Nutrients

20 pages, 724 KB

Open AccessArticle

Validation and Application of an Online Self-Assessment Questionnaire for the Assessment of Perception of Functional Foods: A Cross-Sectional Psychometric Study in Adults

by Leandro Oliveira, Ahmed Othman Alsabih, Hani A. Alfheeaid, Najla A. Albaridi, Sehad N. Alarifi, Nada Alqarawi, Ibrahim Alasqah and António Raposo

Nutrients 2025, 17(18), 2938; https://doi.org/10.3390/nu17182938 (registering DOI) - 12 Sep 2025

Abstract

Background/Objectives: The increasing interest in functional foods has highlighted the need to better understand consumer perceptions and their influence on dietary behaviours. This study aimed to evaluate the psychometric properties of the Questionnaire for the Assessment of Perception of Functional Foods (QAPAF) and [...] Read more.

Background/Objectives: The increasing interest in functional foods has highlighted the need to better understand consumer perceptions and their influence on dietary behaviours. This study aimed to evaluate the psychometric properties of the Questionnaire for the Assessment of Perception of Functional Foods (QAPAF) and apply it to a Portuguese adult population to explore associations with sociodemographic and lifestyle factors. Methods: Participants were recruited through convenience sampling; the achieved sample was predominantly female and highly educated. The 17-item QAPAF was assessed through exploratory factor analysis (EFA), internal consistency (Cronbach’s alpha), and test–retest reliability. Associations between QAPAF scores and participant characteristics were analysed using non-parametric tests. Results: EFA supported a four-factor structure, explaining 58.8% of total variance. Internal consistency was acceptable (α = 0.70), and test–retest analysis (n = 25) showed no significant score differences, indicating temporal stability. QAPAF scores were significantly higher among participants with higher education and among non-smokers and non-drinkers. No associations were found with sex, BMI, or income. Participants with correct understanding of functional foods were more likely to reject misconceptions and express trust in professional recommendations. Conclusions: The QAPAF is a valid and reliable tool for assessing functional food perceptions. Its application provides insights into consumer attitudes and may support the design of targeted food literacy interventions. Generalizability is limited by the convenience sampling and by the predominance of female and highly educated participants; external validation in more diverse samples and cultural contexts is warranted. Full article

(This article belongs to the Special Issue Food Literacy and Public Health Nutrition)

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25 pages, 1655 KB

Open AccessReview

Hydroxytyrosol Bioavailability: Unraveling Influencing Factors and Optimization Strategies for Dietary Supplements

by Marta Jordán, Natalia García-Acosta, José Luis Espartero, Luis Goya and Raquel Mateos

Nutrients 2025, 17(18), 2937; https://doi.org/10.3390/nu17182937 (registering DOI) - 12 Sep 2025

Abstract

Hydroxytyrosol (HT) is a major phenolic compound in olives and extra virgin olive oil (EVOO), known for its antioxidant, anti-inflammatory, and cardiometabolic properties. The European Food Safety Authority (EFSA) has approved a health claim for the protection of LDL particles from oxidative damage [...] Read more.

Hydroxytyrosol (HT) is a major phenolic compound in olives and extra virgin olive oil (EVOO), known for its antioxidant, anti-inflammatory, and cardiometabolic properties. The European Food Safety Authority (EFSA) has approved a health claim for the protection of LDL particles from oxidative damage only when HT is consumed within EVOO, which limits its direct use in supplements or functional foods. Since its biological effects depend on absorption, distribution, metabolism, and excretion (ADME), understanding how formulation and delivery strategies influence bioavailability is essential. HT is mainly present as secoiridoid derivatives in EVOO, whereas in supplements, it often appears in its free form, potentially affecting its metabolic fate. This review summarizes human studies on HT bioavailability from EVOO, isolated supplements, and enriched foods, and examines how matrix type, chemical modifications of HT, and advanced delivery systems, such as emulsions, encapsulation, and vesicular carriers, modulate absorption and metabolism. The gut microbiota is highlighted as an emerging factor in HT biotransformation, although its role remains underexplored. Further well-designed human studies are needed to guide the development of nutraceutical formulations capable of replicating the health benefits of EVOO beyond its natural matrix. Full article

(This article belongs to the Special Issue Phytochemicals in Foods, Plant Extracts, and Nutraceuticals, Their Bioavailability and Integral Health Effects)

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13 pages, 917 KB

Open AccessArticle

Effects of Fermented Soy on Cognition in Older Adults: Outcomes of a Randomized, Controlled Trial

by Laura M. West, Joan Sabaté, Ifeanyi D. Nwachukwu, Grace J. Lee, Rawiwan Sirirat, Amandeep Wright and Sujatha Rajaram

Nutrients 2025, 17(18), 2936; https://doi.org/10.3390/nu17182936 (registering DOI) - 12 Sep 2025

Abstract

Background/Objectives: Soy foods and isoflavones are inversely associated with cognitive decline; however, randomized controlled trials (RCTs) show mixed results. Fermented soy contains bioactive compounds not found in unfermented soybeans, such as peptides and aglycone isoflavones, which may support cognition by reducing neuroinflammation [...] Read more.

Background/Objectives: Soy foods and isoflavones are inversely associated with cognitive decline; however, randomized controlled trials (RCTs) show mixed results. Fermented soy contains bioactive compounds not found in unfermented soybeans, such as peptides and aglycone isoflavones, which may support cognition by reducing neuroinflammation and oxidative stress. Fermented soy RCTs on older adults with mild cognitive impairment show cognitive benefits; however, the effects of fermented soy on cognitively healthy older adults are not known. Methods: We investigated the effects of a non-probiotic fermented soy powder, added to the usual diet, compared to a placebo matched for energy on global cognition, memory, verbal fluency, processing speed, and executive function in a 12-week RCT on 61 adults aged 65 years and older (74 ± 5 y; 47 completers). Results: The fermented soy group showed significant improvement (p = 0.041) in memory scores (1.81%, 95% CI: −2.10, 5.72) vs. placebo (1.16%, 95% CI: −3.64, 5.97) using analysis of variance, adjusted for sex and baseline scores. Post hoc analyses on women 70 years and older (n = 29) found significant improvement in global cognition (p = 0.028) and memory (p = 0.049) in the fermented soy group. Global cognition mean change adjusted for baseline scores was 2.86% (95% CI: 1.52, 4.21) for fermented soy and 0.06% (95% CI: −1.43, 1.55) for placebo. Memory mean change adjusted for baseline scores was 8.47% (95% CI: 5.05, 11.89) in the fermented soy group, compared to 2.05% (95% CI: −1.75, 5.84) for placebo. Conclusions: These outcomes suggest that fermented soy has the potential to slow age-related cognitive decline, especially memory for women 70 and older. Further research to confirm these findings in older women, and in males and other age categories is warranted. Full article

(This article belongs to the Special Issue Natural Products in the Treatment of Neurodegenerative Disorders, Obesity and Cancer—New Insights into Mechanisms and Health Benefits)

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17 pages, 1531 KB

Open AccessArticle

The Accuracy of Potassium Content on Food Labels in Canada

by Kelly Picard, Dani Renouf, Sarah Draheim, Christopher Picard and Michelle M. Y. Wong

Nutrients 2025, 17(18), 2935; https://doi.org/10.3390/nu17182935 - 12 Sep 2025

Abstract

Background/Objectives: In 2017, the Canadian Government updated labeling requirements for prepackaged products to include potassium as a mandatory nutrient. Higher potassium intakes are beneficial in the general population, but for those with hyperkalemia, a lower potassium intake is recommended. Methods: The [...] Read more.

Background/Objectives: In 2017, the Canadian Government updated labeling requirements for prepackaged products to include potassium as a mandatory nutrient. Higher potassium intakes are beneficial in the general population, but for those with hyperkalemia, a lower potassium intake is recommended. Methods: The Canadian Food Inspection Agency (CFIA) collects food products and analyzes them to determine their potassium content. The authors requested data collected by the CFIA between January 2005 and November 2023 through an Access to Information request (A-2023-00410). Paired-sample two-sided t-tests were used to compare the difference between the labeled and analyzed potassium contents. Cohen’s Kappa was also used to assess agreement between values. Results: Data were available for 406 food items, with 376 having a labeled and analyzed potassium value. The number of samples within each product type was not equally spread; 60% of samples (243/405) were considered dairy analogs—comprising either plant-based milk or cheese products. The mean difference between analyzed and labeled potassium content was statistically significant at 15 mg per serving (SD, 68 mg; 95% CI, 8–22 mg; p < 0.001). Cohen’s Kappa suggested moderate agreement between labeled and analyzed values (κ = 0.376; 95% CI, 0.305–0.447; p < 0.001). A total of 271 (69.7%) products exceeded a ±10% difference, with 90 (23.9%) over-reporting potassium and 181 (48.1%) under-reporting potassium. Conclusions: The total number of products that were compliance-tested for potassium in Canada was relatively low and skewed disproportionately toward plant-based dairy analogs. Most products had labeled potassium values that differed from the lab-analyzed values, with a greater tendency to under-report vs. over-report potassium content. This suggests that at least some labels may not be accurate enough to correctly identify high-potassium foods for those who are following a low-potassium diet. Full article

(This article belongs to the Section Clinical Nutrition)

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13 pages, 318 KB

Open AccessArticle

Demographic Determinants of Food Insecurity in Older Adults During the COVID-19 Pandemic

by Lillie Monroe-Lord, Azam Ardakani, Amy Schweitzer, Elmira Asongwed, Xuejing Duan, Tia Jeffery, Phronie Jackson, Elgloria Harrison and Eyerusalem Beza

Nutrients 2025, 17(18), 2934; https://doi.org/10.3390/nu17182934 - 12 Sep 2025

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic exacerbated food insecurity in the United States, with older adults facing heightened vulnerability due to fixed incomes, chronic illness, and limited mobility. Methods: A cross-sectional online survey was conducted with 4961 urban U.S. adults aged 65 [...] Read more.

