Nutrients

16 pages, 932 KiB

Open AccessArticle

Erythrocyte DHA/EPA Ratio Surpasses Its Individual Fatty Acid Levels in Predicting Metabolic Syndrome in Chinese Adults: A Prospective Study

by Pinning Feng, Yan Yan, Hanzu Chen, Dongmei Ru, Xinyue Wang and Yuming Chen

Nutrients 2025, 17(6), 1096; https://doi.org/10.3390/nu17061096 - 20 Mar 2025

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Abstract

Background: The individual roles of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in mitigating metabolic syndrome (MetS) have been well-documented. However, the significance of their ratio (DHA/EPA) in erythrocytes concerning MetS remains underexplored. This study evaluated the association between the DHA/EPA ratio and [...] Read more.

Background: The individual roles of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in mitigating metabolic syndrome (MetS) have been well-documented. However, the significance of their ratio (DHA/EPA) in erythrocytes concerning MetS remains underexplored. This study evaluated the association between the DHA/EPA ratio and MetS including its separate components. Methods: This community-based prospective cohort study involved 3497 participants aged 40 to 75 years enrolled in the Guangzhou Nutrition and Health Study (GNHS) from 2008 to 2013 in China. Baseline erythrocyte fatty acids were quantified using gas chromatography. Over a 12-year follow-up, MetS status was reassessed triennially, identifying 766 new MetS cases among the 2111 participants initially free of the syndrome. The study examined both cross-sectional and prospective relationships of EPA, DHA, and the DHA/EPA ratio with both the presence and incidence of MetS alongside its individual components. Results: Multivariable cross-sectional analyses revealed that the odds ratios (ORs) and 95% confidence intervals (CIs) for MetS prevalence in quartile 4 (vs. 1) were 1.32 (1.07, 1.62) for EPA, 0.52 (0.40, 0.66) for DHA, and 0.66 (0.52, 0.83) for the DHA/EPA ratio (all P-trend < 0.05). Analogous patterns were observed for associations with hyperlipidemia, hypertension, and hyperglycemia. In the prospective analysis, higher DHA/EPA ratios and lower EPA levels were associated with reduced 12-year incidence of MetS and hyperglycemia. Hazard ratios (HRs) and 95% CIs for MetS, comparing the extreme quartiles, were 1.26 (1.02, 1.55) for EPA and 0.75 (0.60, 0.94) for the DHA/EPA ratio. Additionally, DHA was inversely associated with the incidence of hypertension. Conclusions: The study highlights a consistent inverse relationship between the DHA/EPA ratio and both the prevalence and risk of MetS. These findings underscore the potential utility of the DHA/EPA ratio as a predictive marker or therapeutic target in MetS management. Full article

(This article belongs to the Section Lipids)

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15 pages, 653 KiB

Open AccessReview

The Impact of Physical Activity on Weight Loss in Relation to the Pillars of Lifestyle Medicine—A Narrative Review

by Natalia Niezgoda, Tomasz Chomiuk, Przemysław Kasiak, Artur Mamcarz and Daniel Śliż

Nutrients 2025, 17(6), 1095; https://doi.org/10.3390/nu17061095 - 20 Mar 2025

Viewed by 1321

Abstract

Currently, overweight and obesity are key problems globally. Several modifiable factors influence weight management. The number of obese and overweight people has significantly increased over the past few decades. Therefore, it is crucial to find effective and tailored strategies for weight management in [...] Read more.

Currently, overweight and obesity are key problems globally. Several modifiable factors influence weight management. The number of obese and overweight people has significantly increased over the past few decades. Therefore, it is crucial to find effective and tailored strategies for weight management in public health and medicine. It has become necessary to take a comprehensive look at the problem of obesity and the process of weight loss, taking into account various aspects of lifestyle. To date, the effectiveness of dietary interventions, training interventions, or a combination of both has been repeatedly studied, with varying results, but a combination of properly selected diet and physical activity is considered the most effective therapy. Physical activity is one of the main tools in the treatment of obesity, in part due to its direct effect on body weight by increasing energy expenditure, especially when paired with other elements of lifestyle. The effect of physical activity is broad, and to properly implement it in obesity therapy, it is necessary to understand its impact on aspects such as body composition, food intake, sleep, alcohol use, and mental state. The primary aim of this review is to present the influence of physical activity on weight loss in combination with the influence of physical activity on other pillars of lifestyle medicine in adults. The secondary aim is to present various dietary, exercise, and combined interventions on weight loss with their efficacies. Full article

(This article belongs to the Special Issue Exercise and Fat Metabolism)

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16 pages, 3876 KiB

Open AccessArticle

Serotonin Transporter Gene Polymorphisms Predict Adherence to Weight Loss Programs Independently of Obesity-Related Genes

by Mana Yatsuda, Miyako Furou, Keiko Kamachi, Kaori Sakamoto, Kumiko Shoji, Osamu Ishihara and Yasuo Kagawa

Nutrients 2025, 17(6), 1094; https://doi.org/10.3390/nu17061094 - 20 Mar 2025

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Abstract

Background/Objectives: Adherence to treatment instructions is essential in managing chronic diseases related to obesity. One gene associated with adherence is the serotonin transporter (5-HTTLPR) gene, which has long (L) and short (S) alleles, resulting in LL, SL, and SS genotypes. Risk alleles for [...] Read more.

Background/Objectives: Adherence to treatment instructions is essential in managing chronic diseases related to obesity. One gene associated with adherence is the serotonin transporter (5-HTTLPR) gene, which has long (L) and short (S) alleles, resulting in LL, SL, and SS genotypes. Risk alleles for obesity include the R variant of the β3-adrenergic receptor (β3AR) and the G variant of uncoupling protein 1 (UCP1). This study aimed to evaluate whether the S/L variant of 5-HTTLPR, the R variant of β3AR, and the G variant of UCP1 are associated with adherence to a weight loss program. To assess the factors influencing adherence, eating behavior was evaluated using the Eating Behavior Questionnaire (EBQ). Methods: This study included 56 well-educated and middle-class women with a mean age of 57.3 ± 10 years and a mean BMI of 27.2 ± 5.6 kg/m². Long-read sequencing was used to analyze S/L mutations. Participants followed a six-month diet and exercise regimen for obesity management. Outcomes were assessed using clinical data and EBQ scores. Adherence was objectively measured by the reduction in body fat percentage. Results: Participants were classified as SS (69.6%), SL (17.9%), or LL (12.5%). The R variant of β3AR was present in 34% of participants, with the G variant of UCP1 in 75%. After the intervention, SS participants showed significantly greater reductions in weight and body fat percentage than LL participants (p < 0.05). Among EBQ items, significant improvements (p < 0.05) were observed in SS participants for eating as a diversion, feeling of fullness, bad eating habits, unsteady eating patterns, and total EBQ score. In SL participants, only bad eating habits improved, whereas no significant changes were observed in LL participants. Obesity risk alleles did not significantly affect clinical outcomes, though there may be small number bias. Conclusions: SS genotype participants demonstrated higher adherence to the weight loss program, leading to improved clinical outcomes and EBQ scores, independent of obesity risk genes. Full article

(This article belongs to the Special Issue The Impact of Nutrigenomics and Personalized Nutrition on Non-infectious Disease)

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21 pages, 1438 KiB

Open AccessReview

From Mind to Milk: The Influence of Psychological Factors on the Composition of Human Breast Milk

by Krystian Skowron, Igor Lichocki, Filip Godziszewski and Magdalena Orczyk-Pawiłowicz

Nutrients 2025, 17(6), 1093; https://doi.org/10.3390/nu17061093 - 20 Mar 2025

Viewed by 615

Abstract

Background/Objectives: Breast milk is a complex fluid crucial for infant development, nutrition, and immunological and neurodevelopmental support. Recent findings suggest that factors regarding mental health, such as stress, anxiety, and postpartum depression (PPD), may influence the composition of breast milk. This review aims [...] Read more.

