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11 pages, 350 KB  
Article
Preliminary Study on Nutritional Value and Biologically Active Components of Kidney Vetch (Anthyllis vulneraria L.)
by Olga Teneva, Zhana Petkova, Ginka Antova, Maria Angelova-Romova, Elis Yusein, Tsvetelina Mladenova, Donika Gyuzeleva, Anelia Bivolarska, Rumen Mladenov, Krasimir Todorov and Plamen Stoyanov
Plants 2026, 15(13), 1954; https://doi.org/10.3390/plants15131954 (registering DOI) - 25 Jun 2026
Abstract
The aim of the current study is to determine the nutritional value and the content of the biologically active components in kidney vetch (Anthyllis vulneraria L.). It is established that the dry biomass contains substantial amounts of proteins and carbohydrates, primarily dietary [...] Read more.
The aim of the current study is to determine the nutritional value and the content of the biologically active components in kidney vetch (Anthyllis vulneraria L.). It is established that the dry biomass contains substantial amounts of proteins and carbohydrates, primarily dietary fiber, while the total oil content is relatively low (below 3.0%). The isolated glyceride oil represents the complete lipid fraction derived from all plant parts (leaves, stems, and flowers). The glyceride oil of A. vulneraria is notable for its high levels of biologically active constituents, particularly sterols, tocopherols, and phospholipids. Palmitic (30.3%) and oleic (11.5%) acids dominate the fatty acid profile; β-sitosterol, α-tocotrienol, and α-tocopherol are the major sterol and tocopherol components, respectively. On the other hand, phosphatidylinositol, together with phosphatidic acids, prevails within the phospholipid fraction. Based on the obtained fatty acid composition, several important ratios were calculated—unsaturated fatty acids (UFA)/saturated fatty acids (SFA), saturated fatty acids/monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA)/saturated fatty acids, and n-6/n-3, providing an integrated assessment of the lipid quality. The PUFA/SFA value (0.24) suggests relatively high oxidative stability. In contrast, the n-6/n-3 ratio (0.86) shows a balanced distribution of essential fatty acids, which is associated with favorable nutritional properties. Full article
(This article belongs to the Section Phytochemistry)
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28 pages, 681 KB  
Article
The Link Between Dietary Indices, Sarcopenia, and Clinical Parameters in Diabetic and Non-Diabetic Hemodialysis Patients
by Yahya Faruk Karatas, Gulsum Gizem Topal, Damla Gumus and Mevlude Kizil
J. Clin. Med. 2026, 15(13), 4923; https://doi.org/10.3390/jcm15134923 (registering DOI) - 24 Jun 2026
Abstract
Background and Objectives: Sarcopenia is highly prevalent among maintenance hemodialysis (HD) patients, particularly in the presence of diabetes mellitus (DM). Dietary glycemic and insulinemic characteristics may contribute to metabolic disturbances associated with muscle deterioration, although evidence in HD populations remains limited. This [...] Read more.
Background and Objectives: Sarcopenia is highly prevalent among maintenance hemodialysis (HD) patients, particularly in the presence of diabetes mellitus (DM). Dietary glycemic and insulinemic characteristics may contribute to metabolic disturbances associated with muscle deterioration, although evidence in HD populations remains limited. This study aimed to investigate the associations between dietary indices, sarcopenia, nutritional status, and clinical outcomes in diabetic (DM+) and non-diabetic (DM−) HD patients. Materials and Methods: This cross-sectional study included 92 maintenance HD patients (43 DM+ and 49 DM−). Dietary intake was assessed using three-day food records, and dietary insulin index (DII), dietary insulin load (DIL), dietary glycemic index (DGI), and dietary glycemic load (DGL) were calculated. Sarcopenia was evaluated using handgrip strength, bioelectrical impedance analysis, gait speed, and SARC-F. Anthropometric, biochemical, nutritional, and sarcopenia-related parameters were compared across tertiles of dietary indices. Results: Sarcopenia was identified in 32.6% of patients with diabetes and 36.7% of those without diabetes. Diabetic patients exhibited significantly lower handgrip strength, slower walking speed, longer walking time, and higher SARC-F scores (p < 0.01). Across DGL tertiles in DM+ patients, significant progressive increases were observed in body weight (p < 0.05), body mass index (p < 0.05), lean mass (p < 0.05), mid-upper arm circumference (p < 0.01), and triceps skinfold thickness (p < 0.01). Higher DIL and DGL tertiles were also associated with elevated serum phosphorus, LDL cholesterol, triglycerides, and total cholesterol levels (p < 0.05). DIL and DGL showed stronger associations with overall energy and nutrient intake compared with DII and DGI. However, no significant associations were identified between dietary indices and sarcopenia diagnosis or sarcopenia-related risk indicators after adjustment for age and sex. Conclusions: Dietary indices were associated with various anthropometric, biochemical, and nutritional parameters in HD patients, with more pronounced associations observed among patients with DM, suggesting a potential role of dietary quality in the nutritional and metabolic profile of this population. Full article
(This article belongs to the Section Clinical Nutrition & Dietetics)
20 pages, 1117 KB  
Article
Patterns of Ultra-Processed Food Consumption and Cognitive Performance in Older Adults: A Population-Based Cross-Sectional Analysis from Northern Italy
by Federica Prinelli, Elena Perdixi, Gaia Bonassi, Nithiya Jesuthasan, Sara Bernini, Marco Severgnini, Daniela Martini and Silvia Conti
Nutrients 2026, 18(13), 2074; https://doi.org/10.3390/nu18132074 (registering DOI) - 24 Jun 2026
Abstract
Background: Given the increasing consumption of ultra-processed foods (UPFs) and the public health importance of cognitive decline in ageing, understanding how UPFs impact cognitive performance is highly relevant. However, evidence in older adults - particularly in Italy—remains scarce, despite the country’s rapidly [...] Read more.
