Search Results (2,844)

Background/Objectives: Type 2 diabetes (T2D) is a substantial health burden on foreign-born Haitian Americans (FBHAs) in the United States, who experience poorer health outcomes for T2D, in particular, cardiovascular disease and diabetes nephropathy. Understanding the factors that contribute to these disparities is essential. The purpose of this study was to examine the association between demographic, clinical, diabetes self-management, and social determinants of health (SDoH) factors with continuous glucose monitor (CGM-derived) glycemic indices in adult FBHAs with T2D. Methods: A cross-sectional exploratory correlation study was conducted in two urban health clinics, focusing on FBHAs aged 21 or older who had T2D for at least one year. Data were analyzed using SAS 6.4, employing descriptive statistics, bivariate correlations, and multiple regression models. Results: The study included 59 participants (49.2% male; mean age = 51.7 years, SD = 9.9), with an average T2D duration of 7.7 years (SD = 6.8) and an average of 1.63 (SD = 1.30) chronic diseases. A total of 29% were overweight while 21% had obesity with a mean HbA_1c of 58 mmol/mol (7.5%). A higher body weight and poorer dietary habits were associated with elevated glucose levels (standardized β ≈ 0.25 and −0.24). Greater race-related stress was correlated with greater glucose variability (β ≈ 0.46). Conclusions: These findings highlight the importance of addressing SDoH, such as race-related stress and food insecurity, to improve T2D self-management among FBHAs. Assessing and mitigating these risk factors can enhance glycemic control and health outcomes. Additionally, the findings demonstrate that CGM is feasible and acceptable for this population, showing exploratory findings and preliminary effect sizes that provide a strong basis for future, large-scale investigations. Full article

Background: Picky eating behaviors among children challenge nutritional intake and healthy development and place considerable stress on parents. Parenting approaches play a critical role in shaping young children’s dietary behaviors. Mindful parenting, which refers to parents responding to their child’s needs with awareness, acceptance, attention, and mindful discipline, has gained increasing attention. Parental dietary competence may determine whether mindful parenting effectively discourages picky eating behavior in children. Objectives: This study explored whether mindful parenting and parental dietary competence are associated with picky eating behaviors in young children. The mediating role of parental dietary competence in this association was also investigated. Methods: A total of 412 parents of children enrolled in six preschools across six administrative districts in New Taipei City, Taipei City, and Taoyuan City, Taiwan, were invited and recruited. Data were collected using three validated parent-reported instruments, including a mindful parenting scale, parental dietary competence scale, and children’s picky eating behaviors scale. Results: Mindful parenting influenced children’s picky eating behaviors through the full mediation of parental dietary competence. The identification of parental dietary competence as a mediator underscores the need for early preventive interventions and parenting education that integrate parental mindfulness and dietary competence to foster healthy eating habits from the outset of early childhood. Conclusions: Practical recommendations and future research directions are provided regarding mindful parenting, parental dietary competence, and picky eating behaviors in young children. Full article

Background/Objectives: The aim of this study is to evaluate the relation between sleep quantity (TST), efficiency (SE) and regularity (SRI) and cardiometabolic parameters and eating habits. Methods: Seventy clinically healthy adults (74% females; mean age 28.3 ± 10.1 years) were recruited at the Clinical Nutrition Unit of Careggi University Hospital, Florence, between October 2023 and December 2024. Sleep was monitored for 7 days using a Fitbit Alta HR actigraphy. Cardiometabolic health was assessed via bioimpedance and blood samples. Dietary habits were evaluated through 3-day food diaries and the Medi-Lite questionnaire. Results: Participants had an average TST of 7.4 ± 1.1 h, SE of 84.9 ± 6.9%, and SRI of 62.2 ± 19.9. Lower SRI (≤41, 1st quintile) was associated with higher fat mass (19.9 ± 6.7 vs. 15.2 ± 6.6%), higher total cholesterol (183.9 ± 20.9 vs. 155.0 ± 26.8 mg/dL), and lower folate (3.6 ± 1.6 vs. 5.6 ± 2.5 ng/mL) compared to higher SRI (≥80, 5th quintile). Sleeping <7 h/night was linked to higher BMI (22.6 ± 2.1 vs. 21.5 ± 2.0 kg/m²) and homocysteine (11.4 ± 2.3 vs. 10.4 ± 3.3 μmol/L). Weak but significant inverse correlations emerged between TST and BMI (R = −0.26, p = 0.02) and between SRI and cholesterol (R = −0.28, p = 0.01), but these associations disappeared in the multivariable linear regression adjusted model. Conclusions: These findings underscore the role of sleep duration and regularity in shaping body composition and cardiometabolic health, supporting its relevance as a modifiable public health priority. Full article

