Sustainable Development Goal 2: Zero Hunger (4584)

Background: There is a high prevalence of the double burden of malnutrition (DBM) in children and adolescents in South Asia. This research aims to explore which sociodemographic factors are attributed to DBM in urban Bangladesh, a South Asian country. Methods: We conducted secondary analyses of data obtained from the national survey of childhood obesity among school-age children in Bangladesh (2012–2013). The sample includes 4140 children (aged 5–9 years) and adolescents (10–19 years) randomly recruited from the city corporation (urban) areas in all administrative divisions. At the population level, DBM was defined as the coexistence of underweight and overweight/obesity among children and adolescents. At the household level, DBM was defined as maternal underweight co-occurring with child overweight/obesity within the same mother-child dyad. A multivariable logistic regression model was fitted to estimate odds ratios and 95% confidence intervals. A rapid policy review was conducted to understand the implication of the results obtained from the analysis. Results: The prevalence of DBM at the population level was 45.2% (95% CI: 42.5–45.5%), ranging between 40.0% and 47.6% across seven divisions (p < 0.001). At the household level, DBM prevalence was 16.6% (95% CI: 14.7–18.7%), ranging between 14.0% and 19.0% across seven divisions (p = 0.015). At the population level, DBM odds were 56% higher among younger children (5–9 years) than adolescents (10–19 years) (OR: 1.56; 95% CI: 1.37–1.78), and this association was found in four divisions. At the household level (mother-child pairs), DBM odds were 64% higher in younger children than adolescents (OR: 1.64; 95% CI:1.38–1.95); and higher in children living at a lower-middle socioeconomic status (SES) and middle SES, than upper SES. The policy review revealed that Bangladesh has made substantial commitments to improve nutrition; however, reference to DBM is absent from policy documents. Conclusions: The prevalence of DBM is high among children in urban areas in Bangladesh, disproportionately affecting younger children and households with low SES. In the current policy space, Bangladesh should revise national nutrition frameworks to recognize DBM as a public health priority and implement region-sensitive strategies for preventing and reducing malnutrition among school-aged children. Full article

Background/Objectives: Incretin-based medications have transformed obesity management by enabling substantial body weight reduction. However, the rapid and pronounced loss of body mass necessitates a comprehensive, multidisciplinary approach incorporating nutritional and physical activity strategies to preserve lean mass, optimize functional outcomes, and prevent long-term complications. This narrative review provides a critical overview of this emerging clinical concern, which is expected to gain increasing relevance in the coming years. Methods: A literature review was conducted up to 31 October 2025, focusing on studies addressing nutritional, physical activity, and adjunctive interventions in adults with obesity treated with incretin-based medications. Results: Incretin-based agents induce significant weight loss, comparable to bariatric surgery, predominantly targeting adipose tissue. Nevertheless, these medications also cause rapid reductions in muscle and bone mass, often accompanied by nutrient deficiencies, which may compromise metabolic health and physical function. Tailored nutritional strategies—including hypocaloric diets enriched in protein and fiber, as well as amino acid, vitamin, and mineral supplementation—are critical to preserve lean mass and support sustained weight maintenance. Concurrently, structured, supervised physical activity, encompassing aerobics, resistance, and strength training, mitigates muscle loss and enhances functional capacity. Emerging pharmacological agents designed to promote adipose tissue reduction while preserving lean mass, as well as interventions targeting gut microbiota modulation, may represent promising adjunctive strategies to optimize long-term outcomes further. Conclusions: While incretin-based medications produce substantial weight loss, their impact on lean mass underscores the necessity of integrating personalized nutrition, supplementation, and structured exercise to preserve muscle, prevent malnutrition, and optimize long-term health and obesity outcomes. Full article

Phosphate is emerging as an active mediator of oxidative stress and vascular injury in chronic kidney disease (CKD). This emerging pathophysiological framework, referred to as “Phosphatopathy”, describes the systemic syndrome driven by chronic phosphate overload and characterized by oxidative stress, inflammation, endothelial dysfunction, vascular calcification, cellular senescence, and metabolic imbalance. Beyond being a biochemical marker, phosphate overload triggers NOX-derived reactive oxygen species (ROS), activates Wnt/β-catenin and TGF-β signaling, and disrupts the FGF23–Klotho axis, promoting endothelial dysfunction, vascular calcification, and left ventricular hypertrophy (LVH). These pathways converge with systemic inflammation and energy imbalance, contributing to the malnutrition–inflammation–atherosclerosis (MIA) syndrome. Experimental and clinical data reveal that the phosphate/urinary urea nitrogen (P/UUN) ratio is a sensitive biomarker of inorganic phosphate load, while emerging regulators such as microRNA-125b and calciprotein particles integrate phosphate-driven oxidative and inflammatory responses. Therapeutic strategies targeting phosphate burden—rather than serum phosphate alone—include dietary restriction of inorganic phosphate, non-calcium binders, magnesium and zinc supplementation, and activation of important pathways related to the activation of antioxidant defense such as AMP-activated protein kinase (AMPK) and SIRT1. This integrative framework redefines phosphate as a modifiable upstream trigger of oxidative and metabolic stress in CKD. Controlling phosphate load and redox imbalance emerges as a convergent strategy to prevent vascular calcification, improve arterial stiffness, and reduce cardiovascular risk through personalized, mechanism-based interventions. Full article

Post-dialysis fatigue is one of the most frequent and limiting symptoms among patients undergoing hemodialysis (HD), characterized by intense physical exhaustion that may persist beyond the treatment session. Sleep disturbances frequently coexist with fatigue and may contribute to overall symptom burden. Nutritional status has been identified as a potential determinant of fatigue severity. Understanding these relationships may help identify associated factors and guide multidisciplinary interventions. Objectives: To assess the prevalence and intensity of fatigue in patients receiving HD, to describe the burden of sleep disturbances, and to analyze their association with nutritional status and various clinical, dialytic, and sociodemographic variables. Methods: A cross-sectional descriptive study was conducted between November and December 2024 in adults with chronic kidney disease undergoing maintenance HD. Fatigue and sleep disturbances were assessed using brief patient-reported outcome items adapted from PROMIS item bank concepts and analyzed as separate subscales. Nutritional status was evaluated using the Mini Nutritional Assessment–Short Form (MNA-SF). Sociodemographic, clinical, dialytic, and laboratory variables were collected. Statistical analyses were performed using SPSS v29, applying association and correlation tests (p ≤ 0.05). Results: A total of 729 patients were included (67.1% men), with a mean age of 67.7 ± 14.5 years. Clinically relevant fatigue was reported by approximately 50% of participants, with around 20% presenting severe fatigue. Sleep disturbances affected nearly 60% of patients, with severe impairment reported in approximately 30%. Regarding nutritional status, 61.9% had normal nutrition, 33.2% were at risk of malnutrition, and 4.9% were malnourished. Fatigue was significantly associated with female sex (p < 0.001), longer time on hemodialysis (p < 0.001), greater weekly dialysis exposure (p = 0.012), and poorer nutritional status (p = 0.003). The absence of residual urine output showed a borderline association with fatigue (p = 0.059) but was significantly associated with sleep disturbances (p = 0.002). Sleep disturbance scores were also significantly associated with lower levels of albumin, total proteins, and transferrin. No associations were observed between fatigue and age, BMI, comorbidity, ultrafiltration rate, or biochemical parameters. Conclusions: Fatigue is a highly prevalent and clinically relevant symptom in patients undergoing HD and is closely associated with nutritional status and dialysis-related factors. Sleep disturbances are also highly prevalent and may act as an important modulating factor, potentially amplifying fatigue, particularly in patients with greater biological vulnerability or loss of residual kidney function. The systematic use of patient-reported outcome measures (PROMs) to assess fatigue and sleep, together with nutritional evaluation, may facilitate the early identification of vulnerable patients and guide targeted strategies to reduce symptom burden and improve quality of life. Full article

Background and Aims: Gastric cancer remains a major health burden in East Asia. Gastrectomy is a primary treatment, yet postoperative malnutrition—particularly inadequate protein intake—adversely affects outcomes. This study assessed the association between achieving ≥70% of the recommended protein intake one year after gastrectomy and three-year survival. Methods: In this prospective, single-center, observational study, 69 patients with newly diagnosed gastric cancer who underwent gastrectomy between January 2021 and August 2023 were enrolled. Four patients who died within one year postoperatively were excluded, leaving 65 patients for analysis. Protein intake achievement rate (PIAR) at 12 months was calculated based on a recommended intake of 1.2 g/kg/day, and patients were stratified as PIAR ≥ 70% or <70%. Overall survival was analyzed using time-to-event methods, with a median follow-up of 2.1 years. Results: Among the 65 patients (median age 62 years, IQR 56–68; 56.9% male), 75.4% underwent subtotal gastrectomy. At 12 months, 7 patients (10.8%) failed to achieve a PIAR ≥ 70%. Compared with patients achieving adequate protein intake, those with inadequate intake more frequently underwent total gastrectomy (71.4% vs. 19.0%, p = 0.008) and had advanced-stage disease (Stage III–IV: 85.7% vs. 39.7%, p = 0.039). Kaplan–Meier analysis demonstrated significantly lower survival in the inadequate protein group, with a hazard ratio of 13.02 (95% CI 2.53–66.93); the wide confidence interval reflects the small number of patients with inadequate intake (n = 7). Conclusions: Failure to achieve ≥70% of recommended protein intake one year after gastrectomy is a strong independent predictor of mortality, associated with a 13-fold higher risk of death. Nutritional monitoring and early intervention are crucial, particularly for patients with total gastrectomy or advanced disease. Full article

