Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 25 appraisals
Food chemistry
Decoding the neural mechanisms of salty peptide perception via electroencephalography and machine learning
Excessive sodium intake poses major public health risks, driving the search for salt substitutes that preserve desirable flavor. Salty peptides have emerged as promising low-sodium alternatives, yet their neural perception, distinct from the ion-dependent mechanism of sodium chloride, remains poorly understood. This study integrated electroencephalography (EEG) and machine learning to elucidate the neurophysiological mechanisms of salty peptide perception. By extracting temporal, spectral, and spatial EEG features and combining them with source localization, the study identified delta-band predominance and a hierarchical cortical activation cascade extending from the prefrontal to the insular and parietal cortices, reflecting both primary gustatory processing and higher-order integration. Among the tested classifiers, XGBoost achieved the highest performance (AUC = 0.815), demonstrating that EEG features effectively distinguish neural responses between salty and non-salty peptides. These findings provide electrophysiological evidence for salty perception and offer a neural framework for reduced-sodium food design.
16 July 2026
Read appraisal →Nutrition journal
Mindfulness and sustainable diets: a meta-analysis and CO2 emission savings scenarios
BACKGROUND: Dietary habits are a major driver of both human health outcomes and global greenhouse gas emissions, with excessive meat consumption being a key contributor. Mindfulness, understood as purposeful and non-judgmental awareness of the present moment, has been suggested as a psychological factor that can foster more sustainable food choices. However, the empirical evidence on the link between mindfulness and sustainable diets remains fragmented. MAIN BODY: This study presents the first systematic review and meta-analysis of the association between mindfulness and sustainable dietary behaviors. Twelve articles with 13 studies, published between 2018 and 2025, were included, covering both observational and interventional designs with sample sizes ranging from 16 to 560 participants. A random-effects model revealed a small but significant positive association between mindfulness and sustainable diets (d = 0.28, 95% CI [0.13, 0.43]). Subgroup analyses indicated that observational studies tended to show stronger effects than interventions, and that cultural context played an important moderating role, with larger effects reported in Asian samples. Facet-specific analyses suggested that certain mindfulness dimensions - particularly observing, describing, and non-reactivity - were more strongly associated with sustainable food choices, while others showed weaker or non-significant links. A focused analysis on meat consumption revealed that mindfulness was positively associated with reduced meat intake or vegetarian dietary intentions (d = 0.25). Scenario modelling using national Life Cycle Assessment data from Germany, the UK, and the U.S. demonstrated that the potential reductions in meat intake could translate into substantial CO2 emission savings. A full adoption of the EAT-Lancet diet was projected to result in cumulative savings of up to 11% of Germany's total emissions budget by 2040, whereas incorporating the population's willingness to reduce meat intake yielded more conservative cumulative savings of 2.8% over the same period. CONCLUSION: This meta-analysis provides systematic evidence that mindfulness is positively associated with more sustainable dietary behavior and reduced meat consumption. While effects are modest and heterogeneous, the findings suggest that mindfulness could represent a promising lever for promoting dietary change aligned with planetary health goals. Future research should further investigate cultural differences, the role of specific mindfulness facets, and the feasibility of scaling mindfulness-based interventions to support both individual well-being and climate targets.
8 July 2026
Read appraisal →Food & function
Application of artificial intelligence in synbiotic and functional food development for precision nutrition
Synbiotic and functional food formulations modulate gut microbiota, SCFA production, immune signalling and metabolic pathways, yet current development pipelines remain largely empirical and constrained by nonlinear trade-offs among probiotic viability, prebiotic functionality and sensory acceptance. Artificial Intelligence (AI) and machine learning (ML) approaches offer data-driven strategies to support formulation, multi-objective optimization and functional assessment. This review systematically identified and critically synthesized literature published between 2020 and 2025 across five thematic domains: (i) formulation and ingredient selection; (ii) viability and shelf-life modelling; (iii) functional and antioxidant bioactivity assessment; (iv) sensory and consumer prediction; and (v) personalization and precision nutrition. Studies were identified through database searches and screened for relevance to synbiotics, functional foods, microbiome modulation and nutrition outcomes, following PRISMA 2020 guidelines. Current evidence indicates that AI can assist ingredient pairing, viability forecasting, sensory modelling and functional property prediction, often complementing conventional statistical tools such as Response Surface Methodology in multivariate design spaces. However, most implementations remain computational or pilot-scale, with minimal integration of microbiome-informed personalization, clinical endpoints or adherence outcomes. Major translational gaps include data heterogeneity, model interpretability, regulatory substantiation and scarcity of longitudinal evidence. AI should therefore be considered a complementary decision-support tool that can accelerate hypothesis generation and formulation refinement rather than substitute mechanistic validation or human trials. Bridging computational modelling with microbiome science and nutritional evidence may enable precision synbiotic strategies and next-generation functional food innovation.
6 July 2026
Read appraisal →BMC oral health
Can poor nutrition and diet influence temporomandibular disorder? A systematic review.
BACKGROUND: The relationship between diet, nutrition, and painful temporomandibular disorders (TMD) is not well established, despite increasing interest in lifestyle factors in chronic pain. This systematic review aimed to synthesize available evidence on how dietary patterns and nutritional status may be associated with painful TMD. METHODS: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL) and Web of Science for clinical and observational trials from the beginning of each database to November 2025. Risk of bias was performed using the Study Quality Assessment Tools from the National Heart, Lung, and Blood Institute (NHLBI). RESULTS: Out of 7,760 records and after the risk of bias assessment, only seven studies judged as having a low risk of bias were included. Overall, the included studies indicate that the association between dietary factors and TMD remains unclear. Prospective cohort studies did not demonstrate that prenatal or adolescent diet quality independently predicted TMD. Cross-sectional studies suggested that specific dietary patterns may be related to TMD-related symptoms. Women with myogenous TMD showed lower intake of several nutrients compared with controls. Experimental evidence indicated that monosodium glutamate ingestion increased pain intensity in myofascial TMD, while the only randomized trial found no significant pain differences between vitamin D supplementation and diclofenac. CONCLUSIONS: Current evidence suggests that some dietary components and nutritional factors may be associated with TMD-related symptoms or pain responses; however, the findings are limited, heterogeneous, and insufficient to support firm causal or therapeutic conclusions.
