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Search Results (602)

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23 pages, 1600 KB  
Article
The Evidence-Based Instrument for the Nutritional Assessment of Individuals with Autism Spectrum Disorder
by Cristiane Vasconcelos, Kamila Castro and Rudimar dos Santos Riesgo
Dietetics 2025, 4(3), 37; https://doi.org/10.3390/dietetics4030037 (registering DOI) - 1 Sep 2025
Abstract
Background: Autism spectrum disorder (ASD) presents diverse challenges that significantly impact feeding, nutrition, growth, and development. The heterogeneity of ASD manifestations adds complexity to assessments due to the broad range of factors to be considered. Moreover, the literature lacks a comprehensive tool specifically [...] Read more.
Background: Autism spectrum disorder (ASD) presents diverse challenges that significantly impact feeding, nutrition, growth, and development. The heterogeneity of ASD manifestations adds complexity to assessments due to the broad range of factors to be considered. Moreover, the literature lacks a comprehensive tool specifically addressing nutritional aspects in ASD. Methods: Conducted in two steps, this study first involved researchers selecting evidence-based elements related to ASD and nutrition to develop a preliminary tool. Content validation was subsequently undertaken using a modified Delphi method, whereby expert consensus was sought from 30 dietitians with experience in ASD, who evaluated the tool through a digital questionnaire. Four quality criteria were evaluated: functionality, organization, language and comprehensibility, and comprehensiveness. Results: Levels of strong agreement with the quality criteria ranged from 63.3% to 80%, specifically functionality (76.7%), organization (73.3%), language and comprehensibility (80%), and comprehensiveness (63.3%). Thematic analysis highlighted six key areas for improvement. The instrument assesses nutritional aspects across seven domains: life history, food-related aspects, feeding behavior, dietary intake, daily routines, clinical aspects, and anthropometry. Conclusions: This is the first known tool to comprehensively address the nutritional needs of individuals with ASD, offering a detailed framework for clinical application. It supports initial assessments, ongoing monitoring, and targeted interventions, supporting dietitians worldwide in clinical decision-making. Full article
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12 pages, 301 KB  
Article
Patient and Family Perspectives on Integrated Transitional Care for Anorexia Nervosa in Mantova, Italy
by Debora Bussolotti, Giovanni Barillà, Antonia Di Genni, Martina Comini, Alberto Gallo, Mariateresa Torre, Laura Orlando, Beatrice Mastrolorenzo, Eva Corradini, Barbara Bazzoli, Francesco Bonfà, Andrea Mora, Luca Pasqualini, Elisa Mariantoni, Alessandro Cuomo, Despoina Koukouna and Paola Accorsi
Nutrients 2025, 17(17), 2830; https://doi.org/10.3390/nu17172830 - 30 Aug 2025
Viewed by 62
Abstract
Background/Objectives: The child and adolescent mental health service (CAMHS) hand-over to adult mental health service (AMHS) remains an ongoing shortfall in eating disorder (ED) treatment, typically in tandem with diagnostic drift, heightened suicide risk, and carer burn-out. We created one 14-to-25 Transition—ED track [...] Read more.
Background/Objectives: The child and adolescent mental health service (CAMHS) hand-over to adult mental health service (AMHS) remains an ongoing shortfall in eating disorder (ED) treatment, typically in tandem with diagnostic drift, heightened suicide risk, and carer burn-out. We created one 14-to-25 Transition—ED track within our own unit, where a single multidisciplinary team continuously follows each patient and family across the CAMHS–AMHS boundary (via weekly joint paediatric and adult clinician meeting) without changing the individual psychotherapist, family therapist, or dietitian at the age 18 transition. We investigated the manner in which patients and parents perceive this model. Methods: A survey of two naturalistic parent cohorts—CAMHS (n = 16) and Transition—Adult arm (n = 15)—also joined, alongside the original group of young adults who had entered the programme during its set-up phase (n = 9). Here, the 14–25 pathway denotes one unified route of care across adolescence and young adulthood; the Transition—Adult arm is its ≥ 18-years component. All index patients had a primary DSM-5-TR diagnosis of restricting-type anorexia nervosa. Participants completed the Client Satisfaction Questionnaire-8 (CSQ-8; range 8–32) and four bespoke Continuity-of-Care items (1–4 Likert). Results: Overall, the caregivers in both cohorts were pleased (median CSQ-8 = 28.5 [CAMHS] vs. 27.0 [Transition]; p = 0.75). Continuity items were universally well rated across cohorts. Cohort parents reported a median of two unchanged core clinicians (i.e., the individual psychotherapist, the family therapist, or the dietitian), which was nonsignificantly positively correlated with CSQ-8 scores (ρ = 0.22). Early-group patients mirrored caregiver impressions (mean CSQ-8 = 27.0 ± 3.9). Conclusions: It is feasible and highly acceptable to both caregivers and anorexia nervosa young adults to have the same key staff and family-centred sessions over the 14-to-25 age span. Constrained by single-site study and small sample size, these preliminary data provide a rationale for wider implementation and controlled follow-up studies. Full article
11 pages, 475 KB  
Article
Analysis of the Perception of Nutrigenetics in Conventional Nutritional Practice: A Survey-Based Study Applied to Dietitians from Mexico
by Diana Alejandra Vela-Vásquez, Ivan Delgado-Enciso, Janet Diaz-Martinez and Ana María Sifuentes-Rincón
Nutrients 2025, 17(17), 2776; https://doi.org/10.3390/nu17172776 - 27 Aug 2025
Viewed by 289
Abstract
Background/Objectives: Nutrigenetics has emerged as a promising tool to advance personalized nutrition strategies. This study aimed to analyze the scope and perception of Mexican dietitians regarding nutritional genomics with an emphasis on nutrigenetics’ use in clinical practice. Methods: A survey was conducted online [...] Read more.