Background/Objectives: The utility of routine gastric tube (GT) placement following gastrectomy in gastric cancer (GC) patients with pyloric obstruction remains controversial. This practice conflicts with Enhanced Recovery After Surgery (ERAS) principles, and its value in this high-risk subgroup is unclear. This study aimed to compare the clinical and economic outcomes of routine versus selective gastric tube use in these patients, and to identify predictors for prolonged gastric tube retention. Methods: A single-center retrospective cohort study was conducted on 133 GC patients with pyloric obstruction who underwent gastrectomy. Patients were stratified into GT (n = 63) and non-GT (n = 70) groups. Primary outcomes included 30-day complications, 90-day mortality, hospitalization duration, and costs. Univariate and multivariable Cox regression analyses were used to identify predictors of prolonged GT retention. Results: Routine GT use provided no clinical benefit, with similar 30-day complication (22.2% vs. 22.9%, p = 0.945) and 90-day mortality (1.6% vs. 0%, p = 0.290) rates. However, it was associated with a significantly prolonged postoperative hospital stay (8.8 ± 2.5 vs. 8.0 ± 4.2 days, p = 0.034) and a mean cost increase of ¥5900 per patient (p = 0.006). A dose–response relationship was evident: each additional day of GT retention correlated with 0.57 extra hospital days (r = 0.567, p < 0.001) and ¥3600 in added costs (r = 0.360, p = 0.004). Multivariable analysis identified longer preoperative fasting time (Adjusted HR = 1.27 per hour, 95% CI: 1.10–1.45, p = 0.001) and GLIM-defined malnutrition (Adjusted HR = 2.04, 95% CI: 1.02–4.17, p = 0.045) as independent predictors for prolonged GT retention. Conclusions: Routine GT placement after gastrectomy in obstructed GC patients increases healthcare costs and prolongs hospitalization without improving clinical outcomes. Preoperative fasting duration and nutritional status are key predictors for prolonged GT need. A selective GT strategy, guided by these parameters, is recommended to optimize recovery and resource utilization, aligning with ERAS principles. Full article

Restrictions on crop production in Ultisols are primarily driven by low soil fertility, which leads to the unsustainable use of soil resources and food insecurity. Significantly, arbuscular mycorrhizal fungi (AMF) enhance nutrient availability for plants, which in turn contributes to greater soil productivity and supports sustainable crop production. This study aims to evaluate the effects of AMF inoculation combined with chemical fertilisation on maize growth and yield in three series of Ultisols. A pot experiment was performed with a 2 × 3 factorial CRD with five replications. Two factors were studied as follows: (1) AMF (Glomus sp.) (non-AMF and AMF inoculation) and (2) rates of chemical fertiliser (0, 50, and 100% of the recommended fertiliser rate for maize, CF). The results showed that AMF significantly enhanced the growth and yield of maize at all CF rates for all soil series at p ≤ 0.01. Total biomass and grain yield following AMF treatment were markedly higher than yields obtained without treatment. Likewise, AMF significantly improved the photosynthetic physiology and NPK content of maize. The CF rate had a negative impact on AMF root colonisation, and AMF efficiency also decreased as the CF rate increased. The relative mycorrhizal dependency (RMD) on maize growth and yield was the highest at 0% CF, with averages of 34.49% and 52.35%; however, these values decreased to 7.43% and 8.73% at 100% CF, respectively. Despite this, the RMD of maize growth and yield remained positive for all soil series. These findings suggest that AMF are an effective means of supporting sustainable maize cultivation in Ultisols. Full article

This study advances the reconceptualization of Open municipal markets (OMMs) as networked ecosystems that connect food producers, vendors and citizenship across rural and urban contexts, sustaining short food supply chains and reinforcing territorial resilience through the interplay of mobility and embeddedness. Aimed at understanding OMMs as components of a broader, networked and adaptable food ecosystem, the research introduces a new methodology that builds on existing scholarship framing markets as relational and mobile spaces. It contributes to the literature by integrating these perspectives into an ecosystemic lens. By applying a mobility-based approach, the research shifts attention from static views of markets to their dynamic and circulatory nature, highlighting their role in fostering more sustainable and socially rooted food systems. Focusing on 105 OMMs in the Province of Girona (Spain), the research combines spatial analysis and data analysis of 300 surveys completed by 300 stallholders to examine how mobility practices shape market dynamics. The paper provides a new methodology of market stallholders and types of markets as well as four key indicators (recurrence, variety, closeness and rootedness) to assess stallholder activity and territorial embeddedness. These findings reveal that stallholders, particularly producers, connect rural production with urban consumption through flexible and multi-scalar circuits. The paper advocates for ecosystem-based urban food planning that harnesses stallholder mobility to strengthen territorial cohesion and food sovereignty, positioning OMMs as strategic public facilities for resilient and socially responsible food systems. Full article

Background/Objective: Malnutrition is common in hospitalized patients and worsens clinical outcomes, particularly in coronavirus disease 2019 (COVID-19), in which inflammation and metabolic disruption contribute to nutritional decline. Thus, identifying simple and accessible markers is essential for early detection and intervention to prevent further deterioration. This study aimed to investigate biochemical and body composition changes during COVID-19 hospitalization and identify key features of hospital-acquired nutritional status disorders. Methods: We conducted a prospective, single-center, observational study of 66 patients hospitalized with COVID-19 between December 2020 and June 2021. Biochemical markers and body composition parameters were measured at admission and at discharge. Deterioration of nutritional status was defined as a weight loss of more than 3% during hospitalization. Results: A total of 66 patients (61% male, aged 56.7 ± 13.4 years; 39% female, aged 58.8 ± 12.0 years) were included. Deterioration of nutritional status was observed in 20 (30%) individuals, more likely in men (OR 7.94, 95% CI: 1.28–49.08) and patients with longer hospitalization (OR 1.30 per day, 95% CI: 1.08–1.57). Weight loss was primarily characterized by a reduction in adipose tissue mass, whereas lean tissue mass did not change significantly. Traditional biochemical markers of malnutrition, including low albumin, prealbumin, or cholesterol levels, were not present in this cohort. Conclusions: Our study highlights the significant burden of nutritional deterioration in hospitalized patients with COVID-19 and demonstrates its atypical presentation, which may limit the effectiveness of standard malnutrition assessment tools. Full article

Over the past two decades, escalating climate crises, geopolitical conflicts, and pandemics have intensified the frequency and severity of disasters, exposing severe vulnerabilities in global food systems. In this pressing context, disaster nutrition emerges as a vital domain of intervention. However, existing academic literature and field practices often address this topic through fragmented, single-axis perspectives. Nutritional physiology, food technology, humanitarian logistics, and policy–ethics frameworks tend to progress in parallel yet disconnected tracks, which results in a lack of holistic models that adequately reflect field realities. The urgency of this issue is underscored by the latest global data. In 2023 alone, disasters resulted in over 86,000 deaths, a significant increase from the preceding two-decade annual average. Furthermore, the 2025 Global Report on Food Crises reveals that 295.3 million people faced high levels of acute food insecurity in 2024, marking the sixth consecutive year this number has risen. This escalating crisis highlights the inadequacy of fragmented approaches and necessitates the development of an integrated framework for disaster nutrition. To address this fragmentation, this study redefines disaster nutrition as a multi-layered, integrated food system challenge. Based on a comprehensive literature analysis, it proposes an “Integrated Disaster Food System Model” that brings these different dimensions together within a common framework. The model is built on four main components: (i) nutritional requirements and vulnerable groups (such as infants, older adults, pregnant individuals, and populations with chronic diseases requiring special diets); (ii) product design, technology, and packaging (balancing shelf life, nutritional value, cultural acceptability, and sensory attributes, including innovative components such as microalgae and fermented foods); (iii) logistics, storage, and distribution systems (centralized storage versus localized micro-warehouses, as well as the use of drones and digital traceability technologies); and (iv) policy, regulation, ethics, and sustainability (the applicability of the Sphere Standards, fair distribution, food waste, and environmental impact). By emphasizing the bidirectional and dynamic interactions among these components, the model demonstrates how decisions in one domain affect others (for example, how more durable packaging can increase both logistics costs and carbon footprint). The study highlights the risks and cultural mismatches associated with a “one-size-fits-all high-energy food” approach for vulnerable groups and argues for the necessity of localized, context-specific, and sustainable solutions. In conclusion, the article posits that the future of disaster food systems can only be shaped through a holistic approach in which interdisciplinary collaboration, technological innovation, and ethical–environmental principles are integrated into the core of policy-making. Full article

