Substantial changes resulting from the interaction of environmental and dietary factors contribute to an increased risk of obesity, while their specific associations with obesity remain unclear. We identified inflammation-related dietary patterns (DP) and explored their associations with obesity among urbanised Tibetan adults under significant environmental and dietary changes. Totally, 1826 subjects from the suburbs of Golmud City were enrolled in an open cohort study, of which 514 were followed up. Height, weight and waist circumference were used to define overweight and obesity. DP were derived using reduced rank regression with forty-one food groups as predictors and high-sensitivity C-reactive protein and prognostic nutritional index as inflammatory response variables. Altitude was classified as high or ultra-high. Two DP were extracted. DP-1 was characterised by having high consumptions of sugar-sweetened beverages, savoury snacks, and poultry and a low intake of tsamba. DP-2 had high intakes of poultry, pork, animal offal, and fruits and a low intake of butter tea. Participants in the highest tertiles (T3) of DP had increased risks of overweight and obesity (DP-1: OR = 1·37, 95 % CI 1·07, 1·77; DP-2: OR = 1·48, 95 % CI 1·18, 1·85) than those in the lowest tertiles (T1). Participants in T3 of DP-2 had an increased risk of central obesity (OR = 2·25, 95 % CI 1·49, 3·39) than those in T1. The positive association of DP-1 with overweight and obesity was only significant at high altitudes, while no similar effect was observed for DP-2. Inflammation-related DP were associated with increased risks of overweight and/or obesity.

This study examined differences in food groups consumed at eating occasions by the level of adherence to dietary guidelines in Australian adults (≤19 years) and whether consumption differed with respect to age, sex and education levels. Secondary analysis of the 2011–2012 National Nutrition and Physical Activity Survey (n 9054) was performed, using one 24-h dietary recall with self-reported eating occasions. Dietary Guideline Index scores were used to assess adherence to the 2013 Australian Dietary Guidelines. Mean differences (95 % CI) in servings of the five food groups and discretionary foods at eating occasions were estimated for adults with higher and lower diet quality, stratified by sex, age group and education. Using survey-based t-tests, differences of at least half a serving with P values < 0·05 were considered meaningful. Compared with adults with lower diet quality, women and men aged 19–50 years with higher diet quality consumed more serves of vegetables at dinner (mean difference (95 % CI), women; 1·0; 95 % CI (0·7, 1·2); men: 0·9; 95 % CI (0·6, 1·3)) and fewer serves of discretionary foods at snacks (women: −0·7; 95 % CI (−0·9, −0·5); men: −1·0; 95 % CI (−1·4, −0·7). Other food groups, such as grains, dairy products and alternatives, meats and alternatives, were not significantly different between adults with lower and higher diet quality, across any eating occasions and age groups. Discretionary food intake at lunch, dinner and snacks was consistently greater among adults with lower diet quality, regardless of education level. Our findings identify dinner and snacks as opportunities to increase vegetable intake and reduce discretionary food intake, respectively.

Low dietary diversity is a predictor of depression in high-income countries, but evidence from low-income settings where poor nutrition and depression often co-occur is scarce. We examined the association between dietary diversity and depression in rural Western Kenya. We conducted a cross-sectional analysis of data collected between June and August 2025 from 311 participants enrolled in a group-based microfinance (‘BIGPIC’) program. Depression was measured using twenty-item Centre for Epidemiologic Studies for Depression Scale, and dietary diversity was assessed based on the consumption of five food groups in the previous 24 hours using a validated scale. We used linear regression models to estimate the association between high dietary diversity and depression scores and assessed effect measure modification by wealth status. Quantile regression was used to examine variation across the distributions of depression scores. Higher dietary diversity was associated with lower depression scores (adjusted β (95 % CI): −3·49 (–6·62, −0·38)). This association was stronger among individuals with lower wealth (adjusted β (95 % CI): −6·00 (–10·46, −1·42)), compared with those with high wealth (adjusted β (95 % CI): −0·53 (–4·76, 3·68); Wald P–value for interaction = 0·0003). Effect sizes were larger at higher quantiles across 75th (Q75: β = −7·56; 95 % CI: −12·82, −2·27) and 90th (Q90: β = −6·01; 95 % CI: −12·43, 0·43) quantiles, though estimates were imprecise. These findings suggest that greater dietary diversity may be associated with improved mental health, particularly among socio-economically vulnerable individuals, and those with severe depression. Future work using longitudinal and quasi-experimental designs are needed to strengthen causal inference and clarify underlying mechanisms.