Background: Given the increasing consumption of ultra-processed foods (UPFs) and the public health importance of cognitive decline in ageing, understanding how UPFs impact cognitive performance is highly relevant. However, evidence in older adults - particularly in Italy—remains scarce, despite the country’s rapidly ageing population, its comparatively low UPF intake, and its distinct Mediterranean dietary context. Methods: We analysed cross-sectional data from 809 community-dwelling adults aged ≥ 65 years (59.4% women) participating in the NutBrain population-based cohort. Dietary intake was assessed using a 102-item semi-quantitative food frequency questionnaire, and daily grams of foods were classified according to the NOVA system into groups, which were analysed using a compositional data analysis approach. Global cognition and domain-specific performance were measured using standardised neuropsychological tests. Associations between NOVA groups and cognitive outcomes were estimated using multiple linear regression models adjusted for potential confounders. Gender-stratified analyses were also performed. Results: UPFs accounted for 21% of total energy intake, with bakery products as the main contributors. A relative increase of unprocessed or minimally processed foods was associated with better cognitive function (B = 0.36, p = 0.014), whereas a greater contribution of UPFs relative to the overall diet was associated with worse global cognitive function (B = −0.26, p = 0.003). The strongest associations were observed for episodic memory, particularly among women. Conclusions: A higher relative consumption of UPF was associated with worse global and memory-related cognitive performance. Longitudinal and experimental studies are warranted to clarify causality and underlying mechanisms. Full article
(This article belongs to the Special Issue Nutrition for Cognitive Health and Neuroprotection)
10 pages, 420 KB  
Article
Do School Athletes Really Eat Better? Nutritional and Body Composition Differences in Saudi Adolescents
by Ghareeb O. Alshuwaier
Children 2026, 13(7), 852; https://doi.org/10.3390/children13070852 (registering DOI) - 24 Jun 2026
Abstract
Background: Obesity among Saudi adolescents has risen sharply, yet whether school athletic participation is associated with students showing improved dietary habits and better anthropometric profiles compared to those of their non-athlete peers remains unclear. This study compared anthropometric indices and dietary habits [...] Read more.
Background: Obesity among Saudi adolescents has risen sharply, yet whether school athletic participation is associated with students showing improved dietary habits and better anthropometric profiles compared to those of their non-athlete peers remains unclear. This study compared anthropometric indices and dietary habits between school athletes and non-athletes in Riyadh. Methods: A cross-sectional study was conducted with 124 male secondary school students (70 athletes and 54 non-athletes aged 16–17 years) in Riyadh, Saudi Arabia. Athletes were defined as students who reported engaging in vigorous-intensity sport for ≥3 days/week for ≥60 min/session. BMI, body weight, and waist circumference were measured objectively. Dietary habit frequencies across ten food categories were assessed using the validated Arab Teens Lifestyle Study (ATLS) questionnaire. Independent samples t-tests and chi-square tests were used; effect sizes were calculated as Cohen’s d. A Bonferroni-corrected threshold (p < 0.005) was applied for multiple dietary comparisons. Results: Athletes had significantly lower BMI (23.64 ± 5.39 vs. 30.28 ± 7.25 kg/m2; p < 0.001, d = 1.06), body weight (p < 0.001, d = 0.93), and waist circumference (85.46 ± 12.61 vs. 95.50 ± 17.89 cm; p < 0.001, d = 0.66). Obesity prevalence was 15.7% among athletes versus 51.9% among non-athletes. Of ten dietary variables, only fresh fruit consumption showed a between-group difference (62.9% vs. 40.7% high-frequency; p = 0.010), which did not survive Bonferroni correction. Conclusions: School athletes demonstrated substantially better anthropometric profiles than their non-athlete peers, but dietary habit frequencies were largely similar across both groups. The high obesity prevalence among non-athletes underscores the need for school-based programs that combine structured physical activity with targeted nutrition education. Full article
15 pages, 254 KB  
Article
Nutritional Contribution and Quality of Lunches Consumed During School Lunch Periods in Canadian Elementary Schools: A Plate Waste Analysis
by Natalia Alaniz-Salinas, Rachel Engler-Stringer and Hassan Vatanparast
Nutrients 2026, 18(13), 2065; https://doi.org/10.3390/nu18132065 (registering DOI) - 24 Jun 2026
Abstract
Background/Objectives: Foods and beverages consumed during school lunch periods contribute substantially to children’s dietary intake; however, Canadian evidence of their nutritional contribution and quality remains limited. This study assessed nutrient content, nutrient density, and contributions to dietary recommendations among Saskatchewan elementary students. [...] Read more.