Background: Malnutrition is a common yet often underestimated risk factor for adverse outcomes in hospitalized patients, including heart transplant recipients. Assessing nutritional status in this population is challenging due to comorbidities, pharmacotherapy, and the urgent nature of surgery. This study aimed to evaluate the reliability of routinely measured laboratory and anthropometric parameters in diagnosing malnutrition in heart transplant patients. Methods: This retrospective study included 53 adult patients who underwent orthotopic heart transplantation between 2021 and 2024 at the Silesian Center for Heart Diseases in Zabrze, Poland. Anthropometric data (gender, age, BMI) and laboratory parameters—albumin, total protein, hemoglobin, cholesterol, C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR)—were analyzed. Malnutrition was defined as BMI < 22 kg/m². Cut-off points were based on literature data. Correlations between laboratory parameters and nutritional status were assessed, and concordance in malnutrition classification was evaluated. Results: Malnutrition criteria were met by 15% of patients. Only CRP predicted malnutrition risk, though its values did not differ significantly between BMI groups (p = 0.106). Negative correlations were found between CRP and total protein (−0.342; p = 0.012), albumin (−0.666; p < 0.0001), cholesterol (−0.287; p = 0.037), and hemoglobin (−0.383; p = 0.0046). A positive correlation was observed between CRP and NLR (0.333; p = 0.014). Conclusions: Malnutrition assessment in heart transplant recipients should not rely solely on individual laboratory parameters. A multifactorial approach integrating biochemical, anthropometric, and clinical data is necessary. Further research is needed to identify novel biomarkers to improve malnutrition risk evaluation and guide nutritional interventions in this population. Full article

Background/Objectives: Early risk assessment of nutritional and muscular status in geriatric palliative care patients may facilitate timely, personalized care. This study aimed to evaluate the association between the CONUT score, ultrasound-assessed muscle mass, and short-term mortality at 30, 45, and 60 days. Methods: This prospective, single-center study was conducted in a tertiary palliative care unit between May and September 2024. Muscle mass was assessed via ultrasound by measuring the thickness and cross-sectional area of the rectus femoris and biceps brachii. Nutritional status was evaluated using the CONUT score (low: ≤4, high: ≥5). Mortality at 30, 45, and 60 days was analyzed using Kaplan–Meier curves, Cox regression, and ROC analysis. Results: In a cohort of 200 geriatric palliative care patients (mean age 78.4 ± 10.2 years; 54.5% female), those with higher CONUT scores (≥5) had significantly lower ultrasound-assessed muscle mass and higher short-term mortality rates (48.6% vs. 11.3%, p < 0.001). A CONUT score ≥ 5 and the presence of malignancy independently predicted mortality, with hazard ratios up to 3.72. The CONUT score demonstrated moderate predictive accuracy for short-term mortality, highest at 60 days (AUC = 0.736). Kaplan–Meier analysis revealed significantly reduced survival among patients with higher CONUT scores. Conclusions: A CONUT score ≥ 5 and malignancy independently predicted short-term mortality, and higher CONUT scores were associated with lower muscle mass. The CONUT score may be a useful tool for early risk assessment in geriatric palliative care, though further research is warranted. Full article

Background: Nutritional status is a key determinant of surgical outcomes, but its assessment in emergency settings remains challenging. The prognostic nutritional index (PNI), which is derived from the serum ALB concentration and lymphocyte count, is a rapid, objective measure of nutritional and immune status. This study evaluated the associations between the PNI and postoperative outcomes in patients undergoing emergency laparotomy. Methods: A retrospective observational study was conducted at a single district general hospital in England, including adult patients who underwent emergency laparotomy between January 2019 and December 2023. The PNI was calculated as PNI = serum albumin (g/L) + 0.005 × total lymphocyte count (cells/μL). Patients were classified as malnourished (PNI < 50) or not malnourished (PNI ≥ 50). The outcomes assessed included postoperative complications, length of hospital stay (LOS), 30-day readmission, and three-year all-cause mortality. Statistical analyses included chi-square, Mann–Whitney U, logistic regression, and Kaplan–Meier survival analyses. Preoperative albumin and lymphocyte counts were obtained on admission or within 24 h prior to surgery to calculate the PNI. Results: Among 482 patients (median age 68 years; 57% male), 66% were malnourished. Malnutrition was significantly associated with higher ASA grade (p < 0.001), frailty (p = 0.028), and comorbidity burden (p < 0.001). Malnourished patients had longer LOSs (≥12 days; p < 0.001) and higher 30-day readmissions (p = 0.026). After adjustment for key confounders, low PNI remained independently associated with stoma formation and prolonged length of stay. After adjustment for ASA grade, frailty, comorbidity burden, hypotension, and sepsis, low PNI remained independently associated with stoma formation and prolonged length of stay. Kaplan–Meier analysis revealed reduced three-year survival in malnourished patients (log-rank p < 0.01). Conclusions: Malnutrition, as defined by a low PNI, is highly prevalent and associated with adverse postoperative outcomes in emergency laparotomy. PNI is a simple, objective, and clinically useful tool that should be incorporated into preoperative assessments to guide early nutritional optimization. However, albumin and lymphocyte counts may be influenced by acute inflammation and resuscitation in emergency presentations, and nutritional interventions were not captured in this retrospective dataset. Full article

This study investigated the fungal species associated with symptomatic cultivated Brassica crops in Apulia, Southern Italy, during the 2022–2023 growing seasons. Twenty-two samples from Brassica oleracea var. botrytis, B. oleracea var. italica, and B. rapa var. cymosa showing stunting, wilting, necrotic spots, and lesions were analyzed using morphological and molecular analyses. A total of 259 fungal isolates were obtained, mainly belonging to the genera Alternaria, Plectosphaerella, Fusarium, and Sclerotinia, with Alternaria and Plectosphaerella being the most frequent. Microsatellite PCR (MSP-PCR) profiling revealed considerable genetic diversity within the Alternaria and Plectosphaerella genera, whereas Fusarium and Sclerotinia showed uniform profiles. Multilocus analyses (ITS, tef-1α, rpb2, Alt-a1, and gapdh) identified nine species as Alternaria alternata, A. brassicicola, A. japonica, Fusarium solani species complex, Plectosphaerella cucumerina, P. pauciseptata, P. plurivora, Sclerotinia sclerotiorum, and Stemphylium vesicarium. While Alternaria, Fusarium, and Sclerotinia species are well-known Brassicaceae pathogens, P. pauciseptata, P. plurivora, and S. vesicarium have been detected here for the first time on cultivated Brassica crops worldwide. These findings highlight significant intraspecific diversity among the detected fungi and expand the current knowledge of fungal diversity associated with symptomatic cultivated Brassica plants. Full article

Kale (Brassica oleracea L. var. acephala) has a long history of cultivation, and its importance as a source of mineral nutrients has received particular attention. This study aims to screen the variation in elemental leaf accumulation of 23 Croatian autochthonous kale accessions from the Adriatic basin. A two-factorial experiment with harvest time and kale accession as the main factors was conducted under field conditions. Further, the leaf elemental contents were measured and inter-elemental correlations computed. An analysis of the data revealed that IPT 418 accumulated the highest contents of Ca, Ni, and Li, while IPT 401 was most effective in Mg and Zn accumulation. The accessions IPT 411, IPT 384, and IPT 390 had the highest amounts of P, Mn, and Cr, respectively. Considering the range within the highest and lowest content, the accumulation varied 4-fold for Ca; 1.8-fold for Mg; 1.5-fold for P; 1.5-fold for Mn; 2.5-fold for Ni; 2-fold for Zn; 2.2-fold for Cr; and 1.7-fold for Li. According to the correlation matrix, positive correlations in elemental phytoaccumulation were found between macro- and micronutrients, while negative correlations were observed among macronutrients in most cases. In conclusion, the accessions most efficient in accumulating macro- and micronutrients may be potentially used to address nutrient malnutrition and produce more nutritional kale. Full article

To contribute to the United Nations’ 17 Sustainable Development Goals (SDGs), this study focuses on improving two specific goals—SDG 2 (Zero Hunger) and SDG 12 (Responsible Consumption and Production)—by examining how off-farm employment affects agricultural green total factor productivity (GTFP) in China, a key link between rural socio-economic transformation and agricultural sustainability. The results show that: First, the part-time operation of farmers significantly reduces the green total factor productivity, and the negative impact is more pronounced for off-farm employment households with higher non-agricultural income shares. It mainly stems from the redundant input of land and machinery elements. Second, the effect showed obvious heterogeneous effects at different stages of family development and land management scale. In addition, the scale effect of continuous agricultural production services and the technological synergy effect driven by the deepening of agricultural division of labor are the key to improving green total factor productivity and alleviating the negative effects of part-time operations. In summary, promoting sustainable agricultural practices requires the government to further deepen the reform of the land property rights system and optimize the agricultural socialization service system to ensure both food security and environmental sustainability. Full article