The rising incidence of neurodegenerative diseases in an ageing global population has shifted research focus towards modifiable risk factors, such as diet. Despite potential links between dietary patterns and brain health, inconsistencies in neuroimaging outcomes underscore a gap in understanding how diet impacts brain ageing. This study explores the relationship between three dietary patterns – Mediterranean, Dietary Approaches to Stop Hypertension (DASH) and Mediterranean-DASH Intervention for Neurodegenerative Delay – and cognitive outcomes as well as brain connectivity. The study aimed to assess the association of these diets with brain structure and cognitive function, involving a middle-aged healthy group and an older cohort with subjective cognitive decline. The study included cognitive assessments and diffusion-weighted MRI data to analyse white matter microstructural integrity. Participants comprised fifty-five older individuals with subjective cognitive decline (54·5 % female, mean age = 64) and fifty-two healthy middle-aged individuals (48·1 % female, mean age = 53). Age inversely correlated with certain cognitive functions and global brain metrics, across both cohorts. Adherence to the Mediterranean, DASH and Mediterranean-DASH Intervention for Neurodegenerative Delay diets showed no significant cognitive or global brain metric improvements after adjusting for covariates (age, education, BMI). Network-based statistics analysis revealed differences in brain subnetworks based on DASH diet adherence levels in the subjective cognitive decline cohort. In the healthy cohort, lower white matter connectivity was associated with reduced adherence to Mediterranean-DASH Intervention for Neurodegenerative Delay and DASH diets. Ultimately, the study found no strong evidence connecting dietary patterns to cognitive or brain connectivity outcomes. Future research should focus on longitudinal studies and refine dietary assessments.

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.

The early years of life are crucial for developing cognitive abilities, such as intelligence. This period is marked by rapid brain development, in which nutrition is essential. This study aimed to characterise dietary patterns at age 2 and investigate their association with cognitive performance at ages 6–7. The study used data from the 2015 Pelotas Birth Cohort, Brazil (n 4275). Dietary intake was assessed using a habitual consumption questionnaire, and patterns were derived using principal component analysis. Cognitive performance was assessed using the Wechsler Intelligence Scale for Children (4th edition), providing intelligence quotient (IQ) scores. Associations were tested using linear regression models. The unhealthy dietary pattern (characterised by packaged snacks, instant noodles, sweet biscuits, sweets and candies, soft drinks, sausages and processed meats) was negatively associated with IQ (P < 0·001). Exploratory analyses suggest that early-life deficits (low weight, height or head circumference for age) may amplify the negative effect of unhealthy dietary pattern on IQ (interaction P = 0·020). Children with high adherence to this pattern and early-life deficits showed a 4·78-point IQ reduction (95 % CI: −7·06, −2·49), while those without deficits had a 2·24-point reduction (95 % CI: −3·35, −1·13), compared with those with low adherence, even after adjustments. No significant associations were found between the healthy dietary pattern (characterised by beans, baby foods, fruits, vegetables and natural fruit juices) and IQ scores. These findings suggest that an unhealthy diet in early childhood may impair cognitive performance, particularly among children with early-life deficits.

Sichuan cuisine was previously fitted into the Chinese Heart-Healthy Diet (CHH) trial to verify the antihypertensive effect. Whether the modified Sichuan diet lessens cardiovascular disease (CVD) is not fully explored. We aimed to estimate the effects of the Sichuan version of CHH diet (CHH diet-SC) on the 10-year risk of CVD and vascular age. A single-blinded randomised controlled feeding trial was conducted. General CVD prediction model was used in manners of intention-to-treat and per-protocol set. After a 7-d run-in period, fifty-three participants with pre- and grade I hypertension from local communities were randomised and provided with either CHH diet-SC (n 27) or a control diet (n 26) for 4 weeks. Mean absolute and relative estimated CVD risks were reduced by 4·5 % and 27·9 % in the CHH diet-SC group, and the between-group relative risk reduction was 19·5 % (P < 0·001) using linear mixed-effects models. The sensitivity analysis with datasets and models showed consistent results, and pre-specified factors were not associated with the intervention effects. The vascular age of CHH-SC group was theoretically 4·4 years younger than that of the control group after intervention. Compared with a typical diet, adopting the CHH diet-SC over 1 month significantly reduced 10-year CVD risks and vascular ages among local adults with mild hypertension.

