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Objective: This study aimed to evaluate changes in sensory ratings (liking, sweetness intensity, "just about right" (JAR) level of sweetness) of 0-10.7% w/w sugar in soda after 1 and 2 wk of replacing sugar-sweetened soda consumption with unsweetened, flavored, sparkling water., Methods: Consumers of sugar-sweetened sodas (17 men and women, average age 28 years) replaced their sodas with unsweetened, flavored sparkling waters for 2 wk. Changes in sensory ratings were evaluated for sodas ranging from 0-10.7% w/w added sugar. In a secondary analysis, cluster analysis identified "Sweet Likers" (liking increased with sugar concentration) and "Sweet Moderates" (liking peaked in the middle of the concentration range) in the baseline ratings, and models for changes in sensory ratings were reevaluated by sweet-liking group., Results: The primary analyses showed no significant effects of the intervention on sweetness intensity or liking ratings. However, the secondary analysis showed that Sweet Likers reduced liking ratings for all sodas, but particularly for the highest concentration ( p  = 0.0021) after the intervention. Sweet Moderates, however, increased liking ratings after the intervention, driven by an increase in liking for the lower concentrations of sugar ( p  = 0.0058). Additionally, Sweet Moderates increased their overall ratings for sweetness intensity in sodas ( p  = 0.00074)., Conclusion: These results suggest that the intervention may have been more successful in shifting sensory perception and acceptance of less-sweet sodas for Sweet Moderates than for Sweet Likers. These results should be verified in a larger sample that intentionally recruits by sweet liker status, to see if initial liking for sweetness may be a critical factor in interventions aiming to improve liking of less sweet beverages.

Background: Walnuts contain nutrients and phytochemicals that can promote metabolic health. However, the high energy content of walnuts along with other nuts raises the concern that consuming nuts promotes obesity., Objectives: We sought to investigate the associations between consumption of walnuts as well as other nuts and measures of obesity in adolescents and young adults., Methods: This study included 8874 adolescents (12-19 y) and 10,323 young adults (20-39 y) from 8 waves of National Health and Nutrition Examination Survey data (2003-2020). The associations of consumption of 1 ) walnuts only (WO); 2 ) walnuts with other nuts (WON); 3 ) other nuts (ON); and 4 ) no nuts (NN) with obesity status and relative fat mass (RFM) were assessed using logistic and linear regressions stratified by age group and sex. Sample weights were used in all statistical analyses., Results: The mean daily intake of walnuts was not different between the 2 walnut consumption groups within each age group (adolescents: 2.18 [standard error (SE) 0.14] g; P = 0.917; young adults: 4.23 [0.37] g; P = 0.682). The WON group had the lowest prevalence of obesity (adolescents: 8.3%; young adults: 21.1%) while the NN group had the highest prevalence (adolescents: 24.1%; young adults: 35.4%). The models indicated lower odds of obesity in adolescent girls (odds ratio [OR]: 0.27; P < 0.05) and young adult women (OR: 0.58; P < 0.05) who consumed WON than in those who consumed NN. In both young women and girls, RFM was significantly lower in the WON and ON groups than the NN group ( P < 0.001). In young men, WON consumption was also associated with a lower RFM (OR: -1.24; 95% confidence interval: -2.21, -0.28) compared with NN consumption., Conclusions: For adolescents girls and young women, dietary intake of walnuts combined with other nuts has the strongest inverse association with measures of obesity., (© 2024 The Authors.)

