Nutrients

35 pages, 475 KB

Open AccessEditor’s ChoiceReview

Functional Foods in Modern Nutrition Science: Mechanisms, Evidence, and Public Health Implications

by Mónika Fekete, Andrea Lehoczki, Agata Kryczyk-Poprawa, Virág Zábó, János Tamás Varga, Madarász Bálint, Vince Fazekas-Pongor, Tamás Csípő, Elżbieta Rząsa-Duran and Péter Varga

Nutrients 2025, 17(13), 2153; https://doi.org/10.3390/nu17132153 - 28 Jun 2025

Cited by 33 | Viewed by 26758

Abstract

In recent years, functional foods have garnered increasing scientific and public health interest due to their potential to confer physiological benefits beyond basic nutritional value. International bodies such as EFSA, FDA, and WHO define functional foods as those containing bioactive components that may [...] Read more.

In recent years, functional foods have garnered increasing scientific and public health interest due to their potential to confer physiological benefits beyond basic nutritional value. International bodies such as EFSA, FDA, and WHO define functional foods as those containing bioactive components that may contribute to the prevention and management of chronic non-communicable diseases, including cardiovascular disease, type 2 diabetes, and certain cancers. The evolving paradigm of “food as medicine” reflects a broader shift in nutritional science towards proactive, health-oriented dietary strategies. This article provides a comprehensive, interdisciplinary overview of functional foods by examining their biological mechanisms, clinical evidence, public health significance, regulatory frameworks, and future prospects—particularly in the context of advances in personalized nutrition and nutrigenomics. A thorough literature review was conducted, drawing from recent peer-reviewed studies and guidelines from key health authorities. The review highlights the roles of specific compounds such as probiotics and prebiotics in modulating the gut microbiome, flavonoids and polyphenols in anti-inflammatory processes, omega-3 fatty acids in cardiometabolic regulation, and vitamins and minerals in supporting immune function. While an expanding body of clinical trials and meta-analyses supports the health benefits of these compounds—including reductions in LDL cholesterol, improved insulin sensitivity, and mitigation of oxidative stress—the integration of functional foods into everyday diets remains challenging. Socioeconomic disparities and limited health literacy often impede their accessibility and widespread adoption in public health practice. Functional foods represent a promising component of prevention-focused modern healthcare. To maximize their impact, a coordinated, evidence-based approach is essential, involving collaboration among healthcare professionals, nutrition scientists, policymakers, and the food industry. Looking forward, innovations in artificial intelligence, microbiome research, and genomic technologies may unlock novel opportunities for the targeted and effective application of functional foods in population health. Full article

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

19 pages, 2423 KB

Open AccessEditor’s ChoiceReview

The Role of Diet in Modulating Inflammation and Oxidative Stress in Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis

by Daria Kupczyk, Rafał Bilski, Łukasz Szeleszczuk, Katarzyna Mądra-Gackowska and Renata Studzińska

Nutrients 2025, 17(9), 1603; https://doi.org/10.3390/nu17091603 - 7 May 2025

Cited by 14 | Viewed by 9489

Abstract

Rheumatic diseases such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) are chronic autoimmune disorders characterized by persistent inflammation and oxidative stress, leading to joint damage and reduced quality of life. In recent years, increasing attention has been given to [...] Read more.

Rheumatic diseases such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) are chronic autoimmune disorders characterized by persistent inflammation and oxidative stress, leading to joint damage and reduced quality of life. In recent years, increasing attention has been given to diet as a modifiable environmental factor that can complement pharmacological therapy. This review summarizes current evidence on how key dietary components—such as omega-3 fatty acids, fiber, polyphenols, and antioxidant vitamins—affect inflammatory pathways and oxidative balance. Special emphasis is placed on the Mediterranean diet, low-starch diets, and hypocaloric regimens, which have shown potential in improving disease activity. The gut microbiota emerges as a critical mediator between diet and immune function, with dietary interventions capable of restoring eubiosis and strengthening the intestinal barrier. Additionally, this paper discusses challenges in the clinical implementation of diet therapy, the need for personalized nutritional strategies, and the importance of integrating diet into holistic patient care. Collectively, findings suggest that dietary interventions may reduce disease activity, mitigate systemic inflammation, and enhance patients’ overall well-being. Full article

(This article belongs to the Special Issue Rheumatoid Arthritis and Nutrition: Bridging Diet and Disease Management)

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23 pages, 1144 KB

Open AccessEditor’s ChoiceReview

Unraveling MASLD: The Role of Gut Microbiota, Dietary Modulation, and AI-Driven Lifestyle Interventions

by Carolina Jiménez-González, Marta Alonso-Peña, Paula Argos Vélez, Javier Crespo and Paula Iruzubieta

Nutrients 2025, 17(9), 1580; https://doi.org/10.3390/nu17091580 - 4 May 2025

Cited by 17 | Viewed by 3982

Abstract

Gut microbiota has a crucial role in the pathophysiology of metabolic-associated steatotic liver disease (MASLD), influencing various metabolic mechanisms and contributing to the development of the disease. Dietary interventions targeting gut microbiota have shown potential in modulating microbial composition and mitigating MASLD progression. [...] Read more.

Gut microbiota has a crucial role in the pathophysiology of metabolic-associated steatotic liver disease (MASLD), influencing various metabolic mechanisms and contributing to the development of the disease. Dietary interventions targeting gut microbiota have shown potential in modulating microbial composition and mitigating MASLD progression. In this context, the integration of multi-omics analysis and artificial intelligence (AI) in personalized nutrition offers new opportunities for tailoring dietary strategies based on individual microbiome profiles and metabolic responses. The use of chatbots and other AI-based health solutions offers a unique opportunity to democratize access to health interventions due to their low cost, accessibility, and scalability. Future research should focus on the clinical validation of AI-powered dietary strategies, integrating microbiome-based therapies and precision nutrition approaches. Establishing standardized protocols and ethical guidelines will be crucial for implementing AI in MASLD management, paving the way for a more personalized, data-driven approach to disease prevention and treatment. Full article

(This article belongs to the Special Issue Relationship Between Diet and Lifestyle and Liver Health: From the Latest Perspective)

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16 pages, 255 KB

Open AccessEditor’s ChoiceArticle

Patterns of Energy Drink Use, Risk Perception, and Regulatory Attitudes in the Adult Polish Population: Results of a Cross-Sectional Survey

by Paulina Mularczyk-Tomczewska, Aleksandra Lewandowska, Agnieszka Kamińska, Małgorzata Gałecka, Paweł A. Atroszko, Tomasz Baran, Tytus Koweszko and Andrzej Silczuk

Nutrients 2025, 17(9), 1458; https://doi.org/10.3390/nu17091458 - 26 Apr 2025

Cited by 12 | Viewed by 3534

Abstract

Background: From 1 January 2024, Poland legally banned the sale of energy drinks (EDs) containing caffeine and taurine to minors under 18. EDs are rich in stimulants, making them particularly popular among adolescents and young adults seeking energy boosts. Their consumption is associated [...] Read more.

Background: From 1 January 2024, Poland legally banned the sale of energy drinks (EDs) containing caffeine and taurine to minors under 18. EDs are rich in stimulants, making them particularly popular among adolescents and young adults seeking energy boosts. Their consumption is associated with adverse health effects and engagement in risky behaviors. This descriptive snapshot study explores energy drink consumption, motivations, and risk perception among Polish adults. Methods: A cross-sectional, nationwide survey (N = 1121) was conducted over a three-day period using the computer-assisted web interviewing (CAWI) method. The sample was representative of the adult Polish population in terms of gender, age, and geographical location. Data collection occurred 14 months after the implementation of legal restrictions on ED sales to minors. Results: Among 1121 adults (54.3% female), 15.1% reported weekly ED consumption, 9.7% monthly, 13.3% less than monthly, and 62.0% never. Younger age (p < 0.05), male gender (aOR = 1.63 [1.25–2.13]; p < 0.001), and active occupational status (aOR = 1.63 [1.19–2.24]; p = 0.002) were significantly associated with ED use. Overall, 83.0% of respondents perceived EDs as harmful, and 87.2% supported the sales ban to minors, although only 45.6% considered the ban effective. Additionally, 31.8% had observed minors consuming EDs in the past 30 days. Sociodemographic characteristics were associated with risk perception and support for regulation: women (aOR = 1.50), individuals with higher education (aOR = 1.44), and those with good financial status (aOR = 2.35) were more likely to perceive EDs as harmful and endorse regulatory measures. Conclusions: Educational interventions should prioritize young adults, particularly males, who constitute the primary consumers. There is also a need to enhance enforcement mechanisms to limit minors’ access to energy drinks and curb their marketing and availability, thereby improving public health protection. Full article

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

31 pages, 793 KB

Open AccessEditor’s ChoiceReview

Vitamin D and Colorectal Cancer Prevention: Immunological Mechanisms, Inflammatory Pathways, and Nutritional Implications

by Mónika Fekete, Andrea Lehoczki, Ágnes Szappanos, Virág Zábó, Csilla Kaposvári, Alpár Horváth, Árpád Farkas, Vince Fazekas-Pongor, Dávid Major, Ágnes Lipécz, Tamás Csípő and János Tamás Varga

Nutrients 2025, 17(8), 1351; https://doi.org/10.3390/nu17081351 - 15 Apr 2025

Cited by 13 | Viewed by 27074

Abstract

Vitamin D plays a crucial role in the regulation of the immune system, with immunomodulatory effects that are key in the prevention of colorectal cancer (CRC). Over the past decades, research has shown that this steroid hormone impacts much more than bone health, [...] Read more.

Vitamin D plays a crucial role in the regulation of the immune system, with immunomodulatory effects that are key in the prevention of colorectal cancer (CRC). Over the past decades, research has shown that this steroid hormone impacts much more than bone health, significantly influencing immune responses. Vitamin D enhances immune organ functions such as the spleen and lymph nodes, and boosts T-cell activity, which is essential in defending the body against tumors. Additionally, vitamin D mitigates inflammatory responses closely linked to cancer development, reducing the inflammation that contributes to CRC. It acts via vitamin D receptors (VDRs) expressed on immune cells, modulating immune responses. Adequate vitamin D levels influence gene expression related to inflammation and cell proliferation, inhibiting tumor development. Vitamin D also activates mechanisms that suppress cancer cell survival, proliferation, migration, and metastasis. Low levels of vitamin D have been associated with an increased risk of CRC, with deficiency correlating with higher disease incidence. Lifestyle factors, such as a diet high in red meat and calories but low in fiber, fruits, and vegetables, as well as physical inactivity, contribute significantly to CRC risk. Insufficient calcium and vitamin D intake are also linked to disease occurrence and poorer clinical outcomes. Maintaining optimal vitamin D levels and adequate dietary intake is crucial in preventing CRC and improving patient prognosis. This review explores the role of vitamin D in immune regulation and summarizes findings from randomized clinical trials assessing the effects of vitamin D supplementation on CRC outcomes. Full article

(This article belongs to the Special Issue Dose–Response Relationships of Vitamin D Status and Vitamin D Intake with Health Outcomes—2nd Edition)

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26 pages, 1766 KB

Open AccessEditor’s ChoiceReview

Breastfeeding: The Multifaceted Impact on Child Development and Maternal Well-Being

by Aleksandra Purkiewicz, Kamila J. Regin, Wajeeha Mumtaz and Renata Pietrzak-Fiećko

Nutrients 2025, 17(8), 1326; https://doi.org/10.3390/nu17081326 - 11 Apr 2025

Cited by 28 | Viewed by 29862

Abstract

Breastfeeding is recognized as the gold standard in infant nutrition, providing necessary nutrients for optimal growth and development. Beyond its nutritional function, breastfeeding has numerous benefits for both mother and child. This literature review examines the effects of breastfeeding on the development of [...] Read more.

Breastfeeding is recognized as the gold standard in infant nutrition, providing necessary nutrients for optimal growth and development. Beyond its nutritional function, breastfeeding has numerous benefits for both mother and child. This literature review examines the effects of breastfeeding on the development of the nervous and immune systems, its influence on cognitive development, and the impact of stress on lactation. In addition, it explores the emotional effects of breastfeeding on mothers, the challenges associated with exclusive breastfeeding, and the process of weaning along with its implications for both mother and infant. It is indicated that stress significantly affects lactation regulation, with elevated cortisol levels potentially disrupting hormonal balance. Furthermore, the essential roles of oxytocin, sialic acid, and docosahexaenoic acid in infant brain development and cognitive functions are highlighted. Breastfeeding is associated with the regulation of the baby’s sleep through the effects of tryptophan, serotonin, and melatonin, which at the same time provide the baby with a sense of security with the mother. It is indicated that women who breastfeed are less likely to suffer from mental health problems and are at a lower risk of hypertension, diabetes, and cardiovascular disease. The weaning process is often a difficult time for mother and child; thus, it should be introduced gradually to minimize stress, anxiety, and potential mood disturbances in the mother. Full article

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

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23 pages, 962 KB

Open AccessEditor’s ChoiceReview

Effects of GLP-1 Analogues and Agonists on the Gut Microbiota: A Systematic Review

by Krzysztof Ksawery Gofron, Andrzej Wasilewski and Sylwia Małgorzewicz

Nutrients 2025, 17(8), 1303; https://doi.org/10.3390/nu17081303 - 9 Apr 2025

Cited by 32 | Viewed by 14233

Abstract

Background: GLP-1 analogues are a relatively new class of medications that form the cornerstone of diabetes treatment. They possess invaluable glucose-lowering properties without hypoglycemic effects as well as strong cardioprotective effects. The gut microbiome has become the focus of numerous studies, demonstrating its [...] Read more.

