Chronic pain is a leading public health problem, impacting over 1.5 billion people worldwide. Standard-of-care includes pharmaceutical medication, surgery and physical therapy, yet many patients experience continued symptoms. Investigation into lifestyle-based approaches such as dietary interventions has increased in recent years, including intermittent fasting, due to known impacts on inflammation and neurotransmitters.

This systematic review and meta-analysis will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search will include the PubMed/MEDLINE, Embase (Ovid), Web of Science (Core Collection) and LILACS (VHL) databases. The Google Scholar, ClinicalTrials.gov, PROSPERO, Open Science Forum and MedRXiv platforms will also be searched. Randomised, controlled trials investigating the impact of intermittent fasting interventions in adult humans with any chronic pain condition will be included. The primary outcomes will be self-reported pain or function and the secondary outcome will be rescue medication use. Study screening, data extraction and risk of bias assessment will be conducted independently in duplicate. The Cochrane Risk of Bias-2 tool will be used to assess bias at the study level, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines will be used to assess bias at the outcome level. The meta-analysis will use random effects, with heterogeneity assessed using the I² statistic. For studies that report rescue medication use, we will analyse the impact of intermittent fasting on pain or function, adjusting for rescue medication use, using established methods. Subgroup and sensitivity analyses will be conducted to explore heterogeneity.

As this project involves analysis of publicly available data, no ethical oversight was or is required. The results of this review will be disseminated by publication in a peer-reviewed journal.

CRD #420261395061.

To examine associations of overall, healthy and unhealthy low-carbohydrate diet (LCD) scores with all-cause mortality in general and chronic disease populations. Healthy and unhealthy subtypes were compared with assess whether the observed associations depend on macronutrient quality rather than carbohydrate restriction alone.

Systematic review and pairwise category meta-analysis.

PubMed, MEDLINE, ProQuest Medical Database and Web of Science Core Collection were searched from inception to 12 May 2026.

Prospective cohort studies of adults assessing LCD adherence using a validated three-macronutrient composite score and reporting HRs for all-cause mortality were eligible.

Two reviewers independently extracted data and assessed study quality using the Newcastle-Ottawa Scale (NOS). Random-effects meta-analyses compared each higher reported LCD category with the lowest category, stratified by LCD score subtype and population type. Certainty of evidence was assessed using NutriGrade.

18 prospective cohort studies included 779 158 participants and 219 457 deaths; all scored 7–9/9 on the NOS. In chronic disease populations, the highest healthy LCD category was associated with lower mortality than the lowest category (HR 0.72, 95% CI 0.69 to 0.76; I²=0%; high certainty), as was the highest overall LCD category (HR 0.85, 95% CI 0.75 to 0.96; I²=68%; high certainty). In the general population, the highest healthy LCD category was not associated with lower mortality than the lowest category (HR 0.93, 95% CI 0.85 to 1.01; I²=69%; moderate certainty), and neither was the highest overall LCD category (HR 0.96, 95% CI 0.90 to 1.03; I²=87%; low certainty). Unhealthy LCD scores were not associated with mortality in either population.

Healthy LCD adherence was associated with lower all-cause mortality, particularly among individuals with chronic diseases. Unhealthy LCD scores were not associated with mortality in either population, suggesting that macronutrient quality and source may matter more than carbohydrate reduction alone.

Diabetic cardiomyopathy (DCM) is an important contributor to heart failure and death in patients with diabetes. Current management strategies mainly focus on glycaemic control and symptomatic treatment with limited disease-specific therapeutic options available. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated promising cardioprotective effects beyond glucose lowering; however, their efficacy and safety in DCM remain unclear. Therefore, this protocol describes the methods for a systematic review and meta-analysis to evaluate the efficacy and safety of GLP-1RAs in patients with DCM.