Background: The coronavirus disease 2019 (COVID-19) pandemic exacerbated food insecurity in the United States, with older adults facing heightened vulnerability due to fixed incomes, chronic illness, and limited mobility. Methods: A cross-sectional online survey was conducted with 4961 urban U.S. adults aged 65 and older. Food insecurity was assessed using the USDA Six-Item Short Form. Paired sample t-tests, chi-square tests, and multivariate logistic regression were used to examine demographic predictors of food insecurity before and during the pandemic. Results: Logistic regression indicated that race and income were significant predictors of food insecurity. African American and Hispanic participants were 92.1% and 126.4%, respectively, more likely to experience food insecurity than White participants (p < 0.001). Compared with those earning less than USD 50,000, participants earning USD 50,000–USD 100,000 and USD 100,000+ were 32.4% and 63.8% less likely to experience food insecurity (p < 0.001). Bivariate analyses showed that food insecurity increased most among African Americans (9.2%) and middle-income participants (USD 50,000–USD 100,000: 11.0%). Education did not remain significant in the adjusted model. Conclusions: Older adults of color and those with lower incomes were disproportionately impacted by food insecurity during the pandemic. The findings highlight the need for targeted, equity-driven policy responses to mitigate food insecurity in older adulthood. Full article

(This article belongs to the Special Issue Healthy Nutrition as the Key Reference in Special Diets, Quality of Life, and Sustainability—2nd Edition)

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17 pages, 5170 KB

Open AccessArticle

Dual-Action Grouper Bone and Wakame Hydrolysates Supplement Enhances Exercise Performance and Modulates Gut Microbiota in Mice

by Huey-Jine Chai, Tsung-Kai Yi, Yi-Feng Kao, Te-Hua Liu, Tsung-Yu Tsai and Yi-Ming Chen

Nutrients 2025, 17(18), 2933; https://doi.org/10.3390/nu17182933 (registering DOI) - 11 Sep 2025

Abstract

Background: Sustainable, dual-action ergogenic strategies are underexplored; most products target a single pathway and rarely upcycle seafood sidestreams. We therefore tested an upcycled formulation combining grouper bone hydrolysate and Undaria pinnatifida extract (GU) for ergogenic and microbiota effects in mice. We tested [...] Read more.

Background: Sustainable, dual-action ergogenic strategies are underexplored; most products target a single pathway and rarely upcycle seafood sidestreams. We therefore tested an upcycled formulation combining grouper bone hydrolysate and Undaria pinnatifida extract (GU) for ergogenic and microbiota effects in mice. We tested the ergogenic and microbiota modulating effects of GU in mice versus a vehicle and a BCAA control. Methods: GU was prepared via enzymatic hydrolysis of marine by-products and administered to male ICR mice for 4 weeks. Mice were divided into five groups (n = 7/group), receiving a vehicle control, a branched-chain amino acid (BCAA) supplement, or GU at three dose levels (1X, 2X, 3X) based on human-equivalent conversion. Exercise performance was assessed via grip strength and treadmill tests. Biochemical markers of fatigue, body composition, and safety indicators were also analyzed. Gut microbiota was evaluated using 16S rRNA sequencing and constrained principal coordinates analysis (CPCoA). Results: Four weeks of GU supplementation significantly enhanced exercise performance [(treadmill time ↑ Δ = 10.2–11.7 min versus vehicle (q ≤ 0.0002), grip strength ↑ Δ = 40.4–48.5 g (q ≤ 0.05)] and lean body mass [FFM ↑ at GU-1X (Δ = +0.80%, q = 0.0123)], surpassing the commercial BCAA control. Biochemical analyses indicated reduced exercise-induced lactate accumulation [(post-exercise lactate ↓ Δ = −2.71/−2.18 mmol·L⁻¹, q = 0.0006)]. Gut microbiota profiling revealed distinct shifts in community composition in GU-treated groups, notably with an increased abundance of beneficial taxa such as Lactobacillus and Muribaculum. These alterations reflect the prebiotic activity of seaweed-derived polysaccharides, promoting a healthier gut microbial profile. Notably, GU improved metabolic markers (aspartate aminotransferase, [AST]; lactate dehydrogenase, [LDH]) without inducing toxicity. Conclusions: These findings indicate that GU functions as a dual-action supplement, coupling amino acid-mediated muscle anabolism with microbiome modulation to enhance physical performance and metabolic health. As an upcycled marine product, it presents a sustainable and effective strategy for exercise support. Future studies should include 90-day safety, mechanistic assays, and a preregistered human pilot. Full article

(This article belongs to the Topic News and Updates on Probiotics)

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30 pages, 959 KB

Open AccessReview

Exploring the Role of Extra Virgin Olive Oil (EVOO) in MASLD: Evidence from Human Consumption

by Melvin Bernardino, Claudio Tiribelli and Natalia Rosso

Nutrients 2025, 17(18), 2932; https://doi.org/10.3390/nu17182932 - 11 Sep 2025

Abstract

Background/Objectives: Metabolic dysfunction-associated steatosis liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver related morbidity and mortality affecting 38% of the adult global population. As of now, there is no clear consensus on a standardized [...] Read more.

Background/Objectives: Metabolic dysfunction-associated steatosis liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver related morbidity and mortality affecting 38% of the adult global population. As of now, there is no clear consensus on a standardized pharmacological treatment for MASLD; therefore, lifestyle interventions particularly diet and exercise remain the first-line approach for both prevention and management. Extra virgin olive oil (EVOO), the primary source of fat in the Mediterranean diet. (MD) is widely recognized as a key contributor to its well-documented health benefits. As a central component of this dietary pattern, EVOO has demonstrated promising therapeutic potential due to its high phenolic content. The primary aim of this review is to synthesize existing human studies examining the effects of olive oil primarily EVOO on key pathological features of MASLD. Methods: A systematic search of human clinical and observational studies was conducted across major databases. Key outcomes assessed include hepatic steatosis, inflammation, oxidative stress, fibrosis, liver enzymes, and anthropometric measures. Study quality was evaluated using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Results: This review included 25 high-quality studies, 12 of which assessed olive oil alone and 13 evaluated the MD emphasizing extra virgin olive oil (EVOO). EVOO-rich interventions consistently improved hepatic steatosis, liver enzyme levels (ALT, AST), and inflammatory markers in MASLD patients, particularly when paired with calorie-restricted or MD patterns. Benefits were dose- and type-dependent, with EVOO showing superior effects compared to refined olive oils. Modest improvements in lipid profiles and insulin resistance were observed. Longer study durations and higher EVOO intake (>30–50 g/day) yielded greater improvements. Findings suggest EVOO may exert beneficial effects on liver health through its anti-inflammatory and antioxidant properties. Future studies on EVOO’s role in MASLD should use well-characterized oils with known polyphenol and bioactive compound levels and include clear biomarkers of oxidative stress, inflammation, and liver health outcomes on humans. Overall, EVOO represents a promising, non-pharmacological strategy for MASLD prevention and management. Conclusions: Current evidence suggests that EVOO, particularly when rich in phenolic compounds, is a promising dietary strategy for managing MASLD due to its hepato-protective effects, especially within a Mediterranean diet framework. However, findings are limited by study heterogeneity and a lack of high-quality randomized controlled trials, highlighting the need for future research to refine optimal dosing, assess long-term outcomes, and clarify underlying mechanisms. Full article

(This article belongs to the Special Issue Advances in Nutrition for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Management: Current Perspectives from the Bench to the Bedside)

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26 pages, 772 KB

Open AccessArticle

House Cricket (Acheta domesticus) and Spirulina (Arthrospira platensis) as Non-Conventional Sources of Nutrients and Bioactive Ingredients—Evaluation of Physicochemical, Nutraceutical, and Sensory Properties of Supplemented Muffins

by Ewelina Zielińska, Izabela Podgórska-Kryszczuk, Dawid Ramotowski and Urszula Pankiewicz

Nutrients 2025, 17(18), 2931; https://doi.org/10.3390/nu17182931 - 11 Sep 2025

Abstract

Background: Non-conventional protein sources, such as edible insects and microalgae, are gaining popularity due to their high nutritional value and environmental benefits. The presented study aimed to examine the effect of a 4% addition of house cricket and spirulina powders on selected properties [...] Read more.

