Nutrients

22 pages, 1580 KB

Open AccessArticle

Ten-Year Trends in Serum 25-Hydroxyvitamin D in Slovenia (2014–2023): Laboratory-Based Data from Tested Individuals and COVID-19-Period Changes

by Joško Osredkar, Darko Siuka, Aleš Jerin, Borut Štabuc and Uroš Godnov

Nutrients 2026, 18(7), 1168; https://doi.org/10.3390/nu18071168 - 7 Apr 2026

Viewed by 629

Abstract

Background: Vitamin D status is influenced by season, age, and public health messaging. The COVID-19 pandemic was accompanied by heightened interest in vitamin D, but long-term national data from Central/Eastern Europe remain limited. We aimed to characterize 10-year trends, seasonal variation, and demographic [...] Read more.

Background: Vitamin D status is influenced by season, age, and public health messaging. The COVID-19 pandemic was accompanied by heightened interest in vitamin D, but long-term national data from Central/Eastern Europe remain limited. We aimed to characterize 10-year trends, seasonal variation, and demographic determinants of serum 25-hydroxyvitamin D [25(OH)D] in Slovenia, with particular focus on changes during the COVID-19 period. Methods: We performed a retrospective cross-sectional analysis of all serum 25(OH)D measurements performed at the Slovenian national reference laboratory between January 2014 and December 2023. The core analytic cohort included 106,875 patients with valid 25(OH)D results, aged 0–100 years. Vitamin D status was classified as deficient (<30 nmol/L), insufficient (30–50 nmol/L), adequate (50–75 nmol/L), and optimal (>75 nmol/L). Temporal trends, seasonal patterns, and age- and sex-specific differences were assessed using non-parametric tests and Kendall’s τ. Results: Mean 25(OH)D concentration over the study period was 61.9 ± 34.2 nmol/L; 16.0% of patients were deficient and 22.8% insufficient. Annual mean 25(OH)D increased from 57.0 nmol/L in 2014 to 67.2 nmol/L in 2023, with a significant upward temporal trend and a 14.6% higher mean level during 2020–2023 compared with 2014–2019. Seasonal variation was pronounced (≈20% higher summer–autumn vs. winter–spring), and vitamin D status declined progressively with age, with the highest deficiency prevalence in patients ≥ 70 years. Females had slightly higher 25(OH)D than males, although absolute differences were small. Conclusions: This laboratory-based analysis of tested patients showed higher 25(OH)D concentrations during and after the COVID-19 period, superimposed on persistent seasonal and age-related gradients. These observations identify older adults and winter testing periods as important contexts for vitamin D optimization, but they should be interpreted as descriptive trends among tested individuals rather than as evidence of causal pandemic effects or population-wide prevalence changes. Full article

(This article belongs to the Special Issue The Role of B and D Vitamins in Degenerative Diseases)

► Show Figures

Figure 1

22 pages, 2351 KB

Open AccessArticle

Effects of Fortified Formula Milk Supplementation on Neurocognitive Development and the Microbiota–Gut–Brain Axis in Preschool Children: A Cluster-Randomized, Double-Blind, Controlled Trial

by Yifan Gong, Xingwen Zhao, Qi Zhang, Xinxin Yan, Bin Sun, Xinyi Li, Qixu Han, Yiran Guan, Huiyu Chen, Meina Li, Jie Guo, Biao Liu, Ran Wang, Baotang Zhao, Yan Zhang and Jingjing He

Nutrients 2026, 18(7), 1167; https://doi.org/10.3390/nu18071167 - 7 Apr 2026

Viewed by 897

Abstract

Background/Objectives: The preschool period is critical for neurodevelopment, yet evidence investigating fortified formula’s effect and potential microbiota–gut–brain axis mechanisms in this age group is limited. To evaluate fortified formula milk’s effect on neurodevelopment and explore potential microbiota–gut–brain axis mechanisms in preschool children. Methods: [...] Read more.

Background/Objectives: The preschool period is critical for neurodevelopment, yet evidence investigating fortified formula’s effect and potential microbiota–gut–brain axis mechanisms in this age group is limited. To evaluate fortified formula milk’s effect on neurodevelopment and explore potential microbiota–gut–brain axis mechanisms in preschool children. Methods: In this 9-month cluster-randomized, double-blind, controlled trial, 120 healthy children aged 3–6 years from four kindergarten classes were stratified by grade and randomly allocated (1:1) to receive either multi-nutrient fortified formula (intervention, n = 60) or standard control milk (n = 60). Neurocognitive function was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV). Safety was evaluated through anthropometry and blood biochemistry. Gut microbiota (16S rRNA sequencing) and fecal metabolomes (untargeted LC-MS) were analyzed at baseline and 9 months. Results: The intention-to-treat (ITT) analysis showed no significant difference in Full Scale Intelligence Quotient (adjusted mean difference: 1.05 points; 95% CI: −1.42, 3.52; p = 0.400). However, the intervention group significantly improved the Processing Speed Index (adjusted mean difference: 5.91 points; 95% CI: 1.88, 9.93; p = 0.004), increased gut microbial alpha diversity (Shannon index) and Bifidobacterium abundance. Metabolomic analysis revealed elevated fecal 2-hydroxybutyric acid (2-HB), a marker of propanoate metabolism. Increases in both Bifidobacterium and 2-HB levels showed a positive association with PSI improvement (both p < 0.05). All children maintained normal growth and safety parameters. Conclusions: Fortified formula milk improved processing speed in preschoolers, a benefit associated with gut ecosystem modulation characterized by Bifidobacterium enrichment and upregulated microbial propanoate metabolism. These results offer preliminary evidence for the role of the microbiota–gut–brain axis in nutritional cognitive programming during early childhood. (Clinical Trial Registry: ChiCTR2400084211). Full article

(This article belongs to the Special Issue Nutritional Intervention in Mental Health—2nd Edition)

► Show Figures

Figure 1

16 pages, 1219 KB

Open AccessArticle

A Prolonged Nightly Fasting Plus Telehealth Coaching Intervention (PNF+) for Men on Androgen Deprivation Therapy for PCa: A Pilot Feasibility Randomized Controlled Trial

by Kuang-Yi Wen, Julianne Freedman, Kevin Kayvan Zarrabi, Rachel Slamon, Rita Smith, Jessica Liang, Patrick Mille, William J. Tester and William Kelly

Nutrients 2026, 18(7), 1166; https://doi.org/10.3390/nu18071166 - 7 Apr 2026

Viewed by 664

Abstract

Background/Objectives: This study aimed to assess the feasibility and acceptability of a 3-month health coaching intervention to promote PNF and healthy diet for men on ADT for PCa. Methods: The study was carried out via a two-armed randomized controlled trial including [...] Read more.

Background/Objectives: This study aimed to assess the feasibility and acceptability of a 3-month health coaching intervention to promote PNF and healthy diet for men on ADT for PCa. Methods: The study was carried out via a two-armed randomized controlled trial including 40 patients with PCa at a medical center in Philadelphia. During the 3-month period, the intervention group (PNF+) received health coaching utilizing an interactive text message system, and the control group received healthy eating text messages for the same duration. The outcome variables were feasibility and acceptability. Results: The PNF+ group (n = 27) had high adherence to health coaching (82%), picture response (85%) and moderate adherence to the PNF window (69%). The intervention was rated highly acceptable with no reported A/E associated with the intervention, and most participants planning to continue in some capacity. At 3 months, the PNF+ group had numerically lower BMI (29.1) and body weight (195.2 lbs) compared to the control group (n = 13; BMI 31.6, weight 223.3 lbs). Improvements in patient-reported outcomes were observed in both groups. FACIT-F scores (higher scores indicate less fatigue) increased in the PNF+ group (43.6 to 45.2) and in the control group (42.5 to 45.5). FACT-P scores (higher scores indicate better quality of life) increased in the PNF+ group (121.3 to 125.5) but decreased slightly in the control group (121.1 to 119.8). Between-group comparisons of change from baseline showed no statistically significant differences across outcomes (all p > 0.05). Conclusions: The intervention demonstrated partial feasibility and high acceptability. It was associated with numerically lower BMI and body weight and favorable changes in patient-reported outcomes, particularly quality of life; however, no statistically significant differences were observed between groups. These findings should be interpreted cautiously given the small sample size and require confirmation in larger, adequately powered trials. Full article

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

► Show Figures

Figure 1

10 pages, 517 KB

Open AccessArticle

Prevalence of Nutrition Standards Use by Municipalities in Government-Owned or Operated Properties, United States, 2021

by Reena Oza-Frank, Amy Lowry Warnock and Diane M. Harris

Nutrients 2026, 18(7), 1165; https://doi.org/10.3390/nu18071165 - 7 Apr 2026

Viewed by 418

Abstract

Background/Objectives: Adopting written nutrition standards for food sold or served by local governments is a strategy for increasing access to healthier options among employees and residents. Methods: We used data from a 2021 national survey of 1982 municipal governments serving populations of 1000 [...] Read more.