Background/Objectives: Nutrigenetics has emerged as a promising tool to advance personalized nutrition strategies. This study aimed to analyze the scope and perception of Mexican dietitians regarding nutritional genomics with an emphasis on nutrigenetics’ use in clinical practice. Methods: A survey was conducted online among dietitians in Mexico to assess their educational background, awareness of nutrigenetic testing, use in practice, and interest in further training through 33 questions. Results: One hundred and thirty participants from states across six Mexican regions completed the survey, and most of respondents had a bachelor’s degree. The analysis showed that while most respondents were familiar with the concepts of nutrigenomics and nutrigenetics, 92.3% did not incorporate genetic testing into their practice; the main barriers of their use were misinformation, limited access to reliable resources, and ethical concerns surrounding genetic testing. Although 86.2% expressed interest in learning about nutrigenetics, only 31.5% were willing to invest in further training. Social media and non-academic sources were important sources of information, raising concerns about their inaccurate content and highlighting their importance in completing the curricula. Patients’ demand for genetic testing is limited and directed by disease prevention interests. Conclusions: Nutrigenetics is currently an area with limited practical application among Mexican dietitians; however, it is perceived as a valuable tool for future daily practice. The gap between perception and application underscores the need to integrate nutrigenetics into undergraduate curricula and to provide accessible, evidence-based professional development; these are essential to promote the ethical and effective use of nutrigenetics and support the transition toward personalized nutrition. Full article
(This article belongs to the Special Issue Current Insights into Genome-Based Personalized Nutrition Technology)
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16 pages, 446 KB  
Article
Malnutrition and Nutrition Impact Symptoms in Kuwaiti Colorectal Cancer Patients: Validation of PG-SGA Short Form
by Raghad Obaid and Dalal Alkazemi
Nutrients 2025, 17(17), 2770; https://doi.org/10.3390/nu17172770 - 27 Aug 2025
Viewed by 314
Abstract
Background/Objectives: Malnutrition is a common but underrecognized complication in colorectal cancer (CRC), contributing to poor treatment outcomes and reduced quality of life. Regional data from the Gulf remains limited. This study assessed the prevalence of malnutrition and nutrition impact symptoms (NISs) among CRC [...] Read more.