Background/Objectives: Breast milk is a complex fluid crucial for infant development, nutrition, and immunological and neurodevelopmental support. Recent findings suggest that factors regarding mental health, such as stress, anxiety, and postpartum depression (PPD), may influence the composition of breast milk. This review aims to synthesize current knowledge regarding the relationship between a mother’s mental state and the biochemical profile of human milk, focusing mainly on nutrients, hormones, immune factors, and microbiota. Methods: A systematic literature search was conducted in PubMed and the Web of Science using predefined keywords related to psychological factors and milk composition. Studies involving validated psychological assessment tools and only human subjects were included, in accordance with PRISMA guidelines. Results: Findings indicated that maternal stress and PPD are associated with alterations in breast milk composition. Elevated cortisol and changes in melatonin and prolactin levels have been observed. Immune components, such as secretory immunoglobulin A and transforming growth factor beta 2, exhibit variable responses depending on stress type and duration. Lower concentrations of docosahexaenoic acid and polyunsaturated fatty acid have been observed among mothers diagnosed with depression. Additionally, maternal psychological distress may influence infants’ gut microbiota composition, potentially affecting long-term health outcomes. Conclusions: The maternal psychological state plays an essential role in shaping the composition of human breast milk. Understanding these associations highlights the need for mental health support during the postpartum period to optimize infant development. Future research should focus on the molecular mechanisms underlying these changes and potential interventions to mitigate adverse effects. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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11 pages, 2729 KiB

Open AccessArticle

Impact of Alcohol Intake on Body Composition in Patients with Steatotic Liver Disease

by Masahiro Matsui, Akira Fukuda, Saori Onishi, Kosuke Ushiro, Tomohiro Nishikawa, Akira Asai, Soo Ki Kim and Hiroki Nishikawa

Nutrients 2025, 17(6), 1092; https://doi.org/10.3390/nu17061092 - 20 Mar 2025

Viewed by 271

Abstract

Objectives: To examine the effect of alcohol intake on body composition in patients with steatotic liver disease (SLD). Methods: In men, group A (n = 819) was defined as non-drinkers, group B (n = 1147) as <30 g of ethanol equivalent per [...] Read more.

Objectives: To examine the effect of alcohol intake on body composition in patients with steatotic liver disease (SLD). Methods: In men, group A (n = 819) was defined as non-drinkers, group B (n = 1147) as <30 g of ethanol equivalent per day, group C (n = 125) as between 30 and 60 g/day, and group D (n = 344) as >60 g/day. In women, group A (n = 749) was defined as non-drinkers, group B (n = 354) as <20 g/day, group C (n = 36) as between 20 and 50 g/day, and group D (n = 68) as >50 g/day. The fat-free (FF) index and fat (F) index were defined as FF mass and F mass divided by height squared (kg/m²). Results: The average FF index and F index in groups A, B, C, and D in men were 19.01, 19.29, 18.50, and 18.55 kg/m² (overall p < 0.0001), and 6.28, 6.71, 5.66, and 6.03 kg/m² (overall p < 0.0001). The average FF index and F index in groups A, B, C, and D in women were 16.03, 15.96, 15.62, and 15.07 kg/m² (overall p < 0.0001), and 9.89, 9.02, 9.32, and 7.53 kg/m² (overall p < 0.0001). Conclusions: Heavy drinking has a negative effect on skeletal muscle and fat, but complete abstinence from alcohol may not be necessary in SLD patients. Full article

(This article belongs to the Special Issue Alcohol Consumption and Human Health)

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21 pages, 2871 KiB

Open AccessReview

Effects of Different Proportions of DHA and ARA on Cognitive Development in Infants: A Meta-Analysis

by Ailing Tian, Lirong Xu, Ignatius Man-Yau Szeto, Xuemin Wang and Duo Li

Nutrients 2025, 17(6), 1091; https://doi.org/10.3390/nu17061091 - 20 Mar 2025

Viewed by 628

Abstract

Objectives: Previous studies have assessed the effect of docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (ARA, 20:4n-6)-supplemented infant formula on brain development and cognitive function in infants. However, the results have been inconsistent. The aim of this systematic review [...] Read more.

Objectives: Previous studies have assessed the effect of docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (ARA, 20:4n-6)-supplemented infant formula on brain development and cognitive function in infants. However, the results have been inconsistent. The aim of this systematic review and meta-analysis was to assess the effect of DHA and ARA supplementation on cognitive function in infants from randomized controlled trials (RCTs). Methods: We systematically searched and identified relevant literature from the PubMed, Web of Science, and Embase databases up to July 2024. Standard methods were applied to assess publication bias, sensitivity analysis, and heterogeneity among the included studies. A total of nine RCTs were included in the study, which comprised 1039 subjects. Results: Meta-analysis showed significantly positive effects of DHA and ARA supplementation on cognitive development in infants (Standardized Mean Difference (SMD): 0.21; 95% CI: 0.03, 0.38). No significant difference was found in Mental Development Index (MDI) score (Weighted Mean Difference (WMD): 0.20; 95% CI: −0.03, 0.43) and Psychomotor Development Index (PDI) score (WMD: 0.12; 95% CI: −0.11, 0.35) in Bayley Scales of Infant and Toddler Development compared with the control group. In subgroup analysis, when DHA/ARA was 0.5–1, PDI had a significant difference (WMD: 0.48; 95% CI: 0.03, 0.93) compared with the control group, with no significant difference between heterogeneity (I² = 46.4%, p = 0.155). In comparison to the control group, significant differences were observed in MDI when DHA/ARA levels were between 0.5 and 1 (WMD: 0.55; 95% CI: 0.07, 1.02), with no significant difference between heterogeneity (I² = 51.6%, p = 0.127). Conclusion: When the DHA /ARA was 0.5–1 can significantly improve the cognitive function in infants. Full article

(This article belongs to the Section Pediatric Nutrition)

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20 pages, 6169 KiB

Open AccessArticle

Protocatechuic Acid Attenuates Inflammation in Macrophage-like Vascular Smooth Muscle Cells in ApoE^−/− Mice

by Shuangshuang Li, Yushi Du, Guanyu Chen, Yihui Mao, Wenyu Zhang, Mengxi Kang, Shasha Zhu and Dongliang Wang

Nutrients 2025, 17(6), 1090; https://doi.org/10.3390/nu17061090 - 20 Mar 2025

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Abstract

Background/Objectives: Non-resolving inflammation in macrophage-like cells (MLCs) transdifferentiated from vascular smooth muscle cells and monocyte-derived macrophages aggravates atherosclerosis. We previously showed that polyphenolic protocatechuic acid (PCA) could reduce inflammation burden in monocyte-derived macrophages; however, it remains unknown how this compound affects MLCs [...] Read more.

Background/Objectives: Non-resolving inflammation in macrophage-like cells (MLCs) transdifferentiated from vascular smooth muscle cells and monocyte-derived macrophages aggravates atherosclerosis. We previously showed that polyphenolic protocatechuic acid (PCA) could reduce inflammation burden in monocyte-derived macrophages; however, it remains unknown how this compound affects MLCs inflammation. Methods: MLCs from the transdifferentiation of vascular smooth muscle cells induced by cholesterol and 30-week-old male ApoE^−/− mice fed a semi-purified AIN-93G diet containing either 0.003% (wt:wt) of PCA for a duration of 20 weeks were used to examine the impact of PCA on the inflammatory response of MLCs. Results: Physiologically achievable doses of PCA (0.25–1 μM) dose-dependently inhibited lipopolysaccharide-induced NF-κB activation and simultaneously reduced pro-inflammatory cytokine levels. Mechanistically, this effect was mediated by effecting exportin-1 function, promoting nuclear export of phosphorylated-p65, independent of NF-κB kinase inhibitor α/β/γ, NF-κB inhibitor α, or importin-mediated nuclear import of p-p65. PCA reduced the nucleocytoplasmic ratio of exportin-1 (44%) without altering its abundance. Importantly, dietary supplementation with PCA reduced interleukin-1β content within MLCs in atherosclerotic plaques of ApoE^−/− mice. In addition, dietary PCA reduced MLCs content in atherosclerotic plaques. Conclusions: PCA could attenuate inflammatory response in MLCs by targeting exportin-1 and also could inhibit the transdifferentiation of vascular smooth muscle cells into MLCs within atherosclerotic plaques, which might promote the translation from preclinical studies to clinical trials in patients with atherosclerosis. Full article

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

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Graphical abstract

20 pages, 1229 KiB

Open AccessArticle

The Effect of Fatty Acid Desaturase on Cardiovascular Lipid Biomarkers Depends on Circulating ω-3 and ω-6 Polyunsaturated Fatty Acids in the UK Biobank

by Carmen E. Arrington, Jason Westra, Nathan L. Tintle and Gregory C. Shearer

Nutrients 2025, 17(6), 1089; https://doi.org/10.3390/nu17061089 - 20 Mar 2025

Viewed by 282

Abstract

Objectives: The objective of this study is to outline a framework for how fatty acids may be acting as mediators/suppressors and/or moderators of an individual’s genetic predisposition for cardiovascular lipid biomarkers. Methods: All UK Biobank participants with demographic and lifestyle variables, circulating cardiovascular [...] Read more.

Objectives: The objective of this study is to outline a framework for how fatty acids may be acting as mediators/suppressors and/or moderators of an individual’s genetic predisposition for cardiovascular lipid biomarkers. Methods: All UK Biobank participants with demographic and lifestyle variables, circulating cardiovascular lipids, and NMR-measured fatty acid data collected at the baseline visit (N = 229,859) were included in analyses. We fit four separate linear regression models, one for each of the following common measures of cardiovascular lipids: total cholesterol, HDL-c, LDL-c, and total triglycerides. Each model predicted cardiovascular lipids by an individual’s FADS (a well-known fatty acid desaturase gene complex) haplotype, with the addition of individual ω-3 (DHA, non-DHA, and total), ω-6 (LA, non-LA, and total), or SFA factors as additive (mediation/suppression) or using an interaction term (with FADS) (moderation). All models were adjusted for a wide range of demographic and medical history variables and evaluated against a Bonferroni-adjusted significance level (p < 8.9 × 10⁻⁴). Results: Across 56 models (four lipids × seven FAs × two conceptual models (mediation/suppression and moderation)), we found evidence of 19 moderation, 12 mediation, and 16 suppression effects of the FADS–lipid relationship. For example, adjusting for circulating DHA levels as a mediator, the association of the genotype with HDL-c substantially lessened for both minor genotypes reflecting >122% mediation of the association of FADS by DHA. Additionally, we found evidence that LDL-c is moderated, to some extent, by all fatty acid measures. Conclusions: This analysis demonstrates that an individual’s fatty acid profile can act as a mediator/suppressor or moderator of the association of the FADS genotype and various cardiovascular biomarkers. Future work is necessary to expand this cross-sectional examination to determine directionality and temporality of the mediation and moderation evidence presented. This research has been conducted using the UK Biobank Resource under Application Number 85092. Full article

(This article belongs to the Section Clinical Nutrition)

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21 pages, 2857 KiB

Open AccessSystematic Review

Child and Adolescent Health Programs in Obesity and Depression: A Systematic Review and Meta-Analysis

by Ana Sarmiento-Riveros, María José Aguilar-Cordero, Juan A. Barahona-Barahona, Gabriel E. Galindo, Claudia Carvallo, Fernando A. Crespo and Héctor Burgos

Nutrients 2025, 17(6), 1088; https://doi.org/10.3390/nu17061088 - 20 Mar 2025

Viewed by 365

Abstract

Obesity and depression are public health issues of increasing concern worldwide. This study aims to evaluate programs that address obesity and their impact on depressive symptoms in children and adolescents. Obesity and depression share a bidirectional relationship, where each can serve as both [...] Read more.

Obesity and depression are public health issues of increasing concern worldwide. This study aims to evaluate programs that address obesity and their impact on depressive symptoms in children and adolescents. Obesity and depression share a bidirectional relationship, where each can serve as both a cause and a consequence of the other. Methods: A systematic review and meta-analysis were conducted following PRISMA criteria, with the registration recorded under PROSPERO code (CRD42024550644). The selected publications report on intervention programs for obesity and depression in children and adolescents aged 6 to 18 years. The selection was from databases including PUBMED, SCOPUS, LILACS, COCHRANE, WOS, SciELO, and ScienceDirect, using PICOS criteria to define inclusion. ROB-2 and ROBINS-1 were applied to assess bias. Results: Out of 3376 articles reviewed, eight met the inclusion criteria, some including several programs. These programs varied in duration and type, demonstrating changes in reducing Body Mass Index (BMI) and depressive symptoms. However, evidence supporting the effectiveness of programs that address both conditions is limited, particularly in developing countries. Additionally, the results exhibit high heterogeneity due to the diversity of evaluation criteria and methodological approaches, highlighting considerable risks of bias. Conclusions: Intervention programs for obesity management show statistically significant effects on depressive symptoms, although there is heterogeneity in the designs for their standardization and long-term follow-up strategies; however, the evaluations consider DSM-5 and ICD-11 criteria, which contributes to homogeneity. It is vital to address these closely related issues from a multidimensional perspective, considering socio-emotional and psychological factors, and to promote early intervention to maximize effectiveness and enhance quality of life at various stages of development. Full article

(This article belongs to the Special Issue Obesity and Related Diseases: The Role of Nutrition)

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21 pages, 580 KiB

Open AccessReview

Smell and Taste Impairments in Head and Neck Cancer Patients—A Scoping Review

by Nidhi Jha, Jed Speers, Lauren Gastineau, Shivani Patel, William Liu, Emily Pfahl, Apoorva Ramaswamy and Kai Zhao

Nutrients 2025, 17(6), 1087; https://doi.org/10.3390/nu17061087 - 20 Mar 2025

Viewed by 346

Abstract

Head and neck cancer affects millions worldwide. The risk factors are numerous, including smoking, alcohol consumption, and human papillomavirus to name a few. While improved preventative, diagnostic, and treatment methods have decreased mortality rates, the treatments (chemotherapy, radiotherapy, or surgery) often result in [...] Read more.

Head and neck cancer affects millions worldwide. The risk factors are numerous, including smoking, alcohol consumption, and human papillomavirus to name a few. While improved preventative, diagnostic, and treatment methods have decreased mortality rates, the treatments (chemotherapy, radiotherapy, or surgery) often result in smell and/or taste impairments. These can impact quality of life during and after cancer treatment. A scoping review was performed to understand current research and future directions regarding smell and taste impairments in head and neck cancer patients. PRISMA guidelines were followed and Rayyan.ai was used to search and compile journal articles. Three databases, EBSCOhost, Google Scholar, and PubMed, were also searched. Search terms included smell, taste, dysgeusia, ageusia, hypogeusia, parosmia, anosmia, hyposmia, dysosmia, and head and neck cancer. A total of 1580 articles were found through Rayyan.ai and 8022 were found through the three databases, which were manually screened. Articles assessing patients with a different malignancy, benign tumors, pediatric populations, animal studies, abstracts, and review articles were excluded. A total of 47 articles were found using this strategy. Of those we identified, 37 articles discussed taste impairments, 12 articles discussed smell impairments, and 3 articles discussed treatments for smell and/or taste impairments. All 37 articles concluded that there was some taste alteration in head and neck cancer patients due to their treatment. However, the specific taste qualities (sweet, sour, salty, or bitter) that were impaired, whether taste function returned to baseline, and which treatments led to impairments varied. For the 12 studies that assessed smell impairments, the results also varied. Some studies found significant objective impairments in smell while others found no significant impairment. Zinc sulfate was not found to be an effective treatment option for taste impairments; however, a liposomal spray showed some potential. Future studies should aim to understand which treatments and types of head and neck cancer lead to chemosensory impairments, whether chemosensory alterations negatively impact a patient’s nutritional status, and treatments or preventative measures for smell and taste changes. Full article

(This article belongs to the Special Issue The Interaction Between Flavor and Diet)

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15 pages, 1838 KiB

Open AccessArticle

Genome-Wide Impact of Folic Acid on DNA Methylation and Gene Expression in Lupus Adipocytes: An In Vitro Study on Obesity

by Leticia L. Souza, Jhulia C. N. L. da Mota, Lucas M. Carvalho, Amanda A. Ribeiro, Cesar A. Caponi, Marcela A. S. Pinhel, Nicolas Costa-Fraga, Angel Diaz-Lagares, Andrea G. Izquierdo, Carla B. Nonino, Ana B. Crujeiras and Carolina F. Nicoletti

Nutrients 2025, 17(6), 1086; https://doi.org/10.3390/nu17061086 - 20 Mar 2025

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Abstract

Objective: This in vitro study aimed to investigate the impact of folic acid on DNA methylation and gene expression in adipocytes from subcutaneous adipose tissue of patients with systemic lupus erythematosus (SLE), with a focus on the influence of obesity on these epigenetic [...] Read more.