Background/Objectives: Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder affecting almost 10% of the general population, characterized by recurrent abdominal pain and altered bowel habits. Its pathophysiology is incompletely understood, but it is established that symptoms result from an interplay between several environmental- and patient-related factors. This study aimed to analyze the influence of a widespread shift in lifestyle habits and multidimensional stress on IBS manifestations. Methods: An online survey was administered during the COVID-19 lockdown in 2020 to three groups of people representative of the general population. The survey contained questions regarding socio-demographic data, dietary habits, alcohol, smoking, physical activity, sleeping, working activities, stress level, and the characteristics of gastrointestinal symptoms related to both the pre-pandemic period and the lockdown period. The definition of IBS was based on the Rome IV criteria. Multivariate analyses were used to evaluate the association between environmental variables and the occurrence/resolution of IBS. Results: A total of 2735 participants were enrolled. Among them, 122 patients (46.2%) reported symptoms’ improvement during the observation period, while 118 previously healthy subjects (4.8%) developed IBS symptoms. Reduced general stress (OR = 2.2, 95%CI 1.1–4.6, p = 0.029), increased fiber intake (OR = 2.8, 95%CI 1.6–5.0, p < 0.001), and increased hours of sleep (OR = 2.0, 95%CI 1.1–3.8, p = 0.031) were associated with a high probability of IBS resolution, while increased anxiolytic pill intake (OR = 0.14, 95%CI 0.04–0.46, p = 0.001) showed a low likelihood of IBS resolution. Reduced physical activity (OR = 2.0, 95%CI 1.3–3.2, p = 0.002), increased anti-inflammatory effects (OR = 2.4, 95%CI 1.4–4.1, p = 0.002), anxiolytic pill intake (OR = 3.5, 95%CI 2.1–5.9, p < 0.001), and increased work-related stress (OR = 1.8, 95%CI 1.2–2.8, p = 0.009) were risk factors for IBS symptoms’ occurrence. Reduced alcohol consumption was a protective factor (OR = 0.5, 95%CI 0.3–0.8, p = 0.006). The resolution of IBS did not affect upper gastrointestinal functional symptoms (OR = 0.2, 95%CI 0.1–0.3, p < 0.001). Conclusions: The widespread lifestyle change forced by the pandemic created a protective “Cocoon Effect”, resulting in a beneficial effect in almost half of patients with IBS. Our findings provide large-scale evidence that environmental factors play a pivotal role in the pathophysiology of IBS. Specifically, stress levels, fiber intake, sleep patterns, and alcohol consumption are key modifiable drivers of symptom occurrence and resolution. Full article

This study evaluated the physicochemical properties and sensory acceptance of third-generation, potato-based, extruded snacks enriched with mushroom powder (5% and 10%) across different European regions. The mushroom powder was produced from dried button mushrooms (Agaricus bisporus), ground and incorporated into the snack formulations, while control samples contained no mushroom powder. The investigation was conducted in Denmark, Poland, and Spain, involving 230 young adult consumers identified as the target demographic for this snack format. Incorporation of mushroom powder increased protein, fiber, ash, polyphenols, and antioxidant capacity while producing a darker color and crisper texture. Consumer acceptance varied across countries and was significantly influenced by individual differences in food involvement, neophobia, sustainability orientation, and dietary habits. Participants with greater health consciousness and sustainability engagement expressed a higher preference for snacks with greater levels of mushroom enrichment. Overall, moderate mushroom addition (5–10%) provides an optimal balance between enhanced nutritional quality, favorable sensory attributes, and broad consumer appeal, underscoring the potential of mushrooms as sustainable functional ingredients in snack product development. Full article

