Nutrients

23 pages, 1140 KB

Open AccessArticle

Diet Quality, Nutrition Knowledge, and Social Media-Driven Supplement Use Among Polish Adolescents and Young Adults: A Cross-Sectional Study

by Klaudia Sochacka, Agata Kotowska and Sabina Lachowicz-Wiśniewska

Nutrients 2026, 18(9), 1363; https://doi.org/10.3390/nu18091363 (registering DOI) - 25 Apr 2026

Abstract

Diet quality, nutrition knowledge, and psychosomatic literacy—defined as the understanding of the interactions between diet, gut microbiota, and mental well-being—may shape weight-related behaviours in youth. This study used a cross-sectional design to integrate these domains with digital information pathways in Central–Eastern Europe. This [...] Read more.

Diet quality, nutrition knowledge, and psychosomatic literacy—defined as the understanding of the interactions between diet, gut microbiota, and mental well-being—may shape weight-related behaviours in youth. This study used a cross-sectional design to integrate these domains with digital information pathways in Central–Eastern Europe. This study assessed diet quality, nutrition, and psychosomatic knowledge, supplement use, and health-information sources among Polish adolescents and young adults, with emphasis on age-related differences and the role of social media. A cross-sectional, anonymous online survey (October 2025–January 2026) was conducted in Poland (final analytical sample: n = 478; adolescents 15–19 years vs. young adults 20–30 years). Of 591 individuals who accessed the survey, 478 were included in the final analytical sample. Diet quality was estimated from FFQ data using KomPAN-derived indices (pHDI-10, nHDI-14, DQI). Nutrition knowledge (0–25 points), psychosomatic/gut–brain indicators, supplementation, and information sources were analysed using χ²/Fisher tests and Mann–Whitney U tests with effect sizes. The primary outcomes measured were dietary supplement use and excess body weight (BMI ≥ 25 kg/m²). Multivariable logistic regression examined predictors of supplement use and BMI ≥ 25 kg/m². Overall diet quality was low to moderate, with limited intake of whole grains, legumes, and fish, and common nutrition misconceptions. Social media was the most frequently indicated source of diet/supplement information and was independently associated with more frequent supplement use (OR = 2.29; 95% CI: 1.43–3.64). Adolescents reported lower whole-grain intake and more misconceptions than young adults. Predictors of BMI ≥ 25 kg/m² included male sex (OR = 2.46; 95% CI: 1.46–4.15), lower education, and lower nutrition knowledge, while age showed a non-linear positive association with excess body weight. Polish adolescents and young adults show gaps between declared pro-health attitudes and actual diet quality/competencies. Social media reliance appears particularly linked to product-oriented behaviours (supplementation). Prevention should strengthen nutrition and food safety education, digital health literacy, and professional guidance on supplementation, especially in adolescents. Our findings suggest that social media is a primary driver for dietary supplementation among Polish youth, more so than objective nutrition knowledge. While diet quality is linked to weight status, the relationship is complex. These results may inform future public health interventions targeting digital health literacy to promote balanced nutrition and safe supplementation practices. Full article

(This article belongs to the Special Issue Association Between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—3rd Edition)

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13 pages, 402 KB

Open AccessArticle

Prospective Associations of Serum Vitamin B12, Homocysteine, and Ferritin Levels with Probable Sarcopenia

by Inkyung Baik

Nutrients 2026, 18(9), 1362; https://doi.org/10.3390/nu18091362 (registering DOI) - 25 Apr 2026

Abstract

Background/Objectives: Previous cross-sectional studies investigated the associations of low handgrip strength (HS), a primary indicator of probable sarcopenia (PS), with biomarkers related to anemia. However, existing evidence is inconsistent, and data establishing causality remain limited. The present prospective study aimed to evaluate [...] Read more.

Background/Objectives: Previous cross-sectional studies investigated the associations of low handgrip strength (HS), a primary indicator of probable sarcopenia (PS), with biomarkers related to anemia. However, existing evidence is inconsistent, and data establishing causality remain limited. The present prospective study aimed to evaluate whether serum vitamin B12, folate, homocysteine (Hcy), and ferritin levels are associated with PS risk. Methods: This study analyzed data from 1930 adults aged 45–76 years who had normal muscle quantity at baseline. Serum biomarkers were assessed at baseline and PS defined by low HS was determined at 6-year follow-up. The modified Poisson regression method was employed to calculate multivariable risk ratios (RRs) and 95% confidence intervals (CIs). Results: Among all participants, PS risk was inversely related to serum vitamin B12 levels (p = 0.06), while it was lowest in the high-normal ranges of serum Hcy (12.1–15 μmol/L) and ferritin (101–200 ng/mL) levels. The RRs (95% CIs) for PS risk were 0.73 (0.60, 0.89) and 0.75 (0.64, 0.87) for high-normal Hcy and ferritin categories, respectively, compared with the lowest category. On examining the associations of elevated Hcy and ferritin levels with PS risk, age was identified as a significant modifier for elevated Hcy levels (>15 μmol/L) (p for interaction < 0.05); a reduced risk was observed in younger participants, whereas an increased risk was noted in older participants. Conclusions: These findings suggest that high-normal ferritin levels may be optimal for alleviating PS risk, irrespective of age, and that elevated Hcy levels could be detrimental for older adults in preventing PS risk. Full article

(This article belongs to the Special Issue Vitamins and Human Health: 3rd Edition)

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13 pages, 964 KB

Open AccessSystematic Review

Ultraprocessed Food Intake, Cognition, and Executive Function in Adults: A Systematic Review

by Marina Wöbbeking-Sánchez, María Elena Chávez-Hernández, Lizbeth De La Torre, Silvia Wöbbeking-Sánchez, Alba Villasán-Rueda, Octavio Salvador-Ginez and Luis Miguel Rodríguez-Serrano

Nutrients 2026, 18(9), 1361; https://doi.org/10.3390/nu18091361 (registering DOI) - 25 Apr 2026

Abstract

Introduction: This systematic review examines the association between ultraprocessed food (UPF) intake and cognitive and executive function in adults. Given the global rise in overweight and obesity and the increasing consumption of UPFs, understanding their potential impact on brain health is of [...] Read more.

