One of the most significant challenges in research related to nutritional epidemiology is the achievement of high accuracy and validity of dietary data to establish an adequate link between dietary exposure and health outcomes. Recently, the emergence of artificial intelligence (AI) in various fields has filled this gap with advanced statistical models and techniques for nutrient and food analysis. We aimed to systematically review available evidence regarding the validity and accuracy of AI-based dietary intake assessment methods (AI-DIA). In accordance with PRISMA guidelines, an exhaustive search of the EMBASE, PubMed, Scopus and Web of Science databases was conducted to identify relevant publications from their inception to 1 December 2024. Thirteen studies that met the inclusion criteria were included in this analysis. Of the studies identified, 61·5 % were conducted in preclinical settings. Likewise, 46·2 % used AI techniques based on deep learning and 15·3 % on machine learning. Correlation coefficients of over 0·7 were reported in six articles concerning the estimation of calories between the AI and traditional assessment methods. Similarly, six studies obtained a correlation above 0·7 for macronutrients. In the case of micronutrients, four studies achieved the correlation mentioned above. A moderate risk of bias was observed in 61·5 % (n 8) of the articles analysed, with confounding bias being the most frequently observed. AI-DIA methods are promising, reliable and valid alternatives for nutrient and food estimations. However, more research comparing different populations is needed, as well as larger sample sizes, to ensure the validity of the experimental designs.

Dietary guidelines often combine plant and animal protein intake recommendations, yet evidence suggests they may have distinct associations with health. This study aimed to examine relationships between animal and plant protein intake, using different classification approaches, and diet quality and obesity. Plant and animal protein contents of foods reported by 7637 participants (≥ 19 years) during the 2011–2012 National Nutrition and Physical Activity Survey were estimated using Australian food composition databases. Usual animal, plant and total protein intakes were estimated using Multiple Source Methods. Diet quality was assessed using the 2013-Dietary Guidelines Index (DGI), and obesity measures included BMI and waist circumference (WC). Multiple linear and logistic regressions were performed and adjusted for potential confounders. Plant and animal protein intakes were positively associated with DGI scores (plant protein: men, β = 0·74 (95 % CI: 0·64, 0·85); women, β = 0·78 (0·67, 0·89); animal protein: men, β = 0·15 (0·12, 0·18); women, β = 0·26 (0·22, 0·29)). These associations were consistent when examining high-quality plant protein (high-protein-containing plant-based foods with comparable nutritional values to animal proteins) and non-dairy animal protein intakes. Plant protein intake was inversely associated with BMI and WC in men but not women. Animal protein intake was positively associated with BMI in both sexes and WC in men only. Men’s plant protein intake was inversely associated with obesity (OR = 0·97 (0·96, 0·99)) and central obesity (OR = 0·97 (0·95, 0·98)). Further studies are needed to examine the influence of different animal protein sources by accounting for energy intake and sex-specific associations.

Environmental impacts of food systems have stimulated research to examine how to create healthy diets that will be more sustainable while meeting nutrient requirements. Increasing compliance with existing food-based dietary guidelines in most jurisdictions could be a first step to improve health and reduce environmental impact. MyPlanetDiet was an all-Ireland 12-week randomised controlled trial designed to inform sustainable healthy dietary guidelines. Healthy adults (n 355) aged 18–64 years with moderate-to-high greenhouse gas emitting (GHGE) diets were recruited from three study sites on the island of Ireland. The aim of this research is to assess the relationship between dietary intakes, diet-related environmental impacts and metabolic health using baseline data collected during the MyPlanetDiet study. Dietary assessments collected using Foodbook24 were used to calculate diet-related GHGE, adherence to healthy eating guidelines (HEG) and healthy eating index (HEI) score. Anthropometrics and metabolic health markers (e.g. lipids, glucose and insulin) were included. Overall HEG adherence was low, with 43 % meeting zero or one HEG food group recommendations. Adherence to 4 + HEG food group targets was associated with 31 % lower diet-related GHGE compared with those with lowest adherence. Higher HEG adherence was associated with lower BMI and waist circumference and higher HEI scores. While our findings suggest HEG adherence is associated with positive health and environmental impacts, substantial behaviour change will be needed to meet existing HEG. Further research is needed to assess response and acceptability to HEG. However, adherence to HEG may be an important first step to reducing the environmental impact of food consumption.