Agriculture provides food and nutrition security essential for improving livelihoods. However, the region has been experiencing extreme weather events, which cause challenges ranging from reduced agricultural production to threatening food insecurity and lower income. The study aims to evaluate the susceptibility of smallholder farmers to climate change and identify key sustainable agricultural interventions through a systematic review and bibliometric analysis. The Scopus database retrieved the literature on sustainable agriculture following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Publication trends, co-occurrence of citations, and thematic evolution were analysed. The findings show that conservation agriculture and climate-smart agriculture and their role in improving climate resilience among smallholder farmers were the commonly studied interventions. The adoption of these interventions by farmers can positively aid in attaining the Sustainable Development Goals and the Agenda 2063 Goals. This will help mitigate climate change effects while improving agricultural production, fostering entrepreneurship, and enhancing nutrition and livelihoods in South Africa. The findings from the study can inform policymakers in designing localised, scalable, and evidence-based solutions to improve smallholder farmers’ level of resilience. Institutional and governmental support for smallholder farmers in implementing sustainable interventions is important. Full article

Background: Cyproheptadine-based appetite stimulants (CAS) have been safely used in Korea for over 30 years. However, in older adults who are vulnerable to malnutrition, sarcopenia, and fall-related morbidity, safety of CAS in nutrition care remains uncertain due to limited evidence and its antihistaminic effects. This study aimed to assess the real-world safety of CAS compared with megestrol and other antihistamines to inform safe pharmacologic support within clinical nutrition practice. Methods: A retrospective observational study was conducted using Seoul National University Hospital’s common data model. Patients who were prescribed CAS, megestrol, or antihistamines between 2004 and 2022 were enrolled. To balance covariates, propensity score matching was applied. The primary outcomes—dizziness, sedation, and hypotension—were evaluated within 30 days of drug administration. Additionally, sensitivity analyses and subgroup assessments by age and duration of use were performed to evaluate robustness of the findings. Results: No significant differences were observed in the risk of dizziness, sedation, or hypotension when CAS was compared to megestrol, with adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of 1.02 (0.70–1.50) for dizziness, 0.53 (0.19–1.54) for sedation, and 0.70 (0.34–1.44) for hypotension. Similar findings were noted in the comparison with antihistamines, where the aHRs for dizziness, sedation, or hypotension of 0.56 (0.41–0.78), 1.05 (0.46–2.38), and 0.65 (0.36–1.17), respectively. Conclusions: CAS demonstrated an acceptable safety profile in older adults, with safety comparable to both megestrol and antihistamines. Full article

Mesenchymal stromal cells (MSCs) are multipotent and play an important role in regenerative processes such as wound healing. Data on possible changes and functional restrictions of MSCs due to cisplatin chemotherapy, for example, in the treatment of head and neck cancer, diverge. The aim of this study was to evaluate the influence of cisplatin on MSCs with regard to their defining characteristics and their ability to differentiate and to migrate. MSCs from four human donors (a 59-year-old man, a 63-year-old woman, a 70-year-old man, and a 61-year-old man) were cultured in vitro with and without cisplatin for 24 h, and toxic and subcytotoxic concentrations were determined using an MTT. We then examined the surface phenotype markers (flow cytometry), migration (scratch assay), histological differentiation markers (adipo-, chondro-, osteogenic), and the expression of selected line-associated genes in real-time quantitative PCR (RT-qPCR) (LEP, SOX9, RUNX2). These characteristics were evaluated after treatment with different subcytotoxic, clinically relevant doses of cisplatin. Flow cytometry confirmed the presence of MSCs-characteristic surface markers, which remained stable under treatment with subcytotoxic doses of cisplatin. Cisplatin exposure reduced the mRNA abundance of leptin (a marker for adipogenic differentiation) but increased SOX9 mRNA abundance (chondrogenic differentiation). RUNX (osteogenic differentiation) did not change post cisplatin exposure. Histological analysis showed no difference with regard to osteogenic, chondrogenic, and adipogenic differentiation at doses up to 10 μM cisplatin. Cell migration was not restricted by cisplatin exposure under the conditions used here. The characteristics of MSCs were not different to controls post cisplatin exposure. mRNA analysis suggested induced changes by cisplatin, although this effect was not histologically detectable even at high doses. Based on the single-molecule markers used here, indications for an inhibitory effect of cisplatin on adipogenic differentiation and a rather enhancing effect on chondrogenic and osteogenic differentiation may be hypothesized. The process observed here could further aggravate the already serious problem of malnutrition in head and neck cancer patients, for example. Taken together though, our study confirms overall MSCs tolerance towards cisplatin. Full article

This study examines the influence of agricultural labor policies on the sustainability and productivity of farming enterprises in Türkiye, with a particular focus on the sector’s increasing reliance on foreign labor. Using primary data collected through face-to-face surveys with 73 agricultural enterprises in the Çumra District of Konya Province during the 2023–2024 production year, supplemented by secondary data from national and international institutions, the research explores how workforce composition, policy regulations, and socio-economic factors affect farm performance. Descriptive and comparative statistical analyses were conducted using SPSS to evaluate demographic characteristics, employment patterns, wage structures, and satisfaction levels among local and foreign workers. The findings indicate that as farm size expands, the use of foreign labor—mainly from Afghanistan, Uzbekistan, and Turkmenistan—significantly increases, generating cost and productivity advantages but also raising concerns related to social integration and legal employment barriers. Local labor demonstrates greater competence in mechanization but remains insufficient in quantity, deepening the existing labor shortage. A substantial majority (91%) of producers consider current labor regulations restrictive and emphasize the need for government incentives, vocational training programs, and simplified permit procedures for foreign workers. The results highlight the importance of inclusive and adaptive labor policies that harmonize economic efficiency with social cohesion, supporting the achievement of Sustainable Development Goals (SDG) 2, 8, and 11—Zero Hunger, Decent Work and Economic Growth, and Sustainable Cities and Communities. Full article

In the face of escalating global challenges, including climate change, food insecurity, freshwater scarcity, soil degradation, and rapid urbanization, soilless farming systems, such as hydroponics, aquaponics, and bioponics, have emerged as innovative and sustainable farming solutions. Combined with precision agriculture technologies, these systems enable real-time optimization of inputs through smart sensors, automation, and predictive modeling, significantly reducing resource consumption while improving crop yields. This review provides a unique contribution by integrating and comparing the three major soilless systems within a single framework and by highlighting, for the first time, their potential synergies with precision agriculture. It critically examines soilless cultivation systems and their relationship with precision agriculture, assessing the agronomic, environmental, and economic benefits as well as the main challenges, including high initial costs, high energy consumption, the complexity of managing biological inputs, the lack of standardized protocols, and limited accessibility for small-scale producers. The review highlights the need to integrate renewable energy sources, develop biodegradable substrates, apply life cycle assessment methodologies, and implement adequate training and regulatory frameworks to promote wider adoption and sustainability. Full article

Taro (Colocasia esculenta (L.) Schott) is a nutritionally important and climate-resilient crop with high potential for enhancing food security. Despite its significance, taro remains underutilized and excluded from major agricultural policies in Rwanda, resulting in low national yields. This gap hinders evidence-based planning and limits the crop contribution to resilience amidst population growth and climate change. By taking Rwanda as an example, a worldwide top 10 taro-producing country but still facing food insecurity issues, this study conducted a nationwide land suitability assessment to identify optimal areas for taro cultivation and quantify the production gap. The Fuzzy Analytic Hierarchy Process (AHP) model was integrated with GIS, where climatic, topographic, and a remotely sensed soil dataset were weighted and combined to generate a composite suitability index. Results revealed that 22.8% of Rwanda’s land is highly suitable (S1) and 55.7% is moderately suitable (S2) for taro cultivation. Within agricultural land, 30.2% is highly suitable, of which a significant portion (28.7%) remains largely underutilized, especially in the Eastern province. The national production gap was estimated at 32.4%, with over half of the districts exceeding 30%. The study highlights the importance of aligning taro cultivation with biophysical suitability and integrating spatial planning into national agricultural policies. The developed suitability map provides a critical decision-support tool for policymakers, agricultural planners, and extension services. By promoting sustainable taro production, improving farmer livelihoods and food security in Rwanda, it provides a global model for sustainable development for developing countries and advances research on orphan crops such as taro. The methodology offers a replicable framework for evaluating underutilized crops globally, contributing to sustainable agricultural diversification and food security. Full article

