Search Results (3,837)

Introduction: Recent guidelines developed by the European Association for the Study of Obesity (EASO) and the European Federation of the Associations of Dietitians (EFAD) focused on the dietetic management of obesity in adults. The present study aimed to explore the perspectives of healthcare professionals regarding these guidelines. Methods: In total, 85 registered dietitians/nutritionists from Greece, the Netherlands, the Republic of Ireland, and the United Kingdom completed an online survey, and 10 were interviewed, in February–March 2023. Demographic data were also collected. Results: Awareness of the EASO-EFAD guidelines among registered dietitians/nutritionists was moderate (57.6%), but only 20% had read them in full. Dietitians with higher education and relevant experience were more likely to have read the guidelines. Less than half reported that key evidence-based recommendations, such as individualized medical nutrition therapy and intensive behavioral interventions, are already included in national guidance. Recommendations like portfolio or DASH diets, partial meal replacements, and calorie restriction were less commonly part of national guidance/usual practice. A small percentage of participants described their adoption of several nutritional approaches novel to them. These included the portfolio dietary pattern, partial meal replacements, and intermittent fasting or continuous calorie restriction. For some Irish dietitians, prioritizing weight as the main outcome conflicted with their emphasis on overall health and individualized nutrition therapy. Other barriers of recommendation implementation included exclusive availability in English, rapid changes in obesity management, staffing shortages, limited multidisciplinary collaboration, and inconsistent knowledge among healthcare providers. Conclusions: The present study identified gaps in the adoption of the EASO-EFAD guidelines into dietetic/clinical practice. EFAD will develop strategies to disseminate these guidelines at different levels of stakeholders (national/local authorities, dietitians/nutritionists, and patients). Full article

Background/Objectives: There is clear evidence that maternal micronutrient deficiencies result in adverse maternal and fetal health outcomes. Therefore, corrective supplementation should be considered when dietary intake is insufficient, particularly for vitamin D (VD), omega-3 fatty acids (O3), folic acid (FA), or prenatal multiple micronutrient products (PMM). Despite its significance, intake patterns in Hungary remain largely unexplored, and evaluating adherence to recommended intake levels would be of even greater importance. This is the first Hungarian study to provide a comprehensive overview of the frequency and adherence patterns of micronutrient supplementation among pregnant women, while also analyzing their association with predictors and outcomes. Methods: This cross-sectional study involved 300 pregnant women who delivered in a university hospital. Data were collected using a self-reported questionnaire and clinical maternal and neonatal records. Results: The prevalence of FA, VD, O3, and PMM intake among the participants was 89.0%, 76.4%, 58.7%, and 67.6%, respectively. However, adherence to recommendations was notably lower: 41.1% for VD, 37.5% for O3, 36% for PMM, and 31% for FA. Higher adherence was associated with older maternal age, higher educational level, county town residence, planned pregnancy, primiparity, previous spontaneous abortion, and early initiation of antenatal care. Our findings refute concerns about the obesogenic effect of supplementation for both mothers and newborns. FA intake correlated with a lower likelihood of cesarean section, while O3 use was associated with improved uterine contractility and reduced risk of gestational diabetes mellitus. Conclusions: Our study underscores the need for individualized counselling on micronutrient supplementation, with particular emphasis on appropriate timing, dosage, and potential benefits. Full article