This study evaluated the effects of chenodeoxycholic acid (CDCA), a farnesoid X receptor (FXR) potential activator, on growth performance, antioxidant capacity, glucose metabolism and inflammation in largemouth bass (Micropterus salmoides) (initial body weight: 5·45 ± 0·02 g) fed a high-carbohydrate diet. Experimental diets included a positive control (5 % α-starch), a negative control (10 % α-starch) and two diets containing 10 % α-starch supplemented with either 0·05 % or 0·10 % CDCA. After 8 weeks, the high-carbohydrate diet reduced growth performance and increased hepatosomatic and viscerosomatic indexes, which were mitigated by 0·10 % CDCA supplementation. The high-carbohydrate diet also increased hepatic glycogen and crude lipid content, both of which were reduced by 0·10 % CDCA. Furthermore, the high-carbohydrate diet-induced oxidative stress, histopathological changes and reduced liver lysozyme activity, which were ameliorated by CDCA supplementation. Molecular analysis showed that the high-carbohydrate diet suppressed FXR and phosphorylated AKT1 (p-AKT1) protein expression in the liver, downregulated insulin signalling (ira, irs, pi3kr1 and akt1), gluconeogenesis (pepck and g6pc) and glycolysis genes (gk, pk and pfkl). CDCA supplementation upregulated fxr expression, activated shp, enhanced the expression of insulin signalling and glycolytic genes (gk, pk and pfkl) and inhibited gluconeogenesis. Additionally, CDCA reduced inflammatory markers (nf-κb and il-1β) and restored anti-inflammatory mediators (il-10, iκb and tgf-β). In conclusion, 0·10 % CDCA improved carbohydrate metabolism and alleviated liver inflammation in largemouth bass fed a high dietary carbohydrate, partially through FXR activation.

This study investigates the effects of fat emulsion-based early parenteral nutrition in patients following hemihepatectomy, addressing a critical gap in clinical knowledge regarding parenteral nutrition after hemihepatectomy. We retrospectively analysed clinical data from 274 patients who received non-fat emulsion-based parenteral nutrition (non-fatty nutrition group) and 297 patients who received fat emulsion-based parenteral nutrition (fatty nutrition group) after hemihepatectomy. Fat emulsion-based early parenteral nutrition significantly reduced levels of post-operative aspartate aminotransferase, total bilirubin and direct bilirubin, while minor decreases in red blood cell and platelet counts were observed in the fatty nutrition group. Importantly, fat emulsion-based early parenteral nutrition shortened lengths of post-operative hospital stay and fasting duration, but did not affect the incidence of short-term post-operative complications. Subgroup analyses revealed that the supplement of n-3 fish oil emulsions was significantly associated with a reduced inflammatory response and risk of post-operative infections. These findings indicate that fat emulsion-based early parenteral nutrition enhances short-term post-operative recovery in patients undergoing hemihepatectomy.

Artificial sweeteners are used to reduce energy intake, but studies suggest that consumption during pregnancy may impact the offspring’s risk of overweight. In this longitudinal cohort study, we aimed to examine the association between consumption of artificially sweetened or sugar-sweetened beverages during pregnancy and offspring overweight from birth to 18 years in the Danish National Birth Cohort. A total of 101 042 pregnancies were enrolled in the Danish National Birth Cohort from 1996 to 2002. Follow-up was conducted throughout pregnancy, childhood and adolescence. Additionally, 72 821 women completed an FFQ during pregnancy, reporting intake of beverages sweetened with artificial sweeteners or sugar. Offspring height and weight were obtained during childhood and adolescence. Multivariate logistic regression was performed to estimate the OR for overweight concerning maternal beverage consumption. Analyses were adjusted for risk factors for childhood overweight, including maternal age, pre-pregnancy BMI, physical activity and smoking in pregnancy, healthy eating index, paternal BMI, socio-economic status and duration of breastfeeding. We found increased odds of overweight in 7-, 11-, 14- and 18-year-old offspring whose mothers reported drinking ≥ 1 artificially sweetened beverage daily during pregnancy compared with no consumption (18 years: adjusted OR 1·26 (95 % CI 1·12, 1·42)). We found decreased adjusted odds of overweight in 11- and 18-year-old offspring whose mothers reported drinking ≥ 1 sugar-sweetened beverage daily during pregnancy compared with no consumption. We found that consumption of artificially sweetened beverages during pregnancy was associated with an increased risk of overweight in childhood and adolescence after adjustment for risk factors for childhood overweight.