Background/Objectives: Malnutrition is a common but underrecognized complication in colorectal cancer (CRC), contributing to poor treatment outcomes and reduced quality of life. Regional data from the Gulf remains limited. This study assessed the prevalence of malnutrition and nutrition impact symptoms (NISs) among CRC patients in Kuwait. It evaluated the diagnostic performance of the PG-SGA Short Form (PG-SGA SF) in comparison to the full PG-SGA and the Malnutrition Screening Tool (MST). Methods: A cross-sectional study was conducted among 65 CRC outpatients at the Kuwait Cancer Control Center. Nutritional status was assessed using the full PG-SGA, PG-SGA SF, and MST. Dietary intake, anthropometry, biochemical parameters, and NISs were collected. Logistic regression identified independent predictors of malnutrition, and the performance of the tool was evaluated using kappa statistics and diagnostic accuracy metrics. Results: Malnutrition (PG-SGA B/C) was identified in 61.4% of patients. Loss of appetite, dry mouth, and nausea were significantly associated with malnutrition (p < 0.00385); dry mouth independently predicted malnutrition (OR: 17.65, 95% CI: 2.02–154.19, p = 0.009). BMI was not predictive, but reduced mid-arm circumference was significantly associated. PG-SGA SF showed strong agreement with the full PG-SGA (κ = 0.75), with high sensitivity (87.2%) and specificity (88.5%), outperforming MST (κ = 0.38). Only 23.5% of moderately malnourished patients were referred to a dietitian. Conclusions: Malnutrition and NIS are highly prevalent among Kuwaiti CRC patients. PG-SGA SF is a valid and efficient screening tool that should replace MST in oncology settings. Symptom-informed screening and structured referral protocols are crucial for enhancing nutrition care. Full article
(This article belongs to the Section Clinical Nutrition)
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14 pages, 804 KB  
Article
Dietitians’ Adherence and Perspectives on the European Association for the Study of Obesity (EASO) and the European Federation of the Associations of Dietitians (EFAD) Recommendations for Overweight and Obesity Management: A Mixed-Methods Study
by Odysseas Androutsos, Hilda Mulrooney, Vaios Svolos, Antonis Vlassopoulos, Elisabeth Govers and Maria Hasssapidou
Nutrients 2025, 17(17), 2736; https://doi.org/10.3390/nu17172736 - 23 Aug 2025
Viewed by 486
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue Nutritional Assessment in Preventing and Managing Obesity)
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20 pages, 275 KB  
Article
Global Clinical Practice in Transitioning Protein Substitutes for Children with Phenylketonuria
by Ozlem Yilmaz Nas, Catherine Ashmore, Sharon Evans, Alex Pinto, Anne Daly, Nurcan Yabancı Ayhan and Anita MacDonald
Nutrients 2025, 17(16), 2650; https://doi.org/10.3390/nu17162650 - 15 Aug 2025
Viewed by 490
Abstract
Background: Protein substitutes are essential in the dietary management of phenylketonuria (PKU). Transition from first-stage phenylalanine (Phe)-free infant formula to second- and third-stage protein substitutes is carefully managed to meet a child’s evolving nutritional needs, feeding abilities, and developmental progression. However, clinical protocols, [...] Read more.
Background: Protein substitutes are essential in the dietary management of phenylketonuria (PKU). Transition from first-stage phenylalanine (Phe)-free infant formula to second- and third-stage protein substitutes is carefully managed to meet a child’s evolving nutritional needs, feeding abilities, and developmental progression. However, clinical protocols, product access, and reimbursement vary globally. This study assessed international transition practices. Methods: A cross-sectional online survey explored health professionals’ practices on transition timing, influencing factors, product forms, casein-glycomacropeptide (cGMP) use, and perceived barriers and facilitators. Results: A total of 106 professionals from 32 countries participated: Europe (67%), Asia (12%), North America (10%), South America (8%), and Oceania (3%). Dietitians led transitions in 83% of centers. First-stage Phe-free infant formula was typically discontinued at 1–2 years (66%). Second-stage substitutes were introduced at 6–12 months in Europe (61%) and Oceania (100%), but after age one in Asia (69%), North America (72%), and South America (100%). Influencing factors included weaning alignment (46%) and nutritional needs (42%). Semi-solids were preferred in Europe (56%) and Oceania (67%), while powdered drinks dominated in Asia (62%), North America (82%), and South America (100%). Third-stage protein substitutes were introduced at 3–5 years (45%), with later transitions more common in South America (88%) and North America (63%). Ready-to-drink forms were frequent in Oceania (100%), Asia (92%), and Europe (85%). cGMP was prescribed by 61%, mainly guided by preference, Phe tolerance, and adherence; 26% reported no access. Key facilitators for transition included motivation (79%) and sensory properties (69%); barriers included aversion (70%) and poor taste/texture (69%). School involvement was reported by 32%. Conclusions: Protein substitute transition practices in PKU vary globally. International guidance and equitable product access are needed. Full article
(This article belongs to the Special Issue Dietary Practices and Dietary Treatment in Phenylketonuria)
19 pages, 971 KB  
Article
Impact of Dietary Patterns on the Lipidemic Profile and the Cardiovascular Risk in Stage 1 Hypertension: A Post Hoc Analysis of the HINTreat Trial
by Anastasios Vamvakis, Antonios Lazaridis, Maria G. Grammatikopoulou, Anastasia Malliora, Kyriaki Tsiroukidou, Christos Tzimos, Andrea Di Blasio, Pascal Izzicupo and Eugenia Gkaliagkousi
Nutrients 2025, 17(16), 2632; https://doi.org/10.3390/nu17162632 - 14 Aug 2025
Viewed by 452
Abstract
Background/Objectives: In hypertension (HTN), lifestyle modification is important for controlling blood pressure (BP) and lipidemic profile. The HINTreat trial showed that an anti-inflammatory diet was associated with improved endothelial function, after six months of intensive nutritional treatment. Methods: This post hoc [...] Read more.