Background: GLP-1 analogues are a relatively new class of medications that form the cornerstone of diabetes treatment. They possess invaluable glucose-lowering properties without hypoglycemic effects as well as strong cardioprotective effects. The gut microbiome has become the focus of numerous studies, demonstrating its influence not only on the gut but also on the overall well-being of the entire body. However, the effects of GLP-1 analogs on gut microbiota remain uncertain. Scope of review: Our systematic review (based on PRISMA guidelines) aimed to gather knowledge on the effects of GLP-1 analogue medications on the composition, richness, and abundance of gut microbiota in both animal and human models. Conclusions: Thirty-eight studies were included in this systematic review. GLP-1 analogues have demonstrated a notable impact on the composition, richness, and diversity of gut microbiota. We can conclude, following the obtained research results of our study, that liraglutide promotes the growth of beneficial genera relevant for beneficial metabolic functions. Exenatide and exendin-4 administration showed various effects on the microbiome composition in animal and human studies. In animal models, it increased genera associated with improved metabolism; however, in human models, genera linked to better metabolic functions and escalated inflammation increased. Following dulaglutide administration, increases in Bacteroides, Akkermansia, and Ruminococcus, genera connected to an improved metabolic model, were significant. Finally, varied results were obtained after semaglutide treatment, in which A. muciniphila, known for its positive metabolic functions, increased; however, microbial diversity decreased. Semaglutide treatment provided various results indicating many confounding factors in semaglutide’s impact on the gut microbiota. Results varied due to dissimilarities in the studied populations and the duration of the studies. Further research is essential to confirm these findings and to better recognize their implications for the clinical outcomes of patients. Full article

(This article belongs to the Special Issue The Role of Diet and Medication in Shaping Gut Microbiota in Disease)

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24 pages, 3725 KB

Open AccessEditor’s ChoiceArticle

The Influence of an AI-Driven Personalized Nutrition Program on the Human Gut Microbiome and Its Health Implications

by Konstantinos Rouskas, Mary Guela, Marianna Pantoura, Ioannis Pagkalos, Maria Hassapidou, Elena Lalama, Andreas F. H. Pfeiffer, Elise Decorte, Veronique Cornelissen, Saskia Wilson-Barnes, Kathryn Hart, Eugenio Mantovani, Sofia Balula Dias, Leontios Hadjileontiadis, Lazaros P. Gymnopoulos, Kosmas Dimitropoulos and Anagnostis Argiriou

Nutrients 2025, 17(7), 1260; https://doi.org/10.3390/nu17071260 - 3 Apr 2025

Cited by 21 | Viewed by 13731

Abstract

Background/Objectives: Personalized nutrition programs enhanced with artificial intelligence (AI)-based tools hold promising potential for the development of healthy and sustainable diets and for disease prevention. This study aimed to explore the impact of an AI-based personalized nutrition program on the gut microbiome of [...] Read more.

Background/Objectives: Personalized nutrition programs enhanced with artificial intelligence (AI)-based tools hold promising potential for the development of healthy and sustainable diets and for disease prevention. This study aimed to explore the impact of an AI-based personalized nutrition program on the gut microbiome of healthy individuals. Methods: An intervention using an AI-based mobile application for personalized nutrition was applied for six weeks. Fecal and blood samples from 29 healthy participants (females 52%, mean age 35 years) were collected at baseline and at six weeks. Gut microbiome through 16s ribosomal RNA (rRNA) amplicon sequencing, anthropometric and biochemical data were analyzed at both timepoints. Dietary assessment was performed using food frequency questionnaires. Results: A significant increase in richness (Chao1, 220.4 ± 58.5 vs. 241.5 ± 60.2, p = 0.024) and diversity (Faith’s phylogenetic diversity, 15.5 ± 3.3 vs. 17.3 ± 2.8, p = 0.0001) was found from pre- to post-intervention. Following the intervention, the relative abundance of genera associated with the reduction in cholesterol and heart disease risk (e.g., Eubacterium coprostanoligenes group and Oscillobacter) was significantly increased, while the abundance of inflammation-associated genera (e.g., Eubacterium ruminantium group and Gastranaerophilales) was decreased. Alterations in the abundance of several butyrate-producing genera were also found (e.g., increase in Faecalibacterium, decrease in Bifidobacterium). Further, a decrease in carbohydrate (272.2 ± 97.7 vs. 222.9 ± 80.5, p = 0.003) and protein (113.6 ± 38.8 vs. 98.6 ± 32.4, p = 0.011) intake, as well as a reduction in waist circumference (78.4 ± 12.1 vs. 77.2 ± 11.2, p = 0.023), was also seen. Changes in the abundance of Oscillospiraceae_UCG_002 and Lachnospiraceae_UCG_004 were positively associated with changes in olive oil intake (Rho = 0.57, p = 0.001) and levels of triglycerides (Rho = 0.56, p = 0.001). Conclusions: This study highlights the potential for an AI-based personalized nutrition program to influence the gut microbiome. More research is now needed to establish the use of gut microbiome-informed strategies for personalized nutrition. Full article

(This article belongs to the Special Issue Towards Healthy and Sustainable Diets: Environmental and Nutritional Perspectives)

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33 pages, 666 KB

Open AccessEditor’s ChoiceReview

The Impact of Dietary Interventions on Metabolic Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Comorbid Conditions, Including Obesity and Type 2 Diabetes

by Joanna Michalina Jurek, Katarzyna Zablocka-Sowinska, Helena Clavero Mestres, Leyre Reyes Gutiérrez, Javier Camaron and Teresa Auguet

Nutrients 2025, 17(7), 1257; https://doi.org/10.3390/nu17071257 - 3 Apr 2025

Cited by 13 | Viewed by 6281

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a public health concern, linked with immune-metabolic dysfunction. While lifestyle and dietary modifications remain the cornerstone of MASLD management, the optimal dietary approach remains uncertain. Objectives: This systematic review aims to investigate the impact of [...] Read more.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a public health concern, linked with immune-metabolic dysfunction. While lifestyle and dietary modifications remain the cornerstone of MASLD management, the optimal dietary approach remains uncertain. Objectives: This systematic review aims to investigate the impact of model dietary patterns on metabolic outcomes in patients with MASLD and evaluate their effects in individuals with coexisting metabolic conditions, such as obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM). Methods: To conduct the review, PubMed, Scopus, Google Scholar, Cochrane CENTRAL, and ClinicalTrials.gov databases were searched for Randomized Controlled Trials (RCTs) on the adult population, published between January 2019 and September 2024, following PRISMA principles. The quality of the included RCTs was assessed qualitatively based on study characteristics. Results: The main findings of this review demonstrated that the use of interventions with dietary model based on Mediterranean diet (MED) and intermittent fasting (IF) approaches, such as alternative-day fasting (ADF) and time-restricted feeding regimens (TRF) may have potential in reducing body weight, BMI, and waist circumference, with additional benefits of improving glycemic control and reducing inflammation. The effects on hepatic functions, although limited, may be linked with reduced enzyme activity and liver stiffness. Additionally, the use of lacto-ovo-vegetarian diet (LOV-D) and the Dietary Approaches to Stop Hypertension (DASH) diet may offer additional health benefits, including blood pressure management. Conclusions: This review suggests that MED and IF-based strategies may reduce BW, improve glycemic control, and lower inflammation, with potential benefits for hepatic function. Further long-term studies are needed to confirm these effects and underlying mechanisms, which will allow for the optimization of protocols and ensure their safety in MASLD. Full article

(This article belongs to the Special Issue Dietary Advice and Guidance on Liver Metabolism)

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28 pages, 1584 KB

Open AccessEditor’s ChoiceReview

Beneficial Effects of Omega-3 Fatty Acids on Obesity and Related Metabolic and Chronic Inflammatory Diseases

by Donia Jerab, Ferdinand Blangero, Paulo César Trindade da Costa, José Luiz de Brito Alves, Rym Kefi, Henda Jamoussi, Beatrice Morio and Assia Eljaafari

Nutrients 2025, 17(7), 1253; https://doi.org/10.3390/nu17071253 - 3 Apr 2025

Cited by 27 | Viewed by 16861

Abstract

Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are known to help resolve inflammation through generation of anti-inflammatory eicosanoids and specialized pro-resolving mediators, including resolvins, protectins, and maresins. Through binding to the GPR120/FFAR4 receptor, their beneficial effects result from phospholipid membrane remodeling, impairment [...] Read more.

Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are known to help resolve inflammation through generation of anti-inflammatory eicosanoids and specialized pro-resolving mediators, including resolvins, protectins, and maresins. Through binding to the GPR120/FFAR4 receptor, their beneficial effects result from phospholipid membrane remodeling, impairment of inflammatory signaling molecules clustering, subsequent inhibition of NF-κB and inflammasome activation, and a reduction in oxidative stress. Obesity, a chronic inflammatory disease that contributes to metabolic disorders, is alleviated by n-3 PUFAs. In the adipose tissue (AT) of individuals with obesity, n-3 PUFAs counteract hypoxia, inhibit immune cell infiltration and AT inflammation, improve insulin sensitivity, and reduce fat mass. Beyond AT, n-3 PUFAs also alleviate other metabolic disorders such as metabolic-associated steatotic liver disease (MASLD), gut dysbiosis, and/or renal dysfunction. In cardiovascular disease (CVD), they are mainly recommended as a secondary prevention for patients with coronary heart disease risks. This review provides an in-depth analysis of the benefits of n-3 PUFAs in obesity and related metabolic diseases, examining both the mechanistic and clinical aspects. Additionally, it also explores the effects of n-3 PUFAs in obesity-related chronic inflammatory conditions, including inflammatory bowel disease, psoriasis, rheumatoid arthritis, osteoarthritis, and multiple sclerosis, by targeting specific pathophysiological mechanisms. Clinical applications and limitations of n-3 PUFAs are discussed based on findings from human clinical trials. Full article

(This article belongs to the Section Nutrition and Obesity)

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25 pages, 1923 KB

Open AccessEditor’s ChoiceReview

Proteins and Amino Acids from Edible Insects for the Human Diet—A Narrative Review Considering Environmental Sustainability and Regulatory Challenges

by Lukas Nachtigall, Tilman Grune and Daniela Weber

Nutrients 2025, 17(7), 1245; https://doi.org/10.3390/nu17071245 - 2 Apr 2025

Cited by 15 | Viewed by 7236

Abstract

The scientific interest in edible insects as an alternative source of high-value protein for the human diet has increased drastically over the last decade. Edible insects harbour enormous potential in terms of planetary health. Their lower water and land use, lower feed conversion [...] Read more.

The scientific interest in edible insects as an alternative source of high-value protein for the human diet has increased drastically over the last decade. Edible insects harbour enormous potential in terms of planetary health. Their lower water and land use, lower feed conversion ratios, and overall lower global warming potential paired with a high nutritional value compared with conventional livestock are key drivers towards an environmentally sustainable diet. However, low consumer acceptance, as well as regulatory challenges, have slowed down the success of edible insects in Western countries, despite edible insects being consumed regularly all over the world. To date, four edible insect species have been approved as novel foods in the European Union—namely yellow mealworm (Tenebrio molitor), migratory locust (Locusta migratoria), house cricket (Acheta domesticus), and lesser mealworm (Alphitobius diaperinus). Depending on the species, they have a high protein content (48–67%), with a beneficial indispensable amino acid profile, high fat content (21–39%), with a high content of unsaturated fatty acids based on the dry matter, and contain reasonable amounts of minerals and vitamins. Unlike other animal-based foods, edible insects contain dietary fibre. Data on the bioavailability of nutrients in humans are scarce. Although numerous publications have investigated the nutritional profiles, environmental impacts, and future perspectives of edible insects, here, those findings are reviewed critically, as some publications were partially contradictory or related to selected species only. In this narrative review, we emphasise that edible insects could play a key role in a changing world with a steadily increasing demand for nutritionally valuable food and the depletion of natural resources. Full article

(This article belongs to the Special Issue Feature Papers in Proteins and Amino Acids in Relation to Human Health)

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16 pages, 936 KB

Open AccessEditor’s ChoiceArticle

Preliminary Evidence Suggests That a 12-Week Treatment with Tirzepatide Plus Low-Energy Ketogenic Therapy Is More Effective than Its Combination with a Low-Calorie Diet in Preserving Fat-Free Mass, Muscle Strength, and Resting Metabolic Rate in Patients with Obesity

by Luigi Schiavo, Biagio Santella, Monica Mingo, Gianluca Rossetti, Marcello Orio, Luigi Cobellis, Attilio Maurano, Antonio Iannelli and Vincenzo Pilone

Nutrients 2025, 17(7), 1216; https://doi.org/10.3390/nu17071216 - 30 Mar 2025

Cited by 11 | Viewed by 14350

Abstract

Background: Tirzepatide (TZP), a unimolecular dual agonist targeting glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, is a promising weight loss agent in obesity. The preservation of metabolically active fat-free mass (FFM), muscle strength (MS), and resting metabolic rate (RMR) is essential for optimizing [...] Read more.

Background: Tirzepatide (TZP), a unimolecular dual agonist targeting glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, is a promising weight loss agent in obesity. The preservation of metabolically active fat-free mass (FFM), muscle strength (MS), and resting metabolic rate (RMR) is essential for optimizing fat mass (FM) reduction. Although TZP is typically combined with a low-calorie diet (LCD), its impact on FFM is uncertain, and studies on MS and RMR are lacking. Evidence suggests that Low-Energy Ketogenic Therapy (LEKT) may reduce FM while preserving FFM, MS, and RMR. Therefore, this study aimed to compare the effects of an LEKT and an LCD, both combined with TZP, on body weight (BW), FM, FFM, MS, and RMR in patients with obesity. Methods: We prospectively compared the effects of TZP combined with either an LCD or LEKT in 60 patients with obesity (n = 30 per group) over 12 weeks. BW, FM, FFM, MS, and RMR were measured at baseline and after 12 weeks. Clinical parameters, an assessment of dietary compliance, and side effects were also evaluated. Results: At 12-week follow-up, both groups showed a significant BW reduction from baseline (TZP+LEKT, p = 0.0289; TZP+LCD, p = 0.0278), with no significant intergroup difference (p = 0.665). Similarly, FM decreased significantly in both cohorts (TZP+LEKT, p < 0.001; TZP+LCD, p = 0.0185), with the TZP+LEKT group achieving a greater FM loss (p = 0.042). However, the TZP+LCD group exhibited significant declines from baseline in FFM (p = 0.0284), MS (p = 0.0341), and RMR (p < 0.001), whereas we did not observe any significant changes in FFM (p = 0.487), MS (p = 0.691), and RMR (p = 0.263) in the TZP+LEKT group. Intergroup direct comparisons confirmed that the TZP+LCD group experienced significantly greater reductions in FFM (p = 0.0388), MS (p = 0.046), and RMR (p = 0.019). Conclusions: Based on the findings of these preliminary data, we are able to support the hypothesis that TZP+LEKT seems to be superior to TZP+LCD in promoting FM reduction while preserving FFM, MS, and RMR in patients with obesity. Full article

(This article belongs to the Section Nutrition and Obesity)

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38 pages, 512 KB

Open AccessEditor’s ChoiceReview

Nutritional Quality, Safety and Environmental Benefits of Alternative Protein Sources—An Overview

by Anna Choręziak, Dawid Rosiejka, Joanna Michałowska and Paweł Bogdański

Nutrients 2025, 17(7), 1148; https://doi.org/10.3390/nu17071148 - 26 Mar 2025

Cited by 17 | Viewed by 10011

Abstract

Protein is a fundamental macronutrient in the human diet. It supplies our organisms with essential amino acids, which are needed for the growth and maintenance of cells and tissues. Conventional protein sources, despite their complete amino acid profiles and excellent digestibility, have a [...] Read more.