n-3 PUFA delivered by fish oil supplements alter the number and functions of circulating extracellular vesicles (EV), but consumption of oily fish does not reproduce this effect. In order to assess the effects of fish oil supplements and oily fish, at a level achievable in the diet, on EV numbers, composition and procoagulant activity in healthy human volunteers, forty-two healthy subjects were assigned to one of three treatment groups: (i) fish oil supplements plus white fish meals, (ii) control supplements plus oily fish meals or (iii) control supplements plus white fish meals for 12 weeks in a randomised, double-blind, placebo-controlled, parallel trial; circulating EV were enumerated and their procoagulant activity assessed using thrombin generation and fibrinolysis assays. Our results showed that fish oil supplements decreased circulating EV numbers and reduced EV-stimulated thrombin generation, but the consumption of oily fish at half the dose of EPA had no effect on either EV number or thrombogenic capacity. Consumption of both oily fish and fish oil supplements increased the EPA and DHA contents of EV, and the proportion of EPA in circulating EV was strongly associated with EV-stimulated thrombin generation. This study revealed that the additional 1 g/d EPA delivered in the fish oil supplements is required to decrease the numbers and thrombogenic capacity of EV, since oily fish at a level achievable in the diet had no effect. Increasing EPA intake beyond current guidelines for oily fish consumption may therefore be required for cardiovascular benefits relating to EV.

Whole-body and regional raw bioelectrical impedance analysis (BIA) parameters have been used to develop lean soft tissue estimation prediction models. Still, no regional fat mass (FM) assessment models have been provided. Hence, we aimed to develop and validate BIA-derived equations to predict regional FM against dual-energy X-ray absorptiometry (DXA) in healthy adults. One hundred and forty-eight adults (77 females) were included in this cross-sectional investigation. DXA assessed whole-body and regional FM and raw bioelectrical parameters of distinct body regions were measured using a 50 kHz phase-sensitive BIA analyser. BIA-derived equations were developed for each sex using a stepwise multiple linear regression approach in 2/3 of the sample and cross-validated in the remaining sample. The BIA-derived equations exhibited moderate to very strong relationships (P < 0·001) with DXA-measured FM of all body regions in females (r = 0·650 to 0·907) and males (r = 0·401 to 0·807). Also, for all the models, no significant deviation from linearity was found (P > 0·10). Agreement analyses revealed no associations between the differences and the means of the predicted and DXA-derived FM. However, the limits of agreement were large, with individual errors exceeding 50 % in females and 70 % in males. While the new BIA-derived equations provide a valid estimate of regional FM in middle-aged healthy adults at the population level, demonstrating a cost-effective alternative to DXA for assessing regional FM, caution is advised when applying these equations for individual-level analysis.

There has been concern regarding the consumption of fruit juices because of the high levels of naturally occurring sugars they contain, which could rapidly elevate glycaemic response and increase the risk of cardiometabolic diseases. We conducted two trials in which each volunteer ingested (1) white bread with 200 ml of two types of orange juice (OJ) prepared from ‘Moro’ and ‘Pera’ varieties (MOJ and POJ) – the former containing anthocyanins – and the same juices alone; and (2) 200 ml of POJ or MOJ followed by a sandwich made with white bread, plus light cheese or butter, and also the same juices alone. Capillary blood was collected over 120 min, and glucose and insulin levels were analysed. In the cross-over clinical design with healthy volunteers, we observed that both OJ does not increase blood glucose and insulin, even when co-consumed with other typical breakfast foods in Brazil. In conclusion, OJ does not elevate postprandial glycaemic responses to the meal while providing additional sugars and nutrients.

