This study aims to address a critical gap in literature by examining the mediating role of coping strategies in the relationship between mental health issues and food addiction among university students, contributing to the understanding of how stress management mechanisms affect addictive eating behaviours during this vulnerable period. A cross-sectional, quantitative study was conducted with 1947 students enrolled at a university in Istanbul during the 2024–2025 academic year. Data were collected online, using a Personal Information Form, the Depression-Anxiety-Stress-21 Scale (DASS-21), the Coping Orientation to Problems Experienced Inventory (Brief COPE) and the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). Data were analysed using Pearson’s correlation analysis, multiple regression analysis and PROCESS Macro Model 4. Moderate, positive and statistically significant correlations were observed between depression, anxiety and stress levels and food addiction (r = 0·398–0·417; P < 0·001). Multiple regression analysis demonstrated that mental health issues explained 20·8 % of the variance in food addiction scores. Mediation analyses indicated that adaptive coping strategies (e.g. humour, acceptance and using instrumental social support) and maladaptive coping strategies (e.g. restraint coping, behavioural disengagement and suppression of competing activities) significantly mediated the relationship between mental health issues and food addiction. Mental health issues represent a substantial risk factor for food addiction among university students in metropolitan areas, influenced by their coping strategies. Promoting adaptive coping strategies and reducing maladaptive ones are essential for preventing food addiction. These findings underscore the need to integrate psychological support and stress management into intervention programmes targeting university students.

To provide a scientific basis for establishing a portion size database for dietary assessment and nutritional education, we determined the portion sizes of commonly consumed food groups among Japanese children and adolescents aged 3–17 years. This study analysed 8-d weighed dietary record data from a nationwide survey conducted between November 2016 and August 2020. Participants were grouped into preschoolers (3–6 years, n 572), elementary schoolchildren (7–12 years, n 406) and middle/high school students (13–17 years, n 379). Age- and sex-specific portion sizes of seventy-three food groups were calculated as weighted averages of median portion sizes of the food items within each group, using the number of consumers for each item as weights. Overall, older participants had larger portion sizes than younger participants, but the magnitude of this difference varied between sexes and food groups. For most food groups, middle/high school students consumed 1·2–1·5 times (29 and 45 food groups for boys and girls, respectively) or 1·6–1·9 times (32 and 18 food groups for boys and girls, respectively) larger portion sizes than preschoolers. Portion sizes among middle/high school students were at least twice as large as those among preschoolers for ten food groups in boys, including staple foods, pork/beef, some vegetables, some beverages and salty snacks, but only for three food groups in girls. In conclusion, these differences in portion sizes according to age, sex and food group should be taken into account when assessing dietary intake and designing nutritional education for portion size control.

Metabolic dysfunction-associated steatotic liver disease (MASLD) was very common worldwide and was associated with metabolic syndrome, modifiable lifestyle factors and socio-economic status (SES). Although provitamin A carotenoid-rich foods have shown potential protective effects against MASLD, there was limited population-based evidence in this regard, and the mediating role of healthy lifestyle and SES in the association of carotenoids induced MASLD was still unclear. This study aimed to assess the association of provitamin A carotenoid-rich foods intake with MASLD risk and the mediating effects of healthy lifestyle and SES. Provitamin A carotenoid-rich foods intake was assessed using a 24-h recall data from the National Health and Nutrition Examination Survey. The USA Fatty Liver Index value ≥ 30 was used to define the MASLD status. SES (education/income) and healthy lifestyle (smoking/drinking/physical activity) were categorised via latent class analysis. Multivariable logistic regression and mediation analysis were used for analyses. A total of 6613 participants (mean (sd) age 50·8 (17·7) years; 53·6 % female) were included. Provitamin A carotenoid-rich foods intake was inversely associated with MASLD risk (adjusted OR, 0·684; 95 % CI: 0·532, 0·879). SES (mediation proportion, 12·92 %) and healthy lifestyle (16·84 %) exerted significant mediating effects. Subgroup analyses showed stronger associations in females (OR, 0·572; 95 % CI: 0·406, 0·805) and adults aged < 45 years (OR, 0·519; 95 % CI: 0·367, 0·734). Higher provitamin A carotenoid-rich foods intake was associated with lower MASLD risk, partially mediated by SES and healthy lifestyle. This provided a feasible dietary strategy for MASLD prevention, especially in females and younger adults.