Background/Objectives: Adopting written nutrition standards for food sold or served by local governments is a strategy for increasing access to healthier options among employees and residents. Methods: We used data from a 2021 national survey of 1982 municipal governments serving populations of 1000 or more. Among municipalities that sell or serve food or beverages, we examined the prevalence and 95% confidence intervals (CI) of those with written nutrition standards. Logistic regression models were used to obtain odds ratios and 95% CIs of written nutrition standards by municipality characteristics. Finally, we examined the prevalence including nutrition standards in food purchasing agreements or food service contracts among municipalities that sell or serve food and have written nutrition standards. Results: Among U.S. municipalities in 2021, 32% reported selling and 21% reported serving food or beverages. Among U.S. municipalities that sell or serve food or beverages, the prevalence of municipalities with written nutrition standards was 19%, and of these, 78% reported including their written nutrition standards in city food purchasing agreements or food service contracts. In adjusted analyses, the region (West vs. Midwest adjusted odds ratio [aOR]: 2.9 [95% CI: 1.7, 4.9]) and presence of a food policy council remained significantly associated with having written nutrition standards (aOR: 1.7 [1.1, 2.5]). Conclusions: Although only 1 in 5 municipalities that sell or serve food or beverages have written nutrition standards, of those that do, almost 80% reported including the standards in contracts, highlighting an important implementation lever and a public health opportunity for communities to adopt standards that offer healthy food and beverage options in public spaces. Full article

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

► Show Figures

Figure 1

21 pages, 652 KB

Open AccessArticle

Iodine Content of Commercially Available Iodized Salts in Hungary Determined by Iodometric Titration: Implications for the Effectiveness of Salt Iodization

by Nicole Hunter, Károly Berényi, Ágnes Csergő, Afshin Zand, Anita Bufa, Ágnes Dörnyei, Balázs Németh, István Kiss, Bálint Árvay and Katalin Szendi

Nutrients 2026, 18(7), 1164; https://doi.org/10.3390/nu18071164 - 7 Apr 2026

Viewed by 828

Abstract

Background/Objectives: Iodine deficiency remains an important global public health concern. Although iodized salt is the primary strategy for iodine deficiency prevention, its effectiveness depends on adequate iodine concentrations in commercially available products. However, laboratory data on the iodine content of retail salt products [...] Read more.

Background/Objectives: Iodine deficiency remains an important global public health concern. Although iodized salt is the primary strategy for iodine deficiency prevention, its effectiveness depends on adequate iodine concentrations in commercially available products. However, laboratory data on the iodine content of retail salt products in Hungary are currently lacking. Therefore, this study aimed to determine the iodine concentration of commercially available iodized table salts in Hungary and to assess their compliance with the WHO-recommended range of 20–40 ppm. Methods: Twenty different brands of iodized table salt were purchased from major retail outlets in Pécs, Hungary, representing the dominant food retail sector. According to product labels, ten salts were fortified with potassium iodate (KIO₃) and ten with potassium iodide (KI). Iodine concentrations were determined by iodometric titration following WHO-recommended laboratory methods. All measurements were performed in triplicate and expressed as mean values. In addition, a small exploratory wholesale micro-survey examined purchasing patterns of iodized and non-iodized salt in the regional supply chain. Results: Measured iodine concentrations varied substantially among products, ranging from 0 to 33.9 ppm. Overall, 65% of the analyzed salt samples contained less than 20 ppm iodine, while only 35% fell within the WHO-recommended range of 20–40 ppm. Notably, several products declared iodine concentrations below recommended levels on their labels. The wholesale micro-survey showed that ten times more iodized than non-iodized salt was ordered during the observation period. Conclusions: These results suggest that the presence of iodized salt on the market does not necessarily guarantee adequate iodine supply and highlight the potential relevance of considering iodine status during the differential diagnosis of hypothyroidism. Full article

(This article belongs to the Special Issue Measuring Healthy Diets: The Past, Present and Future of Dietary Assessment)

► Show Figures

Figure 1

12 pages, 1334 KB

Open AccessArticle

Isomaltulose-Based Stimulant Beverages Can Improve Postprandial Metabolic Responses Without Compromising Cognitive Benefits Associated with Caffeinated Energy Drinks

by Peter Michael Bloomfield and Nicholas Gant

Nutrients 2026, 18(7), 1163; https://doi.org/10.3390/nu18071163 - 6 Apr 2026

Viewed by 624

Abstract

Purpose: We hypothesised that cognition following consumption of an isomaltulose beverage would be comparable to that of an isoenergetic sucrose-based beverage, but the latter would attenuate post-ingestive metabolic responses. Methods: Thirty adults (15 males, 15 females) aged 21–44 years completed three [...] Read more.

Purpose: We hypothesised that cognition following consumption of an isomaltulose beverage would be comparable to that of an isoenergetic sucrose-based beverage, but the latter would attenuate post-ingestive metabolic responses. Methods: Thirty adults (15 males, 15 females) aged 21–44 years completed three experimental sessions, following at least 3 h fasting. Plasma insulin and glucose were measured in arterialised capillary blood 30 min after beverage consumption. Cognitive functions were assessed 45 min after beverage consumption using a computerised test battery; the primary cognitive performance outcome was a composite neurocognitive index score. Subjective symptoms were measured using questionnaires. Data are presented as the mean [95% confidence interval]. Results: Circulating glucose was greater after ingesting sucrose compared to isomaltulose and placebo beverages (sucrose: 7.3 [6.9, 7.7] mmol·L⁻¹; isomaltulose: 6.3 [6.1, 6.6] mmol·L⁻¹; and placebo: 5.3 [5.2, 5.4] mmol·L⁻¹). Insulin rose to a greater degree with sucrose compared to isomaltulose (mean difference = 8.5 [2.4, 14.6] µU·mL⁻¹, p = 0.005). Non-inferiority was shown between isomaltulose and sucrose for the composite neurocognitive index score (isomaltulose mean score = 0.931 [−2.3, 4.2]; sucrose mean score = 0.414 [−2.6, 3.5]). However, performance with the sucrose and placebo beverages was similar, limiting broader interpretation. The sensation of postprandial tiredness for isomaltulose was non-inferior to sucrose (isomaltulose mean score = −3.8 [−15.8, 8.2]; sucrose mean score = 0.1 [−10.9, 11.1]). Conclusions: A commercial stimulant beverage with isomaltulose as the energy substrate elicits substantial reductions in glycaemic and insulinaemic responses compared with an isoenergetic sucrose-based beverage, without compromising cognitive performance. Full article

(This article belongs to the Section Carbohydrates)

► Show Figures

Figure 1

18 pages, 3296 KB

Open AccessSystematic Review

Association Between Levels of Magnesium and Diabetic Retinopathy in Diabetic Patients with Type 2 Diabetes Mellitus: An Updated Systematic Review and Meta-Analysis

by Eman A. Kubbara, Sara Z. Hamdan, Tassneem Awad Hajali, Mohamad Y. Rezk and Hamdan Z. Hamdan

Nutrients 2026, 18(7), 1162; https://doi.org/10.3390/nu18071162 - 6 Apr 2026

Viewed by 1042

Abstract

Background/Objectives: Magnesium is an intracellular cation that plays important roles in metabolism and insulin signaling. The evidence of association between magnesium levels and diabetic retinopathy is limited by small study effects. Therefore, this systematic review and meta-analysis aim to update the current evidence. [...] Read more.

Background/Objectives: Magnesium is an intracellular cation that plays important roles in metabolism and insulin signaling. The evidence of association between magnesium levels and diabetic retinopathy is limited by small study effects. Therefore, this systematic review and meta-analysis aim to update the current evidence. Methods: A comprehensive search of PubMed, ScienceDirect, Google Scholar, and Scopus was conducted from database inception to January 2026 to identify studies examining magnesium levels and diabetic retinopathy. The pooled standardized mean difference in magnesium levels between type 2 diabetic patients with retinopathy and those without retinopathy was estimated using the “meta” package in R software. Results: We included seventeen studies which assessed magnesium levels in 1100 patients with diabetic retinopathy and 1132 diabetic controls without retinopathy. The random-effects model indicated significantly lower magnesium levels in patients with diabetic retinopathy compared to diabetic controls [SMD = −1.19, 95% CI (−1.68; −0.70); p < 0.0001; I² = 95%]. Sensitivity analysis retained all studies, and no evidence of publication bias was detected. Subgroup analyses demonstrated consistent findings across geographic regions (Asian versus non-Asian), study designs (case–control versus cross-sectional), and magnesium assay methods except enzymatic method. Meta-regression analysis revealed that year of publication (coefficient = 0.061; p = 0.009) and non-Asian studies (coefficient = 2.376; p = 0.001) were positively associated with the pooled effect size, while the NOS quality score was inversely associated (coefficient = −0.709; p = 0.035). The magnesium levels were significantly lower in patients with proliferative diabetic retinopathy compared with those with non-proliferative diabetic retinopathy using a fixed effect model [SMD = −1.41, (95% CI: −1.83; −1.00); p < 0.01; I² = 32%; Cochran’s Q statistic (Q = 1.46, p < 0.23)]. The certainty of the generated evidence is rated as low certainty. Conclusions: This systematic review and meta-analysis conclude that magnesium levels are significantly lower in patients with diabetic retinopathy than in diabetic controls without retinopathy. A potential association between hypomagnesemia and the development of diabetic retinopathy in individuals with type 2 diabetes is suggested; therefore, the clinician may check and adjust magnesium levels in patients with type 2 diabetes mellitus. Full article

(This article belongs to the Special Issue Magnesium in Aging, Health and Diseases)

► Show Figures

Figure 1

19 pages, 751 KB

Open AccessReview

Molecular Mechanisms and Nutritional Modulation in Sarcopenia: A Narrative Review

by Hui San Chin, Ling Liu, Pei-Ju Liao, Alexandra L. R. M. Wee, Xiu-Yi Kwek, Bin Tean Teh and Frederick H. Koh

Nutrients 2026, 18(7), 1161; https://doi.org/10.3390/nu18071161 - 5 Apr 2026

Viewed by 1562

Abstract

Sarcopenia is a progressive and multifactorial muscle disorder associated with diminished strength, reduced functional capacity, and increased risk of adverse health outcomes including frailty, falls, and mortality. Despite its clinical burden, the molecular pathogenesis of sarcopenia remains poorly understood, which hinders the development [...] Read more.