Protein is a fundamental macronutrient in the human diet. It supplies our organisms with essential amino acids, which are needed for the growth and maintenance of cells and tissues. Conventional protein sources, despite their complete amino acid profiles and excellent digestibility, have a proven negative impact on the environment. Furthermore, their production poses many ethical challenges. This review aims to present nutritional, more ethical, and environmentally friendly alternatives that could serve as potential protein sources for the population. The available literature on alternative protein sources has been analyzed. Based on the research conducted, various products have been identified and described, including plant-based protein sources such as soybeans, peas, faba beans, lupins, and hemp seeds; aquatic sources such as algae, microalgae, and water lentils; as well as insect-based and microbial protein sources, and cell-cultured meat. Despite numerous advantages, such as a lower environmental impact, higher ethical standards of production, and beneficial nutritional profiles, alternative protein sources are not without limitations. These include lower bioavailability of certain amino acids, the presence of antinutritional compounds, technological challenges, and issues related to consumer acceptance. Nevertheless, with proper dietary composition, optimization of production processes, and further technological advancements, presented alternatives can constitute valuable and sustainable protein sources for the growing global population. Full article

(This article belongs to the Special Issue Future Prospects for Sustaining a Healthier Food System)

22 pages, 884 KB

Open AccessEditor’s ChoiceReview

The Gut–Brain–Microbiota Connection and Its Role in Autism Spectrum Disorders

by Ewelina Młynarska, Ewelina Barszcz, Emilian Budny, Agata Gajewska, Kacper Kopeć, Jakub Wasiak, Jacek Rysz and Beata Franczyk

Nutrients 2025, 17(7), 1135; https://doi.org/10.3390/nu17071135 - 25 Mar 2025

Cited by 18 | Viewed by 17824

Abstract

Autism spectrum disorder (ASD) is a group of complex neurodevelopmental conditions with a heterogeneous and multifactorial etiology that is not yet fully understood. Among the various factors that may contribute to ASD development, alterations in the gut microbiota have been increasingly recognized. Microorganisms [...] Read more.

Autism spectrum disorder (ASD) is a group of complex neurodevelopmental conditions with a heterogeneous and multifactorial etiology that is not yet fully understood. Among the various factors that may contribute to ASD development, alterations in the gut microbiota have been increasingly recognized. Microorganisms in the gastrointestinal tract play a crucial role in the gut–brain axis (GBA), affecting nervous system development and behavior. Dysbiosis, or an imbalance in the microbiota, has been linked to both behavioral and gastrointestinal (GI) symptoms in individuals with ASD. The microbiota interacts with the central nervous system through mechanisms such as the production of short-chain fatty acids (SCFAs), the regulation of neurotransmitters, and immune system modulation. Alterations in its composition, including reduced diversity or an overabundance of specific bacterial taxa, have been associated with the severity of ASD symptoms. Dietary modifications, such as gluten-free or antioxidant-rich diets, have shown potential for improving gut health and alleviating behavioral symptoms. Probiotics, with their anti-inflammatory properties, may support neural health and reduce neuroinflammation. Fecal microbiota transplantation (FMT) is being considered, particularly for individuals with persistent GI symptoms. It has shown promising outcomes in enhancing microbial diversity and mitigating GI and behavioral symptoms. However, its limitations should be considered, as discussed in this narrative review. Further research is essential to better understand the long-term effects and safety of these therapies. Emphasizing the importance of patient stratification and phenotype characterization is crucial for developing personalized treatment strategies that account for individual microbiota profiles, genetic predispositions, and coexisting conditions. This approach could lead to more effective interventions for individuals with ASD. Recent findings suggest that gut microbiota may play a key role in innovative therapeutic approaches to ASD management. Full article

(This article belongs to the Special Issue Pathways Linking Nutrition with Cognitive and Mental Health)

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19 pages, 2354 KB

Open AccessEditor’s ChoiceArticle

Artificial Sweeteners in Food Products: Concentration Analysis, Label Practices, and Cumulative Intake Assessment in Croatia

by Zlatka Knezovic, Branka Jurcevic Zidar, Ajka Pribisalic, Sanja Luetic, Katarina Jurcic, Nina Knezovic and Davorka Sutlovic

Nutrients 2025, 17(7), 1110; https://doi.org/10.3390/nu17071110 - 22 Mar 2025

Cited by 12 | Viewed by 5806

Abstract

Background/Objectives: Artificial sweeteners (ASs) are food additives used to impart sweetness to various food products. Common sweeteners used individually or in combination include acesulfame-K, aspartame, cyclamate, saccharin, sucralose, and neotame. While traditionally considered harmless, emerging research suggest potential health implications. This study aims [...] Read more.

Background/Objectives: Artificial sweeteners (ASs) are food additives used to impart sweetness to various food products. Common sweeteners used individually or in combination include acesulfame-K, aspartame, cyclamate, saccharin, sucralose, and neotame. While traditionally considered harmless, emerging research suggest potential health implications. This study aims to analyze commonly consumed food products in Croatia for ASs presence, quantify four ASs, and estimate daily intake of ASs. Additionally, product labeling was assessed for compliance with Regulation 1169/2011 on food information to consumers. Methods: This study assessed the presence of acesulfame-K, aspartame, cyclamate, and saccharin dihydrate in 121 frequently consumed food products from the Croatian market using a high-performance liquid chromatography method. Based on obtained concentrations, data from a parallel consumption study, and existing literature on acceptable daily intake (ADI), we assessed exposure to ASs. Results: ASs were found in a substantial proportion of analyzed products, with multiple sweeteners often present in a single product. Specifically, ASs were detected in 74% of carbonated drinks, 54% of fruit juices, 86% of energy drinks, 70% of high-protein milk products, and 66% of chewing gums. Hypothetical consumption scenarios demonstrated that children, due to their low body mass, are at the highest risk of exceeding ADI values. Conclusions: The widespread presence of ASs in food products raises concerns about excessive intake, particularly among children who frequently consume soft drinks, instant beverages, and protein drinks. These findings highlight the need for further research into cumulative ASs exposure and its potential health effects, as well as the importance of public health strategies to regulate ASs consumption. Full article

(This article belongs to the Special Issue Nutrients: 15th Anniversary)

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12 pages, 235 KB

Open AccessEditor’s ChoiceArticle

Impact of Physical Activity and Dietary Habits on Mental Well-Being in Patients with Diabetes Mellitus

by Battamir Ulambayar, Amr Sayed Ghanem, Ágnes Tóth and Attila Csaba Nagy

Nutrients 2025, 17(6), 1042; https://doi.org/10.3390/nu17061042 - 16 Mar 2025

Cited by 12 | Viewed by 3817

Abstract

Background: The prevalence of diabetes mellitus (DM) is increasing worldwide, and mental health problems such as depression, anxiety, and diabetes distress are common co-morbidities that negatively impact the quality of life, complications, and treatment outcomes of patients with DM. Objectives: In [...] Read more.

Background: The prevalence of diabetes mellitus (DM) is increasing worldwide, and mental health problems such as depression, anxiety, and diabetes distress are common co-morbidities that negatively impact the quality of life, complications, and treatment outcomes of patients with DM. Objectives: In this study, we assessed the impact of dietary patterns and physical activity on the well-being of patients with DM. Methods: A cross-sectional design and data from the European Health Interview Survey (EHIS) data collected in Hungary in 2019, and determination of the relationship between dietary habits and physical activity-related variables contained in the data and the World Health Organization-Five Well-Being Index (WHO-5 index) by suitable statistical methods. Results: Logistic regression showed higher odds of poor mental well-being in females (OR = 1.61, 95% CI: 1.08–2.42) and lower odds with daily fruit intake (OR = 0.52, 95% CI: 0.31–0.89). Infrequent white meat (OR = 3.34, 95% CI: 1.35–8.22) and dairy intake (OR = 1.60, 95% CI: 1.18–2.64) were associated with poorer well-being. Walking 4–7 days/week reduced the odds by 57% (OR = 0.43, 95% CI: 0.23–0.83). Conclusions: The results demonstrate that regular exercise and the consumption of fruits, dairy products, and white meat have beneficial effects on the mental well-being of patients with DM. Full article

(This article belongs to the Special Issue Nutritional & Lifestyle Psychiatry: The Role of Nutrition and Lifestyle in the Onset, Prevention and Management of Mental Disorders)

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15 pages, 274 KB

Open AccessEditor’s ChoiceReview

Clinical Insights into Non-Alcoholic Fatty Liver Disease and the Therapeutic Potential of Flavonoids: An Update

by Aleksandra Kozłowska

Nutrients 2025, 17(6), 956; https://doi.org/10.3390/nu17060956 - 9 Mar 2025

Cited by 14 | Viewed by 6190

Abstract

Non-alcoholic fatty liver disease (NAFLD) is considered a significant global health issue related to serious metabolic disorders. However, effective pharmacological treatments are still limited. Flavonoids, a wide group of polyphenol substances, exert anti-inflammatory and lipid-lowering effects in preclinical data. Thus, implementing these research [...] Read more.

Non-alcoholic fatty liver disease (NAFLD) is considered a significant global health issue related to serious metabolic disorders. However, effective pharmacological treatments are still limited. Flavonoids, a wide group of polyphenol substances, exert anti-inflammatory and lipid-lowering effects in preclinical data. Thus, implementing these research findings in clinical practice could significantly help manage NAFLD and its consequences. This narrative review assesses the therapeutic potential of flavonoids in managing NAFLD. The research collected randomized controlled trials (RCTs) and meta-analyses of RCTs from the past five years concerning the impact of flavonoids on NAFLD. A total of 20 studies were selected according to predetermined inclusion criteria, comprising thirteen randomized controlled trials (RCTs) and seven meta-analyses. The research underscores the beneficial effects of flavonoids in the management of NAFLD through the enhancement of lipid metabolism, the reduction in hepatic steatosis, and the provision of anti-inflammatory actions. Clinical trials demonstrate that interventions rich in flavonoids, including quercetin, epigallocatechin gallate, naringenin, and isoflavones, substantially reduce liver fat content and enhance liver enzyme profiles, with certain compounds exhibiting superior efficacy in particular subgroups, such as older adults and females. Nonetheless, whereas these therapies significantly diminish hepatic steatosis, their effect on fibrosis is constrained. To sum up, flavonoids exhibit significant potential as supplementary treatments for NAFLD by enhancing liver function, lipid metabolism, and inflammation. Additional extensive controlled clinical trials are necessary to create uniform treatment methods and ascertain their long-term therapeutic advantages. Full article

(This article belongs to the Special Issue Effects of Phytochemicals on Human Health)

24 pages, 1664 KB

Open AccessEditor’s ChoiceReview

Gut Microbiota Modulation Through Mediterranean Diet Foods: Implications for Human Health

by Pasquale Perrone and Stefania D’Angelo

Nutrients 2025, 17(6), 948; https://doi.org/10.3390/nu17060948 - 8 Mar 2025

Cited by 56 | Viewed by 15747

Abstract

The Mediterranean diet (MD) is widely recognized for its health benefits, particularly in modulating gut microbiota composition and reducing the risk of metabolic, cardiovascular, and neurodegenerative diseases. Characterized by a high intake of plant-based foods, monounsaturated fats, and polyphenols, primarily from extra virgin [...] Read more.

The Mediterranean diet (MD) is widely recognized for its health benefits, particularly in modulating gut microbiota composition and reducing the risk of metabolic, cardiovascular, and neurodegenerative diseases. Characterized by a high intake of plant-based foods, monounsaturated fats, and polyphenols, primarily from extra virgin olive oil, the MD fosters the growth of beneficial gut bacteria such as Bifidobacterium, Faecalibacterium prausnitzii, and Roseburia, which produce short-chain fatty acids that enhance gut barrier integrity, reduce inflammation, and improve metabolic homeostasis. Clinical and preclinical studies have proved that the MD is associated with increased microbial diversity, reduced pro-inflammatory bacteria, and improved markers of insulin sensitivity, lipid metabolism, and cognitive function. Additionally, the MD positively influences the gut microbiota in various conditions, including obesity, cardiovascular disease, and neurodegeneration, potentially mitigating systemic inflammation and enhancing neuroprotective mechanisms. Emerging evidence suggests that MD variants, such as the Green-MD, and their integration with probiotics can further optimize gut microbiota composition and metabolic parameters. While the beneficial impact of the MD on the gut microbiota and overall health is well supported, further long-term clinical trials are needed to better understand individual variability and improve dietary interventions tailored to different populations. Full article

(This article belongs to the Special Issue Physical Exercise and Nutrition on the Gastrointestinal Pathophysiology)

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35 pages, 1868 KB

Open AccessEditor’s ChoiceReview

Impact of Vegan and Vegetarian Diets on Neurological Health: A Critical Review

by Vicente Javier Clemente-Suárez, Laura Redondo-Flórez, Alexandra Martín-Rodríguez, Agustín Curiel-Regueros, Alejandro Rubio-Zarapuz and José Francisco Tornero-Aguilera

Nutrients 2025, 17(5), 884; https://doi.org/10.3390/nu17050884 - 28 Feb 2025

Cited by 21 | Viewed by 36277

Abstract

Background/Objectives: The global shift towards vegan and vegetarian diets has garnered attention for their ethical, environmental, and potential health benefits. These diets are often rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein [...] Read more.

