Malnutrition and impaired physical function are common in patients with heart failure and are associated with reduced quality of life and adverse clinical outcomes. However, randomized trials have evaluated clinically diverse nutritional strategies, and their overall effects remain uncertain. PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception to March 30, 2026. Randomized controlled trials evaluating oral nutritional interventions in adults with heart failure and reporting quality of life, functional outcomes, or clinical events were included. Standardized mean differences (SMDs) and odds ratios (ORs) were pooled using random-effects models with restricted maximum-likelihood estimation. Risk of bias was assessed using the Cochrane RoB 2 tool. Exploratory analyses according to intervention category were conducted to examine clinical heterogeneity. Twenty-two randomized controlled trials involving 4,042 participants were included. The primary quality-of-life analysis included seven effect estimates and favored nutritional intervention (SMD = 0.76, 95
Parkinson’s disease is a progressive neurodegenerative disorder with both motor and non-motor manifestations. Dietary factors, including dietary diversity, protein source variety, and adherence to healthy eating patterns, may impact Parkinson’s disease risk. The goal of the current case-control research was to examine the links between the Dietary Diversity Score (DDS), the Diversity of Dietary Protein Index (DDPI), and the Lifeline Diet Score (LLDS) with the odds of Parkinson’s disease among an Iranian population. A total of 320 individuals (215 controls and 105 newly diagnosed Parkinson’s disease patients) were recruited in Arak, Iran. Dietary intake was evaluated by applying a validated 147-item food frequency questionnaire, and DDS, DDPI, and LLDS were calculated. Multivariate logistic regression was utilized to estimate odds ratios (ORs) and 95
To assess the relationships between four sodium knowledge domains and four sodium-related dietary behaviors among university students. Cross-sectional, web-based survey conducted during the 2018–2019 academic year. Three large state universities in Southern California. We conducted a secondary analysis of survey data from 3,094 university students, including those attending a university that implemented LACSRI (Los Angeles County Sodium Reduction Initiative) strategies. Multivariable analyses examined associations between self-reported sodium knowledge measures and self-reported dietary behaviors. We also evaluated associations between LACSRI-targeted university attendance status (classified as exposure) and the four dietary behaviors. Participants who accurately identified the recommended daily sodium intake as one teaspoon or less of salt per day had higher odds of infrequently adding salt during cooking or preparing meals (aOR = 1.44, 95
The consumption of processed and ultra-processed foods is increasing globally and has been associated with an increased risk of diet-related non-communicable diseases (NCDs), partly due to their adverse nutrient profiles. In Uganda, there is limited evidence on whether these products contain excessive levels of nutrients and ingredients of concern, including total fat, saturated fat, trans fats, free sugars, sodium, caffeine, and non-sugar sweeteners (NSS). Evidence is also limited on the nutrient profiles and labelling practices of these processed food products. This study aimed to assess the nutrient profiles and labelling practices of marketed packaged, processed and ultra-processed foods in Uganda. This was a cross-sectional observational study assessing processed and ultra-processed packaged foods in Uganda across 14 health regions, covering 17 towns and border areas. A multistage stratified sampling approach was used to select supermarkets and grocery stores, targeting 452 supermarkets and 85 grocery stores. A total of 3,736 products were collected, of which 1,083 with complete nutrition information were included. Data were collected by trained nutrition professionals using NOVA classification and KoboToolbox. Products were analysed per 100 g/100 ml using Uganda Nutrient Profile Model thresholds. Statistical analysis was conducted at a 95
Cognitive skills play fundamental role in learning, problem-solving, and adapting to new information and everyday situations, enabling children to effectively process and retain knowledge. This study investigated relations between dietary habits, cardiometabolic health parameters, emotional well-being and cognitive performance in schoolchildren. Prospective longitudinal study involved 106 pupils (aged 8 – 10 years; 53.5
Minimum dietary diversity (MDD) is an important indicator of complementary feeding quality and has been associated with child nutritional status. This study examines the association between adequate MDD and growth outcomes among children aged 6–23 months in Pakistan using a pooled dataset comprising children from four provinces of Pakistan. This cross-sectional study analyses pooled data for 18,680 children aged 6–23 months from the most recent Multiple Indicator Cluster Surveys (MICS) conducted in the four provinces of Pakistan. Propensity scores are estimated from child, maternal, and household characteristics to improve covariate balance between children with adequate and inadequate MDD. Survey-weighted logistic regression is then conducted before and after kernel matching to examine the associations of adequate MDD with stunting, wasting, and underweight. The prevalence of stunting, wasting, and underweight was 34
