The goal was to examine father's perspectives of family meals and their role during the meal. Family meals are protective for child health. However, little is known about influential factors that can ensure family meal occurrence. Parents are one such influential factor for family meal occurrence. Mothers' perspectives and family meals have been well researched, but fathers' have not. Fathers (n = 13) from different cultural backgrounds (i.e., Asian, Black, mixed, White) in two-parent households participated in a qualitative interview. A hybrid deductive and inductive qualitative approach was used in analysis. Eleven main themes were found from three research questions: (a) What purpose(s) do family meals serve in your family? (b) What is the role of fathers regarding parenting practices at family meals? and (c) What are barriers and facilitators of family meals? Findings about the purpose of family meals suggested family meals were passed on intergenerationally, created an environment for connection and trust, taught important life lessons and skills, and provided routines and rituals for families. Findings related to fathers' roles showed that fathers had family meal rules and engaged in food parenting practices during the meals. Findings related to barriers and facilitators of family meals included busy schedules and picky eating as barriers; facilitators included reducing other obligations, involving the family, and being creative. Engaging fathers in developing family meal interventions may be beneficial for child health and to lay a foundation for health across the life course.
Background: Plant and animal proteins have been shown to affect postprandial glycaemic, insulin, and appetite responses to carbohydrate meals. Here we compared lamb protein and soy protein effects on glycaemic response, insulin secretion and appetite, examining whether the protein source modified the relative glycaemic effects of different carbohydrate foods, and whether lamb and soy protein differed in their effects. Methods: Healthy participants (n = 15) were randomised to consume meals containing potato, pasta, or rice, either alone or combined with equal amounts of lamb or soy protein, and with lamb fat content equalised across meals. Blood glucose and insulin responses were measured over the postprandial period, and subjective appetite was assessed. Results: Both lamb and soy protein reduced postprandial glycaemic responses and increased insulin responses compared with the carbohydrate staples consumed alone. Soy protein induced a slightly lower glycaemic response than lamb protein (132 ± 18 vs. 144 ± 13; 103 ± 16 vs. 123 ± 19; 112 ± 12 vs. 130 ± 17 mmol/L.min, potato, pasta and rice, respectively), although differences were small and not consistently significant. Adding protein also reduced the differences in glycaemic responses between the carbohydrate staples, particularly diminishing the higher response to potato. Both protein sources suppressed appetite to a similar extent relative to the carbohydrate-only meals. Conclusions: Adding protein to mixed meals had a dominant effect on postprandial glycaemic, insulin, and appetite responses, whereas the specific protein source (lamb versus soy) had a minor influence. These findings indicate that, under the conditions of this study, both animal and plant proteins were effective in moderating postprandial glycaemia and enhancing satiety.
The aquafeed industry is seeking sustainable alternatives to fishmeal, and insect meals are promising candidates. However, quantitative syntheses of their effects on non-fish aquatic animals like shrimp, crabs, turtles, and frogs are limited. This meta-analysis evaluated five insect meals-black soldier fly, Coleoptera, housefly, silkworm, and Orthoptera-on specific growth rate (SGR), weight gain rate (WGR), and feed conversion ratio (FCR). A total of 69 studies (2004-2025) were included. Hedges' g was pooled using random-effects models, and meta-regressions examined dose-response relationships. Among all categories, only silkworm meal improved or maintained growth, showing no significant negative dose-response relationship. In contrast, black soldier fly and Coleoptera meals impaired growth, with a negative linear dose-response. Subgroup analyses revealed species-specific responses; shrimp, particularly Litopenaeus vannamei, exhibited growth depression, whereas some crab species, including Scylla paramamosain and Eriocheir sinensis, showed tolerance or improved performance. Housefly and Orthoptera meals were evaluated in fewer studies, precluding firm conclusions. Thus, the efficacy of insect meal substitution is jointly determined by insect type and host physiology. Silkworm pupae meal is a favourable fishmeal alternative, while black soldier fly and Coleoptera meals require conservative inclusion limits, especially for shrimp.