Background: Non-conventional protein sources, such as edible insects and microalgae, are gaining popularity due to their high nutritional value and environmental benefits. The presented study aimed to examine the effect of a 4% addition of house cricket and spirulina powders on selected properties of muffins. The effects of non-conventional additives on color, textural properties, nutritional value, amino acid composition, and mineral content were determined. Methods: Antioxidant activity was evaluated against DPPH· and ABTS·+, and total phenolic content (TPC) and in vitro predicted glycemic index (GI) were examined. Sensory properties were evaluated using a nine-point hedonic scale and a consumer study. Results: The results showed that the additions of house cricket and spirulina significantly changed the color parameters of the muffins (ΔE 8.28 and 39.17, respectively) and affected their hardness, cohesiveness, gumminess, and chewiness. Nutritional value was improved, mainly due to an increase in protein content (up to 6% more). Overall, the amino acid profile of the muffins was improved, with a higher presence of all essential amino acids. The enriched muffins had a higher content of selected minerals, including iron, calcium, magnesium, potassium, and zinc, and exhibited higher TPC and antioxidant activity along with a lower in vitro predicted glycemic index. In the consumer evaluation, the spirulina muffins scored highest in texture (8.07 ± 1.04), while cricket muffins received the lowest ratings for color (6.60 ± 1.63), aroma (6.36 ± 2.04), and overall impression (7.03 ± 1.38). Taste did not differ significantly among all muffins. Conclusions: The results suggest that muffins can be made using edible insects and microalgae to enhance their nutritional value while maintaining an acceptable taste. Full article

(This article belongs to the Special Issue Functional Foods and Sustainable Health (2nd Edition))

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15 pages, 488 KB

Open AccessArticle

Prospective Observational Case Series in Infertile Women with Overweight or Obesity Treated with a Very-Low Calorie Ketogenic Diet (VLCKD) Prior to an In Vitro Fertilization (IVF) Treatment

by Maíra Casalechi, Alessandra Piontini, Annaelisa Nicolosi, Francesca Bergomas, Filomena Napolitano, Stefano Turolo, Marco Reschini, Alessandra Riccaboni, Roberta Bellinghieri, Edgardo Somigliana and Luisella Vigna

Nutrients 2025, 17(18), 2930; https://doi.org/10.3390/nu17182930 - 11 Sep 2025

Abstract

Background: Elevated BMI in women is linked to metabolic and endocrine imbalances that impair fertility and increase pregnancy risks. While >10% weight loss before an Assisted reproductive technology (ART) treatment may improve outcomes, sustained results through conventional diets are challenging. A very-low calorie [...] Read more.

Background: Elevated BMI in women is linked to metabolic and endocrine imbalances that impair fertility and increase pregnancy risks. While >10% weight loss before an Assisted reproductive technology (ART) treatment may improve outcomes, sustained results through conventional diets are challenging. A very-low calorie ketogenic diet (VLCKD) promotes rapid fat loss while preserving lean mass and may offer long-term benefits. This study evaluated the efficacy (≥10% weight loss without lean mass reduction), adherence, metabolic effects, and pregnancy outcomes of a meal replacement VLCKD in women with overweight or obesity scheduled for ART. Methods: This monocentric, prospective case-series was conducted at the Obesity and Work Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan (September 2019–September 2023). Eligible women underwent a three-phase dietary program: a 3-month VLCKD (<800 kcal/day), a 6-month transition with gradual carbohydrate reintroduction, and a Mediterranean-style maintenance diet. Participants were monitored for safety, body composition, adherence, and biochemical changes. Results: Of 52 women enrolled, 40 initiated the VLCKD; 27 (68%) achieved ≥10% weight loss while preserving lean mass. Eleven conceived naturally during or after the diet; 22 underwent ART, with 12 additional pregnancies. This corresponds to a 58% pregnancy rate among those who began the VLCKD. Significant improvements were observed in body mass index (BMI), fat mass, waist circumference, glucose metabolism, lipid profile, and liver function. No adverse events were reported. Conclusions: A meal replacement VLCKD protocol is feasible, well-tolerated, and associated with significant improvements in weight, especially in body composition, metabolic health, and potentially outcomes in women with overweight or obesity awaiting ART. Full article

(This article belongs to the Section Nutrition in Women)

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20 pages, 7222 KB

Open AccessArticle

Development and Validation of a Universal Eating Monitor (UEM) for Distinguishing the Intake of Multiple Foods and Macronutrients

by Li Xue, Ying Liu, Huihui Mei, Ying Yu, Huanan Zhang, Lin Gao, Zengguang Jin, Lu Wang, Chaoqun Niu and John R. Speakman

Nutrients 2025, 17(18), 2929; https://doi.org/10.3390/nu17182929 - 11 Sep 2025

Abstract

Background/Objectives: Dietary microstructure affects energy intake. Traditional Universal Eating Monitors (UEMs) offer accuracy but are limited for monitoring diverse diets. We developed the ‘Feeding Table’, a novel UEM that simultaneously tracks intake of up to 12 foods, enabling high-resolution monitoring of eating microstructure [...] Read more.

Background/Objectives: Dietary microstructure affects energy intake. Traditional Universal Eating Monitors (UEMs) offer accuracy but are limited for monitoring diverse diets. We developed the ‘Feeding Table’, a novel UEM that simultaneously tracks intake of up to 12 foods, enabling high-resolution monitoring of eating microstructure for multiple foods simultaneously. Methods: Forty-nine healthy volunteers participated: 15 (10 male, 8 female) in a location preference experiment and 31 (15 male, 16 female) in a standard meal test. The location preference study involved four weekly sessions. Participants received a standardized breakfast based on individual energy needs; lunch intake was measured 3 h later with food items in pseudo-randomized positions. The standard meal test occurred over two consecutive days to assess the Feeding Table’s performance in monitoring eating behavior under standardized conditions. Results: In two consecutive days of standard meal tests, the Feeding Table showed reasonable day-to-day repeatability for energy and macronutrient intake (energy: r = 0.82; fat: r = 0.86; carbohydrate: r = 0.86; protein: r = 0.58). Among the four repeated intake measurements, the results demonstrated high intra-class correlation coefficients (ICCs: energy 0.94, protein 0.90, fat 0.90, and carbohydrate 0.93). No significant positional bias was observed (energy: p = 0.07; macronutrients: p = 0.70). Conclusions: The Feeding Table maintains UEM accuracy while enabling multi-food, real-time monitoring of dietary microstructure and food choice, offering enhanced precision for studying eating behaviors. Full article

(This article belongs to the Section Nutrition Methodology & Assessment)

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20 pages, 337 KB

Open AccessReview

Nutritional Challenges in Older Cancer Patients: A Narrative Review of Assessment Tools and Management Strategies

by Giulia Giordano, Roberta Terranova, Luca Mastrantoni and Francesco Landi

Nutrients 2025, 17(18), 2928; https://doi.org/10.3390/nu17182928 - 11 Sep 2025

Abstract

Background/Objectives: Malnutrition, sarcopenia, cachexia, and frailty often coexist in older cancer patients and are associated with worse treatment tolerance, reduced quality of life, and increased mortality. These syndromes can be underrecognized, and the therapeutic approach is often fragmented. In light of this, [...] Read more.