The relationship between the inflammatory potential of foods and sleep, mental health, quality of life and aggressive behaviors is not well understood in Iranian female adolescents. We aimed to address this since there is a high prevalence of these factors in this population. In this cross-sectional study, Dietary data was collected from 670 participants using a food frequency questionnaire. Dietary Inflammatory Index (DII) scores for all participants were calculated and the data was split into quartiles based upon this. Logistic regression was used to obtain odds ratios for quality of life, depression, aggression, insomnia, sleepiness across quartiles of DII and adjustments were applied for a range of confounders. Mean score of depression was significantly different between quartiles of DII score (P = 0.02), but this disappeared after adjusting for confounders. Insomnia scores had significant differences across quartiles of DII score only in adjusted models (P < 0.001). A significant difference was observed for daytime sleepiness score throughout quartiles of DII score in our model adjusted for age and energy (P = 0.04). A positive association was seen between DII score and odds of depression, even after adjusting for age and energy (OR = 1.96; 95
Child undernutrition continues to pose a substantial public health burden in low-resource settings, including Ethiopia. The complementary feeding period (6–23 months) represents a particularly vulnerable stage, during which inappropriate feeding practices may increase the risk of growth faltering. Therefore, this study aimed to evaluate the effect of nutrition counseling on undernutrition among children aged 6–23 months in West Gojjam Zone, Northwest Ethiopia. A two-arm, parallel, cluster-randomized trial was conducted from June 2023 to December 2024 in rural districts of West Gojjam Zone. Thirty kebeles were randomized as clusters and allocated equally to intervention and control arms. At baseline, 802 mothers with infants aged 6–8 months were enrolled (401 per arm) and followed for nine months; anthropometric data were available for 391 intervention and 385 control participants. The intervention comprised structured theory-driven nutrition counseling delivered through home visits by trained Women’s Development Army leaders using an intervention guide, while controls received routine nutrition education. Blinding of participants and counselors was not feasible due to the nature of the intervention. Data were collected using interviewer-administered questionnaires, and anthropometry was measured at baseline and endline. Generalized estimating equations were used to assess the intervention effect, while accounting for clustering and repeated measurements. After adjustment, the nutrition counseling intervention was associated with 36
Underweight is a major indicator of undernutrition among under-five children in India, its responsible for children’s chronic and acute diseases. The study aims to identify hotspot and regional differences accompanied with exploring the different socio-economic, demographic, maternal level factors, and child’s individual characteristics responsible for underweight prevalence, The study has extracted a database of 132,656 children aged between 0 and 59 months, from large scale NFHS-5 (2019–2021) dataset, a nationally representative sample. The key outcome in this study was the children’s underweight status (weight-for-age). To highlight the spatial differences, the country was divided into six regions: North, Central, East, North-East, South, and West. Univariate Moran’s I and Getis-Ord Gi statistics were used to understand the clustered underweight districts and hotspots. Apart from descriptive statistics and cross-tabulations and binary logistic regression were used to examine, the association of region specific of underweight. The findings revealed that pronounced regional disparities regarding underweight prevalence, with the Central (28.26
In low- and middle-income countries, optimal complementary feeding practices for children aged 6–23 months are poorly practiced. Studies in Ethiopia report varying prevalence and factors due to differences in agro-ecological, socioeconomic, and cultural contexts. This systematic review and meta-analysis aimed to estimate the pooled prevalence and identify associated factors among Ethiopian children in this age group. We conducted a comprehensive literature search using major electronic databases, including PubMed, Scopus, ScienceDirect, and HINARI. Data analysis was conducted using STATA version 17.0. Statistical heterogeneity among the included studies was assessed using Cochran’s Q statistic and quantified using the I² test, complemented by subgroup analysis and meta-regression. A random-effects model was used to estimate the pooled prevalence of complementary feeding practices and their associated factors. The results are presented using forest plots with corresponding pooled prevalence estimates, adjusted odds ratios (aOR), and 95