Introduction: This systematic review examines the association between ultraprocessed food (UPF) intake and cognitive and executive function in adults. Given the global rise in overweight and obesity and the increasing consumption of UPFs, understanding their potential impact on brain health is of growing importance. Method: A comprehensive literature search was conducted in PubMed, EBSCO, and Scopus databases following PRISMA guidelines. Fourteen studies met inclusion criteria, encompassing cross-sectional, longitudinal, and experimental designs. Risk of bias was assessed using the National Institutes of Health Quality Assessment Tool. Results: The majority of studies (78.5%) reported a significant association between higher UPF consumption and poorer cognitive outcomes, including deficits in memory, executive function, and global cognition. Longitudinal studies consistently demonstrated that increased UPF intake is linked to accelerated cognitive decline and a higher risk of mild cognitive impairment and dementia, particularly in middle-aged and older adults. In contrast, cross-sectional findings were more heterogeneous, and evidence in younger populations remains limited and inconclusive. Conclusions: Overall, the findings suggest that high UPF consumption may be a modifiable risk factor for cognitive decline. However, methodological variability and the predominance of observational studies highlight the need for further longitudinal and experimental research to clarify causal mechanisms. Full article

(This article belongs to the Special Issue Ultra-Processed Foods and Nutritional Profiles on Chronic Disease)

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14 pages, 684 KB

Open AccessArticle

The Association Between Adherence to the Dutch Healthy Diet Index and Glaucoma Prevalence—The Maastricht Study

by Yu Yu, Tos T. J. M. Berendschot, Simone J. P. M. Eussen, Carla J. H. van der Kallen, Carroll A. B. Webers and Wishal D. Ramdas

Nutrients 2026, 18(9), 1360; https://doi.org/10.3390/nu18091360 (registering DOI) - 25 Apr 2026

Abstract

Objectives: To investigate the association between adherence to national nutritional guidelines (Dutch Healthy Diet Index [DHD-index]) and glaucoma prevalence and to explore whether this association changed after accounting for measured intraocular pressure (IOP). Methods: This cross-sectional study used baseline data 2010–2013 from The [...] Read more.

Objectives: To investigate the association between adherence to national nutritional guidelines (Dutch Healthy Diet Index [DHD-index]) and glaucoma prevalence and to explore whether this association changed after accounting for measured intraocular pressure (IOP). Methods: This cross-sectional study used baseline data 2010–2013 from The Maastricht Study, a population-based cohort in The Netherlands. Adults aged 40–75 years with implausible dietary intake were excluded. Dietary intake was evaluated using a validated food frequency questionnaire, and adherence was quantified by the DHD-index. All participants underwent ophthalmic examination including perimetry and IOP measurement. Logistic and linear regression models examined associations of DHD adherence with glaucoma prevalence and IOP. Additional exploratory analyses assessed whether the association with glaucoma was attenuated after accounting for measured IOP. Results: Among 5729 participants (mean age: 59.5 ± 8.7 years; 50.1% female), glaucoma prevalence was 9.7% (n = 558). Each 10-point increase in DHD-index score was associated with 12.5% lower odds of glaucoma prevalence (odds ratio [OR]: 0.88; 95% confidence interval [CI], 0.83 to 0.93) and lower IOP (β: −0.17; 95% CI, −0.25 to −0.09 mmHg). Individuals in the highest DHD adherence tertile had 38% lower odds of glaucoma than those in the lowest tertile (OR 0.62; 95% CI, 0.50 to 0.76). Additional adjustment for measured IOP yielded similar estimates. Conclusions: Higher adherence to the Dutch Healthy Diet was associated with a lower glaucoma prevalence. The association was only minimally attenuated after accounting for measured IOP. Longitudinal studies should examine whether adherence to national dietary guidelines is associated with glaucoma onset and progression. Full article

(This article belongs to the Section Nutritional Epidemiology)

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18 pages, 858 KB

Open AccessReview

Magnesium in Neurocritical Care: Clinical Relevance, Status Assessment, and Practical Implications for Outcomes—A Narrative Review

by Stefano Marelli, Lorenzo Querci and Arturo Chieregato

Nutrients 2026, 18(9), 1359; https://doi.org/10.3390/nu18091359 (registering DOI) - 25 Apr 2026

Abstract

Background: Magnesium regulates neuronal excitability, NMDA receptor activity, and cerebrovascular tone. Dysmagnesemia is common in patients with acute brain injury (>65%), yet large randomized trials of magnesium neuroprotection have been neutral despite strong physiological rationale and consistent observational associations with outcomes. A key [...] Read more.

Background: Magnesium regulates neuronal excitability, NMDA receptor activity, and cerebrovascular tone. Dysmagnesemia is common in patients with acute brain injury (>65%), yet large randomized trials of magnesium neuroprotection have been neutral despite strong physiological rationale and consistent observational associations with outcomes. A key limitation may be diagnostic misclassification: the total serum magnesium poorly reflects the biologically active ionized fraction and may misclassify magnesium status in 20–85% of ICU patients during critical illness. Purpose: This narrative review synthesizes current evidence on magnesium physiology, measurement limitations, and clinical implications in neurocritical care. Overview: We discuss the mechanisms of magnesium depletion, outline the conceptual “two-hit” model (chronic deficiency plus acute ICU losses), and highlight the potential value of ionized magnesium for improved patient evaluation. Emerging syndrome-specific data suggest that magnesium disturbances are associated with prognostic signals. Improved phenotyping may help explain prior trial neutrality and support stratified approaches to magnesium monitoring and repletion. Future studies should evaluate magnesium-guided strategies and phenotype-driven trials to clarify the therapeutic role of magnesium in neurocritical care. Full article

(This article belongs to the Special Issue Magnesium in Human Health and Disease: Research Advances and Clinical Perspectives)

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11 pages, 216 KB

Open AccessArticle

Affordability and Serving Accuracy of a Publicly Available DASH Meal Plan for Women Using SNAP Benefits

by Kendra OoNorasak, Mansura Shahad Bawa, Nadia A. Sesay, Emma Smith, Taylor Emerson, Jayden Brewer and Brandi M. White

Nutrients 2026, 18(9), 1358; https://doi.org/10.3390/nu18091358 (registering DOI) - 25 Apr 2026

Abstract

Background/Objectives: This regional case study evaluated the affordability and serving accuracy of a publicly available one-week DASH meal plan for single-woman households using Supplemental Nutrition Assistance Program (SNAP) benefits in central Kentucky. Methods: For each food item in the one-week plan, [...] Read more.

Background/Objectives: This regional case study evaluated the affordability and serving accuracy of a publicly available one-week DASH meal plan for single-woman households using Supplemental Nutrition Assistance Program (SNAP) benefits in central Kentucky. Methods: For each food item in the one-week plan, total grocery costs and per-serving costs were calculated using January 2025 prices from two national grocery chains commonly patronized in an urban area in central Kentucky. Calculated costs were compared to the average weekly food cost for women aged 20–50 years in a single household based on the Thrifty Food Plan (TFP). Servings for food groups and categories were calculated using MyPlate and American Heart Association guidelines to compare with those reported in the one-week plan. Results: The total grocery cost was $262.17, including staple foods expected to last more than a week. The adjusted per-serving cost of $82.90 was 21.19% higher than the average weekly food cost based on the January 2025 TFP. All food groups and categories except dairy showed differences of at least one serving between our calculations and the one-week plan. Conclusions: Findings from this case study on grocery costs suggest that the one-week plan may pose affordability challenges in this regional context and continued evaluation of whether SNAP benefit allotments based on TFP adequately reflect regional food cost variations may be warranted. Discrepancies in total servings highlight the need to improve the accuracy of publicly available DASH resources and to review these materials for consistency and accuracy. Full article

(This article belongs to the Special Issue Nutrition Equity and Community Health: Social, Environmental, and Innovative Approaches)

19 pages, 611 KB

Open AccessReview

Carob (Ceratonia siliqua L.) in Glucose Homeostasis and Energy Balance: The Role of D-Pinitol

by Daniel Torres-Oteros, Emily Pardo-Araujo, Pedro F. Marrero, Sílvia Canudas, Diego Haro and Joana Relat

Nutrients 2026, 18(9), 1357; https://doi.org/10.3390/nu18091357 (registering DOI) - 25 Apr 2026

Abstract

The global rise in obesity and metabolic disorders has intensified interest in dietary bioactives capable of improving glycemic control and metabolic health. Inositols, particularly D-pinitol, have emerged as insulin-sensitizing cyclitols with potential metabolic relevance. Carob (Ceratonia siliqua L.), one of the richest [...] Read more.

The global rise in obesity and metabolic disorders has intensified interest in dietary bioactives capable of improving glycemic control and metabolic health. Inositols, particularly D-pinitol, have emerged as insulin-sensitizing cyclitols with potential metabolic relevance. Carob (Ceratonia siliqua L.), one of the richest natural sources of D-pinitol, represents a promising nutritional matrix for metabolic regulation. This narrative review critically evaluates current evidence on the role of D-pinitol in glucose homeostasis and energy balance, integrating data from chemical characterization studies, mechanistic research, preclinical models, and human clinical trials assessing purified D-pinitol and D-pinitol–rich preparations, particularly from carob-derived sources. Available evidence suggests that D-pinitol may enhance insulin signaling efficiency, primarily through PI3K/Akt-dependent pathways, modulate hepatic metabolic flexibility, and influence endocrine balance without acting as a classical hypoglycemic agent. Preclinical models consistently report improvements in insulin sensitivity, lipid handling, oxidative stress parameters, and tissue-specific metabolic adaptations. In contrast, clinical trials in healthy, prediabetic, and type 2 diabetic individuals show more heterogeneous outcomes, including attenuation of postprandial glycemia, reductions in circulating insulin and HOMA-IR, and modest improvements in lipid and inflammatory markers. Overall, carob-derived D-pinitol appears to act as a potential insulin-sensitizing metabolic modulator with context-dependent effects influenced by metabolic phenotype and food matrix composition. However, available data remains limited and heterogeneous, with most data derived from preclinical studies and relatively small clinical trials. These findings should therefore be interpreted with caution. Larger, longer-term randomized controlled trials using standardized preparations are required to establish clinical relevance and translational applicability. Notably, the contribution of other bioactive components within the carob matrix cannot be excluded. Full article

(This article belongs to the Section Phytochemicals and Human Health)

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15 pages, 580 KB

Open AccessArticle

Parenting Style, Caregiver Stress, and Energy-Dense Feeding Episodes in Low-Income Preschoolers: A Pilot Ecological Momentary Assessment Study

by Maryam Yuhas, Katherine M. Kidwell, Xuezhu Hua, Greta M. Smith and Lynn S. Brann

Nutrients 2026, 18(9), 1356; https://doi.org/10.3390/nu18091356 (registering DOI) - 24 Apr 2026

Abstract

Background/Objectives: Excess consumption of energy-dense foods (EDF; ultra-processed snacks, sweets, and sugar-sweetened beverages) among preschool-aged children is a public health concern, particularly in low-income families. Caregiver parenting style, psychological stress, and food-parenting practices (FPP) may shape children’s EDF consumption, yet little is known [...] Read more.

Background/Objectives: Excess consumption of energy-dense foods (EDF; ultra-processed snacks, sweets, and sugar-sweetened beverages) among preschool-aged children is a public health concern, particularly in low-income families. Caregiver parenting style, psychological stress, and food-parenting practices (FPP) may shape children’s EDF consumption, yet little is known about how these factors operate in real time. This exploratory pilot study examined (1) associations between baseline characteristics and EDF feeding episodes across 1 week and (2) whether caregivers’ momentary stress during EDF episodes related to FPP used. Methods: In total, 22 caregivers of Head Start children (ages 3–5) completed baseline measures and 7 days of ecological momentary assessment (up to seven prompts/day). At each prompt, caregivers reported child EDF consumption in the past hour; if confirmed, they reported FPP used and rated momentary stress. Aim 1 used Poisson regression to model caregiver-level EDF episode counts. Aim 2 tested momentary stress–practice associations during EDF episodes using GEE, with within-person and between-person stress modeled separately. Results: Authoritarian parenting was associated with a higher weekly rate of EDF episodes (RR = 1.43, 95% CI 1.23–1.66, p < 0.001); authoritative parenting trended lower (RR = 0.90, p = 0.065). Higher baseline stress was associated with more EDF episodes (RR = 1.25, p = 0.001). Momentarily, elevated stress above a caregiver’s own average increased odds of using food as a reward (OR = 1.08 per +10 points, p = 0.011), while higher average momentary stress was associated with co-eating (OR = 1.59, p = 0.042). Domain-level FPP composites showed no association with momentary stress. Conclusions: Authoritarian parenting and higher caregiver stress were associated with increased EDF feeding, and momentary stress was linked to reward-based feeding during those episodes. These hypothesis-generating findings suggest potential behavioral targets for just-in-time adaptive intervention, pending replication in adequately powered studies. Full article

(This article belongs to the Section Nutritional Policies and Education for Health Promotion)

16 pages, 642 KB

Open AccessArticle

Association of Legume Intake with Incident Hyperuricemia: A Prospective Cohort Study in Shanghai Adult Residents

by Xiaoli Xu, Mengru He, Na Wang, Xing Liu, Minqi Wei, Yonggen Jiang, Qian Peng, Jianhua Shi, Dandan He and Genming Zhao

Nutrients 2026, 18(9), 1355; https://doi.org/10.3390/nu18091355 (registering DOI) - 24 Apr 2026

Abstract

Objective: To evaluate the relationship between legume intake and incident hyperuricemia among Chinese adults using large-scale prospective cohort data. Methods: Baseline and follow-up information from the Shanghai Suburban Adult Cohort and Biobank (SSACB) were used to assess diet and hyperuricemia incidence [serum uric [...] Read more.

Objective: To evaluate the relationship between legume intake and incident hyperuricemia among Chinese adults using large-scale prospective cohort data. Methods: Baseline and follow-up information from the Shanghai Suburban Adult Cohort and Biobank (SSACB) were used to assess diet and hyperuricemia incidence [serum uric acid (SUA) ≥ 420 μmol/L in males and ≥ 360 μmol/L in females]. A Food Frequency Questionnaire (FFQ) covering 29 food categories quantified food consumption during the previous 12 months. Legume intake was calculated by multiplying the reported consumption of each item by (1 − water content), and participants were classified into tertiles with the lowest third (Q1) as the reference. Cox proportional-hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), and restricted cubic splines (RCSs) with three knots (10th, 50th, and 90th percentiles) visualized the dose–response relation. Results: Among 43,371 participants, 1456 new cases of hyperuricemia were documented over 225,002.40 person-years (incidence density 6.47/1000 person-years; 95% CI 6.14–6.80). Incidence density decreased with higher legume intake: each 1 g/day increment was associated with a 2% lower risk (HR 0.98; 95% CI 0.97–0.99; p < 0.05). Compared with Q1, the highest tertile (Q3) showed a 26% risk reduction in the fully adjusted model (HR 0.74; 95% CI 0.64–0.86; p < 0.05). RCS revealed a significant nonlinear relationship (p-overall < 0.001, p-nonlinear = 0.0013), with the significant benefit in risk observed at 6–28 g/day. Conclusions: Legume intake is nonlinearly and inversely associated with hyperuricemia risk among Shanghai suburban adults. Given that the current low median intake, comprehensive strategies are needed to rationally adjust the dietary structure, improve legume intake, and provide sustainable development strategies for effective prevention and control of hyperuricemia. Full article

(This article belongs to the Section Nutritional Epidemiology)

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13 pages, 302 KB

Open AccessEditorial

The Role of Nutrition in Exercise and Sports

by Roberta Ceci and Guglielmo Duranti

Nutrients 2026, 18(9), 1354; https://doi.org/10.3390/nu18091354 - 24 Apr 2026

Abstract

Nutrition affects all bodily processes by supporting energy production and tissue maintenance [...] Full article

(This article belongs to the Special Issue The Role of Nutrition in Exercise and Sports)

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21 pages, 3863 KB

Open AccessArticle

Examining Nutritional Vulnerability in an Under-Resourced Community in Northeastern Connecticut

by Xiran Chen, Daniela C. Avelino, Sydney K. Clements, Manije Darooghegi Mofrad, Xiang Chen, Michael J. Puglisi, Valerie B. Duffy and Ock K. Chun

Nutrients 2026, 18(9), 1353; https://doi.org/10.3390/nu18091353 - 24 Apr 2026

Abstract

Background/Objectives: Nutritional vulnerability (NV) describes the interaction of diet quality, access to food, health status and socioeconomic factors and may differ between neighborhoods. Nevertheless, there is still a limited amount of evidence regarding local NV variations in contrasting resource landscapes. The purpose [...] Read more.

Background/Objectives: Nutritional vulnerability (NV) describes the interaction of diet quality, access to food, health status and socioeconomic factors and may differ between neighborhoods. Nevertheless, there is still a limited amount of evidence regarding local NV variations in contrasting resource landscapes. The purpose of this study was to operationalize NV in Windham, Connecticut and conduct an analysis of its spatial distribution and the differences between neighborhoods for NV and specifically diet quality. Methods: NV was measured with four indicators, including two diet quality measures (liking-based DQI and short food frequency-based sHEI), food security, obesity, and SNAP participation. Areas of vulnerable concentration were determined through spatial mapping. Indicators related to each other were measured by Spearman correlation. To compare the contrasting neighborhoods (resource-dense vs. resource-limited), contextual differences were studied and differences in NV indicators, sociodemographic and movement factors were compared with the help of chi-square tests. Diet quality measures were jointly examined for concordance (both measures low or high) and discordance. Results: Area-level comparisons showed significant differences in mobility-related and sociodemographic characteristics, including vehicle access and education level (p < 0.05). High diet quality (measure concordance) was reported by individuals living in high-resourced regions; low diet quality (measure concordance) by individuals in low-resourced regions. Conclusions: The NV Map illustrated focal patterns of vulnerability determined by the interplay of sociodemographic disadvantage and mobility-related limitations and not by distance to food resources. These results give practical spatial data to promote specific nutrition and resource intervention. Full article

(This article belongs to the Special Issue Digital Tools for Healthy Eating in Underserved Populations)

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18 pages, 1719 KB

Open AccessReview

Sarcopenia in Kidney Transplantation: Bridging Pathophysiology to Patient-Centered Care

by Anna Pisacreta, Paolo Molinari, Lara Caldiroli, Margherita Di Naro, Francesco Pesce, Anna De Amici, Anna Regalia, Simona Verdesca, Silvia Malvica, Giuseppe Grandaliano, Giuseppe Castellano and Carlo Alfieri

Nutrients 2026, 18(9), 1352; https://doi.org/10.3390/nu18091352 - 24 Apr 2026

Abstract

Sarcopenia, defined as the progressive loss of skeletal muscle mass and strength, is increasingly recognized as a significant concern in patients with chronic kidney disease (CKD) and particularly in kidney transplant recipients (KTx-ps). This review explores the complex interplay of pathophysiological mechanisms, prevalence, [...] Read more.

Sarcopenia, defined as the progressive loss of skeletal muscle mass and strength, is increasingly recognized as a significant concern in patients with chronic kidney disease (CKD) and particularly in kidney transplant recipients (KTx-ps). This review explores the complex interplay of pathophysiological mechanisms, prevalence, and management strategies of sarcopenia in the context of kidney transplantation. CKD contributes to sarcopenia through systemic inflammation, malnutrition, uremic toxin accumulation, and metabolic imbalances, all of which persist or are exacerbated after transplantation due to immunosuppressive therapies especially corticosteroids. Notably, the post-transplant period may introduce additional risks, such as altered body composition and reduced physical activity, further aggravating muscle wasting. Sarcopenia affects approximately 26% of KTx-ps, leading to adverse outcomes including decreased quality of life, increased risk of infection, frailty, delayed recovery, and graft loss. The diagnosis remains challenging due to variability in assessment tools and a lack of standardized criteria. Management strategies must be multifactorial, including personalized nutritional support, targeted physical activity, and, where appropriate, pharmacological interventions. Early identification through imaging and functional testing is critical, especially in older patients and those with prolonged dialysis vintage. Emerging therapies, such as myostatin inhibitors, offer promise but require further validation. Additionally, early steroid withdrawal may mitigate muscle loss without compromising graft survival in selected patients. This review underscores the need for heightened awareness and standardized protocols to identify and manage sarcopenia in kidney transplantation, ultimately improving long-term outcomes and patient-centered care. Full article

(This article belongs to the Special Issue Prevention and Treatment of Malnutrition and Its Complications in Chronic Kidney Disease)

23 pages, 2311 KB

Open AccessArticle

Structural Characterization of an Acidic Polysaccharide from Walnut Green Husks and Its Therapeutic Potential in DSS-Induced Ulcerative Colitis

by Sanawar Mansur, Xin Hu, Xinyu Song, Nuerbiye Jueraiti, Anargvl Mahmut, Fuxiang Luo, Aytursun Abuduwaili, Weihao Wang, Zulfiye Talat and Xieraili Tuerxun

Nutrients 2026, 18(9), 1351; https://doi.org/10.3390/nu18091351 - 24 Apr 2026

Abstract

Background/Objectives: The worldwide occurrence of ulcerative colitis (UC) is increasing, but existing treatments frequently suffer from limited effectiveness and notable side effects. walnut green husk polysaccharide (WGHP) has been shown to exhibit anti-inflammatory and immunomodulatory activities; however, its specific potential and mechanisms of [...] Read more.

Background/Objectives: The worldwide occurrence of ulcerative colitis (UC) is increasing, but existing treatments frequently suffer from limited effectiveness and notable side effects. walnut green husk polysaccharide (WGHP) has been shown to exhibit anti-inflammatory and immunomodulatory activities; however, its specific potential and mechanisms of action against colitis remain unclear. This study aimed to evaluate the effectiveness of purified WGHP on (dextran sulfate sodium) DSS-induced UC and elucidate the underlying mechanisms. Methods: WGHP-2-2, a primary acidic polysaccharide fraction, was extracted from crude WGHP and analyzed through chromatography and spectroscopy. The therapeutic efficacy of WGHP-2 was assessed using a murine model of DSS-induced UC. Assessments included disease severity (DAI, colon length, histopathology), inflammatory markers (tissue IL-6, TNF-α, IL-10), and intestinal barrier integrity (Claudin-5, Occludin, ZO-1). Results: WGHP-2-2 is an acidic polysaccharide with a molecular weight of 15.29 kDa. Its composition includes glucosamine, rhamnose, glucuronic acid, galacturonic acid, glucose, galactose, and arabinose, with respective molar ratios of 0.55, 8.48, 3.06, 65.99, 4.49, 10.86, and 6.57. Methylation and NMR analyses revealed a backbone mainly composed of →4)-α-D-GalpA-(1→ and →2)-α-D-Rhap-(1→ linkages, with side chains or terminal residues such as T-Rhap, T-Galp, T-Glcp, and T-Araf. In vivo, WGHP-2 significantly mitigated DSS-induced UC symptoms in a dose-dependent manner. Specifically, the high-dose group (123 mg/kg) markedly attenuated colon shortening and improved histological architecture, including the restoration of colonic crypts. WGHP-2 effectively reduced pro-inflammatory cytokines IL-6 and TNF-α in colon tissues, while increasing the anti-inflammatory cytokine IL-10. Conclusions: WGHP-2 mitigates DSS-induced UC by inhibiting pro-inflammatory cytokines (IL-6, TNF-α), increasing IL-10 levels, and improving intestinal barrier integrity through the upregulation of tight junction proteins. These results position WGHP-2 as a promising lead compound for developing functional foods for UC. Full article

(This article belongs to the Section Carbohydrates)

18 pages, 992 KB

Open AccessReview

Disordered Minds, Disordered Meals: When Emotions Masquerade as Hunger in Eating Disorders—A Systematic Review

by Giuseppe Marano, Marco Lanzetta, Camilla Scialpi, Antonio Sottile, Oksana Di Giacomi, Caterina Brisi, Gianandrea Traversi, Osvaldo Mazza, Esmeralda Capristo, Gabriele Sani, Eleonora Gaetani and Marianna Mazza

Nutrients 2026, 18(9), 1350; https://doi.org/10.3390/nu18091350 - 24 Apr 2026

Abstract

Emotion dysregulation and altered interoceptive processing are increasingly recognized as core processes in eating disorder (ED) psychopathology. Difficulties in identifying, tolerating, and regulating negative emotional states may interact with reduced trust in bodily signals and distorted interpretation of hunger and satiety cues, contributing [...] Read more.

Emotion dysregulation and altered interoceptive processing are increasingly recognized as core processes in eating disorder (ED) psychopathology. Difficulties in identifying, tolerating, and regulating negative emotional states may interact with reduced trust in bodily signals and distorted interpretation of hunger and satiety cues, contributing to maladaptive eating behaviors. The aim of this PRISMA-guided qualitative systematic review was to synthesize original empirical evidence on the interaction between emotion dysregulation and interoceptive processing in EDs, with particular attention to how emotional distress may be misinterpreted as physical hunger or food-related urges. A systematic search of PubMed and Scopus identified 78 records; after removal of duplicates and screening procedures, 24 original empirical studies were included in the qualitative synthesis. Across ED presentations, emotion dysregulation consistently emerged as a central transdiagnostic process associated with symptom severity, impulsivity, maladaptive eating behaviors, and related risk outcomes. Interoceptive alterations were widely reported, particularly involving reduced body trust and distorted interpretation of internal sensations rather than a uniform deficit in interoceptive sensitivity. The reviewed studies also showed that emotional states and cognitive expectations may shape the appraisal of hunger and satiety cues, contributing to the misinterpretation of emotional distress as physiological need across restrictive, binge-purge, and binge-eating presentations. The findings support a close interplay between emotion dysregulation and altered interoceptive processing in EDs and highlight the clinical relevance of interventions that integrate emotion regulation and interoceptive awareness to promote more adaptive eating behaviors. Full article

(This article belongs to the Section Nutrition and Public Health)

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27 pages, 2168 KB

Open AccessArticle

Enhancing Exercise Performance Under Hypoxia: A Network Meta-Analysis and Animal Experimental Validation of Plant Bioactive Compounds

by Huizi Ma, Hongchao Wang, Zhangming Pei, Jianxin Zhao, Hao Zhang, Jing Tian and Wenwei Lu

Nutrients 2026, 18(9), 1349; https://doi.org/10.3390/nu18091349 - 24 Apr 2026

Abstract

Background: Hypoxic environments significantly impair exercise performance, whilst existing interventions are often limited by adverse effects or insufficient efficacy. Objectives and Methods: This study employed network meta-analysis to screen plant bioactive compounds that effectively enhance exercise performance under hypoxic conditions, with subsequent validation [...] Read more.

Background: Hypoxic environments significantly impair exercise performance, whilst existing interventions are often limited by adverse effects or insufficient efficacy. Objectives and Methods: This study employed network meta-analysis to screen plant bioactive compounds that effectively enhance exercise performance under hypoxic conditions, with subsequent validation of the efficacy and underlying mechanisms of their combined formulations through animal experiments. Results: Results from hypoxic mouse experiments demonstrated that supplementation with the plant bioactive compound combination significantly improved exercise performance, as evidenced by increased weight-loaded swimming time and limb grip strength. Differential metabolite analysis revealed that the intervention altered key metabolic pathways, including the biosynthesis of unsaturated fatty acids and the metabolism of arginine and proline. Supplementation with the plant bioactive compound combination modulated short-chain fatty acid (SCFA) production by gut microbiota, decreased levels of lactic acid (LA), lactate dehydrogenase (LDH), and creatine kinase (CK), maintained blood glucose levels before and after exercise, and increased muscle and hepatic glycogen reserves. These effects collectively improved exercise endurance and performance in mice under hypoxic conditions. Conclusions: The findings provide novel insights into developing functional interventions to enhance exercise performance in hypoxic environments. Full article

(This article belongs to the Section Phytochemicals and Human Health)

49 pages, 2150 KB

Open AccessReview

Lentil-Derived Bioactives for Gastrointestinal Health: Potential Complementary Interactions Among Peptides, Resistant Starch, and Polyphenols

by Xingye Wei, Qianwen Sun, Chengxuan Li, Jinghan Wang, Muhammad Sajid Arshad and Hafiz A. R. Suleria

Nutrients 2026, 18(9), 1348; https://doi.org/10.3390/nu18091348 - 24 Apr 2026

Abstract

Lentils (Lens culinaris; family: Fabaceae) are increasingly recognized as functional legumes with potential benefits for gut health because they provide bioactive peptides, resistant starch, and polyphenol-rich fractions within a shared food matrix. However, most existing studies have focused on individual lentil-derived [...] Read more.

Lentils (Lens culinaris; family: Fabaceae) are increasingly recognized as functional legumes with potential benefits for gut health because they provide bioactive peptides, resistant starch, and polyphenol-rich fractions within a shared food matrix. However, most existing studies have focused on individual lentil-derived compounds, and their matrix-dependent complementary interactions during digestion and fermentation remain insufficiently resolved. This review synthesizes current evidence on lentil-derived peptides, resistant starch, and polyphenols, with particular emphasis on their matrix-dependent complementary relationships, digestion-dependent transformation, microbial co-metabolism, and implications for intestinal barrier function. During gastrointestinal digestion and colonic fermentation, lentil proteins, resistant starch, and phenolic compounds undergo sequential transformation, yielding bioactive peptides, fermentable substrates, short-chain fatty acids (SCFAs), and phenolic metabolites that may collectively influence microbial composition and metabolic activity. Emerging evidence suggests that these interconnected processes may support gut health through microbiota–host crosstalk by modulating tight junction-related markers, reducing intestinal permeability, and maintaining epithelial homeostasis. Mechanistically, these effects have been associated with SCFA-mediated G protein-coupled receptor (GPCR) signaling, suppression of TLR4–NF-κB/MAPK inflammatory cascades, and activation of Keap1–Nrf2 antioxidant defenses, thereby attenuating oxidative stress and pro-inflammatory responses. Current evidence is more consistent with matrix-dependent complementary or convergent actions than with demonstrated synergy. At present, phenolic-rich fractions provide clear pathway-level evidence, whereas fermentation-linked carbohydrate effects are more strongly supported by microbiota- and in vivo-associated outcomes, and protein- or peptide-related mechanisms remain comparatively underdefined. Nevertheless, the evidence base remains limited by the scarcity of integrated studies, well-controlled human intervention trials, and factorial experimental designs capable of distinguishing complementary, additive, and truly synergistic effects among lentil bioactives. This review therefore highlights the need to move from describing coexisting beneficial effects toward formally testing interaction effects within physiologically relevant lentil matrices. Full article

(This article belongs to the Special Issue Natural Products for Gastrointestinal Diseases)

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18 pages, 486 KB

Open AccessReview

Nutritional and Therapeutic Strategies in Paediatric Phenylketonuria: A Narrative Literature Review

by Holly Jones and Eugen-Matthias Strehle

Nutrients 2026, 18(9), 1347; https://doi.org/10.3390/nu18091347 - 24 Apr 2026

Abstract

Phenylketonuria (PKU) is an autosomal recessive disorder characterised by an inborn error of phenylalanine (Phe) metabolism. Such errors are attributed to pathogenic gene variants causing phenylalanine hydroxylase (PAH) deficiency, impairing the hydroxylation of phenylalanine to tyrosine in the Phe metabolic pathway. This defect [...] Read more.

Phenylketonuria (PKU) is an autosomal recessive disorder characterised by an inborn error of phenylalanine (Phe) metabolism. Such errors are attributed to pathogenic gene variants causing phenylalanine hydroxylase (PAH) deficiency, impairing the hydroxylation of phenylalanine to tyrosine in the Phe metabolic pathway. This defect leads to plasma Phe concentrations above the normal range. If untreated, hyperphenylalaninemia can adversely affect brain function, leading to severe intellectual disability and seizures. Since 1969, the newborn dried blood spot test has remained the main method of early screening and diagnosis for PKU. The primary therapeutic management is a lifelong phenylalanine-restricted diet with the aim of decreasing plasma Phe levels. The recommended diet consists of avoiding high-protein foods such as meat, fish, eggs and nuts, and can be supplemented with high-protein medical formulas which are low in phenylalanine. Pharmacological interventions such as sapropterin, sepiapterin and pegvaliase can also be used as treatment adjuncts in patients with PKU. Currently, small-molecule inhibitors reducing renal phenylalanine reabsorption are being explored as a potential therapeutic intervention. Furthermore, novel gene-editing techniques are under evaluation as potential curative strategies, with preclinical studies showing promising results in correcting pathogenic phenylalanine hydroxylase variants. This non-systematic review synthesises current literature on the management of PKU, with a focus on dietary interventions and recommendations. Full article

(This article belongs to the Special Issue The Role of Special Diets in Paediatric Metabolic, Neurological and Immune-Mediated Disorders)

41 pages, 901 KB

Open AccessSystematic Review

Nutritional and Age-Related Challenges in Older Adults from Sub-Saharan Africa and Potential Strategies to Promote Healthy Aging Amongst Them: A Systematic Review

by Vanessa Adu Sarpong, Isaac Amoah, Mauro Lombardo, Phyllis Tawiah, Wenze Wu, Kate Ampomah Addo and Deborah Solomon

Nutrients 2026, 18(9), 1346; https://doi.org/10.3390/nu18091346 - 24 Apr 2026

Abstract

Background/Objectives: Aging is associated with physiological, biochemical, and psychosocial changes that can significantly affect nutritional status and overall health. In Sub-Saharan Africa (SSA), older adults face unique age-related challenges that may compromise healthy aging, yet evidence remains fragmented. This systematic review synthesized [...] Read more.

Background/Objectives: Aging is associated with physiological, biochemical, and psychosocial changes that can significantly affect nutritional status and overall health. In Sub-Saharan Africa (SSA), older adults face unique age-related challenges that may compromise healthy aging, yet evidence remains fragmented. This systematic review synthesized the existing literature on the nutritional status, age-related challenges, and strategies to promote healthy aging of older adults in SSA. Methods: A systematic literature search was conducted on PubMed, Scopus, ScienceDirect, and Cochrane Library to identify relevant studies published up to 10 December 2025. Results: Fifty-five studies met the inclusion criteria, with most of the studies coming from South Africa, Ghana, and Nigeria. Amongst community-dwelling populations, approximately 30–65% of the older adults were either malnourished or at risk of malnutrition, while hospital-based studies reported markedly higher burdens, with malnutrition prevalence exceeding 70% in some settings. Undernutrition, micronutrient deficiencies, and the coexistence of overweight and obesity were frequently observed, reflecting the region’s ongoing nutrition transition. Frailty emerged as the predominant age-related challenge, with prevalence ranging around 10–60%. Other common challenges included sarcopenia, reduced muscle strength, functional disability, cognitive impairment, and dysphagia, all of which were closely related to poor nutritional status, food insecurity, multimorbidity, and reduced quality of life. Few studies reported on healthy aging strategies, with the limited evidence suggesting that nutrition education, physical activity, and psychosocial interventions may enhance nutritional and functional outcomes. Conclusions: The need for context-specific, nutrition-sensitive interventions, and stronger health and social support systems is warranted to promote healthy aging in SSA older adults. Full article

(This article belongs to the Special Issue Addressing Malnutrition in the Aging Population—2nd Edition)

22 pages, 5421 KB

Open AccessArticle

Recalibrating Resting Energy Expenditure Prediction Equations in Asian Older Adults with Multimorbidity

by Pei San Kua, Musfirah Albakri, Su Mei Tay, Phoebe Si-En Thong, Olivia Jiawen Xia, Wendelynn Hui Ping Chua, Kevin Chong, Nicholas Wei Kiat Tan, Xin Hui Loh, Jia Hui Tan and Lian Leng Low

Nutrients 2026, 18(9), 1345; https://doi.org/10.3390/nu18091345 - 24 Apr 2026

Abstract

Background/Objective: Accurate resting energy expenditure (REE) estimation is paramount for the nutritional management of older Asian adults with multimorbidity. However, standard predictive equations (PEs) lack precision for this cohort. This study aimed to recalibrate PEs using BMI-stratified, slope-only regression to enhance bedside accuracy. [...] Read more.

Background/Objective: Accurate resting energy expenditure (REE) estimation is paramount for the nutritional management of older Asian adults with multimorbidity. However, standard predictive equations (PEs) lack precision for this cohort. This study aimed to recalibrate PEs using BMI-stratified, slope-only regression to enhance bedside accuracy. Methods: REE was measured via indirect calorimetry in 400 hospitalized patients (age ≥ 65). Sensitivity analyses identified significant proportional bias in existing models. Models were recalibrated and validated using 1000-iteration bootstrap resampling. Results: Standard PEs exhibited significant bias, particularly underpredicting requirements for 68% of underweight patients. The new Singapore Older Adults Resting energy expenditure (SOAR) PE 1 (963.67 + 8.56 × weight − 5.6 × age) eliminated weight-dependent systematic errors. The recalibrated models utilizing actual body weight achieved accuracy rates of up to 64% in obese cohorts, comparable to complex adjusted-weight protocols. Conclusions: Population-specific recalibration is essential to mitigate the bidirectional risks of malnutrition and overfeeding in geriatric rehabilitation. The BMI-stratified multipliers provided offer a robust, clinically efficient framework for individualized nutritional care. Full article

(This article belongs to the Special Issue The Economics, Environment and Policies That Influence Nutrition Management in Healthcare)

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