Background: Public beliefs about dietary risks, such as excessive salt intake, are often not isolated misconceptions but part of structured cognitive systems. This study aimed to explore how individuals organize their beliefs and misperceptions regarding salt-related health consequences. Material and Methods: Using data from an international online survey, we applied a system of multivariate proportional odds logistic regression (POLR) models to estimate conditional associations among beliefs about salt’s links to various diseases—including cardiovascular, metabolic, renal, neuropsychiatric, and mortality outcomes. In addition, exploratory and confirmatory factor analyses (EFA and CFA) were conducted to identify and validate latent constructs underlying the belief items. Beliefs were modeled as interdependent, controlling for latent constructs, sociodemographics, and self-reported health awareness. Statistically significant associations (p < 0.05) were visualized via a heatmap of beta coefficients. Results: Physicians showed almost universal agreement that salt contributes to hypertension (µ = 0.97), compared to non-medical respondents (µ = 0.85; p < 0.0001). Beliefs about mortality (µ = 1.55 for MDs vs. 0.99 for non-medical; p < 0.0001) emerged as central hubs in the belief network. Strong inter-item associations were observed, such as between hypertension and heart failure (β = −0.39), and between obesity and type 2 diabetes (β = −0.94). Notably, cognitive gaps were found, including a lack of association between atrial fibrillation and stroke, and non-reciprocal links between hypertension and heart failure. Conclusions: Beliefs about the health effects of salt are structured and sometimes asymmetrical, reflecting underlying reasoning patterns rather than isolated ignorance. Understanding these structures provides a systems-level view of health literacy and may inform more effective public health communication and education strategies. Full article

Defining appropriate dietary fiber levels is essential for enhancing the sustainability of feedlot lamb production. Optimal dietary fiber levels can enhance meat yield, improve nutrient retention and utilization, and reduce environmental impact. This study aimed to determine the optimal level of dietary fiber to enhance nutrient intake, digestibility, feeding behavior, and rumen fermentation in feedlot lambs. Five rumen-fistulated Santa Inês male lambs (40 kg, 7 months old) were used in a 5 × 5 Latin square design. Diets contained increasing levels of neutral detergent fiber (NDF): 200, 320, 440, 560, and 680 g/kg dry matter (DM), with each period lasting 21 days (total 105 days). Nutrient intake responded quadratically to NDF levels (p < 0.05). Apparent digestibility was significantly affected (p < 0.05), except for crude protein. Feeding (p = 0.001) and rumination times (p = 0.002) increased linearly, while idling time decreased (p < 0.001). Feeder visits declined (p = 0.002), and idling events followed a quadratic trend. Feeding and rumination efficiencies for DM decreased (p = 0.006 and p = 0.010), while NDF rumination efficiency increased (p = 0.014). The ruminal pH rose (p < 0.001), and propionate decreased (p = 0.019); acetate and butyrate showed quadratic responses. Based on intake, digestibility, and fermentation patterns, dietary NDF should be included at 400 g/kg DM to optimize nutrient utilization and rumen function in confined lambs. Full article

Food security among college students is an increasing concern, with potential implications for their health, academic performance, and future well-being. This study investigated food security within a college community in Mexico, focusing on food availability, access (both economic and physical), and consumption patterns. A mixed-methods approach was employed at Ciudad Universitaria, BUAP, Mexico, between 2023 and 2024. Stratified random sampling was used, resulting in a final sample of 606 students. Data were collected through structured questionnaires covering sociodemographic characteristics and eating habits, the ELCSA, structured cafeteria observations, semi-structured interviews with key informants, and three focus groups. Statistical analysis was performed using chi-square tests (p < 0.05). Post hoc analysis with Bonferroni adjustment confirmed that origin (p = 0.0017), mode of transportation (p = 2.31 × 10⁻⁵) and private vehicles (p = 1.77 × 10⁻⁵) were the key determinants. Although the environment offered a variety of options, processed and ultra-processed products dominated the food choices. A total of 95.9% of students purchased food on campus, yet only 21.8% reported engaging in healthy eating habits. Focus groups revealed that students’ food choices were influenced by availability, access, and perceptions of affordability and convenience. These findings highlight the urgent need for targeted interventions to improve food security and promote healthier dietary practices within the college setting. Full article