Objective: This in vitro study aimed to investigate the impact of folic acid on DNA methylation and gene expression in adipocytes from subcutaneous adipose tissue of patients with systemic lupus erythematosus (SLE), with a focus on the influence of obesity on these epigenetic changes. Methods: Tissue biopsies were collected from patients with normal weight (NW) and obesity (OBS). Adipocytes were isolated via enzymatic digestion and density separation. Each group was divided into control (standard medium) and folic acid treatment (2 mg/24 h for 48 h) conditions. After treatment, DNA methylation levels were analyzed using the Infinium Methylation EPIC v2.0 Kit, and gene expression analyses were performed by RT-qPCR. A pathway enrichment analysis was conducted using the KEGG database for functional insight. Results: Folic acid induced differential methylation at 755 CpG sites in NW adipocytes, which were associated with immune regulation, including MAPK signaling. Also, OBS adipocytes showed methylation changes at 92 CpG sites, affecting pathways related to metabolic regulation, such as cAMP signaling. LEP gene expression was upregulated (5.2-fold) in OBS adipocytes, while CREM2 expression was increased (2.8-fold) in NW adipocytes after treatment. These gene expression differences underscore weight-dependent responses to folic acid, with LEP upregulation in OBS cells suggesting links to metabolic dysregulation and CREM2 upregulation in NW cells potentially contributing to immune modulation. Conclusions: Folic acid treatment exerts distinct epigenetic and gene expression effects in adipocytes of SLE patients, modulated by obesity status. This weight-dependent response, marked by changes in pathways relevant to immune and metabolic function, highlights the need for further investigation into how nutrient-based interventions might support SLE management. From a clinical perspective, this study underscores the potential of targeted nutrient-based interventions to address immunometabolic dysfunctions in SLE patients. Further research could explore folic acid supplementation as a complementary approach to personalized treatment strategies, particularly for patients with obesity. Full article

(This article belongs to the Special Issue Epidemiological Epigenomics on Nutrition and Health)

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12 pages, 219 KiB

Open AccessArticle

Quality of Life in Children with Celiac Disease: An Observational Study

by Anna Rozensztrauch and Paulina Mostyńska

Nutrients 2025, 17(6), 1085; https://doi.org/10.3390/nu17061085 - 20 Mar 2025

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Abstract

Background/Objectives: Celiac disease (CD) is one of the most common chronic autoimmune disorders affecting children worldwide. The aim is to explore the significance of quality of life (QOL) research in pediatric CD, highlighting the importance of assessing both physical and psychosocial aspects [...] Read more.

Background/Objectives: Celiac disease (CD) is one of the most common chronic autoimmune disorders affecting children worldwide. The aim is to explore the significance of quality of life (QOL) research in pediatric CD, highlighting the importance of assessing both physical and psychosocial aspects of well-being. Materials and Methods: The study used a self-administered questionnaire, which consisted of questions on sociodemographic and clinical characteristics, as well as a general assessment of the QOL by using the validated PedsQL™ 4.0. Results: Dietary restrictions were associated with social challenges, as reported by 43% of respondents who indicated their child had experienced exclusion or distress during family gatherings, while 48% encountered difficulties in the school setting. The overall QOL score had a mean of 68.9 (SD = 15.00), with a median of 67.4, and ranged from 41.3 to 100.0, reflecting individual variations in perceived well-being. Age is a significant factor influencing children’s social interactions and experiences within educational settings, likely due to increased academic demands, social pressures, or developmental changes. Conclusions: The study suggests that the study factor significantly influences physical functioning and overall quality of life, while its impact on emotional, social, and school domains is comparatively lower. Full article

(This article belongs to the Special Issue Nutritional Support for Gastrointestinal Diseases)

11 pages, 1778 KiB

Open AccessArticle

Translation and Cross-Cultural Adaptation of a Validated Questionnaire to Assess Dietary Fiber Intake Among the Italian Population

by Silvia Marconi, Giulia Gilberti, Elisa Romele, Roxanne Barbara Doerr, Anna Simonetto, Monica Marullo, Alice Vetturi, Giacomo Montani, Maurizio Castellano and Barbara Zanini

Nutrients 2025, 17(6), 1084; https://doi.org/10.3390/nu17061084 - 20 Mar 2025

Viewed by 307

Abstract

Background/Objectives: Regular consumption of dietary fiber (DF) has been associated with non-communicable disease prevention and health benefits. As a result, having the ability to quickly and correctly estimate DF intake would allow the identification of at-risk groups and the development of public [...] Read more.

Background/Objectives: Regular consumption of dietary fiber (DF) has been associated with non-communicable disease prevention and health benefits. As a result, having the ability to quickly and correctly estimate DF intake would allow the identification of at-risk groups and the development of public programs aimed at improving their intake. In this study, the authors translate and cross-culturally adapt a validated short food frequency questionnaire for the assessment of DF intake, thus adapting it to the Italian population. Methods: The process followed a six-step standardized protocol, and the pre-final version was tested among 40 volunteers. Six experts in nutrition performed the content validity study: Scale-level Content Validity Indexes based on Average (S-CVI/Ave) and Universal Agreement (S-CVI/UA) were calculated (cut-off = 0.83). Results: Both S-CVI/Ave and S-CVI/UA were 1.00 ± 0.0, higher than the cut-off value. The preliminary qualitative analysis showed an average DF intake of 21.5 ± 7.2 g/day, which is below the suggested national and international dietary targets, and mainly derives from fruits, vegetables, bread, and cereals. Based on their DF intake, subjects were classified as low (40%), moderate (37.5%), and high (22.5%) consumers. Conclusions: The translation and cross-cultural adaptation of a validated short food frequency questionnaire to assess DF intake provided us with a tool suitable for the Italian population. Its application in a real case has enabled the identification of three consumption classes, which can support the design of future studies and interventions. Full article

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

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2 pages, 496 KiB

Open AccessCorrection

Correction: Bakshi et al. Dietary Crocin is Protective in Pancreatic Cancer while Reducing Radiation-Induced Hepatic Oxidative Damage. Nutrients 2020, 12, 1901

by Hamid A. Bakshi, Mazhar S Al Zoubi, Hakkim L. Faruck, Alaa A A Aljabali, Firas A. Rabi, Amin A. Hafiz, Khalid M Al-Batanyeh, Bahaa Al-Trad, Prawej Ansari, Mohamed M. Nasef, Nitin B. Charbe, Saurabh Satija, Meenu Mehta, Vijay Mishra, Gaurav Gupta, Salem Abobaker, Poonam Negi, Ibrahim M. Azzouz, Ashref Ali K Dardouri, Harish Dureja, Parteek Prasher, Dinesh K. Chellappan, Kamal Dua, Mateus Webba Da Silva, Mohamed El Tanani, Paul A. McCarron and Murtaza M. Tambuwala Show full author list Hide full author list

Nutrients 2025, 17(6), 1083; https://doi.org/10.3390/nu17061083 - 20 Mar 2025

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Abstract

In the original publication [...] Full article

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17 pages, 283 KiB

Open AccessReview

The Role of Dietary Education in Cardiac Rehabilitation

by Joanna Popiolek-Kalisz, Michal Mazur and Francesco Perone

Nutrients 2025, 17(6), 1082; https://doi.org/10.3390/nu17061082 - 19 Mar 2025

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Abstract

Cardiovascular disease remains a leading cause of death globally; however, most cases could be prevented by addressing modifiable risk factors, such as unhealthy lifestyle factors, including diet. These aspects are also crucial in secondary prevention. Cardiac rehabilitation programs are vital in improving cardiovascular [...] Read more.

Cardiovascular disease remains a leading cause of death globally; however, most cases could be prevented by addressing modifiable risk factors, such as unhealthy lifestyle factors, including diet. These aspects are also crucial in secondary prevention. Cardiac rehabilitation programs are vital in improving cardiovascular outcomes, and apart from recommended pharmacotherapy, they focus on lifestyle modifications, including exercise, a healthy diet, and smoking cessation. The aim of this review was to summarize the evidence on the role of dietary education in cardiac rehabilitation programs. The available data show that nutritional recommendations play an important role in cardiac rehabilitation programs, with the Mediterranean diet being widely recommended for its cardiovascular benefits. Adherence to dietary recommendations in the course of cardiac rehabilitation has been linked to improved metabolic and cardiovascular outcomes; however, further studies with long-term follow-up are needed. Moreover, while challenges in following dietary recommendations exist, individualized care and support are essential for successful outcomes in cardiac rehabilitation programs. Including dietary education is an important part of cardiac rehabilitation after myocardial infarction; however, more studies are needed to investigate the role of individualized dietary support and personalized education in cardiac rehabilitation. Full article

(This article belongs to the Special Issue Specialized Diet, Obesity, and Associated Metabolic Diseases (3rd Edition）)

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Open AccessEditor’s ChoiceArticle

The Effect of Creatine Supplementation on Lean Body Mass with and Without Resistance Training

by Imtiaz Desai, Anurag Pandit, Abbie E. Smith-Ryan, David Simar, Darren G. Candow, Nadeem O. Kaakoush and Amanda D. Hagstrom

Nutrients 2025, 17(6), 1081; https://doi.org/10.3390/nu17061081 - 19 Mar 2025

Viewed by 21621

Abstract

Background/Objectives: Creatine monohydrate (CrM) is considered to be one of the most effective supplements for enhancing lean body mass during resistance training. However, CrM may influence body water content, potentially confounding lean body mass measurements. Therefore, this randomised controlled trial assessed the [...] Read more.