Studies on longitudinal associations between diet quality and lipid and amino acid metabolism in children and adolescents are limited. We studied associations between diet quality and serum markers of lipid and amino acid metabolism in the Physical Activity and Nutrition in Children (PANIC) study. These analyses included 403 children aged 6–9 years at baseline, 360 re-examined 2 years later at age 9–11 years and 219 eight years later at age 15–17 years. Food intake was recorded over 4 days, and diet quality was assessed using the Finnish Children Healthy Eating Index (FCHEI). Fasting serum fatty acids, amino acids, apolipoproteins and lipoprotein particle sizes were analysed via NMR spectroscopy. Linear mixed-effects models, adjusted for sex, age, body fat percentage, pubertal stage and physical activity were used to analyse the associations. Better diet quality was linked to increased serum PUFA and reduced saturated and MUFA, alanine and VLDL particle size. Consuming more vegetables, fruits, berries, vegetable oils and margarine with at least 60 % fat, fish and whole grains is associated with higher serum PUFA, lower SFA and smaller VLDL particles. Conversely, consuming higher-fat dairy products and sugary products is associated with higher saturated and MUFA, branched-chain and aromatic amino acids and larger VLDL particles. A diet rich in fruits, vegetables, unsaturated fats and fibre, with reduced sugar consumption, promotes favourable metabolic changes relevant to cardiometabolic health.

Low vitamin D associated with high parathyroid hormone (PTH) is common in HIV infection. We determined the association between total 25(OH)D and PTH in adolescents living with HIV, in Zambia and Zimbabwe. Adolescents (11–19 years) perinatally infected with HIV and established on antiretroviral therapy for ≥ 6 months were recruited into a cross-sectional study. Socio-demographic and clinical characteristics were recorded, anthropometry measured and fasted serum concentrations of 1,25(OH)2D, total 25(OH)D and intact PTH measured. The association between total 25(OH)D and PTH was examined using natural cubic spline regression. 842 participants (female: 53·2%) with a median age of 15·5 (IQR: 13·2–17·9) years were enrolled. Median antiretroviral therapy duration was 9·8 (IQR: 6·3–12·3) years, and 165/841 had an HIV viral-load >60 copies/ml. Stunting (height-for-age z-score <–2) and underweight (weight-for-age z-score <–2) were observed in 29·9 and 30·0%, respectively. Three-quarters reported daily Ca intakes <150 mg/d. The mean (sd) concentrations of total 25(OH)D and 1,25(OH)2D were 66·1(16·5) nmol/l and 210·6 (70·4) pmol/l, respectively, and median PTH level was 4·3 (IQR: 3·3–5·5) pmol/l. There was an inverse non-linear relationship between total 25(OH)D and PTH, 25(OH)D levelling off at 74·6 nmol/l (95 % CI: 74·5, 75·2). Results were consistent in those taking tenofovir disoproxil fumarate and virally unsuppressed participants. In this population with extremely low habitual Ca intakes, the lack of association between 25(OH)D and PTH when 25(OH)D exceeded 75 nmol/l potentially suggests that levels of 25(OH)D >75 nmol/l may need to be achieved to improve bone health; investigation is needed in future research studies.

This study examined the relationship between total body fat percentage (TBFP), trunk fat percentage (TFP), and urinary flow rate (UFR) using NHANES data (2011–2018) from 10 521 participants aged 18–59. Multivariable-adjusted regression models assessed associations between dual-energy X-ray absorptiometry-measured fat percentages and UFR. Results showed that increased TBFP and TFP were inversely associated with UFR (TBFP: β = −0·013, 95 % CI [–0·018, −0·007]; TFP: β = –0·014, 95 % CI [–0·018, −0·009]). Stratified analyses revealed gender differences: in males, higher TBFP and TFP correlated with lower UFR (TBFP: β = –0·011, 95 % CI [−0·019, −0·004]; TFP: β = –0·016, 95 % CI [−0·022, −0·009]), but this association was absent in males aged 18–35. In females, both TBFP and TFP were consistently linked to reduced UFR across all age groups (TBFP: β = −0·016, 95 % CI [−0·023, −0·008]; TFP: β = −0·012, 95 % CI [−0·019, −0·006]). These findings suggest that body and trunk fat accumulation negatively impact UFR, with stronger effects in females and age-dependent variations in males. Further research should explore mechanisms behind these disparities to guide targeted interventions.