Background/Objectives: The global shift towards vegan and vegetarian diets has garnered attention for their ethical, environmental, and potential health benefits. These diets are often rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6), suggesting a potential protective effect against systemic inflammation and oxidative stress. However, despite these benefits, concerns remain regarding their impact on neurological health due to the possible deficiencies of critical nutrients such as vitamin B12, DHA, EPA, and iron. This review critically evaluates the influence of these dietary patterns on neurological outcomes, emphasizing their nutritional composition, potential deficiencies, and their interplay with inflammation and oxidative stress. Methods: A systematic review of the literature published between 2010 and 2023 was conducted, focusing on studies that explore the relationship between vegan and vegetarian diets and neurological health. Key nutrients such as vitamin B12, omega-3 fatty acids, iron, and zinc were analyzed alongside antinutritional factors and their effects on the nervous system. Results: Evidence suggests that vegan and vegetarian diets, when well planned, can be rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6). These findings indicate a potential role in reducing systemic inflammation and oxidative stress, both of which are linked to neurodegenerative diseases. However, deficiencies in critical nutrients such as vitamin B12, DHA, EPA, and iron have been consistently associated with an increased risk of cognitive decline, mood disturbances, and neurodegenerative disorders. Additionally, the presence of antinutritional factors like phytates and oxalates may further impair nutrient absorption, necessitating careful dietary planning and supplementation. Conclusions: While plant-based diets provide anti-inflammatory and antioxidant benefits, their neurological implications depend on nutrient adequacy. Proper planning, supplementation, and food preparation techniques are essential to mitigate risks and enhance cognitive health. Further research is needed to explore long-term neurological outcomes and optimize dietary strategies. Full article

(This article belongs to the Special Issue Neuro-Nutrition in Sports: Advances in Functional Neurology and Metabolic Care)

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21 pages, 330 KB

Open AccessEditor’s ChoiceReview

The Role of the Planetary Diet in Managing Metabolic Syndrome and Cardiovascular Disease: A Narrative Review

by Aleksandra Muszalska, Julia Wiecanowska, Joanna Michałowska, Katarzyna Magdalena Pastusiak-Zgolińska, Izabela Polok, Kinga Łompieś and Paweł Bogdański

Nutrients 2025, 17(5), 862; https://doi.org/10.3390/nu17050862 - 28 Feb 2025

Cited by 11 | Viewed by 3517

Abstract

Introduction: The planetary health diet, introduced by the EAT–Lancet Commission, aims to address global health and sustainability challenges by promoting a plant-based diet with reduced consumption of animal-sourced foods. This diet not only contributes to environmental sustainability but also offers significant health benefits, [...] Read more.

Introduction: The planetary health diet, introduced by the EAT–Lancet Commission, aims to address global health and sustainability challenges by promoting a plant-based diet with reduced consumption of animal-sourced foods. This diet not only contributes to environmental sustainability but also offers significant health benefits, including prevention and management of abdominal obesity, carbohydrate metabolism disorders, dyslipidemia, and elevated blood pressure. These metabolic disorders are components of metabolic syndrome, a cluster of risk factors for cardiovascular disease. Objectives: This narrative review aims to gather the most recent findings on the impact of the planetary diet on individual components of metabolic syndrome and on the prevention and treatment of cardiovascular disease. Methods: The available research on the topic was identified via searches in PubMed, Scopus, and Google Scholar. Results: Abdominal obesity, a major risk factor for a range of chronic diseases, can be effectively mitigated by adhering to plant-based dietary patterns, which have been shown to reduce waist circumference and improve overall cardiometabolic health. Furthermore, the planetary diet plays a crucial role in reducing the risk of type-2 diabetes and improving glycemic control, with specific dietary components such as whole grains and fiber, demonstrating positive effects on blood glucose levels. This diet is additionally associated with favorable lipid profiles, including lower levels of LDL cholesterol and total cholesterol, which are critical in the prevention of atherosclerosis and cardiovascular diseases. Conclusions: These multiple benefits highlight that the planetary diet may be an effective strategy for managing and preventing metabolic syndrome and cardiovascular disease. However, further research is needed to confirm its long-term efficacy and applicability across diverse populations. Full article

(This article belongs to the Special Issue Effects of Nutrient Intake on Cardiovascular Disease)

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14 pages, 266 KB

Open AccessEditor’s ChoiceReview

Gut over Mind: Exploring the Powerful Gut–Brain Axis

by Stefana-Maria Petrut, Alexandra Maria Bragaru, Alice Elena Munteanu, Adina-Diana Moldovan, Cosmin-Alec Moldovan and Elena Rusu

Nutrients 2025, 17(5), 842; https://doi.org/10.3390/nu17050842 - 28 Feb 2025

Cited by 23 | Viewed by 19149

Abstract

Background: The human gastrointestinal tract is home to a wide variety of microorganisms. For some decades now, bacteria known as probiotics have been added to various foods because of their beneficial effects for human health. Evidence indicates that probiotics significantly regulate gut microbiota, [...] Read more.

Background: The human gastrointestinal tract is home to a wide variety of microorganisms. For some decades now, bacteria known as probiotics have been added to various foods because of their beneficial effects for human health. Evidence indicates that probiotics significantly regulate gut microbiota, which is vital for digestion, metabolism, immune function, and mental health. Methods: We conducted a narrative review of available original research published in PubMed for the past ten years focusing on recent advancements that provide a thorough understanding of the relationship between the gastrointestinal system and the brain. Results: Recent advances in research have focused on the importance of gut microbiota in influencing mental health. The microbiota–gut–brain axis is a complex, bidirectional communication network linking the central nervous system and the gastrointestinal tract, which highlights how the gut and brain are deeply interconnected and influence each other in ways that affect our overall health, emotions, and behavior. This powerful link is a major area of research as scientists discover more about how gut health can impact mental well-being. Conclusions: A comprehensive understanding of microbiota composition and mechanisms involved in these interactions between the gut and the brain could shape future medical and therapeutic approaches. It would balance scientific explanation with clinical relevance, offering insights into how understanding the brain–gut axis can revolutionize our approach to treating mental health and gastrointestinal disorders. Full article

(This article belongs to the Special Issue Nutrition, Gut Microbiota and Immunity)

13 pages, 760 KB

Open AccessEditor’s ChoiceReview

Nutrition and Lifestyle Interventions in Managing Dyslipidemia and Cardiometabolic Risk

by Hygerta Berisha, Reham Hattab, Laura Comi, Claudia Giglione, Silvia Migliaccio and Paolo Magni

Nutrients 2025, 17(5), 776; https://doi.org/10.3390/nu17050776 - 23 Feb 2025

Cited by 26 | Viewed by 17246

Abstract

Dyslipidemia, characterized by abnormal blood lipid levels, is a major public health concern due to its association with atherosclerotic cardiovascular disease (ASCVD) and other cardiometabolic disorders. In this context, appropriate nutrition patterns are pivotal as they represent the basic approach for providing a [...] Read more.

Dyslipidemia, characterized by abnormal blood lipid levels, is a major public health concern due to its association with atherosclerotic cardiovascular disease (ASCVD) and other cardiometabolic disorders. In this context, appropriate nutrition patterns are pivotal as they represent the basic approach for providing a wide range of substantial advantages. The best evidence for dyslipidemia management is offered by the Mediterranean Diet, the Plant-Based Diet, the High-Fiber Diet and the Anti-inflammatory Diet, while the DASH Diet and the Ketogenic Diet have also been shown to target additional pathological features like hypertension and other comorbidities. The bioactive compounds that are enriched in these nutrition patterns and able to manage dyslipidemia include monounsaturated fatty acids such as ω-3, polyphenols such as oleuropein, resveratrol, flavonoids, and catechins, carotenoids, phytosterols and soluble and unsoluble fibers. Diets rich in these compounds can improve lipid profile by mitigating oxidative stress, reducing low-grade chronic inflammation, modulating macronutrient absorption and other mechanisms, thereby supporting cardiovascular health. Additionally, lifestyle interventions such as regular physical activity, weight loss, reduced alcohol consumption and smoking cessation further ameliorate lipid metabolism and manage circulated lipid profile. Furthermore, emerging insights from nutrigenomics underscore the potential for proper diet to address genetic factors and optimize treatment outcomes. The pivotal role of nutrition interventions in the context of dyslipidemia and its cardiometabolic implications is discussed in this review, emphasizing evidence-based and personalized approaches. Full article

(This article belongs to the Special Issue Diet, Adipose Tissue and Diabetes)

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31 pages, 2477 KB

Open AccessEditor’s ChoiceReview

The Power of Environment: A Comprehensive Review of the Exposome’s Role in Healthy Aging, Longevity, and Preventive Medicine—Lessons from Blue Zones and Cilento

by Silvana Mirella Aliberti and Mario Capunzo

Nutrients 2025, 17(4), 722; https://doi.org/10.3390/nu17040722 - 18 Feb 2025

Cited by 14 | Viewed by 9633

Abstract

Aging and longevity are shaped by the exposome, a dynamic network of environmental, social, and biological factors. Understanding how these exposures interact with biological mechanisms can inform strategies for healthier aging. Background/Objectives: This review explores the exposome as a dynamic system encompassing [...] Read more.

Aging and longevity are shaped by the exposome, a dynamic network of environmental, social, and biological factors. Understanding how these exposures interact with biological mechanisms can inform strategies for healthier aging. Background/Objectives: This review explores the exposome as a dynamic system encompassing both protective and risk factors, with a specific focus on how beneficial environmental exposures, microbiome diversity, lifestyle behaviors, and resilience mechanisms contribute to successful aging. By analyzing high-longevity populations, such as the Blue Zones and Cilento, it aims to identify common determinants of successful aging. Methods: A mixed-method study was conducted, combining a systematic review of the English literature (2003–2024) with a comparative analysis of longevity regions. A structured search was performed in PubMed, Scopus, and Google Scholar using keywords such as “longevity”, “Blue Zones”, “Cilento”, “microbiome”, “environmental factors”, and related terms. Additionally, qualitative and quantitative analysis were applied to assess key protective factors across different aging models. Results: This study identified key factors contributing to successful aging in longevity hotspots, including sustained exposure to biodiverse natural environments, adherence to Mediterranean or plant-based diet rich in polyphenols and probiotics, regular physical activity, strong social networks, and psychological resilience. A novel aspect of this review is the role of the gut microbiome as a mediator between environmental exposures and immune–metabolic health, influencing inflammation modulation and cellular aging. Despite geographic and cultural differences, case studies reveal a shared pattern of protective factors that collectively enhance lifespan and healthspan. Conclusions: The exposome is a critical determinant of aging trajectories, acting through complex interactions between environmental and biological mechanisms. By integrating insights from high-longevity populations, this mixed-method study proposes a comprehensive framework for optimizing microbiome health, enhancing resilience, and promoting protective environmental exposures. These findings provide a translational perspective to guide future interventions in aging research and global health initiatives. Full article

(This article belongs to the Special Issue The Interdependence of Nutrition and Mental Well-Being)

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17 pages, 315 KB

Open AccessEditor’s ChoiceArticle

Adherence to the Mediterranean Diet in Spanish University Students: Association with Lifestyle Habits, Mental and Emotional Well-Being

by Gloria Tomás-Gallego, Josep María Dalmau-Torres, Raúl Jiménez-Boraita, Javier Ortuño-Sierra and Esther Gargallo-Ibort

Nutrients 2025, 17(4), 698; https://doi.org/10.3390/nu17040698 - 15 Feb 2025

Cited by 13 | Viewed by 4021

Abstract

Background: The Mediterranean Diet is recognized as one of the healthiest dietary patterns; however, in recent years, a decline in adherence has been observed in Mediterranean countries. University students represent a particularly vulnerable population, as starting university introduces new influences and responsibilities [...] Read more.

Background: The Mediterranean Diet is recognized as one of the healthiest dietary patterns; however, in recent years, a decline in adherence has been observed in Mediterranean countries. University students represent a particularly vulnerable population, as starting university introduces new influences and responsibilities that directly impact their lifestyle and health. Objective: Analyze adherence to the Mediterranean Diet among university students and its association with other lifestyle habits and mental and physical health indicators. Methods: A cross-sectional study was conducted with a sample of 1268 students (23.65 ± 7.84 years) from a university in northern Spain between November 2020 and March 2021. An online questionnaire was administered to assess Mediterranean Diet adherence along with variables such as perceived stress, self-esteem, life satisfaction, suicidal behavior, emotional and behavioral problems, emotional intelligence, physical activity, sedentary behavior, alcohol consumption, and compulsive internet use. Results: 29.26% of students had high adherence to the Mediterranean Diet. Regression analysis indicated that high adherence was associated with higher levels of emotional intelligence, as well as lower levels of suicidal ideation, emotional problems, and compulsive internet use. Conclusions: The associations found between Mediterranean Diet and other indicators and lifestyle habits highlight the need for interdisciplinary promotion strategies within the university ecosystem. Full article

(This article belongs to the Special Issue The Impact of Children’s and Adolescents’ Diet, Nutrition and Lifestyle Habits on Physical and Mental Health: From the Latest Perspective)

43 pages, 9268 KB

Open AccessEditor’s ChoiceReview

L-Arginine and Nitric Oxide in Vascular Regulation—Experimental Findings in the Context of Blood Donation

by Natalia Kurhaluk and Halina Tkaczenko

Nutrients 2025, 17(4), 665; https://doi.org/10.3390/nu17040665 - 13 Feb 2025

Cited by 28 | Viewed by 20054

Abstract

This narrative review provides an analysis of the role of nitric oxide (NO) and its precursors, particularly L-arginine, in vascular regulation and health, with an emphasis on findings from our experimental research in animal models. NO serves as a critical mediator of vascular [...] Read more.

This narrative review provides an analysis of the role of nitric oxide (NO) and its precursors, particularly L-arginine, in vascular regulation and health, with an emphasis on findings from our experimental research in animal models. NO serves as a critical mediator of vascular function, contributing to vasodilation, the regulation of blood flow, and the prevention of thrombosis. As a primary precursor of NO, L-arginine is essential for maintaining endothelial integrity, modulating mitochondrial function, and reducing oxidative damage. This review synthesises the data and contextualises these findings within the physiological challenges faced by blood donors, such as repeated blood donation and associated oxidative stress. It examines the effects of L-arginine supplementation on mitochondrial respiration, lipid peroxidation, and microsomal oxidation in different conditions, including differences in age, gender, and dietary interventions. The mechanisms by which L-arginine enhances NO production, improves vascular elasticity, and alleviates endothelial dysfunction caused by reduced NO bioavailability are also investigated. By integrating experimental findings with insights from the existing literature, this review provides a perspective on the potential of L-arginine supplementation to address the specific physiological needs of blood donors. It highlights the importance of personalised nutritional approaches in enhancing donor recovery and vascular resilience. In addition, this review assesses the wider implications of L-arginine supplementation in mitigating oxidative stress and preserving vascular function. The interplay between NO bioavailability, dietary factors, and physiological adaptation in blood donors is highlighted, along with the identification of current knowledge gaps and recommendations for future research. By presenting both original experimental evidence and a critical synthesis of the literature, this article highlights the therapeutic potential of NO precursors, particularly L-arginine, in promoting vascular health in the context of blood donation. Full article

(This article belongs to the Section Proteins and Amino Acids)

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12 pages, 983 KB

Open AccessEditor’s ChoiceSystematic Review

Umbrella Review of Systematic Reviews and Meta-Analyses on the Consumption of Different Food Groups and the Risk of Overweight and Obesity

by Emilie Kristoffersen, Sofie Lassen Hjort, Lise M. Thomassen, Elaheh Javadi Arjmand, Matteo Perillo, Rajiv Balakrishna, Anindita Tasnim Onni, Ida Sofie Karlsen Sletten, Antonello Lorenzini and Lars T. Fadnes

Nutrients 2025, 17(4), 662; https://doi.org/10.3390/nu17040662 - 13 Feb 2025

Cited by 13 | Viewed by 8816

Abstract

Background/Objectives: Dietary choices play an essential role in energy balance and weight gain. This systematic umbrella review investigates the association between the intake of various food groups (whole grains, refined grains, fruits, vegetables, nuts, legumes, fish, eggs, total dairy, red meat, white meat, [...] Read more.