Flavanones represent a significant subgroup of flavonoids and offer various advantages for the human body, such as aiding in metabolic regulation and providing antioxidant properties. The objective of this research was to investigate the relationship between dietary flavanones and the prevalence of kidney stones among adults in the USA. Flavanones, including eriodictyol, hesperetin and naringenin, were sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007–2010 and 2017–2018, utilising two 24-h dietary recall interviews. The definition of kidney stones was established through a self-administered questionnaire. To evaluate the relationships between dietary flavanones and kidney stones, a variety of statistical methods were utilised, such as multivariable regression analysis, restricted cubic splines (RCS) and subgroup analysis. Data from 9790 participants were included in this analysis, with 9·67 % of them indicating that they had experienced kidney stones. After adjusting for potential confounding factors, it was found that kidney stones exhibited a negative correlation with total flavanones and naringenin, with OR of 0·96 (95 % CI 0·93, 1·00) and 0·89 (95 % CI 0·80, 0·99) for the highest intake group compared with the lowest intake group. The RCS plot revealed a notable negative linear association between the consumption levels of total dietary flavanones and the risk of kidney stones, including naringenin. The results of the subgroup analysis indicated that no significant interactions were observed in each subgroup. Our research indicated that a higher intake of flavanones correlates with a lowered prevalence of kidney stones in adults.

The aim of this study was to investigate the predictive validity of a proposed revision of the Nutri-Score and the current Nutri-Score by investigating associations between the diet quality scores measured in mid-pregnancy and the risk of dispensed prescription of medications for hypertension up to 11 years following delivery and blood pressure mid-pregnancy. The study population (n 70 730) were participants in the Norwegian Mother, Father and Child Cohort Study. Food intake was assessed in mid-pregnancy using a validated FFQ. Nutritional scores for each food item were calculated based on content of energy, sugars, saturated fat, salt, fibre, protein, fruit, vegetables and legumes. Diet quality scores were derived using energy-weighted means of nutritional scores. Anti-hypertensive medications were registered in the national prescription database. We estimated hazard ratios (HRs) with 95 % CIs using Cox regression models. During a mean follow-up of 6 years, 4736 (6·7 %) women were dispensed prescription for medications for hypertension. There was a non-linear association between diet quality and hypertension medication. Compared with the median diet quality score, poorer diet quality (90th percentile of the score) was associated with higher risk of medications for hypertension (HR = 1·08, 95 % CI 1·02, 1·14) and cross-sectional high diastolic blood pressure (OR = 1·18, 95 % CI 1·03, 1·32). Both diet quality scores yielded similar results overall. Poorer diet quality during pregnancy, assessed with a proposed version, and the current Nutri-Score, was associated with a higher risk of medications for hypertension, indicating its usefulness as a valuable tool for guiding consumers and improving public health.

