Nutrients

37 pages, 1184 KB

Open AccessEditor’s ChoiceReview

Inflammaging and Sarcopenia as Interconnected Hallmarks of Aging: Integrative Roles of Bioactive Compounds and Lifestyle Interventions

by Dorottya Nyáry, Mónika Fekete, Andrea Lehoczki, Vince Fazekas-Pongor, Ágnes Lipécz, Tamás Csípő, Dávid Major, Anna Péterfi, Boglárka Csík, Virág Zábó, Attila Matiscsák and János Tamás Varga

Nutrients 2026, 18(12), 1920; https://doi.org/10.3390/nu18121920 - 13 Jun 2026

Cited by 4 | Viewed by 2715

Abstract

Background/Objectives: Age-related functional decline is increasingly linked to chronic low-grade inflammation (inflammaging) and sarcopenia, two interconnected processes contributing to frailty, metabolic dysregulation, and impaired physical function. These conditions share several underlying mechanisms, including immune dysregulation, mitochondrial dysfunction, oxidative stress, and impaired anabolic signaling. [...] Read more.

Background/Objectives: Age-related functional decline is increasingly linked to chronic low-grade inflammation (inflammaging) and sarcopenia, two interconnected processes contributing to frailty, metabolic dysregulation, and impaired physical function. These conditions share several underlying mechanisms, including immune dysregulation, mitochondrial dysfunction, oxidative stress, and impaired anabolic signaling. This narrative review critically evaluated the mechanistic and translational interactions between natural bioactive compounds and lifestyle interventions in modulating inflammaging and sarcopenia. Methods: Evidence from molecular, experimental, epidemiological, and clinical studies was synthesized to examine the effects of bioactive compounds—including polyphenols, flavonoids, carotenoids, and omega-3 fatty acids—as well as physical activity and dietary patterns. Particular emphasis was placed on inflammatory regulation, redox homeostasis, mitochondrial adaptation, and muscle metabolism, including NF-κB, AMPK–mTOR, and Nrf2 signaling pathways. Results: Observational studies and randomized controlled trials generally indicate that anti-inflammatory dietary patterns and regular physical activity are associated with improved muscle strength, physical performance, and inflammatory status in older adults. Mechanistically, nutritional bioactives and exercise appear to converge on several pathways involved in mitochondrial function, oxidative stress, anabolic signaling, and immune activation. Emerging evidence suggests potential convergence and interaction of biological pathways affected by nutritional and lifestyle interventions; however, formal evidence demonstrating true synergistic effects in humans remains limited. Nevertheless, substantial heterogeneity persists regarding intervention protocols, dosage strategies, bioavailability, and long-term clinical outcomes. Conclusions: Natural bioactive compounds and lifestyle-based interventions represent promising approaches for targeting biological processes implicated in inflammaging and sarcopenia. By integrating current evidence within a hormesis-oriented geroscience framework, this review highlights the importance of adaptive redox regulation, metabolic resilience, and evidence-based lifestyle strategies in healthy aging. Future well-designed longitudinal and intervention studies are needed to clarify the clinical relevance of these interactions and optimize translational implementation. Full article

(This article belongs to the Special Issue Natural Bioactives for a Healthy and Sustainable Diet)

► Show Figures

Figure 1

28 pages, 954 KB

Open AccessEditor’s ChoiceReview

Gut Microbiome Dysbiosis in Metabolic Syndrome: Current Evidence and Emerging Perspectives

by Fatma Shehata, Karen M. Dwyer, Sean L. McGee and Leni R. Rivera

Nutrients 2026, 18(10), 1540; https://doi.org/10.3390/nu18101540 - 13 May 2026

Cited by 6 | Viewed by 2323

Abstract

The gut microbiota plays a crucial role in human metabolism, and disruptions to its composition, particularly reductions in bacterial diversity, have been increasingly associated with the development of metabolic syndrome (MetS). MetS encompasses a constellation of interrelated metabolic risk factors, including central obesity, [...] Read more.

The gut microbiota plays a crucial role in human metabolism, and disruptions to its composition, particularly reductions in bacterial diversity, have been increasingly associated with the development of metabolic syndrome (MetS). MetS encompasses a constellation of interrelated metabolic risk factors, including central obesity, insulin resistance, dyslipidemia, and hypertension, which collectively elevate the risk of cardiovascular and cerebrovascular disease. A comprehensive understanding of the mechanisms underlying MetS is therefore critical for the development of effective preventive and therapeutic strategies. Complex interactions between the gut microbiota and host metabolic pathways are mediated by multiple factors, including microbial metabolites, inflammatory signaling, and host immune responses. This narrative review characterizes the clinical manifestations of MetS and alterations in gut microbiota composition, characterized by an overrepresentation of potentially pathogenic taxa and a concomitant decline in beneficial microbial species. In addition, we discuss current and emerging approaches to microbiota modulation, including prebiotics, probiotics, synbiotics, postbiotics, and fecal microbiota transplantation, and evaluate their potential roles in the prevention and management of MetS. We identify critical evidence gaps and propose research priorities for evidence-based clinical strategies for MetS management and prevention. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (3rd Edition))

► Show Figures

Figure 1

39 pages, 5125 KB

Open AccessEditor’s ChoiceReview

The Gut Microbiota–Polyphenol–NLRP3 Inflammasome Axis: A Key Regulatory Network Linking Diet to Chronic Inflammation

by Laura Mosca, Cristina Pagano, Maria Giovanna Tafuri, Girolamo Di Maio, Claudia M. Rejano-Gordillo, Roberta Della Marca, Stefania D’Angelo, Marcellino Monda, Giovanni Messina, Rita Polito and Pasquale Perrone

Nutrients 2026, 18(10), 1483; https://doi.org/10.3390/nu18101483 - 7 May 2026

Cited by 8 | Viewed by 2502

Abstract

Background/Objectives: Chronic low-grade inflammation, underpinned by persistent activation of the NLRP3 inflammasome, is a central pathological mechanism in non-communicable diseases including cardiovascular disease, type 2 diabetes, inflammatory bowel disease, and neurodegeneration. Dietary polyphenols have been consistently associated with reduced inflammatory burden; however, [...] Read more.

Background/Objectives: Chronic low-grade inflammation, underpinned by persistent activation of the NLRP3 inflammasome, is a central pathological mechanism in non-communicable diseases including cardiovascular disease, type 2 diabetes, inflammatory bowel disease, and neurodegeneration. Dietary polyphenols have been consistently associated with reduced inflammatory burden; however, the mechanisms underlying these effects remain incompletely understood. This review aims to characterize the gut microbiota–polyphenol–NLRP3 inflammasome axis as a central regulatory network through which diet modulates innate immune signaling and chronic inflammatory tone. Methods: A comprehensive narrative review of the available literature was conducted, integrating evidence from mechanistic studies in cell culture and animal models, microbiome research, metabolomics, and human epidemiological and interventional data. Results: The gut microbiota emerges as a critical biochemical intermediary that transforms dietary polyphenols into bioactive metabolites, including urolithins, phenyl-γ-valerolactones, protocatechuic acid, and short-chain fatty acids, with enhanced bioavailability and potent inflammasome-modulating properties. These compounds suppress NLRP3 activation through multiple converging mechanisms, including inhibition of NF-κB-dependent priming, mitochondrial quality control via mitophagy, Nrf2-mediated antioxidant responses, and HDAC inhibition. Evidence across cardiovascular, metabolic, neurological, and respiratory disease models supports the translational relevance of this axis. Conclusions: The microbiota–polyphenol–NLRP3 axis functions as an integrated, self-regulated network in which each component simultaneously shapes and is shaped by the others: dysbiosis primes NLRP3 and depletes protective metabolites, while inflammasome hyperactivation further destabilises microbial ecology; polyphenol biotransformation by specific taxa interrupts this feed-forward loop at multiple nodes, restoring homeostasis. Full article

(This article belongs to the Special Issue Polyphenols and the Microbiota–Host Axis: Mechanisms of Inflammation Modulation and Cellular Protection)

► Show Figures

Figure 1

36 pages, 1187 KB

Open AccessEditor’s ChoiceReview

Dietary Polyphenols in Brain Aging: Molecular Mechanisms and Implications for Neurodegeneration

by Noémi Mózes, János Tamás Varga, Dominik Szwajgier, Agata Kryczyk-Poprawa, Virág Zábó, Andrea Lehoczki, Ágnes Lipécz, Tamás Csípő, Vince Fazekas-Pongor, Dávid Major, Péter Varga, Attila Matiscsák and Mónika Fekete

Nutrients 2026, 18(9), 1470; https://doi.org/10.3390/nu18091470 - 5 May 2026

Cited by 4 | Viewed by 5552

Abstract

Background/Objectives: Population aging is accompanied by a rapidly increasing burden of neurodegenerative disorders, particularly Alzheimer’s and Parkinson’s diseases. Within the geroscience framework, targeting fundamental mechanisms of aging may delay the onset or progression of multiple age-related conditions. Dietary factors, especially plant-derived polyphenols, have [...] Read more.

Background/Objectives: Population aging is accompanied by a rapidly increasing burden of neurodegenerative disorders, particularly Alzheimer’s and Parkinson’s diseases. Within the geroscience framework, targeting fundamental mechanisms of aging may delay the onset or progression of multiple age-related conditions. Dietary factors, especially plant-derived polyphenols, have gained increasing attention due to their potential to modulate molecular pathways involved in brain aging. This narrative review aims to integrate current evidence on dietary polyphenols and their role in modulating the molecular mechanisms underlying brain aging and neurodegeneration. Methods: This narrative review synthesizes findings from molecular, experimental, epidemiological, and clinical studies to provide an integrated assessment of the effects of dietary polyphenols on key cellular pathways involved in brain aging. Results: Polyphenols are widely present in plant-based foods, and polyphenol-rich dietary patterns—particularly the Mediterranean and MIND diets—have been consistently associated in observational studies with a reduced risk of cognitive decline. Mechanistic evidence, derived predominantly from in vitro and animal studies with limited validation in humans, suggests that polyphenols may influence key hallmarks of aging, including oxidative stress, chronic inflammation, mitochondrial dysfunction, cellular senescence, and impaired proteostasis. These effects are mediated through pathways such as Nrf2, NF-κB, AMPK, mTOR, and SIRT1, as well as via gut–brain axis interactions. However, clinical evidence remains heterogeneous. Conclusions: Dietary polyphenols represent a biologically plausible and promising, yet not fully validated, nutritional strategy for promoting healthy brain aging. Their translation into clinical practice is limited by low bioavailability, substantial interindividual variability, and the lack of large-scale, long-term randomized controlled trials. Full article

(This article belongs to the Special Issue Role of Food-Derived Bioactives in Cognitive Function, Mental Health, and Healthy Aging: A Nutritional Neuroscience Perspective)

► Show Figures

Figure 1

25 pages, 1414 KB

Open AccessEditor’s ChoiceReview

Diet–Microbiome–Brain Axis and Mental Health: Biological Mechanisms and Nutritional Implications

by Diana Uțu, Aniela-Roxana Nodiți-Cuc, Andreea-Mihaela Kiș, Ramona Amina Popovici, Dana Emanuela Pitic, Laria-Maria Trusculescu, Diana Marian, Andreea Georgiana Nan, Asad Salehi Matin, Dora Mihaela Cîmpian, Cristina Raluca Bodo, Alexandra Enache and Iustin Olariu

Nutrients 2026, 18(9), 1412; https://doi.org/10.3390/nu18091412 - 29 Apr 2026

Cited by 5 | Viewed by 2596

Abstract

Background/Objectives: Diet is a primary and modifiable determinant of gut microbiota composition, diversity, and metabolic activity, thereby shaping microbial-derived metabolites, immune and inflammatory signalling, neuroendocrine regulation, and neural communication with the central nervous system. Western dietary patterns, characterised by high intake of ultra-processed [...] Read more.

Background/Objectives: Diet is a primary and modifiable determinant of gut microbiota composition, diversity, and metabolic activity, thereby shaping microbial-derived metabolites, immune and inflammatory signalling, neuroendocrine regulation, and neural communication with the central nervous system. Western dietary patterns, characterised by high intake of ultra-processed foods, saturated fats, and low dietary fibre, are consistently associated with gut dysbiosis, impaired intestinal barrier function, chronic low-grade inflammation, and increased risk of depression, anxiety, cognitive impairment, and neurodegenerative disorders. Methods: This narrative review synthesises evidence from human observational studies, randomised controlled trials, animal models, and mechanistic investigations examining interactions among diet, gut microbiota, and mental health or neurobiological outcomes. Literature searches were conducted in PubMed, Scopus, and Web of Science for articles published up to December 2025. Results: The study highlights the therapeutic potential and limitations of dietary interventions, prebiotics, probiotics, and psychobiotics, and critically evaluates them. Also facilitates an improved understanding of diet–microbiome–brain interactions, which may help the development of personalised, nutrition-based strategies integrated into mental health prevention and clinical care. Conclusions: These findings support diet-based, microbiome-informed strategies as scalable adjuncts in mental health prevention and care. Full article

(This article belongs to the Special Issue Dietary Factors and Emotion and Cognitive Health)

► Show Figures

Figure 1

21 pages, 543 KB

Open AccessEditor’s ChoiceReview

From Plate to Mind: Scientific Perspectives on Foods That May Influence Anxiety and Depression

by Antoniya Hachmeriyan, Gabriela Panayotova and Hristiyana Todorova

Nutrients 2026, 18(9), 1318; https://doi.org/10.3390/nu18091318 - 22 Apr 2026

Cited by 3 | Viewed by 3123

Abstract

Background: Nutritional psychiatry increasingly links diet quality and specific bioactive nutrients to depression and anxiety outcomes. Mechanistic evidence implicates neuroimmune activation, inflammation, altered neurotransmitter synthesis, and microbiota-derived metabolites. Objective: The objective of this study is to synthesize evidence on omega-3 polyunsaturated fatty acids [...] Read more.

Background: Nutritional psychiatry increasingly links diet quality and specific bioactive nutrients to depression and anxiety outcomes. Mechanistic evidence implicates neuroimmune activation, inflammation, altered neurotransmitter synthesis, and microbiota-derived metabolites. Objective: The objective of this study is to synthesize evidence on omega-3 polyunsaturated fatty acids (n-3 PUFAs), the microbiota–gut–brain axis, and vitamins and minerals that influence neurotransmitter synthesis, inflammation, and brain function and to translate these findings into food-based strategies. Methods: This study consisted of a focused synthesis of randomized controlled trials (RCTs), meta-analyses, and systematic reviews indexed in PubMed, Scopus and Web of Science, selected for relevance to omega-3s, probiotics/prebiotics, dietary patterns, and micronutrients (folate/B-vitamins, vitamin D, magnesium, zinc, and vitamin C/copper pathways). Results: RCT and meta-analytic evidence suggest modest benefits of omega-3 supplementation for anxiety severity and depressive symptoms, with heterogeneity by dose, EPA: DHA composition, and baseline inflammatory status. The gut–brain axis literature supports bidirectional effects of stress and microbiota, and meta-analyses of probiotics/prebiotics show small improvements in depressive and anxiety symptoms, likely dependent on strain and host phenotype. Micronutrients serve as enzymatic cofactors for monoamine and GABA synthesis and modulate immune signaling; clinical effects are the most consistent when correcting insufficiency or in biomarker-defined subgroups. A whole-diet RCT demonstrates that structured dietary improvement can reduce depressive symptoms as adjunctive therapy. Conclusions: A food-first approach emphasizing Mediterranean-style dietary patterns, omega-3-rich seafood, a diverse array of fiber, and micronutrient density is the most defensible. Supplementation may be considered selectively, guided by clinical context and nutritional status. Full article

(This article belongs to the Section Nutrition and Neuro Sciences)

► Show Figures

Figure 1

27 pages, 9643 KB

Open AccessEditor’s ChoiceArticle

Konjac Glucomannan–Montmorillonite Hybrids as a Gut-Targeted Therapy for Addressing Diet-Induced Obesity in Mice

by Amin Ariaee, Hannah R. Wardill, Alex Hunter, Anthony Wignall, Aurelia S. Elz, Amanda J. Page, Clive Prestidge and Paul Joyce

Nutrients 2026, 18(8), 1298; https://doi.org/10.3390/nu18081298 - 20 Apr 2026

Cited by 3 | Viewed by 1005

Abstract

Background/Objectives: The growing prevalence of obesity necessitates innovative gut-targeted material strategies to modulate diet-associated metabolic dysfunction. This study investigates a spray-dried konjac glucomannan–montmorillonite (KGM-MMT) hybrid designed to integrate fermentable polysaccharide properties with luminal lipid-adsorptive clay functions within a single micro-engineered formulation. Methods: [...] Read more.