Background/Objectives: Malnutrition, sarcopenia, cachexia, and frailty often coexist in older cancer patients and are associated with worse treatment tolerance, reduced quality of life, and increased mortality. These syndromes can be underrecognized, and the therapeutic approach is often fragmented. In light of this, the aim of this review was to synthesize current evidence on the screening and clinical management of nutritional aspects and the related tools, favoring multidimensional and personalized nutritional care. Methods: This narrative review was conducted according to the SANRA guidelines. A comprehensive literature search was performed on PubMed for studies published between January 2000 and June 2025, with no language restrictions. Eligible studies included adults aged ≥65 with cancer, addressing malnutrition, sarcopenia, cachexia, frailty, or nutrition-related interventions. Results: Malnutrition affects 30–80% of older cancer patients and is strongly associated with reduced survival, impaired treatment tolerance, and poorer quality of life. Tools such as PG-SGA, G8, GNRI, and CONUT offer practical options for early risk identification. Nutritional interventions, including oral supplements, dietary counseling, symptom management, and multimodal strategies (nutrition plus exercise), are associated with improved clinical outcomes. Evidence also supports the prognostic value of early screening and individualized nutrition care pathways. Conclusions: Malnutrition represents a modifiable risk factor in geriatric oncology and should be assessed considering other related conditions such as sarcopenia, cachexia, and frailty. Systematic screening and targeted interventions should be integrated into standard cancer care to improve outcomes in older adults. Future research should prioritize personalized nutrition strategies and multicenter trials focused on survival, function, and quality of life. Full article

(This article belongs to the Special Issue Geriatric Malnutrition and Frailty)

14 pages, 3541 KB

Open AccessArticle

Lacticaseibacillus rhamnosus Probio-M9 Alters the Gut Microbiota and Mitigates Pulmonary Hypertension in a Rat Model

by Zhixin Zhao, Gaopeng Li, Kiyomi Ohmichi, Xiaodong Li, Feiyan Zhao, Kaori Ishikawa, Ryou Ishikawa, Kazufumi Nakamura, Naoya Yokota, Zhihong Sun and Lin Hai Kurahara

Nutrients 2025, 17(18), 2927; https://doi.org/10.3390/nu17182927 - 11 Sep 2025

Abstract

Background: Intestinal microbiota plays an important role in the progression of pulmonary hypertension (PH). Colostrum-derived Lacticaseibacillus rhamnosus Probio-M9 (Probio-M9) has shown protective effects against inflammation and remodeling. We investigated whether Probio-M9 supplementation could improve the pathology of PH. Methods: The monocrotaline [...] Read more.

Background: Intestinal microbiota plays an important role in the progression of pulmonary hypertension (PH). Colostrum-derived Lacticaseibacillus rhamnosus Probio-M9 (Probio-M9) has shown protective effects against inflammation and remodeling. We investigated whether Probio-M9 supplementation could improve the pathology of PH. Methods: The monocrotaline (MCT)-induced PH model rats are created followed by Probio-M9 treatment. Microbiota and pathological analyses were performed to investigate the therapeutic effects of Probio-M9. Results: Probio-M9 significantly suppressed cardiovascular remodeling and reduced mortality in rats. Analysis of the fecal microbiota revealed that Probio-M9 significantly altered the gut microbiota of MCT model rats. Specifically, Alistipes sp009774895 and Duncaniella muris populations increased, whereas Limosilactobacillus reuteri_D, Ligilactobacillus apodeme and Monoglobus sp900542675 decreased compared to those in the MCT group. Focusing on the expression of GPNMB in macrophages and the localization of CD44, we found that the number of these cells increased in the MCT group but significantly decreased with Probio-M9 treatment. In lung tissue from PH patients, more GPNMB-positive macrophages were found than non-PH lungs, and an increase in CD44-positive cells was confirmed in the vicinity of GPNMB. Conclusions: Probio-M9 had a significant impact on the intestinal microbiota and GPNMB/CD44 positive cells in the lungs of PH rats. Full article

(This article belongs to the Special Issue Diet, Gut Health, and Clinical Nutrition)

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12 pages, 278 KB

Open AccessArticle

Vitamin D Genetics Beyond Serum 25(OH)D: VDR rs2228570 (FokI) Polymorphism, Inflammation, and Quality of Life in Orthopedic Patients

by Dariusz Larysz, Remigiusz Recław, Aleksandra Suchanecka, Wojciech Dziurawiec, Rafał Tkacz, Aleksandra Strońska-Pluta, Krzysztof Chmielowiec, Anna Grzywacz and Jolanta Chmielowiec

Nutrients 2025, 17(18), 2926; https://doi.org/10.3390/nu17182926 - 11 Sep 2025

Abstract

Background: Vitamin D receptor (VDR) polymorphisms may influence immune regulation and musculoskeletal health, but their perioperative role is not well understood. This study investigated the rs2228570 (FokI) variant in relation to inflammatory, hematologic, and patient-reported outcomes in orthopedic patients. Methods: We [...] Read more.

Background: Vitamin D receptor (VDR) polymorphisms may influence immune regulation and musculoskeletal health, but their perioperative role is not well understood. This study investigated the rs2228570 (FokI) variant in relation to inflammatory, hematologic, and patient-reported outcomes in orthopedic patients. Methods: We genotyped 300 orthopedic patients and 200 healthy controls using real-time PCR. Regression models in patients adjusted for age and body mass index (BMI) examined associations between rs2228570 genotypes and laboratory as well as clinical outcomes. Results: The CC genotype (homozygous cytosine) was associated with higher white blood cell count (β = 0.52, p = 0.0435), higher lymphocyte count (β = 0.26, p = 0.00025), higher hemoglobin (β = 0.57, p = 0.00197), and higher hematocrit (β = 1.42, p = 0.01102). The TT genotype (homozygous thymine) was associated with higher C-reactive protein (β = 10.90, p = 0.00329), lower mean corpuscular volume (β = −1.63, p = 0.04909), and higher health-related quality of life assessed by the 36-Item Short-Form Health Survey (SF-36) (β = 6.31, p = 0.00009). Conclusions: The rs2228570 polymorphism in the VDR gene is associated with distinct perioperative inflammatory, hematologic, and patient-reported profiles. These findings support the potential clinical utility of VDR genotyping, in combination with routine laboratory tests, to refine perioperative risk stratification and guide personalized rehabilitation in orthopedic patients. Full article

(This article belongs to the Special Issue Vitamin D in the New Decade: Facts, Controversies, and Future Perspectives for Daily Clinical Practice)

20 pages, 1607 KB

Open AccessReview

The Microecological-Immune Axis in Pediatric Allergic Diseases: Imbalance Mechanisms and Regulatory Interventions

by Ziyi Jiang, Jie Zhu, Zhicheng Shen, Linglin Gao, Zihan Chen, Li Zhang and Qiang Wang

Nutrients 2025, 17(18), 2925; https://doi.org/10.3390/nu17182925 - 11 Sep 2025

Abstract

In recent years, the global prevalence of pediatric allergic diseases—including atopic dermatitis, allergic rhinitis, and asthma—has increased significantly. Accumulating evidence underscores the pivotal role of the microbiota–immune axis in the regulation of immune tolerance, wherein microbial dysbiosis is a critical driver in the [...] Read more.

In recent years, the global prevalence of pediatric allergic diseases—including atopic dermatitis, allergic rhinitis, and asthma—has increased significantly. Accumulating evidence underscores the pivotal role of the microbiota–immune axis in the regulation of immune tolerance, wherein microbial dysbiosis is a critical driver in the onset and progression of these conditions. Notably, reduced microbial diversity and imbalanced proportions can also cause immune dysregulation and cross-organ signaling. The skin–lung–gut axis has emerged as a key conduit for multi-organ immune communication. Microbial communities at barrier sites not only mediate local immune homeostasis but also influence distant organs through metabolite production and immune signaling pathways, forming a complex network of organ crosstalk. This mechanism is integral to the maintenance of both innate (e.g., epithelial barrier integrity and phagocytic activity) and adaptive (e.g., the Type 1/Type 2 cytokine balance and regulatory T cell function) immunity, thereby suppressing allergic inflammation. Early microbial colonization is crucial for immune system maturation, and its perturbation is strongly linked to abnormal allergic immune responses. As such, the skin–lung–gut axis functions as a cross-organ microecological–immune regulatory network that is particularly relevant in the context of infantile allergic disorders. Intervention strategies targeting the microbiota—including probiotics, prebiotics, synbiotics, and postbiotics—have demonstrated potential in modulating host immunity. Furthermore, emerging approaches such as engineered probiotics, advanced delivery systems, and fecal microbiota transplantation (FMT) offer promising therapeutic avenues. This review provides a comprehensive overview of microbiota development in early life, its association with allergic disease pathogenesis, and the current progress in microbiota-targeted interventions, offering a theoretical foundation for individualized prevention and treatment strategies. Full article

(This article belongs to the Section Pediatric Nutrition)

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18 pages, 1367 KB

Open AccessArticle

Socio-Demographic Disparities in Diet and Their Association with Physical and Mental Well-Being: Million-Participant Cross-Sectional Study in Poland

by Grażyna Zweifler, Anna Zimny-Zając, Mateusz Babicki, Karolina Kłoda, Grzegorz Mazur, Beata Jankowska-Polańska, Agnieszka Mastalerz-Migas and Siddarth Agrawal

Nutrients 2025, 17(18), 2924; https://doi.org/10.3390/nu17182924 - 11 Sep 2025

Abstract

Background: Dietary habits are key determinants of physical and mental health, yet large-scale, contemporary data on these behaviors and their health correlates are crucial for effective public health policy. This study leverages a uniquely large dataset to quantify the eating behaviors of Polish [...] Read more.

