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The international guidelines recommend nutrition evaluation in all patients with mild and moderately severe acute pancreatitis (AP). The Global Leadership Initiative on Malnutrition (GLIM) criteria were developed for evaluating malnutrition. However, no prospective study has validated GLIM criteria in AP, and research on nutrition assessment tools in AP remains limited. This study aimed to validate GLIM criteria and evaluate nutrition assessment tools in patients with mild and moderately severe AP. This prospective study enrolled patients diagnosed with mild and moderately severe AP from July 2022 to April 2023. GLIM criteria and subjective global assessment (SGA) were assessed by different trained clinicians. SGA was used as a semi-gold standard for diagnosis of malnutrition according to GLIM validation guidance. Clinical outcomes, including mortality, complications, length of stay (LOS), and 90-day readmission, were evaluated. Sixty-five patients were enrolled. Mild and moderately severe AP were observed in 90.8% and 9.2% of patients, respectively. The prevalence of malnutrition, as assessed by GLIM criteria and SGA, was 21.5%. GLIM criteria showed a significant strong agreement (weighted &#x3ba; = 0.817, 95% CI 0.57-1.00, p < 0.001) and strong diagnostic performance, with a sensitivity of 85.7%, specificity of 96.1%, positive predictive value of 85.7%, and negative predictive value of 96.1%. Only SGA was independently associated with LOS&#x2265;6 days (OR 4.67; 95% CI: 1.22-17.89, p = 0.025). GLIM criteria demonstrated strong validity in diagnosing malnutrition in mild and moderately severe AP. Only SGA was independently associated with longer LOS. Further multicenter studies with larger populations are warranted to confirm these findings.

Older adults experience high rates of chronic disease that reduce quality of life and independence. In South Texas, these challenges are compounded by limited access to culturally aligned care and a high burden of chronic conditions. Addressing these disparities requires infrastructure that bridges research and practice to support the translation of evidence into real-world care. This manuscript describes the establishment of the Supporting Older Adults through Research Network (SOARNet), a population-specific practice-based research network (PBRN) and reports early lessons from its development and recruitment strategies. SOARNet employs a multi-level leadership structure and an Advisory Board to guide research priorities, review member-initiated proposals, and facilitate collaboration among clinical, research, and community stakeholders. Recruitment strategies included informational materials, clinic visits, and targeted email outreach. Since inception, SOARNet has enrolled 61 members representing healthcare clinicians (55.7%), researchers (18.0%), community members (32.8%), and organizations (8.2%), with targeted email outreach proving most effective (n = 56). SOARNet has supported a collaborative research study, facilitated member consultations, and contributed to dissemination activities. These findings demonstrate the value of population-specific PBRNs in advancing community-engaged translational research to improve care for older adults. Future priorities focus on expanding partnerships and strengthening culturally responsive, bidirectional research.