Sarcopenia is a progressive and multifactorial muscle disorder associated with diminished strength, reduced functional capacity, and increased risk of adverse health outcomes including frailty, falls, and mortality. Despite its clinical burden, the molecular pathogenesis of sarcopenia remains poorly understood, which hinders the development of precise therapeutic strategies. This review examines emerging evidence linking anabolic resistance, mitochondrial dysfunction, neuromuscular instability, and chronic inflammation to impaired regeneration and disrupted proteostasis. While nutritional interventions such as high-quality protein, leucine metabolites, and vitamin D supplementation preserve lean mass, they fail to consistently restore function independently. Although exercise remains the cornerstone therapy, its benefits are often constrained in patients with multimorbidity or reduced mobility. Given the biological heterogeneity of sarcopenia, there is a need to shift from generic supportive care to stratified, mechanism-based therapy. Emerging omics technologies including transcriptomic, proteomic, and metabolic profiling offer a promising avenue to define molecular endotypes. This will guide the development of precision-based management strategies. Full article

(This article belongs to the Section Nutrition and Metabolism)

► Show Figures

Figure 1

26 pages, 1230 KB

Open AccessArticle

Tracking the Trends and Projection of Pediatric Malnutrition Towards Global Nutrition Targets by 2030—A Secondary Data Analysis of Low Middle-Income Countries

by Asif Khaliq, Bushra Ashar, Amreen, Safi Ullah Khan, Muhammad Junaid, Angus Ruggieri-Guthrie, Mohammad Javad Davoudabadi, Shafaq Taseen, Maryam Ranta, Mezhgan Kiwan, Nazeer Ahmed and Haji Abdul Rehman Akhter

Nutrients 2026, 18(7), 1160; https://doi.org/10.3390/nu18071160 - 4 Apr 2026

Viewed by 1090

Abstract

Objective: This study aimed to estimate the trends, projections, and determinants of standalone and coexisting forms of malnutrition (CFM) at the global, regional, national, and individual level among children under five in low- and middle-income countries (LMICs). It also assessed the projection trajectory [...] Read more.

Objective: This study aimed to estimate the trends, projections, and determinants of standalone and coexisting forms of malnutrition (CFM) at the global, regional, national, and individual level among children under five in low- and middle-income countries (LMICs). It also assessed the projection trajectory towards the 2030 global nutrition targets (GNTs) for child growth including stunting, wasting, obesity, and CFM. Methods: Data from 48 LMICs were analyzed using the Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS). Children with complete anthropometry were included for national- and individual-level descriptive analyses. Projected prevalence of each form of malnutrition, including CFM, was calculated using the Annual Rate of Change. Inferential analyses employed generalized linear regression models with two-way interaction terms to identify determinants of each malnutrition type. Findings: By 2030, 22 of 48 LMICs are projected to achieve the GNT of stunting, wasting, and obesity, that is up from 10 countries currently, while Yemen and Zimbabwe are expected to remain off-track. Stunting is the most prevalent form, affecting 42 countries, with nine nations projected to have over 50% of children affected by a form of malnutrition. Wasting, obesity, and CFM are rising in several countries. Maternal education and household wealth were the strongest determinants, with children of uneducated mothers and from poorest households at the highest risk. Inequalities are narrowing slowly by 1–2% per year, and marked regional disparities persist. Conclusions: Many LMICs are off-track to meet child-growth targets when CFM is considered alongside standalone indicators. The government and global health partners must strengthen nutrition surveillance systems and equity-focused policies and programs to routinely capture CFM and prevent as well as manage all forms of malnutrition at the national and individual levels. Full article

(This article belongs to the Section Pediatric Nutrition)

► Show Figures

Graphical abstract

17 pages, 3400 KB

Open AccessArticle

Lilii bulbus Exerts Anti-Seizure Effects by Modulating GABAergic Synapse Organization in the Pentylenetetrazol Kindling Model

by Hee Ra Park

Nutrients 2026, 18(7), 1159; https://doi.org/10.3390/nu18071159 - 4 Apr 2026

Viewed by 690

Abstract

Background: We investigated whether a water extract of Lilii bulbus (Lilium lancifolium Thunberg; WELB) could modulate inhibitory synaptic organization in a mouse model of pentylenetetrazol (PTZ)-induced kindling. Methods: Starting 14 days prior to the initial PTZ challenge, WELB (500 mg/kg) was delivered [...] Read more.

Background: We investigated whether a water extract of Lilii bulbus (Lilium lancifolium Thunberg; WELB) could modulate inhibitory synaptic organization in a mouse model of pentylenetetrazol (PTZ)-induced kindling. Methods: Starting 14 days prior to the initial PTZ challenge, WELB (500 mg/kg) was delivered via oral gavage once daily. This treatment regimen was maintained for a total of 40 days, spanning the entire period until the animals reached the fully kindled state. Results: Behavioral assessments revealed that WELB treatment significantly reduced seizure severity and Racine scores, prolonged the latency to clonic seizures, and shortened seizure duration, demonstrating potent anticonvulsant activity. Two-photon calcium imaging further showed that WELB markedly suppressed PTZ-induced neuronal hyperexcitability in the posterior parietal cortex, accompanied by decreased expression of neuronal activation markers, including c-fos, phosphorylated-calcium/calmodulin-dependent protein kinase IIα (p-CaMKIIα), and N-methyl-D-aspartate receptor 1 (NR1). In the hippocampus, WELB modulated the expression of GABAergic interneuron markers [glutamate decarboxylase 67 (GAD67), vesicular GABA transporter (VGAT), parvalbumin (PV), somatostatin (SOM)] and upregulated GABAergic gene transcripts [GABA-A receptor α1 subunit (Gabra1), GABA-A receptor α2 subunit (Gabra2), GABA transporter 1 (Gat1), GABA transporter 3 (Gat3), PV, SOM, cholecystokinin (CCK)] that were downregulated by PTZ kindling. Moreover, WELB enhanced the expression of GABAergic synaptic organization-related proteins (gephyrin, collybistin, neurexin-1β, neuroligin-2, and neuropilin-2), indicating its regulatory effect on inhibitory synaptic integrity. Conclusions: Collectively, these findings suggest that WELB may exert its anticonvulsant effects by functionally remodeling GABAergic synaptic organization-related factors, thereby restoring inhibitory circuit integrity and providing a mechanism-based therapeutic strategy for epilepsy and seizure-related neurological disorders. Full article

(This article belongs to the Special Issue Nutrition Research in Brain and Neuroscience)

► Show Figures

Graphical abstract

13 pages, 2084 KB

Open AccessArticle

Telehealth-Delivered Dietary Counseling in Myeloproliferative Neoplasms: A Randomized Feasibility Study

by Angela Fleischman, Jiarui Li, Asmaa Tabban, Shuwei Cai and Andrew Odegaard

Nutrients 2026, 18(7), 1158; https://doi.org/10.3390/nu18071158 - 4 Apr 2026

Viewed by 650

Abstract

Background/Objectives: Patients with myeloproliferative neoplasms (MPNs) experience chronic inflammation, elevated cardiovascular risk, and substantial symptom burden. Dietary patterns with anti-inflammatory and cardioprotective effects may represent a modifiable strategy to address these overlapping risks, yet dietary intervention has not been systematically studied in MPN. [...] Read more.

Background/Objectives: Patients with myeloproliferative neoplasms (MPNs) experience chronic inflammation, elevated cardiovascular risk, and substantial symptom burden. Dietary patterns with anti-inflammatory and cardioprotective effects may represent a modifiable strategy to address these overlapping risks, yet dietary intervention has not been systematically studied in MPN. We evaluated the feasibility, engagement, and preliminary clinical signals of a fully remote dietary counseling intervention in adults with MPN. Methods: In this single-center, randomized, open-label pilot study, 28 adults with polycythemia vera, essential thrombocythemia, or primary myelofibrosis were randomized 1:1 to Mediterranean (MED) or Dietary Approaches to Stop Hypertension (DASH) dietary counseling over 10 weeks. The protocol included a 2-week baseline run-in period, 10-week active intervention with four telehealth dietitian visits, and 4-week postintervention follow-up. Prespecified feasibility endpoints were the completion of dietitian visits, daily MPN Symptom Assessment Form Total Symptom Score (MPN-SAF TSS) surveys, Mediterranean Diet Adherence Screener (MEDAS) questionnaires, and Automated Self-Administered 24-Hour Dietary Recall (ASA24) assessments. Exploratory endpoints included the change in Healthy Eating Index 2015 (HEI-2015) and symptom burden. Results: Twenty-seven participants provided data and were analyzed (14 MED, 13 DASH). Dietitian visit attendance was 96% (MED) and 85% (DASH). Daily symptom survey completion averaged 93% (MED) and 58% (DASH). MEDAS completion was 81% (MED) and 51% (DASH); ASA24 completion was 55% (MED) and 38% (DASH). HEI-2015 increased from 55 to 63 in MED during active intervention. At week 12, 23% of MED and 13% of DASH participants achieved ≥50% TSS reduction. Symptom reductions were observed across multiple domains. Conclusions: A fully remote dietary intervention is feasible in adults with MPN, with strong engagement in the Mediterranean arm. These findings support adequately powered trials incorporating biomarker endpoints to evaluate dietary modification as a strategy for inflammation-driven symptoms and cardiovascular risk in MPN. Full article

(This article belongs to the Special Issue The Role of Nutritional Supplements in Cancer Prevention and Treatment)

► Show Figures

Graphical abstract

21 pages, 3042 KB

Open AccessReview

The Prickly Solution to Metabolic Syndrome: A Multitarget View on the Opuntia ficus-indica Fruit Phytocomplex

by Cristina Russo, Sofia Surdo, Maria Stella Valle and Lucia Malaguarnera

Nutrients 2026, 18(7), 1157; https://doi.org/10.3390/nu18071157 - 3 Apr 2026

Viewed by 800

Abstract

Metabolic syndrome (MetS) is a multifactorial cardiometabolic condition characterized by insulin resistance, visceral adiposity, dyslipidemia, hypertension, and chronic low-grade inflammation, collectively increasing the risk of type 2 diabetes mellitus, non-alcoholic fatty liver disease, and cardiovascular disease. Growing interest has focused on plant-derived dietary [...] Read more.