25 June 2026
Read appraisal →Food & function
Impact of tomatoes and tomato-derived products on obesity and cardiometabolic health: a systematic review and meta-analysis
Tomatoes and tomato-based products are central components of the Mediterranean diet and have been associated with improved cardiometabolic health, but their effects on anthropometric parameters remain unclear. This review aimed to assess the potential effects of tomato-based interventions on obesity-related and cardiometabolic outcomes in individuals with overweight or obesity. We conducted a PRISMA-compliant systematic review and meta-analysis. Eligible studies included populations with a mean BMI ≥ 25 kg m-2, evaluated tomatoes, tomato-based products, or tomato extracts (excluding isolated lycopene) and reported at least one anthropometric outcome. The risk of bias was assessed using RoB 2 for randomized controlled trials (RCTs). Epidemiological and preclinical evidence was synthesized qualitatively. Forty-seven studies met the inclusion criteria: 11 clinical trials (RCTs), 5 epidemiological studies, and 31 preclinical studies. In the RCTs, tomato-based interventions produced a small but significant reduction in waist circumference (MD: -1.153 cm, 95% CI: -2.27 to -0.04, p = 0.0432), with no consistent effects on body weight or BMI. Meta-regression analyses indicated that supplementation type influenced blood pressure-related outcomes. Epidemiological studies consistently linked higher tomato intake to more favorable cardiometabolic profiles, whereas preclinical models showed reduced visceral adiposity, inflammation, and oxidative stress, together with improved glucose and lipid homeostasis. Tomato-based interventions confer modest but biologically consistent benefits, targeting visceral adiposity and cardiometabolic pathways rather than overall weight loss. The absence of a lycopene dose response and the efficacy of lycopene-free matrices support a food-matrix synergy rather than lycopene as the primary bioactive compound. Combined clinical, epidemiological, and preclinical evidence suggests potential beneficial effects of tomatoes and tomato-based products on cardiometabolic health, which deserve further investigation. This review underscores the need to standardize tomato-derived interventions to improve comparability and strengthen the evidence base.
24 June 2026
Read appraisal →Journal of the International Society of Sports Nutrition
Caffeine makes a splash: a systematic review and multilevel meta-analysis exploring the effects of caffeine intake on swimming performance.
BACKGROUND: Evidence for acute caffeine supplementation in swimming remains inconsistent across reviews, likely due to between-study heterogeneity and methodological differences. METHODS: Five databases were searched for randomized placebo-controlled crossover trials exploring the effects of caffeine on swimming performance in competitive swimmers. Performance outcomes were pooled as standardized mean differences (SMD; Hedges' g), with time outcomes sign-reversed so that positive values indicated improved performance. Dependence among multiple outcomes within studies was addressed using three-level random-effects models (REML). As a supplementary, interpretable metric, log ratios of means (lnRoM) were meta-analysed and expressed as percentage change. Post-exercise blood lactate (mmol/L) was pooled as mean differences (MD). Risk of bias was assessed using RoB 2 and certainty of evidence using GRADE. Prespecified exploratory moderator analyses examined potential effect modification (dose, timing, distance, administration form, stroke, gender, and athlete level). RESULTS: Thirteen studies were included (144 men and 48 women), which contributed 28 performance effect sizes. Caffeine improved swimming performance (SMD = 0.57, 95% CI: 0.20 to 0.94; p = 0.005), corresponding to a +1.71% improvement in lnRoM (95% CI: +1.01% to +2.41%; p < 0.001). Heterogeneity was substantial (I²total = 64.7%) and primarily between studies. Eight studies contributed 24 blood lactate effect sizes. In the meta-analysis, caffeine increased post-test lactate (MD = 0.85 mmol/L, 95% CI: 0.22 to 1.49; p = 0.016) with high heterogeneity (I²total = 76.5%). Exploratory moderator analyses suggested a possible dose-related pattern for swimming performance, with larger pooled effects at ≥6 mg/kg (SMD = 0.95, 95% CI: 0.52 to 1.38) than at <6 mg/kg (SMD = 0.22, 95% CI: -0.15 to 0.60; p difference = 0.017). Other performance moderators did not show clear between-subgroup differences. For lactate, exploratory subgroup analyses suggested larger increases in freestyle and short-distance events, although these patterns were more sensitive to modelling assumptions and should be interpreted cautiously. CONCLUSION: Acute caffeine ingestion confers a moderate ergogenic benefit for swimming performance (SMD = 0.57, 1.7% improvement) and is associated with higher post-test blood lactate (MD = 0.85 mmol/L). Dose (≥6 mg/kg) may be associated with larger performance benefits, whereas lactate responses appear more pronounced in freestyle and shorter events. However, these subgroup findings are hypothesis-generating and require exploration.
22 June 2026
Read appraisal →Life sciences
The interplay of plant polysaccharide structure, gut microbiota metabolism, and host health: Mechanisms and perspectives
Plant polysaccharides, as natural biomolecules, possess the capability to modulate the structure and function of gut microbiota, subsequently influencing host health. Nevertheless, the molecular mechanisms underlying their interactions remain insufficiently understood. This article presents a systematic review of the impact of the chemical structure of plant polysaccharides, including monosaccharide composition and types of glycosidic bonds, on the metabolic preferences of gut microbiota. It emphasizes how structural variations in polysaccharides can promote the proliferation of specific gut microbiota, such as Bacteroidetes and Firmicutes. Additionally, the study analyzes critical enzymatic systems, including glycoside hydrolases (GHs) and polysaccharide lyases (PLs), alongside metabolic pathways associated with the production of short-chain fatty acids (SCFAs) that facilitate the degradation of plant polysaccharides by gut microbiota. Furthermore, it explores the influence of these metabolites on conditions such as obesity, diabetes, inflammatory bowel disease (IBD), and non-alcoholic fatty liver disease. The findings provide a robust theoretical framework for enhancing the utilization efficiency of bioactive polysaccharide components through targeted extraction and characterization techniques, thereby fostering potential advancements in innovative nutritional formulations and pharmacological applications.