Background: The Dietary Guidelines for Americans (DGA) and the American Academy of Pediatrics recommend limiting 100% juice consumption to 0.5–1.25 cups/day and to no more than one half of total fruit intake. Objective: To explore the dietary benefits of consuming 100% fruit juice and diluted 100% juice across diverse socio-demographic strata in the US. Methods: Consumption patterns for 100% juice and diluted 100% juice were examined by sex, age group, income-to-poverty ratio (IPR), and race/ethnicity. Dietary intakes came from the National Health and Nutrition Examination Survey (NHANES 2017–2020 and 2021–2023). The Healthy Eating Index 2020 (HEI 2020) and diet-level Nutrient Rich Food (NRF9.3) scores were the two measures of diet quality. The amounts of 100% juice consumed were compared to published DGA recommendations. Results: The consumption of 100% juice was greatly below that of water, milk, and sugar-sweetened beverages (SSBs). The consumption of diluted 100% juice was very low. Consumers of 100% juice had higher HEI 2020 scores (53 vs. 48) and diets with less added sugar and more total fruit, more potassium, calcium, and vitamin C. About 88% of the NHANES sample consumed <4 oz/day (1/2 cup) of 100% juice and most derived at least 50% of fruit from whole fruit, though some variation by income and race/ethnicity was observed. About 93% of the sample consumed <1 cup/day (8 oz) of 100% juice. Lower income groups consumed less whole fruit and more 100% juice. Conclusion: The consumption of 100% fruit juice was a marker of healthier dietary choices. The observed social gradient suggests that 100% fruit juice may provide valuable nutrients to populations who may be unable to afford or access whole fruit. Public health recommendations: The consumption of 100% fruit juice by some population subgroups could be increased. Fruit juice was not displacing whole fruit, and current consumption was well below the current DGA recommended values. Full article

Background: Balancing nutrition security with environmental sustainability is a key priority in global food policy, with Sustainable Healthy Diets (SHDs) serving as a critical framework aligned with the UN Sustainable Development Goals (SDGs). Traditional Japanese cuisine reflects SHD principles through its emphasis on plant-based, seasonal, and minimally processed dishes. However, modern, globalized dietary patterns increasingly feature ultra-processed foods, raising concerns about health risks such as high sodium intake. Methods: This study adopts a novel dish-level content analysis of 120 contemporary recipes from NHK Today’s Cooking between 2023 and 2025, a TV program by Japan’s national public broadcaster that is widely regarded as reflecting the practices of Japanese home cooking, to examine how SHDs pillars—nutritional diversity (e.g., varied protein sources), environmental sustainability (e.g., low-carbon ingredients), and cultural continuity (e.g., traditional techniques)—are embedded in Japanese home cooking. Unlike macro-level consumption or nutrition data, this dish-level approach reveals how individual dishes embody sustainability through ingredient selection, preparation methods, and cultural logic. Results: Quantitatively, pork (33.3%) and seafood (19.2%) together dominated main protein sources, with minimal beef (2.5%) and a notable presence of soy-based foods (12.5%), supporting lower reliance on environmentally intensive red meat; mean salt content per person in main dishes was 2.16 ± 1.09 g (28.9% for men, 33.3% for women of Japan’s daily salt targets), while recipe patterns emphasizing fermentation and seasonal alignment highlight possible pathways through which Japanese dietary practices can be considered ecologically efficient. Simultaneously, the analysis identifies emerging challenges, encompassing environmental issues such as overfishing and public health concerns like excessive sodium consumption. Conclusions: By centering dishes as culturally meaningful units, and using media recipes as reproducible, representative datasets for monitoring dietary change, this approach offers a reproducible framework for assessing dietary sustainability in evolving global food systems. Full article

Background: Cancer remains a leading cause of morbidity and mortality worldwide. In Puerto Rico, patients face additional burdens due to the structural inequalities affecting access to employment, nutritious food, and mental health services. This study examined the associations between employment status, perceived economic hardship, dietary behaviors, and depressive symptoms among 334 adult cancer patients in Puerto Rico. Methods: Using a cross-sectional design, participants provided sociodemographic data, dietary patterns, and self-reports of depression. Results: Statistical analyses revealed that full-time employment was associated with a higher consumption of low-nutritional-value foods (ρ = 0.157, p = 0.015) and significant differences in their consumption having a higher mean against unemployment were observed (mean ranks = 146.09 and 177.08, p = 0.010). A higher employment status also served as a protective factor against depression (p = 0.005). A higher body mass index (BMI) was linked to an increased risk of depression (p = 0.002), and perceived economic hardship was significantly associated with depression (OR= 0.54, p = 0.033). Conclusions: The findings underscore the necessity for comprehensive interventions that account for the synergistic effects of economic perception, employment, nutrition, and psychological well-being in cancer treatment in Puerto Rico. Full article