Obesity and diabetes are associated with impaired iron metabolism. We aimed to examine the independent relationship between diabetes and iron after controlling for body weight (or obesity) in women aged 20-49 years. The National Health and Nutrition Examination Survey data from 2015 to 2018 were used in this investigation. Body composition data, HbAc1, iron biomarkers (serum ferritin (SF), soluble transferrin receptor (sTfR), and body iron index (BII)), mean corpuscular volume (MCV), mean hemoglobin concentration (MCH), red cell distribution width (RDW), and hemoglobin were used. Linear regression models were used to examine how and to what extent body mass index (BMI) modified the relationship between diabetes and iron status biomarkers. A total of 1834 women aged 20-49 were included in the analysis with a mean (SD) age of 32 .2 ± 6.1 years and BMI of 29.5 ± 6.9 kg/m 2 . The mean SF (p = 0.014) and BII (p < 0.001) were lower, while sTfR (p < 0.001) was higher in women with diabetes than those with no diabetes. Mean estimates for MCV and MCH were lower, while RDW (p = 0.001) was higher in diabetes patients (all p < 0.001). Women with diabetes were more likely to have iron deficiency, anemia, and iron deficiency anemia than those without diabetes (18.1% vs 8.6%, p < 0.001), (24.4% vs 8.4%, p < 0.001), and (14.8% vs 5.2%, p < 0.001), respectively. Among women with obesity, those with diabetes had lower predicted ferritin (β = -0.19, p = 0.016), BII (β = -0.99, p = 0.016), and hemoglobin (β = -0.27, p = 0.042) than those without diabetes. The study shows that diabetes is linked to lower iron stores; this is exacerbated in those with obesity., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: There is a lack of consensus on a reference range for ionized magnesium (iMg 2+ ) in blood as a measure of the status of circulating iMg 2+ for the screening of populations., Objectives: We estimated the reference range of iMg 2+ levels for healthy adult populations and the ranges for populations with cardiovascular disease (CVD), type 2 diabetes, hypertension, and renal disease. We also estimated 95% ranges for circulating magnesium (Mg) in healthy and those with cardiometabolic diseases., Methods: We searched Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Embase through 24 July, 2020 to identify articles. We included English, peer-reviewed, randomized controlled trials, prospective and retrospective cohort studies, case-control studies, and cross-sectional studies that measured iMg 2+ in blood or circulating Mg at baseline. The protocol was registered on PROSPERO (CRD42020216100). Estimated ranges were calculated by employing a frequentist random-effects model using extracted (or calculated) means and SDs from each included study. We determined the 95% confidence interval of the pooled mean., Results: A total of 95 articles were included with 53 studies having data for healthy participants and 42 studies having data for participants with cardiometabolic diseases. The estimated reference range for iMg 2+ for healthy populations was 0.40-0.68 mmol/L, 0.38-0.64 mmol/L for CVD, 0.34-0.66 mmol/L for type 2 diabetes, 0.39-1.04 mmol/L for hypertension, and 0.40-0.76 mmol/L for renal disease. For circulating Mg, the estimated range was 0.72-1.0 mmol/L for healthy adults, 0.56-1.05 mmol/L for CVD, 0.58-1.14 mmol/L for type 2 diabetes, 0.60-1.08 mmol/L for hypertension, and 0.59-1.26 mmol/L for renal disease., Conclusions: Estimated reference ranges for cardiometabolic disease states for both iMg 2+ and circulating Mg were broad and overlapped with the estimated range for healthy populations (0.40-0.68 mmol/L). Further studies should evaluate whether iMg 2+ can be used as a biomarker of cardiometabolic disease., Competing Interests: Conflict of interest NG-M and TCW are co-investigators on an investigator-initiated unrestricted educational grant from New Capstone, Inc., the manufacturer of ReMag®. TCW has received speaker honoraria from NOVA Biomedical. AWB’s wife is employed by Reckitt Benckiser. The study has been presented at a conference by the International Society for the Development of the Research on Magnesium and also published in part as a dissertation. KCC’s spouse is employed by Natural Grocers, which sells nutrient supplements. VYAB, SLD, and MC report no conflicts of interest., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Objective: Since we and others have shown that supplemental magnesium raises whole blood ionized magnesium (iMg 2+ ) we investigated the relationships between self-reported dietary magnesium intake and concentrations of whole blood iMg 2+ and serum magnesium (s-Mg)., Methods: We obtained whole blood iMg 2+ concentrations, as well as s-Mg concentrations, from a pilot, three-arm, randomized, controlled, crossover bioavailability study of magnesium supplements ( n  = 23; 105 measures). Dietary magnesium intake was assessed using three-day food records and the Nutrition Data System for Research (NDSR, University of Minnesota, MN, USA). Whole blood iMg 2+ was measured with an electrode analyser (NOVA Biochemical, Waltham, MA, USA), whereas s-Mg was measured using atomic absorption spectroscopy. A linear mixed-effects model was employed with dietary magnesium as the outcome variable and iMg 2+ , s-Mg, study treatment and study visit as fixed effects. We adjusted age, gender, race and body mass index covariates., Results: Values for dietary magnesium, iMg 2+ and s-Mg were 303.8 ± 118.9 mg/day, 1.3 ± 0.1 mg/dL and 2.2 ± 4.1 mg/dL, respectively. No association was found between dietary magnesium intake and iMg 2+ -125 ± 176.95 ( p  = .49) or s-Mg -9.33 ± 5.04 ( p  = .08)., Conclusions: Whole blood iMg 2+ and s-Mg concentrations do not reflect short-term self-reported dietary intake in adults. Further research is needed to determine whether blood biomarkers of magnesium may reflect dietary magnesium intake.Key messagesDietary intake of magnesium, a shortfall nutrient, may be objectively measured using blood biomarkers of magnesium.Serum magnesium and whole blood iMg 2+ were not associated with short-term dietary intake of magnesium.

Objectives: High-dose oral iron supplementation for patients who develop iron deficiency after bariatric surgery may induce oxidative stress in the gastrointestine. The study's objective was to test this hypothesis by determining the impact of high-dose oral iron on systemic oxidative stress., Methods: We used archived plasma samples from a randomized controlled clinical trial (NCT02404012) comparing FeSO 4 (195 mg/day, NatureMade®, West Hills, CA) with a heme iron polypeptide (HIP, 60.4 mg/day, Proferrin®, Colorado Biolabs, Lafayette, CO) for 8 weeks. Systemic oxidative stress was measured using malondialdehyde and total antioxidant capacity (MDA, Abcam, ab238537 and TAC, Abcam, ab65329 Cambridge, UK) assays. Data was log-transformed and presented as means and standard deviations; a mixed model was used to determine the effects of time (0, 2, 4, and 8 weeks) and treatment (FeSO 4 versus HIP) on oxidative stress., Results: The FeSO 4 (N = 8) and HIP (N = 5) participants were balanced in body mass index (35.0 ± 5.5 kg/m 2 ), race (93 % White), time post-surgery (7.3 ± 3.3 years), as well as serum concentrations of iron (P > 0.05). The FeSO 4 group tended to be older (44.3 ± 4.5 years) and they had lower concentrations of serum ferritin (6.5 ± 2.7 µg/mL) than the HIP (38.2 ± 9.3 years, and 12.9 ± 16.8 µg/mL) group (P = 0.080, and P = 0.017 respectively). We observed a larger increase in serum iron in the FeSO4 group during the 8 weeks of Fe supplementation, compared to that in the HIP group (p = 0.004). We observed a decreasing trend in MDA over the 8 weeks (p = 0.080) in the FeSO 4 treatment group. There were no significant differences in TAC between and within FeSO 4 and HIP groups over the 8 week supplementation period., Conclusions: This preliminary study suggests that high-dose oral iron supplementation for iron deficiency does not adversely impact systemic oxidative stress in patients undergoing bariatric surgery., Competing Interests: Declaration of Competing Interest The authors declare that there's no financial/personal interest or belief that could affect our objectivity., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

Purpose of Review: Sexual dysfunction is commonly associated with overweight/obesity, but the underlying physiological and psychosocial mechanisms are not fully understood. This review contextualizes the obesity-sexual (dys)function relationship, describes recent insights from the medical and social science literature, and suggests opportunities for continued research., Recent Findings: Although sexual dysfunction has been historically evaluated as a consequence/outcome of obesity, it is increasingly considered as a harbinger of future metabolic comorbidities, including type 2 diabetes and cardiovascular disease. Body image dissatisfaction is a consistent predictor for lower sexual satisfaction across BMI categories, likely mediated by cognitive distraction during partnered sex. To fully capture the relationship between obesity and sexual dysfunction, multidisciplinary research approaches are warranted. While clinically significant weight loss tends to improve sexual functioning for women and men, higher body image satisfaction may independently promote sexual function and satisfaction without concomitant weight loss., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Sugar-sweetened beverage consumption contributes to obesity and related diseases. Fortunately, beverages with reduced sweetness are a growing category in the beverage industry. These lower sweetness products could be useful for reducing the total dietary intake of sugar, but publicly available data are sparse on how much sweetness can be reduced without the change becoming noticeable to consumers. We investigated the just noticeable difference (JND) in sweetness of a cola-flavored carbonated beverage. Two sensory tests were conducted to detect the JND from 12.00% w/w sucrose. In each test, we used cola-flavored seltzer water with five decreasing sucrose concentrations (test 1:8.02-12.00% w/w; test 2:10.21-12.00% w/w). In both tests, samples were paired with the 12.00% reference, and participants were instructed to identify the sweeter sample. Participants correctly identified the reference sample at 10.21% in test one ( p  = .0039) and at 10.89% ( p  = .014) in test two. The data indicate that in a cola beverage, sucrose can be reduced by ~9.25% of the original concentration (12.00-10.89% w/w) before the sweetness becomes apparent to consumers. However, further work should consider whether sugar reductions greater than 9.25% would be acceptable, even if the difference in sweetness is apparent., Practical Applications: These data could help researchers and industry product developers know how much sugar can be reduced from a cola-flavored beverage before the change is apparent to consumers., Competing Interests: Other authors have no conflicts to declare., (© 2022 The Authors. Journal of Sensory Studies published by Wiley Periodicals LLC.)

Purpose: Serum magnesium is the most frequently used laboratory test for evaluating clinical magnesium status. Hypomagnesemia (low magnesium status), which is associated with many chronic diseases, is diagnosed using the serum magnesium reference range. Currently, no international consensus for a magnesemia normal range exists. Two independent groups designated 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L) as the low cut-off point defining hypomagnesemia. MaGNet discussions revealed differences in serum magnesium reference ranges used by members' hospitals and laboratories, presenting an urgent need for standardization., Methods: We gathered and compared serum magnesium reference range values from our institutions, hospitals, and colleagues worldwide., Results: Serum magnesium levels designating "hypomagnesemia" differ widely. Of 43 collected values, only 2 met 0.85 mmol/L as the low cut-off point to define hypomagnesemia. The remainder had lower cut-off values, which may underestimate hypomagnesemia diagnosis in hospital, clinical, and research assessments. Current serum magnesium reference ranges stem from "normal" populations, which unknowingly include persons with chronic latent magnesium deficit (CLMD). Serum magnesium levels of patients with CLMD fall within widely used "normal" ranges, but their magnesium status is too low for long-term health. The lower serum magnesium reference (0.85 mmol/L) proposed specifically prevents the inclusion of patients with CLMD., Conclusions: Widely varying serum magnesium reference ranges render our use of this important medical tool imprecise, minimizing impacts of low magnesium status or hypomagnesemia as a marker of disease risk. To appropriately diagnose, increase awareness of, and manage magnesium status, it is critical to standardize lower reference values for serum magnesium at 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L)., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Purpose of Review: Increased risk of type 2 diabetes mellitus (T2D) among individuals with overweight or obesity is well-established; however, questions remain about the temporal dynamics of weight change (gain or loss) on the natural course of T2D in this at-risk population. Existing epidemiologic evidence is limited to studies that discretely sample and assess excess weight and T2D risk at different ages with limited follow-up, yet changes in weight may have time-varying and possibly non-linear effects on T2D risk. Predicting the impact of weight change on the risk of T2D is key to informing primary prevention. We critically review the relationship between weight change, trajectory groups (i.e., distinct weight change patterns), and T2D risk among individuals with excess weight in recently published T2D prevention randomized controlled trials (RCTs) and longitudinal cohort studies., Recent Findings: Overall, weight trajectory groups have been shown to differ by age of onset, sex, and patterns of insulin resistance or beta-cell function biomarkers. Lifestyle (diet and physical activity), pharmacological, and surgical interventions can modify an individual's weight trajectory. Adolescence is a critical etiologically relevant window during which onset of excess weight may be associated with higher risk of T2D. Changes in insulin resistance and beta-cell function biomarkers are distinct but related correlates of weight trajectory groups that evolve contemporaneously over time. These multi-trajectory markers are differentially associated with T2D risk. T2D risk may differ by the age of onset and duration of excess body weight, and the type of weight loss intervention. A better understanding of the changes in weight, insulin sensitivity, and beta-cell function as distinct but related correlates of T2D risk that evolve contemporaneously over time has important implications for designing and targeting primary prevention efforts., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Preoperative optimization of iron status is a priority in candidates for bariatric surgery. Inflammation is strongly associated with obesity, and as a consequence, functional iron deficiency (ID) is potentially an underreported issue in surgical candidates., Objectives: In light of updated practice guidelines, to retrospectively review preoperative iron status in an Irish cohort of bariatric surgery candidates, taking account of the relative incidence rate of functional ID., Setting: A tertiary care obesity service with bariatric surgery referral in Ireland., Methods: Baseline nutritional biochemistry records were reviewed between February 2017 and February 2020 in a hospital, Dublin, Ireland. Absolute ID was defined as serum ferritin <30 μg/L; functional ID was defined as ferritin, 30 to 100 μg/L, in the presence of C-reactive protein >5 mg/L. Anemia was indexed with reference to hemoglobin and qualified by vitamin B12 and folate status to rule out anemia unrelated to primary ID., Results: The analysis included 120 patients, 68% female, 49.6 ± 9.3 years, and body mass index, 52.0 ± 9.6 kg/m 2 . The prevalence of absolute and functional ID was 11.7% and 30.8%, respectively (P = .0003). Anemia was associated with absolute ID and functional ID in 14.3% and 10.8% of patients (P = .29). Folate and vitamin B12 deficiency occurred in <5% of patients., Conclusion: In patients seeking bariatric surgery for severe obesity, the prevalence of baseline functional ID is substantial and can be associated with anemia. These findings raise queries with regard to how best to optimize preoperative iron status in the context of ongoing inflammation., (Copyright © 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)