16 June 2026
Read appraisal →BMJ open
Effect of a culturally adapted heart-healthy diet with phytosterols and/or krill oil on lipid-related outcomes in familial hypercholesterolaemia: protocol for a multicentre randomised controlled trial in Brazil
INTRODUCTION: An affordable heart-healthy dietary approach is essential for the management of familial hypercholesterolaemia (FH); however, the optimal dietary pattern and the role of adjunctive nutrient supplementation remain uncertain. This study aims to evaluate the effects of the Brazilian Cardioprotective Diet (DICA Br), adapted from the Portfolio Diet, with or without phytosterol and/or krill oil supplementation in individuals with probable or definite FH according to the Dutch Lipid Clinic Network (Dutch MEDPED) criteria. METHODS AND ANALYSIS: The DICA-FH study is a national, multicentre, randomised, factorial, parallel-group, superiority, placebo-controlled clinical trial with a 1:1:1:1 allocation ratio. Participants aged ≥16 years receiving age-appropriate lipid-lowering therapy will be randomised into four groups: (1) adapted cardioprotective diet (DICA-FH) plus phytosterol placebo and krill oil placebo; (2) DICA-FH plus phytosterol 2 g/day and krill oil placebo; (3) DICA-FH plus phytosterol placebo and krill oil 2 g/day or (4) DICA-FH plus phytosterol 2 g/day and krill oil 2 g/day. All participants will undergo whole-genome sequencing and receive appropriate genetic counselling. Primary outcomes will be means of low-density lipoprotein cholesterol and lipoprotein(a) levels after 120 days. Secondary outcomes will include additional lipid biomarkers, adherence to protocol and adverse events. The planned sample size is 300 participants. Follow-up is expected to conclude in July 2026. ETHICS AND DISSEMINATION: This study was registered under CAAE 65549622.2.1001.0060 and received ethical approval from the Hcor Research Ethics Committee (approval number 5.805.072) and the Brazilian National Research Ethics Commission (CONEP; approval number 6.864.951). Written informed consent will be obtained from all participants prior to enrolment. The study findings will be disseminated through peer-reviewed publications, scientific conferences and channels aimed at the general public. TRIAL REGISTRATION NUMBER: NCT06331195.
14 June 2026
Read appraisal →JMIR mHealth and uHealth
WeChat-Delivered Mobile Medical Nutrition Therapy Intervention in Gestational Diabetes Mellitus: Randomized Controlled Trial
BACKGROUND: Medical nutrition therapy (MNT) serves as the foundational intervention in the clinical management of gestational diabetes mellitus (GDM) management. However, inadequate supportive care often hinders patients' ability to sustain dietary modifications and self-management behaviors, particularly for complex regimens. Flexible online interventions are thus gaining interest as adjuncts to clinical care, with the potential to improve the outcomes of GDM self-management. OBJECTIVE: This study sought to evaluate the benefits of WeChat-delivered medical nutrition therapy (WeMNT), a WeChat-delivered MNT intervention, for patients with GDM. METHODS: A parallel-group, single-blind randomized controlled trial (with outcome assessor blinding) was implemented at a university hospital's obstetric clinic. Eligible participants were those with a 24- to 28-week singleton pregnancy, a GDM diagnosis confirmed by the 75 g oral glucose tolerance test, no requirement for insulin therapy, and the ability to use a smartphone and WeChat, as well as to communicate in Chinese. Participants were randomized 1:1 to the intervention (n=47, 50%) or control group (n=47, 50%) using a random number table. The WeMNT intervention was designed per the behavior change wheel framework: (1) analyze capability-, opportunity-, and motivation-based barriers related to MNT adherence; (2) formulate targeted intervention functions; and (3) select evidence-based behavior change techniques. Three WeChat mini-programs served as the core delivery platform to implement the multifaceted intervention functions. The primary outcomes measured in this study included fasting blood glucose, 2-hour postprandial glucose (2hPG), hemoglobin A1c (HbA1c), and gestational weight gain (GWG). The secondary outcomes assessed included obstetric complications and neonatal parameters. Intention-to-treat analysis using adjusted generalized linear mixed models was conducted to evaluate the effects of the intervention. RESULTS: From March 2023 to October 2023, a total of 94 participants were enrolled in this study. Among the participants, 88 (93.62%) individuals (mean age 32.18, SD 5.04 years) successfully completed the study, 44 (46.81%) in the intervention group and 44 (46.81%) in the control group. Approximately 68.18% (30/44) of the participants in the intervention group demonstrated sustained adherence, as expected, adhered to the diet plan ≥60% of the days. Compared with the control group, the intervention group showed a significantly greater decrease in GWG over time (group×time interaction: β=-1.96, 95% CI -3.58 to -0.34; P=.02), with no significant effects on fasting blood glucose. Conversely, significant decreases in 2hPG (β=-0.12, 95% CI -0.19 to -0.04; P<.001) and HbA1c (β=-0.49, 95% CI -0.74 to -0.23; P<.001) were noted in the intervention group. No unexpected maternal adverse events occurred, and no significant effects on other health outcomes were detected. CONCLUSIONS: As a WeChat-delivered, behavior change wheel-informed intervention, WeMNT successfully reduced 2hPG, HbA1c, and GWG in GDM management. Its integrated self-management model yields robust evidence, validating this patient-centered tool as a viable option for clinical adoption.
14 June 2026
Read appraisal →The Journal of clinical endocrinology and metabolism
Lifestyle intervention before and during fertility treatment in women with obesity or with overweight and PCOS-a RCT
CONTEXT: Lifestyle interventions are recommended for women with obesity and infertility, but trial evidence is scarce, and studies have not investigated interventions that continue during fertility treatment. OBJECTIVE: Evaluate effectiveness of a lifestyle intervention compared with usual care on fertility outcomes in women with obesity and infertility. DESIGN: The Obesity-Fertility randomized controlled trial (RCT), at an academic fertility clinic, included 127 women aged 18 to 40 years with infertility and obesity (body mass index ≥30 kg/m2, or ≥27 kg/m2 with polycystic ovary syndrome [PCOS]), excluding those unlikely to conceive naturally. The intervention group (IG) received a 6-month lifestyle intervention alone (individual follow-up with a dietician and kinesiologist, and group sessions) before adding fertility treatments. The control group (CG) received usual fertility care directly. Rate of live birth conceived within 18 months of randomization was analyzed. RESULTS: Compared to CG, the IG lost more weight (-3.21% ± 4.73% vs -0.40% ± 3.66%, P = .003) and waist circumference (-2.62 ± 4.46 cm vs -0.23 ± 3.81 cm, P = .01) at 6 months. The live-birth rate was 44.4% in the IG (n = 63) vs 35.9% in the CG (n = 64) (risk ratio [RR] = 1.24 [95% CI 0.81-1.90]). In IG vs CG, clinical pregnancy rates were 52.4% vs 37.5% (RR = 1.40 [0.94-2.07]) and natural pregnancy rates were 27.0% vs 12.5% (RR = 2.16 [1.01-4.64]). CONCLUSION: Compared with usual care, a lifestyle intervention alone for 6 months and then combined with fertility treatments did not increase the 18-month rate of pregnancies leading to a live birth, but significantly increased natural pregnancy rates, potentially reducing the need for costly assisted reproduction in this population.