Although the ultimate drivers of bat fatalities at wind turbines are still not well understood, the foraging behavior of insectivorous bats puts them at increased risk of collision with rotating blades. Wind energy facilities are commonly located in agriculture fields where bats can exploit periodic superabundant insect emergence events in the late summer and early autumn. Thermal imaging, acoustic monitoring, and bat carcass stomach content analyses show that bats prey upon insects on and near wind turbine towers. Studies have shown a positive association between insect abundance and bat activity, including in agricultural systems. We conducted a systematic review of bat diets for four common bat species in the Midwest and northern Great Plains to synthesize existing knowledge across species, assess the extent to which these bat focal species consume crop pests, and evaluate the potential for crop pest emergence models to predict temporal and spatial patterns of bat fatalities in this region. Big brown bats and eastern red bats consumed a variety of crop pests, including some for which emergence models may be available. In contrast, there were few studies for hoary bats or silver-haired bats, and the dietary evidence available has insufficient taxonomic resolution to conclude that crop pests were consumed. To augment existing data and illuminate relationships, we recommend that genetic diet analyses for bats, specifically hoary and silver-haired, be conducted in the late summer and autumn in this region. The results of these studies may provide additional candidate insect models to evaluate for predicting bat fatalities at wind turbines and clarify if the superabundant insect emergence hypothesis warrants further investigation. Full article

Background/Objectives: Suboptimal gestational weight gain (GWG) has been linked to increased risks of adverse maternal outcomes. Evidence linking diet in pregnancy to GWG remains limited. We assessed relationships between adherence to five dietary patterns (Planetary Health Diet [PHD], Dietary Approaches to Stop Hypertension [DASH], Alternate Mediterranean Diet [AMED], Healthy Eating Index [HEI], and Alternate Healthy Eating Index [AHEI]) and 2009 Institute of Medicine GWG categories. Methods: Women expecting singleton pregnancies participated in the NICHD Fetal Growth Studies and completed a food-frequency questionnaire (FFQ) at 8 to 13 weeks of gestation that captured their baseline diet. Adherence to each dietary pattern was calculated, with higher scores indicating greater adherence. Women were categorized into low, moderate or high adherence to each dietary pattern. Using multinomial logistic regression, we estimated adjusted odds ratios and 95% confidence intervals [OR (95% CIs)] of inadequate or excessive GWG (reference category: adequate), for high vs. low adherence to each dietary pattern. Results: In the full cohort, women with high vs. low adherence to DASH, AMED, HEI, or AHEI (but not PHD) had a 13% to 31% lowered odds of inadequate total GWG [ranging from 0.87 (0.58, 1.31) for AMED to 0.69 (0.48, 0.99) for DASH]. High adherence to DASH or HEI was associated with lower odds of inadequate first-trimester GWG, after correcting for multiple testing [DASH: 0.36 (0.22, 0.61), HEI: 0.49 (0.30, 0.79)]. No significant association was observed between any of the dietary patterns and excessive total and trimester-specific GWG. Conclusions: Greater adherence to several dietary patterns was associated with lowered odds of inadequate GWG. Future studies could characterize these diets objectively by identifying metabolite signatures and examining their associations with GWG. Full article

