Search Results (600)

Background/Objectives: Fetal growth restriction (FGR) describes the situation of a fetus that fails to reach its genetic growth potential. Postnatal catch-up growth represents a central adaptive process, yet its timing and magnitude vary widely and may influence one individual’s state of health and later metabolic risk. This study aimed to characterize longitudinal growth trajectories from birth to 10 years in children born at term, affected antenatally by growth restriction, with a particular focus on the influence of sex and FGR severity on catch-up growth. Methods: We conducted a retrospective observational study including 170 term-born children with documented FGR, admitted to a tertiary pediatric center between 2019 and 2023. Anthropometric data (weight, length/height, BMI) at birth, 1, 2, 5, and 10 years were converted to World Health Organization (WHO) age- and sex-adjusted z-scores. Catch-up growth was defined as an increase of >0.67 SD. Participants were stratified by sex and FGR severity (moderate: 10th–3rd percentile; severe: <3rd percentile). Results: Severe FGR infants exhibited significantly lower birth anthropometrics but demonstrated more pronounced early catch-up in weight and length at 1 and 2 years (p < 0.01). By 5 and 10 years, growth trajectories converged between severity groups, with no differences in BMI at any age. Sex influenced absolute anthropometric values but not the probability of achieving catch-up growth. Conclusions: Among term-born FGR infants, severity—but not sex—shapes early postnatal growth. Despite early deficits, most children achieved substantial catch-up, underscoring the need for careful monitoring to support healthy, proportionate growth and mitigate subsequent metabolic risk. Full article

Type 2 diabetes is increasingly prevalent among children and adolescents with overweight or obesity, and although lifestyle interventions remain first-line preventive strategies, long-term adherence and effectiveness are often limited. Metformin has demonstrated efficacy in delaying type 2 diabetes onset in adults at high risk, but its preventive role in pediatric populations remains unclear. This systematic review and meta-analysis aims to evaluate the effectiveness of metformin, alone or in combination with lifestyle interventions, in preventing or delaying type 2 diabetes among children and adolescents with overweight or obesity. The protocol is registered in PROSPERO (CRD42024615622), MEDLINE (PubMed), Embase, Cochrane Library, Scopus, and Web of Science and will be searched from inception to June 2025. Eligible studies include randomized controlled trials, quasi-experimental studies, and prospective cohort studies involving individuals under 18 years of age. The primary outcome is incidence of type 2 diabetes, with secondary outcomes including fasting plasma glucose, HbA1c, insulin resistance, BMI z-score, adherence, and adverse events. Where appropriate, random-effects meta-analyses will be conducted. This review will synthesize current evidence on metformin for pediatric type 2 diabetes prevention and inform future preventive strategies and clinical decision-making. Full article

Background: Children and adolescents with autism spectrum disorder (ASD) frequently receive antipsychotics and are considered at increased risk for weight gain. Few studies have compared longitudinal weight trajectories between youth with ASD and those with other psychiatric disorders. Methods: This naturalistic, registry-based study used data from the SENTIA cohort, which prospectively monitors antipsychotic safety in individuals under 18 years at a university hospital in Spain. Clinical characteristics were compared between participants with and without ASD. Longitudinal body mass index (BMI) z-score trajectories were analysed using linear mixed-effects models. Results: The sample included 266 participants, of whom 113 (42.5%) had ASD. Individuals with ASD were more often male and initiated antipsychotic treatment at a younger age. Of the 26 participants prescribed an antipsychotic before age 6, 88.5% had ASD. Comorbidity profiles were similar across groups. Risperidone and aripiprazole were the most frequently prescribed antipsychotics. BMI z-scores increased over time (β = 0.130, p = 0.017), and baseline BMI z-score was the strongest predictor. ASD diagnosis did not modify the average linear rate of BMI z-score change (time × ASD: p = 0.251); however, a significant quadratic time × ASD interaction (β = −0.016, p = 0.041) was consistent with a more pronounced early increase followed by earlier attenuation of BMI z-scores in the ASD group. Conclusions: Although antipsychotic treatment was initiated earlier in youth with ASD, no clear difference was observed in the rate of BMI z-score change. Differences in weight trajectories underscore the need for metabolic monitoring in antipsychotic-treated youth. Full article