Dietary patterns are key modifiable determinants in cardiovascular disease (CVD) prevention, accounting for over half of CVD-related deaths and disabilities. This study aimed to examine whether changes in diet quality and six predefined diet scores were associated with incident cardiovascular (CV) events over four years among secondary care cardiology patients. We conducted a secondary prospective analysis of participants aged ≥45 years from the Brazilian Cardioprotective Nutritional Program Trial, including 1,704, 1,629 and 1,286 individuals for the 12-, 24- and 36-month change analyses, respectively. The assessed diet scores included the Dietary Inflammatory Index (DII), Dietary Total Antioxidant Capacity (dTAC), overall, healthful and unhealthful Plant-Based Diet Index (PDI, hPDI, uPDI), and the modified Alternative Healthy Eating Index (mAHEI). The primary outcome was the incidence of new CV events in each follow-up period, adjudicated by the Clinical Endpoints Committee. Associations were estimated using Cox proportional hazards models, combining intervention and control groups. A total of 162 incident CVD cases occurred over a median follow-up of 3.25 years. After 36 months, improvements in mAHEI scores were inversely associated with CV event incidence in both crude (HR: 0.96; 95% CI: 0.92–0.99) and adjusted models (HR: 0.94; 95% CI: 0.89–1.00). No significant associations were found for changes in DII, dTAC, PDI, hPDI or uPDI across any time point. These findings suggest that, in individuals receiving secondary CV care, sustained improvements in diet quality, particularly those reflected by the mAHEI, may require longer periods to translate into measurable benefits for cardiovascular health.

Inflammation and oxidative stress contribute to the progression of chronic diseases, and the volume of research in this area is rapidly expanding. Various dietary indices have been developed to determine the overall inflammatory or oxidative stress potential of a diet; however, few have been validated in cardiometabolic disease populations. This review aimed to explore the association between dietary indices and biomarkers of inflammation and oxidative stress in adults with cardiometabolic conditions. Four databases were systematically searched for literature in any language (Embase, CINAHL, CENTRAL and MEDLINE) with 12,286 deduplicated records identified. Seventeen studies of adults with metabolic syndrome, cardiovascular disease, type 2 diabetes, non-alcoholic fatty liver disease or chronic kidney disease were included. Fourteen studies were observational studies, one study was a clinical trial, and one was a randomised controlled trial. Four dietary indices were reported on with most studies (n 11) reporting on the dietary inflammatory index. The most reported biomarker was C-reactive protein. The findings were narratively synthesised. Results were inconclusive due to the heterogeneity of dietary indices and their use, disease states and biomarkers reported. Only one study reporting on the dietary inflammatory index assessed all 45 parameters. Observational studies, particularly retrospective designs (n 7), are subject to recall and selection biases, potentially presenting overestimated results. Further research is required to determine the relationship between dietary indices and biomarkers of inflammation and oxidative stress in cardiometabolic disease populations. Future research should be prospective, utilise rigorous research methods, assess the full range of index parameters, and examine biomarkers the tool was developed for.

Few studies investigated the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status, particularly among adolescents. The present study was designed to investigate the association of MIND diet with metabolic health status in Iranian adolescents with overweight/obesity. This cross-sectional study was done among 203 adolescents with overweight/obesity (12–18 years) in Isfahan, Iran. A validated FFQ was applied to collect dietary intakes. Anthropometric indices and blood pressure were also measured by standard procedures. Fasting blood samples were obtained to determine serum insulin, glucose and lipid profile. To categorise participants as being with metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO), two methods including International Diabetes Federation (IDF) criteria and IDF plus Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were applied. Participants had a mean age of 13·98 years and 50·2 % of them were girls. In fully adjusted models, participants with highest MIND diet adherence had lower odds of MUO status based on IDF (OR = 0·20; 95 % CI 0·08, 0·51) and IDF/HOMA-IR (OR = 0·22; 95 % CI 0·08, 0·59) criteria. Stratified analyses revealed that this association was stronger among girls and was only significant among individuals with overweight. An inverse association was also found between MIND diet score and odds of hyperglycaemia and insulin resistance (IR). Higher MIND diet adherence was associated with lower odds MUO in adolescents with overweight/obesity. Inverse associations were also found between MIND diet and odds of hyperglycaemia and IR. Future longitudinal prospective studies are necessary to confirm our results.