Background/Objectives: The growing prevalence of obesity necessitates innovative gut-targeted material strategies to modulate diet-associated metabolic dysfunction. This study investigates a spray-dried konjac glucomannan–montmorillonite (KGM-MMT) hybrid designed to integrate fermentable polysaccharide properties with luminal lipid-adsorptive clay functions within a single micro-engineered formulation. Methods: In HFD-fed mice treated for 42 days with 2% w/w KGM-MMT, cumulative body weight gain was attenuated by 7.6%, with an AUC of 5094 ± 52.95, compared to 5513 ± 81.35 in HFD controls (p < 0.0001). Results: Serum IL-6 concentrations were reduced by 97% (p = 0.0002), while blood glucose decreased by 46% (p < 0.0001); these effects were greater than those observed with MMT (24%, p = 0.0271) and KGM (16%, ns). Gut microbiota profiling demonstrated a significant 6.2-log₂-fold increase in Lactobacillaceae (p = 0.023) and a 2.4-log₂-fold increase in Enterococcaceae (p = 0.015) following KGM-MMT treatment. Functional shifts inferred from 16S rRNA gene-based prediction indicated a 1.9-fold increase in short-chain fatty acid-related pathways and a 5.4-fold increase in bile acid deconjugation pathways. Conclusions: Although the KGM-MMT hybrid did not consistently outperform its individual components across all endpoints, it consolidated complementary KGM- and MMT-associated effects within a single dosage form. These findings support spray-dried KGM-MMT as a gut-targeted biomaterial strategy that integrates multiple luminal and microbiota-associated functions within a single formulation. Future studies should define dose–response relationships, validate microbiota-derived functional predictions using higher-resolution approaches, and assess durability and safety under longer-term exposure. Full article

(This article belongs to the Special Issue Functional Foods, Obesity and Gut Microbiota: Mechanisms and Interventions)

► Show Figures

Graphical abstract

34 pages, 1572 KB

Open AccessEditor’s ChoiceReview

Venous Thromboembolism and Gut Dysbiosis: Mechanistic Links Between Endotoxemia, Microbial Metabolites, and Thromboinflammation

by Leon Smółka, Miłosz Strugała, Karolina Blady, Karolina Kursa, Bartosz Pomianowski and Agata Stanek

Nutrients 2026, 18(8), 1231; https://doi.org/10.3390/nu18081231 - 14 Apr 2026

Cited by 4 | Viewed by 1364

Abstract

Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is increasingly recognized as a thromboinflammatory disorder involving coagulation, innate immunity, endothelial dysfunction, and vascular homeostasis. Emerging evidence suggests that gut microbiome-related inflammatory and metabolic signals may influence pathways potentially relevant to [...] Read more.

Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is increasingly recognized as a thromboinflammatory disorder involving coagulation, innate immunity, endothelial dysfunction, and vascular homeostasis. Emerging evidence suggests that gut microbiome-related inflammatory and metabolic signals may influence pathways potentially relevant to VTE through intestinal barrier dysfunction, microbial translocation, and microbiome-derived metabolites. This review critically examines the direct and indirect evidence relating gut dysbiosis to mechanisms potentially relevant to venous thrombogenesis. Methods: A structured literature search of PubMed, Scopus, and Web of Science was conducted from database inception to February 2026. Observational, translational, experimental, preclinical, and selected genetic studies were narratively synthesized across heterogeneous evidence types. Results: Available evidence suggests that intestinal barrier dysfunction and microbial translocation may increase systemic exposure to lipopolysaccharide and other microbial products, potentially contributing to inflammatory signaling and procoagulant responses. Proposed downstream effects include tissue factor (TF) activation, platelet reactivity, neutrophil extracellular traps (NETs) formation, complement signaling, endothelial perturbation, and impaired balance of anticoagulant and fibrinolytic pathways. Microbiome-derived metabolites, including trimethylamine N-oxide (TMAO), phenylacetylglutamine (PAGln), bile acids, and short-chain fatty acids (SCFAs), have been linked, mainly in experimental or non-VTE settings, to thrombosis-related biology. However, most evidence remains indirect, associative, or experimental, whereas direct human VTE-specific evidence is limited and heterogeneous. Conclusions: The gut microbiome–VTE axis is biologically plausible and supported mainly by mechanistic and indirect evidence, but current data are insufficient to support strong causal conclusions. Further longitudinal, well-phenotyped, mechanistically informed studies are needed to determine whether microbiome-related pathways have measurable clinical relevance in human VTE. Full article

(This article belongs to the Special Issue Prebiotics, Probiotics, and Gut Microbiota with Chronic Disease (2nd Edition))

► Show Figures

Figure 1

25 pages, 1552 KB

Open AccessEditor’s ChoiceReview

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

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

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

Cited by 3 | Viewed by 6949

Abstract

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

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

(This article belongs to the Section Nutrition in Women)

► Show Figures

Figure 1

33 pages, 530 KB

Open AccessEditor’s ChoiceReview

Targeting Insulin Resistance Through Nutrition: Pathophysiological Insights and Dietary Interventions

by Amelia Caretto, Anna Zanardini, Giulio Frontino and Erika Pedone

Nutrients 2026, 18(7), 1119; https://doi.org/10.3390/nu18071119 - 31 Mar 2026

Cited by 5 | Viewed by 9981

Abstract

Background: Insulin resistance (IR) is a hallmark of metabolic disorders including type 2 diabetes mellitus (T2DM), metabolic syndrome, metabolic dysfunction-associated steatotic liver disease (MASLD), obesity, polycystic ovary syndrome (PCOS), and cardiovascular diseases. It arises from impaired insulin signaling in muscle, liver, and adipose [...] Read more.

Background: Insulin resistance (IR) is a hallmark of metabolic disorders including type 2 diabetes mellitus (T2DM), metabolic syndrome, metabolic dysfunction-associated steatotic liver disease (MASLD), obesity, polycystic ovary syndrome (PCOS), and cardiovascular diseases. It arises from impaired insulin signaling in muscle, liver, and adipose tissue, driven by ectopic lipid accumulation, chronic inflammation, oxidative stress, and gut microbiota dysbiosis. Methods: This narrative review synthesizes IR mechanisms and the evidence on specific dietary patterns. A structured search of PubMed/MEDLINE and Embase (up to January 2026) prioritized RCTs, systematic reviews, meta-analyses, and clinical guidelines. Results: IR assessment relies on the hyperinsulinemic–euglycemic clamp as gold standard, with HOMA-IR and QUICKI as validated clinical surrogates. The Mediterranean diet is the most evidence-supported strategy, with consistent HOMA-IR reductions, a 31% decrease in T2DM incidence (PREDIMED-Plus), and demonstrated efficacy across T2DM, MASLD, and PCOS. Low-GI and DASH diets improve postprandial insulin dynamics and are particularly effective in PCOS. Low-carbohydrate and ketogenic diets produce the largest short-term reductions in fasting glucose and insulin secretion, though long-term sustainability requires further study. Plant-based diets and intermittent fasting improve IR primarily via weight loss and gut microbiota modulation. Most studies rely on surrogate IR indices and are short-term (≤26 weeks). Conclusions: Dietary pattern selection should be individualized according to metabolic phenotype, comorbidities, and adherence potential. Larger, longer, head-to-head trials measuring hard clinical outcomes are needed. Full article

(This article belongs to the Special Issue Customized Dietary Interventions for Patients with Diabetes)

► Show Figures

Figure 1

26 pages, 1136 KB

Open AccessEditor’s ChoiceReview

Diet, the Gut Microbiome, and Estrogen Physiology: A Review in Menopausal Health and Interventions

by Michelle Jing Sin Lim, Elvina Parlindungan, E’ein See, Ching Hwee Gan, Rachel Yap and Germaine Jia Min Yong

Nutrients 2026, 18(7), 1052; https://doi.org/10.3390/nu18071052 - 26 Mar 2026

Cited by 6 | Viewed by 7534

Abstract

Menopause represents a key transitional phase in women’s health, characterized by declining estrogen levels and increased risk for cardiometabolic, musculoskeletal, and urogenital disorders. Beyond its endocrine roots, emerging evidence highlights the gut microbiome as a critical modulator of systemic hormonal balance. This review [...] Read more.

Menopause represents a key transitional phase in women’s health, characterized by declining estrogen levels and increased risk for cardiometabolic, musculoskeletal, and urogenital disorders. Beyond its endocrine roots, emerging evidence highlights the gut microbiome as a critical modulator of systemic hormonal balance. This review synthesizes current understanding of the bidirectional relationship between estrogen and the gut microbiome and its implications for women’s health during menopause. Evidence from current studies reveals distinct findings across populations, reflecting the complexity of estrogen regulation in part by the gut microbiome (i.e., estrobolome). While no ideal gut microbial composition has been identified for women across stages of perimenopause, likely due to geographically unique gut microbiome profiles among healthy women, greater microbial diversity has been positively associated with improved estrogen regulation. Conversely, reduced diversity and altered Firmicutes/Bacteroidetes ratios have been linked to biomarkers of inflammation during perimenopause, which is a key driver across many perimenopausal symptoms. Although hormone replacement therapy remains the primary clinical intervention during perimenopause, we highlight emerging evidence on the adjuvant potential of diet, synbiotics, phytoestrogens, and strain-specific probiotics in modulating the estrogen–gut microbiome axis for improved health span trajectories and better symptom management. Future longitudinal studies integrating diet, gut microbiome profiles and symptom trajectories are essential to clarify these mechanisms across ethnicity and geography. Ultimately, understanding localized diet–microbiome interactions will enable the development of accessible, personalized, and non-hormonal strategies to complement and increase agency in proactive management during the perimenopausal transition. Full article

(This article belongs to the Special Issue The Role of Diet and Microbiome in Peri/Menopause)

► Show Figures

Figure 1

30 pages, 920 KB

Open AccessEditor’s ChoiceReview

Biological Activity of Hops (Humulus lupulus L.): Molecular Mechanisms and Significance for Human Health—A Review

by Łukasz Kogut, Czesław Puchalski, Julia Jastrzębska and Grzegorz Zaguła

Nutrients 2026, 18(7), 1056; https://doi.org/10.3390/nu18071056 - 26 Mar 2026

Cited by 3 | Viewed by 2822

Abstract

Introduction/Objective: Common hop (Humulus lupulus L.) is a multi-component plant material that has been extensively studied for its antioxidant, anti-inflammatory, cardioprotective, metabolic, neuroprotective, immunomodulatory and anti-cancer properties. This review summarises current data on the molecular mechanisms of action of hop compounds, their [...] Read more.

Introduction/Objective: Common hop (Humulus lupulus L.) is a multi-component plant material that has been extensively studied for its antioxidant, anti-inflammatory, cardioprotective, metabolic, neuroprotective, immunomodulatory and anti-cancer properties. This review summarises current data on the molecular mechanisms of action of hop compounds, their therapeutic potential, metabolic interactions and biological significance, with particular emphasis on bioavailability, signalling pathways and organ-specific effects. Methods: A comprehensive literature review was conducted, covering in vitro and in vivo studies and available clinical trials analysing the biochemical activity, molecular targets and physiological effects of bioactive compounds in hops. Particular attention was paid to the regulation of oxidative stress, inflammatory signalling, mitochondrial function, metabolic pathways, interactions with the gut microbiota and their impact on the development of chronic diseases. Results: Bioactive compounds in hops modulate numerous key signalling pathways, including NF-κB, Nrf2, AMPK, MAPK, PPAR and PI3K/AKT/mTOR. They have been shown to reduce oxidative stress, inhibit the production of pro-inflammatory cytokines, regulate apoptosis, improve mitochondrial function, and activate endogenous antioxidant systems. Hops have a protective effect in cardiovascular diseases, metabolic disorders, neurodegenerative diseases and selected cancers through anti-inflammatory, anti-proliferative and metabolic mechanisms. In addition, hop compounds modulate the composition and activity of the gut microbiota, which promotes improved metabolic homeostasis. Despite relatively good intestinal absorption, systemic bioavailability remains limited; however, modern delivery systems significantly increase the stability and plasma concentrations of these compounds. Conclusions: Common hops have broad therapeutic potential due to their ability to regulate oxidative, inflammatory, metabolic and apoptotic processes at multiple levels. Their pleiotropic activity makes them a promising candidate for the prevention and treatment of chronic diseases. The development of delivery systems and consideration of the role of the gut microbiota may further increase its clinical application. Full article

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

► Show Figures

Figure 1

26 pages, 871 KB

Open AccessEditor’s ChoiceReview

Physiological Regulation of Nutritional and Metabolic Biomarkers in Obesity: Implications for Precision Nutrition

by Girolamo Di Maio, Maria Giovanna Tafuri, Maria Casillo, Antonietta Messina, Salvatore Allocca, Ines Villano, Fiorenzo Moscatelli, Antonietta Monda, Marco La Marra and Vincenzo Monda

Nutrients 2026, 18(6), 1014; https://doi.org/10.3390/nu18061014 - 23 Mar 2026

Cited by 15 | Viewed by 3002

Abstract

Obesity represents a heterogeneous metabolic disorder characterized by substantial interindividual variation in inflammatory status, insulin sensitivity, and cardiometabolic risk. Traditional anthropometric measures fail to capture this metabolic diversity, limiting risk stratification and personalized intervention strategies. This review critically examines nutritional and metabolic biomarkers [...] Read more.

