BackgroundHypothyroidism is a prevalent endocrine disorder with wide-ranging metabolic and psychological consequences. While links between thyroid dysfunction, obesity, and depression are recognized, few studies have concurrently explored dietary factors, body composition, and mental health in women, the most affected population.ObjectivesTo assess dietary and micronutrient intake, body composition, and psychological well-being in women with hypothyroidism compared with euthyroid controls.MethodsIn this cross-sectional study, 128 women (64 with hypothyroidism; 64 euthyroid) were evaluated. Dietary and micronutrient intake were assessed via a 24-h recall and food frequency questionnaire analyzed using BEBİS 8.1 Nutrition System. Anthropometric indices included body mass index (BMI) and waist-to-hip ratio (WHR). Psychological status was assessed with the Beck Depression Inventory-II (BDI-II) and Perceived Stress Scale-10. Multiple linear regressions identified independent predictors of psychological outcomes.ResultsWomen with hypothyroidism exhibited higher BMI (26.58 ± 4.96 vs 23.58 ± 4.56 kg/m2; p = 0.001) and WHR (0.83 ± 0.09 vs 0.79 ± 0.09; p = 0.011). Depression scores were higher in hypothyroid group (BDI-II: 23.9 ± 21.4 vs 15.7 ± 11.6; p = 0.008), whereas perceived stress did not differ (p = 0.752). Micronutrient intake, including iodine and iron, was comparable between groups. BMI and hypothyroidism were independent predictors of depressive symptoms and perceived stress (p < 0.01; Cohen's d = 0.63).ConclusionHypothyroid women exhibit adverse body composition and higher depressive symptoms independent of diet. The associations between adiposity, depression, and stress emphasize the interconnection between metabolic and mental health. These findings highlight the holistic management combining hormonal, nutritional, and psychological care.

BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disease causing joint damage and disability. Vitamin D (VD) shows immunomodulatory effects in RA, but its causal role and potential mediation by sex hormones remain unclear.ObjectivesTo examine the VD-RA causal relationship and investigate androgen/estrogen mediation using Mendelian randomization (MR).MethodsWe conducted two-sample MR analyses using UK Biobank and IEU OpenGWAS data, with genetic variants as instruments. Mediation analyses assessed sex hormone effects.ResultsDietary VD associated with reduced RA risk (odds ratio (OR) = 0.994, 95%CI 0.992-0.996). Protective effects were stronger in males with seropositive RA (OR = 0.97, 95%CI 0.96-0.99) and females with seronegative RA (OR = 0.99, 95%CI 0.98-0.99). VD significantly lowered female testosterone (OR = 0.54, 95%CI 0.42-0.66), a RA risk factor (OR = 1.03, 95%CI 1.01-1.04), but did not affect male testosterone or female estrogen levels.ConclusionVD may reduce RA risk via gender-specific mechanisms, particularly by decreasing female testosterone. While MR supports causality, potential confounding requires cautious interpretation.

BackgroundGut microbiota plays an essential role in metabolic and immune functions, and its composition is influenced by diet and probiotic intake. The Mediterranean diet (MD) improves microbiota diversity and health outcomes. However, the association between microbiota awareness, MD adherence, and probiotic consumption among adults is underexplored.AimThis study aimed to examine the relationship between MD adherence, microbiota awareness, and probiotic consumption among adults aged 18-64 years in the central district of Kırklareli, Türkiye.MethodsA cross-sectional survey was conducted with 420 individuals familiar with the term "probiotic." Data were collected via face-to-face interviews using a structured questionnaire including sociodemographic data, dietary habits, physical activity, anthropometrics, probiotic use, the Microbiota Awareness Scale (MAS), and the MD Adherence Scale. Descriptive and inferential statistics were used.ResultsAmong participants, 45% showed high MD adherence. Higher MAS scores were observed in females, those aged 26-35, with normal BMI, or prior nutrition education. Regular probiotic consumers had significantly higher MD adherence (p = 0.011) and MAS scores (p = 0.000). A weak but significant correlation was found between MAS and MD adherence (r = 0.120, p = 0.014). Awareness of probiotic microorganisms and consumption for digestive, immune, or cancer-related benefits were also associated with greater MAS and MD scores.ConclusionMicrobiota awareness is positively associated with probiotic consumption and MD adherence. Increasing microbiota literacy could potentially inform future dietary education strategies.

BackgroundZinc deficiency (ZD) is one of the most prevalent nutritional deficiencies reported in celiac disease (CeD). Oral supplementation and dietary modifications are the primary strategies for addressing it. However, it is unclear whether individuals with CeD would prefer to make additional dietary modifications or opt for supplementation to treat ZD.AimThis study aimed to explore patient preferences for the treatment of ZD.MethodsAdult patients (≥18 years) with a confirmed diagnosis of CeD who were already adopting a gluten-free diet (GFD) and had untreated ZD were recruited from the Adult Celiac Disease Clinic at McMaster University. After providing informed consent, participants completed study questionnaires at baseline and three months after initiating zinc supplementation. Data were collected using REDCap. Statistical analyses were performed using IBM SPSS software (V22, Chicago, USA).ResultsFrom March 2022 to January 2024, 44 participants were enrolled in the study. All completed baseline questionnaires, of them 25 (57%) completed questionnaires at follow-up. At baseline, 34% of participants preferred to treat nutrient deficiencies through dietary changes, compared with 28% at follow-up. Plasma zinc level normalized in all participants after 3 months of supplementation. At follow-up, the proportion of participants with significant gastrointestinal symptoms increased from 72% at baseline to 80% (p = 0.01).ConclusionsOne-third of patients with CeD preferred to manage nutrient deficiencies through dietary modifications. A zinc-optimized GFD may represent a promising approach to address zinc deficiency in this population. These findings provide preliminary evidence to inform the design of future randomized clinical trials.

BackgroundSevere Acute Malnutrition (SAM) among children is often characterized by the presence of morbidities, impacting recovery pathways. Even so, the effect of morbidity at admission on Length of Stay (LoS) among children with SAM admitted in Outpatient Therapeutic Program (OTP) in Rohingya contexts remains unexamined.Aims/objectivesTo estimate the effects of morbidity at admission on LoS of children with SAM admitted in OTP in Rohingya refugee camps in Bangladesh.Methods/methodologyA longitudinal study design was employed and data was collected from children with SAM admitted in four OTP centers in Rohingya refugee camps at Cox's Bazar, Bangladesh. A Kaplan-Meier survival estimate and Cox proportional hazards model were used to estimate the relevant effect.Results/FindingsA total of 297 children with SAM were included. Among them, 190 (63.97%) had morbidity at admission. The mean LoS (days) among children with SAM with and without morbidity at admission was 68 ± 10 and 64 ± 9 (p = 0.002), respectively. Furthermore, at any given time during follow-up, children with SAM who had morbidity at admission had 25% lower hazard (rate) of being discharged as cured (adjusted HR: 0.75, 95% CI: 0.59, 0.96, p = 0.03) compared with those without morbidity at admission, indicating a longer LoS and slower rate of recovery.ConclusionEffective prevention of morbidity at admission can improve nutrition program efficacy by decreasing the LoS and increasing the likelihood of recovery. These findings can inform integrated health-nutrition interventions in refugee contexts.

Background: Ageing is frequently associated with systemic inflammation and cognitive decline, yet the impact of diet and lifestyle factors on these age-related processes remains unexplored. Nutrient deficiencies, particularly in essential vitamins and minerals, may accelerate cognitive decline and heighten inflammation in older adults. Aim: This pilot study aimed to examine how dietary intake, body mass index (BMI) and physical activity affect plasma cytokine levels and cognitive performance in older adults. Methods: Twenty-nine healthy Irish adults, aged 65-85 years participated in the study. Physical examination, cognitive testing using the Cambridge Neuropsychological Test Automated Battery and plasma cytokine analysis (tumor necrosis factor-alpha [TNF-α], interleukin [IL]-6, IL-10, IL-8, IL-4, IL-1β) were conducted. Dietary intake was assessed using a validated Food Frequency Questionnaire, and physical activity was evaluated using the International Physical Activity Questionnaire. Summary: Participants with higher BMI and lower physical activity levels exhibited increased plasma concentrations of TNF-α, indicating elevated systemic inflammation and altered IL-10 levels, reflecting changes in anti-inflammatory regulation. Cognitive performance was poorer in participants who consumed excessive carbohydrates and polyunsaturated fatty acids and also in those whose total caloric intake fell below European Food Safety Authority dietary reference values. In contrast, participants with higher intake of saturated and monounsaturated fatty acids demonstrated better cognitive function. Deficiencies in vitamin B12, magnesium, manganese and copper were linked to elevated inflammatory markers and poorer cognitive outcomes. Conclusion: This study highlights the importance of nutrition and lifestyle in managing inflammation and cognitive decline in ageing. Targeted dietary interventions which address nutrient deficiencies may help preserve cognitive health and reduce inflammation in older adults.

BackgroundCircadian rhythm, the body's internal clock, synchronises with the 24-h light-dark cycle and is influenced by environmental cues such as light exposure and meal timing. Disruptions in this rhythm due to modern lifestyle factors, including irregular eating schedules, are linked to increased risks of cardiometabolic diseases. Time-restricted eating (TRE), which limits food intake to an 8-12 h window, often aligns with daytime (diurnal) eating and supports circadian alignment. In contrast, nocturnal TRE patterns, such as during Ramadan, may disrupt this rhythm by shifting food intake to nighttime.AimTo conduct a systematic review and meta-analysis evaluating the differential impacts of diurnal and nocturnal TRE on cardiometabolic health and circadian rhythm in healthy adults.MethodsThis review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and is registered with PROSPERO (CRD42023374947). A comprehensive search will be conducted using PubMed, Web of Science and Scopus. Two independent reviewers will screen titles, abstracts and full texts, extract data using a standardized form and assess risk of bias. Qualitative and quantitative (meta-analysis) synthesis will be conducted where appropriate.SummaryThis protocol outlines the methodology for synthesising current evidence on the differential effects of diurnal versus nocturnal TRE patterns. The findings will inform future dietary interventions aimed at optimising cardiometabolic health through circadian-aligned nutrition strategies.

BackgroundAerobic exercise improves fitness but can induce oxidative stress, muscle damage, and inflammation. Sesame (Sesamum indicum L.), rich in lignans and antioxidants, may help reduce these effects and support immune function.AimThis systematic review examines the synergistic effects of sesame supplementation and aerobic exercise on oxidative stress, muscle damage, immune response, and inflammatory markers in athletes.MethodsFollowing PRISMA guidelines, a systematic search of PubMed, Scopus, Web of Science, CENTRAL, and EMBASE was conducted up to September 2024. Eligible randomized controlled trials included semiprofessional athletes receiving sesame supplementation (oil, extract, capsule, or whole seed) for ≥4 weeks, with placebo or no-supplement comparators under identical training protocols. Primary outcomes assessed oxidative stress biomarkers, muscle damage markers, inflammatory cytokines, and immune response parameters.ResultsA total of 290 studies were initially identified, with four randomized controlled trials meeting the inclusion criteria after screening. These trials, spanning 4-10 weeks with a total of 140 participants, revealed that sesame supplementation significantly enhanced antioxidant defenses, as indicated by increased levels of glutathione peroxidase (GPx), superoxide dismutase (SOD), and vitamins A, C, and E, while reducing oxidative stress markers such as malondialdehyde (MDA). Additionally, the combination of aerobic exercise and sesame improved anti-inflammatory markers, including a reduction in interleukin-6 (IL-6) and interleukin-1β (IL-1β), though cytokine modulation appeared to be primarily attributable to exercise alone.ConclusionThese findings highlight the potential of sesame supplementation as a natural adjunct to exercise regimens in mitigating oxidative and inflammatory stress, with implications for enhancing athletic performance and recovery.

BackgroundEarly nutrition is critical to later health outcomes. Infants exposed to maternal incarceration are a marginalized population and may be at elevated risk for suboptimal feeding.AimTo assess adherence to recommended timing of complementary food introduction among infants exposed to maternal incarceration in utero.MethodsWe analyzed data from 69 infants and caregivers in Georgia. Formerly incarcerated mothers (n = 17) and nonmaternal caregivers (n = 52) reported timing of complementary food introduction. Regression analyses assessed associations with independent variables, including poverty, food insecurity, Supplemental Nutrition Assistance Program receipt, and caregiver education, psychological distress, and age.ResultsApproximately 47.8% of infants received complementary foods early, defined as before four months of age. The mean age of introduction was 3.6 months. Caregiver distress was associated with earlier introduction.ConclusionThis population of caregivers requires tailored nutrition education, financial assistance, and mental health and social support services to promote optimal infant feeding practices.