Background/Objectives: Foods and beverages consumed during school lunch periods contribute substantially to children’s dietary intake; however, Canadian evidence of their nutritional contribution and quality remains limited. This study assessed nutrient content, nutrient density, and contributions to dietary recommendations among Saskatchewan elementary students. Methods: A descriptive quantitative study was conducted among 379 students aged 5–13. Dietary intake during school lunch periods was assessed using a photography-assisted plate waste method. Nutrient content was estimated using standard nutrient databases, nutrient density was evaluated using the Nutrient-Rich Food (NRF) 9.3 Index, and contributions to dietary recommendations were examined. Results: Median lunch energy was 411.4 kcal (IQR: 296.7), and the mean NRF 9.3 score was 292.6 (SD: 130.7). Compared with home-packed and mixed lunches, school-provided lunches contained less energy, carbohydrate, fat, and sugar, while protein was similar across lunch types. Overall, lunches contributed <25% of daily requirements for key nutrients, including fibre, vitamin D, calcium, and potassium. Older students had lower proportional nutrient contributions relative to their higher nutritional requirements. Nutrient density differed by lunch provenance, but not by age or reported gender, with school-provided lunches achieving the highest NRF 9.3 scores. Conclusions: Lunches contributed modestly to daily nutrient requirements, particularly among older students. In this sample, school-provided lunches were associated with higher nutrient density than home-packed lunches, although their absolute contributions to several nutrients remained limited. These findings provide baseline evidence on lunches consumed during school lunch periods among Saskatchewan elementary students and may inform future evaluations of school food systems and policies. Full article
(This article belongs to the Special Issue The Influence of School Meals on Children and Adolescents)
16 pages, 1517 KB  
Article
Oral Hygiene Behaviors and Their Association with Angle Malocclusion Classes in Children Aged 6–9 Years: A WHO Questionnaire-Based Study
by Kaltrina Veseli, Fehim Haliti and Enis Veseli
Healthcare 2026, 14(13), 1837; https://doi.org/10.3390/healthcare14131837 (registering DOI) - 24 Jun 2026
Abstract
Background: Childhood oral hygiene behaviors are crucial to preventing oral diseases and can influence the development and progression of malocclusions. The World Health Organization (WHO) Oral Health Questionnaire is a standardized tool for assessing oral hygiene behaviors, oral health-related behaviors, and preventive dental [...] Read more.
Background: Childhood oral hygiene behaviors are crucial to preventing oral diseases and can influence the development and progression of malocclusions. The World Health Organization (WHO) Oral Health Questionnaire is a standardized tool for assessing oral hygiene behaviors, oral health-related behaviors, and preventive dental awareness in children. Aim: This study aimed to assess oral hygiene behaviours and examine associations between WHO Oral Health Questionnaire variables and Angle malocclusion classes among children aged 6–9 years. Materials and Methods: This cross-sectional study included 90 children aged 6–9 years from the Pristina region, Kosovo. Data were collected using the WHO Oral Health Questionnaire for Children, which assessed oral hygiene habits, toothbrushing frequency, fluoride awareness, dental attendance, dietary behaviors, oral symptoms, and oral-health-related quality of life. Malocclusion was classified according to Angle classification into Class I, II, and III malocclusions with 3D intraoral scanners, Aerolscan 3. Descriptive statistical analysis, Chi-square (χ2) test, Spearman correlation analysis, and reliability analysis using Cronbach’s Alpha were performed using SPSS Statistics 23.0 (IBM Corp., Armonk, NY, USA) and Statistica 7.1 (StatSoft Inc., Tusla, OK, USA). Results: Most participants reported regular oral hygiene practices, with 46.7% brushing their teeth two or more times daily. However, limited awareness regarding fluoride-containing toothpaste was observed, as most children answered “don’t know” regarding fluoride use. Occasional toothache or oral discomfort was reported by 33.3% of participants, while 23.3% reported dissatisfaction with dental appearance. Difficulty biting hard foods was present in 34.4% of children. Reliability analysis of the Q10 section demonstrated moderate internal consistency (Cronbach’s Alpha = 0.500). Chi-square analysis demonstrated no statistically significant association between Angle malocclusion classes and WHO questionnaire variables (p > 0.05). The highest χ2 value was observed for tooth-cleaning frequency (Q7) (χ2 = 11.97; p = 0.152), although the association remained statistically non-significant. Psychosocial impact questions and oral health-related quality of life questions also demonstrated no statistically significant association with malocclusion classes. Conclusions: oral hygiene practices, preventative oral health practices, and oral health-related experiences were comparatively similar among children in different Angle malocclusion classes. Although there were no statistically significant correlations found between malocclusion classes and WHO questionnaire variables, the results show that some children have psychosocial concerns about their dental appearance and insufficient awareness of preventive oral health. The WHO Oral Health Questionnaire is a useful epidemiological tool for evaluating pediatric oral health behaviors and may help build youth orthodontic and preventive oral health policies. Full article
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16 pages, 1538 KB  
Article
Observational Assessments of Chicken, Beef, and Seafood Proportions with a Mediterranean-Style Healthy Dietary Pattern and Cardiovascular Risk Factor Changes: Post Hoc Analysis of a Controlled Feeding Trial
by Eric M. Davis, Robert E. Bergia, Austin S. Hartman, Rikard Landberg, Gabriele Riccardi and Wayne W. Campbell
Nutrients 2026, 18(13), 2062; https://doi.org/10.3390/nu18132062 (registering DOI) - 24 Jun 2026
Abstract
Background: We previously reported that consuming a Mediterranean-style healthy dietary pattern (MED-HDP) with lower vs. higher glycemic index foods differentially changed indices of postprandial glucose control and daily glycemic variability but did not influence improvements in cardiovascular health indices. Methods: Fifty-two [...] Read more.
Background: We previously reported that consuming a Mediterranean-style healthy dietary pattern (MED-HDP) with lower vs. higher glycemic index foods differentially changed indices of postprandial glucose control and daily glycemic variability but did not influence improvements in cardiovascular health indices. Methods: Fifty-two adults (31 females, 21 males; aged 49 ± 11 y, BMI 31 ± 3.1 kg/m2, mean ± SD) with two or more features of metabolic syndrome participated for 12 weeks in the randomized, controlled trial with all foods provided. At dinner only, participants could select from protocol-approved foods, including unprocessed chicken breast, unprocessed lean beef, and unprocessed salmon and shrimp (seafood). Objective: Herein, we retrospectively assessed whether the frequency of consuming different sources of meat (i.e., the exposures) was associated with MED-HDP-induced changes in cardiovascular health indices (i.e., the outcomes). Results: Among all participants, consuming the MED-HDP foods (88% adherence) reduced fasting systolic (SBP) and diastolic (DBP) blood pressures and serum total cholesterol (TC), triglycerides (TGs), and HDL. More frequent consumption of chicken at dinner, in place of beef and seafood, was associated with greater reductions in SBP (p = 0.034 and p = 0.047 for replacing beef and seafood, respectively) and DBP (p = 0.021 and p = 0.043, respectively). Frequency of chicken, beef, and seafood intakes at dinner did not associate with the reductions in serum TC, TG, HDL, or LDL. Conclusions: These results support that adoption of a MED-HDP improved multiple cardiovascular risk factors among middle-aged and older adults at elevated cardiovascular risk. The observed modest associations between more frequent consumption of unprocessed chicken at dinner and greater blood pressure reductions, which do not mean that eating more chicken at dinner causes lower blood pressure, warrant independent replication. Full article
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13 pages, 409 KB  
Article
Factors Affecting Mandibular Movement During Mastication in Nursing Home Residents: A Two-Year Follow-Up Study
by Enri Nakayama, Haruka Tohara, Masanori Kimura, Shinya Ohno, Fuka Shima, Iki Koide, Kimiko Abe and Kazumichi Yonenaga
Nutrients 2026, 18(13), 2060; https://doi.org/10.3390/nu18132060 (registering DOI) - 24 Jun 2026
Abstract
Background/Objectives: Declining masticatory function affects dietary variety, nutritional status, cognitive function, and health. Although factors related to chewing ability have been reported, the causes of temporal changes in masticatory kinematics in older adults remain unclear because prospective longitudinal data remain limited. Objectives: [...] Read more.
Background/Objectives: Declining masticatory function affects dietary variety, nutritional status, cognitive function, and health. Although factors related to chewing ability have been reported, the causes of temporal changes in masticatory kinematics in older adults remain unclear because prospective longitudinal data remain limited. Objectives: This follow-up study investigated factors associated with changes in masticatory movement in older adults requiring long-term care. Methods: Participants were 42 older adults residing in long-term care facilities. Survey items included mandibular kinematic data during rice cracker chewing and variables related to chewing, and the same assessment was performed two years after baseline. Relationships between changes in masticatory movement and other variables were examined, and factors associated with masticatory movement were identified using a linear mixed model (LMM). Results: A change in the number of cycles was significantly associated with the rate of change in the appendicular skeletal muscle mass index (ASMI). The rates of change in the number of linear motions and circular motion frequency were significantly associated with changes in the ABC Dementia Scale (ABC-DS). In the LMM results, cycle frequency remained associated with ASMI after adjustment for confounding factors, and both the number of circular motions and circular motion frequency were associated with ABC-DS. Conclusions: The findings suggest that masticatory movement in older adults requiring long-term care is influenced by skeletal muscle mass and cognitive function. In care facilities, interventions to maintain these factors are essential to help prevent dietary texture modifications among residents, while supporting nutrition, oral function, and health in this population. Full article
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12 pages, 979 KB  
Article
Nutritional Imbalance and Oral Functional Limitation Jointly Associated with Depressive Symptoms in Adults Living Alone: A Nationally Representative Cross-Sectional Study
by Young-Suk Jung and Hyunjoo Joo
Nutrients 2026, 18(13), 2055; https://doi.org/10.3390/nu18132055 (registering DOI) - 24 Jun 2026
Abstract
Background/Objectives: Adults living alone are vulnerable to nutritional inadequacy and depressive symptoms; however, their combined influence remains poorly understood. This study examined the independent and joint associations of nutritional imbalance and oral functional limitation with depressive symptoms among adults living alone and explored [...] Read more.
Background/Objectives: Adults living alone are vulnerable to nutritional inadequacy and depressive symptoms; however, their combined influence remains poorly understood. This study examined the independent and joint associations of nutritional imbalance and oral functional limitation with depressive symptoms among adults living alone and explored potential indirect pathways involving metabolic syndrome (exploratory). Methods: This cross-sectional study used nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2022 and 2024, including 1572 adults aged ≥19 years living alone. Nutritional imbalance was assessed by the number of essential nutrients consumed below the Estimated Average Requirement (EAR; range 0–8). Oral functional limitation was defined as chewing or speaking difficulty. Depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9). Survey-weighted regression and bootstrapped indirect-effect analyses were performed. Results: Nutritional imbalance was associated with higher PHQ-9 scores (β = 0.216; 95% CI: 0.098–0.335). Oral functional limitation (β = 1.278; 95% CI: 0.739–1.816) and metabolic syndrome score (β = 0.156; 95% CI: 0.006–0.306) were independently associated with depressive severity. Participants with both high nutritional imbalance and oral functional limitation had substantially higher odds of clinical depression (PHQ-9 ≥ 10; OR = 4.268; 95% CI: 2.037–8.943) than the reference group. Exploratory analyses suggested that indirect effects via oral functional limitation and metabolic syndrome were directionally consistent but did not reach statistical significance. Conclusions: Nutritional imbalance and oral functional limitation were jointly associated with depressive symptoms among adults living alone. These findings highlight the importance of integrated strategies targeting dietary quality, oral health, and metabolic health in vulnerable single-person households. Full article
(This article belongs to the Section Nutritional Epidemiology)
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16 pages, 1551 KB  
Article
Changes in Resting Energy Expenditure in Response to Different Dietary Patterns: A Randomized Clinical Trial Exploratory Sub-Analysis
by Irene García-Gómez, Ainoa Mallorquín Castillo, Cristina Navas-Moreno, José Ignacio Martínez-Montoro, María Molina-Vega, Ana María Gómez-Pérez, Juan Alcaide-Torres, Alba Subiri-Verdugo, María Luisa García-Martín, Isabel Moreno-Indias and Francisco J. Tinahones
Nutrients 2026, 18(13), 2053; https://doi.org/10.3390/nu18132053 (registering DOI) - 24 Jun 2026
Abstract
Background: Evidence comparing the effects of novel alternative dietary strategies on resting energy expenditure (REE) with a hypocaloric standard Mediterranean diet (MedDiet) with continuous caloric restriction remains limited. This study aimed to evaluate the effects of diets with varying ketogenic potentials—including a very-low-carbohydrate [...] Read more.