Metabolic syndrome (MetS) is a multifactorial cardiometabolic condition characterized by insulin resistance, visceral adiposity, dyslipidemia, hypertension, and chronic low-grade inflammation, collectively increasing the risk of type 2 diabetes mellitus, non-alcoholic fatty liver disease, and cardiovascular disease. Growing interest has focused on plant-derived dietary strategies capable of targeting multiple pathogenic pathways simultaneously. Opuntia ficus-indica fruits (OFIF) represent a complex food matrix containing betalains, polyphenols, carotenoids, soluble fiber, functional amino acids, vitamins, and minerals. Experimental evidence suggests that these constituents interact with key molecular networks implicated in MetS pathophysiology, including redox-sensitive pathways (NRF2), inflammatory signaling (NF-κB), energy-sensing regulators (AMPK), and lipid metabolism proliferator-activated receptor alpha (PPAR-α) dependent mechanisms. Preclinical studies consistently report associations with improvements in oxidative stress, inflammatory markers, hepatic steatosis, and glucose homeostasis following OFIF supplementation. However, human evidence remains limited by small sample size, short intervention duration, and variability in compositional standardization. This narrative review adopts a systems-level perspective to integrate mechanistic, preclinical, and early clinical evidence in the context of metabolic syndrome pathophysiology, while critically addressing translational gaps, compositional variability, and current limitations in human validation. Full article

(This article belongs to the Special Issue Nutritional Strategies Targeting Metabolic Dysfunction and Its Systemic Complications)

► Show Figures

Figure 1

24 pages, 2196 KB

Open AccessArticle

Underweight in Young Adult Women as a Dynamic Nutritional State: Evidence from Four Complementary Longitudinal Methods

by Katsumi Iizuka, Hitomi Matsuura, Kotone Yanagi, Eri Hiraiwa, Yuka Sato, Kiyomi Kaito, Risako Yamamoto-Wada, Kanako Deguchi and Hiroyuki Naruse

Nutrients 2026, 18(7), 1156; https://doi.org/10.3390/nu18071156 - 3 Apr 2026

Cited by 1 | Viewed by 695

Abstract

Background: Underweight (BMI < 18.5 kg/m²) remains prevalent among young Japanese women but lacks standardized measurement approaches. We compared four analytical methods and identified discrepancies. Methods: A retrospective analysis of 883 underweight women aged 20–29 years followed for 6.1 ± 4.2 [...] Read more.

Background: Underweight (BMI < 18.5 kg/m²) remains prevalent among young Japanese women but lacks standardized measurement approaches. We compared four analytical methods and identified discrepancies. Methods: A retrospective analysis of 883 underweight women aged 20–29 years followed for 6.1 ± 4.2 years was performed. We compared (1) year-to-year transitions, (2) state occupancy, (3) the Aalen–Johansen estimator, and (4) Kaplan–Meier Survival Analysis. We performed bidirectional flow analysis quantifying inflow/outflow rates, BMI distribution analysis, and time-weighted classification. Results: Methods 1 and 4 showed 31-point discrepancies (78.1% vs. 47.1% in women). In bidirectional flow, inflow exceeded outflow at ages 22–27 (35.7%/yr vs. 20.7%/yr, outflow/inflow ratio: 0.58), balanced at ages 27–37 (ratio: 1.02) and showed outflow-dominant pattern at ages 37–47 (ratio: 4.92). BMI clustered at 18.0–19.0 kg/m² (42.7%); 69.4% crossed the threshold once. Time-weighted classification revealed four phenotypes: persistent (≥75% time underweight; 40.1%, BMI: 17.54 kg/m²), moderate (50–74%; 17.6%, BMI: 18.40 kg/m²), intermittent (25–49%; 17.6%, BMI: 18.97 kg/m²), and transient (<25%; 24.8%, BMI: 19.49 kg/m²). The moderate + intermittent group showed yo-yo phenotypes (35.2%). Conclusions: Underweight in young Japanese women should be viewed as a heterogeneous dynamic nutritional state. The methodological discrepancy, threshold crossing, and phenotypic classification show that BMI-defined underweight comprises distinct patterns. Cross-sectional data evaluation may lead to incorrect assessments. Future research examining relationships between longitudinal low body weight subgroups and clinical outcomes could identify at-risk populations within the underweight group. Full article

(This article belongs to the Section Nutrition in Women)

► Show Figures

Figure 1

23 pages, 2794 KB

Open AccessSystematic Review

Fucoidan Treatment Improves Diabetic Hyperglycemia and Dyslipidemia in Rodents: A Systematic Review and Meta-Analysis

by Kana Watanuki, Rin Akiyama, Shiita Watanabe, Eri Adachi and Masako Shimada

Nutrients 2026, 18(7), 1155; https://doi.org/10.3390/nu18071155 - 3 Apr 2026

Viewed by 797

Abstract

Background/Objectives: Fucoidan is a sulfated long-chain polysaccharide found mainly in sea cucumbers and brown algae. Studies suggest that fucoidan may play a role in treating various diseases, including metabolic syndrome and diabetes mellitus. The purpose of the current study was to investigate [...] Read more.

Background/Objectives: Fucoidan is a sulfated long-chain polysaccharide found mainly in sea cucumbers and brown algae. Studies suggest that fucoidan may play a role in treating various diseases, including metabolic syndrome and diabetes mellitus. The purpose of the current study was to investigate the effects of fucoidan isolated from brown algae on diabetic hyperglycemia and dyslipidemia. Methods: Two databases, PubMed and Embase, were searched to identify peer-reviewed articles written in English and published up to 30 June 2025. Studies reporting blood glucose and serum/plasma lipid levels of diabetic rodents treated with fucoidan or vehicle were included in the meta-analysis. Results: Forty-seven studies reported blood glucose levels. The pooled effect size for blood glucose levels was −2.26 (95% CI: −2.78 to −1.75), with substantial heterogeneity. Subsequent analyses showed that diabetic dyslipidemia was markedly improved in the fucoidan-treated group compared with the control. Conclusions: Fucoidan treatment could improve hyperglycemia and dyslipidemia in diabetic rodents. Full article

(This article belongs to the Section Nutrition and Diabetes)

► Show Figures

Figure 1

24 pages, 1361 KB

Open AccessArticle

Association Between Socio-Demographic, Behavioural, and Health-Related Factors and Fruit, Vegetable, and Salt Consumption Among Adults Aged 18–69 Years in Kazakhstan: A Cross-Sectional Study

by Marat Shoranov, Anel Ibrayeva, Mirzakarim Alchinbayev, Bolat Sadykov, Yerlan Ismoldayev, Asset Izdenov, Ildar Fakhradiyev, Sergey Lee and Shynar Tanabayeva

Nutrients 2026, 18(7), 1154; https://doi.org/10.3390/nu18071154 - 3 Apr 2026

Viewed by 560

Abstract

Background/Objectives: Low fruit and vegetable consumption and unhealthy salt-related behaviours are important modifiable risk factors for non-communicable diseases. Nationally representative data on these dietary patterns in Kazakhstan remain limited. We aimed to assess fruit, vegetable, and salt-related behaviours among adults aged 18–69 [...] Read more.

Background/Objectives: Low fruit and vegetable consumption and unhealthy salt-related behaviours are important modifiable risk factors for non-communicable diseases. Nationally representative data on these dietary patterns in Kazakhstan remain limited. We aimed to assess fruit, vegetable, and salt-related behaviours among adults aged 18–69 years and examine the socio-demographic and geographic factors associated with inadequate fruit and vegetable consumption and unfavourable salt-related knowledge, attitudes, and behaviours. Methods: We conducted a nationally representative cross-sectional survey of 6720 adults across all 17 administrative units of Kazakhstan in 2021–2022 using multistage stratified cluster sampling and the WHO STEPS questionnaire. Fruit and vegetable consumption, as well as salt-related knowledge, attitudes, and behaviours, were assessed by interview. Associations were examined using weighted logistic regression. Results: Mean fruit and vegetable consumption was 3.0 (SD 2.3) servings/day, and only 15.7% of respondents met the WHO recommendation of ≥5 servings/day. Women were more likely than men to meet the WHO recommendation (17.9% vs. 13.4%), and men had lower adjusted odds of adequate fruit and vegetable consumption (aOR 0.72, 95% CI 0.62–0.84). Adequate fruit and vegetable consumption was most common in southern regions and least common in northern and urban areas. Although 80.6% of participants were aware of the health risks of high salt consumption, only 41.7% considered salt reduction very important, while 64.6% reported adding salt during cooking and 39.6% at the table, and 29.2% frequently consumed salty processed foods. Less favourable salt-related patterns were more common among men, younger adults, less educated respondents, smokers, and residents of several administrative units. Conclusions: Adults in Kazakhstan show insufficient fruit and vegetable consumption and suboptimal salt-related behaviours. Targeted, geographically adapted, multisectoral measures are needed to support healthier dietary practices. Full article

(This article belongs to the Section Nutritional Epidemiology)

► Show Figures

Figure 1

16 pages, 900 KB

Open AccessArticle

Perceived Stress and Associations Between Food Insecurity, Diet Quality, and Eating Behaviors: Evidence from Two Cross-Sectional Studies in U.S. Samples

by David G. Figueroa, Athena Cisneroz, Caroline A. Stiver, Lauren Tiongco-Hofschneider, Barbara A. Laraia, Elissa S. Epel and A. Janet Tomyiama

Nutrients 2026, 18(7), 1153; https://doi.org/10.3390/nu18071153 - 3 Apr 2026

Viewed by 883

Abstract

Background/Objectives: The present investigation examined whether perceived stress statistically mediated the association between food insecurity and diet quality, as well as maladaptive eating behaviors (i.e., reward-based eating, comfort eating). Methods: Study 1 used cross-sectional data from the National Heart, Lung, and Blood Institute [...] Read more.