This study evaluated the effects of sodium supplementation on growth, electrolyte balance, and neurodevelopmental outcomes in preterm infants. A systematic review and meta-analysis of published studies were conducted using data from PubMed, Embase, Scopus, and Google Scholar, including randomized controlled trials and observational studies involving infants born before 37 weeks of gestation. Twelve studies comprising more than 2,800 participants were analysed using random-effects models. Sodium supplementation was associated with improved weight gain and a significant reduction in the risk of hyponatremia (RR = 0.28, 95
Malnutrition remains a major public health concern among women in low-and middle-income countries, where undernutrition and overnutrition increasingly coexist. This pattern reflects rapid socioeconomic, dietary, and lifestyle transitions that disproportionately affect women of reproductive age. In sub-Saharan Africa, urbanization, changing food environments, and socioeconomic inequalities are associated with rising overweight and obesity while undernutrition persists among disadvantaged populations. This study examined the prevalence, socioeconomic inequalities, and determinants of underweight, overweight, and obesity among women in Malawi. We conducted a cross-sectional analysis of nationally representative data from the 2024 Malawi Demographic and Health Survey (2024 MDHS). The analytic sample included 9,286 non-pregnant women aged 15–49 years with valid anthropometric measurements. All analysis incorporated sampling weights, clustering, and stratification. Body mass index (BMI) was calculated as weight in kilograms divided by height in meters squared (kg/m²) and categorized using World Health Organization criteria as underweight (< 18.5 kg/m²), normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²), and obesity (≥ 30.0 kg/m²). Survey-weighted descriptive statistics were used to estimate the prevalence across sociodemographic characteristics. Socioeconomic inequality was assessed using concentration indices based on household wealth ranking. Multinomial logistic regression was used to identify factors associated with underweight, overweight, and obesity, using normal weight as the reference category. Overall, 6.9
Controlling appetite during the postprandial phase is proposed to be an effective strategy for preventing and managing obesity, therefore, considering the conflicting results of previous studies, we aimed, in this pilot study, to explore the feasibility of assessing postprandial appetite responses to meals with different macronutrient compositions in both normal-weight and obese men. In this randomized crossover clinical trial, two groups of obese (n = 10) and normal-weight (n = 10) men received each test meal, which included high protein (30
In the NAKO cohort, dietary assessment instruments were applied at baseline (2014–2019) and during the first re-examination (2019–2024). The aim was to assess and describe changes in dietary intake over time, and to evaluate the possible consequences of pooling dietary data from both assessment periods for NAKO participants with insufficient or missing dietary information at baseline. Full dietary information in both examination waves was collected in a group of 9,035 participants recruited in the study centers in Berlin-South and Freiburg. The mean difference between the baseline and first re-examination visit was 4.8 years (SD = 0.5). For both time periods, the usual intake of food items for each participant was estimated per examination wave using the modified Multiple Source Method (MSM) that incorporated repeated 24-hour food lists (24 h-FL) and a food frequency questionnaire (FFQ), combined with external data from the German National Nutrition Survey II (NVS II). Total energy intake and macronutrient intake were derived by linking food items to the German food composition database. On the individual level, differences in intake estimates were examined and the concordance was assessed. Overall, the results showed a high concordance of energy and macronutrient intake estimates between both time periods (ICC ≥ 0.70 for macronutrients) and only small mean differences. On average, energy intake decreased by 56 kcal/day in males and 37 kcal/day in females. At the food group level, only small changes were observed, except for the consumption of meat and meat products, as well as milk and dairy products. In females, average meat and meat product consumption decreased from baseline to the first re-examination by 7.3 g/day and in males by 14.6 g/day; the intake of milk and dairy products decreased by about 20 g/day in both females and males. In this NAKO sub-sample, habitual intake estimates for energy, macronutrients and most food groups were highly consistent between recruitment and first re-examination. While changes in two specific food groups were observed, overall macronutrient and energy intake remained stable over the five-year period. These findings suggest that in case of incomplete dietary data at baseline, it may be appropriate to use data from both examination waves to estimate a person’s usual dietary intake.