19 May 2026
Read appraisal →Journal of global health
Global prevalence of underweight and overweight/obesity among migrant workers: a systematic review and meta-analysis
BACKGROUND: Migrant workers are increasingly recognised as a nutritionally vulnerable population due to unstable working conditions, disrupted food environments, and limited access to health services. However, global estimates of malnutrition in this group remain fragmented. We aimed to identify the global prevalence of underweight and overweight/obesity among migrant workers and identify key moderating factors. METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. We searched seven databases without restrictions on language, region, or year of publication. Observational studies reporting the prevalence of underweight (body mass index (BMI) < 18.5 kg/m2) or overweight/obesity (BMI ≥ 25 kg/m2) among migrant workers were included. We calculated pooled prevalence estimates using generalised linear mixed models with random effects. We assessed heterogeneity with I2 and Cochran's Q statistics. Moderator analyses were conducted using meta-regression and subgroup comparisons. Further, we appraised study quality using the Joanna Briggs Institute tools, and assessed the certainty of the evidence using GRADE. RESULTS: We included 30 studies involving 135 404 migrant workers with a mean age of 32.3 years (standard deviation = 11.1). The pooled prevalence was 4.7% (95% confidence interval (CI) = 3.1, 6.9) for underweight and 43.7% (95% CI = 39.8, 47.6) for overweight/obesity, suggesting a substantial double burden of malnutrition. Underweight was more common among local migrants and in lower-middle-income settings, particularly in South Asia, whereas overweight/obesity was more common among international migrants, especially in high-income countries and in Europe and Central Asia. Moderator analyses identified female proportion, destination country or region, income level, and marital status as significant moderators for both outcomes. CONCLUSIONS: Migrant workers experience a substantial double burden of malnutrition, although the pattern varies across migration contexts. Undernutrition remains a concern in lower-income settings, whereas overweight and obesity are more common in high-income settings. Integrating nutrition-sensitive strategies into labour and migration health policies, including healthier food environments, routine nutritional screening, and culturally appropriate interventions, may help reduce health inequalities in this population. REGISTRATION: INPLASY: 202540030.
16 May 2026
Read appraisal →European respiratory review : an official journal of the European Respiratory Society
Evolution of body image across treatment eras: a systematic review in young people and adults living with cystic fibrosis
OBJECTIVES: Advancements in treatments for cystic fibrosis (CF) have improved prognosis, but variant-specific therapies have also driven weight gain. Traditional challenges to maintain weight are now less prevalent, with new body image concerns potentially emerging. This review aims to synthesise quantitative and qualitative evidence on body image in adults and young people (aged ≥16 years) with CF. METHODS: Systematic search of MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health, the Allied and Complementary Medicine Database and the Cochrane Library (January 2011 to August 2025) using CF-related keywords including body image and physical appearance. RESULTS: Searches retrieved 29 eligible studies (26 quantitative, two qualitative, one mixed methods). The Cystic Fibrosis Questionnaire - Revised (CFQ-R) and Cystic Fibrosis Quality of Life Questionnaire (CFQoL) questionnaires assessed body image quantitatively (0-100). 15 studies reported CFQ-R body image scores (58±19 to 78±23) and five reported CFQoL body image scores (21±26 to 76). Pre-modulator era (≤2012) scores ranged from 64±27 to 70±27; initial rollout phase (2012-2019) scores ranged from 58±19 to 81 (post-ivacaftor); and in the widespread modulator era (2020 to present) were 63±32 to 67 (31). Gender effects were inconsistent. Higher body mass index, weight, and body fat were linked to better body image in some studies; psychological wellbeing and lower anxiety/depression consistently correlated with body image. Ivacaftor and life coaching improved body image, while elexacaftor/tezacaftor/ivacaftor, cognitive behavioural therapy, and self-management programmes showed no effect. Functional health was strongly linked to body image.Qualitative findings highlighted influences of gender, weight change, functional and mental health, social support, early eating experiences, and limited clinician-initiated body image discussions. CONCLUSION: This is the first systematic review of body image in CF since new drug regimens emerged. Emerging body image disturbance patterns highlight the need for clinical strategies to screen for and address body image issues in CF care.
15 May 2026
Read appraisal →Journal of the International Society of Sports Nutrition
Carbohydrate supplementation for endurance exercise in the heat: a systematic review with practical recommendations
BACKGROUND AND OBJECTIVES: Endurance exercise performance is impaired by heat stress. Although the mechanisms are not yet fully understood, heat-induced increases in glycogenolysis may play a role. Therefore, carbohydrate supplementation recommendations may differ for endurance exercise in hot environments. This systematic review aims to investigate the efficacy of carbohydrate supplementation for endurance performance in hot environments. METHODS: Electronic databases, including PubMed, the Cochrane Library, MEDLINE, and SPORTDiscus were searched through to April 14, 2026 for studies evaluating endurance performance outcomes under heat stress in response to carbohydrate supplementation. Studies were included if the participants were healthy, aged 18-65 years, and at least recreationally active. A hot environment was defined as an ambient temperature >23 °C. Studies were required to involve an endurance-based and continuous exercise protocol lasting >30 min and a direct performance measure. This cutoff was selected based on evidence indicating glycogen stress at ~40 min under heat stress. In total, 3151 records were identified, and nine randomized, crossover studies met the inclusion criteria. Risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias. Primary outcomes (endurance performance and carbohydrate oxidation rates) and secondary outcomes (including gastrointestinal symptoms, thermoregulation, and hydration markers) were extracted. Mean carbohydrate intake rates were calculated, and a narrative synthesis was performed. RESULTS: Mean carbohydrate ingestion rates ranged between 14 and 140 g·h-1, and the exercise trial duration ranged between ~50 and 152 min. Carbohydrate supplementation resulted in equivocal benefits to endurance performance: five studies found significant (p < 0.05) positive effects for carbohydrates (increases of 13.4%-19.3% in time to exhaustion and 3.3%-12.7% in time trial), and four studies found no significant effects. Although nonsignificant, three studies reported average improvements of 6.7%-11.6%, which may be meaningful in elite athletes. Most studies reported no differences in the respiratory exchange ratio between trials, indicating a preferential reliance on glycogen, which is in line with the literature. Carbohydrate ingestion during exercise in the heat did not influence markers of hydration, thermoregulation, or fatigue compared with placebo. Given that prior research shows gastrointestinal symptoms is common in endurance events in hot environments, the absence of symptom investigations in seven out of nine studies reviewed has important implications for interpreting findings. Overall, the results suggest that carbohydrate intake may not reduce glycogen breakdown during endurance performance in heat. Future research should help to better understand the underlying reasons, including any moderating effects of gastrointestinal distress. CONCLUSIONS: Carbohydrate intake during endurance exercise in the heat does not consistently improve exercise performance. Athletes may focus on maintaining hydration during exercise and practice gut-training, based on the wider literature. Future studies should fill the gaps in research, namely, the measurement of gastrointestinal symptoms, the mechanisms of exogenous carbohydrate use in heat, and different modes of exercise, including running, to enable the development of robust, evidence-based recommendations.