Background/Objectives: In hypertension (HTN), lifestyle modification is important for controlling blood pressure (BP) and lipidemic profile. The HINTreat trial showed that an anti-inflammatory diet was associated with improved endothelial function, after six months of intensive nutritional treatment. Methods: This post hoc analysis of the HINTreat trial examined how adherence to various nutritional patterns like the Mediterranean Diet (MedDiet), the Dietary Approaches to Stop Hypertension (DASH) diet, and anti-inflammatory diet, had impact on the blood lipids profile and the CVD risk. Patients with stage 1 HTN, allocated either on intensive lifestyle treatment (ILT) or usual care (UC) standard treatment, participated in the analysis. From the original sample size of the HINTreat trial, all patients that were prescribed lipid lowering medication at any time of the study period were excluded from the total analysis; thus, the intervention and the control groups consisted of 33 and 28 patients, respectively. Nutritional intakes were assessed with repeated 24 h recalls from the previous day, and dietary indexes and scores were calculated as follows: MedDiet score, DASH index, and Dietary Inflammatory Index (DII). After six months of intervention, changes in the nutritional indexes and their effect on the lipidemic profile and CVD risk were analyzed. Results: In the ILT group, reductions were noted in Ambulatory Blood Pressure Monitoring (ABPM) for day systolic BP (SBP) (−12.7 mmHg) and diastolic BP (DBP) (−8.4 mmHg), total cholesterol (TC) (−35.4 mg/dL), triglycerides (TG) (−21.4 mg/dL), LDL cholesterol (LDL-C) (−27.5 mg/dL) concentrations, and CVD risk score (−1.5%), p < 0.001 for all. Multiple regression analysis showed that dietary quality indices independently influenced improvements in blood lipid profile and cardiovascular disease (CVD) risk among patients receiving ILT. Specifically, a higher Mediterranean Diet (MedDiet) score was significantly associated with reductions in TC (B = −7.238, p < 0.001), TG (B = −4.103, p = 0.035), and LDL-C (B = −6.431, p = 0.004). The DASH index was positively associated with TG levels (B = 9.913, p = 0.010), suggesting a more complex relationship that may require further investigation. In addition, DII was positively associated with increased CVD risk (B = 0.973, p < 0.001). Conclusions: The findings suggest that ILT can improve BP levels, target blood lipids concentrations, and reduce CVD risk in patients with stage 1 HTN. Full article
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21 pages, 834 KB  
Article
Mismatch Between Perceived and Actual Dietary Nutrition in Hospitalized Cardiovascular Patients and Clinicians: A Cross-Sectional Assessment and Recommendations for Improvement
by Di Li, Jiaheng Han, Ye Peng, Xi Yu, Ying Xiao, Junxian Song and Peng Liu
Nutrients 2025, 17(16), 2624; https://doi.org/10.3390/nu17162624 - 13 Aug 2025
Viewed by 505
Abstract
Background: Multiple studies demonstrated that nutritional risk and malnutrition were associated with prolonged hospitalization, extended rehabilitation duration, and increased mortality among patients with cardiovascular diseases (CVD). However, current research on dietary behaviors and nutritional status in hospitalized CVD patients remains insufficient. Objective: This [...] Read more.
Background: Multiple studies demonstrated that nutritional risk and malnutrition were associated with prolonged hospitalization, extended rehabilitation duration, and increased mortality among patients with cardiovascular diseases (CVD). However, current research on dietary behaviors and nutritional status in hospitalized CVD patients remains insufficient. Objective: This study systematically evaluated the concordance between cardiology inpatients’ and clinicians’ subjective nutritional status assessments and objective energy and protein intake achievement rates, while comprehensively investigating the multidimensional associations among Nutritional Risk Screening 2002 (NRS 2002), Global Leadership Initiative on Malnutrition (GLIM), blood parameters, and dietary intake. Methods: This study adopted a cross-sectional design to investigate hospitalized patients in the department of cardiology. Dietary knowledge and behavior data were collected through questionnaires, and actual dietary intake was recorded. Nutritional risk assessment and malnutrition diagnosis were performed for all inpatients. Differences between subjective evaluations and actual intake were compared, and the correlation between blood biochemical indicators and nutritional status was analyzed. Results: The study enrolled 618 valid cases, with male and female patients accounting for 67.48% and 32.52%, respectively. The patients’ age was 61.89 ± 12.88 years. The NRS 2002 score was 3.01 ± 0.94, with 132 inpatients diagnosed with malnutrition according to GLIM criteria. Energy and protein intake reached only 63.09 ± 18.23% and 74.98 ± 22.86% of target values, respectively. NRS 2002 showed significant correlations with estimated glomerular filtration rate (eGFR), C-reactive protein (CRP), albumin (ALB), etc. No significant difference was found between physician and inpatient evaluations (χ2 = 1.465, p < 0.05). Both ordinal and multivariable logistic regression analyses demonstrated significant discrepancies between subjective assessments (inpatient perceptions and physician evaluations) and objective energy and protein intake levels (p < 0.05). Conclusions: Hospitalized cardiovascular patients commonly exhibited insufficient nutritional intake and limited dietary awareness. A mismatch existed between patient/clinician perceptions and objectively assessed nutritional intake. Subjective evaluations could not accurately reflect actual nutritional status, necessitating enhanced nutritional monitoring—including nutritional risk screening, biochemical testing, and dietary surveys—along with personalized interventions. Future efforts should enhance collaboration between clinicians and dietitians to improve patients’ nutritional status and clinical prognosis. Full article