Background/Objectives: Dietary choices play an essential role in energy balance and weight gain. This systematic umbrella review investigates the association between the intake of various food groups (whole grains, refined grains, fruits, vegetables, nuts, legumes, fish, eggs, total dairy, red meat, white meat, processed meat, added sugar, and sugar-sweetened beverages) and their associations to the risk of obesity and being overweight. Methods: We systematically searched Medline, Embase, Web of Science, and Epistemonikos for systematic reviews and meta-analyses. A total of 2925 articles were screened, and 13 articles were included in our analysis. Results: For each food group, data included a mean of 166,100 participants and 36,760 cases, ranging from 19,885 participants and 7183 cases for red meat to 520,331 participants and 91,256 cases for nuts. Heterogeneity was high for most of the food groups except for whole grains and sugar-sweetened beverages. The quality of the most comprehensive meta-analyses was high for all food groups, except for processed meats, which was of low quality. High intakes of whole grains, legumes, nuts, and fruits are associated with a reduced risk of overweight and obesity. In contrast, high intakes of red meat and sugar-sweetened beverages are associated with increased risk of overweight and obesity. No significant results were found for the remaining food groups, and no meta-analysis was found for fish, eggs, white meat, and added sugars. Conclusions: Diets rich in whole grains, legumes, nuts, and fruits are associated with a lower risk of developing obesity and being overweight. In contrast, diets high in red meat and sugar-sweetened beverages are associated with an increased risk of overweight and obesity. Full article

(This article belongs to the Special Issue Nutritional Surveys and Assessment of Unhealthy Eating Behaviors)

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28 pages, 3110 KB

Open AccessEditor’s ChoiceReview

The Role of Dairy in Human Nutrition: Myths and Realities

by Laura Sanjulián, Salvador Fernández-Rico, Nerea González-Rodríguez, Alberto Cepeda, José Manuel Miranda, Cristina Fente, Alexandre Lamas and Patricia Regal

Nutrients 2025, 17(4), 646; https://doi.org/10.3390/nu17040646 - 11 Feb 2025

Cited by 14 | Viewed by 17441

Abstract

Milk is a highly complex food that contains all the nutrients necessary for the development of mammalian offspring. For millennia, humans have included milk and milk products as major components of their diet. However, the effect of the consumption of dairy products on [...] Read more.

Milk is a highly complex food that contains all the nutrients necessary for the development of mammalian offspring. For millennia, humans have included milk and milk products as major components of their diet. However, the effect of the consumption of dairy products on health has been a concern in recent years in terms of myths and realities. This review briefly describes the composition of bovine milk, the positive and negative effects that have been related to dairy products, and those aspects where the scientific evidence is still inconclusive. In addition to being nutritional, dairy products are a source of bioactive peptides, prebiotics and probiotics, fatty acids such as CLA, and fat globule membranes or have a protective effect against certain diseases. Negative effects include milk protein allergy or lactose intolerance. The effects of dairy products on certain cancers, such as prostate cancer, and their role in type II diabetes mellitus or weight gain are still inconclusive. Although the role of dairy products in cardiovascular risk is still inconclusive, recent meta-analyses have shown that dairy products may have a protective effect. Full article

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

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15 pages, 890 KB

Open AccessEditor’s ChoiceArticle

An Evaluation of ChatGPT for Nutrient Content Estimation from Meal Photographs

by Cathal O’Hara, Gráinne Kent, Angela C. Flynn, Eileen R. Gibney and Claire M. Timon

Nutrients 2025, 17(4), 607; https://doi.org/10.3390/nu17040607 - 7 Feb 2025

Cited by 14 | Viewed by 10919

Abstract

Background/Objectives: Advances in artificial intelligence now allow combined use of large language and vision models; however, there has been limited evaluation of their potential in dietary assessment. This study aimed to evaluate the accuracy of ChatGPT-4 in estimating nutritional content of commonly [...] Read more.

Background/Objectives: Advances in artificial intelligence now allow combined use of large language and vision models; however, there has been limited evaluation of their potential in dietary assessment. This study aimed to evaluate the accuracy of ChatGPT-4 in estimating nutritional content of commonly consumed meals using meal photographs derived from national dietary survey data. Methods: Meal photographs (n = 114) were uploaded to ChatGPT and it was asked to identify the foods in each meal, estimate their weight, and estimate the nutrient content of the meals for 16 nutrients for comparison with the known values using precision, paired t-tests, Wilcoxon signed rank test, percentage difference, and Spearman correlation (r_s). Seven dietitians also estimated energy, protein, and carbohydrate content of thirty-eight meal photographs for comparison with ChatGPT using intraclass correlation (ICC). Results: Comparing ChatGPT and actual meals, ChatGPT showed good precision (93.0%) for correctly identifying the foods in the photographs. There was good agreement for meal weight (p = 0.221) for small meals, but poor agreement for medium (p < 0.001) and large (p < 0.001) meals. There was poor agreement for 10 of the 16 nutrients (p < 0.05). Percentage difference from actual values was >10% for 13 nutrients, with ChatGPT underestimating 11 nutrients. Correlations were adequate or good for all nutrients with r_s ranging from 0.29 to 0.83. When comparing ChatGPT and dietitians, the ICC ranged from 0.31 to 0.67 across nutrients. Conclusions: ChatGPT performed well for identifying foods, estimating weights of small portion sizes, and ranking meals according to nutrient content, but performed poorly for estimating weights of medium and large portion sizes and providing accurate estimates of nutrient content. Full article

(This article belongs to the Special Issue New Advances in Dietary Assessment)

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12 pages, 731 KB

Open AccessEditor’s ChoiceArticle

Impact of Polyphenol-Rich Nutraceuticals on Cognitive Function and Neuroprotective Biomarkers: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

by Juan Ángel Carrillo, Raúl Arcusa, Raquel Xandri-Martínez, Begoña Cerdá, Pilar Zafrilla and Javier Marhuenda

Nutrients 2025, 17(4), 601; https://doi.org/10.3390/nu17040601 - 7 Feb 2025

Cited by 19 | Viewed by 10243

Abstract

Background: Recent studies have highlighted the neuroprotective effects of polyphenols, particularly their role in enhancing brain-derived neurotrophic factor (BDNF) and cAMP response element-binding protein (CREB) activity. This study aimed to evaluate the relationship between BDNF and CREB levels and cognitive performance in individuals [...] Read more.

Background: Recent studies have highlighted the neuroprotective effects of polyphenols, particularly their role in enhancing brain-derived neurotrophic factor (BDNF) and cAMP response element-binding protein (CREB) activity. This study aimed to evaluate the relationship between BDNF and CREB levels and cognitive performance in individuals undergoing a polyphenol-rich dietary intervention. Methods: A randomized, crossover, double-blind, placebo-controlled clinical trial was conducted with 92 participants. The intervention involved the daily intake of an encapsulated concentrate of fruit, vegetable, and berry juice powders (Juice Plus+ Premium^®) over two 16-week periods, separated by a 4-week washout phase. Cognitive function was assessed using the Stroop Test, Trail Making Test, and Reynolds Intellectual Screening Test (RIST). The plasma levels of CREB and BDNF were measured using ELISA. Results: The polyphenol-rich product significantly improved cognitive performance, as evidenced by higher scores in the Stroop Test and RIST, compared to the placebo. Additionally, the plasma levels of CREB and BDNF were notably elevated in the product condition, indicating enhanced neuroprotective activity. Conclusions: The findings suggest that polyphenol-rich nutraceuticals can modulate neurobiological mechanisms underlying cognitive improvements, primarily through the reduction of oxidative stress and the regulation of signaling pathways associated with synaptic plasticity. These results support the potential of dietary polyphenols in promoting cognitive health and preventing neurodegenerative diseases. Full article

(This article belongs to the Special Issue Sensory Nutrition and Health Impact on Metabolic and Brain Disorders)

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36 pages, 2145 KB

Open AccessEditor’s ChoiceReview

Nutrients and Nutraceuticals from Vitis vinifera L. Pomace: Biological Activities, Valorization, and Potential Applications

by Cecilia Prata, Chiara Zalambani, Francesca Rossi, Simone Rossello, Teresa Cerchiara, Concettina Cappadone and Emil Malucelli

Nutrients 2025, 17(3), 583; https://doi.org/10.3390/nu17030583 - 5 Feb 2025

Cited by 12 | Viewed by 3993

Abstract

Grape pomace, also known as wine pomace, is a by-product of winemaking that has traditionally been discarded. However, recent studies have highlighted its rich nutritional and bioactive potential, positioning it as a promising resource for various applications in the functional food, pharmaceutical, and [...] Read more.

Grape pomace, also known as wine pomace, is a by-product of winemaking that has traditionally been discarded. However, recent studies have highlighted its rich nutritional and bioactive potential, positioning it as a promising resource for various applications in the functional food, pharmaceutical, and cosmetic sectors. This review explores the nutrient and nutraceutical contents of grape pomace, including its high levels of polyphenols, dietary fiber, vitamins, minerals, and melatonin. The biological activities of grape pomace, such as antioxidant, anti-inflammatory, antimicrobial, and anticancer effects, are also discussed, emphasizing its potential as raw material endowed with multifunctional properties. Additionally, the valorization of grape pomace as a food supplement and for the development of cosmetics is examined, focusing on its incorporation into dietary products and skincare formulations. The growing interest in the sustainable utilization of grape pomace is underscored, highlighting its significant role in promoting human health and contributing to a circular economy. Full article

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

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40 pages, 673 KB

Open AccessEditor’s ChoiceSystematic Review

Mediterranean Diet and Quality of Life in Adults: A Systematic Review

by Justyna Godos, Monica Guglielmetti, Cinzia Ferraris, Evelyn Frias-Toral, Irma Domínguez Azpíroz, Vivian Lipari, Andrea Di Mauro, Fabrizio Furnari, Sabrina Castellano, Fabio Galvano, Licia Iacoviello, Marialaura Bonaccio and Giuseppe Grosso

Nutrients 2025, 17(3), 577; https://doi.org/10.3390/nu17030577 - 5 Feb 2025

Cited by 52 | Viewed by 25148

Abstract

Background/Objectives: With the increasing life expectancy and, as a result, the aging of the global population, there has been a rise in the prevalence of chronic conditions, which can significantly impact individuals’ health-related quality of life, a multidimensional concept that comprises an individual’s [...] Read more.

Background/Objectives: With the increasing life expectancy and, as a result, the aging of the global population, there has been a rise in the prevalence of chronic conditions, which can significantly impact individuals’ health-related quality of life, a multidimensional concept that comprises an individual’s physical, mental, and social wellbeing. While a balanced, nutrient-dense diet, such as Mediterranean diet, is widely recognized for its role in chronic disease prevention, particularly in reducing the risk of cardiovascular diseases and certain cancers, its potential benefits extend beyond these well-known effects, showing promise in improving physical and mental wellbeing, and promoting health-related quality of life. Methods: A systematic search of the scientific literature in electronic databases (Pubmed/Medline) was performed to identify potentially eligible studies reporting on the relation between adherence to the Mediterranean diet and health-related quality of life, published up to December 2024. Results: A total of 28 studies were included in this systematic review, comprising 13 studies conducted among the general population and 15 studies involving various types of patients. Overall, most studies showed a significant association between adherence to the Mediterranean diet and HRQoL, with the most significant results retrieved for physical domains of quality of life, suggesting that diet seems to play a relevant role in both the general population and people affected by chronic conditions with an inflammatory basis. Conclusions: Adherence to the Mediterranean diet provides significant benefits in preventing and managing various chronic diseases commonly associated with aging populations. Furthermore, it enhances the overall health and quality of life of aging individuals, ultimately supporting more effective and less invasive treatment approaches for chronic diseases. Full article

(This article belongs to the Special Issue Mediterranean Diet and Chronic Diseases)

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26 pages, 861 KB

Open AccessEditor’s ChoiceReview

Health Effects and Therapeutic Potential of the Gut Microbe Akkermansia muciniphila

by Ezinne Aja, Amber Zeng, Weston Gray, Kaden Connelley, Anil Chaganti and Jonathan P. Jacobs

Nutrients 2025, 17(3), 562; https://doi.org/10.3390/nu17030562 - 31 Jan 2025

Cited by 26 | Viewed by 13778

Abstract

Akkermansia muciniphila is a bacterium commonly found in the human gastrointestinal tract that has received considerable interest as a potential probiotic for the improvement of gut health and overall metabolic function. A. muciniphila is enriched in the mucus layer of the intestinal lining, [...] Read more.

Akkermansia muciniphila is a bacterium commonly found in the human gastrointestinal tract that has received considerable interest as a potential probiotic for the improvement of gut health and overall metabolic function. A. muciniphila is enriched in the mucus layer of the intestinal lining, where it degrades mucin and plays a significant role in gut barrier maintenance and immune regulation. A higher abundance of A. muciniphila has been observed in the gut of healthy individuals relative to those with metabolic disorders, and multiple metabolic benefits, including improved glucose management, reduced body fat, and reduced inflammation have been linked to A. muciniphila. Current research on A. muciniphila primarily relies on mouse models, with limited human interventional studies available. While these animal studies offer valuable insights into the potential roles of A. muciniphila in health and disease, further clinical investigations in humans are needed to fully understand its impact. Here, we explore the current scope of A. muciniphila research and its potential as a therapeutic agent to improve gut and metabolic health while also emphasizing the need to optimize techniques to further improve studies of this organism. Full article

(This article belongs to the Section Prebiotics, Probiotics and Postbiotics)

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27 pages, 4544 KB

Open AccessEditor’s ChoiceSystematic Review

Dietary Patterns, Oxidative Stress, and Early Inflammation: A Systematic Review and Meta-Analysis Comparing Mediterranean, Vegan, and Vegetarian Diets

by Sara Ilari, Stefania Proietti, Francesca Milani, Laura Vitiello, Carolina Muscoli, Patrizia Russo and Stefano Bonassi

Nutrients 2025, 17(3), 548; https://doi.org/10.3390/nu17030548 - 31 Jan 2025

Cited by 22 | Viewed by 15728

Abstract

Background: Dietary habits influenced by lifestyle and cultural factors play a critical role in health by modulating oxidative stress and inflammation. While diets offer significant benefits, they may also pose risks, such as nutrient deficiencies, emphasizing the need for a balanced approach. Exploring [...] Read more.