12 May 2026
Read appraisal →Journal of global health
The effectiveness and cost-effectiveness of cash plus interventions to prevent acute malnutrition in Somalia: evidence from an adaptive cluster randomised control trial
BACKGROUND: Acute malnutrition affects millions of children aged <5 years, as well as pregnant and lactating women globally, especially in humanitarian settings. Although cash plus interventions - cash or food transfers combined with complementary components - are widely implemented, evidence remains limited on which combinations and durations are most effective at preventing acute malnutrition. METHODS: We conducted a three-arm cluster-randomised trial within the 'Save the Children's Cash Plus for Nutrition' programme in Somalia. Monthly support was provided as cash alone (arm 1), cash plus social and behaviour change communication (arm 2), or cash plus an additional cash top-up (arm 3). Further, we randomised 33 villages across arms, targeting approximately 1500 households. Primary outcomes included the prevalence and incidence of acute malnutrition in children aged 6-59 months and in mothers, assessed at baseline, midline (three months), and endline (six months). We also conducted market monitoring, qualitative data collection, and analysis. RESULTS: Child acute malnutrition prevalence was approximately 15.0% in each arm at baseline. After three months, prevalence declined by 2.0 percentage points in arm 1 to 13.0% (95% confidence interval (CI) = 10.3, 16.1), representing a relative reduction of 13.3%. In arm 2, prevalence declined by 5.9 percentage points to 9.1% (95% CI = 6.8, 11.8), a relative reduction of 39.3%. In contrast, prevalence in arm 3 remained essentially unchanged, increasing to 15.1% (95% CI = 12.1, 18.6). By endline, there was little change from midline in all arms. Maternal malnutrition improved most in arm 2, but differences were not statistically significant. All arms showed improvements in dietary diversity and food security, but only arm 2 achieved sustained nutrition gains. Household livelihood conditions appeared to improve overall, though monthly expenditures nearly doubled. Arm 2 was the most effective and cost-effective. CONCLUSIONS: Adding social and behaviour change communication to cash transfers significantly improved child nutrition compared to cash alone, highlighting that integrated approaches can enhance nutritional outcomes and at minimal additional cost in humanitarian settings. REGISTRATION: ClinicalTrials.gov: NCT06642012.
12 May 2026
Read appraisal →PloS one
Effects of a spore-forming probiotic blend on bowel habits and physical well-being in adults with functional constipation: A randomized, double-blind, placebo-controlled trial
We aimed to evaluate the efficacy and safety of a spore-forming probiotic blend containing Clostridium butyricum IDCC 1301, Weizmannia coagulans IDCC 1201, and Bacillus subtilis IDCC 1101 for improving bowel function and well-being in adults with functional constipation (FC). In a randomized, double-blind, placebo-controlled trial, 78 adults with FC (Rome IV criteria) received either probiotic blend (n = 40) or placebo (n = 38) daily for 4 weeks. Primary outcomes were changes in weekly spontaneous bowel movements (WSBM) and stool form. Secondary outcomes included physical functioning scores from the 36-Item Short Form Health Survey. The probiotic blend group showed significant improvements in irritant bowel movements (p = 0.0458), incomplete evacuation (p = 0.0374), and abdominal pain before defecation (p = 0.0090). Stool consistency shifted toward normal types (Bristol types 3-4, p = 0.0176). Physical functioning improved only in the probiotic blend group (p = 0.0300). Probiotic blend effectively alleviated symptoms of FC and improved physical well-being. Trial registration: Clinical Research Information Service (CRIS), KCT0010085.
28 Apr 2026
Read appraisal →PloS one
Global folate deficiency among adolescent girls: A systematic review and meta-analysis
INTRODUCTION: Adolescents have higher nutrient requirements than adults, as this stage accounts for approximately 40% of total adult weight gain, 45% of skeletal mass and about 15% of adult height. Adequate micronutrient intake is particularly essential for adolescent girls to support growth, reproductive health, and cognitive development. Adolescent folate deficiency disrupts hematopoiesis, causing megaloblastic anemia, and hinders growth, cognition, and immune function and becoming a major public health concern. OBJECTIVE: This global systematic review and meta-analysis aims to address the gap in comprehensive evidence on the prevalence of adolescent folate deficiency. METHODS: This systematic review was conducted and reported according to PRISMA guidelines. We conducted a systematic literature search in PubMed, HINARI, Science Direct, DOAJ, Google, and Google Scholar for studies reporting the prevalence of folate deficiency among adolescent girls up to August 2025. Study quality was assessed using the Newcastle-Ottawa Scale, and evidence certainty was evaluated using GRADE. Pooled prevalence estimates with 95% confidence intervals were calculated using a random-effects model (DerSimonian-Laird method). Heterogeneity was assessed with Cochrane Q and I² statistics. Publication bias was evaluated through visual inspection of funnel plots and Egger's regression test, and adjusted estimates were calculated using the trim-and-fill method. Meta-regression analyses were conducted to explore potential sources of heterogeneity. Sensitivity analyses were performed to assess the robustness of pooled estimates. RESULTS: The search strategy identified 1,498 records, of which 26 studies met the eligibility criteria and were included in this systematic review and meta-analysis. The pooled global prevalence of folate deficiency among adolescent girls was 26.9%(95% CI: 20.5-33.2), with substantial heterogeneity observed between studies (I² = 99.99%, p < 0.001). On average across included studies, approximately one-quarter of adolescent girls were classified as folate deficient, though the true prevalence varied markedly between settings.. The pooled prevalence of folate deficiency among adolescent girls varied across regions, with the highest rate observed in Africa at 35.5%. CONCLUSION: These findings revealed folate deficiency as a substantial global public health concern among adolescent girls with a disproportionately high burden in low-resource settings. Region-specific strategies are urgently needed to prevent folate deficiency among adolescent girls, particularly in low-resource settings. Implementing targeted nutritional interventions and public health policies is essential to reduce its associated health consequences in this vulnerable population.