Background/Objectives: School feeding is a fundamental component of public policies aimed at promoting health, improving educational outcomes, reducing inequalities, and guaranteeing the human right to adequate food. This study aimed to evaluate the nutritional quality of school meals offered to public school students in a federal unit of Brazil, quantify the environmental impacts using carbon and water footprints, and simulate potential reductions through a strict vegetarian menu. Methods: This cross-sectional, descriptive study analyzed 130 daily menus (390 meals) from full-time public schools in the Federal District of Brazil in 2024. Nutritional quality was assessed based on energy, nutrients, food groups, degree of processing, and food origin. Carbon and water footprints were estimated using literature-based indicators. A nutritionally adequate strict vegetarian menu was then developed and compared with the observed menus. Results: The current menus presented good overall nutritional quality, with high food diversity and predominance of fresh or minimally processed foods. Most nutritional parameters met the recommended levels; however, protein and saturated fat exceeded the recommended limits. Animal-based foods accounted for most of the carbon and water footprints. The simulated strict vegetarian menu demonstrated significantly lower environmental impacts while maintaining nutritional adequacy. Conclusions: These findings highlight the importance of integrating nutritional and environmental strategies, such as a weekly "Meatless Monday" initiative alongside food and nutrition education, to improve student health outcomes and reduce the environmental burden of public school meals. Incorporating environmental sustainability criteria into school meal planning and public food procurement may advance nutritional quality, resource efficiency, and climate goals, positioning school feeding programs as strategic instruments for sustainable development.
Mobile-based dietary assessment tools have the potential to capture real-time eating behaviors and food environment exposure, but their feasibility and usability in workplace contexts remain underexplored. To evaluate the feasibility and usability of the Mobile Sense App among employees and students at the Karolinska Institute. This study employed the Mobile Sense App, which was developed to record dietary intake and food purchasing patterns through photographs and geospatial data. The study combined data from the pre-pilot and pilot studies (n=56). Participants, who were students and employees at a public institution, completed a baseline questionnaire and used the application (app) for two weeks to photograph all meals, snacks, and drinks consumed during working hours on campus. Adherence was evaluated based on the number of photographs submitted over a six-day monitoring period. Usability was assessed using the System Usability Scale (SUS). Image data were manually annotated, ultra-processed foods (UPFs) were identified according to the NOVA classification system, and inter-rater reliability was evaluated using Cohen's κ. Food purchasing 'hotspots' were examined through geospatial analyses. Participants submitted n=1178 photographs. Cohen's κ indicated strong agreement between independent researcher annotation (κ=1.00 for meals/snacks; κ=0.91 for drinks). The mean SUS score was 75.2 ± 12.2. Store-bought meals showed a higher prevalence of UPFs (64%) than home-made meals (13%) (χ2 (1)=178.63, p<.001). Global Positioning System (GPS) data indicated food purchases clustered around campus dining areas. Open-ended feedback emphasized the need for reminders, clarity in user interface (UI) instructions, and flexibility in annotation options as desired improvements. The proposed approach is a feasible and scalable methodology for real-world dietary monitoring, supporting further evaluation for larger-scale implementation.
Despite the growing availability of plant protein ingredients on the market, data on their digestibility and metabolic effects in humans are limited. This study examined the effects of differently processed pea proteins on postprandial metabolism and compared them with those of whey protein. In a randomized crossover trial, healthy men and women (n=20, aged 24 ± 3 y, BMI 21.6 ±1.8 kg/m2) consumed four test meals each containing 25 g protein from (i) pea protein concentrate (PC), (ii) pea protein isolate (PI), (iii) pea protein extrudate (PE) or (iv) whey protein (WP). Acetaminophen was administered with each test meal as a marker for gastric emptying. Venous blood samples were obtained in fasting state and at multiple time points postprandially (15-300 min). Samples were analyzed for the concentration of plasma amino acids (primary outcome), serum urea, plasma glucose, serum insulin, and uric acid. Satiety was assessed using visual analog scales. All data were analyzed using linear mixed models. Plasma essential amino acid (EAA) concentrations increased after ingestion of all test meals. Compared with WP, meals containing PC, PI, and PE resulted in lower plasma EAA concentrations (iAUC0-300, P<0.001) without any significant difference between the three degrees of processing. The PE meal showed a delayed increase in EAA compared with PC, PI, and WP (iAUC0-120P=0.008, 0.016, <0.001 and Tmax P<0.001). Following the WP meal uric acid decreased but increased after the PC, PI, and PE meals (P<0.001). No meal effect was observed for postprandial urea, glucose, insulin, and acetaminophen concentrations or in satiety ratings. In healthy young adults, pea protein elicits a lower postprandial EAA response than WP, independent of processing degree. Comparisons across processing degrees indicate a delayed EAA response following PE consumption. Other metabolic parameters and satiety responses are comparable between pea and WP. This trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/) as NCT06155656, date of registration: 30 November 2023.
