051","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}
Rachel E Walker, Sarah M Scott, Abdullah Al Mahmud, M Munirul Islam, Alison D Gernand
{"title":"Milk mid-chain fatty acids and vitamin D supplementation are associated with the prevalence of exclusive breast-feeding in Bangladeshi mothers.","authors":"Rachel E Walker, Sarah M Scott, Abdullah Al Mahmud, M Munirul Islam, Alison D Gernand","doi":"10.1017/S000711452610796X","DOIUrl":"10.1017/S000711452610796X","url":null,"abstract":"<p><p>Exclusive breastfeeding in the first 6 months of life is crucial for the health of mothers and babies in low-and middle-income countries. Milk mid-chain fatty acids (MCFA) are potential biomarkers of milk production in other settings. This study investigates MCFA as markers of exclusive breastfeeding in low-and middle-income countries. This was an ancillary observational analysis of human milk fatty acids from a parent randomised controlled trial of vitamin D supplementation in Bangladesh. We categorised mothers as currently exclusively or non-exclusively breastfeeding based on weekly infant feeding questionnaires. We analysed milk fatty acids at 3 months postpartum by GC and modelled longitudinal exclusive breastfeeding using milk fatty acids in repeated-measures Poisson regression. Fatty acids are reported as % total fatty acids. The prevalence of currently exclusive breast-feeding was 76 % at 3 months and 43 % at 6 months (<i>n</i> 587). Both C6:0 and C15:0 were higher with exclusive breastfeeding (C6:0, <i>P</i> = 0·001; C15:0, <i>P</i> = 0·007), while C12:0 and C14:0 were lower (C12:0, <i>P</i> < 0·001; C14:0, <i>P</i> < 0·001). We combined these into an MCFA index defined as ((C6:0 + C15:0)/(C12:0 + C14:0)) × 1000 (Excl: 25 ± 0·50, Non-excl: 20 ± 0·60, <i>P</i> < 0·001). Mothers in the highest and lowest MCFA index tertiles had an exclusive breastfeeding prevalence at 3 months of 95 % and 60 %, respectively (<i>P</i> < 0·001), and remained different until 6 months. In secondary analysis, vitamin D supplementation during lactation was moderately associated with exclusive breastfeeding (relative prevalence: 1·17 (95 % CI 1·04, 1·32)). Milk MCFA were markers of exclusive breastfeeding in this cohort, and the milk MCFA index at 3 months predicted exclusive breastfeeding from 3 to 6 months postpartum.</p>","PeriodicalId":9257,"journal":{"name":"British Journal of Nutrition","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410504","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}