Abstract Vitamin D may help reduce the risk of colorectal cancer (CRC) by exerting an anti-inflammatory or modulatory effect on biomarkers associated with the disease. While previous studies have investigated individual biomarkers, our approach evaluates their combined effects. We investigated the association between 25-hydroxyvitamin D (25(OH)D) levels, measured using MS, and the expression of 92 inflammatory biomarkers assessed using the Olink Target 96 inflammation panel. This analysis was conducted in women from the Norwegian Women and Health Study (NOWAC), utilising plasma samples taken 1–6 years prior to CRC diagnosis ( n = 163) and 163 matched cancer-free controls. Factor analysis was used to identify biomarker patterns, and linear regression examined the association of each factor with 25(OH)D levels. Women with 25(OH)D deficiency (≤30 nmol/L) had significantly higher Factor 1 scores compared to those with sufficient levels (≥50 nmol/L) (β = 0.72, 95% CI: 0.26–1.18). This association was specific to pre-diagnostic CRC cases (β = 0.97, 95% CI: 0.33–1.60) and was not observed in cancer-free controls (β = 0.22, 95% CI: −0.50–0.93). Factor 1 represents a cluster of biomarkers, many of which are pro-inflammatory (TNFSF14, S100-A12, IL-8, IL-18) and many that play key roles in processes such as cell growth, angiogenesis, and apoptosis (OSM, TGF-alpha, VEGF-A, CASP-8). Several of these biomarkers have been independently linked to CRC, exhibiting both unfavourable and favourable roles. The observed association between 25(OH)D deficiency and Factor 1 in pre-diagnostic CRC cases supports the hypothesis that sufficient levels of vitamin D could potentially contribute to prevention of CRC development.
Abstract Household food (HFI) and water insecurity (HWI) have each been linked to poorer child health but their joint relationship is understudied. We used 2023–2024 Ecuadorian National Infant Malnutrition Survey data to examine the independent and joint associations of HFI and HWI exposure with illness, anaemia, and malnutrition in 6–59 month olds. The Food Insecurity Experience Scale measured marginal and moderate–severe HFI. Water indicators (source, availability, accessibility, microbial safety) measured HWI. We used a 4-category indicator to classify HFI only, HWI only, joint HFI/HWI, and secure food and water. Child respiratory (RI) and diarrheal illness (DI) were assessed from caregiver reports, anaemia from blood haemoglobin, and nutrition indicators from anthropometric measurements. Modified Poisson regression models estimated adjusted prevalence ratios (aPR). Joint HFI/HWI was associated with a higher RI and DI prevalence, HFI only with higher RI, stunting and overweight/obesity, and HWI only with higher overweight/obesity but lower anaemia. The age-stratified analyses linked joint HFI/HWI and HFI only to higher RI and DI in 6–23 month olds and higher RI in 24–59 month olds. Joint HFI/HWI and HWI were linked to lower anaemia. In 24–59 month olds, HFI only was associated with higher stunting and HWI only with higher overweight/obesity. Exclusion of marginal HFI in the sensitivity analysis identified child-level double malnutrition as more prevalent in 24–59 month olds from HFI only or joint HFI/HWI households. These findings suggest HFI and HWI independently and jointly influence child health and nutrition, underscoring the need for effective multisectoral policies and interventions simultaneously targeting both.