Background/Objectives: The present investigation examined whether perceived stress statistically mediated the association between food insecurity and diet quality, as well as maladaptive eating behaviors (i.e., reward-based eating, comfort eating). Methods: Study 1 used cross-sectional data from the National Heart, Lung, and Blood Institute Growth and Health Study (N = 624), in which Black and white women completed self-report measures of food security, perceived stress, diet quality, and reward-based eating. Study 2 used cross-sectional data from a census-matched U.S. sample by age, gender, income, race/ethnicity, and census region (N = 1993), with self-report measures of food security, perceived stress, and comfort eating. Mediation analyses tested the indirect effect of perceived stress on associations between food insecurity and diet quality, reward-based eating, and comfort eating, controlling for sociodemographic factors. Results: In Study 1, food insecurity was positively correlated with perceived stress (r = 0.30) and negatively correlated with diet quality (r = −0.11). Perceived stress mediated the relationship between food insecurity and higher reward-based eating (indirect effect = 0.14, 95% CI [0.08, 0.22]) but did not mediate the association between food insecurity and diet quality (indirect effect = −0.04, 95% CI [−0.11, 0.03]). In Study 2, food insecurity was positively correlated with perceived stress (r = 0.42) and comfort eating (r = 0.19). Using a two-part mediation model, perceived stress mediated the association between food insecurity and the frequency of comfort eating among individuals who reported at least one day of comfort eating, with the strongest indirect effect observed among food-insecure individuals (conditional indirect effect = 0.75, 95% CI [0.49, 1.13]). Conclusions: Across two cross-sectional studies, higher perceived stress statistically mediated the relationship between food insecurity and two forms of maladaptive eating behaviors, suggesting that perceived stress is an important correlate of these relationships. Future work is needed to further evaluate the causal relationships between these constructs. Full article

(This article belongs to the Special Issue Food Security, Food Insecurity, and Nutritional Health)

► Show Figures

Figure 1

12 pages, 711 KB

Open AccessArticle

Does Resistant Starch Formed by Cooling Pasta Decrease the Postprandial Glycemic Response in Type 1 Diabetes? A Randomized Single-Blind Crossover Study

by Anita Rogowicz-Frontczak, Sylwia Strozyk, Stanislaw Pilacinski, Anna Koperska, Joanna Le Thanh-Blicharz, Magdalena Tanska and Dorota Zozulinska-Ziolkiewicz

Nutrients 2026, 18(7), 1152; https://doi.org/10.3390/nu18071152 - 3 Apr 2026

Viewed by 1518

Abstract

Background: Carbohydrate quality and culinary processing can meaningfully alter postprandial glycemia in people with type 1 diabetes (T1D). Cooling gelatinized starch promotes retrogradation and increases resistant starch (RS), potentially attenuating postprandial glucose excursions. Objectives: We investigated whether pasta cooled after cooking (24 h [...] Read more.

Background: Carbohydrate quality and culinary processing can meaningfully alter postprandial glycemia in people with type 1 diabetes (T1D). Cooling gelatinized starch promotes retrogradation and increases resistant starch (RS), potentially attenuating postprandial glucose excursions. Objectives: We investigated whether pasta cooled after cooking (24 h at 4 °C) and reheated before consumption improves postprandial glycemia in adults with T1D without increasing hypoglycemia risk under routine insulin pump bolus-calculator dosing. Methods: In this randomized, single-blind, crossover study, 32 adults with T1D treated with continuous subcutaneous insulin infusion (CSII) consumed two standardized pasta-based meals (50 g of available carbohydrate): freshly cooked pasta and cooled/reheated pasta. Participants administered rapid-acting insulin boluses calculated by their pump bolus calculator 10 min before the meal. Interstitial glucose was recorded for 180 min using flash glucose monitoring. Results: Compared with freshly cooked pasta, cooled/reheated pasta produced lower maximum glycemia (10.7 vs. 12.6 mmol/L, p = 0.0001), lower maximum glycemic rise (2.8 vs. 4.7 mmol/L, p < 0.0001), lower incremental area under the curve (iAUC; 211.9 vs. 524.8 mmol/L × 180 min, p < 0.0001), and a shorter time-to-peak (65 vs. 125 min, p = 0.014). Resistant starch content increased after cooling (12.88 ± 0.06 vs. 8.03 ± 0.08 g/100 g). The number of hypoglycemic episodes did not differ between conditions. Conclusions: Cooling and reheating pasta therefore increased RS and attenuated postprandial glycemia in adults with T1D without increasing early postprandial hypoglycemia in the studied setting. Full article

(This article belongs to the Special Issue Nutrition and Behavioral Interventions for Diabetes)

► Show Figures

Graphical abstract

15 pages, 261 KB

Open AccessArticle

Socio-Ecological Correlates of Food Literacy Across Regional Contexts in China

by Yingying Li and Ji-Yun Hwang

Nutrients 2026, 18(7), 1151; https://doi.org/10.3390/nu18071151 - 3 Apr 2026

Viewed by 440

Abstract

Background: Food literacy (FL) comprises the knowledge, skills, and motivation needed for food production, selection, preparation, intake, and waste management. This study examined whether socio-ecological correlates of FL differ across settlement contexts in China. Methods: Cross-sectional survey data from Chinese adults (N [...] Read more.

Background: Food literacy (FL) comprises the knowledge, skills, and motivation needed for food production, selection, preparation, intake, and waste management. This study examined whether socio-ecological correlates of FL differ across settlement contexts in China. Methods: Cross-sectional survey data from Chinese adults (N = 1145) were analyzed across four settlement tiers: tier-1 metropolitan cities (R1), provincial/secondary cities (R2), smaller prefecture-level cities (R3), and county/rural areas (R4). General linear models estimated associations between socio-ecological predictors and overall FL after adjustment for sociodemographics, health behaviors, chronic disease, and BMI. Significant interactions were probed using HC3-robust simple slopes and pairwise slope contrasts. Robustness checks included domain-specific measurement invariance, variance inflation factor (VIF) diagnostics, and a regional sensitivity analysis. Results: The fully adjusted model explained substantial variance in FL (R² = 0.629). Awareness showed the strongest association with FL, followed by family support, injunctive norms, and social norms. Moderation was modest and predictor-specific: dining preferences and family support were positively associated with FL across all regions, with the strongest effects in county/rural areas. Although the omnibus interaction for injunctive norms was statistically significant, follow-up slope contrasts were not, indicating limited substantive regional heterogeneity. Component analyses indicated that preference-related heterogeneity was concentrated in food intake and food choices/selection, whereas family-support heterogeneity was most pronounced for waste disposal. Domain-level invariance analyses supported broad cross-regional comparability of the FL structure, VIFs were all below 5, and the regional distribution of valid and invalid responses did not differ significantly. Conclusions: Socio-ecological correlates of FL were broadly robust across China, with limited context-specific variation driven mainly by stronger household-support effects in county/rural settings. These findings support region-sensitive FL strategies that strengthen household-based support while leveraging normative influences across regions. Full article

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

17 pages, 2897 KB

Open AccessArticle

Cocoa Powder Modulates HIF-1α Stability and Inhibits Ocular Angiogenic and Degenerative Pathology

by Su Jung Hwang, InWha Park, Yeo Jin Sa, Kyu Ha Lee, Chung Sub Kim and Hyo-Jong Lee

Nutrients 2026, 18(7), 1150; https://doi.org/10.3390/nu18071150 - 3 Apr 2026

Viewed by 1402

Abstract

Background/Objectives: Vascular inflammation and impaired endothelial regeneration contribute to chronic degenerative disorders, including ocular neovascularization and retinal degeneration. Nutritional bioactives that modulate molecular pathways governing angiogenesis and tissue remodeling represent promising adjunct strategies for vascular health. This study investigated whether cocoa powder [...] Read more.

