Objectives:This study aimed to investigate whether C-reactive protein (CRP) and interleukin-6 (IL-6) mediate the relationship between various antioxidants-specifically vitamin A, vitamin E isoforms, and carotenoids-and insulin resistance (IR). Methods:We conducted a bias-corrected bootstrapping cross-sectional mediation analysis using biomarker data from the Midlife in the United States (MIDUS3) study (2017-2022). Antioxidants evaluated included Total lycopene, β-cryptoxanthin, retinol, and α- and γ-tocopherol. Insulin resistance was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). CRP and IL-6 were included as mediators. Analyses were adjusted for age, sex, waist-hip ratio (WHR), smoking status, physical activity, dyslipidemia (assessed via Total to HDL cholesterol ratio), and dietary quality, with all continuous covariates mean-centered. Results:The analytic sample comprised 747 participants (56% female; mean age, 66 years; SD = 9.6). After adjustment, higher Total lycopene and β-cryptoxanthin levels were significantly associated with lower HOMA-IR, with no evidence of mediation by CRP or IL-6. In contrast, γ-tocopherol was associated with higher HOMA-IR, an effect partially mediated by elevated CRP (percent change per 10-unit increase: 7.79%; 95% CI: 2.12 to 18.53). Retinol showed significant indirect mediating associations through reduced CRP (-31.48%; 95% CI: -50.24 to -13.50) and IL-6 (-15.46%; 95% CI: -33.57 to-1.49), though these effects did not yield a significant total association. However, α-tocopherol didn't demonstrate a significant indirect or total association. Conclusion:Among older adults, γ-tocopherol was positively associated with insulin resistance, partially mediated by CRP, whereas β-cryptoxanthin and lycopene were inversely associated with HOMA-IR without a significant mediation for inflammatory markers. Although retinol reduced insulin resistance via reduced inflammatory markers, its overall association with insulin resistance was not significant.
Background: Obesity increases the risk of metabolic disorders and is a growing global health issue. However, not all people with obesity share the same metabolic profile. Some are classified as metabolically healthy obese (MHO), while others are metabolically unhealthy obese (MUHO), with a higher risk of complications. These phenotypes can shift over time, influenced by diet and lifestyle. This study aimed to analyze the effect of a low-calorie diet enriched with medium-chain triglycerides (MCT) on anthropometric parameters and metabolic status in individuals with obesity. Methods: A pre-post intervention trial without a control group was conducted involving 41 obese participants who followed a low-calorie, high-MCT diet for 8 weeks. Pre- and post-intervention assessments included body weight, body mass index (BMI), waist circumference, body fat percentage, blood pressure, fasting blood glucose, lipid profile, and metabolic status. Paired sample t tests and McNemar were used to analyze the data. Results: Significant reductions were observed in body weight ( P < 0.001), waist circumference ( P < 0.001), and body fat percentage ( P < 0.001). Changes in systolic and diastolic blood pressure, as well as fasting glucose levels, were not statistically significant ( P > 0.05). Total cholesterol increased significantly ( P = 0.008), while low-density lipoprotein (LDL) cholesterol decreased significantly ( P =0.033). No significant changes were observed in triglycerides or high-density lipoprotein (HDL) cholesterol. The proportion of MHO individuals increased from 29.3% to 46.3%, while the proportion of MUHO individuals decreased from 70.7% to 53.7%, indicating a shift toward a healthier metabolic phenotype. Conclusion: A low-calorie, MCT-enriched diet effectively improves anthropometric and metabolic parameters in individuals with obesity, supporting its potential as a nutritional strategy for metabolic syndrome management in Indonesia.