Students in senior high school face substantial academic demands, prolonged sedentary time, constrained daily routines, and multiple imbalances in health-related behaviors. Their mental health may therefore be shaped by dietary habits, lifestyle, sedentary behavior, physical activity level, and body mass index (BMI). However, within the same school context, it remains unclear which factors-dietary habits, lifestyle habits, sedentary behavior, physical activity level, or BMI-show stronger associations with students' mental health. This cross-sectional questionnaire study was based on a school-based questionnaire survey conducted among students aged 15-17 years from a senior high school in Nanjing, China. Mental health was assessed using the World Health Organization-Five Wellbeing Index (WHO-5). Data on dietary habits, lifestyle, sedentary behavior, physical activity level, and BMI were collected. Correlation analyses and multiple linear regression analyses were performed to examine the associations between these behavioral factors and mental health. Overall mental health in the sample was moderate. Sedentary time was prolonged, physical activity level was generally low, and dietary patterns were characterized by relatively regular main meals but suboptimal supplementary dietary habits. Correlation analyses showed that mental health was positively correlated with overall dietary habits (r = 0.243, p < 0.01) and overall lifestyle habits (r = 0.279, p < 0.01), and negatively correlated with sedentary habits (r = -0.756, p < 0.01), with sedentary habits showing the strongest correlation. In the overall multivariable model, physical activity level was negatively associated with mental health (β = -0.330, p < 0.001), a finding that should be interpreted cautiously because of the cross-sectional design and measurement approach; BMI category was also negatively associated (β = -0.148, p < 0.001), whereas overall dietary habits (β = 0.167, p < 0.001) and overall lifestyle habits (β = 0.248, p < 0.001) were positively associated with mental health. In the dimension-specific model, sedentary habits showed the strongest negative association (β = -0.722, p < 0.001), whereas weekday lifestyle habits (β = 0.168, p < 0.001) and regular meal habits (β = 0.074, p = 0.011) were positive correlates. Supplementary dietary habits (β = 0.050, p = 0.080) and weekend lifestyle habits (β = 0.025, p = 0.421) were not independently significant. Mental health in senior high school students was closely related to the structure of daily behaviors, with sedentary behavior showing the most prominent adverse association. Compared with focusing solely on increasing exercise, reducing sedentary behavior, optimizing weekday routines, and maintaining regular main meals may better align with the mental health promotion needs of the school setting.
Adolescents' social development is shaped by everyday family interactions, yet evidence on whether routine family practices are associated with social and emotional skills remains limited, particularly in China. Using data from the 2016-2022 China Family Panel Studies, this study examined the association between family meal frequency and five CFPS-based proxy indicators of social and emotional skills among 3727 adolescent-wave observations from adolescents aged 10-16 years. Ordinary least squares models were estimated, with propensity score matching used as a robustness check and subgroup analyses supplemented by formal interaction tests by school stage, residence, and family socioeconomic status (SES). More frequent family meals were positively associated with the proxy indicators for agreeableness, extraversion, and emotional stability, while conscientiousness showed weaker but positive evidence of association; no significant association was found for openness. The subgroup and interaction analyses suggested some group-specific patterns, including tentative differences by school stage and somewhat broader positive associations among rural and low-SES adolescents, although the interaction evidence was limited. The findings suggest that regular family meals may represent a routine family interaction context modestly associated with selected proxy indicators of adolescents' social and emotional skills.