Background/Objectives: Vascular inflammation and impaired endothelial regeneration contribute to chronic degenerative disorders, including ocular neovascularization and retinal degeneration. Nutritional bioactives that modulate molecular pathways governing angiogenesis and tissue remodeling represent promising adjunct strategies for vascular health. This study investigated whether cocoa powder (CP) regulates hypoxia-driven molecular signaling and attenuates vascular inflammation and degeneration. Methods: The vascular-modulatory effects of CP were examined in human umbilical vein endothelial cells (HUVECs) and in murine models of alkali-induced corneal neovascularization and N-methyl-N-nitrosourea (MNU)-induced retinal degeneration. Hypoxia-inducible factor-1α (HIF-1α) signaling and downstream angiogenic targets were assessed by Western blotting and quantitative PCR. Endothelial migration, tube formation, and transwell assays were performed to evaluate angiogenic responses. In vivo, oral CP (50 or 200 mg/kg) was administered, and vascular growth, inflammatory and remodeling markers, and retinal structural integrity were analyzed by histology, immunofluorescence, and protein expression. Results: At non-cytotoxic concentrations (0.1–1.0 μg/mL), CP suppressed hypoxia-induced HIF-1α protein stabilization without altering HIF-1α mRNA levels and reduced expression of VEGFA, EPO, and GLUT1. CP significantly inhibited VEGF-A-induced endothelial migration, network formation, and chemotactic invasion. In alkali-injured corneas, CP reduced the neovascularized area and downregulated VEGF, MMP2, MMP9, α-smooth muscle actin, and Ninj1, indicating attenuation of vascular inflammation and fibrotic remodeling. In the MNU model, CP preserved outer nuclear layer thickness, reduced glial activation (GFAP), maintained rhodopsin expression, and decreased MMP9 induction. Conclusions: CP functions as a nutritional modulator of hypoxia-responsive and inflammatory pathways, suppressing pathological angiogenesis while supporting structural preservation in degenerative vascular conditions. These findings highlight the translational potential of dietary polyphenol-rich interventions in regulating vascular inflammation and regeneration. Full article

(This article belongs to the Special Issue Nutritional and Molecular Modulators of Vascular Inflammation and Regeneration)

► Show Figures

Figure 1

22 pages, 339 KB

Open AccessArticle

Sustainable Eating in Saudi Arabia: Associations Between Food Sustainability Knowledge, Attitudes, Food Waste-Related Behaviours, and Dietary Choices Among Adults

by Areej A. Alghamdi, Najlaa M. Aljefree, Israa M. Shatwan and Noha M. Almoraie

Nutrients 2026, 18(7), 1149; https://doi.org/10.3390/nu18071149 - 3 Apr 2026

Viewed by 617

Abstract

Background/Objectives: Sustainable food habits are essential for reducing the environmental impacts of a food system. We investigated food sustainability knowledge, attitudes, and food waste-related behaviours among Saudi adults and assessed their associations with socio-demographic characteristics and dietary choices, which are subjects that [...] Read more.

Background/Objectives: Sustainable food habits are essential for reducing the environmental impacts of a food system. We investigated food sustainability knowledge, attitudes, and food waste-related behaviours among Saudi adults and assessed their associations with socio-demographic characteristics and dietary choices, which are subjects that remain under-researched. Methods: A cross-sectional study was conducted among 855 Saudi adults (≥18 years) using convenience sampling. Data were collected using a validated online questionnaire assessing sustainability knowledge, attitudes, food waste behaviours, dietary choices, and socio-demographic characteristics. Descriptive statistics, chi-square tests, and linear regression analyses were performed using SPSS version 29. Results: Overall, 32% of the study population demonstrated adequate sustainability knowledge, 61% expressed positive attitudes towards food sustainability, and 45% demonstrated favourable food waste management. Women were more knowledgeable than men. Participants who possessed a better understanding of food sustainability consumed more vegetables, fruits, and bread and less processed meat. Those with a positive attitude towards food sustainability exhibited higher consumption of red meat, white meat, eggs, milk, yogurt, cheese, vegetables, fruits, bread, and sweet or savoury snacks. Meanwhile, individuals with better food waste behaviours demonstrated significantly lower consumption of legumes, fish, pasta, red meat, white meat, processed meat, eggs, milk, yogurt, cheese, fruits, bread, and sweet or savoury snacks. Conclusions: Saudi adults possess limited knowledge of sustainability and suboptimal food waste behaviours despite having relatively positive attitudes. These findings highlight opportunities for intervention. Public education, targeted campaigns, and media communication could enhance sustainability awareness and promote healthier, environmentally sustainable dietary patterns. Full article

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

18 pages, 316 KB

Open AccessArticle

Factors Affecting Wound Healing in Patients with Venous Leg Ulcers: A Pilot Study

by Hubert Aleksandrowicz, Joanna Czerwińska, Waldemar Placek and Agnieszka Owczarczyk-Saczonek

Nutrients 2026, 18(7), 1148; https://doi.org/10.3390/nu18071148 - 3 Apr 2026

Viewed by 656

Abstract

Background/Objectives: Previous studies have compared nutritional deficiency parameters in patients with venous leg ulcers (VLUs) to healthy individuals or those with unrelated conditions. This single-center study assessed blood levels of factors involved in ulcer healing and compared patients with VLUs to those with [...] Read more.

Background/Objectives: Previous studies have compared nutritional deficiency parameters in patients with venous leg ulcers (VLUs) to healthy individuals or those with unrelated conditions. This single-center study assessed blood levels of factors involved in ulcer healing and compared patients with VLUs to those with chronic venous insufficiency without ulcers. Methods: A total of 24 patients were included: 17 with VLUs formed the study group, and 7 with lower-limb venous insufficiency without ulcers served as controls. Disease severity was assessed using the CEAP classification, and all participants underwent ankle–brachial index (ABI) measurement. Venous blood samples were analyzed for selected vitamins, proteins, ions, protein electrophoresis, and amino acid profiles. Results: Strong correlations were identified (r > 0.5 or r < −0.5), some of which were statistically significant. Positive associations in the study group included BMI with waist circumference (r = 0.85, p < 0.05), tyrosine with proline (r = 0.84, p < 0.05), and valine with leucine (r = 0.82, p < 0.05). Negative correlations included albumin with folic acid (r = −0.73, p < 0.05), albumin with vitamin B6 (r = −0.71, p < 0.05), and folic acid with waist circumference (r = −0.65, p < 0.05). No significant differences in blood concentrations were observed between groups. Conclusions: Statistically significant correlations were observed between selected biochemical parameters, including albumin and alpha-1 globulins, as well as amino acid and vitamin concentrations, in both patients with VLUs and controls with chronic venous insufficiency without ulcers. Larger studies are needed to confirm these findings and clarify their relevance to venous leg ulcers. Full article

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

16 pages, 1159 KB

Open AccessArticle

Development and Validation of an Algorithm for Constructing an Amino Acid Database for Application to the Korean Genome and Epidemiology Study Cohort

by Su-Jin Lee and Ji-Yun Hwang

Nutrients 2026, 18(7), 1147; https://doi.org/10.3390/nu18071147 - 2 Apr 2026

Viewed by 533

Abstract

Background/Objectives: The Korean Genome and Epidemiology Study (KoGES) is a large population-based cohort designed to investigate chronic disease risk using long-term dietary and health data. However, comprehensive amino acid information for estimating long-term intake from food frequency questionnaire (FFQ) data remains limited. This [...] Read more.

Background/Objectives: The Korean Genome and Epidemiology Study (KoGES) is a large population-based cohort designed to investigate chronic disease risk using long-term dietary and health data. However, comprehensive amino acid information for estimating long-term intake from food frequency questionnaire (FFQ) data remains limited. This study aimed to develop and validate a standardized, rule-based algorithm for food matching and substitution and to construct an amino acid database applicable to the KoGES FFQ. Methods: The algorithm sequentially evaluated food name concordance, preparation forms, substitutability of similar foods, and differences in energy, macronutrients, and moisture (±20%). Amino acid composition data were derived from domestic and international food composition tables and published literature, with protein–nitrogen conversion factors applied by food group. Results: Amino acid information was established for 475 FFQ food items covering 19 amino acids. Of the database values, 31.0% were analytical, 64.2% were calculated, and 4.8% were substituted. Overall database coverage across all amino acid–food item combinations was 98.8%. The constructed database was applied to dietary data from the second follow-up (Phase 3) of the KoGES Ansan and Ansung community-based cohorts, showing that total amino acid intake accounted for 86.7% of total protein intake, reflecting the inclusion of non-protein nitrogen in conventional protein estimates. Based on the Estimated Average Requirement (EAR) criteria, the proportions of participants with intakes below the EAR for protein and essential amino acids varied across age and sex groups. Overall and in both men and women, lysine showed the highest proportion of participants below the EAR, whereas tryptophan showed the lowest proportion. Conclusions: This standardized algorithm provides a reproducible framework for constructing amino acid databases and can be applied to large-scale cohort and dietary survey data. Full article

(This article belongs to the Section Nutritional Epidemiology)

► Show Figures

Figure 1

28 pages, 815 KB

Open AccessReview

Gut Health Responses to Nutritional Interventions in Paediatric Crohn’s Disease, Including the Potential Outcomes of Mucosal Barrier Preservation: A Systematic Review

by Ervine Chastine Marind and Fiona McCullough

Nutrients 2026, 18(7), 1146; https://doi.org/10.3390/nu18071146 - 2 Apr 2026

Viewed by 813

Abstract

Background/Objectives: Dietary treatment may play a complimentary part alongside established medical treatment pathways for children with Crohn’s disease. The aim of this review was to explore the impact of a range of dietary treatments, including the capability of preserving the mucosal barrier, [...] Read more.