(This article belongs to the Section Clinical Nutrition)
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12 pages, 477 KB  
Article
A Descriptive Study of Caregivers’ Awareness, Practices, Challenges Faced, and Methods of Adherence to the Ketogenic Diet in Children with Refractory Epilepsy
by Nora Alafif, Fahdah AlShaikh, Monirah Albloushi, Nawaf W. Alruwaili, Waad Alfawaz, Fay Almutairi, Entisar Alhany, Jamilah Ghazwani, Nesreen Alduhaim, Shabana Tharkar and Khalid M. Almutairi
Nutrients 2025, 17(16), 2605; https://doi.org/10.3390/nu17162605 - 11 Aug 2025
Viewed by 424
Abstract
Background: Refractory epilepsy refers to a type of epilepsy in which anti-epileptic medications do not yield results, necessitating alternative medical interventions. The ketogenic diet (KD) is utilized as a non-pharmacologic treatment for refractory epilepsy. This study aims to assess details regarding caregivers’ [...] Read more.
Background: Refractory epilepsy refers to a type of epilepsy in which anti-epileptic medications do not yield results, necessitating alternative medical interventions. The ketogenic diet (KD) is utilized as a non-pharmacologic treatment for refractory epilepsy. This study aims to assess details regarding caregivers’ awareness and practices, challenges faced, and other details regarding the KD as a treatment option for children with refractory epilepsy. Methods: A cross-sectional study included 15 caregivers of children with refractory epilepsy who adhere to the KD. Data were collected using an online, self-administered questionnaire including socio-demographic characteristics and descriptive aspects of KD on 15 caregivers. Results: Caregivers’ awareness scores varied, over half of the caregivers (53.3%) demonstrated low awareness levels, scoring below the midpoint on the awareness scale, while both caregivers’ adherence (t value = 31.5; p < 0.001) and patients’ adherence levels (t value = 26.1; p < 0.001) significantly exceeded the minimum expected thresholds, indicating effective implementation of the diet protocols. Challenges faced by caregivers were categorized as follow: logistical challenges (e.g., issues related to KD availability, cost, and weighing (15.6%)), behavioral challenges (e.g., avoiding prohibited foods (18.8%), feelings of hunger, the social environment, and never eating without caregivers), and medical challenges (e.g., frequent blood glucose monitoring (25%)). The most common side effects of the KD were gastrointestinal symptoms, including constipation (33.3%) and gastroesophageal reflux disease (GERD). Physical symptoms such as dyslipidemia were also reported by 13.3% of participants. In terms of neurological and behavioral improvements, the three most reduced symptoms following KD adoption were hyperactive attention deficit (25%), tremors (20%), and insomnia (20%). Conclusions: This study reveals a significant gap between high adherence and low awareness of the KD among caregivers of children with refractory epilepsy. While adherence is crucial for the success of KD, this discrepancy highlights the need for comprehensive caregiver education that not only focuses on practical implementation but also on the underlying rationale of the diet. This study underscores the importance of multidisciplinary support, by including dietitians, to bridge the knowledge gap. These findings suggest that dietary education programs should aim to improve caregivers’ understanding, ultimately enhancing adherence and long-term outcomes. Future research should explore the psychosocial factors influencing adherence and the role of trust in healthcare professionals in shaping caregiver behaviors. The findings also call for further exploration into the impact of caregiver education on child health outcomes in the long term. The varied knowledge among caregivers indicates a need for further educational interventions or increased visits from dietitians. Strategies need to be framed to overcome the challenges faced and improve adherence. Full article
(This article belongs to the Section Nutrition and Neuro Sciences)
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14 pages, 746 KB  
Article
Long-Term Outcomes of the Dietary Approaches to Stop Hypertension (DASH) Intervention in Nonobstructive Coronary Artery Disease: Follow-Up of the DISCO-CT Study
by Magdalena Makarewicz-Wujec, Jan Henzel, Cezary Kępka, Mariusz Kruk, Barbara Jakubczak, Aleksandra Wróbel, Rafał Dąbrowski, Zofia Dzielińska, Marcin Demkow, Edyta Czepielewska and Agnieszka Filipek
Nutrients 2025, 17(15), 2565; https://doi.org/10.3390/nu17152565 - 6 Aug 2025
Viewed by 725
Abstract
In the original randomised Dietary Intervention to Stop Coronary Atherosclerosis (DISCO-CT) trial, a 12-month Dietary Approaches to Stop Hypertension (DASH) project led by dietitians improved cardiovascular and metabolic risk factors and reduced platelet chemokine levels in patients with coronary artery disease (CAD). It [...] Read more.
In the original randomised Dietary Intervention to Stop Coronary Atherosclerosis (DISCO-CT) trial, a 12-month Dietary Approaches to Stop Hypertension (DASH) project led by dietitians improved cardiovascular and metabolic risk factors and reduced platelet chemokine levels in patients with coronary artery disease (CAD). It is unclear whether these benefits are sustained. Objective: To determine whether the metabolic, inflammatory, and clinical benefits achieved during the DISCO-CT trial are sustained six years after the structured intervention ended. Methods: Ninety-seven adults with non-obstructive CAD confirmed in coronary computed tomography angiography were randomly assigned to receive optimal medical therapy (control group, n = 41) or the same therapy combined with intensive DASH counselling (DASH group, n = 43). After 301 ± 22 weeks, 84 individuals (87%) who had given consent underwent reassessment of body composition, meal frequency assessment, and biochemical testing (lipids, hs-CRP, CXCL4, RANTES and homocysteine). Major adverse cardiovascular events (MACE) were assessed. Results: During the intervention, the DASH group lost an average of 3.6 ± 4.2 kg and reduced their total body fat by an average of 4.2 ± 4.8 kg, compared to an average loss of 1.1 ± 2.9 kg and a reduction in total body fat of 0.3 ± 4.1 kg in the control group (both p < 0.01). Six years later, most of the lost body weight and fat tissue had been regained, and there was a sharp increase in visceral fat area in both groups (p < 0.0001). CXCL4 decreased by 4.3 ± 3.0 ng/mL during the intervention and remained lower than baseline values; in contrast, in the control group, it initially increased and then decreased (p < 0.001 between groups). LDL cholesterol and hs-CRP levels returned to baseline in both groups but remained below baseline in the DASH group. There was one case of MACE in the DASH group, compared with four cases (including one fatal myocardial infarction) in the control group (p = 0.575). Overall adherence to the DASH project increased by 26 points during counselling and then decreased by only four points, remaining higher than in the control group. Conclusions: A one-year DASH project supported by a physician and dietitian resulted in long-term suppression of the proatherogenic chemokine CXCL4 and fewer MACE over six years, despite a decline in adherence and loss of most anthropometric and lipid benefits. It appears that sustained systemic reinforcement of behaviours is necessary to maintain the benefits of lifestyle intervention in CAD. Full article
(This article belongs to the Special Issue Nutrients: 15th Anniversary)
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19 pages, 618 KB  
Article
Effect of a Nutritional Education Intervention on Sports Nutrition Knowledge, Dietary Intake, and Body Composition in Female Athletes: A Pilot Study
by Macarena Veloso-Pulgar and Andreu Farran-Codina
Nutrients 2025, 17(15), 2560; https://doi.org/10.3390/nu17152560 - 5 Aug 2025
Viewed by 1040
Abstract
Background/Objectives: Studies have reported that female athletes often exhibit low levels of nutritional knowledge and inadequate dietary intake to meet their nutritional needs. The aim of this study was to evaluate the effect of a nutritional education intervention on nutrition knowledge, dietary intake, [...] Read more.