Measurement error undermines the accuracy of dietary intake data. The 24-h dietary recall (24HR) is the standard data collection method in nutrition surveillance. Several neurocognitive processes underpin the act of recall, and individuals differ in their performance of these processes. This study aimed to investigate whether variation in neurocognitive processes, measured using four cognitive tasks, was associated with variation in measurement error of 24HR. Participants (n 139) completed the Trail Making Test, the Wisconsin Card Sorting Test, the Visual Digit Span and the Vividness of Visual Imagery questionnaire. During a controlled feeding study, participants completed three technology-assisted 24HR: the Automated Self-Administered Dietary Assessment Tool, Intake24 and an Interviewer-Administered Image-Assisted 24HR (IA-24HR) 1 week apart. The percentage error between reported and true energy intakes was calculated. Using linear regression, the association between cognitive task scores and absolute percentage error in estimated energy intake was assessed. Longer time spent completing the Trail Making Test, an indicator of visual attention and executive functioning, was associated with greater error in energy intake estimation using ASA24 (B 0·13, 95 % CI 0·04, 0·21) and Intake24 (B 0·10, 95 % CI 0·02, 0·19). Regression models explained 13·6 % (ASA24) and 15·8 % (Intake24) of the variance in energy estimation error. No cognitive task scores were associated with error using IA-24HR. This study demonstrates that variation between individuals in neurocognitive processes explains some of the variation in 24HR error. Further investigation into the role of neurocognitive processes in 24HR and their role in the reliability of dietary intake data is warranted.

High intake of dietary advanced glycation end products (AGE) could induce oxidative stress, inflammation and the gut microbiota dysbiosis processes that play a major role in the development of functional gastrointestinal disorders (FGID). There is limited data on the association between AGE intake and FGID. Therefore, this study aimed to examine the association of AGE with FGID in Iranian adults. In a cross-sectional analysis under the framework of the Isfahan functional disorders study, data on 1892 Iranian healthy adults aged 18–65 years were examined. Participants’ dietary intakes were collected using a validated dish-based, 106-item FFQ. Dietary AGE content of seventy-two food items was measured for all participants. FGID were assessed using Rome IV criteria. In total, 38 % of subjects had one of the most prevalent upper or lower FGID. The mean of AGE intake was 14690·10 (sd 8797·25) (kU/gr). In the fully adjusted model, being in the highest v. lowest tertile of AGE intake was associated with increased odds of FGID (OR = 1·78; 95 % CI: 1·01, 3·36). In stratified analysis by sex, males in the highest tertile of AGE intake showed higher odds of FGID than those in the lowest tertile (OR = 2·15; 95 % CI: 1·04, 4·45). However, in females, the AGE intake was not significantly associated with the risk of FGID in the fully adjusted model. Higher AGE intake was significantly associated with an increased risk of FGID, particularly in men. Further prospective studies are warranted to confirm these findings.

Prior studies have shown that plant-based diets are associated with lower cardiovascular risk. However, these diets encompass a large diversity of foods with contrasted nutritional quality that may differentially impact health. We aimed to investigate the pooled cross-sectional association between metabolic syndrome (MetS), its components and healthy and unhealthy plant-based diet indices (hPDI and uPDI), using data from two French cohorts and one representative study from the French population. This study included 16 358 participants from the NutriNet-Santé study, 1769 participants from the Esteban study and 1565 participants from the STANISLAS study who underwent a clinical visit. The MetS was defined according to the International Diabetes Federation definition. The associations between these plant-based diet indices and MetS were estimated by multivariable Poisson and logistic regression models, stratified by gender. Meta-analysis enabled the computation of a pooled prevalence ratio. A higher contribution of healthy plant foods (higher hPDI) was associated with a lower probability of having MetS (PRmen: 0·85; 95 % CI: 0·75, 0·94, PRwomen: 0·72; 95 % CI: 0·67, 0·77), elevated waist circumferences and elevated blood pressure. In women, a higher hPDI was associated with a lower probability of having elevated triacylglyceride (TAG), low HDL-cholesterolaemia and hyperglycaemia; and a higher contribution of unhealthy plant foods was associated with a higher prevalence of MetS (PRwomen: 1·13; 95 % CI: 1·01, 1·26) and elevated TAG. A greater contribution of healthy plant floods was associated with protective effects on metabolic syndrome, especially in women. Gender differences should be further investigated in relation to the current sustainable nutrition transition.