Obesity represents a heterogeneous metabolic disorder characterized by substantial interindividual variation in inflammatory status, insulin sensitivity, and cardiometabolic risk. Traditional anthropometric measures fail to capture this metabolic diversity, limiting risk stratification and personalized intervention strategies. This review critically examines nutritional and metabolic biomarkers that reflect the physiological dysregulation underlying obesity, including adipokines (leptin, adiponectin, resistin), inflammatory markers (C-reactive protein, interleukin-6, TNF-α), insulin resistance indices (HOMA-IR, fasting insulin, HbA1c), and lipid metabolism indicators (LDL cholesterol, triglycerides, HDL cholesterol, and liver enzymes such as ALT and GGT). Among these, elevated CRP, reduced adiponectin, and increased HOMA-IR have demonstrated the strongest clinical utility for early metabolic risk identification. We further evaluate emerging biomarkers—including circulating microRNAs, gut microbiota-derived metabolites (short-chain fatty acids, TMAO, lipopolysaccharides), and bile acid profiles—which offer additional mechanistic insight into diet–microbiome–host interactions. We systematically assess the mechanistic basis, clinical relevance, and nutritional modulation of each biomarker class, emphasizing how dietary composition—particularly fatty acid quality, fiber intake, and overall dietary patterns such as the Mediterranean diet—influences biomarker profiles and metabolic outcomes. Furthermore, we explore how biomarker-based phenotyping enables precision nutrition approaches by identifying individuals most likely to benefit from specific dietary interventions. Integration of multi-biomarker panels with clinical and genetic data holds promise for advancing from population-based dietary guidelines toward individualized nutrition strategies that optimize metabolic health and prevent obesity-related complications. Future research should prioritize validating biomarker-guided intervention frameworks, establishing standardized thresholds across diverse populations, and developing clinically implementable tools for personalized nutritional medicine. Full article

(This article belongs to the Special Issue Nutritional and Metabolic Biomarkers in Obesity)

► Show Figures

Figure 1

22 pages, 1375 KB

Open AccessEditor’s ChoiceArticle

Dietary Patterns, Cooking Methods, and Their Association with Prediabetes Risk Markers in Romanian University Students: A Cross-Sectional Analysis

by Teodora Piroș, Raluca Lupusoru, Lavinia Cristina Moleriu, Călin Muntean, Radu Dumitru Moleriu, Dora Mihalea Cîmpian, Mădălina Gabriela Cincu, Elena Gabriela Strete, Amalia Gabriela Timofte and Ruxandra-Cristina Marin

Nutrients 2026, 18(6), 977; https://doi.org/10.3390/nu18060977 - 19 Mar 2026

Cited by 3 | Viewed by 1131

Abstract

Background: Young adulthood represents a critical period for the emergence of early metabolic disturbances, potentially influenced by dietary shifts toward convenience and ultra-processed foods. However, evidence linking dietary patterns and cooking practices with objective metabolic biomarkers in Romanian university students remains limited. [...] Read more.

Background: Young adulthood represents a critical period for the emergence of early metabolic disturbances, potentially influenced by dietary shifts toward convenience and ultra-processed foods. However, evidence linking dietary patterns and cooking practices with objective metabolic biomarkers in Romanian university students remains limited. Methods: This cross-sectional study included 693 students aged 18–24 years at the Victor Babeș University of Medicine and Pharmacy, Romania (June–July 2025). Dietary habits, food preferences, and cooking practices were assessed using a structured online questionnaire, while anthropometric and biochemical data were obtained from university health records. The primary outcome was glycated hemoglobin (HbA1c), a marker of average blood glucose levels over the previous 2–3 months. Prediabetes was defined as HbA1c 5.7–6.4%. Dietary patterns were identified using k-means clustering based on fast-food consumption frequency, main meal of the day, fruit and vegetable intake frequency, and predominant cooking method. Multivariable regression models assessed associations between dietary variables and glycemic or lipid outcomes. Results: Prediabetes prevalence was 21.1% (diabetes: 1.4%). Three dietary patterns were identified: health-conscious (prediabetes 15.4%), mixed (20.0%), and fast-food oriented (27.3%; χ² p = 0.003). Fast-food consumption frequency was independently associated with higher prediabetes risk (OR = 1.78 per category; 95% CI 1.38–2.30; p < 0.001) and higher HbA1c levels (β = 0.147; p < 0.001), while fruit and vegetable intake showed an inverse association with HbA1c (β = −0.109; p < 0.001). A dose–response relationship was observed between fast-food frequency and both HbA1c and prediabetes prevalence (p-trend < 0.001). An interaction between high-temperature cooking methods and frequent fast-food consumption was observed for HbA1c (p = 0.023). BMI and sex were the strongest predictors of lipid outcomes, although fast-food intake was associated with higher triglyceride levels (p = 0.034). Conclusions: Among Romanian university students, dietary patterns characterized by frequent fast-food consumption were associated with higher HbA1c levels and greater prediabetes prevalence. A high-temperature cooking method was associated with higher glycemic levels when combined with frequent fast-food intake. These findings suggest that early dietary behaviors during university years may be relevant for metabolic risk profiles in young adults. Full article

(This article belongs to the Special Issue Dietary Factors and Emotion and Cognitive Health)

► Show Figures

Figure 1

31 pages, 601 KB

Open AccessEditor’s ChoiceReview

Generative AI in Precision Nutrition: A Review of Current Developments and Future Directions

by Lubnaa Abdur Rahman, Vasileios Dedousis, Ioannis Papathanail, Rooholla Poursoleymani, Maria Kafyra, Ioanna Panagiota Kalafati and Stavroula Georgia Mougiakakou

Nutrients 2026, 18(6), 938; https://doi.org/10.3390/nu18060938 - 17 Mar 2026

Cited by 6 | Viewed by 4437

Abstract

Background: Precision nutrition (PN) aims to personalize dietary guidance by accounting for inter-individual variability across biological, metabolic, lifestyle, and environmental factors influencing nutritional needs and health outcomes. While traditional Artificial Intelligence (AI) has advanced nutritional research through systems like automated dietary assessment, these [...] Read more.

Background: Precision nutrition (PN) aims to personalize dietary guidance by accounting for inter-individual variability across biological, metabolic, lifestyle, and environmental factors influencing nutritional needs and health outcomes. While traditional Artificial Intelligence (AI) has advanced nutritional research through systems like automated dietary assessment, these models often operate rigidly. Generative AI (GenAI) introduces the capacity for adaptive interventions for enhanced PN. However, the scope and maturity of its applications remain insufficiently characterized. Objective: This review examined original works applying GenAI in PN, focusing on application, methodology, and limitations. Methods: A systematic search was conducted in PubMed, ACM Digital Library, and Scopus. Inclusion criteria focused on original works deploying GenAI models in PN contexts. Included works were further formally assessed based on data used, validation, transparency, bias, and security and privacy. Results: 21 eligible studies were identified, all published after 2024. The literature indicated a surge in large language model-based systems for personalized dietary recommendations, followed by applications in data foundation building and food effect understanding. A recurrent limitation was questionable evaluation on synthetic data and hallucinations, necessitating a human-expert-in-the-loop, especially in high-stakes clinical settings. Additionally, only 4 of 21 reviewed studies incorporated biological content or biological inputs, and fewer approached biologically grounded PN within implemented personalization workflows using metabolic and/or genomic variables. Conclusions: Although GenAI research in PN is expanding rapidly, most applications remain personalized at a user-preference level rather than including biological determinants. The need for standardized reporting, stronger genome-informed modeling, and consistent human-in-the-loop validation protocols is further highlighted to advance towards holistic PN. Full article

(This article belongs to the Special Issue Current Insights into Genome-Based Personalized Nutrition Technology)

► Show Figures

Figure 1

21 pages, 1299 KB

Open AccessEditor’s ChoiceReview

System-Level, Molecular and Cellular Mechanisms of Selected Plant Adaptogens—A Review

by Sebastian Such, Czesław Puchalski, Łukasz Kogut and Grzegorz Zaguła

Nutrients 2026, 18(6), 931; https://doi.org/10.3390/nu18060931 - 16 Mar 2026

Cited by 8 | Viewed by 3891

Abstract

Background/Objectives: Adaptogens are plant-derived substances that enhance the body’s nonspecific resistance to physical, chemical, biological, and psychological stressors by normalizing physiological functions. This article discusses the molecular mechanisms of action of seven key plant adaptogens—Rhodiola rosea, Schisandra chinensis, Withania [...] Read more.

Background/Objectives: Adaptogens are plant-derived substances that enhance the body’s nonspecific resistance to physical, chemical, biological, and psychological stressors by normalizing physiological functions. This article discusses the molecular mechanisms of action of seven key plant adaptogens—Rhodiola rosea, Schisandra chinensis, Withania somnifera, Eleutherococcus senticosus, Panax ginseng, Ocimum tenuiflorum, and Bacopa monnieri—in the context of chronic stress and lifestyle-related diseases. Methods: A review of the scientific literature is performed, including preclinical in vitro and in vivo studies, randomized placebo-controlled clinical trials, and studies employing network pharmacology analyses, molecular docking, and genomic techniques such as gene expression profiling. The interactions of active constituents with signaling pathways, molecular targets, and synergistic mechanisms were analyzed based on publications from the years 2010–2025. Results: Adaptogens exhibit pleiotropic activity: they regulate the HPA axis (Hypothalamic–Pituitary–Adrenal axis); induce Hsp70/Hsp16 expression; modulate SAPK/JNK, FOXO, and NF-κB pathways; and demonstrate antioxidant and mitoprotective effects. Specific mechanisms include: salidroside from R. rosea activating PI3K/Akt; schizandrin B from S. chinensis stimulating Hsp70; withanolides from W. somnifera inhibiting PDE4D; ginsenosides from P. ginseng suppressing FKBP51; and bacosides from B. monnieri enhancing acetylcholine synthesis. Clinical studies confirm reductions in cortisol levels (14–30%), decreased fatigue, and improved cognitive function without adverse effects. Conclusions: Understanding the molecular mechanisms of adaptogens supports their application in integrative medicine for the treatment of stress-related disorders, depression, anxiety, and neurodegenerative diseases. Further clinical studies are needed to optimize dosages and standardize extracts. Full article

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

► Show Figures

Figure 1

23 pages, 2398 KB

Open AccessEditor’s ChoiceArticle

Extracellular Vesicles from the Probiotic Yeast Pichia kudriavzevii: Proteomic Characterization and Modulation of Immune and Defense Responses in an Induced Inflammation Model of Intestinal Epithelial Cells

by Angela Maione, Monica Matuozzo, Marianna Imparato, Chiara D’Ambrosio, Elisabetta de Alteriis, Marco Guida, Andrea Scaloni and Emilia Galdiero

Nutrients 2026, 18(6), 912; https://doi.org/10.3390/nu18060912 - 13 Mar 2026

Cited by 4 | Viewed by 1289

Abstract

Background/Objectives: Extracellular vesicles (EVs) derived from probiotics represent a new and exciting frontier in host-microbe therapeutics. These nanoscale carriers are not merely cellular byproducts but are sophisticated mediators of intercellular communication, capable of modulating immune responses, reducing inflammation, and inhibiting pathogens through [...] Read more.

Background/Objectives: Extracellular vesicles (EVs) derived from probiotics represent a new and exciting frontier in host-microbe therapeutics. These nanoscale carriers are not merely cellular byproducts but are sophisticated mediators of intercellular communication, capable of modulating immune responses, reducing inflammation, and inhibiting pathogens through a rich cargo of bioactive molecules. Methods: The EVs isolated from the culture supernatants of the yeast probiotic candidate Pichia kudriavzevii were characterized for their dimensions, protein composition, and targeting both the gut pathogen virulence and the host inflammatory response. Results: The vesicles had a size distribution from 100 to 150 nm, which is consistent with previous reports on fungal EVs. Proteomic analysis of the purified EVs identified a complex array of 189 proteins, hypothesized to be responsible for some of the antimicrobial and immunomodulatory properties observed. Safety was a key consideration, and the isolated EVs demonstrated no cytotoxicity in human Caco-2 cells and no in vivo toxicity in the Galleria mellonella larval model, confirming their potential for safe use. Conclusions: The field is moving towards a new era of “postbiotics,” where cell-free therapies offer a safer, more stable alternative to live probiotics. Full article

(This article belongs to the Section Nutritional Immunology)

► Show Figures

Figure 1

15 pages, 1458 KB

Open AccessEditor’s ChoiceArticle

Cardiometabolic Risk Profiles Associated with Chronic Gastrointestinal Symptoms in Adults: A Cross-Sectional Exploratory Analysis Using Routine Clinical Markers

by Ramona Alina Tomuța, Roxana Daniela Brata, Marc Cristian Ghitea, Evelin Claudia Ghitea, Maria Flavia Gîtea, Timea Claudia Ghitea and Florin Banica

Nutrients 2026, 18(6), 892; https://doi.org/10.3390/nu18060892 - 12 Mar 2026

Cited by 3 | Viewed by 944

Abstract

Background: Persistent gastrointestinal (GI) symptoms are common in adults and are often considered functional conditions. Emerging evidence suggests that gastrointestinal function may be intertwined with systemic metabolic regulation, yet the association between chronic GI symptoms and cardiometabolic risk assessed using routine clinical biomarkers [...] Read more.

Background: Persistent gastrointestinal (GI) symptoms are common in adults and are often considered functional conditions. Emerging evidence suggests that gastrointestinal function may be intertwined with systemic metabolic regulation, yet the association between chronic GI symptoms and cardiometabolic risk assessed using routine clinical biomarkers remains insufficiently explored. Methods: In this cross-sectional observational study, 93 adults were consecutively enrolled during routine clinical evaluations. Anthropometric parameters, fasting plasma glucose, glycated hemoglobin (HbA1c), lipid profile, and blood pressure were assessed. Participants were classified as having persistent gastrointestinal symptoms (GI+) or being asymptomatic (GI−) based on symptom duration and clinical documentation. A composite metabolic stress score, derived from routinely available biomarkers, was used to summarize multidimensional cardiometabolic burden. Group comparisons and correlation analyses were performed using non-parametric methods. Results: Participants with persistent gastrointestinal symptoms exhibited higher triglyceride levels, lower HDL-cholesterol concentrations, and higher fasting plasma glucose compared with asymptomatic individuals (all p < 0.05). The composite metabolic stress score was significantly higher in the GI+ group, indicating greater overall cardiometabolic burden, while body mass index and HbA1c did not differ significantly between groups. Conclusions: Persistent gastrointestinal symptoms were associated with an unfavorable cardiometabolic profile characterized by atherogenic dyslipidemia and impaired fasting glycemia. An exploratory composite metabolic stress score based on routine clinical biomarkers effectively summarized this pattern. These findings support the biological plausibility of shared metabolic vulnerability between gastrointestinal symptom burden and cardiometabolic risk and highlight the need for longitudinal and mechanistic studies incorporating objective gastrointestinal and metabolic biomarkers. Full article

(This article belongs to the Section Nutritional Epidemiology)

► Show Figures

Figure 1

20 pages, 936 KB

Open AccessEditor’s ChoiceReview

Bioactive Compounds from Cruciferous Vegetables as a Therapeutic Option for the Prevention and Treatment of Cardiovascular Diseases

by Beata Olas

Nutrients 2026, 18(5), 810; https://doi.org/10.3390/nu18050810 - 1 Mar 2026

Cited by 4 | Viewed by 2376

Abstract

Vegetables, including cruciferous vegetables, contain a variety of active compounds with cardioprotective potential, for example fiber, minerals, and phytochemicals such as phenolic compounds, terpenes, carotenoids, and others. Cruciferous vegetables are also particularly rich in sulfur-containing compounds such as glucosinolates, which have cardioprotective effects. [...] Read more.