Background: Epilepsy is one of the most prevalent neurological disorders and is increasingly recognized to coexist with metabolic disturbances, including insulin resistance and impaired insulin sensitivity. This study aimed to examine the association between dietary selenium intake and multiple metabolic indices among adults with epilepsy. Methods: A total of 484 adults with epilepsy were identified from the National Health and Nutrition Examination Survey (NHANES). Dietary selenium intake was assessed using 24-hour dietary recalls and categorized into quartiles. Associations between selenium intake and multiple metabolic indices, including Triglyceride-glucose (TyG), Triglyceride-glucose-body mass index (TyG-BMI), Triglyceride-glucose-waist circumference (TyG-WC), homeostatic model assessment-insulin resistance (HOMA-IR), glucose-to-insulin (GI) ratio, McAuley index, and Quantitative Insulin Sensitivity Check Index (QUICKI), were evaluated using multiple linear regression models. Results: In fully adjusted models (model 4), dietary selenium intake showed a statistically significant positive association with TyG-WC in both continuous ( β = 1.69, [95% confidence interval {CI} = 1.08, 2.31]; P < 0.001) and quartile analyses ( β Q2 vs. Q1 = 290, [95% CI = 260–320], β Q3 vs. Q1 = 194, [95% CI = 159, 230], β Q4 vs. Q1 = 56.5, [95% CI = 20.0, 93.1]; P trend = 0.014). Selenium intake was also positively associated with TyG-BMI ( β = 0.433, [95% CI = 0.190, 0.675]; P < 0.001) and HOMA-IR ( β = 0.030, [95% CI = 0.02, 00.039]; P < 0.001) in continuous analyses. In contrast, insulin sensitivity indices, including QUICKI ( β Q4 vs. Q1 = −0.010 , [95% CI = −0.016, −0.005]; P < 0.001), GI ratio ( β Q4 vs. Q1 = −12.8 , [95% CI = −17.4, −8.22]; P < 0.001), and the McAuley index ( β Q4 vs. Q1 = −1.47, [95% CI = −2.02, −0.921]; P < 0.001), showed inverse associations with higher selenium intake. The association with the TyG index was non-linear after full adjustment. Conclusions: Higher dietary selenium intake was most consistently associated with increased TyG-WC, suggesting a closer link with central adiposity-related insulin resistance in adults with epilepsy. Concurrent inverse associations with insulin sensitivity indices highlight a less favorable metabolic profile at higher selenium intake levels. These findings underscore the importance of considering metabolic heterogeneity when evaluating dietary selenium exposure in individuals with epilepsy.
Background: Leukemia comprises a heterogeneous group of hematologic malignancies and remains a leading cause of cancer-related mortality among young individuals. Although its precise etiology is not fully understood, known risk factors include immunosuppression, exposure to ionizing radiation, carcinogenic chemicals, and oncogenic viruses. Conventional treatment strategies, including cytotoxic agents and chemotherapy, are often effective but are frequently associated with severe adverse effects, therapeutic failure, drug resistance, and poor patient compliance, underscoring the urgent need for safer and more effective therapeutic alternatives. Methods: A comprehensive literature search was conducted using SciVerse Scopus ® (Elsevier Properties S.A., USA), Web of Science ® (Thomson Reuters, USA), and PubMed ® (U.S. National Library of Medicine, USA) from inception to December 2024. Relevant studies were identified using keywords such as “mushrooms,” “leukemia,” “antileukemic properties of mushrooms,” and “blood cancer.” Results: Mushrooms, long valued as functional foods and integral components of traditional medicine, have recently attracted growing scientific interest for their potential anticancer properties, particularly against leukemia. This review highlights medicinal mushrooms with pronounced antileukemic activity and summarizes their mechanisms of action in leukemia prevention and treatment. Species such as Ganoderma lucidum , Agaricus blazei , Coriolus versicolor , and Cordyceps militaris have demonstrated significant inhibitory effects on leukemia cell proliferation and progression by modulating key signaling pathways, including phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR), Hedgehog, Wnt/ β -catenin, p53, and Ras. In addition, these mushrooms exert notable immunomodulatory effects via both immune checkpoint–dependent and immune checkpoint–independent mechanisms. Bioactive constituents such as small molecules, polysaccharides, saccharides, and antitumor proteins derived from mushrooms further contribute to their antileukemic potential. Conclusions: Despite encouraging evidence from a total of 109 in vitro and in vivo studies, the clinical translation of mushroom-derived antileukemic agents remains limited due to challenges such as variability in extract composition, insufficient pharmacokinetic data, and a lack of well-designed clinical trials. Future research should focus on the isolation and standardization of active compounds, mechanistic validation using advanced molecular approaches, optimization of bioavailability, and rigorous preclinical and clinical investigations. Addressing these limitations may facilitate the development of mushroom-based therapeutics as complementary or alternative strategies for leukemia management.