Background: Dietary habits influenced by lifestyle and cultural factors play a critical role in health by modulating oxidative stress and inflammation. While diets offer significant benefits, they may also pose risks, such as nutrient deficiencies, emphasizing the need for a balanced approach. Exploring Mediterranean and plant-based diet effects on oxidative stress and inflammation biomarkers may help improve health outcomes and disease prevention strategies. Methods: This study analyzed 65 studies following PRISMA guidelines to evaluate the effects of Mediterranean and plant-based diets on biomarkers of oxidative stress and inflammation in healthy individuals. Results: The Mediterranean diet was weakly associated with reductions in oxidative stress markers, including MDA (ROM: 0.80; 95% CI: 0.57–1.13; p = 0.2092) and 8OHdG (ROM: 0.81; 95% CI: 0.59–1.11; p = 0.1847), as well as inflammation markers such as CRP (ROM: 0.72; 95% CI: 0.42–1.23; p = 0.1545) and IL-6 (ROM: 1.23; 95% CI: 0.97–1.55; p = 0.08). The vegetarian diet significantly reduced CRP (ROM: 0.82; 95% CI: 0.69–0.98; p = 0.0297), while the vegan diet showed a borderline reduction (ROM: 0.81; 95% CI: 0.56–1.17; p = 0.2544), suggesting lower systemic inflammation compared to omnivorous diets. Conclusions: Although all three diets demonstrate potential in reducing oxidative stress and inflammation, the antioxidant effects—especially for the Mediterranean diet—are lower than anticipated, indicating alternative mechanisms. Further research is essential to confirm these findings and clarify the underlying mechanisms to enhance preventive health strategies. Full article

(This article belongs to the Section Nutritional Epidemiology)

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20 pages, 677 KB

Open AccessEditor’s ChoiceReview

Dietary Habits, Obesity, and Bariatric Surgery: A Review of Impact and Interventions

by Mădălina Maxim, Radu Petru Soroceanu, Vlad Ionuț Vlăsceanu, Răzvan Liviu Platon, Mihaela Toader, Ancuța Andreea Miler, Alina Onofriescu, Irina Mihaela Abdulan, Bogdan-Mihnea Ciuntu, Gheorghe Balan, Felicia Trofin and Daniel Vasile Timofte

Nutrients 2025, 17(3), 474; https://doi.org/10.3390/nu17030474 - 28 Jan 2025

Cited by 15 | Viewed by 7622

Abstract

Eating behavior encompasses the psychological, physiological, and environmental factors influencing food intake. Dysregulation in eating behavior, such as emotional eating, binge eating, or loss of satiety signals, contributes to excessive caloric intake and weight gain. These behaviors are often linked to hormonal imbalances, [...] Read more.

Eating behavior encompasses the psychological, physiological, and environmental factors influencing food intake. Dysregulation in eating behavior, such as emotional eating, binge eating, or loss of satiety signals, contributes to excessive caloric intake and weight gain. These behaviors are often linked to hormonal imbalances, stress, or genetic predisposition. Obesity is a chronic, multifactorial disease characterized by excessive body fat accumulation, with a body mass index (BMI) ≥ 30 kg/m² often used for diagnosis. It is associated with significant morbidity, including type 2 diabetes, cardiovascular disease, and obstructive sleep apnea. Pathophysiological mechanisms underlying obesity include insulin resistance, leptin dysregulation, and altered gut microbiota, which perpetuate metabolic derangements. Lifestyle interventions remain first-line treatment, but sustained weight loss is challenging for many patients. Bariatric surgery is a therapeutic option for individuals with severe obesity (BMI ≥ 40 kg/m² or ≥35 kg/m² with comorbidities) who have failed conservative management. Procedures such as Roux-en-Y gastric bypass and sleeve gastrectomy alter gastrointestinal anatomy, promoting weight loss through restriction, malabsorption, and hormonal modulation (e.g., increased GLP-1 secretion). Bariatric surgery improves obesity-related comorbidities and enhances quality of life. However, it requires lifelong medical follow-up to address potential nutritional deficiencies and ensure sustainable outcomes. Full article

(This article belongs to the Special Issue Nutrition Support in Bariatric Surgery)

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16 pages, 596 KB

Open AccessEditor’s ChoiceArticle

Ultra-Processed Food Consumption and Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD): A Longitudinal and Sustainable Analysis

by Silvia García, Margalida Monserrat-Mesquida, Lucía Ugarriza, Miguel Casares, Cristina Gómez, David Mateos, Escarlata Angullo-Martínez, Josep A. Tur and Cristina Bouzas

Nutrients 2025, 17(3), 472; https://doi.org/10.3390/nu17030472 - 28 Jan 2025

Cited by 11 | Viewed by 4022

Abstract

Background: The rising prevalence of metabolic-dysfunction-associated steatotic liver disease (MASLD) is a significant health challenge, and the consumption of ultra-processed foods (UPFs) could play a key role. Aim: The aim is assess the impact of UPF consumption changes on the development and progression [...] Read more.

Background: The rising prevalence of metabolic-dysfunction-associated steatotic liver disease (MASLD) is a significant health challenge, and the consumption of ultra-processed foods (UPFs) could play a key role. Aim: The aim is assess the impact of UPF consumption changes on the development and progression of MASLD in adults. Design: This is a longitudinal study to assess how changes in UPF consumption affect liver fat and MASLD parameters over 6 months in 70 participants. Methods: Dietary intake was assessed using a validated food frequency questionnaire, and foods were classified according to the NOVA system. Participants were divided into three groups based on UPF consumption changes: maximum (T1), medium (T2), and minimum reduction (T3). Fatty liver parameters were assessed with magnetic resonance imaging and ultrasonography. Mediterranean diet (Med-diet) adherence and sociodemographic parameters were also recorded. The General Linear Model was used to determine relationships between UPF consumption, fatty liver disease parameters, and diet. Results: Participants in T1 experienced a 7.7% reduction in intrahepatic fat content (IFC) compared to 2.6% in T3. T1 showed increased Med-diet adherence and decreased meat and sweets consumption. The energy intake decreased by 605.3 kcal/day in T1, while T3 showed an increase of 209.5 kcal/day. Conclusions: Reducing UPF consumption leads to a decrease in IFC, associated with high Med-diet adherence and low calorie intake. Adopting these dietary patterns aligns with global sustainability goals and could further benefit MASLD patients by addressing environmental challenges alongside improving liver health. Full article

(This article belongs to the Special Issue Sustainability of Optimal Diets)

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28 pages, 2730 KB

Open AccessEditor’s ChoiceReview

Minerals and Human Health: From Deficiency to Toxicity

by Mohammed S. Razzaque and Sunil J. Wimalawansa

Nutrients 2025, 17(3), 454; https://doi.org/10.3390/nu17030454 - 26 Jan 2025

Cited by 61 | Viewed by 35093

Abstract

Minerals are essential nutrients that play critical roles in human health by regulating various physiological functions. Examples include bone development, enzyme function, nerve signaling, and the immune response. Both the deficiencies and toxicities of minerals can have significant health implications. Deficiencies in macrominerals [...] Read more.

Minerals are essential nutrients that play critical roles in human health by regulating various physiological functions. Examples include bone development, enzyme function, nerve signaling, and the immune response. Both the deficiencies and toxicities of minerals can have significant health implications. Deficiencies in macrominerals such as calcium, magnesium, and phosphate can lead to osteoporosis (associated with falls and fractures), cardiovascular events, and neuromuscular dysfunction. Trace mineral deficiencies, such as iron and zinc. Selenium deficiency impairs oxygen transport, immune function, and antioxidant defenses, contributing to anemia, delaying wound healing, and increasing susceptibility to infectious diseases. Conversely, excessive intake of minerals can have severe health consequences. Hypercalcemia can cause kidney stones and cardiac arrhythmias as well as soft-tissue calcification, whereas excessive iron deposition can lead to oxidative stress and organ/tissue damage. Maintaining adequate mineral levels through a balanced diet, guided supplementation, and monitoring at-risk populations is essential for good health and preventing disorders related to deficiencies and toxicities. Public health interventions and education about dietary sources of minerals are critical for minimizing health risks and ensuring optimal well-being across populations. While a comprehensive analysis of all macro and micronutrients is beyond the scope of this article, we have chosen to focus on calcium, magnesium, and phosphate. We summarize the consequences of deficiency and the adverse events associated with the overconsumption of other minerals. Full article

(This article belongs to the Special Issue Mineral Nutrition on Human Health and Disease)

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22 pages, 637 KB

Open AccessEditor’s ChoiceReview

Protective Effects of Sulforaphane Preventing Inflammation and Oxidative Stress to Enhance Metabolic Health: A Narrative Review

by Inês Alves, Edilene Maria Queiroz Araújo, Louise T. Dalgaard, Sharda Singh, Elisabet Børsheim and Eugenia Carvalho

Nutrients 2025, 17(3), 428; https://doi.org/10.3390/nu17030428 - 24 Jan 2025

Cited by 18 | Viewed by 18191

Abstract

The worldwide obesity epidemic has led to a drastic increase in diabetes and cardiovascular disease in younger generations. Further, maintaining metabolic health during aging is frequently a challenge due to poor diets and decreased mobility. In this setting, bioactive nutrients that are naturally [...] Read more.

The worldwide obesity epidemic has led to a drastic increase in diabetes and cardiovascular disease in younger generations. Further, maintaining metabolic health during aging is frequently a challenge due to poor diets and decreased mobility. In this setting, bioactive nutrients that are naturally occurring antioxidants, such as sulforaphane (SFN), are of high nutritional interest. SFN, a bioactive compound that is present in cruciferous vegetables, is a molecule that protects cells from cytotoxic damage and mitigates oxidative stress, protecting against disease. It exerts its action through the activation of the transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2). Many studies have been performed in animals and humans to evaluate its effects on cancer, brain health, and neurodegenerative disorders. However, fewer clinical studies have been performed to evaluate its effects on insulin resistance and the development of type 2 diabetes mellitus (T2DM) across the lifespan. Given that, in some parts of the world, particularly in Europe, the population is growing older at a significant rate, it is crucial to promote healthy habits (healthy foods, dietary pattern, precision nutrition, and physical activity) from an early stage in life and across the lifespan to avoid debilitating health conditions occurring during adulthood and aging. Thus, in this narrative review, we discuss the protective effects of SFN supplementation on inflammatory and oxidative stress pathways and relate them to metabolic disease. Full article

(This article belongs to the Special Issue Anti-inflammatory and Anti-obesity Properties of Food Bioactive Components)

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23 pages, 877 KB

Open AccessEditor’s ChoiceArticle

Nutritional Status of Vitamin E and Its Association with Metabolic Health in Adults

by Kacper Szewczyk, Joanna Bryś, Rita Brzezińska and Magdalena Górnicka

Nutrients 2025, 17(3), 408; https://doi.org/10.3390/nu17030408 - 23 Jan 2025

Cited by 10 | Viewed by 8125

Abstract

Background: Vitamin E is one of the key dietary antioxidants. However, current evidence remains insufficient to establish a definitive relationship between circulating vitamin E levels, body fat content, and their influence on metabolic health. This study aimed to assess and compare the vitamin [...] Read more.

Background: Vitamin E is one of the key dietary antioxidants. However, current evidence remains insufficient to establish a definitive relationship between circulating vitamin E levels, body fat content, and their influence on metabolic health. This study aimed to assess and compare the vitamin E nutritional status in adults with normal and excess body fat and its determinants. Methods: Concentrations of vitamin E isoforms (α- and γ-tocopherols, α- and γ-tocotrienols) were assessed in 127 individuals. Body fat content and other anthropometric indices, as well as biochemical markers such as lipid profile, plasma fatty acid concentration and C-reactive protein, were identified as markers of metabolic health. Participants were divided into two groups: with normal and excess body fat (defined as more than 30% in women and more than 25% in men). Results: The determinants of higher α-tocopherol concentrations were lower body fat content and higher levels of circulating lipids as HDL and LDL (R² = 0.221, p < 0.001 in a model of multivariate linear regression). The level of circulating vitamin E isoforms correlated with the concentration of CRP (r = −0.464 for α-T, r = −0.453 for αT3, r = −0.270 for γ-T, r = −0.355 for γ-T3). Similarly, elevated concentrations of vitamin E isoforms are linked to lower adipose tissue content, which may contribute to lower inflammation and improved metabolic health (r = −0.359 for α-T, r = −0.333 for αT3, r = −0.276 for γ-T3, no significant correlation for γ-T). Conclusions: These results reveal that the vitamin E status of adults with excess body fat may be inadequate and linked to poorer metabolic health. We found that the determinants of lower plasma vitamin E were higher BF and lower TC and its fraction, with the strongest correlations being found for HDL. Full article

(This article belongs to the Special Issue Antioxidants in Diet: Metabolic Impacts and Mechanisms of Action)

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58 pages, 871 KB

Open AccessEditor’s ChoiceReview

Effects of Trace Elements on Endocrine Function and Pathogenesis of Thyroid Diseases—A Literature Review

by Łukasz Bryliński, Katarzyna Kostelecka, Filip Woliński, Olga Komar, Agata Miłosz, Justyna Michalczyk, Jan Biłogras, Anna Machrowska, Robert Karpiński, Marcin Maciejewski, Ryszard Maciejewski, Gabriella Garruti, Jolanta Flieger and Jacek Baj

Nutrients 2025, 17(3), 398; https://doi.org/10.3390/nu17030398 - 22 Jan 2025

Cited by 21 | Viewed by 7537

Abstract

The thyroid gland is an endocrine organ whose hormones enable the proper functioning of the organism. The normal function of this organ is influenced by internal and external factors. One of the external factors is trace elements. Trace elements in appropriate concentrations are [...] Read more.