Background: Dietary habits are key determinants of physical and mental health, yet large-scale, contemporary data on these behaviors and their health correlates are crucial for effective public health policy. This study leverages a uniquely large dataset to quantify the eating behaviors of Polish adults and examines how these behaviors relate to socio-demographic characteristics, health status, and subjective well-being. Methods: We analyzed data from 1,196,102 adult respondents who participated in the National Poles’ Health Test, a recurring online survey, between 2019 and 2024. The study used self-reported data on dietary habits, socio-demographic variables, chronic conditions, and self-assessed physical and mental health. Descriptive statistics and comparative analyses, such as the chi-square test, Student’s t-test, or ANOVA, were used. Results: Our findings reveal stark socio-demographic disparities in nutrition. Younger respondents and lower educational attainment were strongly correlated with more frequent consumption of fast food and sugar-sweetened beverages. Crucially, these unhealthy eating patterns were significantly associated with poorer self-rated physical and, notably, mental health (among people who consumed fast food every day, as many as 16.6% rated their mental health as bad, and 6.7% as very bad). In contrast, higher vegetable and fruit consumption correlated with markedly better health outcomes and greater subjective well-being. Conclusions: This large-scale study provides evidence of the profound link between diet and both physical and mental well-being in Poland. The results underscore the urgent need for targeted public health strategies aimed at improving dietary behaviors, particularly among younger and less-educated populations. The strong associations between diet, health status, and well-being highlight the importance of integrating nutritional education into both general healthcare and mental health services. Full article

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

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16 pages, 1240 KB

Open AccessArticle

Hepatic Copper Accumulation Predicts Fibrosis Progression and Mortality in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

by Suha Shabaneh, Elliot M. Berry, Ashraf Imam, Mohamad Suki, Ahmad Salhab, Abed Khalaileh and Rifaat Safadi

Nutrients 2025, 17(18), 2923; https://doi.org/10.3390/nu17182923 - 11 Sep 2025

Abstract

Background: Copper is an essential trace element involved in antioxidant defense and mitochondrial function. Evidence suggests that copper homeostasis may also influence metabolic liver diseases. We investigated the association between hepatic copper levels (HCLs) and liver-related outcomes among patients with Metabolic Dysfunction-Associated Steatotic [...] Read more.

Background: Copper is an essential trace element involved in antioxidant defense and mitochondrial function. Evidence suggests that copper homeostasis may also influence metabolic liver diseases. We investigated the association between hepatic copper levels (HCLs) and liver-related outcomes among patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Methods: In this retrospective cohort study, we analyzed 215 MASLD patients who underwent liver biopsy with copper quantification. Patients were categorized based on hepatic copper content; normal < 50 vs. high ≥ 50 μg/g dry tissue (165 vs. 50 patients, respectively). The primary outcomes were progression in non-invasive fibrosis score (FIB-4) and incidence of clinical events (cirrhosis, liver transplantation, cardiovascular events or death) during a median follow-up of 4.9 ± 4.2 years. Multivariable linear and logistic regression models were adjusted for metabolic and demographic confounders. Results: Both liver copper groups shared similar baseline characteristics. High hepatic copper levels independently predicted higher FIB-4 scores at the end of follow-up in the fully adjusted linear regression model (β = 0.41; 95% CI: 0.05–0.76; p = 0.026). Logistic regression confirmed that high HCLs were associated with significant FIB-4 deterioration (OR = 41.3; 95%; p = 0.008). Kaplan–Meier analysis revealed significantly reduced overall survival among patients with high HCLs (Log-Rank p = 0.034), and multivariable Cox regression showed a markedly increased mortality risk (HR = 18.51; 95%; p = 0.032). Subgroup analyses highlighted greater risk among females, patients with diabetes or dyslipidemia, and individuals of Arab ethnicity. Conclusions: Elevated hepatic copper levels are associated with long term worsened liver fibrosis and higher mortality in MASLD. These findings support hepatic copper as a potential nutritional biomarker for risk stratification. Further studies are needed to explore copper modulation as a therapeutic target in MASLD. Full article

(This article belongs to the Section Clinical Nutrition)

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4 pages, 144 KB

Open AccessEditorial

New Evidence of Roles of Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease: Insights from This Special Issue

by Marta Gómez-Sánchez, Leticia Gómez-Sánchez and Manuel A. Gómez-Marcos

Nutrients 2025, 17(18), 2922; https://doi.org/10.3390/nu17182922 - 11 Sep 2025

Abstract

Obesity and type 2 diabetes are two prevalent health problems worldwide [...] Full article

(This article belongs to the Special Issue Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease)

11 pages, 472 KB

Open AccessArticle

The Role of Dietary Supplements in Modulating Menopause Onset: A Comprehensive Analysis of Nutritional and Lifestyle Influences on Menopause Timing

by Shekhinamary Jebaraj and Valentine Nlebedim

Nutrients 2025, 17(18), 2921; https://doi.org/10.3390/nu17182921 - 10 Sep 2025

Abstract

Background: The age at natural menopause (ANM) has a significant impact on women’s health later in life, although the contribution of changeable dietary and lifestyle factors remains uncertain. Methods: We examined data from 3566 participants in the UK Women’s Cohort Study, [...] Read more.

Background: The age at natural menopause (ANM) has a significant impact on women’s health later in life, although the contribution of changeable dietary and lifestyle factors remains uncertain. Methods: We examined data from 3566 participants in the UK Women’s Cohort Study, assessing their baseline use of dietary supplements and lifestyle habits. Associations with ANM were evaluated using multivariable Cox proportional hazards models and gradient boosting machine (GBM) analyses. We adjusted our models for factors such as BMI, smoking status, alcohol consumption, physical activity levels, and socioeconomic status. Results: The use of fish oil (HR 0.05; 95% CI 0.02–0.09), vitamin B-complex (HR 0.48; 0.38–0.62), antioxidant mixtures (HR 0.54; 0.38–0.69), and vitamin C (HR 0.75; 0.56–0.93) was linked to a delay in ANM, with all p-values less than 0.05. Folic acid showed near significance (HR 0.81; p = 0.059). GBM analyses highlighted red meat consumption, BMI, educational level, smoking duration, and fish consumption as important indicators. Conclusions: The regular consumption of certain supplements has a connection to later menopause onset, while smoking and red meat consumption tend to predict an earlier onset. These findings underline the potential of lifestyle changes in managing reproductive aging, although further interventional studies are necessary to confirm them. Full article

(This article belongs to the Section Nutrition in Women)

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20 pages, 714 KB

Open AccessArticle

Talking About Weight with Children: Associations with Parental Stigma, Bias, Attitudes, and Child Weight Status

by Anca Georgiana Ispas, Alina Ioana Forray, Alexandra Lacurezeanu, Dumitru Petreuș, Laura Ioana Gavrilaș and Răzvan Mircea Cherecheș

Nutrients 2025, 17(18), 2920; https://doi.org/10.3390/nu17182920 - 10 Sep 2025

Abstract

Background/Objectives: Parental weight stigma and bias can shape how parents talk about weight and health with their children, yet their interplay in Romania is unexplored. We examined how parents’ experienced stigma, internalized bias, and explicit antifat attitudes relate to weight- and health-focused conversations [...] Read more.

Background/Objectives: Parental weight stigma and bias can shape how parents talk about weight and health with their children, yet their interplay in Romania is unexplored. We examined how parents’ experienced stigma, internalized bias, and explicit antifat attitudes relate to weight- and health-focused conversations with 5–17-year-olds, and whether these links vary by child weight status. Methods: In a cross-sectional survey of 414 Romanian parents, we assessed stigma (teasing/unfair treatment), internalized bias (WBIS-M), antifat attitudes (AFA, UMBFAT), and frequency of health (healthy eating/PA) versus weight-focused talks and comments. BMI-derived child weight status was classified via WHO percentiles. Multivariate regressions and mediation analyses tested predictors and indirect effects. Results: Nearly 80% of parents discussed weight at least sometimes; higher child BMI percentile and parental internalized bias independently predicted more weight conversations (β = 0.44 and β = 0.25, both p < 0.001). Internalized bias mediated the effect of experienced stigma on weight talk (indirect effect = 0.105, 95% CI [0.047, 0.172]). Explicit antifat attitudes drove comments about others’ weight (β = 0.17, p = 0.002). Health-focused talks were unrelated to stigma or bias but were more frequent among parents with higher education, better self-rated health, and lower BMI. Conclusions: Parents’ internalized weight bias—shaped by stigma—fuels weight-focused conversations, especially when children have higher BMI, while antifat attitudes underlie negative comments about others. Interventions should reduce parental internalized bias and train supportive, health-centered communication to curb weight stigma transmission. Full article

(This article belongs to the Special Issue Safeguarding the Next Generation: Nutritional Strategies for Preventing Childhood Obesity)

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15 pages, 1677 KB

Open AccessArticle

Synthetic Mimics of Wound-Induced Carrot MicroRNAs Affect Lipid Metabolism in Cultured Adipocytes

by Edwin E. Reza-Zaldívar and Daniel A. Jacobo-Velázquez

Nutrients 2025, 17(18), 2919; https://doi.org/10.3390/nu17182919 - 10 Sep 2025

Viewed by 38

Abstract

Background/Objectives: Plant-derived microRNAs (miRNAs) have emerged as cross-kingdom regulatory molecules, but their capacity to influence mammalian metabolism is still poorly understood. This study aimed to investigate whether miRNAs induced in carrots (Daucus carota) by postharvest wounding stress can modulate adipocyte lipid [...] Read more.