Abstract Happy Healthy Homes is a randomised controlled trial (RCT) studying the efficacy of in-person and virtual interventions on family child care home (FCCH) providers’ nutrition practices, self-efficacy, and Child and Adult Care Food Program (CACFP) knowledge. FCCH were randomly assigned to the intervention (NUT) or attention control (CON). Cohort1 (in-person 2017–2018) included 45 (NUT n = 24; CON n = 21) FCCHs. Cohort2 (virtual 2020) included 36 (NUT n = 15; CON n = 21) FCCHs. Outcomes included self-reported nutrition practices, confidence, barriers, and CACFP best practice knowledge. Measures were collected at 3 and 12 months. The primary 12-month analyses accounted for intent-to-treat and used a mixed model on all providers with 3-month outcomes including those who withdrew prior to 12-month assessments. At 12 months, both cohorts demonstrated significant effects. In Cohort1, NUT improved self-reported beverages provided and feeding environment, and confidence in serving healthy foods, while CON remained unchanged. No changes were observed for CACFP best practice knowledge. In Cohort2, NUT did not demonstrate a group effect over time for self-reported nutrition practices. NUT did increase confidence in serving healthy foods and decreased barriers related to food waste, whole grain service, children’s healthy eating habits, and CACFP best practice knowledge while CON experienced minimal changes. This study demonstrated that in-person and virtual interventions can help FCCHs improve their nutrition practices, confidence, and barriers in serving optimal foods, and knowledge in CACFP best practices. The utilisation of virtual interventions may increase reach in rural areas and be appealing to FCCH providers. Trial Registration: Clinicaltrials.gov, NCT03560050. Retrospectively registered on 23 May 2018. First participant enrolled October 2017. Trial protocol and analyses plan can be accessed on clinicaltrials.gov.
Abstract The study aimed to evaluate ultra-processed foods (UPFs) consumption among school-aged children and adolescents in Lebanon and examine factors associated with its intake. A cross-sectional national survey was conducted in 2014–2015 on a nationally representative sample of households with children and adolescents aged 5–18 years in Lebanon ( n = 1111). Dietary assessment was performed using 24-h recall method and UPF were identified based on the NOVA classification. Information pertinent to sociodemographic characteristics and physical activity levels was also collected. Percent of energy intake (%E) from UPF ranged between 48.3% and 51.4% amongst children in our study sample with pizzas, dough-based dishes, sweets, and fast food as main energy contributors. Overall, UPFs were the largest contributors to carbohydrates, total sugar, total fat, saturated fat, sodium, and iron intakes. Unprocessed or minimally processed foods contributed most to protein, fibre, calcium, zinc, and vitamins A and C intakes, while being the lowest contributors to sodium intakes. Age and sex-based differences in UPF intakes were also noted. Adjusted regression models showed that girls and children of working fathers had significantly lower %E from UPF compared to boys and children of unemployed fathers ( β : −0.18, 95% CI: −0.22, −0.14 and β : −0.27, 95% CI: −0.34, −0.20, respectively). In addition, higher household income was associated with increased %E from UPF. Public health action is needed to reduce the high UPF intake observed amongst children and adolescents in Lebanon and promote minimally processed, culturally appropriate diets to improve nutrition and protect the health of this vulnerable population.
Abstract In Switzerland, as in many other countries, national guidelines recommend individualized rather than systematic vitamin D supplementation in children beyond the age of three, making routine assessment challenging. This study aimed to examine paediatricians’ reported practices and opinions regarding vitamin D management in children aged 3–17 years in Geneva, Switzerland. A cross-sectional online survey was distributed to 193 paediatricians, of whom 59 completed the questionnaire (85% women). The questionnaire covered assessment frequency and methods, deficiency management, and views on systematic supplementation. Fewer than half reported assessing vitamin D adequacy at every check-up, with 49% ( n = 29) for children aged 3–10 years and 44% ( n = 26) for adolescents. Among children with clinical signs of deficiency, 76% ( n = 45) reported assessment at every check-up, compared with 63% ( n = 37) for children with dark skin or chronic digestive disorders and 58% ( n = 34) for those with overweight or obesity. Assessments relied mainly on reported supplementation, followed by diet and sun exposure. Regarding prophylactic supplementation, 61% of paediatricians were in favour for children aged 3–10 years and 76% for those aged 11–17 years. Among those opposed, the main reason cited was the absence of clear national guidelines. Overall, this survey highlights marked variability in paediatricians’ approaches to vitamin D, with routine assessment remaining infrequent, even among children with clinical signs of deficiency. This gap may leave vulnerable children and adolescents with undetected deficiency, underscoring the need for harmonized national guidance and targeted educational initiatives to support preventive paediatric care.