22 Apr 2026
Read appraisal →Scientific reports
Food preferences and mortality risk in the prospective cohort of UK Biobank participants.
Food preferences may serve as less biased proxies for self-reported food intake in predicting health outcomes but have not yet been linked to mortality risk. We included 177,148 UK Biobank participants who completed a food preference questionnaire (FPQ), with a mean follow-up of 3.4 years (607,779 person-years; 3355 deaths). High versus low preference for 140 food items was tested using Cox regression with Holm adjustment. Sensitivity analyses excluded participants with key health conditions, additional supplement use, or short follow-up, added BMI and physical activity as covariates, and redefined preference groups. Higher preference for asparagus (hazard ratio (95% confidence interval)): 0.69 (0.62, 0.77)), aubergine (0.79 (0.72, 0.87)), black pepper (0.72 (0.64, 0.81)), broccoli (0.69 (0.61, 0.79)), butternut squash (0.75 (0.68, 0.83)), and extra virgin olive oil (0.67 (0.58, 0.78)) was linked to lower all-cause mortality, whereas higher preference for regular fizzy drinks (1.38 (1.24, 1.54)) was linked to higher mortality across all analyses. Specific food preferences are associated with all-cause mortality risk. FPQs may, therefore, complement conventional dietary assessments. Further studies should examine their associations with metabolic and cardiovascular outcomes.
19 Apr 2026
Read appraisal →JMIR aging
Leveraging Digital Health Technologies to Assess Older Adults' Frailty and Nutritional Status: Two Cross-Sectional Studies
BACKGROUND: With the rising prevalence of aging worldwide, there is a necessity for reliable and frequent assessments of older individuals' health status to manage and potentially prevent age-related complications. Digital health technologies (DHTs), such as wearable devices, provide an opportunity to gather objective, continuous, and unobtrusive measurements, enabling effective health management in everyday life. OBJECTIVE: We aimed to evaluate the relationship between digital endpoints and frailty, nutritional status, and patient-reported outcomes (PROs) in older individuals, as well as quantified their compliance and comfort with DHTs. METHODS: In two cross-sectional studies, namely the Geriatric Anorexia Studies 1 and 2, including three in-clinic visits and 2-3 weeks of at-home monitoring, 94 participants (mean age 72.98 years, SD 6.28 years) were stratified based on their frailty status (n=39, 41%, nonfrail; n=45, 48%, prefrail; and n=10, 11%, frail) and nutritional status (n=70, 74%, with normal nutrition and n=24, 26%, at risk for malnutrition), as assessed in a clinical setting using the Fried Frailty Score and the Simplified Nutritional Appetite Questionnaire, respectively. We remotely monitored older adults using different DHTs. At home, participants were monitored with a wrist accelerometer for physical activity, continuous glucose monitoring (CGM) for glucose concentration, a digital body scale for weight and body composition, and a digital nutritional scale for meal tracking. Compliance with devices was assessed via wear time and correct at-home usage, while comfort was evaluated using questionnaires. The association between digital endpoints and frailty/nutritional status was investigated via linear regression, followed by ANOVA, and the relationship between digital endpoints collected at home and PROs was evaluated via Spearman's ρ. Weight and body composition were also assessed during in-clinic visits with a research-grade scale, used to validate the at-home digital body scale measurements, via the intraclass correlation coefficient, Pearson's R, and Bland-Altman plots with mean bias. RESULTS: Physical activity digital endpoints collected at home were significantly different across frailty and nutritional groups and significantly correlated with self-reported appetite, fatigue, and physical function (eg, for mean daily activity in the maximum 60 minutes of activity, ρ=0.28, -0.23, and 0.47, respectively). More than 80% of participants reported that all devices were mostly to very acceptable to wear/use: 95% (88/93) for the body scale, 86% (43/50) for CGM, 80% (40/50) for the nutrition scale, and 91% (84/93) for the wrist accelerometer. Compliance ranged from 60% of monitoring days for the digital nutrition scale to 90% for the wrist accelerometer. CONCLUSIONS: Physical activity digital endpoints show clear prognostic significance for frailty and malnutrition in older individuals and reflect self-reported measures. DHTs can be reliably deployed at home for older individuals to measure their physical activity, weight and body composition, glucose concentration, and meal intakes, thus enabling patient-centric, data-centric clinical trials. TRIAL REGISTRATION: ClinicalTrials.gov NCT04858932; https://clinicaltrials.gov/study/NCT04858932; ClinicalTrials.gov NCT05211973; https://clinicaltrials.gov/study/NCT05211973.
18 Apr 2026
Read appraisal →PloS one
Ultra-processed food consumption and the risk of overweight and obesity in adolescents: A systematic review and meta-analysis
INTRODUCTION: Overweight and obesity during early life increase the risk of premature morbidity and mortality. Adolescent obesity raises the likelihood of developing cardiovascular risk factors, including prediabetes, type 2 diabetes, dyslipidemia, hypertension, liver disease, and metabolic syndrome. Sedentary lifestyles and unhealthy diets are major contributors, with one of the fastest-growing unhealthy eating patterns being the consumption of ultra-processed foods (UPFs). No systematic review and meta-analysis has specifically examined the association between UPF consumption and overweight/obesity in adolescents. OBJECTIVE: To systematically review and conduct a meta-analysis of available evidence on the association between UPF consumption and overweight or obesity among adolescents. METHODS: We searched PubMed, ScienceDirect, HINARI, Google, and Google Scholar for primary studies reporting UPF consumption and overweight/obesity outcomes in adolescents, without restrictions on language or study period. Study quality was assessed using the Newcastle-Ottawa Scale. Heterogeneity was evaluated using Cochrane's Q test and the I² statistic. Publication bias and small-study effects were assessed using Egger's regression test (p < 0.05). A random-effects model estimated pooled associations. RESULTS: Twenty-three studies involving 155,000 adolescents were included. Adolescents with higher UPF consumption had 63% greater odds of overweight or obesity compared with those with lower intake (OR = 1.63; 95% CI: 1.36-1.95). CONCLUSION: High UPF consumption is associated with an increased risk of overweight and obesity among adolescents. Public health strategies targeting reduced UPF intake and promotion of healthier diets should be prioritized to prevent adolescent overweight/obesity and associated health risks.
16 Apr 2026
Read appraisal →Food & function
Metabolic and inflammatory effects of oleuropein and olive leaf extract: a systematic review and meta-analysis
Background: Olive leaves, a by-product of olive oil production, are rich in oleuropein, a phenolic compound with antioxidant and anti-inflammatory properties. This systematic review and meta-analysis evaluated the effects of olive leaf extract (OLE) and oleuropein on glucose metabolism, lipid profile, and inflammatory markers in randomized clinical trials (RCTs). Methods: The review was registered in PROSPERO (CRD42022375615) and followed PRISMA guidelines. PubMed, Scopus, and Web of Science were searched up to January 2026 without restrictions. Eligible studies were RCTs in adults comparing OLE or oleuropein with placebo or control. Study selection, data extraction, and risk of bias (RoB 2) assessment were performed independently by two reviewers; certainty of evidence was assessed with GRADE. Meta-analyses were conducted when at least two trials reported suitable data. Results: Eleven RCTs were included (4 short-term and 7 continuous-intake trials). Short-term crossover studies showed heterogeneous effects on postprandial glycemia and insulin responses, precluding meta-analysis. In continuous-intake, parallel-design RCTs, pooled analyses demonstrated no statistically or clinically significant effects on glycemic or lipid outcomes. Evidence regarding inflammatory markers was scarce and of low certainty. Conclusion: The current evidence does not support clinical recommendations for OLE supplementation aimed at health benefits. Data from methodologically consistent and robust trials indicate no statistically significant metabolic or inflammatory effects under usual human consumption patterns, whereas evidence from other study designs remains inconclusive. Further high-quality RCTs are required to clarify potential metabolic benefits.
15 Apr 2026
Read appraisal →Food & function
Regular black tea kombucha consumption is associated with improved insulin resistance and increased ADIPOQ expression in adults with obesity: a pre-post clinical trial
Kombucha is a fermented beverage obtained by a Symbiotic Culture of Bacteria and Yeast (SCOBY). Although in vitro and animal studies suggest that kombucha has anti-inflammatory and anti-obesogenic properties, no clinical trials have confirmed that. In this pre-post clinical intervention study, we aimed to evaluate whether regular black tea kombucha consumption would impact metabolic, inflammatory, and oxidative stress markers; body weight and composition; and obesity-associated genes in individuals with and without obesity. This study follows the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) guidelines. Individuals with normal weight (Group 1; n = 20) and with obesity (Group 2; n = 16) received 200 mL of black tea kombucha for 8 consecutive weeks. Blood and subcutaneous adipose tissue (SAT) were collected at the baseline (T0) and after 8 weeks of intervention (T8). Most inflammatory (hs-CRP, IFN-γ, TNF-α, and IL-4, IL-6, IL-8, IL-10, and IL-12p70) and oxidative stress markers (FRAP, MDA, and NO) showed significant changes over time following the intervention. However, interaction analyses revealed that responses to kombucha consumption differed between groups for only a limited number of variables: body weight, conicity index, HOMA-IR, and hs-CRP. An upregulation of the gene ADIPOQ in the SAT (p = 0.0481) was also observed, alongside a positive correlation between the BMI and PPARγ (r = 0.58; p = 0.030), and between HOMA-IR and both NFκB (r = 0.73; p = 0.002) and SREBF1 (r = 0.66; p = 0.010). In conclusion, metabolic and inflammatory pathways may respond differently to kombucha consumption depending on the obesity status. The results are mainly attributed to the high number and diversity of phenolic compounds identified in the black tea kombucha, which confer a high antioxidant capacity to the beverage.
15 Apr 2026
Read appraisal →JMIR mHealth and uHealth
Effectiveness of mHealth-Based Nutritional Interventions on Iron Status of Pregnant Women: Systematic Review of Randomized Controlled Trials
BACKGROUND: Anemia is a global health concern. It is disproportionately prevalent among pregnant women in low-resource regions, where iron deficiency is the leading cause. Given the multifactorial nature of anemia, a range of nutritional interventions is recommended. However, effective implementation is often hindered by limited health care access, poor adherence to supplementation, and gaps in nutrition knowledge and counseling. To address these challenges and optimize hemoglobin (Hb) levels among pregnant women, mobile health (mHealth)-based nutritional interventions offer a promising alternative. OBJECTIVE: The aim of the study is to review available evidence on the effectiveness of mHealth-based nutritional interventions on iron status (Hb and/or serum ferritin concentration) among pregnant women. METHODS: Searches were conducted in Embase, CINAHL, Cochrane Library, PubMed, Web of Science, and Scopus, and supplemented by snowballing to identify additional relevant studies from citation lists. The key search strings comprised 4 concepts: "mobile health," "nutritional intervention," "Hb, anemia or iron deficiency anemia," and "pregnant women." Predefined inclusion and exclusion criteria were applied during screening. The methodological quality of included studies was assessed using the Risk of Bias 2 tool. The primary end point was the change in mean Hb concentration or serum ferritin level. Effect sizes (ESs) were calculated as standardized mean differences, including Cohen d and Hedges g. RESULTS: Of the 14,284 studies identified, only 11 randomized controlled trials were included. These studies used various modes of delivery, including mobile phone calls (n=1), SMS text messaging (n=3), and mobile apps (n=4), with some using more than 2 modes (n=3). The effect of mHealth-based nutritional interventions on iron status varied significantly. In total, 4 studies demonstrated a large ES (>0.8), with 3 relying on WhatsApp Messenger as an mHealth delivery mode. Approximately 82% (9/11) of the included studies reported a positive effect (P values ranging from <.001 to .047) of the intervention on Hb level, whereas 2 studies reported no statistically significant association (P=.33 and P=.35, respectively). Notably, interventions with the largest ES achieved clinically significant improvements in Hb concentration, with within- and between-group differences exceeding 1 g/dL. However, including behavioral change theories and nutrition-sensitive components was not consistently associated with larger ESs. Due to high heterogeneity (I2>95%), attributed to variations in mHealth delivery modes, functions, and interactive features across the included studies, meta-analysis could not be performed. CONCLUSIONS: This review demonstrates that mHealth-supported nutritional interventions effectively optimize Hb concentration in pregnant women. While SMS text messaging was less effective in improving Hb concentration, combining it with another mHealth delivery mode, such as phone calls, improved intervention effectiveness. However, the variability in mHealth delivery modes, functions, and interactive features underscores the need for tailored strategies that account for context-specific challenges, digital literacy, and access to technology to enhance effectiveness.