Nutritional risk and fluid balance evolve rapidly during critical illness, but their joint longitudinal patterns and prognostic relevance remain incompletely characterized. This study identified early joint trajectories of GNRI-derived nutritional risk and fluid balance and evaluated their associations with mortality in critically ill adults. This retrospective dual-database study used MIMIC-IV as the development cohort and eICU as an independent reproducibility cohort. Adult ICU patients with an ICU stay >=3 days and at least three paired daily measurements of GNRI-derived nutritional risk and weight-standardized fluid balance during ICU days 1-7 were included. Nutritional risk was defined as 98 minus daily GNRI. Group-based multi-trajectory modeling identified joint phenotypes. Multivariable logistic and Cox regression models evaluated associations with hospital and short-term mortality. Sensitivity analyses included landmark analyses, extended covariate adjustment, proportional-hazards diagnostics, posterior-classification assessment, and incremental prediction evaluation. The analysis included 1,243 patients from MIMIC-IV and 9,912 from eICU. Three reproducible joint trajectory phenotypes were identified: persistent moderate-to-high nutritional risk with gradual deresuscitation (Group A), initially severe nutritional risk with high early fluid load and rapid decline (Group B), and worsening nutritional risk with mild-to-moderate deresuscitation (Group C). Group B had the highest crude mortality in both cohorts, with hospital mortality of 40.0% in MIMIC-IV and 34.7% in eICU. In fully adjusted models, Group B was associated with higher 30-day mortality in MIMIC-IV (HR 1.59, 95% CI 1.12-2.28) and higher hospital mortality in eICU (OR 1.95, 95% CI 1.55-2.45). Group C was also associated with increased 90-day mortality in MIMIC-IV (HR 1.37, 95% CI 1.10-1.72) and hospital mortality in eICU (OR 1.29, 95% CI 1.14-1.46). Early joint trajectories of GNRI-derived nutritional risk and fluid balance identified reproducible prognostic phenotypes in selected critically ill adults with sufficient repeated measurements. The phenotype combining severe early nutritional risk with high initial fluid load showed the highest mortality risk. Incremental prediction analyses indicated modest additional prognostic information beyond baseline GNRI and early fluid balance, supporting dynamic nutrition-fluid phenotyping as a complement to conventional severity assessment.

The lack of harmonization for microbiome-based clinical studies represents a critical issue for microbiome researchers and stakeholders, although microbiome research and clinical studies on the gut microbiome have been intensively conducted for more than a decade. The selection of a minimum metadata set to be analysed and reported during clinical studies with microbiome outcomes, the identification of reference materials, the definition of standardized sampling procedures and data analysis protocols, and the choice of unified clinical end points are still lacking. The two-round Delphi survey, conducted within the framework of the Horizon Europe Human Microbiome Action (HMA) consortium, aimed to standardize metadata collection, sampling procedures, data generation and sharing, and standard operating procedures for aspects of gut microbiome-based clinical studies beyond outcomes. The process involved 72 scientists and experts worldwide in the first round and 61 experts in the second round, with an 85% participation rate from the first to the second round. On the basis of the outcome of the Delphi survey, the HMA consortium provided 15 recommendations that might be taken up by the community at large to promote coherence and harmonization in the way microbiome clinical research is and will be performed. The recommendations mainly focus on the gut microbiome and diseases associated with the gastrointestinal tract and gut-organ axes.

Recent advances in multiomics technologies, continuous glucose monitoring, and machine learning (ML) enable precision nutrition by prediction of glycemic responses to foods. To date, no narrative reviews have focused on advances, challenges, and future directions in ML-based prediction of glycemic responses. This narrative review aimed to summarize the existing research on ML-based prediction of postprandial glycemic responses, highlight the challenges in prediction of glycemic responses, and offer directions for future research. We searched PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Institute of Electrical and Electronics Engineers (IEEE) Xplore, and Association for Computing Machinery (ACM) Digital Library, from inception to 21 November, 2025. Studies that developed/updated/conducted external validation of an ML model and predicted the outcomes of interest (i.e., glycemic responses, peak glucose, and glucose excursions) were included. A total of 13,471 records and 2 reports identified 26 studies for inclusion. Although some studies used traditional linear or deep learning models, most existing prediction models were tree-based ML models and developed for healthy people and those with prediabetes or diabetes. Most existing models included anthropometry, biomarkers, and microbiota as personal features and nutrients/food groups as food features. However, some key food features such as food processing were overlooked. Some clinical trials reported that ML-based personalized dietary recommendations failed to yield favorable and clinically significant glycemic outcomes compared with dietary guidelines. There are challenges in ethics and compliance of algorithms, reliability of measurement instruments, prediction of multiple metabolic outcomes, trade-offs in raw data collection and feature selection, and the balance of performance metrics and clinical benefits. Most existing ML-based prediction models for postprandial glycemic responses are tree-based and incorporate personal and food features. Research on prediction of glycemic responses faces challenges that require careful consideration during study design. To improve transparency, reproducibility, and quality of future research, this review provides a minimum reporting framework with checklist items and recommendations.