Background/Objectives: Convenience-oriented dietary behaviors acquired during the transition to university life may be associated with overweight and obesity status in young adults. This study aimed to characterize the dietary behaviors of Romanian university students and to evaluate their associations with overweight and obesity. Methods: This cross-sectional study included 921 university students aged 18-24 years (60.6% female; 67.8% urban residents). Self-reported dietary variables included fast-food consumption, sweets intake, fruit and vegetable intake, water intake, and replacement of meals with desserts. BMI categories were classified according to WHO criteria. Associations were evaluated using chi-square tests, Cramer's V, and multivariable logistic regression adjusted for sex, age group, and residence environment. A five-item Dietary Risk Score (DRS; range 0-5) was constructed as an exploratory composite indicator of cumulative dietary behavioral burden. Cluster analysis was additionally performed to identify dietary behavioral phenotypes. Results: A total of 24.1% of participants were classified as overweight/obese, including 19.4% overweight and 4.7% obesity. Frequent replacement of meals with desserts (aOR 7.20; 95% CI 4.26-12.17) and fast-food consumption ≥3 times/week (aOR 1.98; 95% CI 1.26-3.10) were independently associated with overweight/obesity after adjustment for demographic variables. Male sex, older age, and urban residence were also independently associated with overweight/obesity. Distinct dietary behavioral phenotypes were identified, including a convenience-oriented cluster characterized by higher fast-food and sweets intake and the highest prevalence of overweight/obesity. The DRS demonstrated a dose-response relationship with overweight/obesity prevalence, increasing from 19.8% at DRS = 0 to 50.0% at DRS = 4, with an adjusted OR of 1.43 per one-point increase (95% CI 1.23-1.66; p < 0.001). Conclusions: Frequent meal replacement with desserts, higher fast-food consumption, and greater cumulative dietary behavioral burden were associated with overweight and obesity status among Romanian university students. The findings support the relevance of evaluating cumulative dietary behavioral patterns in young adults; however, the cross-sectional design precludes conclusions regarding causality or temporal directionality.
Optimal glycemic control is essential to prevent complications in diabetes, and insulin administration practices play a key role. This study assessed insulin injection behaviors and related glycemic outcomes among individuals using multiple daily injections in Spain. A cross-sectional online survey was conducted via an independent patient platform (Canal Diabetes). Adults (18-65 years) with type 1, type 2, or other forms of diabetes (e.g., maturity-onset diabetes of the young (MODY) or secondary diabetes) requiring daily insulin injections were included. Demographic, clinical, and behavioral data were analyzed using SPSS Statistics, version 23 (IBM Corp., Armonk, NY, USA). Among 288 participants (mean age: 43.7 ± 14.7 years; 28.8% male, 71.2% female), 74.7% had type 1 diabetes. Most were white (95.8%) with a mean diabetes duration of 17.8 ± 14.5 years. While 83.3% injected prandial insulin before meals, only 71.2% did so at least 15 min before eating. Errors were frequent: 38.5% reported underdosing and 26.7% overdosing more than five times in the past month. Participants injecting before meals had significantly better outcomes than those injecting at other times, including higher rates of glycated hemoglobin (HbA1c) ≤ 7.5% (83.3% versus 62.5%, p = 0.001), greater time in range (TIR) (74.4% versus 66.3%, p = 0.032), and lower mean glucose (144 versus 159 mg/dL, p = 0.019). Smart pen users (41.2%) reported fewer mild-to-moderate hypoglycemic events (p = 0.021), though no differences were observed in HbA1c or TIR. Insulin injection practices in Spain reveal significant variability and opportunities for improvement. Promoting timely premeal insulin administration and leveraging technologies such as smart pens may improve glycemic outcomes. ClinicalTrials.gov identifier, NCT06421467.