Objectives: Graves’ disease (GD) is the most common cause of hyperthyroidism and is associated with marked changes in body weight and body composition. Although weight loss is frequently reported, the extent and clinical relevance of body composition alterations, as well as their relationship with thyroid function, remain unclear. This study aimed to evaluate body composition and eating habits in patients with newly diagnosed hyperthyroid GD according to pre-morbid weight variation, and to compare these findings with those of matched euthyroid controls. Methods: Forty-four consecutive GD patients were enrolled and stratified based on the presence or absence of pre-morbid weight loss. Anthropometric measurements, thyroid function tests, thyroid volume, dietary habits (PREDIMED score, macronutrient intake and total daily caloric intake) and body composition assessed by bioelectrical impedance analysis (BIA) were collected. Standardized phase angle (SPA) and body cell mass index (BCMI) were calculated as nutritional indices. Body composition parameters and dietary adherence were compared with those of 44 age-, sex- and BMI-matched euthyroid controls. Results: Most GD patients (70.3%) reported weight loss before diagnosis; however, the magnitude of weight change did not correlate with the biochemical severity of thyrotoxicosis. Patients without weight loss showed higher fat mass percentage and higher caloric intake than those who lost weight. SPA was significantly associated with FT3, FT4 and TRAb levels, independently of age, sex, BMI and fat mass. Compared with controls, GD patients exhibited lower phase angle and SPA, higher extracellular water percentage and reduced BCMI, whereas fat mass and adherence to the Mediterranean diet were similar. Conclusions: Hyperthyroid GD patients display increased extracellular water and reduced body cell mass. SPA is inversely associated with GD severity and represents a valuable clinical tool for assessing nutritional status in thyrotoxic patients. Pre-morbid weight changes are not proportional to disease severity and may instead reflect increased caloric intake. Full article

The COVID-19 pandemic and its associated economic stressors have profoundly reshaped consumer eating behaviors, presenting an urgent and underexplored challenge for the academic community. This interdisciplinary review critically examines how these disruptions have influenced both food approach and food avoidance patterns, offering a structured analysis of eight key behavioral parameters: Hunger (H), Food Responsiveness (FR), Emotional Overeating (EOE), Enjoyment of Food (EF), Satiety Responsiveness (SR), Emotional Under Eating (EUE), Food Fussiness (FF), and Slowness in Eating (SE). Drawing on recent literature, we highlight significant shifts in these traits—such as heightened hedonic hunger, age-related changes in food preferences, and gender-specific emotional-satiety dynamics—underscoring the complex interplay between emotional states, physiological cues, and behavioral tendencies. Grounded in the systematic examination of peer-reviewed studies in the post-COVID period, this review offers a robust and comprehensive synthesis of current evidence. The novelty of this work lies in its integration of findings into targeted proposition statements for each parameter, visually supported by original flow charts. These culminate in the development of a “Consumers’ Eating Behavior Index”—a conceptual tool designed to guide researchers, healthcare professionals, and policymakers in understanding and responding to post-pandemic dietary transformations. By emphasizing the emotional and psychological dimensions of eating, this index offers a timely framework for designing tailored public health interventions that promote sustainable nutritional habits. This study calls for renewed academic attention to the behavioral consequences of global crises, positioning eating behavior research as a critical frontier in post-COVID recovery and resilience. Full article