Background: Evidence comparing the effects of novel alternative dietary strategies on resting energy expenditure (REE) with a hypocaloric standard Mediterranean diet (MedDiet) with continuous caloric restriction remains limited. This study aimed to evaluate the effects of diets with varying ketogenic potentials—including a very-low-carbohydrate diet (ketogenic diet, KD), time-restricted eating (TRE), and modified alternate-day fasting (mADF)—on the REE of individuals with obesity compared to those of a standard MedDiet. Methods: This was a secondary post hoc sub-analysis of a three-month, parallel-arm, randomized clinical trial (RCT) including 160 adults with obesity (body mass index > 30 kg/m2). The participants were randomly assigned to one of five calorie-restricted dietary interventions: control (MedDiet), KD, early time-restricted eating (eTRE), late time-restricted eating (lTRE), or mADF. All interventions featured an individualized energy deficit of 600 kcal/day. In this sub-analysis, a total of 102 participants with valid baseline measures were included. The REE was assessed by indirect calorimetry, and longitudinal trajectories were evaluated using Linear Mixed Models (LMMs) in 98 participants to account for baseline variability and to maximize data retention. Results: The mean age of participants in this sub-analysis was 45.3 years (SD 10.8), and 73.1% were women. The longitudinal modeling confirmed no statistically significant differences in the adjusted REE trajectories among the five dietary groups over the 3-month intervention (Group × Time interaction, p = 0.506). Furthermore, the LMMs showed that total body weight (p < 0.001) and biological sex (p < 0.001) were the variables most strongly associated with REE within the model. No independent associations between circulating beta-hydroxybutyrate levels and REE trajectories were detected. Conclusions: Hypocaloric diets with varying macronutrient distributions and fasting windows did not show statistically significant differences in REE trajectories over the 3-month intervention. In this exploratory sub-analysis, the REE trajectories were more closely associated with individual biological characteristics, particularly body weight and sex, than with the specific dietary strategy employed. Given the modest sample size and exploratory nature of the study, these findings should be interpreted cautiously and require confirmation in larger, adequately powered prospective trials. Full article
(This article belongs to the Section Nutrition and Metabolism)
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14 pages, 1169 KB  
Protocol
Promoting Physical Activity and Reducing Sedentary Behavior in Adults with Type 2 Diabetes: Study Protocol of the DIA/01 Randomized Trial
by Roberto Pippi, Deborah Prete, Michelantonio De Fano, Daniela Fruttini, Maurizio Caprai, Maria Pia Mele, Domenico Stabile, Elisabetta Torlone, Francesca Porcellati, Giuseppe Rinonapoli, Carmine Giuseppe Fanelli and Efisio Puxeddu
Diabetology 2026, 7(7), 120; https://doi.org/10.3390/diabetology7070120 (registering DOI) - 24 Jun 2026
Abstract
Background: Sedentary behavior is a major modifiable risk factor for chronic metabolic disorders, particularly type 2 diabetes mellitus (T2DM). Despite recommendations promoting regular physical activity (PA), adherence remains low. DIA/01 is a multidisciplinary study designed to promote healthy lifestyles for the prevention [...] Read more.
Background: Sedentary behavior is a major modifiable risk factor for chronic metabolic disorders, particularly type 2 diabetes mellitus (T2DM). Despite recommendations promoting regular physical activity (PA), adherence remains low. DIA/01 is a multidisciplinary study designed to promote healthy lifestyles for the prevention and management of T2DM, supporting healthcare systems. Methods: A total of 123 adults with T2DM diagnosed will be enrolled at the Diabetes Center of the University Hospital of Perugia throughout 2025. Inclusion criteria are age 25–80 years, ability to walk independently, being inactive, and BMI 18.5–40 kg/m2. Exclusion criteria include severe cardiovascular, central nervous system, or musculoskeletal diseases contraindicating PA. Participants will be randomized into three groups: (1) standard care (SC); (2) SC plus theoretical PA counseling (TCPA); and (3) SC plus TCPA plus a 3-month supervised mixed exercise program. The assessment, conducted at baseline and at 6 and 12 months, includes total weekly PA (WPA) time, using IPAQ-SF and actigraphy. Moreover, glycated hemoglobin, sedentary time (ST), functional capacity, body composition, cardiometabolic risk factors, dietary adherence, perceived barriers and willingness to initiate PA, readiness to change, health-related quality of life, and sleep quality will be studied. This study is registered in the Clinical Trials Registry on 13 May 2026, with the identifier NCT07583355. Conclusions: Participants in groups (2) and (3) are expected to show greater improvements in WPA, reductions in ST, and favorable changes in metabolic and functional outcomes compared with SC. This approach may support long-term engagement in regular PA and contribute to improving the clinical management of T2DM. Full article
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24 pages, 1188 KB  
Article
Effectiveness of a School Physician-Led Counseling Intervention on Cholesterol Levels and Lifestyle Behaviors in Children with Hypercholesterolemia: A Randomized Controlled Trial
by Katarina Tomelić Ercegović, Josipa Glavaš, Ivana Sikirica, Andrea Vrdoljak, Helena Tokić, Jelica Perasović and Željka Karin
Children 2026, 13(7), 848; https://doi.org/10.3390/children13070848 (registering DOI) - 24 Jun 2026
Abstract
Background: This randomized controlled trial aimed to evaluate the effects of a school physician-led counseling intervention on total cholesterol (TC) levels, adherence to the Mediterranean diet, physical activity, and sedentary behavior in children aged 6–7 years with elevated cholesterol levels in a [...] Read more.