Fatigue and insomnia, potentially induced by inflammation, are distressing symptoms experienced by colorectal cancer (CRC) survivors. Emerging evidence suggests that besides the nutritional quality and quantity, also the timing, frequency and regularity of dietary intake (chrono-nutrition) could be important for alleviating these symptoms. We investigated longitudinal associations of circadian eating patterns with sleep quality, fatigue and inflammation in CRC survivors. In a prospective cohort of 459 stage I-III CRC survivors, four repeated measurements were performed between 6 weeks and 24 months post-treatment. Chrono-nutrition variables included meal energy contribution, frequency (a maximum of six meals could be reported each day), irregularity and time window (TW) of energetic intake, operationalised based on 7-d dietary records. Outcomes included sleep quality, fatigue and plasma concentrations of inflammatory markers. Longitudinal associations of chrono-nutrition variables with outcomes from 6 weeks until 24 months post-treatment were analysed by confounder-adjusted linear mixed models, including hybrid models to disentangle intra-individual changes from inter-individual differences over time. An hour longer TW of energetic intake between individuals was associated with less fatigue (β: −6·1; 95 % CI (−8·8, −3·3)) and insomnia (β: −4·8; 95 % CI (−7·4, −2·1)). A higher meal frequency of on average 0·6 meals/d between individuals was associated with less fatigue (β: −3·7; 95 % CI (−6·6, −0·8)). An hour increase in TW of energetic intake within individuals was associated with less insomnia (β: −3·0; 95 % CI (−5·2, −0·8)) and inflammation (β: −0·1; 95 % CI (−0·1, 0·0)). Our results suggest that longer TWs of energetic intake and higher meal frequencies may be associated with less fatigue, insomnia and inflammation among CRC survivors. Future studies with larger contrasts in chrono-nutrition variables are needed to confirm these findings.

Fine particulate matter (PM2·5) is a known risk factor for heart failure (HF), while plant-based dietary patterns may help reduce HF risk. This study examined the combined impact of PM2·5 exposure and a plant-based diet on HF incidence. A total of 190 092 participants from the UK Biobank were included in this study. HF cases were identified through linkage to the UK National Health Services register, with follow-up lasting until October 2022 in England, August 2022 in Scotland and May 2022 in Wales. Annual mean PM2·5 concentration was obtained using a land use regression model, while the healthful plant-based diet index (hPDI) was calculated using the Oxford WebQ tool based on two or more 24-hour dietary assessments of seventeen major food groups. Cox proportional hazard models assessed the associations of PM2·5 and hPDI with HF risk, and interactions were evaluated on additive and multiplicative scales. During a median of 13·4-year follow-up, 4351 HF cases were recorded. Participants in the highest PM2·5 tertile had a 23 % increased HF risk (hazard ratio: 1·23, 95 % CI: 1·14, 1·32) compared with those in the lowest tertile. Moderate or high hPDI was associated with reduced HF risk relative to low hPDI. The lowest HF risk was observed in individuals with high hPDI and low PM2·5 exposure, underscoring the protective role of a plant-based diet, particularly in areas with lower PM2·5 levels. A healthy plant-based diet may mitigate HF risk, especially in populations exposed to lower PM2·5 levels.

Evidence suggests that differences in meal timing between weekends and weekdays can disrupt the body’s circadian rhythm, leading to a higher BMI. We aimed to investigate the associations between mealtime variation from weekdays to weekends (eating midpoint jetlag), dietary intake and anthropometric parameters, based on individuals’ chronotype. The study utilised data from National Health and Nutrition Examination Survey 2017–2018. Food consumption was estimated by weighted average of participants’ food intake on weekdays and weekends. Eating midpoint jetlag, defined as the difference between the midpoint of the first and last mealtimes on weekends and weekdays, was calculated. Chronotype was assessed by participants’ mid-sleep time on weekends, adjusted for sleep debt. Linear regression analysis was conducted to investigate the associations between variables. The sample was categorised into chronotype tertiles. Among individuals in the third chronotype tertile, there was a positive association between eating midpoint jetlag and BMI (β = 1·2; 95 % CI (1·13, 1·27)). Individuals in the first tertile showed a positive association between eating midpoint jetlag and energy (β = 96·9; 95 % CI (92·9, 101·7)), carbohydrate (β = 11·96; 95 % CI (11·2, 12·6)), fat (β = 3·69; 95 % CI (3·4, 3·8)), cholesterol (β = 32·75; 95 % CI (30·9, 34·6)) and sugar (β = 8·84; 95 % CI (8·3, 9·3)) intake on weekends. Among individuals with an evening tendency, delaying meals on weekends appears to be linked to a higher BMI. Conversely, among individuals with a morning tendency, eating meals later on weekends is associated with higher energetic intake on weekends.