Background/Objectives: Type 2 diabetes (T2D), a chronic metabolic disorder characterized by systemic inflammation, disproportionately affects African American adolescents. Metformin may reduce inflammation beyond glycemic control; however, its impact on inflammatory markers in adolescents remains unclear. We hypothesized that inflammatory markers would differ across groups defined by diabetes, obesity, and metformin use. Methods: In this cross-sectional analysis, inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6], and tumor necrosis factor-alpha [TNF-α]), metabolic panels, and metformin exposure were assessed in African American adolescents from Children’s of Alabama. Simple and multivariate linear regression models were used to test associations between metformin use and inflammatory markers, adjusting for age, sex, and BMI z-score. Results: Among 78 adolescents, metformin use was reported in 73.6% of those with T2D + obesity and 27.3% of those with obesity-only. In the T2D + obesity group, metformin use was associated with TNF-α (β = 0.34, p = 0.02). Conclusions: Metformin use was associated with higher levels of specific inflammatory markers, potentially reflecting that metformin was more likely utilized in more severe diseases. Longitudinal studies are needed to disentangle treatment effects from underlying disease progression. Full article

Background: Existing exercise metabolomics studies have predominantly focused on changes in the type and abundance of metabolites, while rarely addressing the toxicity risk of differential metabolites. Metabolic toxicity refers to the potential of endogenous or exogenous metabolites to induce oxidative stress, cell death, and other forms of biological damage when excessively accumulated and serves as a key driver of metabolic disorders. This study aims to characterize the toxicity risk of plasma differential metabolites before and after a single session of moderate-intensity running, so as to investigate the exercise-induced changes in metabolic toxicity. Methods: A single-group self-pretest–posttest control design was adopted in this study. Participants were recruited from Wuhan Sports University, China, with the inclusion criteria of healthy females aged 22–30 years and BMI 18.5–24.9. Individuals with a history of metabolic diseases or who met other exclusion criteria were excluded, and 5 females were finally enrolled. The exercise protocol consisted of a single 40 min session of moderate-intensity running on a treadmill. We collected plasma samples from five healthy females before and after exercise and performed untargeted LC-MS/MS metabolomic profiling. The gap-Δenergy algorithm was applied to calculate the toxicity scores of differential metabolites, and the proportion of metabolites with high toxic potential (score > 0.6) was compared. Results: Plasma metabolic profiles underwent notable remodeling after exercise. Thirty-two metabolites were upregulated and the phosphosphingolipid SM(d18:2(4E,14Z)/16:0) was the most significant. Meanwhile 32 metabolites were downregulated and the phosphosphingolipid PC(18:1(9Z)/14:0) was the most significant. The 64 differential metabolites were enriched in 9 KEGG pathways including amino acid metabolism and lipid metabolism. Moreover, we systematically evaluated the toxicity of these metabolites using the gap-Δenergy algorithm and found that the downregulated metabolites exhibited a significantly higher toxicity score compared to the upregulated ones. In addition, 37.5% of the downregulated metabolites had a high toxicity score, while the proportion of high toxicity in the upregulated group was only 15.6%. Conclusions: This study demonstrates that moderate-intensity running may confer metabolic health benefits to individuals by reducing metabolic toxicity, specifically through the downregulation of metabolites with high toxic potential. These findings offer novel evidence for exercise’s role in improving metabolic health. They also open a new direction for exercise-based interventions in metabolic disease–toxicity regulation. Full article