Background/Objectives: Dietary treatment may play a complimentary part alongside established medical treatment pathways for children with Crohn’s disease. The aim of this review was to explore the impact of a range of dietary treatments, including the capability of preserving the mucosal barrier, during the maintenance phase of Crohn’s disease. Methods: Randomised controlled trials and cohort studies were retrieved from five databases (Cochrane library, MEDLINE, EMBASE, ScienceDirect, and Web of Science) and through hand searching (last search: June 2025). In the inclusion criteria, this review only included studies that directly assessed children with Crohn’s disease who achieved clinical remission after the induced phase but simultaneously appeared to have signs of inflammation. Results: Six studies were identified, three of which reported outcomes directly associated with the mucosal barrier, while the other studies reported intestinal inflammation and nutritional status. A range of dietary approaches were investigated, with mixed outcomes. A carbohydrate-based diet had a mixed-effect influence on the mucosal barrier, whereas an exclusion diet significantly reduced intestinal inflammation (p = 0.01). One study reported that bovine colostrum (BC) milk (a novel approach) demonstrated mucosal integrity improvement, while the timing of partial enteral nutrition (PEN) also improved nutritional status. Importantly, compliance with all these strict regimes is complex and difficult to implement, even with the support of a dietitian. Conclusions: Consideration of the most appropriate dietary approach within CD management including remission has reported mixed effects to date. Further research is needed, especially to establish the benefits and any negative consequences of dietary intervention more clearly, and especially regarding mucosal integrity. Full article

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

► Show Figures

Figure 1

20 pages, 628 KB

Open AccessArticle

Nutritional Status and Dietary Assessment in Kidney Transplant Recipients

by Martyna Magalska and Sylwia Małgorzewicz

Nutrients 2026, 18(7), 1145; https://doi.org/10.3390/nu18071145 - 2 Apr 2026

Viewed by 646

Abstract

Background: Proper nutrition plays a crucial role in post-kidney transplantation care, influencing graft function, body composition, and the risk of metabolic complications. Protein intake is of particular importance due to its role in preserving muscle mass and preventing protein energy wasting. Objective: This [...] Read more.

Background: Proper nutrition plays a crucial role in post-kidney transplantation care, influencing graft function, body composition, and the risk of metabolic complications. Protein intake is of particular importance due to its role in preserving muscle mass and preventing protein energy wasting. Objective: This study aimed to assess dietary intake, with emphasis on protein consumption, and to analyze its associations with nutritional status, anthropometric indices, and metabolic complications in kidney transplant recipients. Materials and Methods: A cross-sectional study was conducted in 71 adult kidney transplant recipients. Dietary intake was assessed using a 24 h dietary recall and the FFQ-6 questionnaire. Anthropometric measurements were performed, and multiple indices of body composition and central obesity were calculated. Associations between dietary intake, anthropometric parameters, age, and kidney graft function were analyzed. Results: Mean BMI was within the upper normal range; however, a high prevalence of central adiposity was observed. Age was positively correlated with indices of visceral obesity (ABSI, AVI, WHtR, and CI). Protein intake was positively associated with calf circumference, indicating a relationship with muscle mass preservation. Dietary analysis revealed excessive sodium intake and insufficient intake of potassium, calcium, vitamin D, and unsaturated fatty acids. Post-transplant diabetes mellitus was present in 25.35% of participants. Conclusions: Kidney transplant recipients frequently present with unfavorable body composition and dietary imbalances that are not adequately reflected by BMI alone. Comprehensive nutritional assessment and individualized dietary counseling are important strategies that may help reduce the risk of metabolic complications and support long-term transplant outcomes. Full article

(This article belongs to the Special Issue Kidney Nutrition and Metabolism)

► Show Figures

Figure 1

25 pages, 1552 KB

Open AccessReview

Menstrual Cycle and Hormonal Contraceptives in Female Athletes: Should Symptoms and Nutrition Matter More than Cycle Phase? A Narrative Review

by Valentina Natalucci, Gioi Spinello, Tatiana Moro, Gaspare Pavei, Gennaro Boccia, Antonio La Torre and Matteo Bonato

Nutrients 2026, 18(7), 1144; https://doi.org/10.3390/nu18071144 - 2 Apr 2026

Viewed by 3373

Abstract

Background: Understanding how endogenous hormonal fluctuations and exogenous hormonal modulation influence exercise-related outcomes in women is essential for developing individualized and evidence-informed training and nutritional strategies. This narrative review summarizes the endocrine physiology of the eumenorrheic menstrual cycle and hormonal contraceptive (HC) use [...] Read more.

Background: Understanding how endogenous hormonal fluctuations and exogenous hormonal modulation influence exercise-related outcomes in women is essential for developing individualized and evidence-informed training and nutritional strategies. This narrative review summarizes the endocrine physiology of the eumenorrheic menstrual cycle and hormonal contraceptive (HC) use and critically examines their implications for athletic performance, neuromuscular function, injury risk, and metabolic regulation in physically active women. Methods: A non-systematic literature search was conducted in PubMed, Scopus, and Web of Science for articles published up to January 2026. Search terms combined menstrual cycle-related, hormonal contraceptive, performance, and metabolic/nutritional keywords, and relevant studies were selected based on their relevance to the scope of this narrative review. Results: Estradiol and progesterone fluctuations may modulate substrate utilization, connective tissue properties, central fatigue regulation, and symptom expression; however, evidence indicates that performance-related effects across menstrual phases are generally small and inconsistent, reflecting both the modest magnitude of physiological effects and the methodological heterogeneity in menstrual cycle phase classification and verification across studies. Similarly, although HC use suppresses endogenous hormonal variability, current findings do not support consistent benefits for performance, injury prevention, or metabolic outcomes, and responses remain heterogeneous. From a nutritional perspective, the endocrine context may contribute to modest changes in energy expenditure, insulin sensitivity, appetite regulation, inflammation, and recovery-related processes. Importantly, symptom burden—including pain, fatigue, sleep disturbances, gastrointestinal discomfort, and fluid retention—emerges as a practical driver of day-to-day training tolerance. Conclusions: We propose an integrative framework in which sex hormones define a physiological context rather than deterministic performance regulators, while nutrition acts as a key modifiable factor influencing metabolic responses, symptom severity, and performance consistency. Full article

(This article belongs to the Section Nutrition in Women)

► Show Figures

Figure 1

16 pages, 679 KB

Open AccessArticle

Dietary Lycopene Intake and Gastric Cancer Risk: Findings from a Case-Control Study

by Ngoan Tran Le, Yen Thi-Hai Pham, Linh Thuy Le, Phuong M. Nguyen, Ninh Thi Nguyen, Minh Hoang Nhat Phuong, Chi Thuy Nguyen, Phong Gia Dang, Thao Thu Thi Vu, Nam S. Vo, Lang Wu, Tin C. Nguyen, Jennifer Cullen and Hung N. Luu

Nutrients 2026, 18(7), 1143; https://doi.org/10.3390/nu18071143 - 2 Apr 2026

Viewed by 957

Abstract

Background/Objectives: Lycopene, a red lipophilic carotenoid hydrocarbon pigment found primarily in tomatoes and other red/pink fruits and vegetables, has anti-inflammatory, anticarcinogenic and cardioprotective properties. There is a lack of evidence regarding the effect of lycopene intake on gastric cancer risk in the [...] Read more.

Background/Objectives: Lycopene, a red lipophilic carotenoid hydrocarbon pigment found primarily in tomatoes and other red/pink fruits and vegetables, has anti-inflammatory, anticarcinogenic and cardioprotective properties. There is a lack of evidence regarding the effect of lycopene intake on gastric cancer risk in the Asian population. We, thus, evaluate the association between lycopene intake and gastric cancer risk in a hospital-based case–control study, including 1182 incident cases of gastric cancer and 2995 controls in Vietnam. Methods: Lycopene intake was derived from a semi-quantitative, validated food frequency questionnaire. An unconditional logistic regression model was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for gastric cancer risk in relation to lycopene intake, adjusted for potential confounding factors. Results: Overall, there was a dose–response inverse association between lycopene intake and gastric cancer risk (OR_{per-SD increment} = 0.88, 95% CI: 0.81–0.95; P_trend = 0.002). Compared with quintile 1 (the lowest quintile), the ORs and 95% CIs of gastric cancer for quintiles 2, 3, 4 and 5 of the lycopene intakes were 0.63 (0.51–0.79), 0.64 (0.51–0.80), 0.65 (0.52–0.81) and 0.62 (0.50–0.78), respectively. A similar pattern of inverse association between lycopene intake and gastric cancer risk was seen only in females, ever alcohol drinkers, and individuals with H. pylori negative status, without type 2 diabetes and with blood group B (all P_{heterogeneity} > 0.05). Conclusions: We observed a reduced risk of gastric cancer in individuals with higher lycopene intake in the Vietnamese population, regardless of BMI or smoking status. Our results have great implications for a healthy dietary pattern (i.e., lycopene with major sources from fruits and vegetables) for strategies in the prevention and control programs of gastric cancer in low-and middle-income countries. Full article

(This article belongs to the Special Issue Nutrients and Cancer: Unraveling Complex Connections)

► Show Figures

Figure 1

16 pages, 1029 KB

Open AccessArticle

Ketoanalogue-Supplemented Low-Protein Diet in Patients with Stage 4+ Chronic Kidney Disease in Italy: A Cost–Utility Analysis

by Luca De Nicola, Filippo Aucella, Antonio De Pascalis, Giovanni Stallone, Massimiliano Povero, Linet A. Odonde, Roberta Germanò, Chiara Ruotolo, Maria Serena Russo, Dario Troise and Loreto Gesualdo

Nutrients 2026, 18(7), 1142; https://doi.org/10.3390/nu18071142 - 2 Apr 2026

Viewed by 854

Abstract

Background/Objectives: Chronic kidney disease (CKD) is associated with substantial clinical and economic burden, largely driven by progression to dialysis. Nutritional interventions have shown potential in delaying disease progression, yet evidence on their cost-effectiveness remains limited. This study evaluated the long-term cost–utility profile [...] Read more.

Background/Objectives: Chronic kidney disease (CKD) is associated with substantial clinical and economic burden, largely driven by progression to dialysis. Nutritional interventions have shown potential in delaying disease progression, yet evidence on their cost-effectiveness remains limited. This study evaluated the long-term cost–utility profile of a low-protein diet supplemented with ketoanalogues (s-LPD) versus a standard low-protein diet (LPD) in patients with stage 4+ CKD from both the Italian National Health System (NHS) and societal perspectives. Methods: A Markov model with monthly cycles simulated disease progression from pre-dialysis to dialysis or death. Clinical inputs were derived from the published literature, while costs reflected 2024 Italian tariffs. Three effectiveness scenarios (optimistic, conservative, and pessimistic) were explored to account for uncertainty in the treatment effect. Outcomes included costs, life-years, quality-adjusted life-years (QALYs), and incremental cost–utility ratios. Deterministic and probabilistic sensitivity analyses assessed model robustness. Results: Across all scenarios, s-LPD improved survival (up to +0.59 life-years), increased QALYs (up to +0.48), and delayed dialysis initiation (up to +2.88 years) compared with LPD. From the NHS perspective, s-LPD was dominant in the optimistic scenario and cost-effective in both conservative and pessimistic scenarios, with cost savings or only a marginal cost that increases under extreme assumptions. Probabilistic sensitivity analyses confirmed a high probability of cost-effectiveness across scenarios. Results remained robust in additional scenario analyses, including the societal perspective. Conclusions: This first Italian cost–utility analysis of s-LPD highlights that s-LPD is a cost-effective strategy for patients with advanced CKD, offering clinically meaningful benefits while reducing or containing healthcare costs. These findings support the adoption of s-LPD as part of conservative management strategies aimed at safely delaying dialysis initiation. Full article

(This article belongs to the Special Issue Protein Intake and Kidney Disease)

► Show Figures

Figure 1

17 pages, 2716 KB

Open AccessArticle

Divergent Liver and Kidney Metabolic Responses to Ketogenic, High-Fat, and Sucrose-Enriched Diets in Mice

by Giulia Grillo, Nathalie Vega, Agnieszka Zaczek, Anna Selmi, Stéphanie Chanon, Aurelie Vieille Marchiset, Alessandra Santillo, Aneta Balcerczyk, Maura Strigini and Luciano Pirola

Nutrients 2026, 18(7), 1141; https://doi.org/10.3390/nu18071141 - 1 Apr 2026

Viewed by 893

Abstract

Background/Objectives: Feeding with a ketogenic diet (KD), nutritionally devoid of carbohydrates, may be metabolically beneficial. The administration of a KD to mice after previous feeding with a high-fat, high-carbohydrate diet (HFD) induced weight loss, ketonemia, and glycemic normalization. Here, to compare organ-specific responses [...] Read more.

Background/Objectives: Feeding with a ketogenic diet (KD), nutritionally devoid of carbohydrates, may be metabolically beneficial. The administration of a KD to mice after previous feeding with a high-fat, high-carbohydrate diet (HFD) induced weight loss, ketonemia, and glycemic normalization. Here, to compare organ-specific responses to KD, we analyzed lipogenic and gluconeogenic enzymes and genes in the liver and kidney of mice submitted to KD versus (i) HFD or (ii) a saccharose-enriched diet. Methods: Liver and kidney were from (i) mice fed a HFD followed by an 8-week switch to a chow diet (CD), KD continuation of HFD, and (ii) mice submitted to CD, KD, or a saccharose-enriched diet for 1 week. Protein expression levels were determined by Western blotting, and gene expression by qPCR. Hepatic lipid accumulation was visualized by red oil-O. Results: Switch to a KD led to a simultaneous decrease in lipogenic FASN (Fatty Acid Synthase), ACC (Acetyl-CoenzymeA Carboxylase), and its phosphorylated form (pACC-Ser79) in the liver and kidney. In parallel, we observed increased activating phosphorylation of AMPK, the kinase responsible for ACC phosphorylation. In the liver, but not in the kidney, the gluconeogenic rate-limiting enzyme G6Pase (Glucose 6-phosphatase) was repressed under a KD. The switch to a CD significantly reduced hepatic fat accumulation, while a switch to a KD did not allow a significant reversal of hepatic fat accumulation, suggesting resilience to hepatic fat loss under KD. Comparison of a KD versus saccharose-supplemented diet showed an opposite expression pattern of lipogenic enzymes. Conclusions: Administration of KD after previous HFD induced convergent repression of lipogenic enzymes in the liver and kidney, and specific repression of G6Pase in the liver, suggesting a role for kidney gluconeogenesis during KD. KD versus saccharose-supplemented diet had opposite effects on lipogenesis and glycemic control, but both induced loss of lean body mass. Full article

(This article belongs to the Section Nutrition and Obesity)

► Show Figures

Figure 1

18 pages, 1181 KB

Open AccessArticle

Digital-Assisted Nutritional Monitoring and Body Composition Changes in Aging Adults: A 6-Month Controlled Longitudinal Study

by Rareș Gheorghe Mihuț, Timea Claudia Ghitea, Marian Morenci, Carmen Delia Cseppento Nistor, Sebastian Tirla, Diana Carina Iovanovici, Anett Karetka, Akos Tiboldi, Réka Kovács and Tünde Jurca

Nutrients 2026, 18(7), 1140; https://doi.org/10.3390/nu18071140 - 1 Apr 2026

Viewed by 699

Abstract

Background: Aging is associated with increased adiposity, sarcopenia risk, and metabolic vulnerability. Digital tools may enhance adherence to nutritional strategies, but their impact on detailed body composition remains insufficiently explored. Methods: This 6-month prospective controlled longitudinal intervention study included 60 middle-aged and older [...] Read more.

Background: Aging is associated with increased adiposity, sarcopenia risk, and metabolic vulnerability. Digital tools may enhance adherence to nutritional strategies, but their impact on detailed body composition remains insufficiently explored. Methods: This 6-month prospective controlled longitudinal intervention study included 60 middle-aged and older adults. All participants received a smart watch and smart scale for self-monitoring. The control group attended evaluations only at baseline and study completion, while the intervention group received monthly follow-up and remote feedback. Body composition was assessed using multi-frequency BIA. Statistical analyses included paired tests, effect sizes, correlations, and linear mixed-effects models. Results: Significant reductions were observed in BMI (p < 0.001), fat mass (p = 0.003), and visceral fat (p = 0.003; Cohen’s d = 0.41). The sarcopenic index improved (p = 0.001), while skeletal muscle mass remained stable. ECW increased significantly (p = 0.010). Age was inversely associated with the magnitude of improvement. Mixed-effects modeling confirmed a time-dependent reduction in visceral fat independent of age and sex. Conclusions: A 6-month digitally assisted nutritional monitoring program was associated with favorable changes in adiposity, muscle quality, and hydration status. Multi-frequency BIA provides valuable integrative markers for monitoring nutritional interventions in aging populations. Full article

(This article belongs to the Section Geriatric Nutrition)

► Show Figures

Graphical abstract

22 pages, 1936 KB

Open AccessArticle

The LO-VEg Project—A School-Based Nudging and Communication Intervention to Promote Vegetable and Legume Consumption: Preliminary Evidence from an Ecological Study in Italian Primary Schools

by Silvia Mattoni, Barbara Dragoni, Federico Maria Mongardini, Michail Koutentakis, Alessandro Celestini, Aman Goyal, Salvatore Tolone, Adolfo Perez-Bonet, Ludovico Docimo and Rodolfo J. Oviedo

Nutrients 2026, 18(7), 1139; https://doi.org/10.3390/nu18071139 - 1 Apr 2026

Viewed by 608

Abstract

Background/Objectives: In Italy, food waste within school meal services represents a major public health and sustainability challenge, with approximately 21.7% of meals discarded, and vegetables and legumes among the most frequently rejected components. Low consumption of these foods during childhood contributes to unhealthy [...] Read more.

Background/Objectives: In Italy, food waste within school meal services represents a major public health and sustainability challenge, with approximately 21.7% of meals discarded, and vegetables and legumes among the most frequently rejected components. Low consumption of these foods during childhood contributes to unhealthy dietary trajectories and increased long-term cardiometabolic risk. Evidence indicates that information-based nutrition education alone is insufficient to modify children’s eating behaviors within complex food environments. This study aimed to describe and evaluate the LO-VEg project, a school-based intervention designed to address dietary behavior and food waste simultaneously by integrating environmental nudging with child-centered communication strategies. Methods: The LO-VEg project was implemented as a quasi-experimental ecological school-based intervention combining environmental nudging strategies and multisensory communication tools to promote vegetable and legume consumption in primary school canteens. The intervention involved approximately 1500 pupils across four primary schools in the Lombardy region of Italy and was conducted over a 10-week period within routine school meal settings. Consumption outcomes were assessed through aggregated anonymous plate-waste observations collected during school meals. Results: Preliminary aggregated analyses indicated favorable trends in vegetable and legume consumption and plate-waste reduction during the intervention period. The broader intervention architecture also included communication, digital, and family-oriented components, which are described in the present manuscript as part of the implementation framework. Conclusions: The LO-VEg project suggests that integrating environmental nudging with child-centered communication strategies may represent a scalable approach to improving dietary behaviors and reducing food waste in school settings. Full article

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

► Show Figures

Figure 1

Journal Menu

Journal Browser

Nutrients, Volume 18, Issue 7 (April-1 2026) – 152 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI