Abstract Diet may influence circulating sex steroid hormones, but evidence for overall dietary patterns remains limited. We examined associations of dietary patterns reflecting lower inflammatory potential, lower insulinaemic potential and higher overall diet quality, with circulating sex steroids in older men and systematically reviewed the literature in apparently healthy men published through June 2024. We conducted cross-sectional analyses of 1622 men aged ≥65 years from the Osteoporotic Fractures in Men Study. Diet was assessed using FFQ and sex hormone-binding globulin (SHBG), total and free testosterone and total and free estradiol were measured. Dietary patterns included the reversed Empirical Dietary Inflammatory Pattern (rEDIP), reversed Empirical Dietary Index for Hyperinsulinaemia (rEDIH) and Healthy Eating Index-2020 (HEI-2020). Among older men, each 1-standard deviation increase in rEDIP was associated with higher total testosterone ( β = 2·15; 95 % CI 0·12, 4·18) and free testosterone ( β = 2·02 ng/dL; 95 % CI 0·29, 3·75), whereas rEDIH showed similar but non-significant associations with total testosterone ( β = 1·64; 95 % CI –0·28, 3·57) and free testosterone ( β = 1·43; 95 % CI –0·21, 3·08). Higher HEI-2020 scores were associated with higher free estradiol ( β = 2·46 pg/mL; 95 % CI 0·85, 4·07). Across twenty-one studies, healthier dietary patterns were generally associated with lower estradiol and higher concentrations of SHBG and total testosterone. Taken together, the individual-level analyses and systematic review suggest that anti-inflammatory, low-insulinaemic and overall healthy dietary patterns are associated with more favourable sex steroid hormone profiles in men, although prospective studies are needed to establish temporality.
Abstract Accurate dietary assessment in non-Western populations is hindered not only by recall bias but also by the limited representation of local foods in international reference databases. When standardised tools fail to capture regional dietary practices, the quality of dietary assessments is potentially compromised. This cross-sectional study evaluated the accuracy of photograph-assisted 24-h recalls (24hr) analysed using the United States Department of Agriculture (USDA) Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) system (based on Food and Nutrient Database for Dietary Studies (FNDDS) 2017–2018) or a customised database enriched with local foods and international measurement units (DbF). Twenty Colombian adults photographed and weighed foods consumed over two non-consecutive days. A dietitian conducted 24hr interviews using the multiple-pass method based on the photographs. Intake estimated with ASA24 and DbF was compared against weighed food records as reference. Blood and urine samples were collected to assess nutrient biomarkers. Accuracy was evaluated using correlation analyses and Bland–Altman plots, while usual intake was estimated using PC-SIDE. Misreporting was similar between ASA24 and DbF (15 %). However, DbF improved accuracy, showing stronger correlations with weighed foods for calories and macronutrients ( ρ > 0·90) and narrower limits of agreement for energy intake compared with ASA24 (−364 to 256 v . −771 to 909 calories, respectively). DbF allowed estimation of twenty-eight nutrients compared with twenty using ASA24 and showed stronger correlations for micronutrient intake estimates ( r 0·86–0·96 v . 0·69–0·96; all P < 0·05) and urinary biomarkers ( r > 0·6, P < 0·0001). These findings demonstrate that integrating locally contextualised food databases with technology-assisted recalls improves the quality of dietary assessment in underrepresented populations and provides a scalable model to enhance nutritional epidemiology and health monitoring worldwide.