Background/Objectives: Creatine monohydrate (CrM) is considered to be one of the most effective supplements for enhancing lean body mass during resistance training. However, CrM may influence body water content, potentially confounding lean body mass measurements. Therefore, this randomised controlled trial assessed the effect of CrM alone on lean body mass following a supplement wash-in, and when combined with a resistance training program. Methods: Sixty-three (34 females, 29 males, 31 ± 8 years) participants were randomised to supplement with CrM (5 g/day for 13 weeks: wash-in + 12-week resistance training) or serve as a control (received no creatine or placebo). Lean body mass was measured using dual X-ray absorptiometry at baseline, post 7-day wash-in, and post 12 weeks of resistance training. Both groups began the same training program post CrM wash-in. Results: After the 7-day wash-in, the supplement group gained 0.51 ± 1.79 kg more lean body mass than the control group (p = 0.03). Following the wash-in, both groups gained 2 kg after resistance training (p < 0.0001), with no between-group difference in lean body mass growth (p = 0.71). Sex-disaggregated analysis showed that the supplement group, only in females, gained 0.59 ± 1.61 kg more lean body mass than the controls (p = 0.04). There were no group differences in lean body mass growth following resistance training in females (p = 0.10) or males (p = 0.35). Conclusions: A 7-day CrM wash-in increased lean body mass, particularly in females. Thereafter, CrM did not enhance lean body mass growth when combined with resistance training, likely due to its short-term effects on lean body mass measurements. A maintenance dose of higher than 5 g/day may be necessary to augment lean body mass growth. Full article

(This article belongs to the Section Sports Nutrition)

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13 pages, 242 KiB

Open AccessArticle

The Impact of Dietary Counseling on the Nutritional Status of Pediatric Patients with Non-IgE-Mediated Gastrointestinal Food Allergies: A Non-Randomized, Prospective Intervention Study

by Serena Coppola, Laura Carucci, Alessandra Agizza, Rita Nocerino, Rosilenia Carandente, Maria Francesca Catalano and Roberto Berni Canani

Nutrients 2025, 17(6), 1080; https://doi.org/10.3390/nu17061080 - 19 Mar 2025

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Abstract

Background/Objectives: Pediatric patients with non-IgE-mediated gastrointestinal food allergies (non-IgE-GIFAs) may experience alterations of nutritional status. This non-randomized, prospective intervention study investigated the impact of dietary counseling on nutritional status in pediatric patients with non-IgE-GIFAs. Methods: Patients of both sexes aged 0–14 [...] Read more.

Background/Objectives: Pediatric patients with non-IgE-mediated gastrointestinal food allergies (non-IgE-GIFAs) may experience alterations of nutritional status. This non-randomized, prospective intervention study investigated the impact of dietary counseling on nutritional status in pediatric patients with non-IgE-GIFAs. Methods: Patients of both sexes aged 0–14 years newly diagnosed with non-IgE-GIFAs received dietary counseling provided by certified pediatric dietitians immediately after diagnosis. Nutritional status parameters were assessed to identify nutritional status alterations at baseline and after 12 months of intervention (T12). Results: The study included 100 patients (58% male, mean age 8.5 ± 8.8 months). Non-IgE-GIFAs phenotypes included food protein-induced enteropathy (FPE, 44%), food protein-induced enterocolitis syndrome (FPIES, 11%), food protein-induced allergic proctocolitis (FPIAP, 17%), and food protein-induced motility disorders (FPIMD, 28%). At diagnosis, 1% was affected by obesity (1 FPIAP), 5% were affected by overweight (2 FPE, 1 FPIAP, and 2 FPIMD), 7% were moderately underweight (5 FPE and 2 FPIMD), 1% was severely underweight (1 FPE), 7% were moderately stunted (4 FPE, 1 FPIAP, and 2 FPIMD), 16% were moderately wasted (11 FPE, 1 FPIES, 1 FPIAP, and 3 FPIMD), and 4% were severely wasted (2 FPE and 2 FPIMD). At T12, improvements in anthropometric parameters were observed, along with a reduction in the prevalence of malnutrition by excess (6% at diagnosis vs. 2% at T12) and a reduction in the undernutrition subtypes rate, including underweight, stunting, and wasting (26% at diagnosis vs. 3% at T12, p < 0.001). Conclusions: Non-IgE-GIFAs can negatively impact the nutritional status of pediatric patients. Thus, dietary counseling could be an effective strategy for preventing and managing nutritional alterations in these patients. Full article

(This article belongs to the Special Issue Nutritional Intervention for Pediatric Allergy and Asthma)

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Open AccessArticle

Dental Caries, Periodontal Status, and Lifestyle Connections: Examining the Moderating Effects of Sleep, Smoking, Diet, and Mealtime Routines

by Marta Olmos-Valverde, María Carrillo-Díaz, María José González-Olmo, Martín Romero-Maroto and Isabel Jiménez-Trujillo

Nutrients 2025, 17(6), 1079; https://doi.org/10.3390/nu17061079 - 19 Mar 2025

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Abstract

Background: Lifestyle habits such as sleep, hygiene, or eating conducts are nowadays suffering from a lack of consistency, and this situation is being linked to systemic and mental health consequences. Nevertheless, not enough attention has been paid to investigate the plausible relation [...] Read more.

Background: Lifestyle habits such as sleep, hygiene, or eating conducts are nowadays suffering from a lack of consistency, and this situation is being linked to systemic and mental health consequences. Nevertheless, not enough attention has been paid to investigate the plausible relation between lifestyle habits and oral health, and hence, this investigation aims to study the possible effects of certain lifestyle conducts on oral health in dental students. Methods: A sample of 195 dental students was gathered and basic sociodemographic data (gender, age, and nationality), hygiene habits, as well as data related to smoking, adherence to healthy habits, and daily schedule constancy were recorded. Oral health, with reference to decayed, missing, and filled teeth, was recorded using the DMFT index and bleeding upon probing (BOP). The Healthy Lifestyle Scale (EVS) was utilized to record sleep, smoking, and mealtime and diet characteristics. Descriptive analysis, Pearson correlations, a hierarchical linear regression model, and moderation analysis were performed. Results: The present evidence showed a direct relation between healthy lifestyle habits and oral health indicators. Respect to mealtime routines (MT), correct sleep hygiene habits (SR) and eating a balanced diet (BD) exert a moderator effect on caries and smoking. Smoking shows a positive correlation with the number of filled teeth and BOP. Conclusions: Findings suggest that healthy lifestyle habits are related to better oral health status. In addition, correct sleep hygiene habits, a balanced diet, and a mealtime schedule can act as a moderator factor between caries and smoking. Full article

(This article belongs to the Special Issue Diet and Oral Health)

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Open AccessArticle

Hydration Status, Dietary Habits, and Functional Food Consumption Preferences of Football Athletes: A Cross-Sectional Pilot Study

by Georgios Papaoikonomou, Aikaterini Kandyliari, Antonis Vlassopoulos, Olga Malisova and Antonios E. Koutelidakis

Nutrients 2025, 17(6), 1078; https://doi.org/10.3390/nu17061078 - 19 Mar 2025

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Abstract

Background/Objectives: Hydration and nutrition are two key aspects of high-quality athletic performance. However, little is known about the potential beneficial effects of functional foods in sports. The present study investigates the hydration statuses of and knowledge, dietary habits, and consumption of functional [...] Read more.