Vegetables, including cruciferous vegetables, contain a variety of active compounds with cardioprotective potential, for example fiber, minerals, and phytochemicals such as phenolic compounds, terpenes, carotenoids, and others. Cruciferous vegetables are also particularly rich in sulfur-containing compounds such as glucosinolates, which have cardioprotective effects. However, there is little information about the molecular mechanisms of their action. This paper reviews the current state of knowledge regarding the cardioprotective capacity of cruciferous vegetables; it also examines their chemical composition and the mechanisms behind this biological property. In this narrative review, the author also summarizes data on changes in the content of various bioactive compounds (especially phenolic compounds, carotenoids, and glucosinolates) and their biological properties, including cardioprotective efficacy during vegetable processing (for example, lactic acid fermentation, cooking and other). Full article

(This article belongs to the Special Issue Exploring the Key to Healthy Cardiac Metabolism: Managing Diet, Nutrients, and Lifestyle Choices)

► Show Figures

Figure 1

14 pages, 455 KB

Open AccessEditor’s ChoiceReview

The Role of Ketogenic Diet and β-Hydroxybutyrate in the Prevention of Muscle Catabolism and Sarcopenia in Aging Populations: Mechanisms, Evidence, and Clinical Perspectives

by Claudia Venturini, Giulia Matacchione, Lucia Mancinelli, Sara Caccese, Michele Alfieri, Fabrizia Lattanzio, Fabiola Olivieri and Roberto Antonicelli

Nutrients 2026, 18(5), 761; https://doi.org/10.3390/nu18050761 - 26 Feb 2026

Cited by 3 | Viewed by 3574

Abstract

Sarcopenia, characterized by the progressive loss of skeletal muscle mass, strength, and function, represents a growing public health challenge in aging populations. Emerging mechanistic evidence suggests that ketogenic diets (KDs) and elevated circulating β-hydroxybutyrate (βOHB) levels may offer selective and context-dependent nutritional strategies [...] Read more.

Sarcopenia, characterized by the progressive loss of skeletal muscle mass, strength, and function, represents a growing public health challenge in aging populations. Emerging mechanistic evidence suggests that ketogenic diets (KDs) and elevated circulating β-hydroxybutyrate (βOHB) levels may offer selective and context-dependent nutritional strategies to support muscle health during aging. This review summarizes current evidence on the effects of ketogenic diets and ketone body metabolism on muscle mass and function, with a focus on underlying molecular mechanisms and clinical relevance in older adults. βOHB acts not only as an alternative energy substrate but also as a signaling molecule, notably through histone deacetylase inhibition and modulation of inflammatory pathways. Nutritional ketosis in humans typically results in circulating βOHB concentrations of approximately 0.5–3.0 mM, which may be sufficient to engage some of these signaling pathways, although the extent of these effects in human tissues remains incompletely defined. Preclinical studies indicate that long-term ketogenic diets preserve muscle mass, strength, and mitochondrial function in aging models. Limited clinical evidence, largely derived from populations with sarcopenic obesity or metabolic comorbidities, suggests that protein-adequate ketogenic diets, when implemented as an adjunct to physical exercise, may help preserve fat-free mass and improve functional outcomes, while exogenous ketones show potential to augment post-exercise anabolic signaling. Overall, the integration of mechanistic and preliminary clinical data provides a supplementary and exploratory framework suggesting that ketogenic diets may represent a promising adjunctive strategy for sarcopenia prevention, although well-designed long-term randomized controlled trials are required to define their efficacy, safety, and optimal clinical application. Full article

(This article belongs to the Special Issue The Effects of Ketogenic Diet on Human Health and Disease)

► Show Figures

Graphical abstract

18 pages, 1501 KB

Open AccessEditor’s ChoiceArticle

Effect of Prebiotic Supplementation With and Without Physiotherapy on Pain and Pain Sensitivity in People with Knee Osteoarthritis

by Afroditi Kouraki, Susan Franks, Amrita Vijay, Thomas Kurien, Moira A. Taylor, Stephanie L. Smith, Benjamin Smith, Anthony Kelly and Ana M. Valdes

Nutrients 2026, 18(5), 714; https://doi.org/10.3390/nu18050714 - 24 Feb 2026

Cited by 6 | Viewed by 13019

Abstract

Background: Emerging evidence links the gut microbiome to chronic pain processing. Inulin, a prebiotic fibre, modulates the gut microbiome, while physiotherapy-supported exercise (PSE) improves pain and function. We evaluated the effects of inulin supplementation with and without PSE on knee osteoarthritis (OA) [...] Read more.

Background: Emerging evidence links the gut microbiome to chronic pain processing. Inulin, a prebiotic fibre, modulates the gut microbiome, while physiotherapy-supported exercise (PSE) improves pain and function. We evaluated the effects of inulin supplementation with and without PSE on knee osteoarthritis (OA) pain. Methods: In a 2 × 2 factorial RCT, 117 community-dwelling adults with knee OA received 6 weeks of: (A) 20 g/day inulin, (B) digital PSE (Joint Academy™), (C) inulin +PSE, or (D) 10 g/day maltodextrin. Primary outcome: pain (Numerical Rating Scale). Secondary: 30 s sit-to-stand (30-CST), timed up and go (TUG), grip strength, and quantitative sensory testing. Serum short-chain fatty acids (SCFAs) and glucagon-like peptide-1 (GLP-1) were measured. The study was not powered to detect synergistic interaction. Results: A total of 117 participants (58.1% female; mean ± SD age = 67.5 ± 9.4 years; BMI = 29.5 ± 5.3 kg/m²; NRS = 3.96 ± 2.67) completed the trial. Pain improved with inulin (baseline-adjusted between-group mean difference (Δ) = −1.11 [95%CI −2.18, −0.04], p = 0.045) and PSE (Δ = −1.55 [95%CI −2.52, −0.58], p = 0.002) compared to placebo, with no synergistic effect. PSE improved TUG (p = 0.02) and 30-CST (p = 0.0004), while inulin improved grip strength (p = 0.002), pressure pain thresholds (p = 0.009) and temporal summation (p = 0.025) compared to placebo and had significantly lower dropout rates (3.6%) compared with PSE (21% p < 0.01). Only inulin increased SCFA butyrate (p = 0.0248) and GLP-1 (p = 0.0109), and higher GLP-1 was associated with improved grip strength, suggesting a gut–muscle link. Conclusions: Inulin and PSE each produced meaningful pain reductions. Only inulin improved pain sensitivity and grip strength, the latter paralleled by increased GLP-1, and had much higher rates of retention compared to PSE. Full article

(This article belongs to the Special Issue The Role of Nutritional Interventions in the Prevention and Management of Osteoarthritis)

► Show Figures

Graphical abstract

17 pages, 2039 KB

Open AccessEditor’s ChoiceArticle

Short-Term Effects of Broccoli-Derived Glucoraphanin on Recovery from Eccentric Muscle Damage: A Double-Blind Randomized Crossover Study

by Leonardo Cesanelli, Rono Thomas, Mantas Mickevičius, Audrius Sniečkus, Dalia Mickevičienė, Tomas Venckūnas, Arvydas Stasiulis and Sigitas Kamandulis

Nutrients 2026, 18(4), 710; https://doi.org/10.3390/nu18040710 - 23 Feb 2026

Cited by 4 | Viewed by 1542

Abstract

Background/Objectives: Broccoli-derived glucoraphanin (a sulforaphane precursor that activates Nrf2 defenses) may aid repair; however, its short-term effects in humans remain unknown. This study aimed to evaluate whether short-term supplementation with broccoli-derived glucoraphanin improves recovery from exercise-induced muscle damage. We hypothesized that short-term [...] Read more.

Background/Objectives: Broccoli-derived glucoraphanin (a sulforaphane precursor that activates Nrf2 defenses) may aid repair; however, its short-term effects in humans remain unknown. This study aimed to evaluate whether short-term supplementation with broccoli-derived glucoraphanin improves recovery from exercise-induced muscle damage. We hypothesized that short-term supplementation with broccoli-derived glucoraphanin would attenuate exercise-induced muscle damage and accelerate recovery. Methods: In a randomized, double-blind, placebo-controlled crossover design, fifteen participants consumed either high-glucoraphanin broccoli powder (320 μg) or placebo for two weeks, followed by elbow flexor eccentric exercise. Strength, soreness, creatine kinase (CK), range of motion (ROM), arm girths, and ultrasound-assessed muscle and tendon morphology were measured at baseline, immediately post-exercise, and at 48 and 96 h post-exercise. Results: Significant main effects of time were observed for isometric and isokinetic torque (p < 0.05), CK (p < 0.05), soreness (p < 0.05), and structural swelling markers (p < 0.05), confirming exercise-induced muscle damage. However, there were no significant Time × Supplement interactions for any variable (p > 0.05), indicating that glucoraphanin did not influence recovery dynamics. Conclusions: These findings suggest that short-term high-dose broccoli supplementation reconstituted with hot water does not modulate recovery following eccentric muscle damage under the conditions tested, including the chosen preparation method and experimental context. Full article

(This article belongs to the Special Issue Nutrition Strategy and Resistance Training)

► Show Figures

Figure 1

19 pages, 777 KB

Open AccessEditor’s ChoiceReview

Dietary Fiber in Endometriosis: Mechanisms, Evidence, and Potential Clinical Benefits—Up-to-Date Review

by Justyna Czerniak, Michał Ciebiera, Natalia Zeber-Lubecka and Piotr Olcha

Nutrients 2026, 18(4), 690; https://doi.org/10.3390/nu18040690 - 21 Feb 2026

Cited by 4 | Viewed by 4043

Abstract

Background: Endometriosis is a chronic, estrogen-dependent inflammatory disorder. It is associated with hormonal dysregulation, pelvic pain, and a reduced quality of life. Dietary factors may influence disease development and symptom severity. Objective: This article aims to summarize current evidence on the role of [...] Read more.

Background: Endometriosis is a chronic, estrogen-dependent inflammatory disorder. It is associated with hormonal dysregulation, pelvic pain, and a reduced quality of life. Dietary factors may influence disease development and symptom severity. Objective: This article aims to summarize current evidence on the role of dietary fiber in endometriosis and to discuss the underlying biological mechanisms and clinical implications. Methods: A narrative review of the literature was conducted using peer-reviewed original research articles and review papers published in English. Studies examining dietary fiber intake, fiber-rich dietary patterns, and their associations with endometriosis risk, symptoms, estrogen metabolism, gut microbiota, and inflammation. Results: Observational studies suggest that higher dietary fiber intake, particularly from fruits, vegetables, and whole grains, may be associated with a reduced risk of endometriosis. Interventional evidence remains limited. However, available studies indicate that fiber-rich dietary patterns may contribute to pain reduction and improvements in quality of life. Conclusions: Current evidence suggests that dietary fiber may play a supportive role in the prevention and management of endometriosis through multiple interconnected biological pathways. Nevertheless, the limited number of high-quality interventional studies highlights the need for further well-designed clinical trials to clarify the therapeutic potential of fiber-rich diets as an adjunct to standard endometriosis care. Full article

(This article belongs to the Special Issue Nutrition, Dietary Patterns, and Biochemical Mechanisms in Endometriosis)

► Show Figures

Figure 1

19 pages, 923 KB

Open AccessEditor’s ChoiceReview

The Role of Dietary Fibers in the Management of Type 2 Diabetes: A Synthesis of Current Evidence and Clinical Implications

by Finta Hajnal, Ruța Florina, Avram Călin, Toncean Florentina Simona and Georgescu Mihai

Nutrients 2026, 18(4), 691; https://doi.org/10.3390/nu18040691 - 21 Feb 2026

Cited by 4 | Viewed by 4303

Abstract

Type 2 diabetes (T2D) represents a major public health challenge, being associated with significant metabolic and cardiovascular complications. Evidence-based nutritional interventions are essential for the prevention and management of the disease. Dietary fibers, particularly soluble fibers such as psyllium, β-glucan, inulin, and fermentable [...] Read more.

Type 2 diabetes (T2D) represents a major public health challenge, being associated with significant metabolic and cardiovascular complications. Evidence-based nutritional interventions are essential for the prevention and management of the disease. Dietary fibers, particularly soluble fibers such as psyllium, β-glucan, inulin, and fermentable fiber blends, have demonstrated beneficial effects on glycemia, glycated hemoglobin (HbA1c), lipid profile, body weight, and medication requirements. This narrative review synthesizes the results of recent clinical trials and meta-analyses, highlighting the underlying physiological mechanisms, including colonic fermentation and short-chain fatty acid (SCFA) production, as well as the impact on gut microbiota composition. The findings support the integration of soluble fibers into a personalized dietary plan as part of a multidimensional strategy for T2D management. Further long-term randomized studies are warranted to standardize doses and assess the metabolic and microbiota-mediated effects of dietary fibers. Full article

(This article belongs to the Special Issue Dietary Regulation of Glucose and Lipid Metabolism in Diabetes)

► Show Figures

Figure 1

27 pages, 2418 KB

Open AccessEditor’s ChoiceReview

Prebiotics and Synbiotics in Asthma: An Integrative Review of Human Trials and Murine Meta-Analysis

by Louise C. Bonnard, Graham R. Sharpe, Matthew Martin, Georgina F. Dodd and Neil C. Williams

Nutrients 2026, 18(4), 683; https://doi.org/10.3390/nu18040683 - 20 Feb 2026

Cited by 3 | Viewed by 1055

Abstract

Background/Objectives: The objectives of this study were to systematically review the literature on the effects of prebiotics and synbiotics on asthma control, lung function and asthma-associated inflammation from murine and human trials. Methods: A systematic review was performed following the PRISMA guidelines across [...] Read more.

Background/Objectives: The objectives of this study were to systematically review the literature on the effects of prebiotics and synbiotics on asthma control, lung function and asthma-associated inflammation from murine and human trials. Methods: A systematic review was performed following the PRISMA guidelines across multiple databases. A meta-analysis was performed on murine trials assessing asthma-associated inflammation and airway hyperresponsiveness, whilst a narrative review of human studies assessed asthma control, lung function, and inflammation. Results: Seventeen studies met the eligibility criteria for inclusion; eleven murine studies were included for meta-analysis and six human studies were for narrative review. The meta-analysis revealed significant effects of prebiotics and synbiotics on multiple markers of asthma-associated inflammation. Prebiotic intervention significantly reduced airway hyperresponsiveness (AHR) and type 2 cytokines (IL-4, IL-5, IL-13) and various cell counts, including neutrophil, macrophage, lymphocyte, eosinophil, and total bronchoalveolar (BALF). Synbiotics were also effective in reducing type 2 cytokines, including, IL-4, IL-5, IL-13, and lymphocytes, eosinophils, and total BALF cell count. A narrative review of human intervention trials of prebiotics and/or synbiotics revealed improvements in lung function, asthma control, and systemic and airway inflammation. Conclusions: This review indicates that dietary prebiotics and synbiotics may be suitable adjunct treatments to support asthma management, but further well-controlled human RCTs are required. Full article

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

► Show Figures

Graphical abstract

14 pages, 473 KB

Open AccessEditor’s ChoiceReview

Micronutrient Deficiencies in the Era of Second-Generation Incretin-Based Therapies for Obesity

by Andrijana Koceva, Andrej Janež, Tajda Pečko and Mojca Jensterle

Nutrients 2026, 18(4), 677; https://doi.org/10.3390/nu18040677 - 19 Feb 2026

Cited by 5 | Viewed by 2261

Abstract

Second-generation incretin-based therapies have transformed the pharmacological management of obesity by inducing substantial and sustained weight loss. The weight-reducing effects are primarily mediated through appetite suppression, reduced energy intake, and modulation of eating behavior. While therapeutically beneficial, these mechanisms may also influence dietary [...] Read more.