The thyroid gland is an endocrine organ whose hormones enable the proper functioning of the organism. The normal function of this organ is influenced by internal and external factors. One of the external factors is trace elements. Trace elements in appropriate concentrations are necessary for the proper functioning of the thyroid. Fe, Cu, Mn, I, Zn, and Se are part of the enzymes involved in oxidative stress reduction, while Cd, Hg, and Pb can increase ROS production. Cu and Fe are necessary for the correct TPO synthesis. An imbalance in the concentration of trace elements such as Fe, Cu, Co, I, Mn, Zn, Ag, Cd, Hg, Pb, and Se in thyroid cells can lead to thyroid diseases such as Graves’ disease, Hashimoto’s thyroiditis, hypothyroidism, autoimmune thyroiditis, thyroid nodules, thyroid cancer, and postpartum thyroiditis. Lack of adequate Fe levels may lead to hypothyroidism and cancer development. The thyroid gland’s ability to absorb I is reversibly reduced by Co. Adequate levels of I are required for correct thyroid function; both deficiency and excess can predispose to the development of thyroid disorders. High concentrations of Mn may lead to hypothyroidism. Furthermore, Mn may cause cancer development and progression. Insufficient Zn supplementation causes hypothyroidism and thyroid nodule development. Cd affecting molecular mechanisms may also lead to thyroid disorders. Hg accumulating in the thyroid may interfere with hormone secretion and stimulate cancer cell proliferation. A higher risk of thyroid nodules, cancer, autoimmune thyroiditis, and hypothyroidism were linked to elevated Pb levels. Se deficiency disrupts thyroid cell function and may lead to several thyroid disorders. On the other hand, some of the trace elements may be useful in the treatment of thyroid diseases. Therefore, the effects of trace elements on the thyroid require further research. Full article

(This article belongs to the Section Nutrition and Metabolism)

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24 pages, 1625 KB

Open AccessEditor’s ChoiceReview

Nitric Oxide in Parkinson’s Disease: The Potential Role of Dietary Nitrate in Enhancing Cognitive and Motor Health via the Nitrate–Nitrite–Nitric Oxide Pathway

by Gianluca Tripodi, Mauro Lombardo, Sercan Kerav, Gilda Aiello and Sara Baldelli

Nutrients 2025, 17(3), 393; https://doi.org/10.3390/nu17030393 - 22 Jan 2025

Cited by 15 | Viewed by 6503

Abstract

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta, leading to motor symptoms such as tremor, rigidity, and bradykinesia. The pathological hallmarks of PD include Lewy bodies and mechanisms [...] Read more.

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta, leading to motor symptoms such as tremor, rigidity, and bradykinesia. The pathological hallmarks of PD include Lewy bodies and mechanisms like oxidative/nitrosative stress, chronic inflammation, and mitochondrial dysfunction. Nitric oxide (NO), produced by nitric oxide synthase (NOS) isoforms, plays a dual role in neuroprotection and neurodegeneration. Excessive NO production exacerbates neuroinflammation and oxidative/nitrosative damage, contributing to dopaminergic cell death. This review explores NO’s role in PD pathogenesis and investigates dietary nitrate as a therapeutic strategy to regulate NO levels. Methods: A literature review of studies addressing the role of NO in PD was conducted using major scientific databases, including PubMed, Scopus, and Web of Science, using keywords such as “nitric oxide”, “NOSs”, “Parkinson’s disease”, and “nitrate neuroprotection in PD”. Studies on nitrate metabolism via the nitrate–nitrite–NO pathway and its effects on PD hallmarks were analyzed. Studies regarding the role of nitrosamine formation in PD, which are mainly formed during the nitrification process of amines (nitrogen-containing compounds), often due to chemical reactions in the presence of nitrite or nitrate, were also examined. In particular, nitrate has been shown to induce oxidative stress, affect the mitochondrial function, and contribute to inflammatory phenomena in the brain, another factor closely related to the pathogenesis of PD. Results: Excessive NO production, particularly from iNOS and nNOS, was strongly associated with neuroinflammation and oxidative/nitrosative stress, amplifying neuronal damage in PD. Dietary nitrate was shown to enhance NO bioavailability through the nitrate–nitrite–NO pathway, mitigating inflammation and oxidative/nitrosative damage. Conclusions: Dysregulated NO production contributes significantly to PD progression via inflammatory and oxidative/nitrosative pathways. Dietary nitrate, by modulating NO levels, offers a promising therapeutic strategy to counteract these pathological mechanisms. Further clinical trials are warranted to establish its efficacy and optimize its use in PD management. Full article

(This article belongs to the Special Issue Dietary Nitrate in Health and Diseases: Pathways from Nitrate and NOS to Nitric Oxide and Beyond)

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16 pages, 760 KB

Open AccessEditor’s ChoiceArticle

Tying Food Addiction to Uncontrolled Eating: The Roles of Eating-Related Thoughts and Emotional Eating

by Alessandro Alberto Rossi

Nutrients 2025, 17(3), 369; https://doi.org/10.3390/nu17030369 - 21 Jan 2025

Cited by 13 | Viewed by 5321

Abstract

Background. Food addiction is often linked to overeating and difficulty in controlling eating habits. At the same time, food addiction is often associated with intense eating-related thoughts and emotional eating behaviors. However, despite extensive research on food addiction, the psychological processes that [...] Read more.

Background. Food addiction is often linked to overeating and difficulty in controlling eating habits. At the same time, food addiction is often associated with intense eating-related thoughts and emotional eating behaviors. However, despite extensive research on food addiction, the psychological processes that contribute to these outcomes have not been fully examined. Consequently, this study aims to fill that gap by investigating the influence of eating-related thoughts, as well as emotional eating behaviors that may precede episodes of uncontrolled eating. Methods. A cross-sectional design was used. A sample of 467 individuals was enrolled from the general population. Participants completed a battery of self-report questionnaires. A sequential mediation analysis with latent variables (i.e., structural equation modeling; SEM) using 5000 bootstrap samples and observed variables was performed. Results. The proposed model provides good fit indices. Indeed, food addiction predicts uncontrolled eating behaviors through eating-related thoughts (p < 0.001), which were also significantly associated with the emotion-driven eating patterns (p < 0.001), revealing a fully mediated model explaining 61.6% of the outcome variance (R² = 0.616). Discussion. The findings underscore the critical influence of cognitive factors (i.e., eating-related thoughts) in driving maladaptive coping mechanisms like emotional eating. Moreover, emotional eating may act as a precursor to behaviors associated with overeating, which are often rooted in food addiction. Conclusions. Recognizing the central role of thoughts and emotions can help clinicians develop more targeted psychological interventions for those experiencing food addiction symptoms. Full article

(This article belongs to the Special Issue Nutrition, Disordered Eating and Mental Health)

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21 pages, 1920 KB

Open AccessEditor’s ChoiceReview

Effects of the Mediterranean Diet on the Components of Metabolic Syndrome Concerning the Cardiometabolic Risk

by Stefania Scaglione, Tiziana Di Chiara, Mario Daidone and Antonino Tuttolomondo

Nutrients 2025, 17(2), 358; https://doi.org/10.3390/nu17020358 - 20 Jan 2025

Cited by 30 | Viewed by 23496

Abstract

Metabolic syndrome is a cluster of risk factors, including abdominal obesity, insulin resistance, hypertension, dyslipidemia (intended as an increase in triglyceride levels and a reduction in HDL cholesterol levels), and elevated fasting glucose, that increase the risk of cardiovascular disease and type 2 [...] Read more.

Metabolic syndrome is a cluster of risk factors, including abdominal obesity, insulin resistance, hypertension, dyslipidemia (intended as an increase in triglyceride levels and a reduction in HDL cholesterol levels), and elevated fasting glucose, that increase the risk of cardiovascular disease and type 2 diabetes. With the rising prevalence of metabolic syndrome, effective dietary interventions are essential in reducing these health risks. The Mediterranean diet, rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil and moderate in fish and poultry, has shown promise in addressing metabolic syndrome and its associated components. This diet’s anti-inflammatory and antioxidant properties, primarily due to its unsaturated fats, polyphenols, and fiber, have improved blood pressure, lipid levels, and insulin sensitivity. Adherence to the Mediterranean diet has been linked to reductions in central obesity and insulin resistance, both key elements in managing metabolic syndrome. Regarding lipid management, the Mediterranean diet lowers triglyceride levels and low-density lipoprotein (LDL) cholesterol while raising high-density lipoprotein (HDL) cholesterol, enhancing lipid profiles. It also helps regulate blood glucose levels, reducing the likelihood of developing type 2 diabetes. Additionally, the diet promotes weight loss and improves body composition, particularly by decreasing visceral fat, a primary driver of metabolic syndrome according to IDF classification. The Mediterranean diet offers a holistic approach to managing metabolic syndrome and reducing the risk of related chronic diseases. Its positive impact on metabolic health, combined with lifestyle changes like increased physical activity, provides a sustainable method for addressing the global burden of this syndrome. This review aimed to summarize the positive effects of the Mediterranean diet on the component of the metabolic syndrome with subsequent positive effects on cardiometabolic risk profile. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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18 pages, 2893 KB

Open AccessEditor’s ChoiceArticle

Exploring Gender Differences in the Effects of Diet and Physical Activity on Metabolic Parameters

by Stefania Gorini, Elisabetta Camajani, Alessandra Feraco, Andrea Armani, Sercan Karav, Tiziana Filardi, Giovanni Aulisa, Edda Cava, Rocky Strollo, Elvira Padua, Massimiliano Caprio and Mauro Lombardo

Nutrients 2025, 17(2), 354; https://doi.org/10.3390/nu17020354 - 20 Jan 2025

Cited by 13 | Viewed by 6754

Abstract

Background: Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults. Methods: A prospective cohort study was [...] Read more.

Background: Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults. Methods: A prospective cohort study was conducted in an obesity clinic in Rome, Italy, involving overweight adults (BMI ≥ 25 kg/m²) motivated to improve their lifestyle. Participants (n = 205; 107 men and 98 women) self-selected into physical activity groups (aerobic, anaerobic, combined or no activity). Gender-specific metabolic changes were assessed, including lipid profiles, liver markers and fasting glucose. Results: Significant gender differences in metabolic results were observed. Men showed greater reductions in total cholesterol (TC) and LDL, as well as significant reductions in alanine aminotransferase (ALT). Women showed a significant increase in HDL cholesterol. Fasting blood glucose decreased significantly in both sexes, with no differences between the sexes. Activity-specific analysis revealed that anaerobic activity significantly improved lipid metabolism in men, while aerobic activity produced the greatest benefits in women, including increased HDL and improved liver marker profiles. Conclusions: Therapeutic strategies combining MD and physical activity must take into account gender-specific physiological differences and the type of sport activity to optimise metabolic benefits. Personalised approaches may improve the management of cardiovascular risk factors in overweight individuals. Study registration: This study is registered on ClinicalTrials.gov (NCT06661330). Full article

(This article belongs to the Special Issue Eating Behaviors, Body Composition and Neuro Vulnerability in Energy Metabolism Regulation—2nd Edition)

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16 pages, 1033 KB

Open AccessEditor’s ChoiceArticle

The Association Between Adherence to the Mediterranean Diet and Depression and Anxiety Symptoms in University Students: The Mediating Role of Lean Mass and the Muscle Strength Index

by Sofía Alfaro-González, Miriam Garrido-Miguel, Carlos Pascual-Morena, Diana P. Pozuelo-Carrascosa, Rubén Fernández-Rodríguez, José Alberto Martínez-Hortelano, Arthur E. Mesas and Vicente Martínez-Vizcaíno

Nutrients 2025, 17(2), 346; https://doi.org/10.3390/nu17020346 - 18 Jan 2025

Cited by 11 | Viewed by 3933

Abstract

Background/objectives: recent studies have suggested that components typical of the Mediterranean diet (MedDiet) are associated with depression and anxiety prevention. In this sense, the main objective of this study was to analyse the associations between adherence to the MedDiet and depression and anxiety [...] Read more.

Background/objectives: recent studies have suggested that components typical of the Mediterranean diet (MedDiet) are associated with depression and anxiety prevention. In this sense, the main objective of this study was to analyse the associations between adherence to the MedDiet and depression and anxiety symptoms and to examine whether this relationship is mediated by lean mass and the muscle strength index (MSI). Methods: a cross-sectional study (based on data obtained from the Nuts4Brain-Z study) was conducted from 2023–2024, involving 428 university students, aged 18–30 years, from a Spanish public university. Depression was assessed using the Beck Depression Inventory (BDI-II), and anxiety was assessed via the General Anxiety Disorder-7 (GAD-7) tool. Adherence to the MedDiet was assessed using the MEDAS questionnaire. Lean mass was assessed via bioimpedance, and MSI was measured via a dynamometer. ANCOVA models were used to test the mean differences in depression and anxiety scores using MEDAS categories (low adherence < 9 points vs high adherence ≥ 9 points). Serial multiple mediation models, adjusted for the main confounders, were used to explore the role of lean mass and MSI in the relationships between adherence to the MedDiet and depression and anxiety symptoms. Results: university students with high adherence to the MedDiet exhibited lower scores for depression and anxiety symptoms (p < 0.05) than did students with low adherence to the MedDiet. The mediation analysis preliminarily revealed that both lean mass and MSI acted as mediators of the relationships between adherence to the MedDiet and depression and anxiety. Conclusion:adherence to the MedDiet in university students per se does not appear to have a direct effect on depression and anxiety symptoms because these associations are partially (for depression) or entirely (for anxiety) explained by lean mass and MSI. Full article

(This article belongs to the Special Issue Dietary Habits and Body Composition of Children, Adolescents and Young Adults)

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58 pages, 856 KB

Open AccessEditor’s ChoiceSystematic Review

Dietary Intake, Mediterranean and Nordic Diet Adherence in Alzheimer’s Disease and Dementia: A Systematic Review

by Christiana C. Christodoulou, Michalis Pitsillides, Andreas Hadjisavvas and Eleni Zamba-Papanicolaou

Nutrients 2025, 17(2), 336; https://doi.org/10.3390/nu17020336 - 17 Jan 2025

Cited by 14 | Viewed by 9791

Abstract

Background/Objectives: Dementia is not a single disease but an umbrella term that encompasses a range of symptoms, such as memory loss and cognitive impairments, which are severe enough to disrupt daily life. One of the most common forms of dementia is Alzheimer’s Disease [...] Read more.