Background/Objectives: Hydration and nutrition are two key aspects of high-quality athletic performance. However, little is known about the potential beneficial effects of functional foods in sports. The present study investigates the hydration statuses of and knowledge, dietary habits, and consumption of functional foods among football athletes, both professional (n = 24) and non-professional (n = 20). Methods: The study sample had a mean age of 19.9 ± 4.9 years, a mean weight of 74.0 ± 6.0 kg, and a mean body mass index (BMI) of 23.0 ± 1.40 km/m². All the athletes filled out a questionnaire about their hydration knowledge regarding sports and a functional food consumption questionnaire. Hydration status was assessed through urine color (Ucol) before and after training. Results: The results of this study show that 65% of the non-professional and 59.1% of the professional football players started their training dehydrated, and this proportion increased to 73.7% at the end of the training. Moreover, >50% of athletes were poorly educated in hydration practices during and after exercise. In addition, nutritional habits differences were observed among the professional and non-professional athletes regarding alcohol consumption (p < 0.0001) and fries (p < 0.05). Conclusions: A comprehensive understanding of and tailored approaches to nutrition and hydration need to be promoted among football athletes to realize the benefits of hydration and nutritional strategies that optimize their physiological resilience and competitive edges. Full article

(This article belongs to the Special Issue Food First: A New Perspective on Sports Nutrition)

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12 pages, 226 KiB

Open AccessArticle

The Influence of Maternal Diet in Late Pregnancy on Malondialdehyde and Cortisol Levels in Maternal and Cord Blood

by Mai Quynh Nguyen, Kinuyo Munakata, Midori Natsume, Yoshitaka Nakamura, Hiroshi Miyabayashi, Nobuhiko Nagano and Ichiro Morioka

Nutrients 2025, 17(6), 1077; https://doi.org/10.3390/nu17061077 - 19 Mar 2025

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Abstract

Background/Objectives: Research suggests that diet influences oxidative stress status in pregnant women and is related to their stress and depressive symptoms. This study aimed to investigate how maternal diet during late pregnancy affects oxidative stress status, maternal stress, depression, and fetal physical development. [...] Read more.

Background/Objectives: Research suggests that diet influences oxidative stress status in pregnant women and is related to their stress and depressive symptoms. This study aimed to investigate how maternal diet during late pregnancy affects oxidative stress status, maternal stress, depression, and fetal physical development. Methods: This study included 58 mother–child pairs. Dietary intake, depressive symptoms, and clinical information were obtained through questionnaires and clinical records. Maternal and cord blood concentrations of malondialdehyde (MDA), paraoxonase-1, platelet activating factor-acetylhydrolase, and cortisol were measured using spectrophotometric and enzyme-linked immunosorbent assays. Results: Maternal serum MDA levels were inversely associated with nut consumption (β = −0.40, p = 0.01) and positively associated with vitamin B2 (β = 2.43, p = 0.04) and manganese intake (β = 0.44, p = 0.02). Fruit consumption was positively associated with Center for Epidemiologic Studies Depression Scale score (β = 0.35, p = 0.03). Intakes of beans (β = −3.37, p = 0.04), vitamin B1 (β = −738.92, p = 0.04), vitamin B6 (β = −562.21, p = 0.04), vitamin C (β = −4.75, p = 0.009), iron (β = −106.63, p = 0.03), and copper (β = −863.31, p = 0.01) were inversely associated with maternal serum cortisol level, whereas dairy intake (β = 1.45, p = 0.003) showed a positive association. Cord plasma cortisol levels were inversely associated with the consumption of other vegetables (β = −2.89, p = 0.02). Conclusions: The findings encourage further research towards the refinement of dietary guidelines for pregnant women and recommendations for expecting mothers. Full article

(This article belongs to the Section Nutrition in Women)

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Open AccessArticle

EFINUTRILES Study: Integrative Extra Virgin Olive Oil and Multimodal Lifestyle Interventions for Cardiovascular Health and SLE Management

by Rocío Gil-Gutiérrez, Irene Medina-Martínez, Miguel Quesada-Caballero, Francisco Javier de la Hera-Fernández, Mónica Zamora-Pasadas, Irene Cantarero-Villanueva, Luis Albendín-García, Vítor Parola, Blanca Rueda-Medina and María Correa-Rodríguez

Nutrients 2025, 17(6), 1076; https://doi.org/10.3390/nu17061076 - 19 Mar 2025

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Abstract

Objectives: To analyze the effects of the combination of Extra Virgin Olive Oil (EVOO) supplementation and a health-related lifestyle intervention on disease activity and cardiovascular disease risk factors in Systemic Lupus Erythematosus (SLE). Methods: A total of 38 women with SLE were randomly [...] Read more.

Objectives: To analyze the effects of the combination of Extra Virgin Olive Oil (EVOO) supplementation and a health-related lifestyle intervention on disease activity and cardiovascular disease risk factors in Systemic Lupus Erythematosus (SLE). Methods: A total of 38 women with SLE were randomly assigned to EVOO (n = 9) and EVOO combined with multicomponent health promotion and physical exercise program (EVOO + HRLI) (n = 15) or control (CG) (n = 14) groups for 24 weeks. Baseline and post-intervention assessments were performed, collecting data on disease activity, accrual damage, blood biochemical parameters, arterial stiffness parameters, Framingham risk score, anthropometric and body composition measurements, and cardiovascular risk factors. Results: No changes in disease activity were observed in any group after the intervention. For cardiovascular risk, significant differences were observed in the intervention groups for systolic and mean blood pressure, with greater reductions in the EVOO + HRLI (p = 0.036 vs. p < 0.001; p = 0.017 vs. p < 0.001, respectively). The EVOO group showed significant reductions in BFM and BFP (p = 0.042, p = 0.022, respectively). The EVOO+ HRLI group also showed significant reductions in triglycerides (p < 0.001), Aix brachial (p = 0.037), central systolic blood pressure (p < 0.001), central pulse pressure (p = 0.05), body mass index (p = 0.006), body fat mass and skeletal muscle mass (p = 0.039) after the intervention. Conclusions: Our findings suggest that a multidisciplinary program integrating nutritional interventions, health education, and the promotion of regular physical activity in SLE patients has the potential to significantly improve cardiovascular risk factors and body composition parameters. Thus, integrating this approach into clinical practice alongside usual pharmacological treatments would be beneficial for SLE patients. Clinical Trial Registration: NCT05261529. Full article

(This article belongs to the Special Issue Dietetic Care in Primary Care and Prevention)

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10 pages, 1356 KiB

Open AccessArticle

Inadequate Calcium and Vitamin D Intake Among Japanese Women During the Perinatal Period: A Cross-Sectional Study with Bone Health Assessment

by Ryoko Ichikawa, Megumi Shibata, Yuko Nakura, Katsumi Iizuka, Kazuhiro Uenishi, Takao Sekiya, Atsushi Suzuki and Haruki Nishizawa

Nutrients 2025, 17(6), 1075; https://doi.org/10.3390/nu17061075 - 19 Mar 2025

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Abstract

Objectives: We previously reported a high prevalence of hypovitaminosis D (25OHD < 20 ng/mL) in Japanese pregnant women with threatened premature delivery. This study aimed to assess nutritional status and its relationship with bone-related markers and microarchitecture, as measured using quantitative ultrasonography (QUS), [...] Read more.

Objectives: We previously reported a high prevalence of hypovitaminosis D (25OHD < 20 ng/mL) in Japanese pregnant women with threatened premature delivery. This study aimed to assess nutritional status and its relationship with bone-related markers and microarchitecture, as measured using quantitative ultrasonography (QUS), in Japanese women during the perinatal period. Methods: We recruited Japanese women who had just delivered at Fujita Health University Hospital (n = 103, cesarean/vaginal delivery = 50/53, age 33.9 ± 4.9 years). On the third day postpartum, their calcaneal QUS was measured, and fasting blood samples were collected. Results: The mean total energy intake (1720 ± 298 kcal/day) was lower than the normal range for Japanese women (2100 kcal/day). Their calcium intake (446 ± 130 mg/day) was significantly below the recommended daily intake (RDI) in Japan (660 mg/day), with 95% of participants consuming less than the RDI. Although the average vitamin D intake (8.7 ± 1.8 μg/day) met the Japanese RDI (8.5 μg/day), 36% of participants consumed less than the RDI. Calcium intake was positively associated with the intake of lipids, protein, and vitamins A, D, and K. Additionally, calcium intake but not vitamin D intake tended to correlate with serum 25-hydroxyvitamin D (25OHD) levels. The QUS indices showed no significant association with calcium or vitamin D intake. Conclusions: During the perinatal period, Japanese women had low calcium intake and relatively low vitamin D intake, accompanied by reduced 25OHD levels. These findings highlight the need for public health recommendations and policies to promote adequate calcium and vitamin D intake during pregnancy. Full article

(This article belongs to the Special Issue Diet, Maternal Nutrition and Reproductive Health)

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12 pages, 753 KiB

Open AccessArticle

The Global Leadership Initiative on Malnutrition (GLIM) Tool for Nutritional Assessment of Adult Patients After Sleeve Gastrectomy: Is It the Recommended Tool?

by Amani N. Alotaibi, Fahad Bamehriz, Nadia A. Aljomah, Khalid Almutairi, Shabana Tharkar, May Al-Muammar, Adel Alhamdan, Dara Aldisi and Mahmoud M. A. Abulmeaty

Nutrients 2025, 17(6), 1074; https://doi.org/10.3390/nu17061074 - 19 Mar 2025

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Abstract

Background/Objectives: Malnutrition frequently occurs following bariatric surgery and can lead to higher morbidity rates, hospitalizations, and extended hospital stays. Nutritional assessment tools such as the Global Leadership Initiative on Malnutrition (GLIM) are not validated for diagnosis of malnutrition following bariatric surgery. This [...] Read more.

