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Background/Objectives: Children with autism spectrum disorder (ASD) commonly experience feeding- and nutrition-related problems, while families increasingly encounter large language model (LLM)-based tools as sources of health information. Evidence on the reliability of these tools for ASD-specific medical nutrition therapy (MNT) remains limited. The aim of this study is to compare the responses of four publicly available LLM-based platform configurations to nutrition questions related to ASD in terms of quality, guideline compliance, readability, and hallucination. Methods: In this cross-sectional comparative benchmark study, 60 standardized, unbiased informational questions across five MNT domains (12 per domain) were each submitted once in separate sessions to four LLM-based platform configurations: ChatGPT, ChatGPT Plus, Microsoft Copilot, and Google Gemini, yielding 240 responses. Only one response was evaluated for each question-platform combination, and variability between repeated productions was not measured. Four nutrition and dietetics experts, blinded to platform identity, assessed response quality using Medical Artificial Intelligence Quality Analysis (QAMAI) and Global Quality Score (GQS), and reviewed compliance with NICE guidelines and the American Academy of Pediatrics clinical report, and evaluated readability and binary hallucination classifications. QAMAI, GQS, and guideline-concordance scores were compared using generalized estimating equations with a Gamma distribution and a log link. Results: Platform, domain (D), and platform × domain effects were significant for QAMAI, GQS, and guideline concordance (all omnibus p < 0.05). ChatGPT Plus had the highest overall mean QAMAI, GQS, and guideline-concordance scores. Gemini showed relatively high quality ratings but the lowest overall concordance with guidelines. In the analyzed response set, no hallucinations were detected in either the ChatGPT or ChatGPT Plus configurations (0/60 each; 0%). Hallucinations were detected in 21/60 (35.0%) of the Copilot responses and in 38/60 (63.3%) of the Gemini responses. Overall platform comparisons of hallucination classifications across the five domains were significant in all five domains after false discovery rate correction; pairwise differences remained significant in D1, D2, and D5, but not in D3 or D4. Mean Flesch–Kincaid Grade Level scores ranged from 14.62 to 18.87 across platforms. Conclusions: In this standardized single-generation comparison, overall response quality, guideline compliance, readability, and findings on hallucinations did not always coincide. Observed hallucination rates are limited to the response set examined. The observation of zero events in two ChatGPT configurations does not indicate the absence of hallucination risk, nor does it provide a basis for differentiating the configurations or concluding that they are equivalent in this respect. The binary hallucination rates did not reflect error severity and therefore should not be used to compare the clinical risks of the platforms. The findings are limited to a controlled set of questions and cannot be generalized to emotional, directive, or multi-round caregiver interactions. The ASD nutritional information generated by the LLM should be evaluated multidimensionally and subjected to expert validation. Studies involving repeated independent response generation in each question-platform combination are necessary for comparing hallucination tendencies.

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and linked to shift work. This study aimed to investigate the associations of circadian rhythm, sleep characteristics, anthropometric measures, and adiposity-related parameters with controlled attenuation parameter (CAP) values, and to assess their independent associations and sex-specific discriminatory performance in identifying hepatic steatosis among shift and non-shift workers. Methods: A total of 436 workers (328 men and 108 women), aged 19–64 years, from seven large-scale tea factories in Rize, Türkiye, were included. Social jetlag (SJL) and eating jetlag (EJL) were calculated from workday–free-day differences in sleep and meal timing, respectively, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariable linear regression and sex-specific receiver operating characteristic analyses were performed. Results: Mean SJL (p = 0.017) and the distribution of SJL categories (p = 0.022) differed significantly between female shift and non-shift workers, whereas neither differed in men (p = 0.827 and p = 0.542, respectively). These comparisons are exploratory because SJL and EJL estimates are not directly comparable across rotating shift assignments or between shift and non-shift workers. CAP values and the prevalence of CAP-defined hepatic steatosis did not differ significantly by shift-work status in either sex. CAP was positively correlated with anthropometric and adiposity-related measures, with the strongest adjusted correlations observed for waist circumference, abdominal volume index (AVI), BMI, and body fat mass (all r_s = 0.66, p < 0.001). In the fully adjusted regression model, age, BMI, and neck circumference were independently associated with higher CAP values, whereas SJL, EJL, sleep duration, and PSQI total score were not. In sex-specific ROC analyses, waist circumference and AVI showed the highest discriminatory performance in men (both AUC = 0.86), whereas BMI showed the highest discriminatory performance in women (AUC = 0.81). SJL and EJL did not significantly discriminate hepatic steatosis in either sex, while sleep duration showed weak discrimination in women (AUC = 0.63, q = 0.042). Conclusions: Anthropometric and adiposity-related measures were strongly associated with CAP values and showed good sex-specific discriminatory performance for hepatic steatosis. However, SJL findings, particularly comparisons by shift-work status, should be considered exploratory given the limited comparability of SJL and EJL estimates among rotating shift workers and between shift and non-shift workers. These simple, readily obtainable anthropometric measurements and derived adiposity indices may facilitate preliminary risk stratification for hepatic steatosis in occupational settings.

