Chrono-nutrition is an emerging field that examines how the frequency and timing of meals impact health. Previous research shows inconsistency in the relationship between chrono-nutritional components and cardiometabolic health. We investigated cross-sectional associations between these components and cardiometabolic health in 825 Iranian adults aged 20-59 years. Dietary data, including the number of eating occasions (EOs), meal timing, and meal irregularity of energy intake, were collected using three 24-hour dietary recalls. Anthropometric measurements, blood pressure, and laboratory tests (fasting plasma glucose, lipid profile, insulin, uric acid, and c-reactive protein) were conducted. Insulin resistance and sensitivity (HOMA-IR, HOMA-IS), the triglyceride-glucose, the lipid accommodation product and body mass index (BMI) were calculated. The demographic and morning-evening questionnaire (MEQ) was completed. General linear regression was used to assess associations between chrono-nutritional components and outcomes. Interactions with age and BMI were examined in all associations. Chrono-nutrition components were not significantly related to cardiometabolic risk factors in the total population. However, a lower number of EOs was associated with an increased LDL/HDL-C ratio (β (95% CI): 0.26 (0.06–0.48)) among overweight and obese participants. Additionally, less irregularity in breakfast energy intake was associated with a lower total cholesterol/HDL-C ratio (-0.37 (-0.95 to -0.18)) and a lower LDL-C/HDL-C ratio (-0.32 (-0.79 to -0.13)) among participants with a normal BMI (all p < 0.05). The study concluded that more frequent meals, and regular energy intake might enhance cardiometabolic health cross-sectionally, highlighting the need for prospective studies to further investigate these associations and the mediating role of BMI.

This scoping review aimed to evaluate the effect of exercise combined with vitamin D supplementation on skeletal muscle health in older individuals. We implemented a systematic search of electronic databases, including PubMed, the Cochrane Library, Web of Science, and Embase, was conducted from the time of library construction to January 2024. Eligible studies were randomized controlled trials (RCTs) including men and women aged 65 years or mean age 65 years; exercise training and vitamin D supplementation; outcomes of muscular strength, function, muscular power, body composition, and quality of life; and results compared with those of exercise intervention alone. The results showed 13 studies including 1483 participants were identified. The proportions of male and female sex were 22.05% and 77.95%, respectively. Exercise intervention methods included resistance exercises and multimodal exercise training. All vitamin D interventions involved supplementation with vitamin D3. A significant increase was identified in short physical performance battery (SPPB) and stair climbing but not in skeletal muscle mass, skeletal strength, the timed up and go (TUG) test, and gait speed in older adults after exercise combined with vitamin D supplementation. In conclusion，exercise combined with vitamin D supplementation has additive health effects on SPPB and stair climbing. Furthermore, when vitamin D was deficient at baseline, the combined effect of exercise and vitamin D intervention significantly increased the TUG and gait speed in older adults. In future RCTs on this topic, baseline vitamin D nutritional status, health condition, and sex should be considered.

Early childhood growth is associated with cognitive function. However, the independent associations of fat mass (FM) and fat-free mass (FFM) with cognitive function are not well understood. We investigated associations of FM and FFM at birth and 0-5 years accretion with cognitive function at 10 years. Healthy term newborns were enrolled in this cohort. FM and FFM were measured at birth, 1.5, 2.5, 3.5, 4.5, 6 months, 4 and 5 years. Cognitive function was assessed using Peabody Picture Vocabulary Test (PPVT) at 10 years. FM and FFM accretion were computed using statistically independent conditional accretion from 0-3 months, 3-6 months, 6 months-4 years, and 4-5 years. Multiple linear regression was used to assess associations. At the 10-year follow-up, we assessed 318 children with mean (SD) age of 9.8 (1.0) years. A 1 SD higher birth FFM was associated with a 0.14 SD (95% CI: 0.01, 0.28) higher PPVT at 10 years. FFM accretion from 0-3 and 3-6 months was associated with PPVT at 10 year, β = 0.5 SD (95% CI: 0.08, 0.93) and β = -0.48 SD (95% CI: -0.90, -0.07, respectively. FFM accretion after 6 months showed no association with PPVT. Neither FM at birth nor 0-5 years accretion showed association with PPVT. Overall, birth FFM, but not FM was associated with cognitive function at 10 years, while the association of FFM accretion and cognitive function varied across distinct developmental stages in infancy. The mechanisms underlying this varying association between body composition and cognitive function need further investigation.