Assessing children’s diets is currently challenging and burdensome. Abbreviated FFQ have the potential to assess dietary patterns in a rapid and standardised manner. Using nationally representative UK dietary intake and biomarker data, we developed an abbreviated FFQ to calculate dietary quality scores for pre-school and primary school-aged children. UK National Diet and Nutrition Survey (2008–2016) weekly consumption frequencies of 129 food groups from 4-d diaries were cross-sectionally analysed using principal component analysis. A 129-item score was derived, alongside a 12-item score based on foods with the six highest and six lowest coefficients. Participants included 1069 pre-schoolers and 2565 primary schoolchildren. The first principal component explained 3·4 and 3·0 % of the variation in the original diet variables for pre-school and primary school groups, respectively, and described a prudent diet pattern. Prudent diet scores were characterised by greater consumption of fruit, vegetables and tap water and lower consumption of crisps, manufactured coated chicken/turkey products, purchased chips and soft drinks for both age groups. Correlations between the 129-item and 12-item scores were 0·86 and 0·84 for pre-school and primary school-aged children, respectively. Bland–Altman mean differences between the scores were 0·00 sd; 95 % limits of agreement were −1·05 to 1·05 and −1·10 to 1·10 sd for pre-school and primary school-aged children, respectively. Correlations between dietary scores and nutritional biomarkers showed only minor attenuation for the 12-item compared with the 129-item scores, illustrating acceptable congruence between prudent diet scores. The two 12-item FFQ offer user-friendly tools to measure dietary quality among UK children.

The World Cancer Research Fund and the American Institute for Cancer Research recommend a plant-based diet to cancer survivors, which may reduce chronic inflammation and excess adiposity associated with worse survival. We investigated associations of plant-based dietary patterns with inflammation biomarkers and body composition in the Pathways Study, in which 3659 women with breast cancer provided validated food frequency questionnaires approximately 2 months after diagnosis. We derived three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI). We assayed circulating inflammation biomarkers related to systemic inflammation (high-sensitivity C-reactive protein [hsCRP]), pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and anti-inflammatory cytokines (IL-4, IL-10, IL-13). We estimated areas (cm2) of muscle and visceral and subcutaneous adipose tissue (VAT and SAT) from computed tomography scans. Using multivariable linear regression, we calculated the differences in inflammation biomarkers and body composition for each index. Per 10-point increase for each index: hsCRP was significantly lower by 6·9 % (95 % CI 1·6%, 11·8%) for PDI and 9·0 % (95 % CI 4·9%, 12·8%) for hPDI but significantly higher by 5·4 % (95 % CI 0·5%, 10·5%) for uPDI, and VAT was significantly lower by 7·8 cm2 (95 % CI 2·0 cm2, 13·6 cm2) for PDI and 8·6 cm2 (95 % CI 4·1 cm2, 13·2 cm2) for hPDI but significantly higher by 6·2 cm2 (95 % CI 1·3 cm2, 11·1 cm2) for uPDI. No significant associations were observed for other inflammation biomarkers, muscle, or SAT. A plant-based diet, especially a healthful plant-based diet, may be associated with reduced inflammation and visceral adiposity among breast cancer survivors.

To investigate the associations between dietary patterns and biological ageing, identify the most recommended dietary pattern for ageing and explore the potential mediating role of gut microbiota in less-developed ethnic minority regions (LEMRs). This prospective cohort study included 8288 participants aged 30–79 years from the China Multi-Ethnic Cohort study. Anthropometric measurements and clinical biomarkers were utilised to construct biological age based on Klemera and Doubal’s method (KDM-BA) and KDM-BA acceleration (KDM-AA). Dietary information was obtained through the baseline FFQ. Six dietary patterns were constructed: plant-based diet index, healthful plant-based diet index, unhealthful plant-based diet index, healthy diet score, Dietary Approaches to Stop Hypertension (DASH), and alternative Mediterranean diets. Follow-up adjusted for baseline analysis assessed the associations between dietary patterns and KDM-AA. Additionally, quantile G-computation identified significant beneficial and harmful food groups. In the subsample of 764 participants, we used causal mediation model to explore the mediating role of gut microbiota in these associations. The results showed that all dietary patterns were associated with KDM-AA, with DASH exhibiting the strongest negative association (β = −0·91, 95 % CI (–1·19, −0·63)). The component analyses revealed that beneficial food groups primarily included tea and soy products, whereas harmful groups mainly comprised salt and processed vegetables. In mediation analysis, the Synergistetes and Pyramidobacter possibly mediated the negative associations between plant-based diets and KDM-AA (5·61–9·19 %). Overall, healthy dietary patterns, especially DASH, are negatively associated with biological ageing in LEMRs, indicating that Synergistetes and Pyramidobacter may be potential mediators. Developing appropriate strategies may promote healthy ageing in LEMRs.