Background/Objectives: Celiac disease (CD) is a chronic autoimmune enteropathy with increasing recognition of systemic involvement, including potential microvascular alterations. While nailfold videocapillaroscopy (NVC) is an established tool in rheumatology for assessing microcirculation, its application in pediatric CD remains unexplored. Our aim was to investigate capillaroscopic abnormalities in children with CD and assess their associations with clinical and laboratory parameters, including dietary adherence. Methods: This cross-sectional study included 76 pediatric CD patients and 76 age- and sex-matched healthy controls. All participants underwent standardized NVC evaluation, assessing capillary density, dilatation, morphology, and microhemorrhages. Clinical data, laboratory values, and dietary adherence (based on clinical symptoms and tissue transglutaminase-IgA levels) were recorded. Results: Compared to controls, CD patients exhibited significantly lower capillary density and increased frequencies of dilated capillaries, microhemorrhages, and abnormal morphologies (p < 0.001). A nonspecific NVC pattern predominated among CD patients. Capillary abnormalities were more pronounced in patients without tTG-IgA normalization (>10 U/mL) and with symptoms suggestive of gluten exposure. Additionally, the number of dilated capillaries positively correlated with age and disease duration. No significant differences were found based on ANA status. Conclusions: This is the first study to demonstrate NVC-detectable microvascular alterations in pediatric CD. Findings suggest subclinical microvascular involvement, which may be potentially modifiable through dietary adherence. NVC may serve as a non-invasive tool to detect early vascular changes and monitor systemic manifestations in pediatric CD. Longitudinal studies are warranted to clarify the reversibility and prognostic implications of these abnormalities. Full article

Background/Objectives: Fetal exposure to essential metals, such as iron (Fe), zinc (Zn), copper (Cu), and manganese (Mn), is influenced by maternal nutrition and lifestyle during pregnancy, potentially impacting newborn health. This study aimed to quantify concentrations of these metals in meconium and evaluate their associations, together with newborn length and weight, in relation to maternal dietary and lifestyle factors. Methods: This cross-sectional study included 152 mother–infant pairs recruited from various regions of Split-Dalmatia County, Croatia. Meconium samples were collected within 24 h after birth and analyzed for Fe, Zn, Cu, and Mn concentrations. Maternal characteristics, dietary intake, supplement use, and lifestyle factors were collected via structured questionnaires and supplemented by hospital records. Associations among maternal factors, meconium metal concentrations, and newborn birth weight and length were assessed using non-parametric statistical methods. Results: Meconium concentrations of Fe, Zn, Cu, and Mn showed substantial interindividual variability, with a strong positive correlation between Fe and Cu. Higher maternal pre-pregnancy BMI was linked to lower meconium Fe, while BMI at delivery was associated with Zn. Dietary patterns influenced metal levels: higher fruit intake was linked to increased Cu, greater vegetable intake with lower Fe, and moderate tea consumption with higher Zn. No significant associations were found with maternal smoking, residence, or supplement use. Maternal meat consumption and higher pre-pregnancy BMI were both associated with higher newborn birth weight and length. Conclusions: Maternal BMI and specific dietary patterns during pregnancy significantly influence essential metal concentrations in newborn meconium and are associated with newborn size, highlighting the importance of balanced maternal nutrition and healthy metabolic status during pregnancy. Full article