Smoking has been confirmed to induce systemic inflammation and oxidative stress (OS) and is associated with higher odds of chronic obstructive pulmonary disease (COPD). Dietary antioxidants can reduce inflammation and OS. This study seeks to score the dietary antioxidant intake and then assess its impact on the association between smoking and COPD in adults. The data extracted from the 2007–2012 National Health and Nutrition Examination Survey database were used. The Dietary Antioxidant Quality Score (DAQS) was evaluated by the total intake of vitamins A, C and E, Se, Zn and Mg in the daily diet. Smoking was used as the exposure variable and COPD as the outcome variable. Weighted multivariable logistic regression was conducted to evaluate the associations of DAQS with smoking and COPD, as well as their joint effects on the odds of COPD. The relationships between dietary antioxidant quality score, smoking status and COPD were subsequently assessed. Subgroup analyses were performed to explore associations between relevant covariates and smoking and COPD across DAQS strata. Current smoking was found to be linked to COPD (OR = 4·06, 95 % CI = 3·14, 5·27) in comparison to never smoking. Among smokers, significant associations were observed in both the medium-quality DAQS group (OR = 3·48, 95 % CI: 2·34, 5·17) and the low-quality DAQS group (OR = 5·60, 95 % CI: 3·58, 8·76). In conclusion, high DAQS levels are inversely related to the odds of COPD in adult smokers. Our findings provide valuable insights for management strategies for COPD.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing in prevalence and is the leading cause of hepatic fibrosis and cirrhosis in the industrialised world. Despite growing evidence for lifestyle interventions, adherence to nutritional and physical activity recommendations and psychological behaviours among patients with MASLD has not been previously characterised in Canada. We conducted a cross-sectional analysis of baseline data from patients with MASLD. Lifestyle adherence, including dietary patterns, physical activity and psychological measures, was assessed at a single time point to describe prevalence and patterns among participants. Adults with MASLD and advanced fibrosis were older (median age 58·4 v. 45·3 years; P < 0·001), had a greater BMI (median 36·3 v. 31·2; P < 0·001) and have higher presence of metabolic risk factors including type 2 diabetes mellitus (P < 0·001), hypertension (P = 0·001), thyroid disease (P = 0·02) and were of White ethnicity (P = 0·002). The prevalence of mood disorder was 31 % for anxiety and 16 % for depressive symptoms based on HADS-A and HADS-D ≥ 8 indicating borderline/abnormal anxiety and depression, respectively. Twenty per cent of patients had a Binge Eating Score ≥ 18 indicating moderate/severe binge eating behaviour. Most had poor adherence to a Mediterranean diet with the energy-restricted Mediterranean Diet Adherence Screener (er-MEDAS) ≤ 7 (56 % with poor adherence, 34 % with moderate adherence), 42 % reported weekly alcohol consumption and one-third had low self-reported activity levels on the International Physical Activity Questionnaire Short Form (IPAQ-SF). Here, we identified barriers to risk reduction in patients with MASLD, including increased prevalence of anxiety and depressive symptoms, high frequency of binge eating behaviours, poor adherence to Mediterranean diet quality and sedentary self-reported activity levels.

This paper summarises the UK Scientific Advisory Committee on Nutrition’s (SACN) 2023 and 2025 assessments of processed foods and health and its 2025 review of the WHO guideline on non-sugar sweeteners (NSS). On processed foods, SACN sought to identify available evidence on existing processed food classification systems, applying NOVA to UK National Diet and Nutrition Survey data and associations between food processing and health outcomes. For NSS, health outcomes of greatest policy relevance to the UK were considered. The assessments were undertaken in line with SACN’s Framework for the evaluation of evidence. SACN found that NOVA dominated the research literature and ultra-processed food (UPF) constitutes a significant proportion of UK dietary energy intake, especially among children. Higher UPF consumption was consistently associated with increased risks of adverse health outcomes, although not for all subgroups. Important limitations included most evidence being observational and inconsistent adjustment for covariables. For NSS, randomised controlled trials indicate a small reduction in body weight when NSS replace sugars, whereas prospective cohort studies indicate higher NSS intake is associated with higher measures of body fatness and may be associated with a range of adverse health outcomes. The findings were based on low- and/or very low-certainty evidence. SACN concluded that, on balance, most people are likely to benefit from reducing consumption of processed foods high in energy, saturated fat, salt and free sugars and low in fibre. SACN made a precautionary recommendation that intake of NSS be minimised. SACN made a range of recommendations to the government on processed foods and sweeteners.