Background/Objectives: Plant-derived microRNAs (miRNAs) have emerged as cross-kingdom regulatory molecules, but their capacity to influence mammalian metabolism is still poorly understood. This study aimed to investigate whether miRNAs induced in carrots (Daucus carota) by postharvest wounding stress can modulate adipocyte lipid accumulation. Methods: High-throughput small RNA sequencing was performed to identify stress-responsive miRNAs in wounded carrots. Bioinformatic analyses predicted potential mammalian targets, focusing on genes involved in adipogenesis and lipid regulation, including those in the insulin and FoxO signaling pathways. Selected miRNAs were functionally validated in 3T3-L1 adipocytes by assessing intracellular triglyceride levels and glycerol release. Results: Six stress-responsive carrot miRNAs were predicted to target mammalian lipid metabolism genes. Functional assays revealed that miR165a-3p, miR232a-5p, and miR1799 significantly decreased intracellular triglyceride accumulation and increased glycerol release, suggesting enhanced lipolysis. These effects support the potential regulation of adipocyte metabolism through plant miRNA mimics. Conclusions: Our findings provide experimental evidence for stress-induced carrot miRNAs mimics potentially modulate fat accumulation. This work expands current understanding of dietary plant miRNAs and highlights their potential role as functional food components for metabolic health improvement. Further research is needed to establish their gastrointestinal stability, uptake from dietary matrices, and in vivo effects. Full article

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

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14 pages, 5273 KB

Open AccessArticle

α-Lack-SPI Alleviates MASLD in Rats via Regulating Hepatic Lipid Accumulation and Inflammation

by Mingtao Chen, Shanshan Guo, Xuye Lai, Qiyao Xiao, Xueqian Wu, Jinzhu Pang, Lei Pei, Yingying Gu, Xuguang Zhang and Lili Yang

Nutrients 2025, 17(18), 2918; https://doi.org/10.3390/nu17182918 - 10 Sep 2025

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Abstract

Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has become a worldwide health concern. Soy protein isolate (SPI) is a plant-derived protein with high nutritional value and has shown promising effects in regulating lipid metabolism and inflammation. Objectives: This study aimed to investigate the [...] Read more.

Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has become a worldwide health concern. Soy protein isolate (SPI) is a plant-derived protein with high nutritional value and has shown promising effects in regulating lipid metabolism and inflammation. Objectives: This study aimed to investigate the effects of an α-subunit-deficient SPI (α-lack-SPI) on MASLD and the underlying molecular mechanisms. Methods: Rats were fed with a high-fat, high-cholesterol diet (HFD) to induce MASLD. Results: The results showed that α-lack-SPI significantly reduced the levels of hepatic TG and TC, serum ALT, AST, TC, and LDL-C, and increased serum HDL-C in rats with HFD-induced MASLD. α-lack-SPI significantly attenuated hepatic steatosis and hepatocyte ballooning revealed by histopathological analysis. Meanwhile, α-lack-SPI markedly downregulated the mRNA expressions of Srebf1, Acaca, Fasn, Pcsk9, and Hmgcr, while significantly upregulating Pparα. Additionally, α-lack-SPI treatment significantly reduced the mRNA expressions of hepatic pro-inflammatory cytokines (Tnf-α, Il-1β, Il6), chemokine (Ccl2), and inflammasome component (Nlrp3), as well as the protein expression of COX-2. Conclusions: In conclusion, α-lack-SPI alleviated MASLD in HFD-fed rats probably via improving hepatic lipid metabolism and mitigating hepatic inflammation. These findings indicate that α-lack-SPI may serve as a promising nutritional intervention for MASLD management. Full article

(This article belongs to the Section Nutrition and Metabolism)

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20 pages, 1093 KB

Open AccessArticle

Influence of Tempeh, Daidzein, Probiotics, and Their Combination on Magnesium Status and Hematological Ratios in a Postmenopausal Osteoporotic Animal Model

by Iskandar Azmy Harahap, Omar Salem, Rifaldi Lutfi Fahmi, Naglaa Ahmed, Natalia Leciejewska and Joanna Suliburska

Nutrients 2025, 17(18), 2917; https://doi.org/10.3390/nu17182917 - 9 Sep 2025

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Abstract

Background/Objectives: Postmenopausal osteoporosis disrupts magnesium homeostasis and hematological balance, contributing to systemic inflammation and metabolic alterations. This study aimed to assess the effects of dietary interventions—tempeh, daidzein, probiotics, and their combinations—on magnesium status and hematological ratios in a postmenopausal osteoporotic Wistar rat model. [...] Read more.

Background/Objectives: Postmenopausal osteoporosis disrupts magnesium homeostasis and hematological balance, contributing to systemic inflammation and metabolic alterations. This study aimed to assess the effects of dietary interventions—tempeh, daidzein, probiotics, and their combinations—on magnesium status and hematological ratios in a postmenopausal osteoporotic Wistar rat model. Methods: Sixty-four rats were divided into one sham group (n = 8) and seven ovariectomized (OVX) groups (n = 56), with different modified diets administered for six weeks. In addition, one of the groups received alendronate bisphosphonate as a pharmacological reference to benchmark the dietary interventions against standard anti-osteoporotic therapy. Magnesium levels in the tissues and feces, along with blood hematological ratios (neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and triglyceride-to-glucose index (TyG)), were evaluated. Results: The results revealed that a combination of tempeh and probiotics (OTL) significantly increased magnesium levels in the feces, spleen, and hair, while reducing liver magnesium levels. Compared to the standard groups (S and O), the hematological analysis revealed that the daidzein group (OD) had the highest MLR, while the OTL group exhibited the lowest TyG index. The alendronate bisphosphonate (OB) intervention showed no significant effect on tissue magnesium levels, feces magnesium levels, or hematological ratios. Correlation analysis revealed a strong negative association between spleen magnesium levels and the PLR (r = −0.626) and a positive relationship between liver magnesium levels and TyG (r = 0.422). Conclusions: The authors of this study concludes that while ovariectomy significantly altered magnesium status and hematological ratios, the dietary combination of tempeh, daidzein, and probiotics did not demonstrate an apparent beneficial effect on magnesium status or inflammatory ratios in a postmenopausal osteoporotic rat model. However, the findings highlight interesting aspects of magnesium status and its correlations with metabolic and inflammatory parameters, warranting further investigation. Full article

(This article belongs to the Special Issue The Potential Health Effects of Dietary Phytoestrogens)

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21 pages, 833 KB

Open AccessArticle

Food Allergy and Foodservice: A Comparative Study of Allergic and Non-Allergic Consumers’ Behaviors, Attitudes, and Risk Perceptions

by Fatemeh Shirani, Silvia Dominguez, Jérémie Théolier, Jennifer Gerdts, Kate Reid, Sébastien La Vieille and Samuel Godefroy

Nutrients 2025, 17(18), 2916; https://doi.org/10.3390/nu17182916 - 9 Sep 2025

Viewed by 224

Abstract

Background: Food-allergic reactions in restaurants often result from miscommunication between customers with allergies and staff, or from staff members’ insufficient knowledge of food allergies. This study examined the behaviors, attitudes, and risk perceptions of food-allergic consumers when dining out or ordering from foodservice [...] Read more.

Background: Food-allergic reactions in restaurants often result from miscommunication between customers with allergies and staff, or from staff members’ insufficient knowledge of food allergies. This study examined the behaviors, attitudes, and risk perceptions of food-allergic consumers when dining out or ordering from foodservice establishments (FSEs) compared to consumers without food allergies. Methods: A representative pan-Canadian survey was conducted amongst three groups: one of individuals without food allergies (n = 500) and two of food-allergic individuals (allergic-convenience sample [n = 500] and allergic-general population [n = 500]). The convenience sample comprised members of Food Allergy Canada, a national patient advocacy organization. Some participants with food allergies had experienced reactions linked to an FSE (43% convenience, 27% general). Weighted responses from food-allergic groups were compared to those of non-allergic ones using chi-square (p < 0.05). Statistical comparison between allergic groups was not attempted due to inherent differences in their allergic condition. Results: In several questions, responses from the non-allergic group differed significantly from those of the allergic-convenience sample, but not from those of the allergic-general population. Food-allergic-convenience respondents were more likely to avoid ordering food or dining out than non-allergic ones, with the highest avoidance (66%) noted for third-party platforms. Cost was the main barrier for non-allergic and allergic-general populations, whereas the allergic-convenience sample prioritized allergy-related concerns. Although at a lower rate than for participants with food allergies, food allergies influenced restaurant selection for 44% of participants without food allergies when dining with individuals outside their household. Most allergic respondents perceived that FSEs underestimate the seriousness of food allergies (82% convenience, 71% general), yet they felt safe while dining out (60% convenience, 85% general), pointing at loyalty to specific FSEs as a risk mitigation strategy. Conclusions: This study highlights a potentially higher burden of disease (psychological and social strain, reduced quality of life) among a subgroup of the food-allergic population (convenience sample), as reflected in their behaviors, attitudes, and risk perceptions towards meals prepared in FSEs. Nevertheless, both allergic groups expressed shared concerns and needs related to safety (e.g., ingredient disclosure for all menu items, prevention of allergen cross-contact, ability of an FSE to offer a safe meal, establishing clear communication processes for allergy-related information), which FSEs and regulators should consider when designing risk management strategies. Full article

(This article belongs to the Special Issue Adopting Sustainable Dietary Patterns: Effects of Food Labeling, Food Choices, and Eating Behaviors (2nd Edition))

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13 pages, 320 KB

Open AccessArticle

Prevalence and Predictors of Self-Prescribed Vitamin D Supplementation Among University Students in the UAE

by Aaesha H. Alnaqbi, Rubina Sabir, Hafiz M. Shahbaz, Zahra Khan and Mo’ath F. Bataineh

Nutrients 2025, 17(18), 2915; https://doi.org/10.3390/nu17182915 - 9 Sep 2025

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Abstract

Background/Objectives: Vitamin D deficiency is widespread globally, including in the Middle East. In the UAE, vitamin D deficiency contributes to 78% of bone losses because of cultural and lifestyle factors, which limit sun exposure. Although supplementation is effective, increasing rates of self-prescribed [...] Read more.

Background/Objectives: Vitamin D deficiency is widespread globally, including in the Middle East. In the UAE, vitamin D deficiency contributes to 78% of bone losses because of cultural and lifestyle factors, which limit sun exposure. Although supplementation is effective, increasing rates of self-prescribed use raise concerns about safety and efficacy, particularly among university students. Therefore, this study aims to assess the prevalence, patterns, and predictors of self-prescribed vitamin D supplementation among university students in the United Arab Emirates. Methods: A descriptive cross-sectional survey was conducted among 450 university students aged 18–39 who had used vitamin D supplements in the past 12 months. Data were collected using an online questionnaire and analyzed using chi-square tests and binary logistic regression. Results: Among participants, 44.9% reported self-prescribed vitamin D use. Males were more likely to self-prescribe (p = 0.010). Self-prescribers used supplements for shorter durations (p < 0.001) and were more likely to report motivations like physical performance (p = 0.005). Predictors of self-prescription included short-term use (OR = 2.57), non-daily intake (OR = 3.49), use for performance (OR = 2.72), and concurrent vitamin C use (OR = 1.85). Conclusions: Self-prescription of vitamin D is common among university students and associated with irregular use and non-clinical motivations, primarily to improve overall health and wellness. While such practices are unlikely to result in toxicity, they may not adequately address the widespread problem of vitamin D deficiency. These findings suggest the need for clear, locally relevant guidance to promote safe and effective supplementation among young adults. Full article

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

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15 pages, 1050 KB

Open AccessReview

The Impact of the Alternate Mediterranean Diet (aMED) on the Prevention of Chronic Liver Disease: A Meta-Analysis of Observational Studies

by Linjie Zhang, Jing Sui, Hanlin Yin, Qun Zhao, Yajie Zhou and Hui Xia

Nutrients 2025, 17(18), 2914; https://doi.org/10.3390/nu17182914 - 9 Sep 2025

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Abstract

Conventional research mainly focuses on individual nutrients or specific foods in relation to chronic liver disease, but the cumulative effects of dietary patterns are underexplored. This study aimed to assess current evidence on the alternate Mediterranean Diet (aMED) and chronic liver disease risk [...] Read more.

Conventional research mainly focuses on individual nutrients or specific foods in relation to chronic liver disease, but the cumulative effects of dietary patterns are underexplored. This study aimed to assess current evidence on the alternate Mediterranean Diet (aMED) and chronic liver disease risk via a meta-analysis of observational studies. A systematic search of PubMed, Web of Science, Cochrane, and Embase (up to February 2025) identified studies on aMED and chronic liver disease, using predefined criteria for screening, quality assessment, and data extraction. A total of 20 articles (3 cross-sectional, 15 cohort, and 2 case–control; 1,286,480 participants) were analyzed using a random-effects model. The analysis showed that aMED was significantly negatively correlated with chronic liver disease (OR = 0.65, 95% CI: 0.56–0.75), indicating that adherence reduces risk. Subgroup analysis showed aMED’s protective effects in North America (OR = 0.67, 95% CI: 0.54–0.83) and Europe (OR = 0.54, 95% CI: 0.44–0.66). The results suggest aMED adherence may lower chronic liver disease risk, emphasizing dietary modifications for prevention. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Eating Behaviors in the Prevention and Management of Cancer and Chronic Diseases)

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16 pages, 1598 KB

Open AccessArticle

Caffeinated Energy Drink Formulations Differentially Impact Hydration Versus Water: Does Habitual Caffeine Intake or Biological Sex Matter?

by Melinda Millard-Stafford, Brian Hack, Alec Harp and Ella Smith

Nutrients 2025, 17(18), 2913; https://doi.org/10.3390/nu17182913 - 9 Sep 2025

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Abstract

Background/Objectives: The beverage hydration index (BHI) assesses the relative hydration properties of beverages. Commercially available caffeinated energy drinks (with and without electrolytes or carbohydrates) were compared to water. Methods: Fourteen men and fourteen women completed four trials: 500 mL water plus either [...] Read more.

Background/Objectives: The beverage hydration index (BHI) assesses the relative hydration properties of beverages. Commercially available caffeinated energy drinks (with and without electrolytes or carbohydrates) were compared to water. Methods: Fourteen men and fourteen women completed four trials: 500 mL water plus either 500 mL water or caffeinated energy drink beverage (CAF) with 280 mg, CAF (280 mg) plus electrolytes (CAF + E), or CAF (106 mg) + E and carbohydrates (CAF + CE). Participants’ habitual caffeine intake (0–535 mg/day) was used to stratify users into naïve (<25 mg/day, n = 19) or regular users. Results: BHIs at 240 min for CAF (0.86 ± 0.16) and CAF + E (0.91 ± 0.16) were lower (p < 0.001) versus water (1.0 ± 0.0) and CAF + CE (1.01 ± 0.12). Urine mass with CAF and CAF + E was significantly greater (p < 0.01) by 244 g and 162 g versus CAF + CE. The % fluid retained at 240 min was lower (p < 0.001) for CAF (−71.2 ± 21.5%) and CAF + E (−65.1 ± 26.3%) versus CAF + CE (−46.4 ± 18.8%). Habitual intake status had no effect on the BHI (p = 0.827) between the naïve (0.92 ± 0.1) and habitual user group (0.93 ± 0.1) averaged across all three caffeinated beverages for 120 and 240 min. At 240 min, the drink (p < 0.001) and drink x sex interaction (p = 0.042) indicated women had higher BHI than men (p = 0.03) for caffeinated drinks despite higher relative fluid and caffeine dosages. Conclusions: A low-carbohydrate–electrolyte beverage with moderate caffeine had similar hydration properties compared to water; however, this differs from beverages with higher caffeine containing limited carbohydrate and/or electrolytes, which were inferior to water. Habitual caffeine intake had no apparent influence, but men and women exhibited differences in the diuretic response to energy drink consumption. Full article

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

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12 pages, 254 KB

Open AccessArticle

Impact of Preoperative Malnutrition on Postoperative Quality of Life in Older Adults Undergoing Surgery for Degenerative Cervical Myelopathy: A Retrospective Cohort Study

by Yuki Taniguchi, Hideki Nakamoto, So Kato, Hiroyuki Nakarai, Kosei Nagata, Kenichi Kono, Yuhei Saito, Reo Inoue, Hiroshi Okawa, Sakae Tanaka, Yasushi Oshima and Kazuhiko Fukatsu

Nutrients 2025, 17(18), 2912; https://doi.org/10.3390/nu17182912 - 9 Sep 2025

Viewed by 217

Abstract

Background/Objectives: Malnutrition, which is closely associated with frailty and sarcopenia, is common in older adults and is linked to adverse perioperative complications in musculoskeletal surgery. However, its influence on postoperative health-related quality of life (HRQOL) remains unclear. This study aimed to investigate the [...] Read more.

Background/Objectives: Malnutrition, which is closely associated with frailty and sarcopenia, is common in older adults and is linked to adverse perioperative complications in musculoskeletal surgery. However, its influence on postoperative health-related quality of life (HRQOL) remains unclear. This study aimed to investigate the impact of preoperative malnutrition on HRQOL one year after surgery in elderly patients with degenerative cervical myelopathy (DCM). Methods: We retrospectively analyzed 188 patients aged ≥ 65 years who underwent elective surgery for DCM between 2017 and 2024. Preoperative nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI), with GNRI ≤ 98 indicating malnutrition risk. Patient-reported outcome measures were assessed using the EuroQol Five-Dimension Questionnaire (EQ-5D) both preoperatively and at one year postoperatively. The minimum clinically important difference (MCID) threshold was applied to evaluate significant changes. Multivariate logistic regression was used to identify independent risk factors for postoperative deterioration in EQ-5D score. Results: Of the 188 patients, 35 were classified as having malnutrition risk. While preoperative EQ-5D scores were comparable between the two groups, the postoperative EQ-5D score was significantly lower in the malnutrition risk group than in the no-risk group (0.58 vs. 0.67, p = 0.003). Deterioration in EQ-5D scores exceeding the MCID threshold occurred more frequently in the malnutrition risk group (37.1% vs. 21.2%, p = 0.049). Furthermore, multivariate analysis identified preoperative GNRI ≤ 98 as an independent risk factor for deterioration in EQ-5D score exceeding the MCID threshold (OR 2.40, 95% CI 1.03–5.52). Conclusions: Preoperative malnutritional status was significantly associated with impaired postoperative HRQOL in elderly patients with DCM. These findings highlight the need for preoperative nutritional assessment and optimization in this vulnerable population. Full article

(This article belongs to the Section Geriatric Nutrition)

24 pages, 2076 KB

Open AccessSystematic Review

The Effect of Portion Size Interventions on Energy Intake and Risk of Obesity in School-Aged Children: A Systematic Review and Meta-Analysis

by Salma Luthfiyah Sani, Sara Alfaraidi, Yongqi Mu, Gideon Hot Partogi Sinaga and Atul Singhal

Nutrients 2025, 17(18), 2911; https://doi.org/10.3390/nu17182911 - 9 Sep 2025

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Abstract

Objectives: An increase in food portion size offered to children over recent decades has been suggested to contribute to the rise in childhood obesity. This review investigated the effect of interventions that manipulated portion size on energy intake and risk of obesity [...] Read more.

Objectives: An increase in food portion size offered to children over recent decades has been suggested to contribute to the rise in childhood obesity. This review investigated the effect of interventions that manipulated portion size on energy intake and risk of obesity in school-aged children. Methods: A systematic search was performed using MEDLINE, Embase, and Cochrane Library databases (from inception to 2025). Included studies were original articles in English, involving children aged 5–17 years, that focused on portion size interventions using an experimental or controlled study design, with energy intake, body weight, or body mass index (BMI) as the study outcome. The risk of bias was evaluated using the Quality Criteria Checklist (QCC). Results: From 514 articles identified, 10 met the inclusion criteria, including a total of 1765 participants. Larger portion sizes increased food intake (grams) and/or energy intake (kcal) in eight studies but did not affect energy intake in one study. Another study focusing on fruit and vegetable portions found inconsistent results. The meta-analysis found that larger portion sizes were associated with higher energy intake compared to the reference portion (mean difference = 86.0 kcal/meal, 95% CI [62.2, 109.9], p < 0.00001). Conclusions: Offering children larger portions increases energy intake. However, this finding was limited by being based mainly on studies which manipulated portion size at a single meal, in a laboratory setting, and with only short-term measures of energy intake. Future studies need to investigate the long-term effects of portion size interventions on energy intake and risk of childhood obesity. Full article

(This article belongs to the Section Pediatric Nutrition)

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18 pages, 1483 KB

Open AccessArticle

Protective Role of Multiple Essential Minerals Against Cadmium-Related Cognitive Decline in Middle-Aged and Older Adults: A Prospective Study

by Jing Yang, Zongyao Li, Yongbin Zhao, Yanzhen Hu, Xinyang Guo, Xi Kang, Zhenyu Wu, Chang Su and Tao Zhang

Nutrients 2025, 17(18), 2910; https://doi.org/10.3390/nu17182910 - 9 Sep 2025

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Abstract

Background: Cadmium (Cd) exposure is linked to cognitive decline in middle-aged and older adults, but the modifying role of essential minerals is unclear. This study aimed to identify key protective minerals and quantify their joint antagonistic effect against Cd neurotoxicity. Methods: Baseline serum [...] Read more.

Background: Cadmium (Cd) exposure is linked to cognitive decline in middle-aged and older adults, but the modifying role of essential minerals is unclear. This study aimed to identify key protective minerals and quantify their joint antagonistic effect against Cd neurotoxicity. Methods: Baseline serum minerals and urinary Cd were measured in 6795 adults (≥40 years) from the 2015 China Health and Nutrition Survey. Cognitive function (MMSE) was assessed after 3 years. Associations were analyzed using multiple linear regression and Quantile g-computation (QGC) for joint effects. Combined exposure groups and interaction terms were assessed. Restricted cubic spline (RCS) models explored potential nonlinear dose–response relationships. Results: Participants in the highest urinary Cd quartile had significantly lower MMSE score (β = −0.09, 95% CI: −0.15, −0.02) than the lowest quartile. Serum calcium (Ca), ferrum (Fe), magnesium (Mg), selenium (Se), and phosphorus (P) were positively associated with MMSE. QGC revealed that the joint effect of Cd and the 5-mineral mixture (β = 0.10, 95% CI: 0.05, 0.14) was weaker than the protective effect of the 5-mineral mixture. Any high-mineral group had significantly higher MMSE score compared to the high-Cd/low-mineral group. Conclusions: Essential minerals Ca, Fe, Mg, Se, and P effectively antagonize Cd-associated cognitive decline. Their combined exposure demonstrates significant protective effects, providing key evidence for precision nutrition and environmental health risk management in Cd-exposed populations. Full article

(This article belongs to the Special Issue A New Perspective: The Effect of Trace Elements on Human Health)

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11 pages, 517 KB

Open AccessArticle

Association Between Diet and Emotional Symptoms in Early Childhood: Cross-Sectional Results from the Piccolipiù Cohort

by Federica Concina, Giulia Zamagni, Eleonora Maurel, Claudia Carletti, Alessandra Knowles, Martina Culasso, Franca Rusconi, Maja Popovic, Luca Ronfani, Lorenzo Monasta, Deborah N. Ashtree and Paola Pani

Nutrients 2025, 17(18), 2909; https://doi.org/10.3390/nu17182909 - 9 Sep 2025

Viewed by 348

Abstract

Background/Objectives: Emerging evidence suggests the critical role of diet in shaping mental health outcomes, which are increasingly prevalent among children and adolescents worldwide. This study aims to investigate whether the dietary habits of children in the Italian multicenter Piccolipiù birth cohort at four [...] Read more.

Background/Objectives: Emerging evidence suggests the critical role of diet in shaping mental health outcomes, which are increasingly prevalent among children and adolescents worldwide. This study aims to investigate whether the dietary habits of children in the Italian multicenter Piccolipiù birth cohort at four years of age were associated with anxiety and depression symptoms. This analysis was conducted within the framework of the Global burden of disease Lifestyle And mental Disorder (GLAD) Project (DERR2-10.2196/65576). Methods: Data from 1726 children were analyzed. Emotional symptoms were assessed with the Child Behavior Checklist (CBCL), and diet was assessed using a food frequency questionnaire. Sociodemographic data, including per capita income, were also collected. Associations between food intake (grams per day) and clinical anxiety/depression (T-scores > 70) or total symptom scores were examined using univariate and multivariable logistic and robust linear regressions adjusted for sex and income. Results: In 1726 children (median age 4.4 years; 50% female), 3% exhibited clinical anxiety and 2% clinical depression. Higher grain intake was associated with increased odds of clinical anxiety (OR = 1.004; 95% CI: 1.001–1.007), while greater fish consumption reduced odds of clinical depression (OR = 0.946; 95% CI: 0.903–0.992). Vegetable intake was associated with lower anxiety and depression scores. Multivariable analyses confirmed that grain intake is positively associated with anxiety, while fish consumption is inversely associated with depression. Conclusions: Higher intake of vegetables, fruits, and fish may be associated with better emotional health in preschoolers, although effect sizes were modest. Early dietary interventions may offer a practical approach to improving children’s long-term mental health. Longitudinal studies are needed to confirm these associations and clarify underlying mechanisms. Full article

(This article belongs to the Section Pediatric Nutrition)

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Nutrients, Volume 17, Issue 18 (September-2 2025) – 30 articles

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