Beyond obesity, visceral adipose tissue (VAT) has emerged as an important predictor of chronic disease, but the role of diet quality patterns (DQP) in VAT development is not well defined. Therefore, we conducted a systematic review of how various DQP are associated with VAT via literature searches in PubMed and EMBASE. We included observational investigations in disease-free adults/adolescents that related DQP to VAT assessed by imaging methods. The studies were evaluated separately for a priori and a posteriori DQP and according to design differences. Study quality was assessed using the Risk of Bias in Non-randomised Studies of Interventions tool. Of the 1807 screened articles, thirty-five studies met the inclusion criteria. The majority of a priori indices, for example, the Healthy Eating Index, showed significant inverse associations with VAT, while only a small proportion of a posteriori patterns were related to VAT. Results did not differ substantially by the method of exposure and outcome assessment or between studies with (n 20) or without (n 15) body-size adjustment, but significant findings were more common in younger v. older individuals, USA v. other populations and investigations with moderate v. serious risk of bias. The heterogeneity of the existing literature limited the ability to quantify the magnitude of the associations across studies. These findings suggest that a high-quality diet, as assessed by a priori DQP, is generally inversely associated with VAT, but results for a posteriori DQP are less consistent. As associations persisted after adjusting for body size, diet quality may beneficially influence VAT beyond its association with obesity.

Healthy dietary patterns such as the Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) have been evaluated for their potential association with health outcomes. However, the lack of standardisation in scoring methodologies can hinder reproducibility and meaningful cross-study comparisons. Here we provide a reproducible workflow for generating the MeDi, DASH and MIND dietary pattern scores from frequently used dietary assessment tools including the 24-h recall tool and two variations of FFQ. Subjective aspects of the scoring process are highlighted and have led to a recommended reporting checklist. This checklist enables standardised reporting with sufficient detail to enhance the reproducibility and comparability of their outcomes. In addition to these aims, valuable insights in the strengths and limitations of each assessment tool for scoring the MeDi, DASH and MIND diet can be utilised by researchers and clinicians to determine which dietary assessment tool best meets their needs.

No study has validated questionnaires for assessing easily calculable diet quality scores in Japan. The Brief-type self-administered Diet History Questionnaire (BDHQ) is widely used to assess dietary intake in Japan, while the Meal-based Diet History Questionnaire (MDHQ) assesses dietary intake for each meal (breakfast, lunch, dinner and snacks) and overall dietary intake. This study examined the relative validity of the BDHQ and MDHQ for assessing three diet quality scores in Japanese adults. A total of 111 women and 111 men aged 30–76 years completed the web MDHQ and BDHQ, followed by 4-non-consective-day weighed dietary records. The diet quality scores examined included the Diet Quality Score for Japanese (DQSJ), Dietary Approaches to Stop Hypertension (DASH) score and Alternate Mediterranean Diet (AMED) score. The means of the three scores for overall diet from the BDHQ were not significantly different from those from the dietary records in both sexes, whereas those from the MDHQ were higher than those from the dietary records, except for the DASH and AMED in women. Pearson’s correlation coefficients between both questionnaires and dietary records were 0·57–0·63 for DQSJ, 0·49–0·57 for DASH and 0·31–0·49 for AMED across both sexes and both questionnaires. For each meal, Pearson’s correlation coefficients between the MDHQ and dietary records ranged from 0·01 (DASH for snacks in women) to 0·55 (DQSJ for breakfast in men), with a median of 0·35. This study showed that the ability of the BDHQ and MDHQ to rank individuals was good for DQSJ and DASH and acceptable for AMED.