Background: The potential carcinogenic role of iron—particularly heme iron—has been proposed based on its pro-oxidant and nitrosating capacity, but systematic reviews show heterogeneous results. The objective of this study is to synthesize the evidence from systematic reviews on iron consumption/exposure and cancer risk, assessing methodological quality, certainty of evidence, and use of causal inference frameworks. Methods: Systematic reviews of observational studies on dietary iron (total/heme/non-heme) or biomarkers vs . cancer incidence were included. Searches were conducted in PubMed, Scopus, Embase, and Web of Science, without language restriction. A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2), Risk Of Bias In Systematic reviews (ROBIS), and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were applied. Results: Nine reviews met the inclusion criteria. For colorectal cancer, three cohort meta-analyses found a positive association between heme iron and risk (per 1 mg/day: relative risk [RR]: 1.08–1.18), with low to moderate heterogeneity and extensive adjustment; GRADE: low. In esophageal cancer, total iron was associated with lower risk and heme iron with higher risk in dose–response analyses; GRADE: very low due to inconsistency and imprecision. In lung and breast cancer, syntheses showed null associations for total and heme iron; a subgroup of women suggested a modest increase with heme iron in lung cancer; GRADE: low. Biomarkers yielded mixed results. Methodological quality was low to moderate; no use of directed acyclic graphs (DAGs), G-methods, or causally justified confounder sets was identified. Conclusions: The evidence shows a consistent and modest association between heme iron and colorectal cancer (RR: 1.08–1.18 per additional mg/d), with a dose–response gradient and low heterogeneity, although certainty is low due to residual confounding and measurement error. No consistent evidence of association was found between total dietary iron or non-heme iron and cancer risk. For esophageal cancer, findings are paradoxical and of very low certainty; for lung and breast cancer, null effects predominated. The universal absence of formal causal frameworks in the included reviews limits causal inference.
Background: To critically evaluate the biological and epigenetic pathways through which pranayama may influence metabolic regulation relevant to the prevention and management of type 2 diabetes mellitus. This review also synthesizes mechanistic findings across oxidative stress pathways, mitochondrial bioenergetics, inflammatory signaling, cortisol dynamics, and autonomic regulation to analyze how breath-based interventions may modulate diabetes-related molecular and physiological processes. Methods: Databases were searched for the decade 2014–2024 using the Keywords “Pranayama,” or “Pranayama therapy,” and “Oxidative stress,” and “Mitochondrial function,” and “cortisol,” and “Autonomic nervous system,” in combination with “Type 2 Diabetes” or “Diabetes Mellitus.” The review aimed to provide a comprehensive discussion of the current topic and, thus, does not include any specific data synthesis. Results: Current literature demonstrates that pranayama modulates several biological pathways implicated in both the development and management of type 2 diabetes. Studies report reductions in reactive oxygen species (ROS) and improvements in total antioxidant capacity (TAC), indicating enhanced regulation of oxidative stress. Improved NAD + levels and COX-II activity suggest a positive influence on mitochondrial function. Additionally, pranayama has been shown to lower cortisol levels and C-reactive protein (CRP) while improving autonomic balance, all of which are associated with improved insulin sensitivity and glycemic control. Conclusions: By mitigating oxidative stress, enhancing mitochondrial efficiency, modulating inflammation, lowering stress-related cortisol secretion, and improving autonomic nervous system tone, pranayama may support both the prevention and management of type 2 diabetes. Future randomized controlled trials are warranted to further validate these mechanisms and clinical outcomes.