A systematic search will be conducted in PubMed (National Library of Medicine), Embase (Elsevier), the Cochrane Library (Wiley) and Web of Science (Clarivate Analytics), along with clinical trial registries and other relevant sources, up to 31 December 2026. All randomised controlled trials investigating GLP-1RAs for the treatment of DCM will be included. The primary outcomes will be cardiac function parameters, including left ventricular ejection fraction and left ventricular fractional shortening, while secondary outcomes will include metabolic indicators such as glycaemic and lipid profiles, biochemical markers such as oxidative stress-related indices and safety outcomes. Study selection and data extraction will be performed independently by two reviewers and risk of bias will be evaluated using version 2 of the Cochrane Risk of Bias tool. Statistical analyses will be performed using Stata V.16.0. Pooled effect sizes will be calculated using mean differences for continuous outcomes and risk ratios for dichotomous outcomes, with fixed-effect or random-effect models applied as appropriate. Meta-regression, subgroup and sensitivity analyses will be conducted to investigate the sources of heterogeneity. Publication bias will be assessed using funnel plots and Egger’s test, and the certainty of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Ethical approval is not required because this protocol relies exclusively on secondary analysis of previously published randomised trial data. The review findings will be disseminated through peer-reviewed journal publication.

CRD420261360886.

Evidence of an association between carbohydrate intake and atrial fibrillation (AF) incidence remains limited. We investigated the association between carbohydrate and staple food consumption and AF risk in a Japanese urban population.

Our population-based prospective cohort study included 5229 adult participants (mean age 56.9 years; 46.5% men) who completed a Food Frequency Questionnaire. Multivariable-adjusted Cox regression models were used to assess the association between carbohydrate intake (g/day) and staple food consumption (rice, noodles and bread) and AF incidence after adjusting for confounding factors. During 68 668 person-years of follow-up (mean, 13.1 years), 226 individuals developed AF. Total and simple carbohydrate intakes were associated with an increased AF risk in men (HR and 95% CI for Q4 vs Q1 were 2.51 (1.06 to 5.96) and 3.29 (1.33 to 8.13), respectively). In contrast, there were no significant associations between total carbohydrate, simple or complex carbohydrate intake and AF risk in women (HR and 95% CI for Q4 vs Q1 were 1.33 (0.27 to 6.65), 2.75 (0.74–10.26) and 1.04 (0.38-2.83), respectively). We found no association between staple foods and AF risk in men or women.

Our findings imply that the association between carbohydrate intake and AF risk is influenced by the type of carbohydrates. We found a positive association between high intake of simple carbohydrates and AF risk in men whereas the association was negative for complex carbohydrate intakes. Meanwhile, the results in the women’s group were inconclusive.

Rural residents are less likely to meet the recommendations for fruit and vegetable intake and disproportionately carry the burden of nutrition-related chronic disease. Nutrition incentive or voucher programmes aim to increase fruit and vegetable intake by reducing the financial burden of purchasing produce. Additionally, mobile markets have emerged as a potential strategy for increasing access to affordable fresh fruits and vegetables, particularly among rural residents. Yet, few studies have assessed the effectiveness of mobile markets to improve fruit and vegetable intake and the food and nutrition security status of rural residents, particularly those provided with vouchers.

This quasi-experimental, pre-post study examines the impact of vouchers provided to North Carolina (NC) Cooperative Extension programme participants to shop for produce at the Ripe for Revival (RfR) mobile market in eight rural eastern NC counties. The RfR mobile market sells fruits, vegetables, eggs, meat and milk at affordable prices in rural, economically disadvantaged communities. The trial’s primary outcome is the change in fruit and vegetable intake (self-reported and objectively measured) among rural Extension participants who use vouchers to shop at the RfR mobile market. The trial’s secondary outcomes include food security status, nutrition security status, blood pressure, height, weight (Body Mass Index (BMI) calculated), food utilisation, mobile market satisfaction, voucher redemption, and pounds and dollars of produce distributed. We will recruit participants (n=150) through NC Cooperative Extension programmes in the eight participating counties to receive a $20 monthly voucher each month for 3 months and shop at the RfR mobile market. Data will be collected at 4 time points: baseline (week 0, when a voucher is issued), 4–6 weeks post-baseline (1 month), 8–10 weeks post-baseline (2 months) and 12–16 weeks post-baseline (3 months). One-sided paired t-tests or Wilcoxon signed-rank tests (depending on normality) will evaluate mobile market voucher effectiveness.

The North Carolina State University Institutional Review Board approved the trial procedures. We plan to disseminate the main outcomes at the conclusion of grant funding (year 2) in both scientific and community settings.

NCT07218978.

B-vitamins and herbal supplements such as Passiflora incarnata have demonstrated potential benefits for cognitive and neurological functions. This study aims to evaluate the neural and biochemical effects of high-dose vitamin B multivitamin supplementation, with and without P. incarnata, in healthy adults using multimodal neuroimaging and biomarker assessments.

This is a phase I/II, randomised, double-blind, placebo-controlled clinical trial involving 108 healthy adults aged 30–55 years, allocated to three groups: (A) high-dose vitamin B multivitamin supplementation with P. incarnata; (B) high-dose vitamin B multivitamin supplementation alone; and (C) placebo. Participants will take two tablets daily for 24 weeks. The primary outcomes are changes in default mode network connectivity assessed using resting-state functional magnetic resonance imaging and diffusion magnetic resonance imaging, together with safety outcomes including vital signs, clinical laboratory parameters and adverse event monitoring. Secondary outcomes include regional brain metabolite concentrations measured by proton magnetic resonance spectroscopy and plasma biomarkers of one-carbon metabolism, including vitamin B₆, vitamin B₁₂, folate and homocysteine.

Ethics approval was granted by the Medical Research Ethics Committee, Ministry of Health Malaysia (NMRR-19-379-46101 (ISR); Protocol Number: Exec B). Results will be disseminated through peer-reviewed publications and scientific conferences.

ACTRN12622001150730.

To identify risk factors associated with inpatient mortality among under-five children admitted with complicated severe acute malnutrition (cSAM) at Woldia Comprehensive Specialized Hospital, Ethiopia.

Hospital-based unmatched case–control study conducted from 1 January 2016 to 30 December 2022. Data were extracted from 588 medical records (147 cases and 441 controls). Bivariable and multivariable logistic regression analyses were performed to identify predictors of mortality. Adjusted ORs (AORs) with 95% CIs were used to measure associations and statistical significance was set at p

Stabilisation centre of Woldia Comprehensive Specialized Hospital, Northeastern Ethiopia.

Under-five children admitted with cSAM.

Inpatient mortality among under-five children with cSAM.

A total of 588 records were included in the analysis. In multivariable logistic regression, grade I nutritional oedema (AOR 13.70; 95% CI 1.09 to 172.76), history of bottle feeding (AOR 5.43; 95% CI 1.09 to 26.98), vomiting (AOR 7.96; 95% CI 1.97 to 32.17), pale conjunctiva (AOR 8.68; 95% CI 2.47 to 30.53), shock (AOR 6.11; 95% CI 1.44 to 25.88), no vaccination history (AOR 11.83; 95% CI 3.09 to 45.29) and intravenous fluid administration (AOR 5.55; 95% CI 1.33 to 23.10) were independent predictors of mortality. Children in the first treatment phase had lower odds of death compared with those in later phases (AOR 0.017; 95% CI 0.003 to 0.098).

Bottle feeding history, grade I nutritional oedema, shock, intravenous fluid administration, pale conjunctiva, lack of vaccination and treatment phase were independent predictors of mortality among under-five children with cSAM. Strengthening adherence to cSAM management protocols and improving routine immunisation coverage may reduce inpatient mortality.

The purpose of this research was to assess the association between work stress and dietary patterns on metabolic syndrome (MetS) among Ghanaian military personnel.

A cross-sectional survey.

37 Military Hospital, Accra.

390 military personnel were recruited for this study.

Lipid profiles, fasting blood sugar, waist circumference, frequency of food intake, work stress and clinical profiles. MetS was defined according to the International Diabetes Federation criteria. Univariate and multivariate logistic regression models were applied to determine the associations.

The prevalence of MetS was 13.3%, with elevated blood pressure (69.7%) and abdominal obesity (43.8%) being the most common. Low work stress was reported by 62.8% (Effort-Reward Imbalance) and 63.6% (Job Content Questionnaire; JCQ) of participants. The JCQ model was associated with MetS (OR 6.472, 95% CI 1.535 to 27.292, p=0.011). About 61.0% of participants reported high physical activity levels. Two dietary patterns were identified, namely sugary and energy-dense and high protein and vegetables. Moderate consumers of the sugary and energy-dense dietary pattern were less likely to have MetS (Tertile 2: OR 0.368, 95% CI 0.168 to 0.805, p=0.012). Similarly, this pattern was also associated with lower odds of low high-density lipoprotein cholesterol (Tertile 2: OR 0.408, 95% CI 0.191 to 0.873, p=0.021) and reduced the odds of abdominal obesity (Tertile 3: OR 0.605, 95% CI 0.369 to 0.991, p=0.046). High triglyceride levels were also significantly lower across both Tertile 2 and Tertile 3 of this pattern (OR 0.331, 95% CI 0.116 to 0.949, p=0.040; OR 0.129, 95% CI 0.029 to 0.582, p=0.008), respectively. Further, the protein and vegetable dietary pattern was associated with increased odds of high blood pressure (Tertile 3: OR 2.132, 95% CI 1.231 to 3.693, p=0.007).

Moderate consumption of the sugary and energy-dense dietary pattern was surprisingly associated with reduced odds of MetS and several of its components, while the protein and vegetable-based pattern was linked to higher odds of elevated blood pressure. Further, work stress was significantly associated with increased odds of MetS. The findings of this research highlight the need to address psychosocial stressors in cardiometabolic risk prevention.

To determine the level and predictors of micronutrient intake inadequacy among pregnant women attending antenatal public health facilities in Bahir Dar City, Northwest Ethiopia.

A multicentre, cross-sectional study.

The study was conducted in public health facilities in Bahir Dar City, Northwest Ethiopia from January to March 2024.

About 420 pregnant women aged 18 years and older attending antenatal care at public health facilities in Bahir Dar. Pregnant women diagnosed with chronic diseases, sick and unable to communicate, and who had attended weddings, birthday celebrations or religious festivals within the past 24 hours were excluded.

Micronutrient intake inadequacy among pregnant women was measured using a single multiphasic 24-hour dietary recall. The Nutria-Survey Food Processor software, the Ethiopian food composition table and the World food composition table were used for the calculation of the nutrient value of micronutrients. The nutrient intakes were assessed by nutrient adequacy ratio and mean adequacy ratio. Data were analysed using SPSS V.26. Multivariable logistic regression analysis was done to identify the predictors of micronutrient intake inadequacy.

A total of 411 pregnant women were recruited in the study, yielding a 97.8% response rate. The overall prevalence of micronutrient intake inadequacy was 76.4% (95% CI 72.0% to 80.3%). The proportions of zinc, vitamin A, iron and calcium intake inadequacies were 48.2%, 66.7%, 14.8% and 74%, respectively. Having nutrition counselling (adjusted ORs (AOR)=3.5; 95% CI 2.00 to 6.48), having

Micronutrient intake among pregnant women was lower than the recommended levels. Therefore, strengthening community efforts to promote the consumption of a diversified diet for pregnant women, encourage nutrient-dense food production and enhance food security is essential.

Preterm birth (PTB) is a major adverse outcome in developing countries, including India, with serious adverse consequences. Although the pathophysiology is not fully understood, maternal biomarkers influencing placental function may contribute to premature rupture of membranes and PTB. Vitamin D₃ supplementation during pregnancy may lower the risk of PTB, particularly in populations with a high prevalence of vitamin D deficiency (~90% in India). However, available biomarkers for PTB prediction are non-confirmatory, costly and not part of routine care. The aim of the study is to evaluate whether 2000 IU/day vitamin D₃ supplementation during pregnancy reduces PTB compared with 500 IU/day (standard care).

Singleton pregnant women ≤18 weeks gestation with deficiency of 25-hydroxyvitamin D (

The study has been funded by the Department of Biotechnology, India (Grant Ref: BT/PR41941/MED/97/548/2021). Ethical clearance has been obtained from Institutional Ethics Committee (Ref No. IEC/344/2021), St. John’s Medical College & Research Institute and Ethics Committee of Bangalore Medical College & Research Institute (BMCRI/EC/25/2024). Study data will be disseminated through peer-reviewed publications and conference presentations.

Trial has been prospectively registered with Clinical Trials Registry - India (CTRI/2021/10/037658).

Infant and young child feeding (IYCF) practices are critical for child growth and survival, yet they are strongly shaped by sociocultural and livelihood contexts. In pastoralist settings, feeding practices are influenced by traditional beliefs, mobility, environmental constraints and access to health services. However, limited evidence exists on how community norms and social structures influence IYCF in remote pastoralist communities of Ethiopia.

This study aimed to explore maternal and community perspectives on IYCF practices in the pastoralist communities of Afar Region, Ethiopia.

Qualitative observational study using a phenomenological approach.

Pastoralist communities in the Afar Region, Ethiopia.

16 mothers of children aged 6–23 months participated in in-depth interviews, and 20 community members (religious leaders, elders and clan leaders) participated in three focus group discussions.

Participants were purposively selected. Data were collected using semi-structured interviews and focus group guides, audio-recorded, transcribed verbatim and translated into English. Data were analysed using an inductive thematic analysis approach.

Four interrelated themes shaped IYCF practices. Cultural rituals and elder authority influenced breastfeeding initiation, particularly following home births, where pre-lacteal feeding linked to the Onor/Onqor ritual was described as delaying initiation. Although awareness of exclusive breastfeeding was commonly reported among participants, seasonal water supplementation and maternal workload limited consistent adherence. Complementary feeding was generally introduced at 6 months; however, dietary diversity was constrained by pastoral livelihood instability, drought, market inaccessibility and rising food prices. Gendered household dynamics shaped resource control and caregiving responsibilities, with women bearing primary responsibility for childcare, feeding and hygiene. Clan-based social networks provided support during hardship but also reinforced some traditional feeding practices.

IYCF practices in pastoralist Afar are shaped by cultural norms, gender relations and structural constraints, including livelihood insecurity and limited service access. Interventions should integrate culturally responsive community engagement with gender-sensitive and livelihood-informed nutrition strategies.

An affordable heart-healthy dietary approach is essential for the management of familial hypercholesterolaemia (FH); however, the optimal dietary pattern and the role of adjunctive nutrient supplementation remain uncertain. This study aims to evaluate the effects of the Brazilian Cardioprotective Diet (DICA Br), adapted from the Portfolio Diet, with or without phytosterol and/or krill oil supplementation in individuals with probable or definite FH according to the Dutch Lipid Clinic Network (Dutch MEDPED) criteria.

The DICA-FH study is a national, multicentre, randomised, factorial, parallel-group, superiority, placebo-controlled clinical trial with a 1:1:1:1 allocation ratio. Participants aged ≥16 years receiving age-appropriate lipid-lowering therapy will be randomised into four groups: (1) adapted cardioprotective diet (DICA-FH) plus phytosterol placebo and krill oil placebo; (2) DICA-FH plus phytosterol 2 g/day and krill oil placebo; (3) DICA-FH plus phytosterol placebo and krill oil 2 g/day or (4) DICA-FH plus phytosterol 2 g/day and krill oil 2 g/day. All participants will undergo whole-genome sequencing and receive appropriate genetic counselling. Primary outcomes will be means of low-density lipoprotein cholesterol and lipoprotein(a) levels after 120 days. Secondary outcomes will include additional lipid biomarkers, adherence to protocol and adverse events. The planned sample size is 300 participants. Follow-up is expected to conclude in July 2026.

This study was registered under CAAE 65549622.2.1001.0060 and received ethical approval from the Hcor Research Ethics Committee (approval number 5.805.072) and the Brazilian National Research Ethics Commission (CONEP; approval number 6.864.951). Written informed consent will be obtained from all participants prior to enrolment. The study findings will be disseminated through peer-reviewed publications, scientific conferences and channels aimed at the general public.

NCT06331195.

Undernutrition remains a public health challenge in Ethiopia, despite several nutrition programmes. Therefore, the aim of this study was to assess the prevalence of undernutrition and its associated factors among children aged 6–59 months in rural model households in the Central Zone of the Sidama regional state.

This study employed a community-based cross-sectional design between 4 July and 4 August 2024.

The study was conducted in selected woredas of the Central Zone of the Sidama regional state.

A multi-stage sampling technique was used to select 627 children aged 6–59 months in the model households. Model households, defined as those that attended at least 75% of the 96-hour training sessions and successfully implemented 75% of the Health Extension Program (HEP) packages, were awarded certificates.

The primary outcomes of this study were undernutrition, specifically stunting, underweight and wasting.

The secondary outcome focused on factors associated with stunting, underweight and wasting. Bivariable and multivariable robust Poisson regression analyses were used to identify the associations between outcome and risk factors. The strength and significance of associations were assessed using adjusted prevalence ratios (APRs) with 95% CIs and p

Although multilevel analysis was performed to account for woreda and kebele clustering, no significant effects were found. Simple robust Poisson regression findings are therefore presented. Stunting prevalence was 37.6%, underweight 13.9% and wasting 9.4%. Being male is linked to a higher prevalence of stunting (APR 1.37, 95% CI 1.11 to 1.69), underweight (APR 1.72, 95% CI 1.12 to 2.65) and wasting (APR 1.73, 95% CI 1.003 to 2.98). Conversely, spoon-feeding (APR 0.61, 95% CI 0.39 to 0.95), mothers as housewives (APR 0.56, 95% CI 0.42 to 0.76) versus farmers and maternal household decision-making (APR 0.29, 95% CI 0.12 to 0.70) were associated with lower prevalence of stunting. Additionally, larger households (≥5 members) were also associated with higher prevalence of underweight (APR 1.61, 95% CI 1.04 to 2.52) and wasting (APR 1.88, 95% CI 1.09 to 3.24).

Our findings indicate a higher prevalence of stunting, accompanied by moderate rates of wasting, among children residing in rural model households in the Sidama region. Notably, practices such as spoon-feeding and maternal involvement in decision-making were associated with a lower prevalence of stunting. Conversely, larger family size was linked with a higher prevalence of underweight and wasting among children. To address these challenges, it is essential to promote hygienic feeding practices via the HEP, empower women in their communities, advocate for family planning to manage family size and strengthen community-based nutrition programmes. These measures could help combat undernutrition in rural areas.

This study aims at understanding the important correlates of child undernutrition in India using a quantile regression approach.

Cross-sectional study.

The study utilizes the secondary data from the latest round of the National Family Health Survey (2019–2021) to assess the individual, maternal and household-level determinants of under-nutrition among Indian children aged 0–5 years.

The unit of analysis is children under the age of 5 years and the sample size is 224, 218.

The outcome measures of this study are stunting, wasting and underweight.

Results from our study show that birth order and size of the child at birth have a statistically significant association with stunting, wasting and underweight. While currently breastfeeding is negatively associated with HAZ scores (below 50th quantile), maternal height is positively associated with HAZ, WAZ and WHZ scores in all quantiles. Mother’s age, body mass index and education level have significantly stronger association with HAZ and WHZ scores. Furthermore, children from richer and richest households are likely to have higher HAZ, WAZ, and WHZ scores compared to the children from poorest households. For instance, the WHZ scores increased from 0.15 in the 10th quantile among the poorest to 0.43 among the richest at the same quantile. Moreover, at the 90th percentile, this coefficient increased from 0.11 among the poorest to 0.46 among the richest.

It is crucial to acknowledge that to have healthy babies, we must have healthy mothers. Thus, interventions to address child nutrition in India should also focus on maternal health, education, increasing the women’s agency and women empowerment. The findings of the study suggest that concerted efforts addressing the manifold determinants of children’s nutritional status from the government, non-governmental organisations and civil societies will ensure bolstered nutritional outcomes for children in India.

Parents play a pivotal role in shaping their children’s food environment and eating behaviours. Involving parents in interventions designed to promote nutritional outcomes such as dietary intake in children has been shown to improve parental feeding practices. However, it remains unclear how such interventions influence children’s eating behaviour outcomes. This protocol describes the methods of a systematic review evaluating the effectiveness of interventions involving parents in improving the eating behaviours of healthy children aged 0–12 years.

Electronic databases including MEDLINE, EMBASE, CENTRAL, APA PsycINFO, CINAHL, Scopus and Web of Science will be searched from inception to September 2025. A search strategy is developed to identify randomised controlled trials directly involving parents and reporting eating behaviours in children as either primary or secondary outcomes. Two independent reviewers will screen identified records and extract data on study, participant and intervention characteristics. Study results relevant to our primary and secondary outcomes will also be extracted using a prepiloted standardised data extraction form. We will use the Revised Cochrane Risk of Bias tool (RoB2) and Grading of Recommendations Assessment, Development and Evaluation approach to assess risk of bias and certainty of evidence, respectively. Where possible, meta-analysis using random-effects models will be performed; otherwise a qualitative summary will be provided.

Ethics approval is not required for this study as no primary data will be collected. The findings will provide valuable insights for stakeholders to inform and optimise public health policies and practices aimed at empowering families to promote healthy eating behaviours early in childhood. The results will be submitted for publication in a peer-reviewed journal.

CRD420251076540.