Beef-on-dairy calves are present in dairy farms worldwide; however, little is known about their behavior or if social housing with purebred dairy calves may influence each other's behavioral patterns. The aim of this paper was to evaluate, through 2 studies, the effects of breed (Holstein vs. beef-on-dairy [Angus × Holstein] calves) and pair composition on performance, behavior, and behavioral responses in standardized tests. In Study 1 (n = 26 calves: 18 Holstein, 8 beef-on-dairy), we compared behavior and performance between the 2 breeds. Calves were observed by scan sampling (5 d/wk; after morning and afternoon milk meals; 14 scans/d per calf) using an ethogram including lying, self-grooming, exploration, idle, allogrooming, feeding, play, and abnormal oral behaviors. In Study 2 we compared breed and pair composition effects on behavior and performance. Calves were assigned (19 ± 2 d) to one of 3 possible pair composition: Holstein calves in homogeneous pairs (Holstein + Holstein; n = 13 pairs), mixed pairs (Holstein + beef-on-dairy; n = 11 pairs), and beef-on-dairy calves in homogeneous pairs (beef-on-dairy + beef-on-dairy; n = 7 pairs). Behavioral assessments were conducted weekly by scan sampling, twice a day, for 1h around milk meals (30 min before + 30 min after). Calves also underwent behavioral tests: food neophobia (2 times; 19 ± 2 and 48 ± 2 d), novel object (2 times; 16 ± 3 and 41 ± 2 d), unknown human test (65 ± 3 d). In Study 1, beef-on-dairy calves had greater body weight (BW) at weaning than Holstein calves. These calves also had more feeding, idle, and non-nutritive oral behavior scans, but fewer exploratory behavior scans compared with Holstein calves. Together, these results suggest that beef-on-dairy calves differ from Holstein calves in both growth and behavioral patterns during the preweaning period. In Study 2, Holstein calves showed more scans of exploration, whereas beef-on-dairy calves performed more abnormal oral behaviors (non-nutritive oral behaviors and cross-suckling), and feeding behaviors. In the food neophobia test, Holstein calves contacted less, took longer to contact, and consumed less novel food than beef-on-dairy calves. In contrast, in the novel object tests, Holstein calves were more likely to contact the object. Pair composition affected calf behavior, with more pronounced effects on Holstein calves when paired with Beef-on-dairy calves. When paired with beef-on-dairy, Holstein calves showed increased feeding behavior and abnormal oral behaviors and exhibited a longer latency to contact an unfamiliar human compared with homogeneous Holstein calves. BW did not differ between calves housed in mixed versus homogeneous pairs. However, within homogeneous pairs, beef-on-dairy calves were heavier than Holstein calves from approximately 70 d of age onward. Overall, Study 2 indicates that pair mixing influences the behavior of Holstein calves when housed with beef-on-dairy calves, but does not affect performance.
With obesity rates remaining high in the United States, many individuals attempt weight loss using self-directed approaches that may not align with clinical recommendations. This secondary data analysis examines the association between a desire to weigh less and unhealthy weight control behaviors among American adults. Data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) were assessed through variables representing a desire to weigh less and self-regulated weight control behaviors that are not clinically recommended: skipping meals, using non-RX weight loss supplements, and using laxatives or self-induced vomiting. Chi-square tests and a linear probability model were employed to evaluate their relationship. Of adult survey respondents, 62.6% indicated a desire to weigh less. It was more likely to be reported by female, non-Hispanic white, and college-educated participants. Respondents who wanted to weigh less were more likely to engage in unhealthy weight loss strategies than those who wanted to gain weight or maintain their weight. There was a statistically significant relationship between a desire to weigh less and each unhealthy weight loss behavior (all p < 0.001). The linear probability model demonstrated that wanting to weigh less had the strongest effect on skipping meals. Findings indicate a strong relationship between a desire to lose weight and engaging in potentially harmful weight control behaviors, broadening our understanding of self-regulated approaches that adults may resort to. More attention should be directed to patient weight satisfaction and monitoring of unhealthy weight control practices in patient-provider collaborations through nutrition support and healthcare settings for improved weight management care.