Introduction: The PROMOTE cohort study is a prospective pregnancy cohort study that seeks to improve the understanding of cardiometabolic risk and determinants, such as diet, during pregnancy in a multi-ethnic population. Increasing age and obesity has resulted in an increased risk of cardiometabolic complications during pregnancy, including gestational diabetes. Trials of lifestyle interventions have so far produced mixed results, partly due to a wide variation in the methods, duration, adherence and type of dietary intervention. There is a need for high quality data about dietary habits in pregnancy, particularly in multi-ethnic populations. Objectives: In this study, we report the dietary habits of women in early pregnancy in the population of interest. We report early data seeking to assess the relationship between dietary patterns and risks of gestational diabetes. Methods and analysis: The PROMOTE cohort study is a prospective pregnancy cohort study recruiting pregnant participants with <16 weeks gestation in an area of high social and cultural diversity in western Sydney, Australia. The participants are surveyed about their physical activity levels, diet quality, emotional wellbeing and sociodemographic status using validated tools. Participants have consented to the use of routinely collected clinical and social data, including medical conditions, body mass index (BMI), blood pressure (BP) and glycaemia. The follow-up is from routinely collected data. This paper presents dietary data. Results: A total of 459 participants were recruited (n = 459), including 416 with GDM data available, at the conclusion of the first 2 years of recruitment. No participants met national dietary guideline recommendations. Fifty-six participants (n = 56, 13%) met a pragmatic composite standard of favourable diet, defined as two servings of vegetables and two servings of fruit per day, with a maximum of one discretionary serving per day. Over half the participants (n = 215, 51%) reported an adequate daily fruit intake. In total, 7 participants ate at least five servings of vegetables per day (n = 7, 1.7%), 61 participants (14.7%) ate three or more servings of vegetables per day and 212 (51.2%) participants reported one discretionary item per day. The data suggest that few women meet dietary recommendations in pregnancy. The association between dietary habits and GDM was unable to be assessed. The study was underpowered to detect an association due to the highly skewed distribution of dietary patterns in our population. Conclusions: The uptake of dietary recommendations was very low in our sample. This represents a major population health concern. Multi-level approaches are urgently needed to address poor dietary habits in pregnancy. Full article

Background/Objectives: Chronic inflammatory diseases (CIDs) often present a preclinical phase influenced by genetic and environmental factors, including nutrition. Early dietary habits may modulate long-term health trajectories by shaping the intestinal microbiota. Previous work showed that weaning with fresh foods from the Mediterranean diet (MD) improved dietary habits and microbiota composition at 3 years of age. This study aimed to assess whether such benefits persist at 9 years. Methods: This long-term follow-up included 191 children (96 MD, 95 controls) from the original randomized cohort (ClinicalTrials.gov NCT05297357). The primary endpoint was adherence to MD (KidMed score ≥ 8). Secondary endpoints included BMI, incidence of CID, maternal dietary adherence, and intestinal microbiota composition in a subset of 36 children. Results: At 9 years, no difference was found in overall MD adherence (27.4% controls vs. 27.1% MD; p > 0.99) or BMI (17.7 vs. 18.1 kg/m²; p = 0.384). However, children from the MD group reported higher daily vegetable intake (71.9% vs. 51.6%; p = 0.005). Microbiota analyses revealed persistent differences between groups, with higher alpha diversity in the MD group. Although not statistically significant, the MD group showed lower prevalence of atopic dermatitis, allergic rhinitis, autism spectrum disorder, and ADHD. Maternal adherence to MD did not differ between groups. Conclusions: Early introduction of Mediterranean-style foods during weaning exerts lasting effects on dietary patterns and gut microbiota, with a potential protective trend against CID. While overall MD adherence converged between groups by 9 years, these findings suggest that early-life nutritional interventions may induce durable microbiome-mediated benefits and contribute to preventive strategies for chronic disease, warranting confirmation in larger, extended cohorts. Moreover, this study highlights the value of the collaboration between the Italian primary care pediatric system and the integration of the pediatric residency program, demonstrating a feasible and cost-effective methodology to generate large-scale prospective data within routine clinical practice. Larger studies and a longer follow-up period are necessary to confirm these results. Full article