Background: The inflammatory potential of diet and the accumulation of advanced glycation end products (AGEs) are key factors contributing to cellular dysfunction and aging-related processes. The dietary inflammatory index (DII) is a validated tool used to quantify the inflammatory potential of dietary intake. This study aimed to investigate the association between serum carboxymethyl lysine (CML), a major biomarker of AGE burden, and DII scores. Methods: A total of 149 volunteers were included. DII scores were calculated based on three-day dietary records. Anthropometric measurements were obtained using the Tanita MC 980 body composition analyzer. Serum CML levels were measured using the enzyme-linked immunosorbent assay. Results: A statistically significant but weak inverse correlation was observed between serum CML levels and DII scores ( r = −0.175; P = 0.033). Serum CML concentrations did not differ significantly according to sex, body mass index, or presence of chronic disease ( P > 0.05 for all). Conclusions: These findings demonstrate an inverse association between dietary inflammatory potential and circulating CML levels, highlighting the potential role of diet-related inflammation in AGE formation and aging-associated metabolic processes. Although the observed correlation was modest, the results emphasize the complex biological interplay between diet, inflammation, and AGE accumulation. Given the relatively young study population and limited sample size, the findings should be interpreted cautiously. Future studies including larger and more diverse cohorts, as well as comprehensive assessments of dietary components and antioxidant capacity, are warranted to inform dietary strategies for the prevention of AGE-related diseases.
Colorectal cancer (CRC) is the most prevalent cancer that affects both genders, making it among the top three cancers in terms of both incidence and mortality. Natural products, known for their bioactive compounds, are essential resources for treating various health disorders, including cancer. This systematic review investigates the effectiveness and safety of these natural products in managing CRC that underwent clinical studies and examines their mechanisms of action. PubMed, Google Scholar databases, Science Direct, and Scopus were examined thoroughly for relevant literature using terms like “Natural products against colorectal cancer” and “Clinically investigated medicinal plant against colorectal cancer,” among others. The current study aimed at understanding the beneficial impacts and mechanisms of action of medicinal plants that have undergone clinical study for their efficacy in the fight against CRC, including Green tea extract, B6-pyridoxine, Aged Garlic, Berberine, Camptothecin, Curcumin, Epothilones, Korean Red Ginseng, Fucoidan, Lycopene, Resveratrol, Rhus verniciflua Stokes (RVS), Silybum marianum L., Probiotics, Ganoderma lucidum, Plocabulin, Everolimus, Anthocyanin. The chosen natural products showed a substantial protective impact against CRC in a varied study. These products demonstrated beneficial effects mediated by numerous physiological processes associated with cell cycle, apoptosis, inflammation, angiogenesis, cell growth and survival, etc, and importantly, a few of them exhibited mild undesirable effects in patients. This review indicates that the medicinal plants discussed have the potential to lower CRC. Nonetheless, comprehensive investigations are warranted to clarify their underlying molecular pathways and assess their safety profiles for clinical application.