Sleep health is a multi-faceted biopsychosocial concept that affects well-being across the lifespan. Insufficient sleep occurs in large numbers of children and there is emerging evidence for the influence of socioecological factors and adverse childhood experiences (ACEs). The purpose of this study was to determine the influence of adverse childhood experiences on sleep health in preschool age children as mediated by family interaction habits and outdoor play. Our secondary analysis of the 2023 National Survey of Children's Health used the weighted dataset filtered for children ages 3-5 years. Sixty-six percent of parents reported adequate child sleep; nearly 89% of parents reported consistent bedtimes. Seventy-one percent reported no ACEs. Most children had one or more hours of outdoor play each day. Daily family interaction (reading, singing, stories, meals) occurred in approximately half of families. Structural equation modeling results indicated that the negative effects of ACEs on consistent bedtime were mediated by reading aloud and family meals, while adequate sleep duration was mediated by reading aloud and singing/storytelling. These findings represent a promising picture of young children and families, and insight into a window of time during child development when family interaction can positively affect sleep health in spite of adverse childhood experiences.
Background Anaemia remains a major public health problem among adolescent girls, particularly in low- and middle-income countries. Adolescence is associated with increased iron requirements due to rapid growth and the onset of menarche. In India, anaemia prevalence remains high despite ongoing national nutrition programmes, and district-level data remain limited in several regions. Methods A school-based cross-sectional study was conducted among 278 adolescent girls aged 13-17 years in Srikakulam district, Andhra Pradesh. Data on socio-demographic, dietary, and menstrual factors were collected using a semi-structured questionnaire. Haemoglobin levels were measured using a point-of-care haemoglobinometer. For consistency across the study population, anaemia was defined as haemoglobin <12 g/dL using the World Health Organization (WHO) criteria for non-pregnant adolescent females. Bivariate analysis and multivariable logistic regression were performed. Results The mean age of participants was 15.1 ± 1.4 years, and the mean haemoglobin level was 10.9 ± 1.8 g/dL. The prevalence of anaemia was 66.9% (95% confidence interval (CI): 61.4%-72.4%). In multivariable analysis, inadequate iron intake (adjusted odds ratio (AOR): 3.0; 95% CI: 1.8-5.2), tea consumption with meals (AOR: 2.0; 95% CI: 1.2-3.6), low green leafy vegetable intake (AOR: 1.8; 95% CI: 1.1-3.0), lower socioeconomic status (AOR: 1.6; 95% CI: 1.0-2.7), prolonged menstrual flow (AOR: 2.0; 95% CI: 1.2-3.4), and irregular menstrual cycles (AOR: 1.5; 95% CI: 1.0-2.8) were independently associated with anaemia. Conclusions Anaemia was highly prevalent among rural school-going adolescent girls in this study population. Inadequate iron intake, tea consumption with meals, low green leafy vegetable intake, lower socioeconomic status, prolonged menstrual flow, and irregular menstrual cycles were independently associated with anaemia. These findings highlight the multifactorial nature of anaemia and suggest that school-based programmes should address dietary practices, behavioural factors, and menstrual health in an integrated manner. Such approaches may contribute to reducing the burden of anaemia among adolescent girls.
Food processing is intrinsic to modern food systems, yet its role in dietary exposures and health outcomes remains difficult to interpret because prevailing classifications treat processing as a categorical property rather than a quantifiable dietary exposure. The introduction of a transformation-based framework that distinguishes physical and chemical modification of foods (Food Processing Levels, FPL) was further complemented to derive Processed Food Intake (PFI)-based descriptors and quantify cumulative exposure to processing across meals and diets. Studies commonly cited in support of ultra-processed food hypotheses exhibit substantial heterogeneity within and between 'unprocessed' or 'ultra-processed' diets. Across studies, diets classified as UPF result in a wide variation in cumulative processing exposure, while substantial overlap is observed between UPF and non-UPF diets when processing is expressed quantitatively. Item-weighted, energy-weighted and nutrients-weighted PFI descriptors capture graded differences that are obscured by categorical classifications and enable comparison of diets matched for nutritional quality yet differing in processing history. Treating food processing as a continuous dietary exposure provides a reproducible basis for analyzing intervention designs, interpreting experimental outcomes, and designing studies that explicitly test the nutritional and health relevance of food processing.