School-based interventions offer a promising setting to promote healthier nutritional behaviours (NB) such as physical activity (PA), sedentary behaviour (SB) and eating behaviour, while addressing weight social inequalities. NB changes may occur before measurable effects on weight, which can take longer to emerge. This study evaluated the overall effectiveness of the school-based Promotion de l’ALIMentation et de l’Activité Physique – INEgalités de Santé (PRALIMAP-INÈS) trial on weight and NB social inequalities reduction among adolescents with overweight or obesity. Adolescents were divided into two intervention groups according to their socio-economic status (socially advantaged and socially less advantaged). NB were self-reported by adolescents. Outcomes were BMI z-score (BMIz), fruit and vegetables (FV) consumption, sweetened products and beverages (SPB) consumption, vigorous/moderate PA, walking and SB. Overall effectiveness was estimated using generalised pairwise comparisons, estimating net benefit for each outcome (δ) and overall net benefit (Δ). Of 985 adolescents (age = 15·3 (sd 0·7 years; 46·7 % boys), those in less advantaged group were 12·5 % more likely to have a favourable change in weight status and NB than those in advantaged group (Δ = 12·5 % (6·1, 19·1 %)). For each outcome, net benefits were as follows: BMIz (δ = 4·2 % (0·0, 8·6)), vigorous PA (δ = 4·2 % (0·4, 8·3)), FV (δ = 3·2 % (0·9, 5·5)), SB (δ = 0·8 % (–1·6, 3·2)), SPB (δ = −0·2 % (–1·1, 0·6)), moderate PA (δ = 0·2 %) (–0·7, 1·1) and walking (δ = 0·2 % (–0·2, 0·6)). Results showed an overall beneficial effect of the PRALIMAP-INÈS trial in reducing social inequalities in weight and NB among adolescents with overweight or obesity. Long-term effectiveness could be expected by reducing social inequalities in NB.

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.

Plant-based diets have been associated with favourable health outcomes; however, not all plant-based diets are of the same quality. This study aimed to investigate the associations between three plant-based diet indices: overall plant-based diet index (PDI), healthy PDI (hPDI) and unhealthy PDI (uPDI) and measures of adiposity: wrist circumference, waist circumference, waist:hip ratio and BMI. This study used data from 2027 controls in the Costa Rica Heart Study, a case–control study. A validated FFQ was used to create the plant-based diet indices. Multivariable linear regression was used to examine associations between quintiles of the plant-based diet indices and adiposity indicators. Higher hPDI scores were associated with lower adiposity, with waist circumference showing the strongest association. Participants in the highest hPDI quintile had a β = −1·90 cm (95 % CI: −3·32, −0·49) lower waist circumference and a β = −0·72 kg/m2 (95 % CI: −1·33, −0·10) lower BMI compared with participants in the lowest quintile. Significant linear trends were observed with waist circumference (P-trend = 0·0037), waist:hip ratio (P-trend = 0·0064) and BMI (P-trend = 0·0171). Subjects in the 5th quintile of the overall PDI had significantly lower waist circumference (β = −1·75 cm (95 % CI: −3·14, −0·36)), waist-to-hip ratio (β = −0·010 (95 % CI: −0·019, −0·001)) and BMI (β = −0·62 kg/m2 (95 % CI: −1·22, −0·02)). In general, uPDI showed no significant associations with adiposity indicators. Among Costa Rican adults, adherence to hPDI is associated with lower adiposity, whereas uPDI showed no association, indicating the quality of plant-based diets plays a role in body composition.

We examined differences in characteristics between dietary supplement (DS) users and non-users in three age groups of Japanese women, including younger women (dietetic students), middle-aged women (their mothers) and older women (their grandmothers). In total, 3952 younger women (aged 18 years), 3780 middle-aged women (aged 34–60 years) and 2192 older women (aged 61–94 years) participated in this cross-sectional study in 2011 and 2012. DS use and other characteristics were self-reported using a questionnaire, and dietary intake from foods was assessed using a validated, self-administered diet history questionnaire. DS users were defined as participants who reported using DS at least once in the past month. We calculated the percentage of participants with nutrient intakes below the estimated average requirement (EAR) from the Japanese Dietary Reference Intakes. The proportion of DS users was 5·7 % in younger women, 24·3 % in middle-aged women and 27·7 % in older women. In younger and older women, DS users were more likely to live in a city with a population of ≥1 million. In middle-aged women, DS users were more likely to have an education level of more than high school or to be former smokers. In older women, DS users tended to have shorter sleep duration. Among the 15 nutrients examined, DS users were less likely to have intake levels below the EAR for 10 nutrients in younger women, 9 nutrients in middle-aged women and 4 nutrients in older women. Some characteristics of Japanese female DS users differed from non-users depending on the age group.