Background/Objectives: Studies have reported that female athletes often exhibit low levels of nutritional knowledge and inadequate dietary intake to meet their nutritional needs. The aim of this study was to evaluate the effect of a nutritional education intervention on nutrition knowledge, dietary intake, and body composition in female handball players (n = 45; age, 17.6 ± 2.1 years). Methods: A quasi-experimental intervention design was implemented, consisting of a 3-week educational program delivered through six in-person sessions led by a registered dietitian. Nutrition knowledge, dietary intake, adherence to the Mediterranean diet, and anthropometric and body composition measurements were assessed. Results: Nutrition knowledge levels were significantly higher both immediately post-intervention and three months later compared to baseline (p < 0.05, ES > 0.8). A total of 36 participants completed a 3-day dietary record at baseline and at follow-up. Initial assessments revealed insufficient energy (31 kcal/kg/day) and carbohydrate intake (3.0 g/kg/day) and a high intake of total fats (1.4 g/kg/day). During follow-up, a significant decrease in the consumption of foods rich in sugar was observed (p = 0.0272). A total of 82.2% of the players needed to improve their adherence to the Mediterranean diet. No significant changes were found in Mediterranean diet adherence or body composition following the intervention. Conclusions: The nutritional education intervention significantly improved athletes’ nutritional knowledge and significantly decreased their consumption of sugary foods; however, further studies are needed to evaluate its impact on dietary intake and body composition, considering the study’s limitations. Full article
(This article belongs to the Special Issue Food Habits, Nutritional Knowledge, and Nutrition Education)
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19 pages, 656 KB  
Article
The Effect of Nutritional Education on Nutritional Status and Quality of Life in Patients with Liver Cirrhosis
by Seymanur Tinkilic, Perim Fatma Turker, Can Selim Yilmaz, Meral Akdogan Kayhan, Derya Ari and Dilara Turan Gökce
Healthcare 2025, 13(15), 1905; https://doi.org/10.3390/healthcare13151905 - 5 Aug 2025
Viewed by 418
Abstract
Objectives: This study aimed to evaluate the effect of nutritional education on nutritional knowledge, nutritional status, and quality of life in patients with liver cirrhosis. Methods: Thirty patients participated. At baseline, assessments were conducted to collect data on demographics, physical activity, anthropometric and [...] Read more.
Objectives: This study aimed to evaluate the effect of nutritional education on nutritional knowledge, nutritional status, and quality of life in patients with liver cirrhosis. Methods: Thirty patients participated. At baseline, assessments were conducted to collect data on demographics, physical activity, anthropometric and biochemical measures, dietary habits, 24 h food intake, nutritional status, quality of life, and nutritional knowledge. Participants received a 30 min face-to-face nutritional education session by a registered dietitian, repeated after one month. A follow-up phone call was conducted one month later to reinforce the education. Final evaluations were completed one month after the call. Results: A significant upward trend was detected in nutritional knowledge scores after the intervention period (from 7.4 ± 2.76 to 9.2 ± 3.45). The physical component of quality of life improved, while the mental component showed a slight decline. Dietary changes included reduced energy and protein intake among females and increased protein intake in males. In both genders, fat intake increased and carbohydrate intake decreased. Biochemical improvements were observed, including significant reductions in gamma-glutamyl transferase, aspartate aminotransferase, alanine aminotransferase, and triglycerides in females and alanine aminotransferase and gamma-glutamyl transferase in males. Conclusions: Structured nutritional education may improve nutritional knowledge, dietary behavior, and biochemical markers in cirrhosis patients. Longer follow-up durations may further enhance these improvements. Full article
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15 pages, 408 KB  
Article
A Cross-Sectional Study: Association Between Nutritional Quality and Cancer Cachexia, Anthropometric Measurements, and Psychological Symptoms
by Cahit Erkul, Taygun Dayi, Melin Aydan Ahmed, Pinar Saip and Adile Oniz
Nutrients 2025, 17(15), 2551; https://doi.org/10.3390/nu17152551 - 4 Aug 2025
Viewed by 428
Abstract
Background/Objectives: Cancer is a complex disease that affects patients’ nutritional and psychological status. This study aimed to assess the nutritional status of patients diagnosed with lung and gastrointestinal system cancers and evaluate its association with anthropometric measurements, nutrient intake, and psychological symptoms. [...] Read more.
Background/Objectives: Cancer is a complex disease that affects patients’ nutritional and psychological status. This study aimed to assess the nutritional status of patients diagnosed with lung and gastrointestinal system cancers and evaluate its association with anthropometric measurements, nutrient intake, and psychological symptoms. Methods: This cross-sectional study was conducted with 180 patients with lung and gastrointestinal system cancers. Data were collected face-to-face by a questionnaire that included the Subjective Global Assessment-(SGA), Cachexia Assessment Criteria, 24 h Food Consumption Record, and Symptom Checklist-90-Revised-(SCL-90-R). Some anthropometric measurements were collected. Results: Body Mass Index (BMI) was found to be significantly lower (p < 0.001) in SGA-B (moderately malnourished) and SGA-C (severely malnourished) compared to those in SGA-A (well-nourished). The calf circumference was significantly lower (p = 0.002) in SGA-C compared to those in SGA-A and SGA-B. The mean SGA scores were found to be higher in cachexia-diagnosed participants (p < 0.001). The energy intake of SGA-C was significantly lower than SGA-A and SGA-B (p < 0.001). In addition, the energy intake of SGA-B was lower than SGA-A (p < 0.001). The protein intake of SGA-C was lower than SGA-A and SGA-B (p < 0.001). The protein intake of SGA-B was lower than SGA-A (p < 0.001). Regarding the intake of vitamins A, C, E, B1, and B6 and carotene, folate, potassium, magnesium, phosphorus, iron, and zinc, SGA-B and SGA-C were significantly lower than SGA-A (p < 0.001). Additionally, only phobic anxiety was found to be significantly higher in SGA-B than in SGA-A (p: 0.024). Conclusions: As the level of malnutrition increased, a reduction in some nutrient intake and anthropometric measurements was observed. No significant difference was found in any psychological symptoms except phobic anxiety. With this in mind, it is important that every cancer patient, regardless of the stage of the disease, is referred to a dietitian from the time of diagnosis. Full article
(This article belongs to the Section Nutrition and Public Health)
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11 pages, 547 KB  
Article
Gluten-Free Diet, Symptom Burden, and Autoimmune Comorbidities: Insights from the Hellenic Celiac Disease Population
by Emmanuel Psylinakis, Nikolaos Thalassinos, Alexios Manidis, Maria Togia, Vasileia Kounelaki, Anastasia G. Markaki and Aspasia Spyridaki
Dietetics 2025, 4(3), 31; https://doi.org/10.3390/dietetics4030031 - 1 Aug 2025
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Abstract
Introduction: Living with coeliac disease (CD) requires lifelong adherence to a strict gluten-free diet (GFD). This study assessed GFD adherence, symptom burden, autoimmune comorbidities, and dietetic support among Hellenic CD patients. Methods: A cross-sectional survey was completed by 272 adults with CD. Adherence [...] Read more.
Introduction: Living with coeliac disease (CD) requires lifelong adherence to a strict gluten-free diet (GFD). This study assessed GFD adherence, symptom burden, autoimmune comorbidities, and dietetic support among Hellenic CD patients. Methods: A cross-sectional survey was completed by 272 adults with CD. Adherence was measured using the Hellenic version of the Celiac Dietary Adherence Test (H-CDAT). Results: The mean H-CDAT score was 13.5 ± 3.5. Good adherence was observed in 44.9% of participants, while 14.3% showed poor adherence. Symptom burden was high: 39.3% reported partial symptom resolution and 3.7% had ongoing symptoms. Among patients, 25.0% had multiple autoimmune conditions, ranging from two to four. Dietetic support was limited: 61.5% were not referred to a dietitian at diagnosis, and 75.4% had no regular follow-up. Higher H-CDAT scores, indicating poorer adherence, were significantly associated with younger age (p = 0.014), earlier diagnosis (p = 0.01), and ongoing symptoms (p < 0.01). Age at diagnosis was also positively associated with autoimmune comorbidity count. Conclusions: These findings highlight the need for earlier diagnosis, improved access to structured dietetic support, and individualized care to optimize GFD adherence and improve outcomes in patients with CD. Full article
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20 pages, 545 KB  
Study Protocol
Can Dietary Supplements Be Linked to a Vegan Diet and Health Risk Modulation During Vegan Pregnancy, Infancy, and Early Childhood? The VedieS Study Protocol for an Explorative, Quantitative, Cross-Sectional Study
by Wolfgang Huber-Schneider, Karl-Heinz Wagner and Ingrid Kiefer
Int. J. Environ. Res. Public Health 2025, 22(8), 1210; https://doi.org/10.3390/ijerph22081210 - 31 Jul 2025
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Abstract
As veganism becomes more popular, the number of vegan pregnant women and children is steadily increasing. During vegan pregnancy and early childhood, there is a high risk for nutrient deficiencies that may impair child development. External factors, such as healthcare advice, social networks, [...] Read more.
As veganism becomes more popular, the number of vegan pregnant women and children is steadily increasing. During vegan pregnancy and early childhood, there is a high risk for nutrient deficiencies that may impair child development. External factors, such as healthcare advice, social networks, and social environments, that affect the diet of vegan pregnant women, parents, and their children, as well as their approach towards dietary supplementation, have not yet been investigated. Various sources of information, combined with a lack of expertise, sparse food and nutritional health literacy, and qualitatively heterogeneous information provision by medical experts, unsettle vegan pregnant women and parents and affect their dietary choices and potentially the health of their children. The VedieS study aims to investigate potential connections between external influences and associated impacts on a vegan diet and the intake of dietary supplements (DS) of pregnant women and children. Two surveys are being conducted within the study: one targeting 1000 vegan pregnant women and parents, and another targeting 60 experts in each of five healthcare groups: gynecologists, pediatricians, general practitioners, pharmacists, and dietitians. This study is the first to examine how socio-economic, social, and further informational factors influence dietary practices during vegan pregnancy and childhood. It highlights the need for reliable, expert-led guidance, as current information sources are often inconsistent and may put these vulnerable groups at risk. Full article
(This article belongs to the Special Issue Holistic Approach to Pregnancy, Childbirth and Postpartum Period)
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