Micronutrient deficiencies, also known as “hidden hunger,” remain a pervasive public health issue in low- and middle-income countries, particularly among vulnerable populations within these countries. The main drivers of these deficiencies are poverty, limited dietary diversity, weak nutritional strategies, poor health service delivery and general health access barriers. This review assesses the prevalence, drivers, and consequences of selected micronutrient deficiencies: iron, iodine, zinc, vitamin A and vitamin D, within the scope of undernutrition, food insecurity, and socioeconomic inequity. The consequences associated with these deficiencies include stunted growth, increased susceptibility to illness, poor cognitive and social functioning, and deepened poverty. The primary strategies to address these deficiencies include dietary diversification, supplement provision, biofortification, and the production of fortified foods. Barriers to progress include the high cost of food, weak healthcare infrastructure, low educational levels, and ineffective policy implementation. Integrated food systems, personalised nutrition, and innovative food technologies have the potential to address both nutritional and health inequities. Addressing barriers to safe and nutritious food and healthcare systems in order to address health inequities requires integrated, multisectoral planning and contextual policy. Improving individual health outcomes is crucial, but addressing micronutrient deficiencies has a ripple effect throughout society, enabling economic development through poverty reduction and increased productivity. Full article

Background: Socioeconomic disparities may drive cancer inequities in Hispanic/Latino populations. We examined associations of perceived access to healthy foods (AHF) and food insecurity (FI) with diet and body mass index (BMI) changes in Latina breast cancer (BC) survivors. Methods: Latina BC survivors in a 12-month intervention trial aiming to increase fruit/vegetable intake and physical activity were analyzed. AHF was from a modified, validated neighborhood environment scale and dichotomized (low–medium vs. high). FI was defined as eating less and/or going hungry due to a lack of money. AHF and FI surveys were self-reported. Outcomes included dietary intake, diet quality, and BMI. Fruit/vegetable intake was log-transformed. Relationships between AHF and FI and changes in diet and BMI were evaluated using generalized estimating equations. Results: Of women with AHF data (n = 86), 58% reported low–medium access and 42% reported high access. Fruit/vegetable (FV) intake declined overall from baseline to 12 months, with greater reductions among low–medium AHF women (−32%, 95% CI: −51%, −7%) compared with high AHF women (−17%, 95% CI: −40%, +13%). Statistically significant 12-month decreases in total calories, carbohydrates, sugars, and fat occurred in low–medium AHF women but not high AHF women, and changes in total energy density, carbohydrates, sugars, and BMI at 12 months were statistically significantly different between women with low–medium AHF and women with high AHF, p ≤ 0.05. Among 157 women, 23% reported FI. Reductions in fruit/vegetable intake were larger in women with FI (−39%, 95% CI: −57%, −14%) than in women without FI (−10% reductions, 95% CI: −25%, +8%) and between-group differences were significant at both 6 and 12 months, p ≤ 0.05. Most diet measures decreased for both FI and non-FI women, with greater decreases among those with FI. Conclusions: Latina BC survivors with FI or perceived limited AHF experienced greater declines in indicators of healthy diets including FV intake. Future interventions should integrate strategies to measure AHF and FI to address disparate access to healthy food options. Full article

Background: Obesity is a chronic disease that has negative health consequences for children. Peer support models have been used to manage chronic diseases like diabetes; however, little is known about how a peer support intervention might promote healthy infant growth to prevent pediatric obesity. The aim of this project was to explore parental perspectives on how a peer support intervention might be developed to support healthy infant weight gain and nutrition. Methods: Data were collected from November 2022 to October 2023 at a single pediatric primary care clinic. Semi-structured interviews explored parents’ perspectives of how a peer parent coach could promote healthy infant nutrition and growth. Interviews focused on (1) common infant feeding and nutrition questions, (2) the role and importance of peer support during the newborn period, and (3) strategies for addressing and facilitating connections to food-related resources and addressing food insecurity. Results: A total of 18 interviews were conducted. Average parental age was 32.1 years (range 20–46 years). Thirty-three percent of the participants identified as Black, 28% identified as White, 11% identified as Asian, and the remaining identified as Other or preferred not to report. Half of the sample reported a household income of <$20,000, 67% reported having public insurance, and 11% reported household food insecurity. Themes that emerged included: peer parent coaches can (1) provide emotional support to families with young infants, (2) education focused on infant nutrition, and (3) facilitate connections with nutrition resources. Participants also noted the importance of understanding a family’s unique culture when counseling on infant growth and nutrition. Conclusions: Multiple themes were identified about how a peer support intervention could support healthy infant nutrition and growth. Future work should test the feasibility and acceptability of a peer support intervention to promote healthy infant weight gain. Full article

Infants and children with congenital heart diseases (CHDs) are especially susceptible to malnutrition. The pathogenesis of nutritional disorders in this population reflects a multifactorial balance between increased metabolic demands, reduced dietary intake, and altered nutrient absorption. This narrative review summarizes current knowledge on the prevalence, risk factors, and underlying mechanisms of malnutrition in paediatric CHDs. It also discusses available tools for nutritional assessment, practical strategies for dietary management, and perioperative considerations. Early identification through screening, combined with individualized nutritional support and multidisciplinary care, is essential to optimize growth and enhance clinical recovery. Special attention is given to feeding difficulties, micronutrient imbalances, and the contribution of human milk and energy-dense feeding approaches in promoting growth. Integrating nutrition into cardiac management is essential to improve both short- and long-term outcomes. Future research should focus on the development of standardized, evidence-based protocols and the implementation of precision nutrition in paediatric CHDs. Full article

Background: Malnutrition and micronutrient deficiencies remain significant public health burdens among Indonesian children under five years of age. This study assessed the relationship between growth indicators and micronutrient status of children aged 0–59 months. Methods: A cross-sectional design was performed, utilizing the 2018 Indonesian Basic Health Research (Riskesdas) data and biological specimens, including 550 samples from children aged between 0 and 59 months old. The Riskesdas data used in this study were demographic characteristics, anthropometric measurements, and nutritional status. The biological samples were used to measure micronutrients (iron, zinc, calcium, vitamin A (VA), and vitamin D (VD). Results: Overall, 23.1% of children were stunted, and 10.5% were wasted. This study also revealed that the prevalence of micronutrient deficiency was 34.2%, 38.7%, 8.2%, 7.8%, and 0.4% for ferritin, zinc, calcium, VA, and VD, respectively. Moreover, wasting was significantly higher in girls (13.5%) than in boys (8.2%, p = 0.044). Stunted children had significantly lower ferritin values, while wasted children had lower VA concentrations. In contrast, VD was lower in overweight children. Lastly, this study found that height for age Z-scores (HAZ score) and Body Mass Index (BMI) for age Z-scores (BAZ score) correlated positively with ferritin, zinc, and calcium levels. Conclusions: Stunting, wasting, and multiple micronutrient deficiencies remain prevalent among Indonesian children under five years of age. Strengthening nutrition interventions, in particular for iron, zinc, VA, and VD, is essential to improve child growth and health outcomes in this population. Full article

Malnutrition in patients with gastrointestinal (GI) cancers can be the result of functional and/or anatomical changes in the alimentary tract, secondary to malignancy or oncologic therapies. Understanding the underlying mechanisms of malnutrition in these patients is imperative in providing appropriate interventions that can not only improve quality of life for these individuals, but also improve their tolerance of oncologic treatment and progression towards remission or cure. In this narrative review, we address common nutritional deficiencies associated with GI malignancies, including pancreatic, biliary, and hepatic cancers. Furthermore, we address common issues related to these deficiencies and causes of nutrition barriers as they relate to organ malfunction or surgical alterations of anatomy. Recommendations for counseling, dietary modifications, nutritional supplements, and pharmacologic interventions are provided based on individual barriers and the vital role of multidisciplinary care is highlighted. Additionally, we highlight novel techniques, such as the role of psychosocial care, prehabilitation, digital health, and machine learning, which can improve nutritional outcomes, provide patient-directed care, and improve risk stratification for this complex and multifaceted issue that faces patients diagnosed with GI cancers. Full article

Regenerative agroecology promotes a suite of methods that diversify farmers’ techniques, crops, and income-generating opportunities. Many low- and middle-income countries struggle with food insecurity, malnutrition, and poverty, relying on natural resources for their livelihoods. In Madagascar, we led agroecology interventions, sharing locally grounded technologies to increase productivity and regenerate biodiversity. We evaluated the short- and medium-term outcomes using a mixed-methods social science approach. We monitored a cohort of over 500 participants in 27 rural communities who trained in market vegetable farming and poultry husbandry between 2019 and 2025. For participants in market vegetable and poultry husbandry interventions, over half adopted new technologies, reporting positive experiences, though outcome achievement varied. Participants in the market vegetable interventions reported they had the knowledge and skills to practice sustainable agriculture, remarking that the hands-on demonstrations and practice facilitated learning, as well as the accessibility of resources for implementation. Women were 1.68× more likely to adopt vegetable farming than men (multinomial regressions, gender log odds = 0.53, p < 0.01), while there was no difference in genders in adoption of poultry husbandry (gender log odds = 0.28, p > 0.05). Most (95–98%, n = 1012) responded they were satisfied with the results of the interventions and would continue to use the skills they learned. Insights generated by this program evaluation led to the following recommendations and improvements: (1) more hands-on demonstrations compared to classroom presentations; (2) more frequent medium-term consultations with participants; (3) introducing microcredit mechanisms to combat cost-related barriers; (4) diversifying outreach approaches. Implementing these recommendations continues to improve outcomes as we scale our interventions. Full article