This study aims to evaluate the impact of low-carbohydrate diet, balanced dietary guidance, and pharmacotherapy on weight loss among individuals with overweight or obesity over a period of three months. The study involves 339 individuals with overweight or obesity and received weight loss treatment at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University, School of Medicine, between January 1st, 2020 and December 31st, 2023. The primary outcome is the percentage weight loss. Among the studied patients, the majority chose low-carbohydrate diet as their primary treatment (168 [49.56%]), followed by balanced dietary guidance (139[41.00%]) and pharmacotherapy (32 [9.44%]). The total percentage weight loss for patients who were followed up for 1 month, 2 months, and 3 months was 4.98 (3.04,6.29) %,7.93 (5.42, 7.93) % and 10.71 (7.74,13.83) %, respectively. Multivariable logistic regression analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of ≥3% and ≥5% at 1 month (OR [odds ratio] =0.461, P＜0.05; OR=0.349, P＜0.001). The results showed that a low-carbohydrate diet was an effective weight loss strategy in the short term. However, its long-term effects were comparable to those observed with balanced dietary guidance and pharmacotherapy.

Childhood and puberty can affect metabolism, leading to tissue injury and malfunction later in life. The consumption of high-processed foods rich in salt and sugar is increasing in middle- and high-income countries, especially among young people. It is necessary to evaluate the effects of high salt and sugar levels in the youth on most injured organs during metabolic challenges. We aimed to investigate whether high salt/sucrose intake affects whole-body development and leads to end-organ injury. Weaned Male Wistar rats were divided into two groups: a control group fed a standard diet (CO) and tap water, and an experimental group (SS) fed a standard diet and a beverage containing 1.8% NaCl and 20% sucrose instead of tap water. The animals were treated for 60 days, starting after weaning at 21 days of age, after which the animals were subjected to glucose and insulin tolerance tests, urine collection, and heart rate monitoring, and euthanized for sample collection at 81 days of age. SS showed reduced body weight gain and increased food intake of sodium/sucrose solution. Interestingly, high salt/sucrose intake led to increased body adiposity, liver lipid inclusion, heart rate, and renal dysfunction. SS exhibits increased levels of peroxisome proliferator-activated receptor alpha to counterbalance the hypertrophy of brown adipose tissue. Our findings reveal that the SS rat model exhibits non-obvious obesity with end-organ damage and preserved brown adipose tissue function. This model closely parallels human conditions with normal BMI but elevated visceral adiposity, providing a relevant tool for studying atypical metabolic disorders.

Liver has multiple functions such as detoxification, metabolism, synthesis and storage. Folate is a water-soluble vitamin B9, which participates in one-carbon transfer reactions, maintains methylation capacity, and improves oxidative stress. Folic acid is a synthetic form commonly used as a dietary supplement. The liver is the main organ for storing and metabolizing folate/folic acid, and the role of folate/folic acid in liver diseases has been widely studied. Deficiency of folate results in methylation capacity dysfunction and can induce liver disorders. However, adverse effects of excessive use of folic acid on the liver have also been reported. This review aims to explore the mechanism of folate/folic acid in different liver diseases, promote further research on folate/folic acid, and contribute to its rational clinical application.

Skeletal muscle is of great importance for human activity and quality of life, as its loss contributes greatly to immobilization, especially for aged individuals. An increased dietary intake of antioxidant vitamins may be beneficial for muscle loss because of aging. However, the quantitative relationship between total antioxidation capacity (TAC) of antioxidant vitamins and muscle mass is undetermined. 4009 participants from the National Health and Nutrition Examination Survey (NHANES) were included. Multivariate linear regression analysis was performed with demographic, lifestyle and dietary intake adjustment factors. The dose saturation effect was also determined by a saturation effect analysis. Subgroup analysis were performed forage and sex. In the fully adjusted model, per unit increase of dietary TAC was associated with an increase of 0.018 g/kg appendicular lean mass (95% CI: 0.007–0.029), 0.014 g/kg trunk lean mass (95% CI: 0.004–0.024) and 0.035 g/kg total lean mass (95% CI: 0.014–0.055). TAC was associated with an decrease of 0.004 kg/kg total percent fat (95% CI: -0.006–-0.002), 0.005 kg/kg trunk percent fat (95% CI: -0.007–-0.002) and 0.003 kg/m2 BMI (95% CI: -0.006–-0.001) at the same time. Subgroup analysis indicated that women and adults <50 years may experience the most significant association between TAC and skeletal muscle mass. We revealed a positive correlation between TAC and lean body mass, a negative association between TAC and body fat and BMI. Saturation values were found among people aged 40–59. Age and sex mediate these associations.

This study aimed to evaluate the association of consumption of coffee with different additives, including milk and/or sweetener (sugar and/or artificial sweetener), and consumption of different types of coffee, including instant, ground, and decaffeinated coffee, with new-onset acute kidney injury (AKI), and examine the modifying effects of genetic variation in caffeine metabolism. 194,324 participants without AKI at baseline in the UK Biobank were included. The study outcome was new-onset AKI. During a median follow-up of 11.6 years, 5,864 participants developed new-onset AKI. Compared with coffee non-consumers, a significantly lower risk of new-onset AKI was found in coffee consumers adding neither milk nor sugar to coffee (HR, 0.86; 95%CI, 0.78-0.94) and adding only milk to coffee (HR,0.83; 95%CI, 0.78-0.89), but not in coffee consumers adding only sweetener (HR,1.14; 95%CI, 0.99-1.31) and both milk and sweetener to coffee (HR,0.96; 95%CI, 0.89-1.03). Moreover, there was a U-shaped association of coffee consumption with new-onset AKI, with the lowest risk at 2-3 drinks/d, in unsweetened coffee (no additives or milk only to coffee), but no association was found in sweetened coffee (sweetener only or both milk and sweetener to coffee). Genetic variation in caffeine metabolism didn’t significantly modify the association. A similar U-shaped association was found for instant, ground, and decaffeinated coffee consumption in unsweetened coffee consumers, but not in sweetened coffee consumers. In conclusion, moderate consumption (2-3 drinks/d) of unsweetened coffee with or without milk was associated with a lower risk of new-onset AKI, irrespective of coffee type and genetic variation in caffeine metabolism.

Several novel anthropometric indices, including paediatric body adiposity index (BAIp) and triponderal mass index (TMI), have emerged as potential tools for estimating body fat in preschool children. However, their comparative validity and accuracy, particularly when compared to established indicators such as Body Mass Index (BMI), have not been thoroughly investigated. This cross-sectional study enrolled 2869 preschoolers aged 3-6 years in Wuhan, China. The nonparametric Bland–Altman analysis was employed to evaluate the agreement between BMI, BAIp, and TMI with percentage of body fat (PBF), determined by bioimpedance analysis (BIA), serving as the reference measure of adiposity. Additionally, Receiver Operating Characteristic Curve (ROC) analysis was conducted to assess the effectiveness of BMI, BAIp, and TMI in screening for obesity. BAIp demonstrated the least bias in estimating PBF, showing discrepancies of 3.64% (95%CI: 3.40% to 4.12%) in boys and 3.95% (95%CI: 3.79% to 4.23%) in girls. Conversely, BMI underestimated PBF by 3.89% (95%CI: 3.70% to 4.37%)in boys and 4.81% (95%CI: 4.59% to 5.09%) in girls, while TMI also underestimated PBF by 5.15% (95%CI: 4.90% to 5.52%) in boys and 5.68% (95%CI: 5.30% to 5.91%) in girls. BAIp exhibited the highest area under the curve (AUC) values (AUC=0.867-0.996) in boys, whereas in girls, there was no statistically significant difference between BMI (AUC = 0.936, 95% CI: 0.921-0.948) and BAIp(AUC = 0.901, 95% CI 0.883-0.916) in girls (P=0.054). In summary, when considering the identification of obesity, BAIp shows promise as a screening tool for both boys and girls.

A positive association has been demonstrated between consumption of sucrose-sweetened beverages and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD). Since the administration of 30% sucrose in the drinking water (SRD) to rats has proven to be a good model of systemic insulin resistance, the aim of our study was to analyze the effect of caloric restriction applied on SRD-treated rats by switching back to a standard diet, on liver morphology, function, and metabolism.

Consumption of a SRD causes a metabolic shift towards gluconeogenesis and fatty acid synthesis leading to an increase in triacilglyceride (TAG) levels in plasma and in the liver that were associated with a decrease in insulin sensitivity. Moreover, our results show that animals fed a SRD develop steatohepatitis characterized by the generation of oxidative stress, endoplasmic reticulum (ER) stress, inflammation, and apoptosis. Although no histological changes were observed after a two-week caloric restriction, key pathways associated with the progression of MASLD as inflammation, ER stress and apoptosis were slowed down. Notably, this two-week intervention also increased liver insulin sensitivity (evaluated by AKT activity in this tissue) and drove the lipid metabolic profile towards oxidation, thus lowering circulating TAG levels.

In summary, the present study uncovers underlying mechanisms affected, and their metabolic consequences, during the first stages of the phenotypic reversal of steatohepatitis by switching back to a standard diet after receiving sucrose-sweetened water for several weeks.

People with type 2 diabetes are more likely to experience binge eating than the general population, which may interfere with their diabetes management. Guided Self-Help (GSH) is one of the recommended treatment options for binge eating disorder, but there is currently a lack of evidenced treatment for binge eating in individuals living with type 2 diabetes. The aims of this pilot study were to test the feasibility and acceptability of recruiting and delivering the adapted, online Working to Overcome Eating Difficulties GSH intervention to adults with T2 diabetes and binge eating. The intervention comprises GSH materials presented online in 7 sections delivered over 12-weeks, supported by a trained Guide. 22 participants were recruited in a case series design to receive the intervention and we interviewed 4 Guides and 5 participants afterwards. We measured binge eating, mental wellbeing, quality of life and weight at pre-post and 12-week follow-up. Results showed a significant reduction in binge eating at the end of the intervention, which continued to improve at follow-up. Before the programme 92% of participants scored above cut-off for binge eating. This reduced to 41% post-intervention and no-one at follow-up. These changes were accompanied by significant improvements in depression, anxiety and small changes in eating disorder symptoms. Participants reported making better lifestyle choices, eating more mindfully, and having increased self-confidence. The study shows preliminary evidence for online GSH tailored to the needs of individuals with T2D as a feasible and acceptable approach to improving binge eating, diabetes management and mental wellbeing.

Ultra-processed foods (UPF), per the NOVA Classification, provide a major source of calories within modern food systems and are associated with poor health outcomes related to chronic inflammation. Dietary antioxidants play a key role in preventing disease, however, the relationship between the NOVA Classification and the total antioxidant content (TAC) of foods is not well-characterized. We hypothesized that TAC would be highest in Minimally Processed (MPF), lower in Processed (PRF), and lowest in UPF. TAC data for 3,137 animal-based, mixed, and plant-based food items were obtained from a published data set. After data cleaning, 1,946 food items and their TAC values were analyzed using two hierarchal linear models (alpha: p<0.05). MPF had the highest mean TAC (10.79 ± 0.87 mmol/100g) and were 11.31-fold and 10.72-fold higher than PRF and UPF, respectively (p=0.023). Plant-based and Mixed foods had a higher mean TAC (8.55 ± 0.68 and 1.12 ± 0.11 mmol/100g, respectively) and were 22.67-fold and 2.98-fold higher compared to animal-based foods (p<0.001). Food processing did not change mean TAC in Mixed and Animal-based foods; however, plant-based MPF had a higher mean TAC (11.49 ± 0.93 mmol/100g) and were 9.88-fold and 15.12-fold higher compared to plant-based PRF and UPF, respectively (p<0.001). Mean TAC differed between NOVA processing groups for three categories of food: Vegetables, Beverages, and Beans, Nuts & Seeds (p<0.001). Across all food items, and especially plant-based foods, mean TAC decreased with food processing. The lower TAC of UPFs may at least partially explain why their consumption promotes inflammatory chronic disease.

This study aimed to estimate the nationwide prevalence of cardiometabolic diseases (CMDs) among adults with underweight in the US general population. Using data from the National Health and Nutrition Examination Survey (1999-2020), we estimated the age-standardized prevalence of dyslipidemia, hypertension, diabetes, chronic kidney disease, cardiovascular disease, and the presence of 0 or at least 2 CMDs. Multivariable Poisson regressions were used to compare CMD prevalence between subgroups, adjusting for age, sex, and race/ethnicity. Among the 855 adults with underweight included, the weighted mean age was 40.8 years, with 68.1% being women and 70.4% non-Hispanic White. The estimated prevalence rates were 23.4% for dyslipidemia (95% CI, 19.4%-27.5%), 15.6% for hypertension (95% CI, 13.3%-17.8%), 2.5% for diabetes (95% CI, 1.5%-3.5%), 7.9% for chronic kidney disease (95% CI, 6.9%-8.8%), and 6.1% for cardiovascular disease (95% CI, 4.3%-7.9%). The prevalence of having 0 and at least 2 CMDs was 50.6% (95% CI, 44.1%-57.0%) and 12.3% (95% CI, 8.1%-16.4%), respectively. Non-Hispanic Black adults had significantly higher prevalence of diabetes (adjusted prevalence ratio, 3.35; 95% CI, 1.35-8.30) compared to non-Hispanic White adults. In conclusion, approximately half of the underweight adults had at least one CMD, and 12.3% had at least two CMDs. Prevention and management of CMDs in underweight adults are critical yet neglected public health challenges.

Increased intestinal leakiness and associated systemic inflammation are potential contributors to osteoarthritis (OA) and postural imbalance in the geriatric population. To-date, no successful treatment to correct postural imbalance in OA is known. We aimed to explore the effects of a multistrain probiotic upon postural imbalance in OA-affected patients. In this randomized, double-blind trial with a placebo group, 147 patients suffering from knee OA (age-span = 64-75 years) were divided into placebo (n=75) and probiotics (n=72) study groups. Vivomix 112 billion, multistrain probiotic was given once a day for 12 weeks. The outcomes of study variables were determined first at baseline and later after 12 weeks of intervention. These were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee flexion range-of-movement (ROM), pain intensity by visual analogue scale (VAS), handgrip strength (HGS), gait speed, and balance control assessed in standing, semi-tandem, and tandem stances. We determined plasma zonulin, to determine intestinal leak along with c-reactive protein (CRP) and 8-isoprostanes levels. A total of 136 OA patients taking placebo (n=71) and probiotics (n=65) were analyzed. The probiotics group exhibited a reduction in pain intensity, disease severity, and WOMAC scores along with improvement in balance scores, HGS, and walking speed (p<0.05 for all), no change in ROM, resting pain, and 8-isoprostanes levels. The correlation analysis revealed a robust association of balance scores with plasma markers of intestinal leakiness and inflammation in probiotics but not in the placebo group. Probiotics reduce postural imbalance in OA patients partly due to a reduction in intestinal leakiness.

The Cardiovascular Health Diet Index (CHDI) is a diet quality score based on the dietary guidelines of the American Heart Association for cardiovascular health, but with some adaptations, such as red meat, dairy, beans, and ultra-processed foods in its components. The CHDI has shown good relative validity parameters, however, its association with health outcomes is still unclear. Thus, our aim was to investigate the association between the CHDI score with subclinical atherosclerosis. Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort were used. Subclinical atherosclerosis was assessed by measuring coronary artery calcification (CAC) at baseline (2008-2010) and second wave (2012-2014) and carotid intima-media thickness (cIMT) at baseline and at the third wave (2017-2019). The CHDI score (ranges from 0 to 110 points) was applied to dietary data obtained from a food frequency questionnaire at baseline. Poisson regression with robust variance, linear regression and linear mixed-effects models were used to evaluate the association of the CHDI score with CAC incidence (n 2,224), CAC progression (n 725), and changes in cIMT (n 7,341) over time, respectively. After a median 8-year follow-up period, a 10-point increase in the CHDI score was associated with a decrease in cIMT of 0.002 mm (95% CI –0.005; –0.001). No association was observed between the CHDI score and CAC incidence and progression after a 4-year follow-up period. Higher scores in the CHDI were prospectively associated with decreased subclinical atherosclerosis after an 8-year follow-up period.

Emerging evidence has shown a strong correlation between serum triacylglycerol (TAG) levels, the inflammatory response, and Parkinson’s disease (PD) onset. However, the causal relationship between TAG levels and PD has not been well-established. We aimed to investigate the relationship between serum TAG levels and risk of PD and explore the potential mediating role of circulating immune cells and inflammatory proteins. We utilised genotype data from the GeneRISK cohort, and summary data from genome wide association studies investigating PD, circulating immune cells, inflammatory proteins, and plasma lipidomes. Using Mendelian randomization (MR) and multivariate MR (MVMR) analysis, we further adjusted for phosphatidylcholine (17:0_18:1) and triacylglycerol (58:7). Our results suggested a robust causal link between higher serum TAG (51:4) levels and a decreased risk of PD, with one standard deviation genetically instrumented higher serum TAG (51:4) level leading to a 21 percent [95% CI, 0.66 – 0.96] reduction in the risk of PD (p = 0.015). Additionally, the results of the mediation analysis suggested a possible role for mediation through circulating immune cells (including IgD-CD38-B cells and resting CD4 regulatory T cells), but not circulating inflammatory proteins, in the causal relationship between the plasma lipidomes and PD. Our study confirms a causal relationship between higher serum TAG (51:4) levels and a lower risk of PD and clarifies a possible role for mediation through circulating immune cells, but not inflammatory proteins. These findings indicate that serum triacylglycerol (51:4) regulates immunity to effectively lower the risk of PD.

Temporal energy intake (EI) and physical activity (PA) patterns may be associated with obesity. We aimed to derive and characterise temporal EI and PA patterns and assess their cross-sectional association with weight status in participants aged 6–14 years from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016. We extracted times and EI of all eating occasions from two 1-day food diaries/24-hour recalls, while types and times of PA from 4-day PA diaries. We derived EI patterns (n=714) and PA patterns (n=595), using, respectively, a hierarchical and K-means cluster analysis, considering the average proportion of total daily EI (%TEI) and PA intensity (%TPA), within each 2-hour interval across the 24-hour day. We assessed the association between patterns and Overweight or obesity (Body Mass Index z-score ≥+1 Standard Deviation) using adjusted logistic regressions [Odds ratio (95% Confidence Interval)]. Three EI patterns were identified and labelled based on the 2-h interval of %TEI peaks: 1–“Early afternoon & Early evening”; 2–“Early afternoon & Late evening”, and 3–"Late morning, Early and Mid-afternoon & Late evening”. EI Pattern 3 vs. 1 was negatively associated with overweight or obesity [0.49 (0.26,0.92)]. PA pattern 1–“Late Morning, Mid-afternoon & Early evening” vs. Pattern 2–“Late afternoon”, was not associated with weight status [0.95 (0.65,1.38)]. A daily EI pattern characterised by more and even %TEI peaks at earlier daytime periods, instead of less, may be negatively associated with overweight or obesity amongst Portuguese 6-to-14-year-olds, whereas the identified PA patterns might have no relationship.

The aim of this study was to investigate the association between screen time and ultra-processed food consumption (UPF) across the lifespan. Data from the 2019 Brazilian National Health Survey, a cross-sectional and population-based study, was used. UPF consumption was evaluated using a score, calculated by summing the positive answers to questions about the consumption of 10 UPF subgroups on previous day. Scores ≥5 represented high UPF consumption. Daily time spent engaging with television or other screens was self-reported. Crude and adjusted models were obtained through Poisson regression and results were expressed in prevalence ratios by age group. The sample included 2,315 adolescents, 65,803 adults, and 22,728 older adults. Prevalence of UPF scores ≥5 was higher according to increased screen time, with dose-response across all age groups and types of screen time. Adolescents, adults, and older adults watching TV for ≥6 hours/day presented prevalence of UPF scores ≥5 1.8 (95% CI 1.2-2.9), 1.9 (95% CI 1.6-2.3) and 2.2 (95% CI 1.4-3.6) times higher, respectively, compared to those who did not watch TV. For other screens, prevalence of UPF scores ≥5 was 2.4 (95% CI 1.3-4.1) and 1.6 (95% CI 1.4-1.9) times higher for adolescents and adults using screens for ≥6 hours/day, respectively, while for older adults only screen times of 2-<3 and 3-<6 hours were significantly associated with UPF scores ≥5. Screen time was associated with high consumption of UPF in all age groups. Considering these associations when planning and implementing interventions would be beneficial for public health across the lifespan.

Dietary intake assessment is often complicated by intrinsic bias. This study investigated whether food purchase data could constitute a valid indication of dietary intake, by evaluating the extent to which diet quality as measured by supermarket food purchases is correlated with diet quality as measured by reported dietary intake. We used data from the Supreme Nudge cluster-randomised controlled supermarket trial (n=227). Data were collected at baseline from supermarket purchases (loyalty cards) and a dietary questionnaire (short 40-item food frequency questionnaire (FFQ)) to compute two scores reflecting diet quality from purchasing data (purchased diet quality) and FFQs (consumed diet quality). Both scores constituted of 13 food groups and could theoretically range between 0 (low diet quality) to 130 (high diet quality). The relationship between purchased diet quality and consumed diet quality was assessed using correlation coefficients, and the Bland-Altman limits-of-agreement method. Multiple linear regression was fitted between purchased diet quality and consumed diet quality, adjusted for age, sex, waist circumference, educational level, and household size. Consumed and purchased diet qualities were modestly positively correlated (Pearson’s ρ = 0·31, 95% CI: 0·18 - 0·42). A positive association from linear regression was found after confouding adjustments (βbaseline = 0·22, 95%CI: 0·10 - 0·34). Purchased diet quality was systematically lower than the consumed diet quality. This study found that diet quality as measured by supermarket purchases provided a reasonable indication of diet quality as reported by short-FFQs, albeit modest.