The prevalence of overweight and obesity in adults is increasing worldwide. Food portion size (PS) is an important environmental determinant of energy intake (EI) and may contribute to the obesity epidemic. However, UK evidence on the typical PS of commonly consumed foods in adults and how these may have changed over time is limited. Using combined data from Years 1–4 (2008/2009–2011/2012) and Years 9–11 (2016/2017–2018/2019) of the National Diet and Nutrition Survey (NDNS), this study examined trends in the PS of commonly consumed food groups over the last decade among UK adults. Significant increases in both consumption frequency and PS were observed for pasta, rice & pizza, eggs, oils & spreads, vegetables, fruits, nuts & seeds and low-calorie carbonated/soft drinks (all P ≤ 0·005). In contrast, bread, potato & potato products, condiments and fruit juice & smoothies showed significant decreases in both frequency and PS (all P ≤ 0·032). Divergent patterns were also evident: red meat showed increased frequency but reduced PS, while white meat and fish increased in frequency without significant changes in PS. Changes in PS alone were identified for milk and milk products, processed meat, alcoholic drinks and total beverages. Although fibre intake increased, recommendations are still not being met. There was no clear evidence that overweight or obese individuals consumed greater PS than those with normal weight. These findings highlight changes in food patterns among UK adults over the past decade and the importance of continued monitoring.

The interaction between 25-hydroxyvitamin D [25(OH)D] and physical activity (PA) in influencing hypertension remains underexplored. This study aimed to examine their independent and joint associations with hypertension risk among 5327 participants aged ≥ 50 years from the English Longitudinal Study of Ageing. Participants were categorised by 25(OH)D status (sufficient, ≥ 50 nmol/l; insufficient, ≥ 30 to < 50 nmol/l; deficient, < 30 nmol/l) and self-reported PA levels. Multivariable logistic regression, adjusting for the season of measurement and sociodemographic confounders, showed that sufficient 25(OH)D (OR = 0·66, 95 % CI 0·56, 0·78) and higher PA (OR = 0·82, 95 % CI 0·71, 0·94) were independently associated with reduced hypertension prevalence. In joint analyses, the group combining higher PA and sufficient 25(OH)D exhibited the lowest odds of hypertension (OR = 0·55, 95 % CI 0·43, 0·70) compared with the lower PA and deficient group. A significant synergistic interaction was identified, indicating that the combined protective effect of these factors was greater than the sum of their individual associations. These results were corroborated by Mendelian randomisation analysis, which identified inverse causal associations between genetically predicted 25(OH)D, vigorous PA and hypertension risk across independent datasets. These findings emphasise that vitamin D sufficiency acts in synergy with an active lifestyle to enhance cardiovascular protection. This relationship underscores the critical importance in nutritional science of integrating micronutrient status with PA to develop more effective, multifaceted lifestyle-based strategies for hypertension management in middle-aged and older populations.

Body composition and fat distribution were found to display differential effects on the incidence and mortality of chronic disease. However, it remained unclear whether there is an interaction between lifestyle factors and genetic susceptibility on body composition and fat distribution. This study investigated the associations of lifestyle and genetic factors with body composition and fat distribution among 121 664 women from the UK Biobank cohort study. Women with a favourable lifestyle had lower BMI (BMI, –7·72 % (95 % CI: −7·93 %, −7·51 %)), fat mass index (FMI, −15·70 % (95 % CI: −16·09 %, −15·30 %)), fat-free mass index (FFMI, −2·86 % (95 % CI: −2·98 %, −2·74 %)), arm fat ratio (AFR, −5·19 %, (95 % CI: −5·38 %, −5·00 %)) and trunk fat ratio (TFR, −0·73 %, (95 % CI: −0·84 %, −0·62 %)) but higher leg fat ratio (LFR, 2·30 % (95 % CI: 2·16 %, 2·44 %)) than those with an unfavourable lifestyle. Significant interactions between lifestyle factors and genetic susceptibility on BMI, FMI and AFR were observed (Pinteraction < 0·05). Among women with a high genetic susceptibility to body composition or fat distribution, those with a healthy lifestyle still had a lower BMI, FMI, FFMI, AFR and TFR and higher LFR (Ptrend < 0·001). Women who adhere to a favourable lifestyle tend to have healthy body composition and fat distribution, and this association is consistent across all strata of genetic risk.