Vitamin A is essential for vision, immune function, growth, epithelial integrity, and reproduction. Adequate intake reduces all-cause and diarrhoea-specific mortality, especially in children aged 6–59 months. In Tanzania, insufficient consumption of vitamin A-rich foods necessitates routine supplementation to prevent vitamin A deficiency (VAD) complications. However, vitamin A supplementation (VAS) uptake rates remain low, and the factors influencing its uptake are not well understood, lacking evidence for interventions to improve VAS uptake and improve child health outcomes. To address this, data was analysed from the Tanzania Demographic and Health Surveys (TDHS) to assess VAS trends and identify factors associated with VAS uptake among children under five years in Tanzania. Secondary data analysis of Tanzania demographic Health Survey (TDHS) data from 2010 to 2022 was conducted. The Tanzania Demographic and Health Survey (TDHS) is a nationally representative survey conducted approximately every five years, designed to collect comprehensive data on population health, nutrition, and demographic indicators. Analysis was done on children between 6 and 59 months of age who had data on the status of VAS uptake and their caregivers. A logistic regression analysis was deployed to assess associations between VAS and factors associated with its uptake. The analysis was performed using STATA 17 software. A weighted sample of 23,950 children between 6 and 59 months of age and their parents were included in the trend analysis. The study found that VAS uptake among children aged 6–59 months were 61.6
There is a paucity of evidence regarding the association of malnutrition with the severity and activity of systemic sclerosis (SSc). Hence, the current cross-sectional study examined the association between malnutrition, disease severity, and activity in patients with SSc. In the current cross-sectional study, 202 adults aged between 20 and 60 years with a confirmed diagnosis of SSc were selected using a random sampling approach. The Global Leadership Initiative on Malnutrition (GLIM) criteria were implemented to examine malnutrition status. SSc activity was determined using the European Scleroderma Study Group (ESSG) criteria. Severity was examined by Medsger’s disease severity scale. A binomial logistic regression analysis was employed to investigate the association between malnutrition and disease severity and activity, and the corresponding odds ratio (OR) and 95
This scoping review and meta-analysis synthesised current evidence on energy and macronutrient intake and energy expenditure in elite male and female soccer players. Despite established nutritional guidelines, concerns persist regarding chronic low energy availability and its implications for both performance and health. A total of 57 studies involving professional and semi-professional athletes aged 16 years and older were included. Meta-analyses were conducted for energy intake and total energy expenditure, with analyses performed separately for male and female players. Evidence was also synthesised for dietary intake, including carbohydrate, protein, and fat consumption. Energy intake and expenditure comparisons were based on 11 studies in male players and 6 in female players. Across both sexes, findings consistently demonstrated negative energy balance. Male players exhibited significant intake deficits relative to expenditure, averaging up to − 741 kcal.day⁻1, while female players showed deficits of − 544 kcal.day⁻1 (both p < 0.01). Even after adjustment for estimated underreporting ( 19
Vitamin deficiencies remain significant public health concerns that adversely affect children’s growth and development. Mothers, as primary caregivers, play a key role in shaping their children’s health practices. Therefore, this study aimed to evaluate the effect of an educational program on mothers’ reported practice regarding care of their children with vitamin deficiencies. A quasi-experimental study was conducted at the nutrition clinic of the Children’s Hospital, Ain Shams University. A purposive sample of 50 mothers of children diagnosed with vitamin deficiencies (42 vitamin D deficiency, 6 vitamin A deficiency, and 2 vitamin C deficiency) was included. A structured educational program was delivered to mothers, and maternal reported practices were assessed before and after the intervention. There was a statistically significant improvement (p < 0.001) in the total reported practice scores of mothers following the educational program, indicating enhanced care practices related to managing their children’s vitamin needs. the structured educational program was effectively improved mothers’ reported practices regarding care of their children with vitamin deficiencies, emphasizing the importance of mother education and educational intervention in addressing childhood nutritional deficiencies. Enhancing their knowledge and practices is essential in addressing these nutritional deficiencies. Moreover, the findings of this study could be applied to improve mothers’ roles in the physical, psychological, and social aspects of child care.