Background/Objectives: Malnutrition frequently occurs following bariatric surgery and can lead to higher morbidity rates, hospitalizations, and extended hospital stays. Nutritional assessment tools such as the Global Leadership Initiative on Malnutrition (GLIM) are not validated for diagnosis of malnutrition following bariatric surgery. This study aimed to assess the validity of GLIM criteria in evaluating the nutritional status of post-sleeve gastrectomy patients compared to the Subjective Global Assessment (SGA). Methods: A total of 47 adult patients who underwent sleeve gastrectomy (SG) from 6 months to 2 years prior were evaluated using the GLIM and SGA. Additionally, multiple pass 24 h recall was collected for two days, and macronutrient analyses were conducted using ESHA software (version 11.11.x). Agreement between both tools was determined using Kappa (κ) statistics, and the Receiver Operating Characteristics (ROC) curve was used to establish sensitivity and specificity. Results: The study found that malnutrition was diagnosed in 48.9% and 42.6% of patients according to the GLIM and SGA criteria, respectively. The GLIM criteria exhibited inadequate accuracy (AUC = 0.533; 95% CI, 0.38–0.72) with a sensitivity and specificity of 55.0% and 55.6%, respectively. The agreement between both tools was determined to be poor (κ = 0.104). Conclusions: GLIM did not show sufficient agreement with SGA. Consequently, the criteria of GLIM may need revision for better diagnosis of malnutrition in post-sleeve gastrectomy patients. Full article

(This article belongs to the Special Issue Nutrition Guidelines for Bariatric Surgery Patients)

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Open AccessReview

Combined Effects of Early Mobilization and Nutrition on ICU-Acquired Weakness

by Paolo Formenti, Alessandro Menozzi, Giovanni Sabbatini, Miriam Gotti, Andrea Galimberti, Giovanni Bruno, Angelo Pezzi and Michele Umbrello

Nutrients 2025, 17(6), 1073; https://doi.org/10.3390/nu17061073 - 19 Mar 2025

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Abstract

Intensive Care Unit-Acquired Weakness (ICUAW) is a very common condition in patients admitted to intensive care units (ICUs), even after relatively short stays. This weakness can develop with a pre-existing background of sarcopenia or cachexia, although these conditions are not always the direct [...] Read more.

Intensive Care Unit-Acquired Weakness (ICUAW) is a very common condition in patients admitted to intensive care units (ICUs), even after relatively short stays. This weakness can develop with a pre-existing background of sarcopenia or cachexia, although these conditions are not always the direct cause. Over the years, much of the literature has focused on the nutritional aspect of the issue, leading to the development of widely accepted guidelines recommending the initiation of early nutrition, with the goal of achieving caloric and protein targets within the first five days of ICU admission. Despite adherence to these guidelines, several studies have shown a significant loss of muscle mass in critically ill patients, which directly impacts their ability to generate strength. However, it has become increasingly evident that nutrition alone is not sufficient to counteract this muscle loss, which is often closely linked to the prolonged immobility experienced by ICU patients due to a variety of clinical and logistical factors. In particular, there is growing evidence suggesting that even the introduction of early and minimal rehabilitation—including passive mobilization—when combined with appropriate nutritional support, can be a valuable strategy to help reduce the incidence of ICUAW. In this narrative review, we aim to summarize the current scientific knowledge on this topic, emphasizing the importance of an integrated approach that combines nutrition and early mobilization. Such a combined strategy not only holds the potential to reduce the acute incidence of ICUAW but also contributes to better recovery outcomes and, eventually, improved quality of life for these patients. Full article

(This article belongs to the Special Issue Nutritional Management in Intensive Care)

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17 pages, 4277 KiB

Open AccessArticle

Ursodeoxycholic Acid Exhibits Greater Inhibitory Effects on Cancerous HCT116 Colon Cells than on Noncancerous NCM460 Colon Cells

by Huawei Zeng, Bryan D. Safratowich, Wen-Hsing Cheng and Mary Briske-Anderson

Nutrients 2025, 17(6), 1072; https://doi.org/10.3390/nu17061072 - 19 Mar 2025

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Abstract

Background/Objectives: Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, exhibits anti-inflammatory effects and attenuates the process of colon carcinogenesis. Certain healthy diets increase colonic UDCA concentrations, but its anticancer mechanistic actions remain largely unknown. We hypothesize that UDCA preferentially inhibits cancerous colon cell proliferation [...] Read more.

Background/Objectives: Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, exhibits anti-inflammatory effects and attenuates the process of colon carcinogenesis. Certain healthy diets increase colonic UDCA concentrations, but its anticancer mechanistic actions remain largely unknown. We hypothesize that UDCA preferentially inhibits cancerous colon cell proliferation with a minimal effect on noncancerous colon cells. Methods: With human noncancerous NCM460 colon cell and cancerous HCT116 colon cell culture models, we performed biochemical, western blotting, PCR array, cell cycle, apoptosis, and immunofluorescent assays to determine the effects of UDCA treatment on colon cell proliferation and the underlying molecular mechanisms. Results: The inhibitory potential of UDCA against cell proliferation (via cell cycle arrest and apoptosis) was 90% greater in cancerous HCT116 cells than noncancerous NCM460 cells when treated with UDCA (0 to 0.4 mM) for 48 h. In UDCA-treated HCT116 cells, we identified 18 genes with ≥80% change (compared to untreated cells) in mRNA levels out of 93 apoptotic genes which were involved in caspase, death receptor, and NFκB pathways. At the molecular level, 0.4 mM UDCA reduced the protein level of the proto-oncogenic c-Myc gene but increased the putative tumor suppressor p21 gene (≥100%) via the ERK1/2/c-Myc/p21 pathway, which regulates cell cycle and apoptosis. These data are consistent with lower c-Myc but higher p21 expression in normal colon tissues compared to cancerous colon tissues. Conclusions: Collectively, UDCA inhibits cancerous HCT116 colon cells to a higher degree than in noncancerous NCM460 colon cells through cell cycle and apoptosis involving ERK1/2/c-Myc/p21 signaling. Full article

(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to After-Care)

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12 pages, 521 KiB

Open AccessArticle

Development of the Australian Dietary Guidelines Adherence Tool (ADG-AT): A Food Matching Protocol

by Rosa Piscioneri, Karen Zoszak and Yasmine Probst

Nutrients 2025, 17(6), 1071; https://doi.org/10.3390/nu17061071 - 19 Mar 2025

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Abstract

Background/Objectives: Food matching aligns food consumption and food composition data to quantify intakes of a food component or category. A systematic approach to food matching is required to obtain the highest quality match and, therefore, most accurately quantify the intake of the [...] Read more.

Background/Objectives: Food matching aligns food consumption and food composition data to quantify intakes of a food component or category. A systematic approach to food matching is required to obtain the highest quality match and, therefore, most accurately quantify the intake of the food component under investigation. This study aims to provide a tool to assess adherence with the Australian Dietary Guideline food group recommendations by the development of a food matching method that links dietary intake data from a food frequency questionnaire to food group data in the Australian Dietary Guideline database. Methods: Two researchers trained in food composition independently applied a stepwise approach to link the Dietary Questionnaire for Epidemiological Studies Version 2 food frequency questionnaire and the Australian Dietary Guideline database. Food preparation methods, mixed dishes and Australian Dietary Guideline database representative foods were considered to ensure the highest quality result. Average values were calculated for foods for which multiple items were matched. Results: The Australian Dietary Guideline Adherence Tool (ADG-AT) was produced, providing the number of servings of the five Australian Dietary Guideline food groups and discretionary foods per 100 g of food for 5742 food items. Conclusions: The ADG-AT produced in this study allows convenient evaluation of Australian Dietary Guideline adherence in studies using the Dietary Questionnaire for Epidemiological Studies food frequency questionnaire to collect dietary intake data. This informs the identification of dietary risk factors for nutritional inadequacy and chronic disease. The systematic methods used in this study can be reapplied to different dietary intake collection tools and food composition databases. Full article

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

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17 pages, 274 KiB

Open AccessArticle

Infant Feeding Challenges in the First Six Months: Influencing Factors, Consequences, and Strategies for Maternal Support

by Karolina Krupa-Kotara, Jarosław Markowski and Mateusz Grajek

Nutrients 2025, 17(6), 1070; https://doi.org/10.3390/nu17061070 - 19 Mar 2025

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Abstract

Introduction: The first six months of an infant’s life are crucial for the child’s physical and psychological development. During this period, maternal feeding practices significantly impact infant nutrition and growth. The aim of this study was to identify factors associated with feeding difficulties [...] Read more.