The production and quality of wheat and maize grain can be significantly affected by various pests and pathogens, with phytoplasmas posing a particular threat due to their rapid spread and potential to cause severe damage to cultivated crops. The objective of this investigation was to evaluate the risk associated with these wall-less bacteria in wheat and maize crops. To achieve this, a survey was conducted in commercial fields located in southwestern Poland. Samples of winter wheat and fodder maize were collected at two distinct developmental stages, including both symptomatic and asymptomatic plants. Symptoms observed in wheat included yellowing, stunting, and excessive tillering, while maize plants showed yellow leaf striping, red discoloration, and stunted growth. Polymerase chain reaction (PCR) assays using phytoplasma-specific primers, followed by Sanger sequencing and sequence analysis, confirmed phytoplasma infections in 2% of wheat and 1.5% of maize samples. Virtual restriction fragment length polymorphism (RFLP) analysis identified the wheat-infecting phytoplasmas as belonging to subgroup 16SrI-C (‘Candidatus Phytoplasma tritici’-related strain)—a pathogen of major concern for wheat, while maize-infecting phytoplasmas were classified into subgroups 16SrI-B and 16SrV-C. Additionally, wheat plants collected during the early elongation phase were tested for Mastrevirus hordei (former wheat dwarf virus, WDV) using double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA), which confirmed the presence of WDV in all tested samples. Preliminary screening of field-collected leafhoppers revealed that 7.5% of Psammotettix alienus, the predominant species in wheat fields, carried 16SrI-C phytoplasmas. In maize fields, Zyginidia scutellaris was the most prevalent species, with 1.7% of individuals carrying 16SrV-C phytoplasma. These findings suggest that these insect species may contribute to the transmission of phytoplasmas in wheat and maize. This study provides the first documented evidence of 16SrI-C phytoplasma infecting wheat in Poland, and of 16SrV-C and 16SrI-B phytoplasmas infecting maize, expanding the known host range of these subgroups in the country and highlighting their potential phytosanitary importance. Full article

Background: Nigeria faces a severe child malnutrition crisis, with approximately 1 million severe cases reported for 2025. This burden positions Nigeria among the top countries globally for stunting and wasting in under-fives, exacerbated by factors like food insecurity, flooding, and conflict—particularly in the northern part. This study investigated the development and assessment of Ready-to-Use Therapeutic Foods (RUTF) produced from locally sourced ingredients in Kano State, Nigeria, targeting child malnutrition. Methods: Three distinct RUTF formulations were prepared using rice, wheat, groundnut, and soybean, with raw materials purchased from local markets and processed into blends. Proximate, vitamin (A, C, and E), and mineral (zinc, iron, potassium, magnesium, calcium, and sodium) compositions were measured following the Association of Official Analytical Chemists’ (AOAC) standard procedures. Sensory evaluation using a 9-point hedonic scale assessed taste, aroma, flavour, appearance, and overall acceptability. Results: Notable variations were observed among the samples. Blend A exhibited the highest energy (563.08 kcal/100 g), carbohydrate (46.57%), fat (35.84%), and vitamin E (9.29 mg/100 g) content. Blend B was highest in protein (16.71%), iron (2.40 mg/100 g), calcium (21.05 mg/100 g), and vitamin A (15.89 µM). Blend C contained the most potassium (61.65 mg/100 g) and vitamin C (11.70 mg/100 g), with moderate levels of other nutrients. Sensory ratings showed no significant (p < 0.05) differences among the parameters. Conclusions: The nutrient composition and acceptability of RUTF blends suggest that affordable, effective dietary solutions can be produced using local crops. These findings support the potential for locally formulated RUTFs to contribute to reducing child malnutrition in low-resource settings with further enhancements. Full article

This article compares the roles of allotments and community gardens in democratising London’s urban food system. Drawing from ethnographic and participatory action research (PAR), it reveals a recent policy shift favouring community gardens compared to allotments, which has resulted in a net reduction in long-term urban agriculture space in London. The study contrasts these two trajectories of urban agriculture across five democratic processes: (1) fostering food security, (2) expanding health benefits, (3) reclaiming the commons, (4) building spaces of interaction and representation, and (5) decoupling from dominant regimes. While community gardens tend to perform well in terms of social inclusion and environmental education of local communities and marginalised populations, allotments tend to be more successful in terms of productive capacity and developing autonomy due to their relatively more secure tenure. However, both trajectories are increasingly challenged by the dynamics of neoliberal urban development and the withdrawal of the state from its welfare responsibilities. This article argues that both trajectories do not have to be mutually exclusive and that their coexistence is in fact necessary to develop a more resilient urban food system, one that realises the principles of food sovereignty, social justice, and agroecological urbanisms at the local level. Full article

Bangladesh has significantly reduced child undernutrition, yet micronutrient deficiencies and diet-related non-communicable diseases remain pressing challenges. While the afordability of healthy diets is recognized as a key determinant of nutrition outcomes, limited attention has been paid to the uncertainties that affect diet costs and access over time. This paper addresses this gap by exploring the major drivers of uncertainty in the cost of healthy diets in Bangladesh and their implications for nutrition policy. This study emloyed foresight tools to explore future uncertainties affecting the cost and accessibility of healthy diets in Bangladesh. Key drivers of change, such as climate variability, market dynamics, income inequality, and dietary behavior, were identified through a structured expert workshop. Two critical uncertainties were selected using the 2 × 2 scenario planning method: food price volatility and changing dietary patterns. These formed the basis for four plausible future scenarios, each illustrating different trajectories for nutrition and food system outcomes. This foresight approach supports proactive, multisectoral policymaking by highlighting potential risks and opportunities for ensuring affordable, nutritious diets in a changing context. The resulting scenarios underscore the need for integrated, multisectoral strategies to build resilient food systems, improve the affordability of nutrient-rich foods, and promote dietary behavior change. Full article

Background/Objectives: Assessing age-related health decline in the elderly is critical, yet standard metrics like Body Mass Index (BMI) can be misleading. Bioelectrical impedance analysis (BIA) is a popular method to assess body composition. This study evaluated the relationship between BIA-derived parameters, a comprehensive panel of laboratory biomarkers, and nutritional status in a cohort of Polish older adults. Methods: In a cross-sectional study of 126 elderly participants (106 women, 20 men; mean age: 72.4 years), we performed multi-frequency segmental BIA to measure fat-free mass, skeletal muscle mass, and phase angle (PA). Nutritional status was assessed using the Mini Nutritional Assessment (MNA). Venous blood samples were analyzed for a comprehensive panel of hematological, inflammatory (CRP), hormonal (leptin), and metabolic biomarkers. Results: The analysis characterized the body composition and biomarker profiles of the cohort. MNA-defined malnutrition risk was associated with significantly lower muscle mass and PA, and altered fluid distribution (higher extracellular-to-total body water ratio), but not with reduced fat mass. Adiposity correlated strongly with leptin and CRP. Hematological parameters were linked to lean mass, while zinc and albumin correlated with PA. Canonical analysis identified two distinct physiological axes: a dominant “adipo-hormonal” axis linking leptin to fat mass, and a secondary “metabolic–cellular integrity” axis linking zinc and iron status to Phase Angle and fluid balance. Conclusions: In older adults, nutritional risk is characterized by sarcopenia and fluid shifts, not low adiposity, highlighting the inadequacy of BMI. BIA parameters, especially the phase angle, may serve as promising indicators of cellular health that correlate strongly with key micronutrients, suggesting a potential role in complementary geriatric assessment. Full article

Background: Sarcopenia is a progressive and multifactorial condition linked to aging, malnutrition, and chronic diseases, presenting significant clinical and public health challenges. Current screening tools vary in complexity and diagnostic accuracy, emphasizing the need for simple, evidence-based predictive models suitable for settings with limited resources. Methods: A cross-sectional study was conducted among community-dwelling older adults to develop and internally validate hierarchical predictive models for sarcopenia using readily available primary care variables. Three models were built: (1) a basic clinical model (age, sex, BMI, calf circumference, and SARC-F), (2) a model including nutritional status (Mini Nutritional Assessment, MNA), and (3) an extended model adding bioelectrical impedance parameters (phase angle, PhA). Model performance was assessed using AUC, Brier score, Hosmer–Lemeshow test, and decision curve analysis. Results: The parsimonious model demonstrated excellent discrimination (AUC = 0.91) and good calibration (Hosmer–Lemeshow p = 0.36), while the extended model with MNA and PhA achieved the highest overall performance (AUC = 0.95; Brier = 0.064; p = 0.97). Incorporating MNA and PhA enhanced calibration and clinical utility, especially for risk probabilities between 0.10 and 0.40. Internal validation showed minimal optimism and stable coefficients, with BMI, sex, and PhA as consistent predictors. Conclusions: A model combining anthropometric, nutritional, and bioelectrical variables provides high diagnostic accuracy for sarcopenia while remaining practical for clinical use. Its stepwise design facilitates application at various healthcare levels, supporting early detection and targeted interventions in aging populations. Full article

Background: Institutionalized older adults often experience cognitive and functional decline and altered body composition (BC), making nutritional assessment difficult. Bioelectrical impedance analysis (BIA) offers a simple and non-invasive method to evaluate BC; classic and specific bioelectrical impedance vector analysis do not require predictive models or assumptions about hydration status. Objective: This study aimed to evaluate the utility of BIA, classic bioelectrical impedance vector analysis (BIVA), and specific BIVA (BIVA-Sp) in detecting nutritional and other related disorders in institutionalized psychogeriatric patients. Methods: A cross-sectional study was conducted in 95 institutionalized older adults (52 men, 43 women; mean age: 80 years). Clinical and functional data, including frailty, dependency, handgrip strength, and anthropometry, were collected. BC was assessed using BIA. Nutritional diagnoses included malnutrition (GLIM criteria), sarcopenia (EWGSOP2), adiposity, and sarcopenic obesity (SOGLI criteria). Mean impedance vectors and 95% confidence ellipses were generated for BIVA and BIVA-Sp. Individual vectors were compared with reference data from healthy older adults. Statistical analyses compared clinical variables and impedance vector distributions between groups. Results: Classic BIVA differentiated patients with sarcopenia and sarcopenic obesity, while BIVA-Sp identified vector shifts associated with adiposity and sarcopenic obesity. Neither BIVA nor BIVA-Sp discriminated patients based on body mass index or malnutrition status. Conclusions: The application of BIVA in institutionalized psychogeriatric patients allows for easier, faster, and more effective detection of changes in BC and hydration status compared with conventional methods. This enables individualized monitoring and facilitates interventions that may reduce complications, functional decline, and hospitalizations, thereby improving their quality of life. Full article

As role models, military leaders are in a unique position to influence and inspire military members. Military leaders identify and address challenges that threaten operational readiness. A growing national concern across all military branches of service is Service members’ suboptimal nutritional fitness, underpinned by increasing rates of food insecurity and obesity, inadequate nutrition knowledge and cooking skills, and limited access to healthier food options within the military nutrition environment. Military leaders set the standards, conditions, and policies for achieving their organization’s goals. Therefore, Leader-Inspired Nutrition (LIN) is an evidence-based, proposed framework for how military leaders can engage Service members within the domain of nutritional fitness. LIN builds upon the nutritional fitness domain of the Department of Defense’s (DoD’s) Total Force Fitness framework for optimal performance. Subject matter experts in areas of nutrition science and education, military food environment, and leadership from DoD and other outside federal agencies were selected and asked to identify evidence-based strategies leaders can use to optimize nutrition readiness. This concept led to the development of the seven pillars of the LIN framework, outlining how it can be operationalized for leaders to inspire a more nutritionally fit DoD fighting force. Full article

Climate variability directly influences agriculture, especially in a scenario of global change and transition to a sustainable bioeconomy. This study analyzed historical series (1994–2023) of productivity and harvested area of annual crops (corn, cassava, and beans) and perennial crops (pineapple, cocoa, annatto, avocado, and guava), in order to understand the relationship between rainfall, maximum temperature, and agricultural production in northern Brazil. To achieve this, the Augmented Dickey–Fuller (ADF) test was applied to verify the stationarity of the series, and principal component analysis (PCA) was used to identify correlation patterns between climate and production variables. The ADF test showed that annual precipitation is stationary, while maximum temperature is non-stationary, confirming a warming trend. Among the crops, only bean productivity was stationary, albeit at low levels, while corn, cassava, and cocoa showed non-stationary behavior, reflecting technological advances combined with climatic pressures. PCA indicated different responses: corn showed a positive association with temperature, but signs of recent stagnation, whereas cassava and beans depended more on precipitation, demonstrating vulnerability to drought. Among perennials, avocado and guava responded positively to increased temperature, while annatto and pineapple were more dependent on rainfall. Cocoa showed a balanced correlation with both variables. It can be concluded that climate impacts on agriculture are heterogeneous and require specific adaptive strategies. From a bioeconomy perspective, the importance of productive diversification, technological innovation, and public policies aimed at climate resilience and the sustainability of low-carbon value chains is highlighted. Full article

Donkeys (Equus asinus) play a critical role in agricultural, transport, and livelihood systems across Asia, yet they remain among the most neglected domestic species in terms of welfare, management, and research attention. This review synthesizes recent literature on donkey welfare, health, breeding, and conservation across Asia, highlighting regional disparities and emerging challenges. A systematic review of published studies identified welfare determinants including nutrition, workload, shelter, and veterinary access. Welfare conditions are found to be poorest in South Asia, particularly in Pakistan, India, and Afghanistan, where chronic undernutrition, inadequate housing, excessive workloads, and limited veterinary support prevail. Preventive healthcare, such as vaccination and deworming, remains largely absent, reflecting low owner awareness and weak veterinary infrastructure. In contrast, China demonstrates substantial progress through semi-intensive farming systems, structured welfare management, and research-based breeding programs that integrate welfare with productivity enhancement. Recent advancements in molecular genetics have further expanded the scope of donkey conservation and improvement. Studies on key genes, including PRKG2, NR6A1, LTBP2, HOXC8, and DCAF7, have elucidated their roles in vertebral number, skeletal development, and body conformation in Dezhou donkeys, offering new opportunities for genomic-level conservation and marker-assisted selection. Nonetheless, significant health challenges, such as parasitic, bacterial, and viral infections (Theileria equi, Giardia duodenalis, and Equid herpesviruses), continue to threaten productivity and welfare. Reproductive management across most Asian countries remains traditional and uncoordinated, whereas China leads in artificial insemination, genetic resource preservation, and policy-supported breeding initiatives. Ethical concerns surrounding overexploitation and the commercial use of donkeys, particularly in the ejiao (donkey-hide gelatin) industry, are also gaining attention. Overall, this review underscores the urgent need for a “One Welfare” approach, linking Animal Welfare, human livelihoods, and sustainable industry development. Strengthening veterinary infrastructure, promoting owner education, and integrating genomic tools into breeding programs are essential steps toward improving the welfare, productivity, and long-term conservation of donkeys across Asia. Full article

Background/Objectives: Protein-calorie malnutrition (PCM) is common among patients with inflammatory bowel disease (IBD). However, the relationship between PCM and the gut microbiota in patients with IBD remains unclear. This study aimed to investigate the association between PCM and the colonic mucosal microbiota in patients with IBD. Methods: Colonic mucosal samples were obtained from 24 IBD patients with PCM and 24 IBD type-matched patients without PCM. PCM was defined as a body mass index (BMI) < 18.5 kg/m² and/or weight loss of ≥10% within the preceding 6 months. The full-length bacterial 16S ribosomal RNA gene (V1–V9) was sequenced using the PacBio Sequel IIe. Alpha and beta diversity and species-level differential abundance were analyzed, adjusting for age, sex, BMI, and disease type. Results: Among 48 patients (36 Crohn’s disease and 12 ulcerative colitis), diversity indices (Chao1, p = 0.474; Shannon, p = 0.931) and overall composition (Bray–Curtis, p = 0.719) did not differ by PCM status, although microbial composition was associated with age (p = 0.011) and biopsy-site inflammation (p = 0.001). PCM was associated with 12 differentially abundant taxa, including enrichment of Intestinibacter bartlettii and depletion of Bifidobacterium longum, Sphingomonas leidyi, and Clostridium innocuum, along with changes in several previously unclassified species. Conclusions: IBD patients with PCM exhibited shifts in the colonic mucosal microbiota including reduction in Bifidobacterium longum, a well-known probiotic. Further investigations into the role of the microbiota in PCM in IBD patients and the potential beneficial effects of probiotics are warranted. Full article

Background: The paucity of data on the epidemiology of chronic intestinal failure (CIF) in pediatric patients is a matter of particular concern. The objective of this article is to provide a comprehensive description of the epidemiology of CIF in Spain, encompassing its incidence, geographical distribution, underlying causes, and demographic and clinical characteristics. These findings are based on data collected from the multicentre REPAFI registry. Methods: This is a national, multicentre, ambispective cohort study including patients who initiated home parenteral nutrition (HPN) between January 2015 and January 2025. The data collected encompassed various demographic details, underlying diagnoses, the type of HPN utilized, and the nutritional status of the subjects at the commencement of HPN treatment. Results: The study included 163 patients (55.2% male) from 10 hospitals. The principal cause of CIF was short bowel syndrome (SBS) in 77.3% of cases, followed by severe motility disorders (12.9%), congenital enteropathies (CE) (5.5%), and other causes (4.3%). Among patients diagnosed with SBS, necrotizing enterocolitis was identified as the most prevalent underlying cause (32.5%). The most prevalent anatomical configuration was identified as type 2 (jejuno-colic anastomosis). A significant proportion, amounting to 62.7%, exhibited a lack of an ileocecal valve (ICV), while 23% demonstrated a residual bowel length (RBL) of less than 15 centimetres. The median RBL was 35 cm (IQR: 15.7–52.5). Patients diagnosed with SBS exhibited a lower gestational age and birthweight compared with the other groups (p < 0.05). Patients diagnosed with SBS and CE exhibited a lower mean age at the onset of HPN (p < 0.05). Furthermore, patients with CE exhibited the lowest weight-for-age Z-score at the initiation of HPN (p < 0.05). Conclusions: The present study provides the first epidemiological data on the state of pediatric CIF in Spain. The most prevalent cause of CIF was SBS, with a younger age at the initiation of HPN in comparison to other published studies. Patients with CE exhibited the most severe degree of malnutrition at the initiation of HPN. Full article

Background: In pediatric celiac disease (CD), intestinal malabsorption and the restrictive nature of a gluten-free diet (GFD) frequently result in persistent macro- and micronutrient imbalances, despite histological remission. The present review evaluates the evidence on nutritional adequacy of the GFD, identifies common deficiencies, and considers biomarker strategies and dietary recommendations to optimize growth and metabolic health. Methods: A narrative review of the literature was conducted, focusing on studies of nutrient intake, product composition of gluten-free foods, biomarker assessment, and clinical outcomes in children with CD. Both macronutrient (protein, fat, carbohydrate, fiber) and micronutrient (iron, vitamin D, calcium, B-vitamins, zinc, magnesium) domains were included. Results: Children with CD on long-term GFD demonstrate higher intake of lipids (especially saturated fat) and simple carbohydrates, alongside consistently low intake of dietary fiber and key micronutrients. Gluten-free products often exhibit lower protein content, higher glycemic index, and reduced fortification compared to gluten-containing equivalents. Nutritional deficits contribute to impaired linear growth, delayed puberty and increased metabolic risk. Conclusions: Nutritional adequacy of the GFD cannot be assumed in children with CD. Routine monitoring using standardized biomarker panels, combined with personalized dietary counseling and improved formulation and fortification of gluten-free products, is essential to mitigate long-term adverse outcomes. Future work should advance precision nutrition approaches and public-health initiatives to optimize dietary quality in this vulnerable population. Full article

Food insecurity disproportionately affects Hispanic households in the US. This study examines food access perceptions among rural Latinos, acknowledging that food environments are complex systems influenced by factors such as availability, accessibility, affordability, acceptability, and accommodation. This phenomenological qualitative study was conducted with adult Latinas living in Nebraska’s rural areas. Data was collected through participatory mapping, semi-structured interviews guided by the five dimensions of food access, and demographic surveys. Eighteen women participated in in-person interviews, and 68.3% of participants met the criteria for food insecurity. While chain stores were the primary shopping option in rural areas, challenges included limited availability of foods that are culturally relevant and accommodate special dietary needs. Ethnic stores were valued for cultural relevance despite concerns about quality and pricing. Overall, affordability was a significant barrier due to high rural costs, worsened by challenges in navigating nutrition program benefits and documentation status. Research or interventions targeting improvements in rural food security must extend beyond mere store availability, focusing on economic development, policy reform, and enhanced education in assistance programs to address these complex challenges. Full article

Background: Malnutrition among Southeast Asian children remains an issue. Previous studies have linked higher dairy consumption to improved nutrient intake. This study examines the impact of dairy consumption on food, energy, and nutrient intakes among 2- to 12-year-old Southeast Asian children. Methods: We analyzed data from the cross-sectional South East Asian Nutrition Surveys (SEANUTS) II, involving 10,299 children aged 2 to 12 years from Indonesia, Malaysia, Thailand, and Vietnam. Dietary intake was assessed using 24 h dietary recall. Results: Daily dairy consumption was generally low among children aged 2–12 years in Southeast Asia. The proportion meeting daily dairy recommendations was 24% in Indonesia, 17% in Malaysia, 23% in Thailand, and 8% in Vietnam. In younger children aged 2–3 years, this proportion was higher (20–55%), whereas in older children aged 7–12 years, it was lower (2.7–9.6%). In addition, high dairy intake was associated with lower consumption of extra foods, higher overall nutrient intake, and higher proportions of children meeting estimated energy requirements and recommended intakes for vitamins A, B₂, B₁₂, D, and calcium. Conclusions: Dairy consumption was associated with lower consumption of extra foods, and it enhanced nutrient intake among Southeast Asian children, indicating a beneficial impact on their diet. Full article

Objective: This study aimed to investigate the relationship between nutritional status, assessed by the Controlling Nutritional Status (CONUT) score, and functional recovery in patients with stroke undergoing inpatient rehabilitation. Methods: A total of 113 patients diagnosed with stroke were included in this observational study. Nutritional status was evaluated using the CONUT score, and functional independence and baseline disability were assessed with the Modified Barthel Index (mBI) and the Modified Rankin Scale (mRS) at admission. Functional independence was reassessed with the mBI at discharge. Patients were divided into four groups based on their CONUT score: normal, mild, moderate, and severe malnutrition risk. Results: According to CONUT classification, 37.2% of patients were normal, 46.0% were at mild, 13.3% at moderate, and 3.5% at severe risk of malnutrition. A weak positive correlation was found between CONUT score and age (r = 0.186, p = 0.049). CONUT score was negatively correlated with vitamin D (r = –0.212, p = 0.024), albumin (r = –0.636, p < 0.001), total protein (r = –0.387, p < 0.001), LDL (r = –0.445, p < 0.001), and total cholesterol (r = –0.444, p < 0.001). Within-group comparisons showed significant improvement in mBI scores from admission to discharge in the normal (p < 0.001), mild (p < 0.001), and moderate (p = 0.024) groups, but not in the severe malnutrition group (p = 0.317). Conclusions: Although no statistically significant association was found between the CONUT score and mBI outcomes, patients with better nutritional status showed a clinical trend toward greater functional improvement during rehabilitation, whereas those with severe malnutrition demonstrated limited gains. These findings should be interpreted cautiously due to the very small number of patients in the severe malnutrition group. Early screening and appropriate nutritional management using objective tools such as the CONUT score may still support rehabilitation planning in stroke patients. Full article

The global freight transportation industry has experienced exponential growth, significantly contributing to economic development. However, this expansion has also led to considerable environmental challenges, particularly due to the sector’s dependence on fossil fuels and inefficient logistical practices, resulting in high carbon emissions, air pollution, noise pollution, and resource depletion. The complex problems facing the freight transportation sector are directly impacting several United Nations Sustainable Development Goals (SDGs), particularly SDG 2, SDG 3, SDG 7, SDG 9, SDG 11, SDG 12, and SDG 13. This study addresses these challenges by first examining the direct contribution of sustainable freight transportation to the United Nations Sustainable Development Goals (SDGs). Building on this foundation, the paper explores the transformative potential of artificial intelligence (AI) to enhance sustainability in freight transportation. Focusing on advanced analytics, predictive modeling, and real-time optimization, AI provides opportunities to improve route planning, energy efficiency, and emission reduction, while supporting more resilient and sustainable logistics systems. The paper introduces a holistic framework, integrating AI seamlessly throughout the entire freight logistics process. To contextualize these insights, an empirical survey was conducted among Moroccan freight transportation companies, highlighting current practices, the perceived effectiveness of AI adoption, and the level of confidence in achieving long-term carbon neutrality targets. Finally, the paper introduces a practical framework for integrating AI into freight transportation systems, aligning technological innovation with sustainability goals, and offering actionable guidance for both industry stakeholders and policymakers. Full article

Building resilient and sustainable food production systems is a major challenge in Sub-Saharan Africa (SSA) due to environmental, climatic, and economic pressures. Farmers in the region must adopt effective adaptation strategies to maintain productivity and contribute toward achieving the United Nations’ Sustainable Development Goal 2, “Zero Hunger.” Among these, water scarcity adaptation strategies are critical for building resilient food systems that also address poverty reduction. However, various obstacles hinder their widespread adoption, and documentation on these strategies remains fragmented. This paper examines available water scarcity adaptation strategies, the opportunities and challenges faced by farmers, and the policy and infrastructure implications for sustainable food production. The findings highlight the essential role of Indigenous Knowledge Systems (IKS) in adopting these strategies. IKS supports natural resource conservation, promotes inclusive market participation, strengthens institutional frameworks, and improves resource-use efficiency under climate stress. The paper recommends further research on transferring Indigenous Knowledge to future generations and exploring the role of policy in preserving and promoting IKS, especially within the SSA context. Emphasizing Indigenous Knowledge is crucial for creating sustainable, resilient agricultural systems that can thrive amid the region’s growing environmental challenges. Full article