Nutrition insecurity is a major driver of poor cardiovascular health in Indigenous communities. Medically tailored meals that reclaim traditional foods may improve heart failure outcomes and quality of life. Community-based participatory methods were used to design Medically Utilized Tailored Traditional Foods to Optimize Nutrition in Heart Failure (MUTTON-HF), a culturally and medically tailored meal program incorporating traditional Navajo foods and recipes. To determine the efficacy of a culturally and medically tailored meal program on the incidence of hospitalizations and emergency department visits. This pragmatic, open-label randomized clinical trial was conducted from May to November 2025 at 2 Indian Health Service sites in rural Navajo Nation. Eligible patients were adults with heart failure who were receiving care at the study sites and had a hospitalization or emergency department visit during the last 12 months. All patients were followed for 12 weeks for outcomes, death, and adverse events. The data were analyzed from December 2025 to February 2026. Patients were randomized in a 1:1 ratio to 8 weeks of a culturally and medically tailored meal program or usual dietary advice. The primary end point was the proportion of patients with an all-cause hospitalization or emergency department visit within 90 days. Secondary outcomes included hospitalizations or emergency department visits separately, and for heart failure specifically, and change in Kansas City Cardiomyopathy Questionnaire scores, food insecurity, financial strain, blood pressure, and weight from enrollment to 8 weeks. A total of 206 patients (mean [SD] age, 65.8 [14.2] years; 87 female individuals [42%] and 119 male individuals [58%]; 203 American Indian individuals [99%], 2 American Indian or Alaskan Native and White individuals [0.97%], and 1 White individual [0.03%]; ejection fraction, 48%) were randomized. The primary outcome was significantly less frequent in the intervention arm (43 [40.6%] vs 57 [57.0%]; relative risk, 0.72; 95% CI, 0.54-0.96; P = .02), which was driven mainly by reduced hospitalizations (13 [12.3%] vs 26 [26.0%]). There was a lower incidence of heart failure hospitalizations specifically (4 [3.8%] vs 13 [13.0%]). The Kansas City Cardiomyopathy Questionnaire score and food security measures had significantly greater increases in the intervention arm while measures of financial strain, weight, and blood pressure significantly decreased in the intervention arm. Adverse events were uncommon. In this randomized clinical trial, an Indigenous Food is Medicine intervention reduced the incidence of hospitalization and emergency department visits among patients with heart failure. Community-based interventions that leverage protective assets of Native communities are needed to advance Indigenous health. ClinicalTrials.gov Identifier: NCT06549699.
This essay draws on a qualitative study that explored the understandings of employees responsible for planning, preparing, and distributing meals in three food assistance services in downtown São Paulo (Brazil) regarding food provision for people experiencing homelessness. In that study, 12 semi-structured interviews and materials from in-depth fieldwork conducted between December 2022 and December 2023 were analyzed using thematic content analysis. We revisited the previously identified themes through the lens of Enrique Dussel's Philosophy of Liberation, particularly the concepts of Totality, Exteriority, and Dignity, and explored how institutional food practices mediate recognition, autonomy, belonging, and humanity in contexts of social vulnerability. We examined how service workers construct interpretations that shape everyday food practices and how their positions within broader power relations influence daily routines. We also considered the perceptions of belonging, identity, and pleasure associated with the food provided, as well as different conceptions of autonomy within these institutional contexts. The debate centers on the tension between recognizing the human dignity of a group that society often treats as "non-human" and the practices that either reinforce or challenge this treatment. Drawing on Dussel's framework, we argue that food provision simultaneously challenges and reinforces the boundaries of Exteriority, thereby shedding light on the ethical and political dimensions of food as a social and cultural act.