Whether physical activity (PA) could modify the association between alcohol consumption and digestive system cancer (DSC) is still unclear. The primary aim of this study was to evaluate the independent and joint effects of PAs in various intensities and alcohol consumption on DSC risk. A total of 305,699 participants free of cancer at baseline in the UK Biobank were included in this study. PAs, including total PA (TPA), vigorous PA (VPA), moderate-to-vigorous PA (MVPA), moderate PA (MPA), walking and leisure-time PA (LTPA), were self-reported at baseline. Multivariate Cox regression models were used to evaluate the independent and joint associations between PAs, alcohol consumption, and outcomes (DSC, digestive tract cancer, and digestive accessory organ cancer). Except walking, higher levels of PAs were associated with a lower risk of DSC. The inverse associations were more evident for VPA (hazards ratio [HR] = 0.90 [95% confidence interval {CI} = 0.84–0.95]) and MVPA (HR = 0.86 [95% CI = 0.81–0.92]) than TPA, MPA, and LTPA. No additive or multiplicative interactions between PA and alcohol consumption on DSC risk were detected. When stratified by PA, harmful drinking was consistently associated with increased DSC risk. Similar trends were found for digestive tract cancer and digestive accessory organ cancer. PA, especially VPA and MVPA, was inversely associated with DSC risk. However, a high level of PA could not counteract the detrimental effect of alcohol consumption on DSC risk. Our results support current recommendations about alcohol cessation even in physically active individuals.
Cardiovascular diseases (CVDs) impact hundreds of thousands of individuals worldwide and pose a serious threat to global health. These illnesses are the main cause of death and morbidity; they include ailments like coronary artery disease, stroke, and hypertension. Their pervasiveness puts a burden on healthcare systems and emphasizes the critical need for efficient management, therapy, and prevention techniques to lessen their effects. Despite the widespread use of cardiovascular medications, uncertainties regarding their long-term safety and effectiveness remain. Due to these concerns, there has been growing interest in the use of nutraceuticals as complementary or alternative treatments for CVDs. Nutraceuticals that have shown promise for improving cardiovascular health include the fatty acids omega-3, dietary fibers, phytosterols, and polyphenols. These compounds, derived from food sources, possess anti-inflammatory, antioxidant, lipid-lowering, and mitigating oxidative stress properties that can enhance cardiovascular health. This review underscores the evidence supporting the benefits of these nutraceuticals in the prevention and management of CVD. It details their potential benefits and mechanisms, providing a solid foundation for future research. This includes the development of standardized formulations and the execution of large-scale clinical trials to validate their long-term effectiveness and safety. Establishing clear guidelines based on robust evidence will be crucial for effective integration of nutraceuticals into clinical practice. Integrating nutraceuticals with traditional treatments can enhance patient outcomes and offer a holistic approach to cardiovascular health. This will ensure patients receive optimal benefits from both conventional and alternative therapies, leading to improved health outcomes globally.
Obesity is a growing public health concern in India, affecting over 135 million individuals, with urban and Indigenous populations increasingly vulnerable. Mizoram, one of the most urbanized states in Northeast India, has a predominantly tribal population and high literacy rates, yet obesity prevalence among the Mizo tribe remains significant. Concurrently, social media use among youth has surged, influencing dietary habits, body image, and lifestyle behaviors. Despite these trends, limited research has examined the impact of social media on food consumption and obesity among Indigenous youth in Mizoram. This study investigates the influence of social media on eating behaviors and obesity risk among young adults in Aizawl. A cross-sectional survey was conducted between July 2023 and January 2024 among tribal young adults aged 18 to 35 years residing in Aizawl, India, who actively used social media daily. Convenience sampling recruited 521 participants. Data were collected using a validated 31-item questionnaire assessing sociodemographic characteristics and social media influence on food consumption, scored on a five-point Likert scale (range: 0–72). Body mass index (BMI) was measured using World Health organization (WHO) Asian-specific cutoffs (≥25 kg/m² classified as obese). Statistical analysis was performed using SPSS v20, with binary logistic regression applied to identify predictors of social media influence and obesity ( P < 0.05). Of the 521 participants, 62% were female, and 90% resided in urban areas. The median BMI was 23.45 kg/m² (interquartile range [IQR]: 20.72–25.39), with 20% classified as obese. Only 20% reported regular exercise, while 62.8% attributed weight gain to junk food consumption. Social media influence was notable, with 65.1% following influencers and 47% categorized as highly affected by social media regarding eating attitudes (median score: 22 [IQR: 13–29]). Logistic regression indicated that following influencers (odds ratio [OR] = 2.94) and reporting junk food–related weight gain (OR = 5.41) significantly predicted susceptibility to social media influence, while male sex (OR = 1.94) and age 30 to 35 years (OR = 3.87) predicted obesity risk. Social media significantly shapes dietary behaviors and obesity risk among Indigenous youth in Aizawl. Influencer-driven content and junk food marketing contribute to unhealthy eating patterns, even among highly educated populations. These findings underscore the need for culturally tailored interventions, digital nutrition literacy programs, and policy measures to regulate food advertising and promote Indigenous diets. Future longitudinal studies should explore causal relationships and integrate Indigenous food narratives to ensure sustainable health outcomes.
Prostate cancer is a prevalent and significant disease among men, leading to high mortality and morbidity worldwide. Various factors, including diet, lifestyle, and biological and environmental risks, are believed to contribute to prostate cancer progression. Consequently, the exploration of natural products as potential therapeutic agents for prostate cancer has gained attention. This study collected and analyzed clinical trial data from published research articles to investigate the chemopreventive properties, safety profile, and potential side effects of clinically investigated natural products in prostate cancer treatment. The consumption of phytochemical-rich foods has been proposed to minimize the chances of prostate cancer development. Notably, lycopene from tomatoes, green tea, broccoli, soy isoflavones, pomegranate fruit, omega-3 fatty acids from fish, and curcumin from turmeric have demonstrated significant chemopreventive activity in certain instances. Their effects were evaluated based on parameters such as prostate-specific antigen (PSA) levels, prostate cancer rates, progression, and hormonal markers. However, the outcomes of previous clinical trials investigating natural products in prostate cancer prevention remain inconclusive, possibly due to heterogeneity and limited sample sizes. To ascertain the true chemopreventive potential of these natural products, larger clinical trials involving diverse populations and further investigations are warranted. This review emphasizes the significance of natural products with emerging evidences in prostate cancer prevention, providing mechanistic insights and concise information from clinical trials.
As a carcinogenic environmental pollutant, arsenic has been observed to be associated with the development of coronary artery heart disease (CAD) in previous observational studies of occupational populations or populations residing in contaminated areas. Recently, it has been found that arsenic accumulates in rice and other crops that radiate globally with active commodity trade, providing a potentially underestimated arsenic exposure environment for the general population. However, there have been no studies on whether this low-dose arsenic contamination via food sources could lead to CAD of current concern. At present, studies have determined that the strength of arsenic metabolism is related to arsenic poisoning, and three single nucleotide polymorphisms (SNPs) related to arsenic metabolism have been found. The study aims to infer causality between arsenic poisoning and CAD at the genetic level, and especially applies to such low-dose, long-term exposure to arsenic using mendelian randomization (MR). Using data on three different populations from genome-wide association study, we estimated the association of CAD risk with three types of urinary arsenic (representing metabolic efficiency): inorganic arsenic (iAs), monomethylarsinate (MMA), and dimethylarsinate (DMA) by two-sample MR. No significant associations were obtained in Mixed population (iAs% P = 0.882, MMA% P = 0.925, DMA% P = 0.901), East Asian population (iAs% P = 0.959, MMA% P = 0.505, DMA% P = 0.662) and European population (iAs% P = 0.242, MMA% P = 0.395, DMA% P = 0.317). Heterogeneity of the three SNPs observed in Asian populations. This study did not provide evidence to support a causal relationship between arsenic poisoning and CAD at the genetic level in multiple populations irrespective of gender.
Inflammatory bowel disease (IBD) is a chronic inflammatory condition affecting the digestive tract. The precise etiology of IBD remains unclear; however, there is a growing body of evidence suggesting that dietary factors may play a significant role in the pathogenesis of this disease. Dietary habits exert a significant influence on the structure of the gut microbiota, which in turn plays a pivotal role in maintaining intestinal balance. Conversely, intestinal inflammation has the potential to trigger gut dysbiosis, which affects the absorption of nutrients by host cells and gut microbiota. The interaction between diet and gut microbiota is impaired in individuals with IBD. A deeper understanding of the complex links between diet and the gut microbiome offers vital insights into the pathogenesis of IBD and encourages the creation of novel therapeutic approaches. This article reviews the current literature on the interaction between diet, probiotics, and gut microbiota in maintaining gut homeostasis.
Flavonoids possess anti-inflammatory, antioxidant, and free radical scavenging properties. Nevertheless, evidence regarding the relationship between dietary flavonoid intake and frailty remains sparse. This study aimed to examine the association between dietary flavonoid intake and the risk of frailty in U.S. adults. We analyzed data from a nationally representative sample of 3582 middle-aged and older adults from the 2007–2008, 2009–2010, and 2017–2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Flavonoid intake was assessed using a 24-hour dietary recall method. Frailty was measured using a 53-item frailty index. Multivariate logistic regression and restricted cubic splines were used to estimate the association between dietary flavonoid intake and frailty risk. After adjustment for potential confounders, individuals in the highest tertile of total flavonoid intake (odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.48–0.84), flavan-3-ol intake (OR: 0.72, 95% CI: 0.56–0.92), and flavonol intake (OR: 0.69, 95% CI: 0.52–0.91) exhibited a significantly reduced risk of frailty compared to those in the lowest tertile. Restricted cubic spline analysis revealed a non-linear L-shaped relationship between total flavonoid intake and frailty ( P for non-linearity <0.001). Additionally, a non-linear L-shaped dose–response relationship was observed for the risk of frailty with flavan-3-ol intake ( P for non-linearity = 0.005), while a linear dose–response relationship was found with flavonol intake ( P for non-linearity = 0.365). These findings suggest that higher dietary intake of flavonoids, particularly flavan-3-ols and flavonols, was associated with a lower risk of frailty.
The Food is Medicine (FIM) approach has emerged as a promising strategy to address the dual public health challenges of food insecurity and diet-related chronic diseases. Rooted in the concept of using nutrition as a therapeutic intervention, FIM programs such as medically tailored meals (MTMs), medically tailored groceries (MTGs), and produce prescriptions (PRx) aim to integrate food-based support into clinical care. Findings suggest that MTMs are associated with improvements in diet quality, glycemic control, and reductions in hospitalizations and healthcare costs, particularly among patients with diabetes and cardiovascular disease. Produce prescription programs have shown potential in increasing fruit and vegetable consumption, reducing food insecurity, and improving metabolic health indicators, though results vary across populations and program designs. Early research in oncology populations also indicates that FIM interventions may enhance nutritional status and treatment tolerance. Despite these encouraging outcomes, the evidence base remains limited by small sample sizes, short intervention durations, and inconsistent evaluation metrics. Challenges to widespread implementation include limited access to FIM services among underserved populations, reliance on temporary funding sources, and insufficient integration of nutrition education. Additionally, most current programs target a relatively small segment of the population affected by poor diet quality. Broader policy and public health strategies may be needed to complement FIM efforts and address the root causes of nutrition-related disparities. In conclusion, FIM programs represent a valuable addition to the healthcare landscape, with demonstrated benefits in select populations. To maximize their impact, future research should focus on evaluating long-term outcomes, expanding reach to marginalized groups, and assessing cost-effectiveness. A coordinated effort that combines food assistance with nutrition education and policy-level interventions may offer a scalable solution to improve population health and reduce the burden of chronic disease.