Background/Objectives: Dementia is not a single disease but an umbrella term that encompasses a range of symptoms, such as memory loss and cognitive impairments, which are severe enough to disrupt daily life. One of the most common forms of dementia is Alzheimer’s Disease (AD), a complex neurodegenerative condition influenced by both genetic and environmental factors. Recent research has highlighted diet as a potential modifiable risk factor for AD. Decades of research have explored the role of dietary patterns, including the Mediterranean Diet (MD) and its components, in neuroprotection and cognitive health. Systematic review examines studies investigating the impact of the Mediterranean Diet, Mediterranean-like diets, the Nordic Diet (ND), dietary intake patterns, and specific components such as extra virgin olive oil and rapeseed oil on cognitive function, disease onset, and progression in AD and dementia. Methods: A comprehensive search of PubMed, the Directory of Open Access Journals, and the Social Science Research Network was conducted independently by two reviewers using predefined search terms. The search period included studies from 2006 to 2024. Eligible studies meeting the inclusion criteria were systematically reviewed, yielding 88 studies: 85 focused on the MD and its relationship to AD and dementia, while only 3 investigated the ND. Results: The findings suggest that adherence to the Mediterranean and Nordic diets is generally associated with improved cognitive function and delayed cognitive decline and that adherence to both these diets can improve cognitive function. Some studies identified that higher legume consumption decreased dementia incidence, while fruits and vegetables, carbohydrates, and eggs lowered dementia prevalence. Most studies demonstrated that high MD or ND adherence was associated with better cognitive function and a lower risk of poor cognition in comparison to individuals with lower MD or ND adherence. However, some studies reported no significant benefits of the MD on cognitive outcomes, while two studies indicated that higher red meat consumption was linked to better cognitive function. Conclusion: Despite promising trends, the evidence remains varying across studies, underscoring the need for further research to establish definitive associations between diet and cognitive function. These findings highlight the essential role of dietary interventions in the prevention and management of dementia and AD, therefore offering critical insights into the underlying mechanisms by which the diet may impact brain health. Full article

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

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14 pages, 1634 KB

Open AccessEditor’s ChoiceArticle

Vitamins K2 and D3 Improve Long COVID, Fungal Translocation, and Inflammation: Randomized Controlled Trial

by Ornina Atieh, Joviane Daher, Jared C. Durieux, Marc Abboud, Danielle Labbato, Jhony Baissary, Ziad Koberssy, Kate Ailstock, Morgan Cummings, Nicholas T. Funderburg and Grace A. McComsey

Nutrients 2025, 17(2), 304; https://doi.org/10.3390/nu17020304 - 16 Jan 2025

Cited by 14 | Viewed by 28250

Abstract

Background: Long COVID (LC) is characterized by persistent symptoms at least 3 months after a SARS-COV-2 infection. LC has been associated with fungal translocation, gut dysfunction, and enhanced systemic inflammation. Currently, there is no approved treatment for this condition. The anti-inflammatory effect of [...] Read more.

Background: Long COVID (LC) is characterized by persistent symptoms at least 3 months after a SARS-COV-2 infection. LC has been associated with fungal translocation, gut dysfunction, and enhanced systemic inflammation. Currently, there is no approved treatment for this condition. The anti-inflammatory effect of vitamins K2 and D3 was shown to help attenuate the course of acute COVID-19 infection. Objective and hypothesis: This trial aims to investigate the effects of vitamins K2/D3 on LC symptoms, as well as gut and inflammatory markers, in people with established long COVID. Our hypothesis is that by attenuating systemic inflammation, vitamins K2/D3 will improve long COVID symptoms. Methods: This single-site randomized controlled study enrolled adults experiencing ≥2 moderate LC symptoms at least 3 months after a COVID-19 infection. The RECOVER Long COVID Research Index and number and type of LC symptoms were considered. Participants were randomized 2:1 to daily 240 µg K2 (pure MK-7 form) and 2000 UI vitamin D3 or standard of care (SOC) for 24 weeks. The endpoints were changes in symptomatology and in select inflammatory, metabolic, and gut biomarkers at 24 weeks. Results: We enrolled 151 participants (n = 98 received vit K2/D3 and 53 received SOC). The median age was 46 years; 71% were female and 29% were non-white. Baseline demographics were balanced between groups. At 24 weeks, the active treatment group only had a sharp increase in 25(OH) D, indicating good treatment adherence. In the vitamin K2/D3 arm, there was a 7.1% decrease in the proportion who had an LC Index ≥12 (vs. a 7.2% increase in the SOC group; p = 0.01). The average number of LC symptoms remained stable in the vitamin K2/D3 arm but increased in the SOC arm (p = 0.03). Additionally, reductions in oxidized LDL, inflammatory markers sTNF-RI and sCD163, and fungal translocation marker (1,3)-β-d-glucan were observed in the vitamin K2/D3 arm compared to the SOC arm (p < 0.01) over 24 weeks. Conclusions: Vitamins K2/D3 improved the RECOVER Long COVID Index, the number of LC symptoms, and several gut and inflammatory markers. Vitamins K2/D3 provide a promising safe intervention for people suffering from long COVID. Full article

(This article belongs to the Special Issue Dose–Response Relationships of Vitamin D Status and Vitamin D Intake with Health Outcomes—2nd Edition)

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19 pages, 1476 KB

Open AccessEditor’s ChoiceReview

Sarcopenia and Cardiogeriatrics: The Links Between Skeletal Muscle Decline and Cardiovascular Aging

by Dimitrios Anagnostou, Nikolaos Theodorakis, Christos Hitas, Magdalini Kreouzi, Ioannis Pantos, Georgia Vamvakou and Maria Nikolaou

Nutrients 2025, 17(2), 282; https://doi.org/10.3390/nu17020282 - 14 Jan 2025

Cited by 26 | Viewed by 9858

Abstract

Sarcopenia, an age-related decline in skeletal muscle mass, strength, and function, is increasingly recognized as a significant condition in the aging population, particularly among those with cardiovascular diseases (CVD). This review provides a comprehensive synthesis of the interplay between sarcopenia and cardiogeriatrics, emphasizing [...] Read more.

Sarcopenia, an age-related decline in skeletal muscle mass, strength, and function, is increasingly recognized as a significant condition in the aging population, particularly among those with cardiovascular diseases (CVD). This review provides a comprehensive synthesis of the interplay between sarcopenia and cardiogeriatrics, emphasizing shared mechanisms such as chronic low-grade inflammation (inflammaging), hormonal dysregulation, oxidative stress, and physical inactivity. Despite advancements in diagnostic frameworks, such as the EWGSOP2 and AWGS definitions, variability in criteria and assessment methods continues to challenge standardization. Key diagnostic tools include dual-energy X-ray absorptiometry (DXA) and bioimpedance analysis (BIA) for muscle mass, alongside functional measures such as grip strength and gait speed. The review highlights the bidirectional relationship between sarcopenia and cardiovascular conditions such as heart failure, aortic stenosis, and atherosclerotic cardiovascular disease, which exacerbate each other through complex pathophysiological mechanisms. Emerging therapeutic strategies targeting the mTOR pathway, NAD+ metabolism, and senescence-related processes offer promise in mitigating sarcopenia’s progression. Additionally, integrated interventions combining resistance training, nutritional optimization, and novel anti-aging therapies hold significant potential for improving outcomes. This paper underscores critical gaps in the evidence, including the need for longitudinal studies to establish causality and the validation of advanced therapeutic approaches in clinical settings. Future research should leverage multi-omics technologies and machine learning to identify biomarkers and personalize interventions. Addressing these challenges is essential to reducing sarcopenia’s burden and enhancing the quality of life for elderly individuals with comorbid cardiovascular conditions. This synthesis aims to guide future research and promote effective, individualized management strategies. Full article

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

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47 pages, 4285 KB

Open AccessEditor’s ChoiceReview

Protective Role of Dietary Polyphenols in the Management and Treatment of Type 2 Diabetes Mellitus

by Monika Martiniakova, Anna Sarocka, Noemi Penzes, Roman Biro, Veronika Kovacova, Vladimira Mondockova, Aneta Sevcikova, Sona Ciernikova and Radoslav Omelka

Nutrients 2025, 17(2), 275; https://doi.org/10.3390/nu17020275 - 13 Jan 2025

Cited by 30 | Viewed by 11969

Abstract

Type 2 diabetes mellitus (T2DM), a serious metabolic disorder, is a worldwide health problem due to the alarming rise in prevalence and elevated morbidity and mortality. Chronic hyperglycemia, insulin resistance, and ineffective insulin effect and secretion are hallmarks of T2DM, leading to many [...] Read more.

Type 2 diabetes mellitus (T2DM), a serious metabolic disorder, is a worldwide health problem due to the alarming rise in prevalence and elevated morbidity and mortality. Chronic hyperglycemia, insulin resistance, and ineffective insulin effect and secretion are hallmarks of T2DM, leading to many serious secondary complications. These include, in particular, cardiovascular disorders, diabetic neuropathy, nephropathy and retinopathy, diabetic foot, osteoporosis, liver damage, susceptibility to infections and some cancers. Polyphenols such as flavonoids, phenolic acids, stilbenes, tannins, and lignans constitute an extensive and heterogeneous group of phytochemicals in fresh fruits, vegetables and their products. Various in vitro studies, animal model studies and available clinical trials revealed that flavonoids (e.g., quercetin, kaempferol, rutin, epicatechin, genistein, daidzein, anthocyanins), phenolic acids (e.g., chlorogenic, caffeic, ellagic, gallic acids, curcumin), stilbenes (e.g., resveratrol), tannins (e.g., procyanidin B2, seaweed phlorotannins), lignans (e.g., pinoresinol) have the ability to lower hyperglycemia, enhance insulin sensitivity and improve insulin secretion, scavenge reactive oxygen species, reduce chronic inflammation, modulate gut microbiota, and alleviate secondary complications of T2DM. The interaction between polyphenols and conventional antidiabetic drugs offers a promising strategy in the management and treatment of T2DM, especially in advanced disease stages. Synergistic effects of polyphenols with antidiabetic drugs have been documented, but also antagonistic interactions that may impair drug efficacy. Therefore, additional research is required to clarify mutual interactions in order to use the knowledge in clinical applications. Nevertheless, dietary polyphenols can be successfully applied as part of supportive treatment for T2DM, as they reduce both obvious clinical symptoms and secondary complications. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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15 pages, 1223 KB

Open AccessEditor’s ChoiceSystematic Review

Relationship Between the Gut Microbiome, Tryptophan-Derived Metabolites, and Osteoarthritis-Related Pain: A Systematic Review with Meta-Analysis

by Erika Meléndez-Oliva, Oliver Martínez-Pozas, Pierluigi Sinatti, Carmen Martín Carreras-Presas, Juan Nicolás Cuenca-Zaldívar, Silvia Turroni and Eleuterio A. Sánchez Romero

Nutrients 2025, 17(2), 264; https://doi.org/10.3390/nu17020264 - 12 Jan 2025

Cited by 22 | Viewed by 7201

Abstract

Introduction: Osteoarthritis (OA) is the most prevalent form of arthritis and affects over 528 million people worldwide. Degenerative joint disease involves cartilage degradation, subchondral bone remodeling, and synovial inflammation, leading to chronic pain, stiffness, and impaired joint function. Initially regarded as a “wear [...] Read more.

Introduction: Osteoarthritis (OA) is the most prevalent form of arthritis and affects over 528 million people worldwide. Degenerative joint disease involves cartilage degradation, subchondral bone remodeling, and synovial inflammation, leading to chronic pain, stiffness, and impaired joint function. Initially regarded as a “wear and tear” condition associated with aging and mechanical stress, OA is now recognized as a multifaceted disease influenced by systemic factors such as metabolic syndrome, obesity, and chronic low-grade inflammation. Recent studies have focused on the gut-joint axis to investigate how the gut microbiome modulates inflammation and pain in OA. Materials and Methods: A systematic review was conducted following the PRISMA guidelines and was registered with PROSPERO (CRD42024556265). This review included studies involving adults with symptomatic OA and analyzed the relationship between the gut microbiome and OA-related pain. Randomized and non-randomized clinical trials, case reports, editorials, and pilot studies were excluded. Searches were performed in PubMed, Cochrane Library, and Web of Science without publication date restrictions, and filtered for “observational studies”. The study selection and data extraction were performed by two independent researchers, and the risk of bias was assessed using appropriate tools. Results: Five observational studies were included in the systematic review, and three were included in the meta-analysis. Two studies reported an association between different tryptophan metabolites and pain levels in patients with OA. Two other studies demonstrated a correlation between lipopolysaccharide levels and pain in OA. A fifth study confirmed the relationship between Streptococcus relative abundance of Streptococcus spp. and knee pain. These results were not supported by a meta-analysis, which found no significant association between the presence of pain in OA and the presence of bacilli of the genus Streptococcus or plasma markers of the tryptophan pathway. Conclusions: Current evidence indicates a potential link between gut microbiome dysbiosis and OA-related pain. However, methodological limitations preclude definitive conclusions. Further research using advanced techniques and larger cohorts is needed to validate and extend these findings and elucidate the underlying mechanisms. Targeted manipulation of the gut microbiome may be a valuable strategy for pain management in OA patients. Full article

(This article belongs to the Special Issue Association of the Microbiota with Neurodegenerative Diseases)

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29 pages, 642 KB

Open AccessEditor’s ChoiceReview

Non-Celiac Gluten/Wheat Sensitivity—State of the Art: A Five-Year Narrative Review

by Francesca Manza, Lisa Lungaro, Anna Costanzini, Fabio Caputo, Antonio Carroccio, Pasquale Mansueto, Aurelio Seidita, Suneil A. Raju, Umberto Volta, Roberto De Giorgio, David S. Sanders and Giacomo Caio

Nutrients 2025, 17(2), 220; https://doi.org/10.3390/nu17020220 - 8 Jan 2025

Cited by 15 | Viewed by 19223

Abstract

Background: Non-celiac gluten/wheat sensitivity (NCGWS) is a syndrome for which pathogenesis and management remain debated. It is described as a condition characterized by gastrointestinal and extra-intestinal symptoms rapidly occurring after gluten ingestion in subjects who have had celiac disease or wheat allergy excluded. [...] Read more.

Background: Non-celiac gluten/wheat sensitivity (NCGWS) is a syndrome for which pathogenesis and management remain debated. It is described as a condition characterized by gastrointestinal and extra-intestinal symptoms rapidly occurring after gluten ingestion in subjects who have had celiac disease or wheat allergy excluded. To date, the diagnosis of NCGWS is challenging as no universally recognized biomarkers have been yet identified, nor has a predisposing genetic profile been described. However, the research is moving fast, and new data regarding pathogenic pathways, patients’ classification, potential candidate biomarkers, and dietary interventions are emerging. Methods: This literature review aims to address the state of the art and summarize the latest updates in this field from 2019 to date. Results and Conclusions: Clinical studies regarding NCGWS in the last five years are reported to shed light on this complex condition and to guide specialists towards a more in-depth, prompt, and objective diagnosis. Full article

(This article belongs to the Section Nutritional Immunology)

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