Background: Childhood undernutrition and overnutrition continue to be major public health challenges in South Africa. There is limited evidence on how socio-economic factors and dietary behaviors influence nutritional outcomes among school-aged children, particularly in rural areas such as Thulamela Municipality. Objective: This study aimed to examine the socio-demographic determinants, dietary patterns, and nutritional status among school-aged children in Thulamela Municipality, Limpopo Province, South Africa. Methods: A cross-sectional survey was conducted with 347 children aged 8–12 years. Simple random sampling was used to select eight villages from a total of 227 within the municipality. A snowball sampling method was used to recruit eligible children. Data on socio-demographic characteristics, including the child’s sex, parental education level, marital status, and employment status, were collected. Additionally, their dietary habits and meal frequency patterns were collected using structured questionnaires. Anthropometric measurements including height, weight, and BMI-for-age were obtained following WHO growth standards. Associations between variables were assessed using chi-square tests, with p-values < 0.05 considered statistically significant. Results: The prevalence of severe and moderate stunting was 20.5% and 21.0%, respectively. Overweight conditions and obesity affected 32.6% and 16.2% of participants, respectively. Parental education (p = 0.027), marital status (p = 0.001), and household income (p = 0.043) showed significant associations with height-for-age and BMI-for-age Z-scores. Additionally, regular breakfast consumption and the frequent intake of vegetables and dairy products were positively associated with improved nutritional outcomes (p < 0.05). Conclusions: The nutritional profile of school-aged children in Thulamela Municipality reflects a double burden of malnutrition, with concurrent high rates of stunting, overweight conditions, and obesity. Interventions that promote balanced diets and address socio-economic disparities are crucial for improving child growth and overall health. Socio-economic factors, including parental education, marital status, and household income, were significantly associated with children’s height-for-age and BMI-for-age. Furthermore, the regular consumption of breakfast, vegetables, and dairy products was associated with better nutritional outcomes, highlighting the influence of both dietary behaviors and socio-demographic determinants on child growth and health. Implementing nutrition education programs within schools that emphasize the value of balanced diets and highlighting the significance of eating breakfast regularly and incorporating vegetables and dairy products into daily meals is important. These programs should include both children and their caregivers to support regular healthy eating behaviors at home and in school. Additionally, schools should carry out regular growth monitoring and nutritional assessments to identify early indications of undernutrition or overnutrition, enabling prompt referrals and interventions for children who may be at risk. Full article

Background/Objectives: Evidence links children’s health-related quality of life (HRQoL) to overall diet, but data on specific, actionable habits are limited. We tested whether vegetable intake ≥2 portions/day and fish intake ≥2–3 times/week were associated with risk of low HRQoL (KIDSCREEN-10 Index score <40) and assessed their joint effect and robustness to overall diet quality. Methods: In three waves (2020–2023) in Madrid (Spain), 1127 observations from 771 children (8–12 years) were analysed. Logistic Generalised Estimating Equations (GEE) adjusted for age, sex, socioeconomic status (four levels), moderate-to-vigorous physical activity (MVPA), screen time, body mass index (BMI) z-score, wave and school ownership. Marginal predicted probabilities were computed for four exposure combinations (neither, vegetables only, fish only, both). Sensitivity models added school area and the Mediterranean Diet Quality Index (KIDMED; KIDMED_wo_FV and total); hybrid within–between GEE and a linear mixed model for continuous KIDSCREEN-10 were also fitted. Results: Vegetables ≥2/day and fish ≥2–3/week were inversely associated with low HRQoL (odds ratio (OR) 0.49 (95% confidence interval (CI) 0.30–0.82) and 0.61 (0.43–0.87)). The interaction was positive (OR 2.50 (1.39–4.53)). Adjusted probabilities were 40.1% (neither), 25.8% (vegetables only; −14.3 percentage points (p.p.)), 29.7% (fish only; −10.5 p.p.), and 34.0% (both; −6.1 p.p.). Findings persisted with KIDMED_wo_FV and attenuated with total KIDMED. MVPA related inversely and screen time directly to risk. Conclusions: Vegetables ≥2/day and fish ≥2–3/week were associated with lower odds of low HRQoL, with non-additive combined effects. These simple targets may complement physical-activity promotion and reduced screen time; longitudinal/experimental studies should test causality and dose–response. Full article

Background: Childhood obesity continues to pose a major global health challenge, and schools offer a structured and scalable setting for implementing physical activity programs. However, the effectiveness of these interventions remains inconsistent. This systematic review synthesizes evidence from school-based physical activity interventions and evaluates their impact on obesity-related parameters, physical activity levels, physical fitness, and cardiorespiratory fitness among children. Methods: A comprehensive search of PubMed, Scopus, and the Cochrane Library identified randomized controlled trials published between January 2015 and March 2025. Eligible studies included children aged 5–18 years and assessed school-based physical activity interventions. Outcomes included BMI, body fat percentage, physical activity levels (including MVPA), physical fitness, and cardiorespiratory fitness. Due to methodological heterogeneity, a narrative synthesis was conducted. Results: A total of 28 studies met inclusion criteria. Among the 16 studies reporting obesity-related outcomes, 7 demonstrated statistically significant improvements in BMI or BMI z-scores, while 6 of 16 (37.5%) showed no measurable effect. Reductions in body fat percentage were more consistently observed (5 of 6 studies). Both short-term (<6 months) and long-term (>12 months) interventions showed comparable proportions of studies with statistically significant BMI improvements (~50%). For physical activity outcomes, 5 of 11 studies reported increased MVPA, whereas others showed no significant change. Sedentary behavior outcomes were mixed, with only 2 of 6 studies demonstrating significant reductions. Improvements in physical fitness were reported in two-thirds of studies, while cardiorespiratory fitness improvements were inconsistent, with significant gains observed primarily in higher-intensity or well-structured programs. Across outcomes, several findings were statistically significant but modest in clinical magnitude. Conclusions: School-based physical activity interventions have the potential to improve select obesity-related parameters, particularly body fat percentage and BMI in a subset of studies. However, effects on MVPA, sedentary time, overall activity levels, and cardiorespiratory fitness remain variable. The effectiveness of these programs appears influenced by intervention structure, intensity, and adherence rather than duration alone. Future interventions should incorporate tailored, multi-component approaches to enhance both clinical relevance and long-term sustainability. While several effects were statistically significant, most were modest in magnitude. However, even modest improvements in BMI z-score, body fat percentage, and fitness can be meaningful at a population level, particularly when delivered through universal, scalable school platforms that reach large numbers of children. Full article

Background: Antipsychotic medication (APM) can cause weight gain, insulin resistance, dyslipidemias, and an increased risk of developing type-2 diabetes and cardiovascular disease among youth. The study sought to increase water consumption, reduce sugar-sweetened beverage (SSB) intake, and prevent unhealthy weight gain via a healthy lifestyle intervention among youth newly started on a second-generation APM for psychiatric treatment. Methods: This randomized controlled trial enrolled 148 Medicaid-insured youth (ages 8–17) recently starting APM. The treatment group received both a biweekly home-delivery of bottled water and parental phone support from a family navigator. In-home visits conducted at baseline, three months, and six months assessed the participants’ height/weight and dietary intake. All participants received basic healthy lifestyle education emphasizing increased water intake and decreased SSB consumption. Longitudinal linear mixed models were conducted to examine between-group and within-group changes in BMI z-scores, and water/SSB intake. Results: No significant between-group differences in BMI z-score were found at three (p = 0.908) and six months (p = 0.919). However, the within-group increase in BMI z-score in the control group was significant from baseline to three months (p = 0.029). A between-group comparison found the treatment group significantly increased their water intake at three (p = 0.006) and six months (p = 0.002). No between-group differences were identified at three and six months for the reduction in SSB, although the treatment group did demonstrate a decrease from baseline to three months (p = 0.004). Conclusions: Neither group experienced unhealthy increases (>0.5%) in BMI z-score over the six months. Providing a safe/free water supply showed a superior improvement in water consumption in the treatment group, and an initial decrease in SSB. Further studies are needed to identify feasible, effective, and sustainable lifestyle interventions tailored to this at-risk population. Full article

Background: Impaired bone health is a recognized complication of type 1 diabetes. This study evaluated the effects of low-carbohydrate (LC) and Mediterranean (MED) diets on bone turnover markers in adolescents and young adults. Methods: In a 24-week randomized controlled trial, 40 individuals aged 12–21 years, with type 1 diabetes, were assigned to an LC or MED intervention (20 participants per group). C-terminal telopeptide (CTX) and procollagen type 1 N-terminal propeptide (P1NP) were measured at baseline and 24 weeks. Results: The groups had similar baselines. At 24 weeks, the between-group difference in delta glucose time in range was not statistically significant; median daily carbohydrate intake was 86 g (68–95) in LC and 130 g (102–173) in MED (p < 0.001). Comparing LC to MED, the median BMI z-score was lower (−0.1 [−0.3 to −0.1] vs. 0.0 [−0.1 to −0.1], p = 0.10), and calcium (p = 0.035) and magnesium intakes (p = 0.030) were lower. These associations did not remain statistically significant after false-discovery-rate correction. The median-adjusted alkaline phosphatase level decreased significantly in the LC group (p = 0.009). The median CTX changed following LC from 395 pg/mL (232–591) to 423 pg/mL (289–591) (p = 0.278); and following MED, from 357 pg/mL (244–782) to 296 pg/mL (227–661) (p = 0.245). P1NP changed in LC from 95 ng/mL (68–112) to 88 ng/mL (62–97) (p = 0.056) and in MED from 76 ng/mL (54–198) to 71 ng/mL (55–122) (p = 0.594). Conclusions: Exploratory analyses of bone turnover markers showed insignificant differences following LC and MED diets. Full article

Background/Objectives: Early-onset inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), frequently presents with a more severe clinical course. Genetic susceptibility, particularly involving the TGF-β signaling pathway, plays a key role in IBD pathogenesis. SMAD3 and LTBP3 encode crucial components of this pathway and have been implicated in IBD in previous genome-wide association studies. Methods: This study aimed to assess the clinical significance of the rs17293632 (SMAD3) and rs11545200 (LTBP3) polymorphisms in a pediatric IBD cohort. A total of 286 children (133 with UC and 153 with CD) were recruited from seven pediatric centers in Poland. Clinical data included age at diagnosis, inflammatory markers (CRP, albumin), growth indices (Z-scores for weight, height, and BMI), and treatment regimens. Results: The LTBP3 rs11545200 minor allele was significantly associated with a younger age at diagnosis, poorer nutritional status during disease flares, and a more frequent use of infliximab—particularly in patients with UC. In CD, the SMAD3 rs17293632 major homozygous genotype was associated with increased use of systemic corticosteroids, suggesting a more severe or treatment-resistant disease phenotype. Conclusions: The assessed polymorphisms in LTBP3 and SMAD3, both involved in TGF-β signaling, are associated with clinical characteristics of pediatric IBD. These findings support the potential role of genetic variants as biomarkers for disease severity and treatment tailoring, contributing to the development of personalised therapeutic strategies in children with IBD. Full article

Background: Malnutrition and micronutrient deficiencies remain significant public health burdens among Indonesian children under five years of age. This study assessed the relationship between growth indicators and micronutrient status of children aged 0–59 months. Methods: A cross-sectional design was performed, utilizing the 2018 Indonesian Basic Health Research (Riskesdas) data and biological specimens, including 550 samples from children aged between 0 and 59 months old. The Riskesdas data used in this study were demographic characteristics, anthropometric measurements, and nutritional status. The biological samples were used to measure micronutrients (iron, zinc, calcium, vitamin A (VA), and vitamin D (VD). Results: Overall, 23.1% of children were stunted, and 10.5% were wasted. This study also revealed that the prevalence of micronutrient deficiency was 34.2%, 38.7%, 8.2%, 7.8%, and 0.4% for ferritin, zinc, calcium, VA, and VD, respectively. Moreover, wasting was significantly higher in girls (13.5%) than in boys (8.2%, p = 0.044). Stunted children had significantly lower ferritin values, while wasted children had lower VA concentrations. In contrast, VD was lower in overweight children. Lastly, this study found that height for age Z-scores (HAZ score) and Body Mass Index (BMI) for age Z-scores (BAZ score) correlated positively with ferritin, zinc, and calcium levels. Conclusions: Stunting, wasting, and multiple micronutrient deficiencies remain prevalent among Indonesian children under five years of age. Strengthening nutrition interventions, in particular for iron, zinc, VA, and VD, is essential to improve child growth and health outcomes in this population. Full article

Background: Childhood obesity is a global issue, influenced by energy-dense foods and powerful cues that affect brain areas regulating food intake. The olfactory system, linked to food preferences and consumption, is inversely related to body mass index. However, no studies have assessed the possible effect of eating behavior traits on the relationship between olfactory capacity and obesity. Objectives: The aim of this study was to examine whether olfactory capacity, eating behavior traits, and body mass index are associated with obesity in adolescents. Methods: An analysis of 204 Chilean adolescents was undertaken in a cross-sectional study. The proportion of participants with normal weight was found to be 39.2%, that of overweight was 25.9%, and that of obesity was 34.8%. Anthropometric measurements (weight, height, BMI Z-score), eating behavior, and olfactory capacity were evaluated. The Child Eating Behavior Questionnaire (CEBQ) and Food Reinforcement Value Questionnaire (FRVQ) were used to assess eating behavior. The Sniffing sticks test was used to assess olfactory capacity. Results: In the global sample, 1.0% had anosmia, 20.5% had hyposmia, 61.0% had normosmia, and 17.5% were supersmellers. Girls showed higher odor identification percentages than boys (p = 0.01). No gender differences were found in olfactory threshold, discrimination, identification, or TDI (threshold–discrimination–identification) scores, nor nutritional status. Stratified analysis revealed that girls with obesity had significantly lower odor discrimination capacity compared to those with normal weight. Conclusions: the study highlights a potential link between olfactory function and obesity, with obese girls showing reduced odor discrimination compared to normal-weight girls. Further research is needed to explore these mechanisms and their implications for targeted obesity interventions. Full article

Background/Objectives: Lactoferrin, a key bioactive component in human milk, may bridge functional gaps in infant formula; however, its long-term effects on growth and the gut microbiota in term infants remain underexplored, particularly in real-world settings. Methods: This real-world evidence (RWE) study assessed the impact of lactoferrin-fortified formula (LF) on infant growth, the gut microbiota, and feeding tolerance compared with control formula (CF) and exclusive breastfeeding (BF). After propensity score matching (PSM) for maternal education level and infant age, 111 matched Chinese infants (37 per group: LF, CF, and BF; age: 6–12 months) were analyzed. Growth was evaluated using WHO Z-scores (WAZ, LAZ, WLZ, and zBMI). The gut microbiota was profiled via 16S rRNA sequencing (n = 81). Feeding challenges were quantified using the Montreal Children’s Hospital Feeding Scale (MCH-FS). Results: The LF group exhibited significantly higher length-for-age Z-scores (LAZ) compared with both the BF and CF groups (p < 0.001), indicating superior linear growth. LF infants also showed reduced MCH-FS scores (18.0 vs. 36.2 in CF; p < 0.001), signifying fewer feeding difficulties. Gut microbiota analysis revealed enrichment of Bifidobacterium breve and butyrate-producing taxa (e.g., Faecalibacterium and Ruminococcaceae), higher alpha diversity, and metabolic divergence, involving enhanced lysine fermentation to acetate/butyrate in LF infants, suggesting a higher level of short-chain fatty acid (SCFA) production. Beta diversity analysis demonstrated that the LF microbiota clustered close to BF. Conclusions: Lactoferrin-fortified formula was associated with improved linear growth and feeding tolerance while shaping a healthy gut microbiota, showing similarities to breastfed infants’ microbiota. These findings support LF fortification as a strategy to improve functional outcomes in formula-fed infants. Full article

Background: Depression and anxiety are prevalent mental health disorders among children and adolescents, with diet quality emerging as a modifiable risk factor. However, evidence regarding the association between comprehensive diet quality and mental health in school-aged children remains limited. Methods: This cross-sectional study included 400 Chinese children aged 8–12 years. Diet quality was assessed using the low-burden Diet Quality Questionnaire (DQQ), from which three Global Diet Recommendations (GDRs) scores were derived: GDR-Healthy, GDR-Limit, and total GDR. Depression and anxiety symptoms were evaluated using the Children’s Depression Inventory (CDI) and the Social Anxiety Scale for Children (SASC), respectively. Log-binomial regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for the associations between GDR scores and mental health symptoms (depression, anxiety, comorbidity). Subgroup analyses stratified by age and sex were conducted to explore heterogeneity. Results: Higher total GDR scores were associated with lower risks of depressive symptoms (RR = 0.90, 95% CI: 0.84–0.96), anxiety symptoms (RR = 0.93, 95% CI: 0.88–0.99), and their comorbidity (RR = 0.88, 95% CI: 0.79–0.97) after adjustment for age, sex, zBMI, physical activity, region of residence, only-child status and parental education. The GDR-Healthy score was independently associated with lower risks of depression symptoms (RR = 0.89, 95% CI: 0.83–0.96) and comorbidity (RR = 0.87, 95% CI: 0.79–0.95), while no significant associations between GDR-Limit score and mental health disorders were observed. Subgroup analyses indicated that the association was consistent across sex and age subgroups. Conclusions: Better diet quality and particularly higher intake of health-protective foods is associated with lower risks of depression, anxiety, and their comorbidity symptoms in Chinese school-aged children in this cross-sectional study. These findings support the integration of diet quality monitoring and nutritional interventions into public health strategies to promote mental health in children. Full article