Background: Chronic diseases are a significant and escalating public health concern in the United States (U.S.) and globally. Chronic co-morbidities such as heart disease, stroke, diabetes, other cardiovascular diseases, and asthma are major risk factors for death and disability. Behavioral factors such as smoking, alcohol use, sedentary lifestyle, and poor dietary habits are among the major risk factors leading to these chronic diseases. Purpose: This study aims to investigate how combinations of unhealthy behaviors are associated with the risk of cardiovascular diseases in various populations. Methods: Using data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS), we computed multivariable logistic regression models to assess the association of unhealthy behaviors with the risk of chronic diseases. Results: Our results show that compounded score of risky health behaviors such as smoking, alcohol use, and physical inactivity, as well as other covariates such as older age, being male, previously married, living in a rented house, unemployed, living in non-metropolitan counties, having high blood pressure, and high cholesterol, were associated with experiencing a heart attack, coronary heart disease, and stroke. Conclusions: Our results highlight the need for behavior-focused population health interventions to lower morbidity and health inequities by showing that unhealthy behaviors and sociodemographic disparities significantly raise the risk of cardiovascular diseases. Full article

The Mediterranean Diet (MD) is a lifestyle that involves not only dietary habits, well known for their effectiveness in preventing health risks by supplying well-balanced foods rich in bioactive compounds, but also daily habits that improve the quality of life. Older adults represent a segment of the population that can particularly benefit from this dietary pattern. However, the specific characteristics and needs of older individuals require a critical analysis of aspects that may limit adherence to the MD principles, including physical impairments related to eating, sensory and cultural aspects, accessibility of food sources, and the social context. The objective of this study was to review the potential benefits of the MD in relation to the needs, capacities and eating behaviors of older adults, focusing on the beneficial effects of plant-based food metabolites and their suitability for older adult diets. The results demonstrate how the MD can be tailored to meet the nutritional and functional needs of older adults, supporting healthy aging. Therefore, the Mediterranean lifestyle could be an effective tool in public health policies to promote healthy habits, thereby improving the quality of life in vulnerable population categories. Full article

Background/Objectives: Cardiovascular diseases remain the leading cause of death among women, with peripheral arterial disease (PAD) representing an important manifestation of systemic atherosclerosis. The ankle–brachial index (ABI) is a simple, non-invasive measure used for PAD screening and cardiovascular risk assessment. This study aimed to compare ABI values between women of reproductive and postmenopausal age and to explore associations with lifestyle and clinical characteristics in primary care settings. Methods: This cross-sectional study included 437 women recruited from family medicine offices in two Croatian counties between November and December 2024. Participants completed validated questionnaires on dietary habits (MEDAS) and physical activity (IPAQ/PASE), and underwent anthropometric and blood pressure measurements. ABI was assessed using an automated MESI device following a standardized protocol. Multivariable logistic regression was performed to identify independent predictors of abnormal ABI (<1.00), adjusting for age, BMI, hypertension, smoking, and county. Results: Most participants had normal ABI values (right 95.7%; left 95.0%). Mild to moderate PAD (ABI 0.90–0.99) was observed in approximately 3% and severe PAD (ABI < 0.90) in ≤1.1% of cases. Postmenopausal women were more likely to present with lower ABI values (p = 0.046), though this association was attenuated after adjusting for age. Lifestyle factors, including diet and physical activity, showed no significant association with ABI in the adjusted models. Conclusions: Age emerged as the primary determinant of reduced ABI, while hypertension and smoking showed positive but non-significant associations. The findings underscore the importance of early vascular screening and lifestyle-based prevention in women, particularly in the postmenopausal period. Larger longitudinal studies are warranted to clarify causal pathways and the role of hormonal and behavioral factors in peripheral arterial disease development. Full article