Malnutrition in hospital settings requires prompt intervention. Nutritional screening tools like the Malnutrition Universal Screening Tool (MUST) and Nutrition Risk Screening 2002 (NRS 2002) are widely used, but their efficacy in Indian hospital settings remains poorly documented. This study aimed to evaluate and compare the diagnostic performance of the MUST, NRS 2002, and the Indian Malnutrition Self-Screening Tool (IMSST) with a context-specific modified nutritional screening tool developed for Indian inpatients. It was hypothesized that the modified tool would offer improved contextual relevance and balanced accuracy, supporting precision-based nutritional risk assessment in clinical settings. A cross-sectional study was conducted in a tertiary care hospital, involving 200 patients aged 30 to 60 years admitted to various wards. Nutritional risk screening was performed within 24 to 48 hours of admission using MUST, NRS 2002, IMSST, and the modified tool. Agreement between tools was assessed using Cohen’s κ, and diagnostic performance was evaluated through sensitivity, specificity, predictive values, and receiver operating characteristic (ROC) analysis. Among 200 inpatients (mean age 47.6 ± 11.1 years; 64% male), the modified tool and IMSST identified the highest proportion at risk (63.5% and 71.0%). The modified tool showed excellent agreement with IMSST ( κ = 0.80; 91.0%), high sensitivity (87.9%), specificity (98.3%), and the highest accuracy (91.0%) among all tools. MUST demonstrated moderate sensitivity (63.6%), while NRS 2002 had the lowest (40.8%) but high specificity (94.8%). The modified tool achieved the highest average area under the ROC curve AUC (0.809), indicating strong discriminative performance across body mass index (BMI) groups and clinical settings. The context-specific modified screening tool, aligned with Global Leadership Initiative on Malnutrition (GLIM) criteria, exhibited enhanced diagnostic precision, overall performance and contextual adaptability, as compared to MUST, NRS 2002, and IMSST. Its high sensitivity positions it as a reliable tool for early nutritional intervention. Findings affirm the study hypothesis and highlight its value in precision nutrition care. Further validation in larger cohorts is recommended.
Background:Mitochondrial dysfunction has been linked with metabolic disorders, given the central role of mitochondria in multiple crucial metabolic processes. However, little is known about how maternal metabolic conditions may affect mitochondrial function in newborns, although several other prenatal exposures have been associated with impaired mitochondrial function in either the placenta or cord blood. This study aimed to assess the association between maternal metabolic conditions and mitochondrial DNA copy number (mtDNA-CN, as a biomarker for mitochondrial function) in newborns. Methods:Among 999 mother-newborn pairs from the Boston Birth Cohort, mtDNA-CN in newborn umbilical cord blood and maternal blood collected at delivery were measured by a targeted genome sequencing approach. Linear regressions were used to evaluate the association between maternal metabolic conditions (diabetes mellitus, pre-pregnancy obesity, and the combination of the two conditions) and mtDNA-CN Z-scores in cord blood. The models were initially adjusted for maternal and child demographic and lifestyle characteristics, followed by additional adjustment for maternal mtDNA-CN to explore its potential influence on the results. Results:In this sample, 23.6% of mothers had pre-pregnancy obesity, and 13.6% had diabetes. In models examining the two conditions separately, both maternal diabetes (Beta = 0.18, 95% CI: 0.00, 0.36, p = 0.054) and obesity (Beta = 0.10, 95% CI: -0.04, 0.25, p = 0.166) were associated with increased cord blood mtDNA-CN Z scores, but neither association reached statistical significance. When examined together, newborns whose mothers had both diabetes and pre-pregnancy obesity had statistically significantly higher cord mtDNA-CN Z scores (Beta = 0.35, 95% CI: 0.08, 0.63, p = 0.012) compared to newborns whose mothers did not have the two conditions. Further adjustment for maternal blood mtDNA-CN did not substantially alter the above associations. Conclusion:Maternal diabetes and obesity jointly were associated with higher levels of cord blood mtDNA-CN. Future studies should further assess whether cord blood mtDNA-CN explains the link between maternal metabolic conditions and offspring health outcomes.