This study aimed to compare the nutrient intake, nutrition knowledge, and dietary habits of track-and-field (TF) and weight-class (WC) adolescent varsity athletes. This cross-sectional study included 144 adolescent athletes (TF group, 76; WC group, 68) aged 15 to 18 years at a physical education high school in Seoul, South Korea. Their nutrient intake, dietary quality, nutrition knowledge, dietary habits, and weight control behaviors were assessed using food records and questionnaires. Regarding nutrient intake, the consumption of carbohydrates, including energy, was substantially lower than the sports nutrition recommendations in both groups. However, the overall diet quality, including the mean adequacy ratio and nutrient adequacy ratio for key micronutrients, was significantly higher in the WC group than in the TF group, with female WC athletes consuming significantly more energy than female TF athletes (P<0.05). For nutrition knowledge, both groups lacked overall sports nutrition understanding; however, the WC group scored significantly higher in dietary fat knowledge (P<0.05). As for dietary habits, despite having better meal quality, harmful weight control behaviors, including skipping breakfast (P<0.001) and fasting (P<0.05), were significantly more common in the WC group than in the TF group. The WC group, while showing better meal quality, practiced unhealthier dietary behaviors and weight control methods more often than the TF group. Additionally, both groups exhibited insufficient energy intake and lacked overall nutrition knowledge. Therefore, tailored sports nutrition education is urgently needed among South Korean adolescent athletes.

People with cystic fibrosis (PwCF) have historically been counselled to eat a high-energy, high-fat diet to prevent malnutrition. The widespread availability of novel drug therapy has led to increased weight and body composition changes in this population, necessitating dietary and lifestyle changes to promote optimal health and well-being. The objective of our study was to understand the attitudes, perspectives, and practices related to nutrition issues in the context of elexacaftor-tezacaftor-ivacaftor (ETI) use. Semi-structured interviews were conducted with PwCF on topics of body image, perceptions of nutrition status, dietary changes, and CF care team relationships in the context of ETI. Interviews were analysed by two independent coders using inductive thematic analysis. Ten adult PwCF were interviewed. Participants were predominantly white (80%), and half were female. Body mass index ranged from 18.9 to 37.1&#x2009;kg/m2. Three global themes were identified: finding balance, a new normal, and working together. Participants discussed pre and post-ETI diet experiences, body image changes and perceptions, and interactions with CF care teams and other mechanisms of support. Perspectives on nutrition status changes on ETI were diverse in our sample and reflect participants' adjustment to a redefined standard of health and nutrition in this new era of CF care. Findings indicate opportunities for partnership strategies with the CF care team, and for providing updated educational resources and personalised nutritional counselling to support the individual needs of PwCF as they navigate dietary and health behaviour changes.

As global populations age, nutrition management is important for healthy aging. Digital technologies, including mobile applications, web-based platforms, messaging tools, and artificial intelligence (AI)-enabled systems, are used in personalized nutrition interventions. However, evidence on their characteristics, effectiveness, and user experiences remains limited. This scoping review examined technology-based personalized nutrition interventions for older adults. This review followed the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. PubMed, Embase, and Web of Science were searched for studies published from January 1, 2010, to June 30, 2026. Among 2,727 records, 2,044 were screened after duplicate removal, 28 full-text articles were assessed, and 13 articles representing 12 studies were included. Technologies included mobile, messaging, web-based, information and communications technology, tablet-based, and AI-supported systems. Interventions involved dietary recording, personalized feedback, remote counseling, coaching, and self-monitoring. Outcomes included dietary intake and quality, nutritional status, physical function, frailty, cognition, cardiometabolic indicators, engagement, usability, and acceptability. Findings were more consistent for dietary behaviors and individualized nutrition management. Evidence for physical function, frailty, cognition, cardiometabolic health, and quality of life was limited and often based on small or multidomain studies. Familiar interfaces and professional support were accepted, whereas low digital literacy, complex navigation, and limited food databases were barriers. Digital personalized nutrition interventions may support dietary behavior change and individualized nutrition management in older adults. Larger studies and user-centered systems addressing digital literacy, usability, cultural context, and AI-feedback validation are needed.

Dietary intake, including both quantity and quality, plays a critical role in supporting nutrition outcomes and the long-term health and wellbeing of cancer survivors. While primary care dietitians are well-placed to support these outcomes, many report a desire to upskill or expand their scope of practice due to limited access to evidence-based resources that support cancer-related nutrition care. To explore stakeholder perspectives of the usefulness, relevance, and potential application of two prototype resources (Toolkit and Checklist) co-designed to support dietitians in providing care to cancer survivors within primary care settings. This qualitative study used the think-aloud method. Individual interviews were conducted while participants reviewed the Toolkit and Checklist prototypes. This work formed the final phase of a broader co-design project. Eligible participants were clinicians involved in cancer care, and adults with lived experience of cancer as survivors or carers. Twenty stakeholders from across Australia participated in online interviews conducted in August-September 2025. Participants included primary care dietitians (n=14), carers (n=7), cancer survivors (n=3), other health practitioners (n=2). Six participants represented more than one group. Performed: Verbatim interview transcripts were analysed inductively using thematic analysis, supported by the Framework Method. Themes and subthemes were iteratively developed and refined through team discussion. Themes included: (1) building confidence in cancer nutrition care through accessible, evidence-based knowledge; (2) enhancing consultation structure and efficiency through timesaving and trustworthy guidance; and (3) sustaining and expanding future use of the co-designed resources through ongoing updates, digital integration, and broader educational or clinical applications. The co-designed Toolkit and Checklist were perceived as relevant, credible, and feasible supports for equipping primary care dietitians to deliver optimum cancer nutrition care. Future research should evaluate real-world implementation of the resources through a trusted website, workflow integration, and impacts on practitioner confidence and patient outcomes.

The International Organization for the Study of Inflammatory Bowel Disease (IOIBD) is an international scientific organization that has shaped the framework for inflammatory bowel disease (IBD) research, clinical management strategy, therapeutic development, and clinical trial methodology for more than four decades. Formally constituted in April 1981 in Lyon, France, IOIBD was created to address fundamental barriers to scientific and clinical progress in IBD, including inconsistent definitions of disease activity and outcomes across studies and countries. Since the establishment of the IOIBD Foundation for Research and Education in 1997, IOIBD has combined a highly engaged global membership of experts with structured governance, continuously active thematic clusters, and an annual rotating international meeting to deliver consensus frameworks and collaborative initiatives that translate directly to clinical practice and regulatory and translational science. Key outputs include studies of global epidemiology of IBD, the Selecting Therapeutic Targets in IBD (Selecting Therapeutic Targets in Inflammatory Bowel Disease, STRIDE) treat-to-target programs; the SPIRIT consensus initiative addressing long-term disease impact and endpoints for disease-modification trials; validated approaches to capturing disability and patient-reported outcomes; consensus guidance on nutrition and diet as modifiable and potentially disease-modifying factors; recommendations to optimize IBD clinical trial design and endpoints; reclassification of IBD initiative; rapid international guidance during the COVID-19 pandemic; and educational initiatives including topic-focused satellite symposia, the Helmsley-IOIBD Clinical Experience Exchange Program, and the Empowering Women in IBD Leadership Program (EMPOWHER). This manuscript reviews IOIBD's history, operational model, selected scientific contributions, educational mission, and evolving strategy as the field moves toward precision medicine, globalization of care, and data-intensive approaches, including artificial intelligence. International organization for the study of inflammatory bowel diseases (IOIBD) Inflammatory bowel disease (IBD), including Crohn&#x2019;s disease and ulcerative colitis, faces ongoing challenges. Although treatment has improved, many patients still face delayed diagnosis, ongoing inflammation, complications, surgery, and reduced quality of life. These challenges have also made it hard for researchers and clinicians worldwide to compare studies and agree on the best ways to measure improvement. This article reviews the work of International Organization for the Study of Inflammatory Bowel Disease (IOIBD), an international network of experts founded in 1981 to help solve these problems through collaboration and shared standards. IOIBD brings together clinicians and scientists from many countries and disciplines, works year-round in focused topic groups, and meets annually to develop practical guidance and shared definitions that can be used in research studies, clinical trials, and everyday care.

While the Mediterranean diet shows promise in headache management, research on dietary interventions for pediatric patients remains scarce. This study evaluated the impact of a Mediterranean diet-based nutritional education intervention on headache severity, migraine-related disability, and quality of life in children and adolescents. In this 3-month, single-arm intervention study, 17 pediatric patients with primary headache were recruited from a Pediatric Neurology Outpatient Clinic (November 2022 - April 2023). Participants received comprehensive nutritional education emphasizing the Mediterranean diet. Outcomes were assessed preintervention and postintervention using the Mediterranean Diet Quality Index (KIDMED; dietary adherence), Pediatric Migraine Disability Assessment (PedMIDAS; disability), and Pediatric Quality of Life Inventory (quality of life) scales, alongside anthropometric and headache severity measurements. Postintervention, KIDMED scores significantly increased (P < 0.001). Notably, migraine disability scores decreased by approximately 45% (P = 0.001), and headache severity declined (P = 0.024), independent of significant changes in body mass index. Crucially, migraine-related disability (PedMIDAS) decreased significantly (P = 0.001), accompanied by a reduction in headache severity (P = 0.024). Furthermore, significant improvements were observed in quality of life, particularly in physical and psychosocial health domains (P < 0.05). Nutritional education focused on the Mediterranean diet is an effective strategy to improve dietary habits, reduce disability, and enhance quality of life in pediatric headache patients. To our knowledge, this is the first study to demonstrate a relationship between KIDMED and PedMIDAS scores, underscoring the clinical potential of dietary interventions in this population.

Fatty acids (FAs) are bioactive dietary and metabolic molecules that participate in membrane architecture, energy homeostasis, inflammatory signaling, gene regulation and immune function, all of which intersect with breast cancer (BC) risk, progression and treatment response. In this narrative review we integrate epidemiological, clinical, translational and mechanistic evidence on the role of FAs in BC. Saturated, monounsaturated, trans- and polyunsaturated FAs (PUFAs) are treated as distinct biological exposures rather than interchangeable measures of total fat intake. Similarly, evidence from dietary assessment, circulating biomarkers, erythrocyte membrane composition, adipose tissue stores and tumor lipid signatures is interpreted separately, because each captures exposure and biology at a different level. BC subtypes differ in FA synthesis, uptake, oxidation, storage and remodeling: luminal tumors are frequently linked to hormone-regulated lipogenesis, human epidermal growth factor receptor 2 (HER2)-positive tumors to growth-factor-driven lipid metabolism, and triple-negative tumors to exogenous FA uptake, inflammatory lipid mediators and ferroptosis-related vulnerabilities. FA-derived mediators also shape immune-cell polarization, cytokine signaling and the tumor microenvironment, and dietary FAs may reshape the gut microbiota; the fiber-derived short-chain FAs it produces, distinct from dietary FAs, likewise help regulate immune and inflammatory tone. Clinical data suggest possible roles for fat-quality modification and selected n-3 PUFA interventions, but findings are heterogeneous and not yet sufficient to support routine biomarker-guided precision onco-nutrition. Candidate biomarkers, such as erythrocyte n-6:n-3 composition, require prospective validation before clinical implementation. FA biology thus represents a modifiable but complex axis in BC prevention, tumor biology and supportive care.

Development of new evidence-based interventions for youth who are at clinical high risk for psychosis (CHR-P) is needed. Health behaviours and lifestyle habits such as physical activity, sleep, and substance abuse are modifiable risk factors for a variety of health outcomes. We assessed the feasibility and acceptability of a novel health behaviour-focused psychosocial intervention for youth at CHR-P. In a non-randomized feasibility trial, youth aged 13-17 who met CHR-P criteria participated in a 9-week health behaviour promotion group that provided psychoeducation and skills training regarding stress management, sleep, physical activity, nutrition, mitigating substance use, and health behaviour goal setting. Primary outcomes included feasibility and pre-to post-intervention change in health behaviours and symptoms. The secondary outcome explored the social validity of the intervention. Out of 18 invited participants, seven enrolled, and five completed at least two-thirds of the intervention, indicating modest feasibility and good retention in those who enrolled. There were no significant pre-post changes across measures of health behaviours or symptoms. Participants endorsed the goals of the intervention as meaningful and congruent with their treatment goals. Among those who enrolled, the group format was described as acceptable, while the didactic style was less preferred. Findings of this study showed the intervention to be modestly acceptable and feasible. Changes in health behaviours and symptoms were not significant but trended in the expected direction. Future trials are needed to refine the intervention and assess effectiveness. Clinicaltrials.gov Identifier: NCT05532683.

This study aimed to identify dietary patterns and examine their associations with sociodemographic and lifestyle characteristics among South Korean primary school-aged children. Data from 10,173 children aged 6-12 years who participated in the 2007-2022 Korea National Health and Nutrition Examination Survey were analyzed. Their dietary intake was assessed using a 24-hour dietary recall, and dietary patterns were derived from the energy contributions of 26 food groups through cluster analysis. Three patterns were identified: rice-based pattern (47.3%), flour-based pattern (17.7%), and diversified type (35.1%). From 2007 to 2022, the prevalence of the rice-based pattern declined substantially (56.6%-32.6%), whereas that of the diversified type markedly increased (27.3%-47.0%). Survey-weighted analyses revealed that the dietary patterns were significantly associated with age, household income, vigorous physical activity, meal-skipping, eating-out frequency, and dietary supplement use (all, P<0.05). Children following the flour-based pattern tended to be older, skip breakfast more often, and engage in less vigorous physical activities. The rice-based pattern included a higher proportion of children from low-income households, whereas the diversified type showed more favorable socioeconomic characteristics and family breakfast practices. Overall, the rice-based and flour-based patterns were associated with less favorable lifestyle behaviors than the diversified type. Dietary patterns among South Korean primary school-aged children appear to be closely related to socioeconomic status and daily health behaviors. Nutrition education and public health interventions promoting balanced diets, reduced meal skipping, and healthier lifestyles during childhood are needed.

The potential role of Phase angle (PhA) as a biomarker of systemic inflammation in chronic hepatitis C (CHC) remains underexplored. To assess the association between PhA values and the inflammatory marker-tumour necrosis factor alpha (TNF&#x2011;&#x3b1;) in patients with CHC. In addition, associations between PhA and a set of demographics, clinical, nutritional, and biochemical data were evaluated. This cross-sectional study included 81 adults with confirmed CHC (72.8% male; mean age 50.0 &#xb1; 11.7 y; 30.9% with liver cirrhosis). Nutritional status and body composition were assessed using anthropometry and bioelectrical impedance analysis (BIA). Reduced PhA was defined as &#x2264;5.6&#xb0; for men and &#x2264;5.4&#xb0; for women. Serum TNF-&#x3b1; concentrations were measured using an enzyme-linked immunosorbent assay (ELISA), including 81 and 39 samples from patients with CHC and healthy donors, respectively. Logistic regression analyses were conducted to evaluate associations between PhA and inflammatory, demographic, clinical, nutritional, and biochemical variables. Reduced PhA was observed in 14.8% of participants. Among male patients, reduced PhA was independently associated with elevated TNF-&#x3b1; levels (OR: 1.21; 95% CI: 1.06-1.39). However, no significant associations were found in the female patients. Male patients with CHC who present lower PhA values also exhibit elevated TNF&#x2011;&#x3b1; levels, independent of liver disease stage. Given the clinical relevance of identifying systemic inflammation and nutritional risk in this population, integrating a practical and reliable screening tool, such as PhA, into routine care may provide substantial value in health care settings.

This study aimed to adapt a systematic methodology for estimating the added sugars content of South Korean foods and to assess added sugars intake among South Koreans using data from the 2023 Korea National Health and Nutrition Examination Survey. The estimation procedure developed for Australian foods was modified and applied to South Korean foods. Added sugars content was estimated for 2,314 food items using the modified 7-step estimation procedure, and these estimates were applied to dietary intake data. Mean contents of total sugars and estimated added sugars were summarized by food group. Mean intakes of total sugars and added sugars, the percentage of energy from added sugars, and the prevalence of excessive added sugars intake were estimated. According to the modified estimation procedure, 53% of food items were assigned to step 1 (total sugars=0) or step 2 (non-added sugars food groups) and therefore assigned added sugars content of zero, while 21% were assigned to step 3, in which all total sugars were classified as added sugars. Mean added sugars intake was 30.7 g/day, accounting for about half of total sugars intake (58.3 g/day). Overall, 21.2% of the population had energy intake from added sugars exceeding 10% of total energy intake, with the highest proportion observed among adolescent girls (37.9%). This study provides the first nationally representative estimates of added sugars intake among South Koreans by adapting a systematic methodology. These findings provide a robust foundation for monitoring population-level added sugars intake and informing the development of targeted policies and interventions to reduce added sugars intake.

Vegan diets during pregnancy are commonly discussed regarding nutritional risks, often without differentiating between heterogeneous vegan populations. Empirical evidence on clearly defined subgroups who maintain a vegan diet throughout pregnancy remains scarce. This study characterized a highly selected subgroup of pregnant women adhering to a vegan diet, focusing on supplement use, information sources, counseling experiences, and perceived risks of micronutrient deficiency and overdosing. An explorative, cross-sectional online survey was conducted as part of the Vegan Diet and Dietary Supplements Study (VedieS). The questionnaire was developed from a scientific literature review, pilot-tested, and distributed via vegan, nutrition-related, and health-focused organizations and social media across German-speaking regions. Individuals adhering to a vegan diet (defined as a strictly plant-based diet excluding all animal-derived products) participated. The analysis was restricted to those reporting a vegan diet during at least one pregnancy. Supplement use, information seeking, and counseling adequacy were analyzed descriptively. In total, 801 individuals participated. Participants were highly educated and predominantly from urban areas (76.3% tertiary education; 79.6% urban). Adherence during pregnancy was largely consistent (90.5%), and supplement use was nearly universal (99.1%) with high compliance (79.1%), targeting micronutrients critical in vegan pregnancies, including vitamin B12 (77.8%), omega-3 fatty acids (76.9%), folic acid (73.8%), and vitamin D (67.8%). Scientific literature, self-identified by participants, was the primary information source (80.3%), whereas professional counseling was less frequent and often perceived as insufficient. Although 74.7% informed their gynecologist, only 16.1% reported comprehensive counseling. Despite high motivation and self-directed information seeking, considerable uncertainty persisted regarding micronutrient dosage, particularly overdosing, with 40.4% perceiving dosage guidance as insufficient. External influences, including the social environment (46.3%) and physicians (34.2%), were relevant sources of uncertainty. Rather than a uniformly high-risk population, pregnant individuals following a vegan diet represent a highly informed and responsible subgroup whose main challenges relate less to dietary behavior than to structural gaps in professional counseling and access to consistent, evidence-based supplementation guidance. These findings underline the public health relevance of expanding nutrition training and counseling capacities among healthcare professionals and the need for clinical research using objective measures of nutritional status in vegan pregnancies.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a systemic metabolic-inflammatory disorder in which metabolic stress and innate immune activation, particularly through the NLRP3 inflammasome, contribute to disease progression. Metabolic ketosis, characterized by increased levels of circulating ketone bodies, especially &#x3b2;-hydroxybutyrate, has emerged as a promising strategy to modulate substrate utilization, inflammatory signaling, and hepatic injury. However, clinical evidence integrating molecular, metabolic, and hepatic outcomes remains limited. In this pilot randomized controlled trial, 20 participants with newly diagnosed MASLD were randomly assigned to either a 3-month intervention with a daily C8-enriched medium-chain fatty acid formulation (m-CAP; meta-Capridin, providing approximately 20 g/day of C8) or a standardized low-carbohydrate dietary protocol. Metabolic indices, inflammatory mediators, adipokines, and hepatic enzymes were assessed. The expression of key inflammasome components (NLRP3, caspase-1, and ASC) was evaluated in peripheral blood mononuclear cells, and hepatic steatosis and liver stiffness were measured via transient elastography. The C8-enriched intervention was associated with increased circulating &#x3b2;-hydroxybutyrate levels, indicating the achievement of nutritional ketosis. Changes over time were observed in metabolic parameters, including fasting serum glucose (p < 0.05), HOMA-IR (p < 0.05), body fat percentage (p < 0.05), and BMI (p < 0.05). Alterations in inflammatory mediators and adipokine-related outcomes were also observed following the intervention. At the molecular level, changes in inflammasome-related markers were detected, including caspase-1 mRNA expression (p < 0.05) and NLRP3 expression at the transcriptional (p < 0.05) and protein levels (p < 0.01), whereas ASC expression remained unchanged. Changes in hepatic steatosis (p < 0.01) and liver stiffness measurements were observed following the intervention. Given the absence of significant Group &#xd7; Time interactions for several secondary outcomes, these findings should be interpreted as exploratory and hypothesis-generating. Induction of metabolic ketosis was associated with changes in metabolic, inflammatory, and hepatic parameters in patients with MASLD. The observed associations between ketosis, inflammasome-related markers, and noninvasive liver outcomes warrant further investigation of ketosis-based interventions as adjunctive approaches in MASLD. Larger and longer-term clinical trials are needed to confirm these findings and to determine whether short-term changes in liver stiffness reflect sustained alterations in hepatic status rather than structural fibrosis regression. Iranian Registry of Clinical Trials (IRCT); Unique identifier: IRCT20170315033086N12; Registration date: 19 September 2024; Registry URL: https://www.irct.ir. IRCT is a primary registry in the WHO Registry Network (https://www.who.int/tools/clinical-trials-registry-platform/network/primary-registries).

With few exceptions, all organisms on Earth use a common amino acid alphabet for synthesizing protein that consists of 20 canonical amino acids. Heterotrophic organisms have to obtain these amino acids from their food, especially the indispensable amino acids. The amount of and ratio between the indispensable amino acids is therefore a major determinant of protein quality. There exist several measures of protein quality for human nutrition and all of them rely on the empirical estimation of amino acid requirements. With the availability of whole genome sequencing data, however, a new method of deductively deriving amino acid requirements became available which uses the information encoded on the exome (the totality of protein-coding exons). By translating an organism's exome into the corresponding proteome in silico, the average encoded amino acid pattern can be computed and used ex hypothesi for defining an ideal amino acid pattern. Here I review the theoretical concepts behind exome-matched proteins and summarize the preclinical data that provide preliminary evidence for the hypothesis that such proteins indeed constitute an ideal protein source to maximize growth, reproduction and health. While clinical trials are yet to confirm this hypothesis in humans, there is a broad hypothetical range of applications of exome-matched proteins for human consumption. This review concludes that the concept of exome-matched proteins is interesting theoretically, promising for practical applications in animal and human nutrition and stimulating for further transdisciplinary research.