The relationship between vitamin D status and serum calcium, phosphate, and magnesium levels, as well as bone mineral density, in African breastfeeding women remains understudied. Bone resorption is essential for maintaining mineral balance when demand for calcium, phosphate, and magnesium increases during breast milk production. We investigated the association between low serum levels of 25-hydroxyvitamin D (25(OH)D), calcium, phosphate, and magnesium and changes in bone mineral density (BMD) among postpartum women. Out of 540 young, healthy pregnant women not living with HIV enrolled in an open-label randomized controlled HIV pre-exposure prophylaxis (PrEP) trial between September 2018 and December 2019 in Durban, South Africa, 521 women with a mean (SD) age of 23.9 (4.7) years were included in this secondary data analysis. Women were randomized to either initiate tenofovir diphosphate fumarate (TDF)-containing PrEP in pregnancy or defer initiation to the time of breastfeeding cessation. Serum levels of calcium, magnesium, and phosphate, along with bone mineral density (BMD) of the total hip and lumbar spine, were measured in real-time at 6, 26, 54, and 74 weeks postpartum. We also measured serum 25-hydroxyvitamin D (25(OH)D) levels in stored samples collected in the second trimester of pregnancy and at 6 weeks postpartum. The mean (SD) serum 25(OH)D levels during pregnancy and postpartum were 72.4 (30.0) nmol/L and 69.9 (33.2) nmol/L, respectively. The prevalence of low vitamin D status [25(OH)D < 50 nmol/L] was 24.2
School going children and adolescents are at critical period of cognitive, physical and emotional development. Poor dietary behavior developed during these years can hinder healthy adulthood. Integration of nutrition education into curriculum could prove as a cost-effective intervention for behavior change in a low resource country like Nepal. This curriculum analysis study aims to assess the inclusion of nutrition related education in school curricula of Nepal in grades of 6–8, its duration and depth, identify gaps, and propose strategies for effective integration of such topics into the existing curricula and help the children to make informed dietary choices. The researchers used PRECEDE part of PRECEDE_PROCEED and Taba’s model of curriculum development for the review. First a narrative review was undertaken to understand nutritional landscape of Nepalese children from national Demographic Health Surveys and Global Nutrition Reports. Then, the contents of Basic Education Curriculum of Nepal (revised in 2020) for Grades 6–8 and all official textbooks published by the Curriculum Development Centre of Nepal were analyzed. The evaluation of curricula content was based on research questions given by the evaluation models used. Then for comparison of national curricula with global standards, it was compared with international curricula: (1) Alberta Health Services (Canada) and (2) Community Voices for Health (American University, USA) and UK government curriculum. The curriculum of grade 6–8 was found to be nearly aligned from the national needs and priorities only in health education subject. In other subjects like social studies and sciences the topics on nutrition were completely missing. Pedagogical and assessment techniques were traditional. Overall, there is more scope for an enhanced curricum aligned with global standards of teaching and learning. Curricular revision is required prioritizing national nutritional needs among children and should inform healthy choices through creative pedagogical approaches.