10 Apr 2026
Read appraisal →PloS one
Perception and acceptance of micronutrient-Fortified Bouillon among Non-Index Household Members: A longitudinal sub-study nested within a randomized trial in Northern Ghana
BACKGROUND: Fortified bouillon cubes offer a scalable strategy to address micronutrient deficiencies in West Africa. However, success depends on household members' perceptions and acceptance. This study assessed changes in perception and acceptance of fortified bouillon cubes over time and explored factors influencing these outcomes among non-index household members (NIHMs) from trial households in Northern Ghana. METHODS: This longitudinal mixed-methods study was nested within a double-masked randomised controlled trial. Households received micronutrient-fortified bouillon cubes (vitamin A, vitamin B12, folic acid, iron, zinc, iodine) or control cubes (iodine only) for nine months. One NIHM (≥15 years) per household (n = 1,047) was enrolled. Structured interviews were conducted during early (months 1-2; n = 731) and late (months 7-9; n = 796) phases. Composite perception (8 items) and acceptance (10 items) scores (range: 1-5; higher scores = more positive perceptions/greater acceptance) were derived from an 18-item validated instrument. Bayesian linear mixed-effects models assessed temporal changes and associated individual and household factors. Twenty-four focus group discussions (months 4-5) explored drivers and barriers. RESULTS: Mean age of NIHMs was 40 ± 14.7 years; 59% were female. Perception scores increased over seven months, from 3.4 to 4.1 (adjusted posterior mean difference [aPMD] = 0.69; 95% credible interval [CrI]: 0.57, 0.81). Acceptance remained high (4.59 to 4.58; aPMD = -0.02; 95% CrI: -0.07, 0.03). No differences were observed between trial arms. At early timepoint, perception scores were lower among household heads compared with other household members, and lower among formal employees compared with farmers. Acceptance was higher among individuals from severely food-insecure households and lower among those from mildly food-insecure households. Focus groups revealed that perceived health benefits, sensory appeal, and cultural fit drove acceptance, while infertility-related myths and food colour changes were barriers. CONCLUSION: Fortified bouillon cubes were accepted, with perceptions improving over time. Public education will be essential to address misconceptions. TRIAL REGISTRATION: ClinicalTrials.gov (NCT05178407); Pan-African Clinical Trial Registry (PACTR202206868437931). The authors confirm that all ongoing and related trials for this intervention are registered.
5 Apr 2026
Read appraisal →BMJ global health
The effects of antenatal interventions on gestational weight gain in low and middle-income countries: a systematic review
BACKGROUND: Gestational weight gain (GWG) during pregnancy is a critical factor that affects maternal and child health outcomes. The considerable burden of inadequate GWG and the rising tide of excessive GWG are overlooked challenges in low and middle-income countries (LMICs). METHODS: This systematic review assessed the impact of antenatal interventions on GWG in LMICs. Randomised controlled trials (RCTs) on antenatal interventions on GWG in LMICs were included. These interventions included educational, behavioural, nutritional supplementation and pharmacological therapies. A systematic literature search was conducted using PubMed, Embase, Web of Science, CINAHL and the Cochrane Library from the start of each database through September 2025. RESULTS: Out of the 33 642 unique articles identified, 70 articles were included in our systematic review, with 59 individual RCTs and 11 cluster RCTs. Nutritional interventions (31 studies) included food and micronutrient supplementations. Micronutrient supplementation such as multiple micronutrient supplementations was found to reduce the risk of severely inadequate or inadequate GWG among pregnant women compared to iron only or iron and folic acid supplementation (Grading of Recommendations Assessment, Development and Evaluation [GRADE]: moderate certainty). Food supplementation showed mixed results, although most trials demonstrated higher mean GWG among undernourished pregnant women and a greater likelihood of achieving Institute of Medicine-recommended ranges (GRADE: moderate certainty). Behavioural (counselling/education) interventions (20 studies) were associated with significant reductions in excessive GWG among pregnant women with overweight or obesity and improved adequacy of GWG (GRADE: moderate certainty). Physical activity (seven studies) was found to reduce the risk of excessive GWG (GRADE: moderate certainty). Combined dietary and physical activity interventions (six studies) were found to reduce the risk of excessive GWG among pregnant women (GRADE: low certainty). CONCLUSIONS: Well-structured antenatal interventions, initiated before 20 weeks of gestation and continuing beyond this period, tailored to local cultural contexts and available resources, can effectively help pregnant women in LMICs in achieving optimal GWG. PROSPERO REGISTRATION NUMBER: CRD42022366354.
4 Apr 2026
Read appraisal →Nat Hum Behav
Machine learning-assisted optimization of dietary intervention against dementia risk
A healthy diet has been associated with a reduced risk of dementia. Here we devised a Machine learning-assisted Optimizing Dietary intERvention against demeNtia risk (MODERN) diet based on data from 185,012 UK Biobank participants, 1,987 of whom developed all-cause dementia over 10 years. We first identified 25 food groups associated with dementia in a food-wide association analysis. Second, we ranked their importance using machine learning and prioritized eight groups (for example, green leafy vegetables, berries and citrus fruits). Finally, we established and externally validated a MODERN score (0-7), which showed stronger associations with lower risk of dementia-related outcomes (hazard ratio comparing highest versus lowest tertiles: 0.64, 95% CI: 0.43-0.93) than the a priori-defined MIND diet (0.75, 0.61-0.92). Across 63 health-related outcomes, the MODERN diet showed particularly significant associations with mental/behavioural disorders. Multimodal neuroimaging, metabolomics, inflammation and proteomics analyses revealed potential pathways and further support the potential of MODERN diet for dementia prevention.
1 Nov 2025
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