Background: This randomized controlled trial aimed to evaluate the effects of a school physician-led counseling intervention on total cholesterol (TC) levels, adherence to the Mediterranean diet, physical activity, and sedentary behavior in children aged 6–7 years with elevated cholesterol levels in a Mediterranean setting. Methods: A one-year randomized controlled study was conducted among children aged 6–7 years with elevated TC levels, excluding those with familial hypercholesterolemia (FH). Participants were randomly assigned to either a control group (n = 38) or an intervention group (n = 39). All participants received standard care consisting of educational materials and baseline counseling, while the intervention group additionally participated in three structured follow-up counseling sessions conducted by school physicians during the one-year study period. Counseling focused on Mediterranean dietary habits, implementation of basic dietary principles in cases of elevated TC levels, promotion of physical activity, and reduction in sedentary behavior. TC levels were measured at baseline and at the end of the study. Dietary habits, physical activity, and sedentary behavior were assessed using validated questionnaires. For the primary outcome, a descriptive change-from-baseline analysis, unadjusted mean difference, the approximate 95% confidence interval, and Cohen’s d effect size were calculated. Results: At baseline, no significant differences in TC levels were observed between groups (p = 0.852). After the intervention, mean TC levels were lower in the intervention group than in the control group (4.977 ± 0.414 mmol/L vs. 5.137 ± 0.410 mmol/L); however, the between-group difference did not reach statistical significance (p = 0.089). The unadjusted mean difference at follow-up was −0.160 mmol/L, with an approximate 95% confidence interval from −0.35 to 0.03 and a small-to-moderate effect size in favor of the intervention group (Cohen’s d = −0.39). Descriptive change-from-baseline analysis showed a greater mean reduction in TC in the intervention group than in the control group (−0.364 mmol/L vs. −0.195 mmol/L). A statistically significant improvement in adherence to the Mediterranean diet was observed in the intervention group compared with the control group (p < 0.001). Favorable changes were also observed in several physical activity and sedentary behavior variables, including participation in organized physical activity, walking and running activities, and reduced television viewing and video gaming time. Given the exploratory nature of behavioral analyses and the number of physical activity and sedentary behavior outcomes examined, these findings should be interpreted cautiously. Conclusions: The school physician-led counseling intervention did not result in a statistically significant between-group difference in TC levels after one year, although the direction and magnitude of change favored the intervention group. The intervention was associated with improved adherence to the Mediterranean diet and favorable exploratory lifestyle-related behavioral changes. Nevertheless, the findings should be interpreted cautiously in light of the relatively small sample size, non-significant primary outcome, and exploratory nature of behavioral analyses. Full article
(This article belongs to the Section Global Pediatric Health)
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21 pages, 2330 KB  
Review
Advancing Egg Freshness Evaluation with Integrated AI and Spectroscopy
by Ziye Xu, Dachen Wang, Zhihui Zhu, Yushan Jiang, Huang Dai, Yingli Wang and Qiaohua Wang
Foods 2026, 15(13), 2259; https://doi.org/10.3390/foods15132259 (registering DOI) - 23 Jun 2026
Abstract
As hen eggs are a primary source of high-quality dietary protein, egg freshness is fundamentally linked to biochemical alterations during storage, including moisture redistribution, protein degradation, and fluctuating chemical profiles. Accurate assessment of these internal changes is paramount for quality control; nonetheless, conventional [...] Read more.
As hen eggs are a primary source of high-quality dietary protein, egg freshness is fundamentally linked to biochemical alterations during storage, including moisture redistribution, protein degradation, and fluctuating chemical profiles. Accurate assessment of these internal changes is paramount for quality control; nonetheless, conventional analytical techniques remain predominantly destructive, rendering them impractical for high-throughput industrial monitoring. While existing literature has explored individual spectroscopic methods, the synergistic potential of multi-sensor integration and advanced artificial intelligence (AI) algorithms remains insufficiently synthesized. This review systematically evaluates recent breakthroughs in integrating AI with diverse spectroscopic modalities for non-destructive freshness quantification, including Visible-Near-Infrared (VIS-NIR), Raman, Fluorescence, and Hyperspectral Imaging (HSI). We elucidate the underlying mechanisms of spectral response to internal quality degradation and discuss the evolution of data-driven modeling from traditional chemometrics to sophisticated deep learning architectures. Furthermore, this work identifies critical bottlenecks in real-time industrial implementation and proposes future research trajectories toward intelligent multi-sensor fusion platforms. Full article
(This article belongs to the Section Food Engineering and Technology)
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19 pages, 585 KB  
Article
Extending the Validity of the Feeding Practices and Structure Questionnaire Solid Feeding Version (FPSQ-S) to Mothers and Fathers Living with Socioeconomic Disadvantage
by Smita Nambiar, Jeffrey T. H. So and Elena Jansen
Nutrients 2026, 18(13), 2046; https://doi.org/10.3390/nu18132046 (registering DOI) - 23 Jun 2026
Abstract
Background/Objective: Parental feeding practices play an important role in shaping children’s dietary intake, eating behaviours, and long-term health outcomes. Although several questionnaires assess feeding practices, few have been validated among socioeconomically disadvantaged populations, despite these groups being disproportionately affected by food insecurity and [...] Read more.
Background/Objective: Parental feeding practices play an important role in shaping children’s dietary intake, eating behaviours, and long-term health outcomes. Although several questionnaires assess feeding practices, few have been validated among socioeconomically disadvantaged populations, despite these groups being disproportionately affected by food insecurity and diet-related health inequities. This study assessed the structural validity and internal consistency of the Feeding Practices and Structure Questionnaire—Solid Feeding version (FPSQ-S)—among socioeconomically disadvantaged mothers and fathers of young children. Methods: Two cross-sectional online surveys were conducted with 178 mothers and 94 fathers of children aged 5–35 months living in disadvantaged households. Confirmatory factor analysis was used to examine the structural validity of the FPSQ-S. Internal consistency was assessed using Cronbach’s alpha and Hancock’s H coefficients. Results: The original six-factor FPSQ-S structure was retained and demonstrated acceptable overall model fit in this disadvantaged sample (CFI = 0.846, TLI = 0.821, RMSEA = 0.070). Internal consistency ranged from acceptable to excellent across subscales (Cronbach’s α = 0.63–0.93; Hancock’s H = 0.64–0.93). Most items loaded satisfactorily onto their intended constructs; however, two items within the Feeding on Demand construct demonstrated weak factor loadings, and this construct showed lower reliability than the remaining subscales Conclusions: This is the first study to evaluate the FPSQ-S among socioeconomically disadvantaged mothers and fathers of children aged 5–35 months. The FPSQ-S demonstrated acceptable structural validity and reliability. While the six-factor structure was largely supported, further refinement of the Feeding on Demand construct and additional psychometric evaluation are warranted. Full article
(This article belongs to the Special Issue Infant and Toddler Feeding and Development)
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32 pages, 737 KB  
Review
Artificial Intelligence for Weight Management in Children: A Narrative Review
by Valeria Calcaterra, Luca Marin, Hellas Cena, Matteo Vandoni, Maria Vittoria Conti, Luca Guardamagna, Pamela Patanè, Virginia Rossi, Vittoria Carnevale Pellino, Dario Silvestri and Gianvincenzo Zuccotti
Healthcare 2026, 14(13), 1821; https://doi.org/10.3390/healthcare14131821 (registering DOI) - 23 Jun 2026
Abstract
Background/Objectives: Childhood overweight and obesity represent a major global public health challenge, with increasing prevalence and significant long-term metabolic, cardiovascular, and psychosocial consequences. Standard pediatric weight-management strategies based on lifestyle modification often achieve modest and variable results, highlighting the need for more [...] Read more.
Background/Objectives: Childhood overweight and obesity represent a major global public health challenge, with increasing prevalence and significant long-term metabolic, cardiovascular, and psychosocial consequences. Standard pediatric weight-management strategies based on lifestyle modification often achieve modest and variable results, highlighting the need for more personalized and scalable approaches. Artificial intelligence (AI) has emerged as a promising tool to enhance prevention, early risk stratification, and management of pediatric overweight and obesity. Methods: This narrative review was conducted through a structured search of PubMed, Scopus, and Web of Science for English-language studies published up to January 2026. The main search terms included “artificial intelligence”, “machine learning”, and “deep learning”, combined with “child”, “adolescent”, “pediatric”, “childhood obesity”, “pediatric overweight”, “body mass index”, “weight management”, “nutrition”, “diet”, “physical activity”, “lifestyle”, and “behavior change”. After title/abstract and full-text screening according to predefined eligibility criteria, the included studies were qualitatively synthesized and grouped by main application domains. The initial database search identified 412 records. After removal of 96 duplicates, 316 records were screened by title and abstract. Full-text assessment was subsequently performed for 175 potentially eligible articles. Following this evaluation, 51 studies met the eligibility criteria and were retained from the database search. Additional relevant articles were identified through manual screening of reference lists and related reviews, resulting in the final set of studies included in the narrative synthesis. Results: The review identified five main domains of AI application in pediatric weight management: risk assessment and prediction, dietary assessment and nutritional support, physical activity and lifestyle monitoring, behavioral and psychological support, and clinical decision support. Across the included literature, AI-based approaches were most frequently applied to predictive modeling using longitudinal BMI or growth trajectories, birth characteristics, parental BMI, sleep duration, physical activity, sedentary behavior, and family or socioeconomic factors. However, the evidence base was largely composed of observational and predictive-modeling studies, whereas interventional studies, real-world implementation studies, and long-term pediatric weight-outcome data remained limited. Conclusions: This narrative review indicates that AI has potential as a complementary tool within multidisciplinary, family-centered pediatric weight-management pathways, particularly for early risk stratification, personalized monitoring, and behavioral support. However, the findings also highlight that current evidence remains mainly exploratory and predictive rather than interventional. Further longitudinal, real-world, and ethically grounded research is required to confirm effectiveness, safety, clinical usefulness, and equitable implementation in pediatric populations. Full article
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