Abstract Overweight and obesity are major public health challenges, requiring preventive efforts targeting diet, physical activity (PA), sedentary behaviour (SB) and sleep. Current research often treats these behaviours in isolation, ignores daily fluctuations and focuses on between-person differences. Studies examining the temporal covariance of these behaviours, assessing within-day and day-to-day variations in determinants and exploring how these time-varying determinants predict within-person variability in behaviours are needed. This paper aims to evaluate the feasibility of a measurement burst design with repeated intensive longitudinal assessments and to present patterns of behaviours and determinants. A 12-month observational study with a measurement burst design was conducted (January–December 2025). In total, 130 participants aged 55–75 years enrolled in the study, which consisted of four 7-day measurement bursts. Data collection included monitoring of diet, PA, SB, sleep and time-based ecological momentary assessment (EMA). Compliance rates, descriptive statistics per burst and across bursts were computed. 116 participants completed all bursts (retention rate = 89·2 %). Compliance rates ranged from 83·5 % for time-based EMA to 91·8 % for SB, supporting feasibility of the protocol. Mean values of 1692 kcal/day ( sd = 565) for energy intake, 9·4 h/day ( sd = 2·4) for sedentary time and 10 610 steps/day ( sd = 6302) were observed. Mean daily light, moderate and vigorous PA-levels were 102·9 ( sd = 37·4), 65·5 ( sd = 43·4) and 11·5 ( sd = 17·0) minutes, respectively. Mean sleep duration was 6·4 h/night ( sd = 1·3), with a mean sleep efficiency of 79·2 % ( sd = 10·2). This paper demonstrated the feasibility of integrating multiple assessment methods within a measurement burst design for studying health behaviours in adults aged 55–75 years and highlighted the value of analyses at more fine-grained temporal and individual levels.
Abstract Iodine is essential for thyroid hormone synthesis and is needed for brain development. In the UK, milk and dairy products are the main dietary sources, but the increasing consumption of plant-based alternatives may affect iodine intake. Few iodine-specific dietary assessment tools have been validated in UK adults, and none reflects recent changes in food availability, food composition and dietary patterns. This study aimed to develop and validate the Iodine Intake Risk Score screening tool, using a rapid digital iodine-specific questionnaire. Healthy UK adults (n 108) aged ≥18 years completed the Iodine Intake Risk Score screening tool and a 6-d food diary, which served as the reference method. Iodine intake from the tool and food diaries was estimated and was classified as insufficient (<140 µg/d) or sufficient (140–600 µg/d). Agreement between methods was assessed using Cohen’s kappa, Wilcoxon signed-rank tests and Spearman’s correlation. There was substantial agreement in iodine classification (κ = 0·68, p < 0·001). The screening tool demonstrated high sensitivity (82%) and specificity (87%) for identifying individuals with insufficient iodine intake. The median iodine intake from the screening tool did not differ significantly from that of the food diaries (145 v 140 µg/d; p = 0·07), and the two methods were strongly correlated (r 0·70, p < 0·001). Median completion time was 4 min. The screening tool provides a valid and efficient method for assessing iodine intake in UK adults, incorporating conventional and plant-based sources. It offers a practical approach for identifying individuals at risk of iodine deficiency and for supporting population monitoring and dietary interventions.
Abstract Rapid global ageing is increasing the burden of cognitive impairment. Oxidative stress may contribute to cognitive decline, and the oxidative balance score (OBS), which integrates dietary and lifestyle pro- and antioxidants, has an unclear relationship with cognitive function in older adults. This study aimed to investigate the association between the OBS and cognitive function among older adults and to examine potential indirect pathways through circulating oxidative stress-related biomarkers. We used data from 1891 adults aged ≥60 years who participated in the 2011–2014 Chinese Longitudinal Healthy Longevity Survey. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Oxidative stress markers, including albumin, superoxide dismutase, malondialdehyde and plasma 25-hydroxyvitamin D [25(OH)D], were measured at baseline and follow-up. Associations were examined using mixed-effects linear regression models and semi-longitudinal cross-lagged mediation analysis. The median cognitive score was 28 (interquartile range, 23–29). Each one-point higher OBS was associated with a 0·16-point higher MMSE score ( β = 0·16, 95 % CI 0·06 to 0·26), and participants in the highest OBS tertile had a 1·12-point higher MMSE score than those in the lowest tertile ( β = 1·12, 95 % CI 0·50 to 1·73). In mediation analysis, higher baseline OBS predicted lower plasma 25(OH)D at follow-up (path a = –1·015), and higher baseline 25(OH)D was associated with better cognitive scores at follow-up (path b = 0·025). The indirect effect of OBS on cognition through 25(OH)D was significant ( a × b = –0·025). OBS was positively associated with cognitive function, partially mediated by 25(OH)D. Further research is warranted to clarify these mechanisms and implications for cognitive aging.