Background/Objectives: Hypertension is a growing public health concern in Saudi Arabia, driven by rapid socioeconomic changes. This study investigated the interplay between habitual, behavioral, and dietary risk factors associated with hypertension among Saudi adults. Methods: A cross-sectional survey was conducted among 3312 Saudi adults using multistage stratified random sampling. The data were collected via validated questionnaires assessing sociodemographic, anthropometric indicators, lifestyle behaviors, dietary patterns, and medical history. Hypertension status was determined through self-reported diagnosis. Bivariate analyses and multiple logistic regression identified independent predictors (p < 0.05). Results: Hypertension prevalence was 13% (mean age: 34 ± 15 years; 50% male). The strongest predictors were age (OR = 1.08/year; 95% CI: 1.07–1.10; p < 0.001), increased body mass index (OR = 1.03; 95% CI: 1.01–1.06; p = 0.011), smoking (OR = 1.55; 95% CI: 1.04–2.29; p = 0.030), and family history of hypertension (OR = 7.71; 95% CI: 5.61–10.75; p < 0.001). Participants with diabetes mellitus had 89% higher odds of hypertension (OR = 1.89; 95% CI: 1.42–2.51; p < 0.001), and those with dyslipidemia had more than double the odds (OR = 2.45; 95% CI: 1.38–4.22; p = 0.002). Protective factors included higher income (≥15,000 SAR; OR = 0.54; 95% CI: 0.36–0.81; p = 0.003) and regular whole grain consumption (OR = 0.60; 95% CI: 0.46–0.77; p < 0.001). Conclusions: Hypertension risk in Saudi adults is shaped by age, obesity, smoking, comorbid metabolic conditions (diabetes and dyslipidemia), and genetic pre-disposition. In contrast, higher income and whole grain intake may offer protection. These findings underscore the need for comprehensive prevention strategies that address both lifestyle and cardiometabolic comorbidities, in alignment with Saudi Vision 2030 health priorities. Full article

Background/Objectives: Poor nutritional status and cachexia have been well-documented as predictors of adverse outcomes in individuals with chronic heart failure (HF). However, despite obesity being a common observation in this patient population, a growing body of evidence indicates that these individuals may still suffer from nutrient deficiencies and malnutrition. This study aimed to characterize the food and nutrient intake of participants enrolled in the Pro-HEART clinical trial—a study evaluating dietary interventions in overweight and obese individuals with HF—and to compare their consumption patterns to national nutritional guidelines. Methods: A cohort of 92 overweight and obese individuals with chronic HF enrolled in the Pro-HEART trial. Baseline food consumption was assessed via a validated 3-day Food Record. The data were analyzed using descriptive statistics to evaluate adherence to recommended intake levels for energy, macronutrients (fat, carbohydrates, protein), and key micronutrients. Results: Among the 92 participants, 41% exceeded fat intake recommendations, 73% surpassed guidelines for saturated fat, and 95% consumed excessive sodium. Despite adequate caloric intake, many individuals failed to meet recommended levels for key micronutrients known to influence inflammation and metabolic regulation, including vitamin D, calcium, magnesium, and potassium. Conclusions: These findings suggest that overweight and obese individuals with HF, despite their excess body weight, exhibit dietary patterns that place them at risk of malnutrition. The results underscore the necessity of nutritional assessments and interventions in this population to address deficiencies that may contribute to the metabolic and inflammatory abnormalities associated with HF. Full article

The MIND diet was designed as an intervention to delay neurodegeneration and has been explored by systematic reviews for associations with cognition and, more recently, cardiometabolic disease. Comparatively less is known about how the MIND diet is associated with other health outcomes (e.g., all-cause mortality, anxiety, insomnia). This scoping review included studies exploring associations between the MIND diet and health outcomes other than cognition and cardiometabolic disease. Online databases were used to identify 4090 studies published between January 2015 and April 2024, from which 47 publications were included for review. Associations between the MIND diet and health outcomes were assessed as either favorable, unfavorable, or having no statistically significant association. Overall, 47 studies were included in this scoping review, 46 were observational, and several were conducted in large, established cohort studies. Across the 47 studies, 18 different topics were explored. Higher adherence to the MIND diet was mostly associated with favorable health outcomes (65%), while roughly one-third (33%) of studies found no statistically significant associations. One study, in Italy, found that increased adherence to the MIND diet was associated with increased exposure to cadmium, a heavy metal. In populations that may benefit from the MIND diet, we recommend additional observational and exploratory studies to identify health associations. Studies exploring educational interventions would help to identify facilitators and barriers to adopting the MIND diet. This scoping review provides some evidence that higher adherence to the MIND diet is associated with risk reduction for many diseases. Further research on environmental exposures (e.g., cadmium) and other deleterious substances absorbed by food crops will be crucial as we strive to enhance health and food security through plant-rich dietary patterns. Full article