The risk allele (G) of MTNR1B rs10830963 has been associated with impaired glucose tolerance, increased fasting glucose and type 2 diabetes (T2D). Late evening eating, when endogenous melatonin levels are elevated, is associated with impaired glucose control in MTNR1B risk carriers. Endogenous melatonin levels remain elevated into the morning so may influence glucose response to breakfast. To investigate the interaction of MTNR1B genotype and type of breakfast on postprandial glucose response in a real-world setting. Following an overnight fast, participants consumed either a standard carbohydrate-rich or protein-enriched porridge breakfast. Post-prandial glucose levels were recorded for two hours using a continuous glucose monitor (CGM). One week later, participants repeated the protocol consuming the alternate breakfast. A two-way mixed ANOVA determined the effect of breakfast and genotype on post-prandial glucose levels. Fifty-four adults completed the study. Fasting glucose was significantly higher (p = 0.008) in GG (5.53 ± 0.43 mmol/L) compared to CC or CG participants (5.02 ± 0.42 and 5.19 ± 0.52 mmol/L). Post-prandial iAUC was significantly greater following the carbohydrate-rich breakfast compared to the protein-enriched breakfast (p < 0.001). Following the carbohydrate-rich breakfast iAUC was significantly greater in GG participants compared to CC (p = 0.026) and CG participants (p = 0.029). There was no significant difference between genotype groups following the protein-enriched breakfast (p > 0.05). The study findings demonstrate, in a relatively young and healthy population, MTNR1B genotype significantly affects markers associated with T2D risk. Personalised genotype-based advice to adjust timing and composition of meals consumed when endogenous melatonin levels are increased may reduce subsequent T2D risk.
Alcohol Use Disorder (AUD), a chronic, multifactorial condition, heightens mortality risks and can exacerbate comorbidities with age due to indiscriminate alcohol consumption. Ingesting food before and during alcohol intake can attenuate peak blood alcohol concentration. This study aims to evaluate the efficacy of Optimized Food Bar for Blood Alcohol Reduction (OFBAR) in healthy individuals. A four-way Randomized Crossover Clinical Trial enrolled twenty participants, incorporating four alcohol intake intervention, each with different meal conditions (fasting, OFBAR, control meal, full meal), randomized and alternated. Participants underwent morning testing with randomly assigned meals prior to vodka consumption (0.35 g/kg for men and 0.30 g/kg for women). Blood alcohol concentration was measured via breathalyzer for 90 minutes. Post-intervention, participants assessed meal impressions and satiety. Both OFBAR and the control meal reduced alcohol absorption by approximately 30% compared with fasting, as assessed by relative bioavailability based on area under curve (AUC0-t). OFBAR emerged as a viable method, yielding fewer calories than control meal, nutritional value, and convenience. Participants favored its organoleptic attributes, reporting satisfactory satiety without excess. Encouraging strategies like OFBAR could mitigate acute intoxication and associated repercussions, such as accidents, violence, or health deterioration.
Continuous glucose monitoring (CGM) interpretation in people without diabetes is expanding beyond general glycemic control toward more dynamic metrics, such as Rate of Change (RoC). In this fixed-sequence pilot study conducted in 30 healthy adult females, we evaluated associations between two structured 14-day lifestyle interventions and free-living conditions using standard CGM-derived glycemic variability metrics and a novel framework based on the rate-of-change (RoC) metrics and data clarity using an unblinded Abbott FreeStyle Libre 2 monitoring. The dietary intervention (calorie-tailored low-glycemic index regular meals) were associated with lower time spent in rising (+1 to +2 mg/dL/min) and falling (-2 to -1 mg/dL/min) RoC bins by 4.76 ± 1.87% (complete-case delta, p ≤ 0.0071), whereas the 14-day physical activity intervention showed smaller and less consistent RoC changes (0.41 ± 2.20, p ≥ 0.3549). These findings, despite some major study design limitations, suggest that RoC may be more responsive and sensitive to short-term dietary pattern modifications in normoglycemic women.