Introduction: The first six months of an infant’s life are crucial for the child’s physical and psychological development. During this period, maternal feeding practices significantly impact infant nutrition and growth. The aim of this study was to identify factors associated with feeding difficulties in infants younger than six months. Methods: The study was conducted using a CAWI method. The study group consisted of 555 mothers who completed an online questionnaire about demographics, feeding methods, and feeding difficulties experienced, measured using the Montreal Children’s Hospital Feeding Scale (MCH-FS). Infant feeding methods were clearly distinguished as direct breastfeeding, breast milk feeding (expressed milk), and formula feeding. Statistical analyses included effect sizes (Cohen’s d) and 95% confidence intervals (95% CI). Results: In the study group, 65% of mothers reported feeding difficulties. Significant predictors of feeding difficulties included maternal overweight and obesity (p = 0.041; Cohen’s d = 0.37, 95% CI [0.15, 0.59]), lower maternal education (p = 0.014; Cohen’s d = 0.45, 95% CI [0.22, 0.68]), lack of adequate partner support (38%), and the use of mixed feeding methods (mean difference = 4.4 points, p = 0.027; Cohen’s d = 0.46, 95% CI [0.23, 0.69]). Conclusions: Feeding difficulties during infancy are common and influenced by maternal health and sociodemographic factors. These findings emphasize the importance of targeted educational resources and lactation support interventions tailored specifically to mothers at increased risk. Full article

(This article belongs to the Special Issue Breastfeeding and Maternal Health Outcomes)

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30 pages, 601 KiB

Open AccessReview

Natural Products in the Management of Gastroesophageal Reflux Disease: Mechanisms, Efficacy, and Future Directions

by Kayode Komolafe, Titilope Ruth Komolafe, Olamide Olajusi Crown, Basiru Ajiboye, Felicite Noubissi, Ifedayo Victor Ogungbe and Barbara Graham

Nutrients 2025, 17(6), 1069; https://doi.org/10.3390/nu17061069 - 19 Mar 2025

Viewed by 1572

Abstract

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that is defined by the reflux of gastric contents into the esophagus, and it results in symptoms such as esophageal inflammation, regurgitation, and indigestion. Although proton pump inhibitors (PPIs) and histamine-2 receptor antagonists are [...] Read more.

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that is defined by the reflux of gastric contents into the esophagus, and it results in symptoms such as esophageal inflammation, regurgitation, and indigestion. Although proton pump inhibitors (PPIs) and histamine-2 receptor antagonists are frequently employed to treat GERD, their prolonged administration is associated with adverse effects, necessitating the development of alternative therapeutic strategies. Natural products are now recognized as promising candidates for the management of GERD due to their bioactive compounds, which possess antioxidant, anti-inflammatory, and mucosal-protective properties. The potential of natural products in the treatment of GERD is comprehensively examined in this review, with a focus on their mechanisms of action, which include acid suppression, esophageal mucosal regeneration, anti-inflammatory activity, and gut microbiota modulation. Also, the efficacy and safety of key natural products, including flavonoids, polyphenols, plant-derived oils, herbal extracts, probiotics, and dietary components, in preclinical and clinical studies, are assessed. Additionally, this review addresses the barriers confronting the translation of natural therapies into clinical practice, such as regulatory obstacles, variability in bioavailability, and the need for dosage standardization. The integration of natural products into the management of GERD has the potential to enhance conventional therapies, providing a more comprehensive and secure approach for patients. Full article

(This article belongs to the Special Issue Dietary Interventions for Functional Gastrointestinal Disorders)

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25 pages, 2091 KiB

Open AccessReview

In Vivo Evidence on the Emerging Potential of Non-Digestible Oligosaccharides as Therapeutic Agents in Bacterial and Viral Infections

by Amirmohammad Afsharnia, Yang Cai, Arjen Nauta, Andre Groeneveld, Gert Folkerts, Marc M. S. M. Wösten and Saskia Braber

Nutrients 2025, 17(6), 1068; https://doi.org/10.3390/nu17061068 - 19 Mar 2025

Viewed by 412

Abstract

The issue of antibiotic-resistant bacterial infections, coupled with the rise in viral pandemics and the slow development of new antibacterial and antiviral treatments, underscores the critical need for novel strategies to mitigate the spread of drug-resistant pathogens, enhance the efficacy of existing therapies, [...] Read more.

The issue of antibiotic-resistant bacterial infections, coupled with the rise in viral pandemics and the slow development of new antibacterial and antiviral treatments, underscores the critical need for novel strategies to mitigate the spread of drug-resistant pathogens, enhance the efficacy of existing therapies, and accelerate the discovery and deployment of innovative antimicrobial and antiviral solutions. One promising approach to address these challenges is the dietary supplementation of non-digestible oligosaccharides (NDOs). NDOs, including human milk oligosaccharides (HMOs), play a vital role in shaping and sustaining a healthy gut microbiota. Beyond stimulating the growth and activity of beneficial gut bacteria, NDOs can also interact directly with pathogenic bacteria and viruses. Their antiviral and antibacterial properties arise from their unique interactions with pathogens and their ability to modulate the host’s immune system. NDOs can function as decoy receptors, inhibit pathogen growth, bind to bacterial toxins, stimulate the host immune response, exhibit anti-biofilm properties, and enhance barrier protection. However, a notable gap exists in the comprehensive assessment of in vivo and clinical data on this topic. This review aims to provide an in-depth overview of the in vivo evidence related to the antiviral and antibacterial effects of various NDOs and HMOs, with a focus on discussing their possible mechanisms of action. Full article

(This article belongs to the Section Carbohydrates)

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27 pages, 376 KiB

Open AccessArticle

Eating Disorder Risk Among Adolescents: The Influence of Dietary Patterns, Physical Activity, and BMI

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

Nutrients 2025, 17(6), 1067; https://doi.org/10.3390/nu17061067 - 19 Mar 2025

Viewed by 725

Abstract

Background/Objectives: Eating disorders (EDs) are rising among adolescents. BMI, diet, and physical activity influence ED risk, but their interactions are complex and vary by population. Considering sociocultural changes, this study investigated the prevalence and risk factors for EDs in Romanian adolescents. We evaluated [...] Read more.

Background/Objectives: Eating disorders (EDs) are rising among adolescents. BMI, diet, and physical activity influence ED risk, but their interactions are complex and vary by population. Considering sociocultural changes, this study investigated the prevalence and risk factors for EDs in Romanian adolescents. We evaluated demographic factors, BMI, dietary behaviors, physical activity (PA), and previous specialist consultations using the Eating Attitudes Test-26 (EAT-26) and assessed the psychometric properties of the EAT-26 in this population. Methods: A cross-sectional study included 423 youths aged 13 to 20 from Cluj-Napoca. Participants completed an online survey on demographics, BMI, diet, physical activity, and previous health consultations. ED risk was assessed using the EAT-26. Confirmatory and exploratory factor analyses were conducted on the EAT-26, and binary logistic regression identified predictors of ED risk. Results: The prevalence of ED risk was 26.5%, with females having 1.61 times higher odds than males. Consulting a weight or mental health specialist increased the odds of increased ED risk (OR = 3.76). Higher BMI showed a trend in the unadjusted model (OR = 1.06). An initial CFA of the EAT-26 showed a suboptimal fit. Over 60% of the sample reported frequent consumption of ultra-processed foods. Conclusions: Our findings highlight a significant ED risk in Romanian youth, filling a critical gap in regional public health evidence. Despite limitations due to the cross-sectional design and self-reported data, the results stress the need for measures promoting balanced diets, positive body image, and improved mental health access to reduce the growing prevalence of adolescent ED risk in Romania. Full article

(This article belongs to the Special Issue Focus on Eating Disorders of Adolescents and Children)

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Nutrients, Volume 17, Issue 6 (March-2 2025) – 166 articles

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