Background: Advanced glycation end products (AGEs) may link diet, systemic inflammation, and cognitive function; however, evidence in healthy young adults is limited. Objective: This study aimed to examine the associations of dietary AGE (dAGE) intake, circulating AGE–RAGE biomarkers, inflammation, and oxidant–antioxidant markers with cognitive performance. Methods: This cross-sectional study included healthy young adults aged 19–26 years. dAGE intake was estimated using a food-frequency questionnaire (FFQ) and a three-day food record (3D-FR). Serum AGEs (sAGEs), soluble RAGE (sRAGE), interleukin-6, tumour necrosis factor-alpha (TNF-α), malondialdehyde, catalase, superoxide dismutase, and glutathione were measured. Cognitive performance was assessed using Digit Span Forward, Backward, and Total scores and Stroop Interference. Separate multivariable linear regression models were adjusted for age, sex, body mass index, and Beck Depression Inventory-II scores, with Benjamini–Hochberg false-discovery-rate correction. Covariate-adjusted partial least squares structural equation modelling (PLS-SEM) examined the prespecified sAGE–sRAGE–inflammation pathways. Results: In the correlation analyses, dAGE intake estimated using the FFQ and 3D-FR was not significantly associated with sAGE concentrations (p > 0.05). In the separate regression models, higher sAGEs (β = −0.36, 95% CI −0.54 to −0.16) and TNF-α (β = −0.33, 95% CI −0.53 to −0.13) were associated with poorer Digit Span Backward performance after false-discovery-rate correction. No other cognitive associations remained significant. In PLS-SEM, sAGEs were positively associated with sRAGE (β = 0.505, p < 0.001), and sRAGE was positively associated with inflammation (β = 0.601, p < 0.001). Greater inflammation was associated with poorer Digit Span Backward performance (β = −0.398, 95% CI −0.697 to −0.110, p = 0.009), whereas the direct sRAGE–Digit Span Backward path was not significant. An indirect inverse association between sRAGE and Digit Span Backward through inflammation was supported (β = −0.239, 95% bootstrap CI −0.457 to −0.057). Conclusions: In conclusion, higher circulating sAGEs and TNF-α concentrations were associated with poorer working-memory performance, particularly on Digit Span Backward, in healthy young adults, whereas estimated dAGE intake showed no significant associations with cognitive performance. Longitudinal studies with larger samples are needed to establish temporality and confirm the significance of these associations.

Sample-level data preserving dependence among sequential tea infusions remain scarce. This secondary analysis examined a CC BY 4.0 dataset containing 34 black teas with three linked sequential infusions per sample. We reconstructed the cumulative element mass after consuming all three infusions versus discarding the first. The primary hazard index (HI) excluded Pb because no health-protective threshold can be established; Pb exposure and a legacy Pb-based HI were reported separately. At 10 g dry tea/day and 65 kg body weight, the median Pb-excluded HI decreased from 0.419 (IQR 0.258–0.497) to 0.260 (0.157–0.326), with a mean relative reduction of 37.1% (95% bootstrap CI 34.4–39.8%). No sample exceeded HI = 1, but this does not establish safety. When beverage volume was held at 80 mL, the mean HI reduction was only 5.7% (1.5–9.7%), showing that much of the apparent benefit reflected lower consumed volume. The total-As-based As HQ remained below one. Total-As cancer screening decreased by 35.9%; however, the proportion above 10⁻⁴ ranged from 0% to 64.7% across assumed inorganic-As fractions of 10–100%, demonstrating strong speciation dependence. Discarding the first infusion also reduced the estimated brewed yields of Cu, Se, and Zn by amounts equivalent to 2.4% of the adult Cu RDA, 2.5% of the Se RDA, and 0.4–0.5% of the Zn RDA; these estimates describe elemental yield in the beverage rather than absorbed nutrient intake. Overall, discarding the first infusion reduces estimated hazard indices primarily through decreased beverage volume rather than selective removal of toxic elements. Because extraction kinetics heavily depend on preparation techniques—such as traditional two-pot brewing—and regional tea chemistry, these findings cannot be directly extrapolated to Turkish teas. Instead, this study establishes a standardized exposure framework that highlights a critical knowledge gap and underscores the need for paired empirical studies evaluating local cultivars under authentic preparation practices.

Background: Sustainable and healthy eating behaviors play an important role in supporting both individual health and environmental sustainability. This study aimed to examine the relationships of health literacy, digital healthy diet literacy, and food neophobia with sustainable and healthy eating behaviors among university students, and to evaluate the associations of these variables with sustainable and healthy eating behaviors after accounting for sociodemographic, anthropometric, and selected dietary characteristics. Methods: This cross-sectional study was conducted with 300 undergraduate students selected via convenience sampling from a single state university in Türkiye between May and July 2022. Sociodemographic, anthropometric, and nutritional characteristics of the participants were assessed. Health literacy, digital healthy eating literacy, food neophobia, and sustainable and healthy eating behaviors were measured using valid and reliable scales. Relationships among variables were examined using Pearson correlation analysis. Factors independently associated with sustainable and healthy eating behaviors were evaluated using hierarchical multiple linear regression analysis. Results: The mean age of the participants was 22.3 ± 3.16 years, and 70.0% were female. The total score for sustainable and healthy eating behaviors was found to be 3.79 ± 1.13. Health literacy was positively correlated with sustainable and healthy eating behaviors ( r = 0.215; p < 0.001). Digital healthy diet literacy ( r = 0.045; p = 0.435) and food neophobia ( r = 0.017; p = 0.767) were not significantly correlated with sustainable and healthy eating behaviors. In the final hierarchical regression model, perceived healthy eating ( β = 0.310; p < 0.001) and health literacy ( β = 0.221; p < 0.001) were positively associated with sustainable and healthy eating behaviors after accounting for other model variables, while current smoking was negatively associated with sustainable and healthy eating behaviors ( β = −0.154; p = 0.009). The final model explained 19.1% of the variance ( R ² = 0.191). Conclusion: Health literacy was independently associated with sustainable and healthy eating behaviors among university students. However, no significant associations were found between food neophobia and either digital healthy eating literacy or sustainable and healthy eating behaviors. Future longitudinal and intervention studies may clarify the direction of this relationship and the underlying mechanisms.

Background: Advanced glycation end products (AGEs) may link diet, systemic inflammation, and cognitive function; however, evidence in healthy young adults is limited. Objective: To examine the associations of dietary AGEs (dAGEs) intake, circulating AGE–RAGE biomarkers, inflammation, and oxidant–antioxidant markers with cognitive performance. Methods: This cross-sectional study included healthy young adults aged 19–26 years. dAGEs intake was estimated independently using a food-frequency questionnaire (FFQ) and a three-day food record (3D-FR). Serum AGEs (sAGEs), soluble RAGE (sRAGE), interleukin-6, tumour necrosis factor-alpha (TNF-α), malondialdehyde, catalase, superoxide dismutase, and glutathione were measured. Cognitive performance was assessed using Digit Span Forward, Backward, and Total scores and Stroop Interference. Separate multivariable linear regression models were adjusted for age, sex, body mass index, and depressive symptoms, with Benjamini–Hochberg false-discovery-rate correction. Covariate-adjusted partial least squares structural equation modelling (PLS-SEM) examined the prespecified AGE–RAGE–inflammation pathways. Results: Neither FFQ-derived nor 3D-FR-derived dAGEs intake was associated with serum AGEs. In the separate regression models, higher sAGEs (β = −0.36, 95% CI −0.54 to −0.16) and TNF-α (β = −0.33, 95% CI −0.53 to −0.13) were associated with poorer Digit Span Backward performance after false-discovery-rate correction. No other cognitive associations remained significant. In PLS-SEM, sAGEs were positively associated with sRAGE (β = 0.505, p < 0.001), and sRAGE was positively associated with inflammation (β = 0.601, p < 0.001). Greater inflammation was associated with poorer Digit Span Backward performance (β = −0.398, 95% CI −0.697 to −0.110, p = 0.009), whereas the direct sRAGE–Digit Span Backward path was not significant. An indirect inverse association between sRAGE and Digit Span Backward through inflammation was supported (β = −0.239, 95% bootstrap CI −0.457 to −0.057). Conclusions: Circulating AGE–RAGE-related and inflammatory activity, rather than estimated dAGEs intake, was associated with selected aspects of cognitive performance in healthy young adults. Longitudinal studies with larger samples are needed to establish temporality and confirm the significance of these associations.

Background/Objectives: The increasing prevalence of mild cognitive impairment and dementia among older adults represents a major public health concern. This study aimed to examine the relationships between anthropometric status, dietary diversity, dietary quality, and cognitive performance in older adults. Methods: This study was a cross-sectional study. Anthropometric measurements were performed. The Dietary Diversity Score (DDS), Healthy Eating Index-2020 (HEI-2020), 24 h dietary recall and the Montreal Cognitive Assessment (MoCA) were used. We used hierarchical multiple linear regression analysis. Results: Among 117 older adults, 53.0% screened positive for possible mild cognitive impairment (MCI) based on the MoCA. Participants screening positive for possible MCI had a higher body mass index (BMI) compared to those with normal cognitive performance (32.67 ± 5.78 and 29.54 ± 3.39 kg/m²; p < 0.001) and a higher prevalence of obesity (62.9% and 41.8%; p = 0.027). The final regression model explained 26.0% of the variance in MoCA scores (R² = 0.260; adjusted R² = 0.212; p < 0.001). More years of education were associated with higher MoCA scores (B = 0.768, β = 0.363, p < 0.001), while higher BMI was associated with lower MoCA scores (B = −0.301, β = −0.240, p = 0.010). Conclusions: In older adults, higher BMI values were found to be associated with lower MoCA scores in the adjusted model. In this sample, no significant correlation was found between DDS and HEI-2020 scores obtained from a single 24 h food intake record and MoCA scores. Longitudinal studies including repeated nutritional assessments are needed to clarify the direction of these relationships.

Background/Objectives: The increasing incidence of mild cognitive impairment and dementia in older adults are crucial for cognitive impairment. This study aimed to examine the relationships between anthropometric status, dietary diversity, dietary quality, and cognitive performance in older adults. Methods: This single-center cross-sectional study included 117 older adults. Anthropometric measurements were performed. Dietary Diversity Score (DDS), Healthy Eating Index-2020 (HEI-2020), 24-hour dietary recall and Montreal Cognitive Assessment (MoCA) were used. We used hierarchical multiple linear regression analysis. Results: 53.0% of the participants were in the group of possible mild cognitive impairment (MCI). Participants in the probable MCI group had a higher body mass index (BMI) compared to those with normal cogni-tive performance (32.67 ± 5.78 and 29.54 ± 3.39 kg/m²; p < 0.001) and a higher prevalence of obesity (62.9% and 41.8%; p = 0.027). The final regression model explained 23.6% of the variance in MoCA scores (R² = 0.236; adjusted R² = 0.194; p < 0.001). More years of edu-cation were associated with higher MoCA scores (B = 0.795, β = 0.375, p < 0.001), while higher BMI was associated with lower MoCA scores (B = −0.282, β = −0.225, p = 0.016). Conclusions: Higher BMI was found to be associated with lower cognitive performance in older adults. However, DDS and HEI-2020 scores were not associated with cognitive performance. Longitudinal studies including repeated nutritional assessments are needed to clarify the direction and temporal pattern of these relationships.

Objective: This study aimed to evaluate the validity and reliability of the Turkish version of the Short Questionnaire for the Evaluation of Adherence to the Mediterranean Diet and Nutritional Sustainability (MedQ‐Sus), which excludes alcohol consumption and simultaneously assesses adherence to the Mediterranean diet and a sustainable diet, in adults. Methods: The study included 138 adults, of whom 39.9% were male and 60.1% were female, with a mean age of 34.3 ± 12.7 years. The MedQ‐Sus is a brief questionnaire that generates a Mediterranean Diet score and a Sustainable Diet score from the same eight food‐group consumption data using different scoring criteria. Dietary intake was assessed using 3‐day food records. Validity was evaluated by comparing the MedQ‐Sus scores with corresponding food‐group and nutrient intakes derived from the food records and by examining construct validity using a modified alternate Mediterranean Diet score (aMED) and the Planetary Health Diet Index (PHDI). Associations and agreement were assessed using Spearman correlation coefficients, Bland–Altman analysis, and intraclass correlation coefficients (ICCs) based on absolute agreement, as appropriate. Test–retest reliability was evaluated in 71 randomly selected participants 4 weeks after the initial administration. Results: Statistically significant and positive correlations were found between the consumption levels of all food groups associated with the Mediterranean Diet score components. The Sustainable Diet score showed positive correlations with all food groups except legumes and fresh fruits ( p  < 0.05). The strongest relationship for both the Mediterranean Diet score ( r  = 0.490) and the Sustainable Diet score ( r  = 0.488) was observed in the consumption of fish and fish products ( p  < 0.001). Bland–Altman analysis indicated an acceptable level of agreement between the MedQ‐Sus scores and the corresponding estimates derived from the food records. As adherence levels measured by the MedQ‐Sus increased, intakes of fish, olive oil, dietary fibre, magnesium, zinc, monounsaturated fatty acids, and omega‐3 fatty acids increased, whereas polyunsaturated fatty acid intake decreased. In the test–retest analysis, strong positive correlations were observed for the Mediterranean Diet score ( r  = 0.782) and the Sustainable Diet score ( r = 0.813) (both p < 0.001). Conclusion: The MedQ‐Sus demonstrated good validity and reliability as a practical screening tool for simultaneously assessing adherence to the Mediterranean diet and adherence to a sustainable diet among the adults included in this study, while its exclusion of alcohol consumption may support its use across different adult population groups.

Objective: Oxidative stress is triggered by malnutrition and antioxidant losses due to dialysis in hemodialysis patients and thus, oxidative stress increases the risk of mortality in patients with cardiovascular disease and obesity. The study aims to determine differences in cardiovascular risk scores and obesity indices between hemodialysis and control groups and to examine the relationship between the tertiles of dietary total antioxidant capacity with cardiovascular risk, and obesity in hemodialysis and control groups. Methods: This is a cross-sectional case-control study involving hemodialysis patients (n=46) and healthy individuals (n=46). Participants’ general characteristics were obtained via a questionnaire, and the Framingham Risk Score was calculated. The dietary total antioxidant capacity was calculated using two methods based on a seven-day food record. Obesity indices, such as Basal Metabolism Index and Body Shape Index, were calculated using anthropometric measurements. Results: The mean age of the participants was 51.1±10.4 years. In the hemodialysis group, obesity indices including body weight, Basal Metabolism Index, waist circumference, fat mass index, and fat-free mass index were lower, while Framingham Risk Score values were higher than the control group (p<0.05). Energy-adjusted dietary total antioksidant capacity values were lower in hemodialysis group, and most patients were in the low tertiles of Trolox equivalent antioxidant capacity, total radical-trapping antioxidant parameter, ferric reducing-antioxidant power and vitamin C equivalent antioxidant capacity (p<0.05). Conclusion: Providing hemodialysis patients with a healthy diet can increase the dietary total antioxidant capacity, and potentially reduce cardiovascular risk, and obesity indices.