Background/Objectives: Menu calorie labeling policies aim to promote healthier eating habits, yet their effectiveness remains debated. The present study aimed to evaluate the effectiveness of two alternative qualitative labeling strategies—Physical Activity Calorie Equivalent (PACE) labels and Percent Daily Intake (PDI) pie charts—compared to the standard numeric calorie count mandated in several countries, since they have been proposed to enhance consumer comprehension and decision-making. Methods: A nationwide online survey elicited responses from N = 885 individuals living in Italy. Survey participants were randomly assigned to one of three menu conditions: (1) numeric calorie labeling only, (2) numeric calories plus PACE labels, or (3) numeric calories plus a PDI pie chart. Participants selected a three-course meal from their respective menus. Data on sociodemographic factors, dietary habits, BMI, self-assessed nutritional knowledge, and psychological traits—restrained eating (DEBQ-R) and impulsivity (SUPPS-P)—were collected. Ordinal logistic regressions assessed the impact of labeling format, gender, and nutritional knowledge on total calories ordered. Results: Neither PACE labels nor PDI pie charts significantly influenced total calorie selection compared to numeric calorie labels alone. No significant interactions emerged between labeling format and gender or nutritional knowledge. However, age, BMI, and dietary habits were strongly associated with calorie choices: older adults, individuals with restrictive diets, and those with higher restrained eating scores selected lower-calorie meals, while participants with higher BMI or frequent meat intake opted for more calorie-dense options. Conclusions: Alternative calorie labeling formats alone may be insufficient to alter food choices in online settings. Future interventions should integrate motivational and educational strategies tailored to individual traits and dietary habits, rather than relying solely on calorie presentation format. Full article

Background/Objectives: Childhood obesity and nutritional inequalities remain major public health challenges, particularly in socioeconomically disadvantaged settings. In Spain, these disparities are reflected in unequal access to healthy food and differing health outcomes among the young population. This study aimed to explore how social vulnerability influences dietary patterns, body composition, and food insecurity among children and adolescents, with a particular focus on sex differences. Methods: A descriptive cross-sectional study was conducted with 280 participants aged 6 to 15 years old, recruited from urban areas across Spain. Two groups were evaluated, a socioeconomically vulnerable group (VG) (n = 175) and a non-vulnerable group (NVG) (n = 105), classified according to socioeconomic and social established criteria. Validated tools were used to assess diet quality, adherence to the Mediterranean Diet (MD), consumption of ultra-processed foods (UPF), and household food insecurity. Anthropometric measurements were also collected, and body mass index (BMI) was calculated using both national and international reference standards. Results: Vulnerable children and adolescents showed higher prevalence of food insecurity, less favorable body composition indicators, and lower global dietary quality, characterized by lower adherence to the MD and higher consumption of UPF. Multivariate analysis confirmed that socioeconomic vulnerability was significantly associated with female sex, higher BMI, lower adherence to the MD, and greater consumption of UPF. Conclusions: Our findings highlight a concerning pattern of health and nutritional inequality among children and adolescents based on socioeconomic status. There is a clear and urgent need for effective public health strategies with an equity focus that promote healthy and affordable eating habits from early life, especially in the most disadvantaged environments and targeted by gender. Full article

Considering sustainable consumption not just as an exercise of individual choice but a shared and collective activity, this study explores the role of conscious and responsible consumption initiatives (CRCIs) driving citizens’ adoption of sustainable lifestyles. This research followed a qualitative approach, combining documentary research and twenty-six in-depth interviews with practitioners in eight grassroots consumer initiatives located in Galicia (Spain). The results show that CRCIs favor members’ consumption of organic, seasonal, fair, and locally produced food. The findings also reveal that engagement in these initiatives nurtures three interconnected types of learning—cognitive, attitudinal, and behavioral—which contribute to wider adoption of sustainable practices related to shifts in dietary habits, energy use, mobility, and frugality. CRCIs facilitate gradual transitions toward reduced meat consumption, favoring the intake of plant-based foods, and greater self-efficacy in preparing sustainable meals. These behavioral changes are incremental, motivated by inner reflection, practical experience, and consciousness around alternative economic models. However, the consistent adoption of sustainable eating habits is hindered by cultural and psychological barriers like cultural traditions, entrenched habits, and time constraints. In conclusion, these grassroots initiatives are interesting entry points for engaging citizens in sustainable lifestyles, becoming also gateways to the broader social and solidarity economy movement. Full article