Second-generation incretin-based therapies have transformed the pharmacological management of obesity by inducing substantial and sustained weight loss. The weight-reducing effects are primarily mediated through appetite suppression, reduced energy intake, and modulation of eating behavior. While therapeutically beneficial, these mechanisms may also influence dietary quality, micronutrient exposure, and overall nutritional status, particularly in individuals with obesity, a population already characterized by a high prevalence of baseline nutritional inadequacy. This narrative review is intended to inform clinicians, clinical nutrition specialists and researchers involved in obesity management by summarizing baseline micronutrient vulnerability in obesity, synthesizing available evidence on dietary intake, biochemical micronutrient status, and nutrition-related clinical outcomes during incretin-based therapy, discussing plausible mechanisms linking these therapies to micronutrient risk, and outlining approaches to risk-stratified nutritional monitoring in clinical practice. Full article

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

► Show Figures

Figure 1

33 pages, 3004 KB

Open AccessEditor’s ChoiceReview

A Global Perspective on Metabolic Dysfunction-Associated Steatotic Liver Disease: From Molecular Mechanisms to Therapeutic Strategy Innovation

by Yanhao Qiu, Juan Carlos Laguna, Marta Alegret and Laia Vilà

Nutrients 2026, 18(4), 679; https://doi.org/10.3390/nu18040679 - 19 Feb 2026

Cited by 10 | Viewed by 2429

Abstract

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a prevalent global health issue driven by metabolic syndrome, with cardiovascular disease being the leading cause of mortality. This review synthesizes current knowledge on its multifactorial pathogenesis, the impact of sexual dimorphism, and key experimental models. [...] Read more.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a prevalent global health issue driven by metabolic syndrome, with cardiovascular disease being the leading cause of mortality. This review synthesizes current knowledge on its multifactorial pathogenesis, the impact of sexual dimorphism, and key experimental models. The progression of MASLD involves interconnected pathways including dysregulated de novo lipogenesis, insulin resistance, mitochondrial dysfunction, gut dysbiosis, ferroptosis, and genetic and epigenetic predispositions. These mechanisms not only promote hepatic injury but also accelerate atherosclerosis. Notably, MASLD exhibits significant sexual dimorphism, influenced by physiological differences, sex hormones, genetic factors, and the microbiome. The study of these complex processes relies mostly on dietary-induced animal models, particularly in rats, which effectively recapitulate features of the human disease. Given the multifaceted nature of MASLD, the therapeutic focus is shifting from monotherapies to combination or dual-target strategies. To enable this transition, refinement of preclinical models is essential to better understand and target this complex disorder. Full article

(This article belongs to the Special Issue Dietary Patterns, Lipid Metabolism and Fatty Liver Disease)

► Show Figures

Graphical abstract

20 pages, 665 KB

Open AccessEditor’s ChoiceArticle

Teaching Taste: The TASTE–MED Conceptual Framework for a Multisensory Mediterranean Approach to Food Literacy in Adolescence

by Paula Silva

Nutrients 2026, 18(4), 635; https://doi.org/10.3390/nu18040635 - 14 Feb 2026

Cited by 3 | Viewed by 1472

Abstract

Background/Objectives: Adolescence is pivotal for establishing dietary habits; however, school-based nutritional education remains focused on information dissemination, with minimal effects on behavior modification. Evidence from neuroscience, education, and food literacy indicates that attention, engagement, sensory experiences, and social contexts are integral to effective [...] Read more.

Background/Objectives: Adolescence is pivotal for establishing dietary habits; however, school-based nutritional education remains focused on information dissemination, with minimal effects on behavior modification. Evidence from neuroscience, education, and food literacy indicates that attention, engagement, sensory experiences, and social contexts are integral to effective learning in nutrition education. This article conceptualizes a framework for adolescent food education beyond knowledge transmission, aiming to cultivate taste competence using the Mediterranean Diet as a pedagogical ecosystem. Methods: This study employed a conceptual methodology, utilizing interdisciplinary literature from food literacy, sensory education, developmental neuroscience, educational theory, and public health nutrition. It synthesizes empirical findings and theoretical models to develop the Teaching Autonomous Sensory Taste in the Mediterranean Diet (TASTE–MED) framework. Results: This study introduces taste competence as a multifaceted educational outcome, encompassing sensory, relational, cultural, and reflective dimensions. The TASTE–MED framework outlines how experiential, multisensory, and socially embedded learning processes can be implemented in schools, facilitated by the Mediterranean Diet, which provides a sensory-rich and culturally significant context. The educational implications are discussed in terms of curriculum design, teacher training, family involvement and digital tools. Conclusions: The TASTE–MED framework redefines food literacy as an embodied and socially situated competence rather than a cognitive construct. This framework provides a theoretical foundation for informing the design, evaluation, and research of future interventions, advocating for the transition from information-based nutrition education to competence-oriented food education during adolescence. Full article

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

► Show Figures

Graphical abstract

21 pages, 769 KB

Open AccessEditor’s ChoiceReview

Vitamin D in Infectious Diseases: A Narrative Review Focusing on COVID-19, Long COVID, and Influenza

by Olga Adriana Caliman-Sturdza, Roxana Elena Gheorghita, Iuliana Soldanescu, Mihai Dimian and Serghei Mangul

Nutrients 2026, 18(4), 634; https://doi.org/10.3390/nu18040634 - 14 Feb 2026

Cited by 4 | Viewed by 3710

Abstract

Vitamin D is a secosteroid hormone traditionally recognized for its role in bone and mineral metabolism, but it is increasingly understood to also function as an important immunomodulator influencing susceptibility to and outcomes of infectious diseases. This narrative review summarizes current evidence on [...] Read more.

Vitamin D is a secosteroid hormone traditionally recognized for its role in bone and mineral metabolism, but it is increasingly understood to also function as an important immunomodulator influencing susceptibility to and outcomes of infectious diseases. This narrative review summarizes current evidence on the immunological, clinical, and preventive effects of vitamin D in the context of novel coronavirus disease (COVID-19), post-acute sequelae of SARS-CoV-2 infection (long COVID), and influenza. Mechanistically, vitamin D enhances innate immune defenses through the induction of antimicrobial peptides, including cathelicidin and defensins, and modulates adaptive immunity by suppressing maladaptive Th1/Th17 responses while promoting regulatory T-cell activity. Observational studies have frequently associated vitamin D deficiency with more severe COVID-19 outcomes; however, these associations may be influenced by confounding factors and reverse causality. Some meta-analyses suggest that vitamin D supplementation reduced rates of intensive care unit admission and ventilatory support, particularly among older adults and individuals with low baseline serum 25-hydroxyvitamin D concentrations. Emerging evidence also indicates that inadequate vitamin D status may be associated with an increased risk and symptom burden of long COVID, although causality has not been established. In the case of influenza, a limited number of randomized controlled trials (RCTs) and meta-analyses report a modest but statistically significant reduction in infection risk, especially with daily or weekly vitamin D supplementation in populations with low baseline vitamin D levels. Clinical guidelines consistently recommend maintaining adequate vitamin D status for general health but do not endorse high-dose vitamin D as a treatment for COVID-19 due to inconsistent trial findings. Overall, vitamin D should not be considered a standalone therapeutic agent; rather, maintaining sufficient vitamin D levels represents a low-risk, potentially beneficial strategy to support immune resilience against respiratory viral infections. Full article

(This article belongs to the Special Issue Prevalence and Risk Factors of Vitamin D Deficiency)

► Show Figures

Graphical abstract

16 pages, 294 KB

Open AccessEditor’s ChoiceReview

A Narrative Review on GLP-1 Receptor Agonists for Obesity in Older Women: Maximizing Weight Loss While Preserving Lean Mass

by Federica Moscucci, Francesco Baratta, Daniele Pastori, Danilo Menichelli, Anna Vittoria Mattioli, Sabina Gallina, Ilaria Lospinuso, Susanna Sciomer, Gianfranco Piccirillo and Giovambattista Desideri

Nutrients 2026, 18(4), 632; https://doi.org/10.3390/nu18040632 - 14 Feb 2026

Cited by 9 | Viewed by 11322

Abstract

Obesity in women over 65 represents a growing clinical challenge, particularly due to its association with increased risks of cardiovascular disease, osteoarthritis, frailty, sleep-breathing disorders, and sarcopenia. The prevalence of obesity in this demographic is compounded by age-related metabolic changes and declining physical [...] Read more.

Obesity in women over 65 represents a growing clinical challenge, particularly due to its association with increased risks of cardiovascular disease, osteoarthritis, frailty, sleep-breathing disorders, and sarcopenia. The prevalence of obesity in this demographic is compounded by age-related metabolic changes and declining physical activity. In this context, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as semaglutide and tirzepatide, have emerged as promising pharmacological treatments for weight loss, showing substantial efficacy in reducing body weight and improving metabolic health. However, their use in older populations warrants careful consideration due to the potential risk of muscle loss, which may exacerbate sarcopenia and frailty. This review synthesizes current evidence on the efficacy of GLP-1 RAs for weight loss in older women, exploring both the metabolic benefits and potential risks, particularly with regard to muscle mass preservation. We discuss the mechanisms behind muscle loss associated with GLP-1 RAs, focusing on the balance between fat reduction and the preservation of lean body mass. In phase 3 trials, women aged ≥ 65 years achieved sustained weight loss of 10–20%, with consistent cardiometabolic improvements. Furthermore, we propose practical strategies to mitigate sarcopenia, including physical activity interventions, dietary modifications, and combination therapies aimed at maintaining muscle strength while promoting weight loss. By examining clinical trial data, real-world evidence, and physiological mechanisms, this narrative review aims to provide a comprehensive framework for personalized and safe therapeutic decision-making, addressing the unique needs of older women with obesity. Full article

(This article belongs to the Section Nutrition and Obesity)

► Show Figures

Graphical abstract

30 pages, 824 KB

Open AccessEditor’s ChoiceReview

Vitamin D-Mediated Immunoregulation in Degenerative Diseases: Insights into Cardiovascular, Neurodegenerative and Musculoskeletal Disorders

by Ga Young Lee, Chan Yoon Park and Sung Nim Han

Nutrients 2026, 18(4), 629; https://doi.org/10.3390/nu18040629 - 14 Feb 2026

Cited by 5 | Viewed by 1619

Abstract

Degenerative diseases are characterized by the gradual loss of cellular integrity, tissue function, and regenerative capacity. Cardiovascular diseases, neurodegenerative disorders, and musculoskeletal deterioration are considered major categories of degenerative diseases, and vitamin D deficiency has been linked with an increased risk of these [...] Read more.

Degenerative diseases are characterized by the gradual loss of cellular integrity, tissue function, and regenerative capacity. Cardiovascular diseases, neurodegenerative disorders, and musculoskeletal deterioration are considered major categories of degenerative diseases, and vitamin D deficiency has been linked with an increased risk of these conditions. Vitamin D has the potential to modulate neurogenerative process by influencing the progression of neuronal survival, neurogenesis, and synaptic plasticity through both genomic and non-genomic mechanisms mediated by vitamin D receptors, which are widely distributed across brain regions and cell types. Additionally, vitamin D regulates brain immunometabolism by modulating microglial and astrocytic inflammatory responses and oxidative stress. Vitamin D has long been recognized as essential for bone health. Beyond its classical role, vitamin D contributes to the maintenance of bone–muscle homeostasis, enhances mitochondrial biogenesis and ATP production while reducing oxidative stress, and facilitates bidirectional bone–muscle crosstalk through myokines and osteokines to coordinate bone remodeling and muscle regeneration. However, despite these mechanistic insights, the beneficial effects of vitamin D on these diseases—such as reduced risk or mitigation of progression—remains inconclusive. This review explores the relationships between vitamin D and cardiovascular, neurodegenerative, and musculoskeletal diseases, with a focus on the underlying immunological and metabolic mechanisms of actions. Full article

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

► Show Figures

Graphical abstract

15 pages, 498 KB

Open AccessEditor’s ChoiceReview

Alcohol, Wine, and Sleep in Adults: Insights from a Narrative Review

by Jean-Philippe Chaput

Nutrients 2026, 18(4), 585; https://doi.org/10.3390/nu18040585 - 11 Feb 2026

Cited by 3 | Viewed by 6114

Abstract

Alcohol is widely consumed across cultures and is often used to facilitate relaxation or sleep initiation. This narrative review critically examines evidence published over the past decade (2015–2025) on the effects of alcohol, including wine, on sleep health in community-dwelling adults. Priority was [...] Read more.

Alcohol is widely consumed across cultures and is often used to facilitate relaxation or sleep initiation. This narrative review critically examines evidence published over the past decade (2015–2025) on the effects of alcohol, including wine, on sleep health in community-dwelling adults. Priority was given to systematic reviews and meta-analyses, followed by high-quality observational and experimental studies. Across study designs, evidence consistently shows that although alcohol may reduce sleep onset latency, it disrupts sleep architecture, suppresses rapid eye movement sleep, increases sleep fragmentation, and impairs breathing during sleep, particularly in the second half of the night. Habitual alcohol consumption is associated with poorer subjective sleep quality, insomnia symptoms, and increased risk of sleep-disordered breathing. Mechanistic pathways include effects on neurotransmission, sleep homeostasis, circadian regulation, thermoregulation, and alcohol metabolism during sleep. Evidence also suggests that the timing of alcohol intake and alignment with circadian rhythms may modify these effects, with earlier consumption potentially reducing some adverse outcomes. A brief section addresses the reciprocal relationship, showing that circadian disruption, shift work, and evening chronotype are associated with higher alcohol use. Although wine contains bioactive compounds such as melatonin and polyphenols, current evidence indicates that these components are present at levels insufficient to provide meaningful sleep benefits. Overall, alcohol, including wine, should not be considered a sleep aid, and public health messaging should emphasize dose, timing, and regularity of alcohol consumption in relation to sleep health. Full article

(This article belongs to the Special Issue Lifestyle, Diet, Wine and Health)

► Show Figures

Figure 1

12 pages, 608 KB

Open AccessEditor’s ChoiceReview

Fasting and Nutrition as Promising Treatment Strategies for Women with Rheumatoid Arthritis in Transitional Hormonal Stages

by Bérénice Hansen, Evdokia Alvanou, Maria Angeliki S. Pavlou, Paul Wilmes and Jochen G. Schneider

Nutrients 2026, 18(4), 580; https://doi.org/10.3390/nu18040580 - 10 Feb 2026

Cited by 4 | Viewed by 1874

Abstract

Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease affecting about 1% of the global population, with a higher prevalence in women. Its treatment has been improved greatly over the past 30 years but there is no definitive cure available, and another [...] Read more.

Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease affecting about 1% of the global population, with a higher prevalence in women. Its treatment has been improved greatly over the past 30 years but there is no definitive cure available, and another unmet need exists for transitional hormonal stages such as pregnancy or menopause, which spurs the need to research new therapy options. In recent years, dietary interventions, particularly fasting and plant-based nutrition, have gained attention for their potential to alleviate RA symptoms. Fasting has been shown to reduce systemic inflammation, promote autophagy, and modulate immune cell activity, possibly leading to decreased joint pain and swelling. Nutritional strategies, such as anti-inflammatory and plant-based diets, have been shown to impact the gut microbiome and potentially support weight management, improve metabolic health, and reduce oxidative stress, all of which might contribute to better RA disease outcomes. Although the precise mechanisms remain under investigation, these approaches offer promising complementary strategies for enhancing RA management and improving patients’ quality of life. This review explores the preventive and therapeutic potential of fasting and nutrition in RA, and their possible application in the context of hormonal fluctuations and transitional stages during a women’s life. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle and Women’s Health)

► Show Figures

Figure 1

32 pages, 1794 KB

Open AccessEditor’s ChoiceReview

Pathogenetic Gut Microbiota in Aortic Diseases: Evidence and Mechanisms Across Aneurysm, Dissection, and Inflammatory Aortopathies

by Leon Smółka, Miłosz Strugała, Karolina Blady, Bartosz Pomianowski, Karolina Kursa and Agata Stanek

Nutrients 2026, 18(4), 565; https://doi.org/10.3390/nu18040565 - 9 Feb 2026

Cited by 9 | Viewed by 1700

Abstract

Aortic diseases, including abdominal aortic aneurysm (AAA), thoracic aortic aneurysm (TAA), aortic dissection (AD), and Takayasu arteritis (TAK), are characterized by vascular remodeling and chronic immune–inflammatory activation, with AD often representing an acute complication of long-standing aortic wall vulnerability. Increasing evidence suggests that [...] Read more.

Aortic diseases, including abdominal aortic aneurysm (AAA), thoracic aortic aneurysm (TAA), aortic dissection (AD), and Takayasu arteritis (TAK), are characterized by vascular remodeling and chronic immune–inflammatory activation, with AD often representing an acute complication of long-standing aortic wall vulnerability. Increasing evidence suggests that gut dysbiosis, impaired intestinal barrier integrity, and microbiota-derived metabolites may contribute to aortic wall injury. We synthesized current evidence linking the gut microbiome to aortic diseases and explored potential translational implications. PubMed, Scopus, and Web of Science were searched for microbiome-related studies on AAA, TAA, AD, and TAK published up to December 2025. Human observational and interventional studies were integrated with relevant experimental research. The strongest evidence was identified for AAA, where multiple cohorts report gut dysbiosis and reduced microbial diversity. Translational studies have detected bacterial DNA and microbial products in blood, aneurysm wall, or intraluminal thrombus, consistent with barrier-related microbial signaling and vascular inflammation, although these low-biomass findings do not establish microbial viability or causality. Microbiota-derived mediators—including trimethylamine-N-oxide, lipopolysaccharides, short-chain fatty acids, and bile acid derivatives—interact with pathways involved in cytokine signaling, oxidative stress, innate immune activation, and extracellular matrix degradation. Evidence for TAA and AD remains limited and suggests mainly modifier effects, whereas early studies in TAK indicate disease-associated microbiome and metabolite alterations. Mendelian randomization analyses have explored genetically proxied microbiome–AAA associations; however, results are heterogeneous, and causal inference remains provisional. Overall, the gut microbiome emerges as a plausible modifier of aortic disease, with the greatest translational relevance in AAA, highlighting the need for longitudinal multi-compartment studies and targeted interventions with aortic endpoints. Full article

(This article belongs to the Special Issue Prebiotics, Probiotics, and Gut Microbiota with Chronic Disease (2nd Edition))

► Show Figures

Figure 1

16 pages, 609 KB

Open AccessEditor’s ChoiceReview

The Role of Zinc in Pediatric Respiratory Infections: Evidence from Clinical Trials and Real-World Studies

by Giulio Dinardo, Cristiana Indolfi, Angela Klain, Carolina Grella, Maria Angela Tosca, Michele Miraglia del Giudice and Giorgio Ciprandi

Nutrients 2026, 18(4), 557; https://doi.org/10.3390/nu18040557 - 7 Feb 2026

Cited by 3 | Viewed by 3157

Abstract

Background/Objectives: Zinc is an essential trace element involved in multiple aspects of immune function, including epithelial barrier integrity, innate and adaptive immune responses, regulation of inflammation and oxidative stress. Zinc deficiency has been associated with increased susceptibility to infections, particularly in the pediatric [...] Read more.

Background/Objectives: Zinc is an essential trace element involved in multiple aspects of immune function, including epithelial barrier integrity, innate and adaptive immune responses, regulation of inflammation and oxidative stress. Zinc deficiency has been associated with increased susceptibility to infections, particularly in the pediatric population. This narrative review aims to summarize and discuss current evidence on the role of zinc in the prevention and management of pediatric respiratory infections. Methods: A comprehensive literature review was conducted including randomized controlled trials, real-world studies, and international guidelines published in recent years. Both zinc monotherapy and multicomponent dietary supplements containing zinc were considered. Results: Evidence consistently supports a preventive role of zinc supplementation in reducing the incidence and burden of respiratory infections, particularly in children with recurrent disease and in zinc-deficient populations. Zinc-containing multicomponent supplements demonstrated significant reductions in infection frequency and duration, alongside improved patient and parent-reported outcomes, with a favorable safety profile. In contrast, data on zinc as an adjunctive treatment during acute infections, especially severe pneumonia, are less consistent, with limited impact on major clinical outcomes. The effectiveness of zinc appears to be influenced by treatment duration, baseline nutritional status, and formulation. Conclusions: In conclusion, zinc may represent a valuable component of preventive immune-nutritional strategies for pediatric respiratory infections, especially when administered as part of multicomponent formulations and over prolonged periods. While its role in acute disease management remains uncertain, optimizing zinc status may contribute to reducing infection recurrence and overall disease burden. Further well-designed trials are warranted to clarify optimal dosing, timing, and target populations. Full article

(This article belongs to the Special Issue Relationship Between Nutrition and Allergy and Immunity in Children)

► Show Figures

Figure 1

24 pages, 442 KB

Open AccessEditor’s ChoiceReview

Multimodal Therapeutic Strategies for the Management of Sarcopenia and Frailty in Chronic Obstructive Pulmonary Disease: A Narrative Review

by Saoussen Naas, Monika Fekete, Gabriella Szendro, Tamas Komaromi, Zsolt Rozgonyi, Erik Palmer, Lorinc Polivka, Regina Bakos, Borbala Szalai, Veronika Muller and Janos Tamas Varga

Nutrients 2026, 18(3), 543; https://doi.org/10.3390/nu18030543 - 6 Feb 2026

Cited by 10 | Viewed by 3254

Abstract

Introduction: Sarcopenia and frailty are prevalent yet under-recognized contributors to disability, impaired quality of life, and adverse outcomes in chronic obstructive pulmonary disease (COPD). Shared mechanisms, including systemic inflammation, hormonal dysregulation, malnutrition, and physical inactivity, render these syndromes important targets for multimodal intervention. [...] Read more.

Introduction: Sarcopenia and frailty are prevalent yet under-recognized contributors to disability, impaired quality of life, and adverse outcomes in chronic obstructive pulmonary disease (COPD). Shared mechanisms, including systemic inflammation, hormonal dysregulation, malnutrition, and physical inactivity, render these syndromes important targets for multimodal intervention. This review summarizes current evidence on exercise-based, nutritional, pharmacological, and adjunctive strategies for their management in COPD. Materials and Methods: This narrative review is based on a structured literature search of PubMed, Scopus, and Embase to identify relevant studies published between January 2000 and May 2025. Eligible publications included randomized controlled trials, meta-analyses, systematic reviews, and observational studies involving adults with COPD and documented sarcopenia and/or frailty. Interventions were categorized by modality, and outcomes included muscle mass, strength, physical performance, quality of life, and hospitalizations. Data were synthesized thematically. Results: Resistance and combined exercise training consistently improved muscle strength and physical function, while endurance training enhanced cardiorespiratory capacity, particularly within pulmonary rehabilitation programs. Nutritional interventions, especially protein, leucine, or β-hydroxy-β-methylbutyrate supplementation, supported gains in lean mass and exercise tolerance. Pharmacological strategies, including anabolic hormones and myostatin inhibitors, showed early promise but require further evaluation regarding safety and long-term efficacy. Adjunctive therapies, such as neuromuscular electrical stimulation and oxygen supplementation, benefited patients unable to participate in conventional exercise training. Conclusions: An integrated, multimodal approach combining structured exercise training and targeted nutritional support should be considered a cornerstone of COPD management to prevent and treat sarcopenia and frailty. Personalized rehabilitation strategies can substantially improve functional outcomes and quality of life, while future research should prioritize biomarker-guided personalization and long-term intervention studies. Full article

(This article belongs to the Special Issue Optimizing Respiratory Health Through Nutrition: From Prevention to Management)

► Show Figures

Figure 1

17 pages, 3820 KB

Open AccessEditor’s ChoiceArticle

Dietary Polyphenols Curcumin and Resveratrol Exert Selective Anticancer Effects in Melanoma Cells

by Moon-Kyun Cho, Yeji Lee, Ki Dam Kim, Min Hyuk Choi, Sang-Han Lee, Dongsic Choi, Hae-Seon Nam and Yoon-Jin Lee

Nutrients 2026, 18(3), 548; https://doi.org/10.3390/nu18030548 - 6 Feb 2026

Cited by 4 | Viewed by 1161

Abstract

Background/Objectives: Although curcumin (CUR) and resveratrol (RSV) are natural polyphenolic compounds with reported anticancer and anti-inflammatory properties, their combined anticancer effects in melanoma cells remain incompletely characterized. This study aimed to evaluate the anticancer efficacy of CUR and RSV, individually, and in combination, [...] Read more.

Background/Objectives: Although curcumin (CUR) and resveratrol (RSV) are natural polyphenolic compounds with reported anticancer and anti-inflammatory properties, their combined anticancer effects in melanoma cells remain incompletely characterized. This study aimed to evaluate the anticancer efficacy of CUR and RSV, individually, and in combination, in melanoma cells compared to normal melanocytes. Methods: Cell viability and intracellular ATP levels were quantified, and dose–response analyses performed. Cellular morphology and nuclear alterations were examined by phase-contrast microscopy and DAPI staining. Cell cycle distribution and apoptosis were analyzed by Muse™ Cell Analyzer with dedicated assay kits. Survival- and death-related signaling proteins were evaluated by Western blotting. Results: Combined treatment with CUR (60 μM) and RSV (40 μM) for 48 h synergistically reduced melanoma cell viability and markedly depleted intracellular ATP levels, while exerting minimal cytotoxic effects on normal melanocytes. CUR/RSV co-treatment induced pronounced morphological and nuclear alterations, significantly increased apoptotic cell populations, and modulated key signaling pathways regulating cell survival and programmed cell death in melanoma cells. Conclusions: These findings demonstrate that combined CUR and RSV treatment exerts enhanced, melanoma-selective anticancer activity while sparing normal melanocytes. The results provide a strong experimental rationale for further in vivo validation of CUR/RSV-based combination strategies as a potential therapeutic approach for melanoma. Full article

(This article belongs to the Special Issue Anti-Cancer and Anti-Inflammatory Effects of Antioxidant-Rich Natural Food)

► Show Figures

Figure 1

23 pages, 1031 KB

Open AccessEditor’s ChoiceReview

Fermented Foods and the Gut–Liver Axis: Modulation of MASLD Through Gut Microbiota

by Agnieszka Wesołek-Leszczyńska, Dawid Rosiejka, Kalina Bogdańska and Paweł Bogdański

Nutrients 2026, 18(3), 542; https://doi.org/10.3390/nu18030542 - 6 Feb 2026

Cited by 6 | Viewed by 2869

Abstract

Background/Objectives: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a prevalent condition defined by hepatic fat accumulation, inflammation, and metabolic dysregulation. Current evidence demonstrates that gut microbiota and their metabolites are associated with MASLD pathogenesis. Fermented foods, rich in live microbes and bioactive [...] Read more.

Background/Objectives: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a prevalent condition defined by hepatic fat accumulation, inflammation, and metabolic dysregulation. Current evidence demonstrates that gut microbiota and their metabolites are associated with MASLD pathogenesis. Fermented foods, rich in live microbes and bioactive compounds, actively modulate the gut–liver axis and influence disease progression. This narrative review provides a comprehensive summary of current evidence on the impact of fermented foods on gut microbiota, intestinal barrier function, and gut–liver interactions, and demonstrates their potential role in preventing or mitigating MASLD. Methods: A comprehensive literature search of preclinical and clinical studies was conducted. Specifically, the review focused on fermented-food interventions, modulation of gut microbiota, metabolite production, and effects on hepatic metabolism and inflammation. Results: This review found that fermented foods provide probiotics, prebiotics, short-chain fatty acid (SCFAs), and bioactive compounds that enhance microbial diversity, improve intestinal barrier integrity, reduce endotoxemia, and modulate bile acid and lipid metabolism. Evidence from animal and human studies indicates that fermented food consumption can attenuate hepatic steatosis, inflammation, and metabolic dysregulation, with variability depending on individual microbiome composition. Conclusions: Altogether, these findings suggest that fermented foods represent a promising adjunctive dietary strategy for MASLD by modulating the gut–liver axis and supporting metabolic and hepatic health. Personalized approaches and further long-term clinical trials are required to optimize interventions and establish evidence-based recommendations. Full article

(This article belongs to the Special Issue Functional Foods in the Prevention and Treatment of Metabolic Disorders)

► Show Figures

Figure 1

26 pages, 1297 KB

Open AccessEditor’s ChoiceReview

From Dysbiosis to Distress: The Gut–Brain Connection in Trauma-Related Disorders

by Giuseppe Marano, Luca Lo Giudice, Elettra Specogna, Luca Chisari, Caterina Brisi, Gianandrea Traversi, Osvaldo Mazza and Marianna Mazza

Nutrients 2026, 18(3), 530; https://doi.org/10.3390/nu18030530 - 5 Feb 2026

Cited by 6 | Viewed by 3101

Abstract

Background: Post-traumatic stress disorder (PTSD) and trauma-related disorders are increasingly recognized as complex conditions involving not only psychological and neurobiological factors but also systemic physiological alterations. Among these, growing evidence points to the crucial role of the gut–brain axis in modulating stress [...] Read more.

Background: Post-traumatic stress disorder (PTSD) and trauma-related disorders are increasingly recognized as complex conditions involving not only psychological and neurobiological factors but also systemic physiological alterations. Among these, growing evidence points to the crucial role of the gut–brain axis in modulating stress responses, emotional regulation, and neuroinflammation. Objective: This narrative review aims to synthesize the emerging literature on the interactions between the gut microbiota and the central nervous system in PTSD and trauma-related disorders, highlighting potential mechanisms and therapeutic implications. Methods: A comprehensive search of the literature was conducted across PubMed and Scopus and Web of Science as primary bibliographic databases, focusing on clinical, preclinical, and translational studies published in the last two decades. Emphasis was placed on studies exploring the microbiota’s influence on neuroendocrine and immune pathways relevant to trauma, as well as intervention studies targeting the gut–brain axis. Results: Evidence suggests that dysbiosis and gut permeability alterations are associated with PTSD symptomatology, possibly via mechanisms involving hypothalamic–pituitary–adrenal (HPA) axis dysregulation, neuroinflammation, vagal signaling, and altered neurotransmitter production. Preclinical models support a bidirectional relationship between early-life stress, trauma, and gut microbiota alterations. Furthermore, preliminary clinical data indicate that interventions such as probiotics, diet modulation, and psychobiotics may exert beneficial effects on trauma-related psychopathology. Conclusions: The gut–brain axis represents a promising framework for understanding the pathophysiology of PTSD and related conditions. Although research is still in its early stages, targeting gut microbiota may offer novel preventive and therapeutic strategies. Further longitudinal and mechanistic studies are needed to validate these findings and guide clinical translation. Full article

(This article belongs to the Special Issue Probiotics, Postbiotics, Gut Microbiota and Gastrointestinal Health)

► Show Figures

Figure 1

37 pages, 2216 KB

Open AccessEditor’s ChoiceReview

Xanthohumol: Mechanistic Actions and Emerging Evidence as a Multi-Target Natural Nutraceutical

by Mackenzie Azuero, Camilla F. Wenceslau and Wenbin Tan

Nutrients 2026, 18(3), 520; https://doi.org/10.3390/nu18030520 - 3 Feb 2026

Cited by 3 | Viewed by 3673

Abstract

Background: Xanthohumol (XN), a prenylated chalcone flavonoid derived from hops (Humulus lupulus), is increasingly recognized as a highly pleiotropic natural compound. Objective: We aimed to structure XN’s mechanistic hierarchy with emerging translational relevance across disease areas. Methods: We performed a comprehensive [...] Read more.

Background: Xanthohumol (XN), a prenylated chalcone flavonoid derived from hops (Humulus lupulus), is increasingly recognized as a highly pleiotropic natural compound. Objective: We aimed to structure XN’s mechanistic hierarchy with emerging translational relevance across disease areas. Methods: We performed a comprehensive and integrative literature review of XN for its biological and translational effects across cancer, metabolic, neurological, cardiovascular, hepatic, renal, and dermatological disorders. Results: Mechanistically, XN exerts diverse bioactivities by inhibiting major pro-oncogenic and pro-inflammatory pathways, such as NF-κB, PI3K/Akt/mTOR, STAT3, HIF-1α, and selective MAPK cascades, while activating cytoprotective signaling, such as the Nrf2/ARE and AMPK pathways. Through these coordinated actions, XN modulates redox homeostasis, mitochondrial integrity, apoptosis, autophagy, ferroptosis, and inflammatory responses. In oncology, XN demonstrates broad-spectrum anticancer activity in preclinical models by inhibiting proliferation; inducing cell cycle arrest and apoptosis; suppressing epithelial–mesenchymal transition, angiogenesis, and metastasis; and restoring chemosensitivity in resistant cancers, including breast, lung, gastric, liver, and head-and-neck carcinomas. Beyond cancer, XN exhibits multi-organ protective bioactivities through antioxidative, antimicrobial, antiviral, and anti-inflammatory activities; inhibition of ferroptosis and excitotoxicity; and preservation of mitochondrial integrity. It shows beneficial effects in preclinical models of Parkinson’s disease, Alzheimer’s disease, hepatic steatosis and fibrosis, renal ischemia–reperfusion injury, cardiovascular dysfunction, skin photoaging, and atopic dermatitis. Human subject studies demonstrate that XN is safe and well tolerated, with observed reductions in oxidative DNA damage and inflammatory cytokine release. Recent advances in micellar formulations have improved XN’s systemic bioavailability and thus its translational feasibility. Conclusions: In summary, XN is a safe, multifunctional natural compound with strong potential for modulating disease-relevant biological pathways associated with cancer, neurodegenerative diseases, metabolic disorders, and inflammatory skin conditions. Continued efforts to enhance its bioavailability and conduct rigorous clinical trials are essential to fully establish its clinical relevance in patient populations. Full article

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

► Show Figures

Graphical abstract

39 pages, 2306 KB

Open AccessEditor’s ChoiceReview

Serotonin, Kynurenine, and Indole Pathways of Tryptophan Metabolism in Humans in Health and Disease

by Milan Holeček

Nutrients 2026, 18(3), 507; https://doi.org/10.3390/nu18030507 - 2 Feb 2026

Cited by 22 | Viewed by 6939

Abstract

Tryptophan (TRP) is a proteinogenic and nutritionally essential amino acid involved in the formation of numerous bioactive substances. A crucial role in the TRP molecule is played by indole, a bicyclic ring formed by benzene and pyrrole, which confers hydrophobic and antioxidant properties [...] Read more.

Tryptophan (TRP) is a proteinogenic and nutritionally essential amino acid involved in the formation of numerous bioactive substances. A crucial role in the TRP molecule is played by indole, a bicyclic ring formed by benzene and pyrrole, which confers hydrophobic and antioxidant properties and the ability to act as a ligand for aryl hydrocarbon and pregnane X receptors. The first parts of the article examine sources, nutritional requirements, and three pathways of TRP catabolism. Physiologically, ~5% of dietary TRP is catabolized through the pathway forming serotonin and melatonin in the brain and enterochromaffin cells of the gut, ~85% through the pathway resulting in the formation of nicotinamide nucleotides and kynurenine and its derivatives in the liver and immune cells, and ~10% in gut microbiota to indole derivatives. Alterations of individual TRP catabolism pathways in aging, alcoholism, inflammatory bowel disease, metabolic syndrome, renal insufficiency, liver cirrhosis, cancer, and nervous diseases, e.g., depression, Alzheimer’s and Parkinson’s diseases, multiple sclerosis, and schizophrenia, are examined in the central section. The final sections are devoted to the benefits and adverse effects of TRP supplementation, the therapeutic use of various TRP metabolites, and the pharmacological targeting of enzymes, transporters, and receptors involved in TRP catabolism. It is concluded that all pathways of TRP catabolism are altered across a broad spectrum of human illnesses, and further investigation is needed to understand their role in disease pathogenesis better. The goal for clinical research is to explore options for TRP-targeted therapies and their integration into new therapeutic strategies. Full article

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

► Show Figures

Figure 1

12 pages, 266 KB

Open AccessEditor’s ChoiceArticle

The Common FTO rs9939609 Polymorphism Interacts with Sleeping and Eating Windows to Affect Predisposition to Type 2 Diabetes

by Libi Kazarnovsky Nahshan, Danyel Chermon and Ruth Birk

Nutrients 2026, 18(3), 472; https://doi.org/10.3390/nu18030472 - 1 Feb 2026

Cited by 4 | Viewed by 1718

Abstract

Background: The common fat mass and obesity-associated (FTO) gene variant rs9939609 has been linked to elevated risk of obesity and Type 2 diabetes mellitus (T2DM). Eating and sleeping windows gained clinical interest as factors in weight maintenance and have been linked [...] Read more.

Background: The common fat mass and obesity-associated (FTO) gene variant rs9939609 has been linked to elevated risk of obesity and Type 2 diabetes mellitus (T2DM). Eating and sleeping windows gained clinical interest as factors in weight maintenance and have been linked to T2DM risk. Objective: To study the association and interaction between the common FTO rs9939609 variant and eating and sleeping windows to affect T2DM risk in a large community cohort. Methods: This cross-sectional study included 12,254 adult participants. Genetic, anthropometric, and lifestyle behaviors data including eating and fasting windows were analyzed. Logistic and linear regression models, as well as chi-square tests, were applied under additive, dominant, and recessive genetic models (adjusted for age, sex, and BMI). Results: Significant associations between FTO rs9939609 x eating and sleeping window interactions were demonstrated in relation to T2DM risk. Longer eating windows and later last meal timing were associated with an increased risk for T2DM under the additive model (OR = 1.029, 95% CI = 1.002–1.055, and OR = 1.066, 95% CI = 1.012–1.122, respectively), while longer fasting windows were found to be protective under additive model (OR = 0.972, 95% CI = 0.947–0.998). Later bedtime onset was associated with an increased risk for T2DM under additive model (OR = 1.101, 95% CI = 1.005–1.220). Hours of night sleep significantly interacted with FTO rs9939609 under additive genetic model. FTO rs9939609 risk allele carriers with prolonged sleeping windows (OR = 1.137, 95% CI = 1.039–1.354) and poorer sleeping quality (OR = 1.185, 95% CI = 1.038–1.354) had increased risk of T2DM. Conclusions: Eating and fasting windows, late last meal timing, hours of night sleep, late bedtime onset, and poorer sleep quality are significantly associated with T2DM risk among FTO rs9939609 risk carriers and may reflect metabolic vulnerability associated with FTO risk alleles. These findings highlight potential behavioral modification to attenuate genetic risk and provide evidence for actionable prevention strategies in genetically predisposed populations. Full article

(This article belongs to the Section Nutrigenetics and Nutrigenomics)

19 pages, 1224 KB

Open AccessEditor’s ChoiceReview

Dietary Nutrients, Gut Microbiota, and Cardiac Function: From Metabolic Mechanisms to Clinical Applications

by Lucia Scisciola, Manuela Giovanna Basilicata, Marta Belmonte, Ada Pesapane, Rosaria Anna Fontanella, Nunzia Balzano, Alberta Maria Maddalena Palazzo, Rashmi Joshi, Asad Zia, Giovanni Tortorella, Zeeshan Ulfat, Maryam Arshad and Giuseppe Paolisso

Nutrients 2026, 18(3), 467; https://doi.org/10.3390/nu18030467 - 31 Jan 2026

Cited by 11 | Viewed by 2242

Abstract

Background: The heart depends on a continuous and flexible energy supply from fatty acids, glucose, and other substrates. Emerging evidence shows that gut microbiota-derived metabolites—such as trimethylamine-N-oxide (TMAO), short-chain fatty acids (SCFAs), secondary bile acids, indoles, phenylacetylglutamine (PAGln), and branched-chain amino acids—modulate cardiac [...] Read more.

Background: The heart depends on a continuous and flexible energy supply from fatty acids, glucose, and other substrates. Emerging evidence shows that gut microbiota-derived metabolites—such as trimethylamine-N-oxide (TMAO), short-chain fatty acids (SCFAs), secondary bile acids, indoles, phenylacetylglutamine (PAGln), and branched-chain amino acids—modulate cardiac metabolism and function. Although clinical evidence linking these metabolites to cardiovascular outcomes is expanding, most data remain associative, with limited causal or interventional proof. Methods: A comprehensive narrative review was conducted (PubMed 2010–2025) to integrate preclinical, clinical, and Mendelian randomization studies on microbiota-derived metabolites and cardiovascular disease, complemented by evidence from dietary and interventional trials. Results: Gut-derived metabolites regulate mitochondrial energetics, inflammatory, immune system, and oxidative pathways, and endothelial and platelet activation. Elevated plasma TMAO and PAGln levels are often associated with adverse cardiovascular outcomes, while SCFAs and indole derivatives may related to protective effects. However, findings across cohorts remain heterogeneous, largely due to differences in diet, renal function, and analytical methods. Dietary patterns rich in fiber and plant-based nutrients favor beneficial metabolite profiles, underscoring the nutritional modulation of the gut–heart axis. Conclusions: The diet–microbiota–metabolite axis represents an emerging pathway connecting nutrition to cardiovascular health. Translating this knowledge into prevention and therapy will require large-scale randomized studies and integrated multi-omics approaches. Dietary modulation of microbial metabolism may ultimately become a novel strategy for cardiometabolic protection. Full article

(This article belongs to the Special Issue Molecular Mechanisms of Diet-Associated Cardiac Metabolism)

► Show Figures

Figure 1

13 pages, 237 KB

Open AccessEditor’s ChoiceArticle

by Marcelina Porożyńska and Anna Weronika Szablewska

Nutrients 2026, 18(3), 447; https://doi.org/10.3390/nu18030447 - 29 Jan 2026

Cited by 3 | Viewed by 1813

Abstract

Background/Objectives: The World Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, but exclusive breastfeeding (EBF) rates remain low in many countries, including Poland. Factors related to pregnancy, childbirth and the organisation of care can significantly affect the maintenance [...] Read more.

Background/Objectives: The World Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, but exclusive breastfeeding (EBF) rates remain low in many countries, including Poland. Factors related to pregnancy, childbirth and the organisation of care can significantly affect the maintenance of lactation. There is a lack of representative data on these relationships in Poland, which makes it difficult to plan effective support measures. The aim of this study is to analyse the relationship between pregnancy and perinatal factors and exclusive breastfeeding in infants aged 6 to 12 months. Methods: This cross-sectional online survey was conducted between April and October 2025. A total of 557 women aged ≥18 years with infants aged 6–12 months participated in the research. Data were collected using a structured questionnaire covering sociodemographic characteristics, the course of pregnancy and childbirth, postpartum complications, early breastfeeding experiences and maternal birth satisfaction assessed using the Polish version of the Birth Satisfaction Scale—Revised (BSS-R). Multivariable logistic regression analysis was used to identify factors associated with exclusive breastfeeding up to six months. Results: Exclusive breastfeeding was significantly associated with vaginal delivery, the absence of postpartum complications and a lack of early breastfeeding problems in the first days postpartum, with initial lactation difficulties emerging as its strongest predictor. Most specific pregnancy-related conditions, maternal birth satisfaction and selected recommended hospital practices, including early skin-to-skin contact, were not independently associated with exclusive breastfeeding in the model. Conclusions: Exclusive breastfeeding up to six months is primarily determined by factors operating in the immediate perinatal and early postpartum period, particularly postpartum clinical stability and successful early lactation. Targeted support during this critical window may be key to improving exclusive breastfeeding outcomes. Full article

(This article belongs to the Special Issue Infant and Toddler Feeding and Development)

24 pages, 1040 KB

Open AccessEditor’s ChoiceArticle

Gut Microbiota and Nutritional Profiles of Colon Cancer Patients Undergoing Chemotherapy: A Longitudinal Pilot Study

by Claire Han, Daniel Spakowicz, Diane Von Ah, Anne Noonan and Leah Pyter

Nutrients 2026, 18(3), 438; https://doi.org/10.3390/nu18030438 - 29 Jan 2026

Cited by 3 | Viewed by 1923

Abstract

Background/Objectives: Nutrition and the gut microbiota influence treatment tolerance and recovery in patients with colon cancer receiving chemotherapy. This pilot study examined changes in diet quality and fecal microbiota over 6 months of chemotherapy and evaluated longitudinal associations between diet quality and [...] Read more.

Background/Objectives: Nutrition and the gut microbiota influence treatment tolerance and recovery in patients with colon cancer receiving chemotherapy. This pilot study examined changes in diet quality and fecal microbiota over 6 months of chemotherapy and evaluated longitudinal associations between diet quality and gut microbiota diversity and taxa. Methods: 48 adults with stage II–III colon cancer receiving 5-fluorouracil-based chemotherapy were assessed at baseline and 6 months post-initiation. Diet quality was measured using 3-day dietary recalls to calculate Healthy Eating Index (HEI) scores. Stool samples underwent 16S rRNA sequencing to assess Shannon diversity, Beta and taxonomic composition. Pre–post changes were analyzed using paired tests, and associations between HEI and microbiota measures were evaluated using multivariable linear regression adjusting for demographic and clinical covariates. Results: Diet quality declined during chemotherapy, with reduced intake of fiber, fruits and vegetables, and whole grains. Gut microbial alpha diversity decreased over time. At the phylum level, Actinobacteriota decreased, while Bacteroidota and Proteobacteria increased. At the genus level, only Streptococcus (decreased) and Escherichia (increased) remained significantly altered after multiple testing correction. Higher baseline diet quality and improvements over time were associated with greater microbial diversity and lower Proteobacteria abundance. Diet quality was inversely associated with Streptococcus and Escherichia and positively associated with short-chain fatty acid-producing, fiber-responsive genera (Faecalibacterium, Mediterraneibacter, Ruminococcus_E, Fusicatenibacter). Baseline gut microbiota did not significantly associate with changes in diet quality. Conclusions: Chemotherapy was associated with declines in diet quality, gut microbial alpha diversity, along with shifts in beta diversity and microbial taxa. Higher diet quality appeared protective against microbial disruption, supporting a bidirectional relationship between diet and the gut microbiome during chemotherapy. Nutritional and microbiota-focused approaches warrant further investigation in the context of chemotherapy. Full article

(This article belongs to the Special Issue Insights and Innovation for Colorectal Cancer Management: Diet and Nutrition Factors)

► Show Figures

Figure 1

24 pages, 1275 KB

Open AccessEditor’s ChoiceArticle

Impact of Powdered Tart Cherry Supplementation on Performance Recovery Following Repeated Sprint Exercise

by Anthony M. Hagele, Kyle S. Levers, Kevin F. Holley, Alex C. Schrautemeier, Joesi M. Krieger, Joshua M. Iannotti, Connor J. Gaige, Ralf Jäger and Chad M. Kerksick

Nutrients 2026, 18(3), 443; https://doi.org/10.3390/nu18030443 - 29 Jan 2026

Cited by 3 | Viewed by 5506

Abstract

Background: Due to its high polyphenol content and purported capability to mitigate post-exercise muscle soreness and promote recovery, tart cherry (TC) supplementation has been proposed to enhance recovery and athletic performance. This study examined the effects of powdered TC supplementation on various recovery [...] Read more.

Background: Due to its high polyphenol content and purported capability to mitigate post-exercise muscle soreness and promote recovery, tart cherry (TC) supplementation has been proposed to enhance recovery and athletic performance. This study examined the effects of powdered TC supplementation on various recovery and performance metrics following a repeated sprint exercise protocol in physically active young adults. Methods: 40 (18 M, 22 F) healthy, active participants (24.6 ± 5.5 yrs, 171.5 ± 11 cm, 71.7 ± 14.5 kg, 24.2 ± 3.1 kg·m⁻²) participated in this randomized, double-blind, placebo-controlled, parallel study design. Placebo (PLA) or powdered TC supplementation (500 mg/day) occurred for ten days: seven days prior to, day of, and two days following repeated sprints (15 × 30 m with 1 min rest between sprints). Performance was assessed via the countermovement jump, isometric mid-thigh pull, isokinetic knee extension, and the Wingate anaerobic test. Recovery was evaluated using visual analog scales for soreness, recovery, and readiness to train. Muscle damage was evaluated using creatine kinase. These measures were evaluated at baseline, and at 1 h, 24 h, and 48 h post-exercise. Results: Significant main effects of time were observed with recovery VAS (p < 0.001), readiness to train VAS (p < 0.001), and jump height (p = 0.014) experiencing similar reductions, while soreness VAS (p < 0.001) and creatine kinase (p = 0.05) experienced similar increases in response to the repeated sprint protocol and supplementation. Across all measurements, no significant group × time differences were observed for jump height (PLA:−6.7 ± 10.4% vs. TC: −11.0 ± 17.9%, p = 0.608), peak propulsive force (PLA: 0.3 ± 4.6% vs. TC: 2.2 ± 7.4%, p = 0.194), knee extension peak torque at 180°/s (PLA: 10.5 ± 73.5% vs. TC: −1.04 ± 49.6%, p = 0.335), readiness to train VAS (PLA: −23.0 ± 19.2% vs. TC: −14.7 ± 20.2%, p = 0.401), soreness VAS (PLA: 250 ± 323% vs. TC: 261 ± 432%, p = 0.838), recovery VAS (PLA: −24.6 ± 17.9% vs. TC: −8.2 ± 40.5%, p = 0.251), and creatine kinase (PLA: 22.8 ± 35.5% vs. TC: 90.4 ± 225.6%, p = 0.31). Conclusions: A single bout of repeated sprints was responsible for significant reductions in jump height, peak propulsive force, peak torque, and perceived readiness, while perceived soreness, myoglobin, and creatine kinase were significantly increased. Ten days of TC supplementation did not impact any change beyond what was observed in PLA for markers of recovery, readiness, soreness, exercise performance, and markers of muscle damage. Full article

(This article belongs to the Special Issue The Role of Sports Supplements in Sport Performance)

► Show Figures

Figure 1

15 pages, 1298 KB

Open AccessEditor’s ChoiceArticle

Immuno-Nutritional Profiling for Survival Stratification in Gastrectomized Patients with Malignant Chronic Intestinal Failure

by Konrad Matysiak, Magdalena Szewczuk, Aleksandra Hojdis and Tomasz Banasiewicz

Nutrients 2026, 18(3), 451; https://doi.org/10.3390/nu18030451 - 29 Jan 2026

Cited by 3 | Viewed by 977

Abstract

Background/Objectives: Patients who undergo gastrectomy for gastric adenocarcinoma and subsequently develop chronic intestinal failure requiring long-term home parenteral nutrition (HPN) represent a clinically vulnerable cohort in whom survival is shaped by profound nutritional depletion and systemic inflammation. Immuno-nutritional biomarkers may support improved [...] Read more.

Background/Objectives: Patients who undergo gastrectomy for gastric adenocarcinoma and subsequently develop chronic intestinal failure requiring long-term home parenteral nutrition (HPN) represent a clinically vulnerable cohort in whom survival is shaped by profound nutritional depletion and systemic inflammation. Immuno-nutritional biomarkers may support improved risk stratification in this setting. Methods: This retrospective study included adults who underwent gastrectomy for gastric cancer and developed malignant chronic intestinal failure requiring HPN. Immuno-nutritional status at HPN qualification was evaluated using the Controlling Nutritional Status (CONUT) score and the lymphocyte-to-monocyte ratio (LMR). Overall survival was analysed using Cox proportional hazards models. LMR discrimination was assessed using receiver operating characteristic (ROC) analysis with a Youden-derived cut-off, and differences in AUC were tested using DeLong’s method. Results: Ninety-seven patients met the inclusion criteria. Median overall survival was 176 days. In multivariable analysis, CONUT and LMR were the only independent predictors of survival. Each one-point increase in CONUT was associated with an approximately 70% increase in mortality risk. LMR demonstrated good discriminative ability (AUC 0.795), and a cut-off of 2.083 differentiated survival trajectories. The combined CONUT–LMR model improved prognostic classification, and DeLong’s test confirmed a significant AUC difference compared with single-marker models. Kaplan–Meier curves showed clear separation across CONUT and LMR strata (log-rank p < 0.001). Conclusions: Among patients requiring long-term HPN after gastrectomy for gastric cancer, CONUT and LMR provide complementary prognostic information. Their combined use enhances survival stratification and may support earlier identification of patients with high-risk trajectories. Full article

(This article belongs to the Special Issue Clinical Nutrition and Oncologic Outcomes in Cancer Survivors)

► Show Figures

Graphical abstract

31 pages, 1987 KB

Open AccessEditor’s ChoiceArticle

Determining the Global Economic Burden of External Health Effects of Food Consumption in 204 Countries and Territories

by Felix Seidel, Benjamin Oebel, Lennart Stein, Susanne Kleemann and Tobias Gaugler

Nutrients 2026, 18(3), 426; https://doi.org/10.3390/nu18030426 - 28 Jan 2026

Cited by 3 | Viewed by 3368

Abstract

Background/Objectives: Every country and territory worldwide is affected by varying degrees of under- and overconsumption of food. A substantial share of the economic burden of unsustainable malnutrition arises from diet-related health impacts, although existing research has largely focused on environmental consequences. Methods: This [...] Read more.

Background/Objectives: Every country and territory worldwide is affected by varying degrees of under- and overconsumption of food. A substantial share of the economic burden of unsustainable malnutrition arises from diet-related health impacts, although existing research has largely focused on environmental consequences. Methods: This study addresses this gap by combining cost-of-illness (COI) and True Cost Accounting (TCA) approaches, as well as Global Burden of Disease (GBD) data, to estimate external diet-induced health costs. A comprehensive database covering 204 countries and territories is established, quantifying health costs by disease category and dietary risk factor. Results: The results indicate that USD 1719.94 billion in annual global health costs are attributable to poor diets. This corresponds to an average burden of USD 211.08 per capita per year. Cardiovascular diseases (CVDs) constitute the largest share of costs, followed by diabetes mellitus (DM). In absolute and per capita terms, the United States contributes disproportionately. Regionally, North America bears 44.36% of the global monetary burden, while Oceania accounts for only 1.22%. The highest per-capita costs occur in North America, Europe, and Oceania. The most influential dietary risk factors are the overconsumption of processed and red meat, and the underconsumption of whole grains. A strong positive correlation is observed between diet-related health costs and national prosperity levels. Conclusions: This framework represents a novel approach to standardized and holistic valuation, providing a robust basis for deriving policy-relevant insights to inform sustainable nutrition strategies and advance the United Nations (UN) Sustainable Development Goals (SDGs), especially the second SDG, zero hunger. Full article

(This article belongs to the Special Issue Mega-Trend: Sustainable Nutrition and Human Health)

► Show Figures

Figure 1

23 pages, 4970 KB

Open AccessEditor’s ChoiceArticle

Differential Effects of Opuntia ficus-indica and Opuntia stricta var. dillenii Extracts on Liver Steatosis in a Murine Dietary Model

by Irene Besné-Eseverri, Denis Benito, Miren Fisico-Echezarraga, Miguel Arán-González, M. Pilar Cano, María P. Portillo and Jenifer Trepiana

Nutrients 2026, 18(3), 420; https://doi.org/10.3390/nu18030420 - 27 Jan 2026

Cited by 3 | Viewed by 1210

Abstract

Background/Objectives: Metabolic-dysfunction-associated fatty liver disease (MASLD) is characterised by an excessive hepatic lipid accumulation. The present research aims to study the impact of an Opuntia stricta var. dillenii peel extract and an Opuntia ficus-indica var. colorada pulp extract, known for their high [...] Read more.

Background/Objectives: Metabolic-dysfunction-associated fatty liver disease (MASLD) is characterised by an excessive hepatic lipid accumulation. The present research aims to study the impact of an Opuntia stricta var. dillenii peel extract and an Opuntia ficus-indica var. colorada pulp extract, known for their high content of betalains and phenolic compounds, on the prevention of hepatic lipid accumulation in the liver of rats with steatosis. Methods: For this, MASLD was induced in 60 male Wistar rats by a high-fat high-fructose diet. They were supplemented with Opuntia stricta var. dillenii peel extract or Opuntia ficus-indica var. colorada pulp extract at 25 or 100 mg/kg body weight/d. Results: The high-fat high-fructose diet caused an increase in final body and liver weight, hepatic triglyceride (TG) content, and altered liver histology. The increase in hepatic TG was due to the rise in fatty acid uptake and the increased assembly of TG, although increased de novo lipogenesis cannot be ruled out. The treatment with a low dose of Opuntia ficus-indica var. colorada pulp extract (L-OFI group) significantly prevented hepatic TG accumulation, and the high dose (H-OFI group) showed a tendency towards lower values compared to the rats fed the high-fat high-fructose diet. The main mechanism of action appears to be a down-regulation of fatty acid uptake. By contrast, Opuntia stricta var. dillenii peel extract did not prevent the high-fat high-fructose diet-induced steatosis. Conclusions: Overall, Opuntia ficus-indica var. colorada pulp extract may represent a potential strategy for MASLD prevention, although its beneficial effects require confirmation in human studies. Full article

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

► Show Figures

Figure 1

53 pages, 2727 KB

Open AccessEditor’s ChoiceReview

Hepatoprotective Potential of Curcumin in the Prevention of Liver Dysfunction in a Porcine Model

by Kamila Kibitlewska, Varunkumar Asediya, Krzysztof Karpiesiuk, Urszula Czarnik, Marek Lecewicz, Paweł Wysocki, Prarthana Sharma, Iwona Otrocka-Domagała, Łukasz Zielonka, Andrzej Pomianowski, Adam Okorski, Garima Kalra, Sharmin Sultana, Nihal Purohit, Adam Lepczyński, Małgorzata Ożgo, Marta Marynowska, Agnieszka Herosimczyk, Elżbieta Redlarska, Brygida Ślaska, Krzysztof Kowal, Angelika Tkaczyk-Wlizło, Paweł Grychnik, Athul P. Kurian, Kaja Ziółkowska-Twarowska, Grzegorz Roman Juszczak, Mariusz Pierzchała, Katarzyna Chałaśkiewicz, Katarzyna Kępka-Borkowska, Ewa Poławska, Rafał Radosław Starzyński, Magdalena Ogłuszka, Hiroaki Taniguchi, Frieder Hadlich, Henry Reyer, Michael Oster, Nares Trakooljul, Avon Augustin Nalpadan, Siriluck Ponsuksili, Klaus Wimmers, Chandra Shekhar Pareek and Wojciech Kozera Show full author list Hide full author list

Nutrients 2026, 18(3), 408; https://doi.org/10.3390/nu18030408 - 26 Jan 2026

Cited by 4 | Viewed by 2482

Abstract

Curcumin, the major polyphenolic constituent of Curcuma longa, has been widely investigated as a hepatoprotective adjunct due to its antioxidant and immunomodulatory properties. This review evaluates the relevance of curcumin for the prevention and management of liver dysfunction and hepatitis in pigs [...] Read more.

Curcumin, the major polyphenolic constituent of Curcuma longa, has been widely investigated as a hepatoprotective adjunct due to its antioxidant and immunomodulatory properties. This review evaluates the relevance of curcumin for the prevention and management of liver dysfunction and hepatitis in pigs by synthesizing available porcine evidence and integrating mechanistic insights from translational liver injury models where pig-specific data remain limited. Across experimental hepatic injury contexts, curcumin administration is most consistently associated with reduced biochemical and structural indicators of hepatocellular damage, including decreased aminotransferase activity, attenuation of lipid peroxidation, and enhancement of endogenous antioxidant defenses. These effects are mechanistically linked to suppression of pro-inflammatory signaling pathways, particularly NF-κB-related transcriptional activity and inflammasome-associated responses, together with reduced expression of key cytokines such as TNF-α, IL-1β, and IL-6. Concurrent activation of Nrf2-centered cytoprotective pathways and induction of phase II antioxidant enzymes (including HO-1, GST, and NQO1) appear to constitute a conserved axis supporting hepatic oxidative stress resilience. In swine-relevant infectious settings, available data further support antiviral activity against selected porcine pathogens, including classical swine fever virus and porcine reproductive and respiratory syndrome virus, potentially mediated through interference with lipid-dependent stages of viral replication and modulation of Kupffer cell activation. Although combination strategies with established hepatoprotective approaches are conceptually attractive, current synergy evidence remains heterogeneous and largely extrapolated. Overall, curcumin represents a plausible adjunct candidate for supporting porcine liver health; however, translation into practice will depend on resolving formulation-dependent bioavailability constraints and strengthening the pig-specific evidence base. Full article

(This article belongs to the Section Lipids)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Editor’s Choice Articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI