Search Results (2,582)

Background: Male college students are at risk for weight gain due to unhealthy dietary habits. This study assessed the dietary habits of undergraduate college males. Methods: Online cross-sectional survey (n = 235) of randomly sampled male undergraduate college students. Results: The mean age was 21.15 ± 3.21. Most were enrolled full-time (91.5%), lived off-campus (77.4%), upper class (59.6%), had a campus meal plan (52.8%), and white (51.9%). Mean body mass index (BMI) was 25.02 ± 4.86. Males gained an average of 10.81 ± 13.01 lbs while in college. Most ate one to two servings of fruits (67.1%) and vegetables (65.1%). Significant differences in weight gained during college and fruit consumed was significant [p = 0.02 *]. Male students reported on 20 different foods and drinks they consumed at least “a few times per week.” Most ate fresh fruits (76.1%), prepared a hot meal at home (72.7%), ate fresh vegetables (68.1%). Males also ate at fast-food restaurants (47.7%) and drank coffee (44.4%). Males that reported they drank alcohol (p = 0.03*), diet soda (p = 0.03 *), coffee (p = 0.01 *), and ate at fast-food restaurants (p = 0.02 *) “a few times per week” were found to have significantly gained more weight. Conclusions: Increased intake and consumption of alcohol, diet soda, and fast-food was associated with increased weight gain among college males. Full article

Background. Cardiometabolic diseases (CMDs) have become a major health concern among adults living with HIV (ALWH) as antiretroviral therapy (ART) extends life expectancy. Metabolic syndrome (MetS)—a cluster of abdominal obesity, hypertension, hyperglycemia, hypertriglyceridemia, and hypoalphalipoproteinemia—is a key predictor of CMD risk. Despite high HIV prevalence in Panama, data on MetS among ALWH are scarce. Thus, the Colón C3 Study aimed to estimate the prevalence of MetS and its criteria in a large cohort of ALWH in Colón, Panama. Methods. Between April–December 2024, 659 ALWH aged ≥18 years were enrolled at the province’s sole ART Clinic (78.1% of active patients). Participants completed a computer-assisted survey on demographics and social determinants of health (SDoH), underwent anthropometry and body composition assessment, and provided ≥8 h fasting blood samples for glucose, lipid profiles, HbA1c, and high-sensitivity C-reactive protein (hsCRP). MetS was defined using NCEP-R ATP-III criteria, and analyses were stratified by sex. Results. Mean age was 43.9 (range 18–79) years; 55% were female, and 51% identified as Black/Afro-Caribbean. The overall prevalence of MetS was 38.6% (binomial 95% CI 34.5%, 42.9%), exceeding pooled estimates for ALWH in the Americas (30.4%). Among individual criteria, hypoalphalipoproteinemia (59.6%) and hypertension (52.6%) were most prevalent, followed by abdominal obesity (45.2%), hyperglycemia (33.5%), and hypertriglyceridemia (22.5%). Women exhibited significantly higher body fat mass and BMI than men. Mean hsCRP was 7.2 mg/L, indicating persistent inflammation despite virologic suppression. Socioeconomic vulnerabilities, food insecurity (30%), and housing instability (>40%) were common. Conclusions. Findings reveal a substantial cardiometabolic burden among ALWH in Colón and underscore the need for integrated HIV–CMD care models, earlier screening, and natal sex–responsive interventions. The results provide foundational evidence for improving long-term, equitable cardiometabolic outcomes in HIV care across Panama and the broader Latin American region. Full article

Despite Morocco’s emergence as the world’s fourth-largest berry exporter, no comprehensive review has evaluated the polyphenol composition, antioxidant properties, and health benefits of raspberries (Rubus idaeus), blackberries (Rubus fruticosus), and blueberries (Vaccinium corymbosum) specifically within the Moroccan cultivation context. This narrative review synthesized evidence from phytochemical analyses, in vitro and in vivo studies, randomized controlled trials (RCTs), meta-analyses, and epidemiological data sourced from PubMed, Scopus, and Web of Science. Blackberries exhibited the highest total polyphenol content (149 μmol GAE/L) and antioxidant capacity, driven primarily by anthocyanin concentration and diversity. Antioxidant mechanisms included free radical scavenging, transition metal chelation, and upregulation of endogenous antioxidant enzymes. Pooled RCT data demonstrated that regular consumption (150–300 g/day) significantly reduced systolic blood pressure (−2.72 mmHg), LDL cholesterol (−0.21 mmol/L), and fasting glucose (−2.70 mg/dL). Additional benefits included neuroprotection via blood-brain barrier crossing and brain-derived neurotrophic factor (BDNF) elevation, prebiotic modulation of Bifidobacterium, Lactobacillus, and Akkermansia populations, and anti-cancer activity via nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) inhibition. Processing significantly affected bioactive retention: freezing preserved phenolic compounds effectively, while conventional drying reduced anthocyanin content by up to 49%. These findings support the integration of Moroccan-cultivated berries—particularly from the Gharb, Loukkos, and Souss-Massa regions—into evidence-based dietary and functional food strategies. Priority research gaps include bioavailability assessment, dose-response characterization, and cultivar-specific phytochemical profiling under Moroccan agro-climatic conditions. Full article

Background/Objectives: Poor diet quality is common among young Saudi adults, characterised by high fast-food intake and low fruit and vegetable consumption. This study investigated the association between diet quality and lifestyle factors using a validated short Healthy Eating Index (sHEI). Methods: This study adopted a cross-sectional design, gathering responses through a self-completed online questionnaire. Demographic data were collected. Diet quality was assessed using the Arabic version of the sHEI, physical activity was evaluated with the Arabic short form of the International Physical Activity Questionnaire (IPAQ), and sleep quality was measured using the Athens Insomnia Scale (AIS). Saudi residents aged 18–25 years were eligible; pregnant or lactating individuals and those with chronic conditions affecting dietary intake were excluded. Results: Among 478 participants (mean age 21.1 ± 1.9 years), 88.1% were female, 24.7% were overweight or obese, and half reported poor diet quality. Moderation scores were slightly higher (54.2% high), whereas adequacy scores were nearly equal (49.8% high and 50.2% low). Most participants reported low physical-activity levels (78.5%) and poor sleep quality (55.2%). Sleep quality was significantly associated with all diet quality measures, increasing the odds of good total sHEI (OR = 1.74, p = 0.003), adequacy (OR = 1.49, p = 0.034), and moderation (OR = 1.54, p = 0.021). Conclusions: Sleep quality is significantly associated with diet quality among young Saudi adults. While body mass index and physical activity showed no significant associations, improving sleep quality may promote healthier dietary behaviours. Future studies should explore pathways linking sleep and diet. Full article

Nutrient-sensing nuclear receptors (NSNRs), including PPARs, FXR, LXRs, RAR/RXR, VDR, and related orphan receptors, integrate a molecular interface that allows diet to communicate directly with the genome. By binding fatty acids, bile acids, sterols, vitamins, polyphenols, and other food-derived metabolites, NSNRs translate qualitative and quantitative features of the diet into coordinated transcriptional programmes across metabolically active organs. This ligand-dependent signalling network integrates dietary information to orchestrate inter-organ lipid and glucose metabolism, mitochondrial function, thermogenesis, and immune response, thereby enabling the organism to adapt dynamically to fasting–feeding cycles. In this review, we synthesise current evidence on the integrated roles of major NSNRs in the liver, skeletal muscle, white and brown adipose tissue, and kidney, emphasising how receptor networks within and between metabolic organs collectively govern energy expenditure, substrate partitioning, and systemic metabolic flexibility. We propose a conceptual framework in which diet functions as an “external endocrine organ”, acting as the primary source of chemically diverse NSNR ligands, while metabolic tissues serve as secondary signal amplifiers and integrators. Through circulating lipid species, bile acids, oxysterols, and other metabolites, these organs engage in continuous bidirectional communication that reprograms NSNR activity across tissues. We then examine how the global shift from minimally processed, nutrient-rich foods to nutrient-poor, energy-dense ultra-processed diets leads to a reduction in NSNR ligand diversity, promoting hepatic steatosis, muscle metabolic inflexibility, adipose tissue dysfunction, renal lipotoxicity, and chronic low-grade inflammation, ultimately causing obesity, type 2 diabetes, and cardiometabolic disease. Finally, we explore strategies to restore NSNR function, including Mediterranean and plant-based dietary patterns, as well as diets enriched with ω-3 polyunsaturated fatty acids, monounsaturated fats, and polyphenols. By integrating molecular, physiological, and clinical evidence, this review aims to clarify how NSNR networks translate dietary cues into coordinated inter-organ metabolism and how nutrient-poor diets lead to metabolic diseases trough a loss of metabolic information, rather than merely by energy excess. This framework supports a paradigm shift from calorie-centred nutrition to diet quality as the main therapeutic target for preventing metabolic diseases and promoting health. Full article

Purpose: The aims of this study were to evaluate the feasibility of time-restricted eating (TRE) in patients with Cushing’s disease (CD) and assess its effects on body weight and metabolic parameters. Methods: Twelve CD patients in remission with obesity were enrolled in a TRE program restricting food intake to 10:00–18:00. Anthropometric data, glycemic and lipid profiles, and circadian cortisol secretion were assessed at baseline and post-intervention. Serum cortisol levels were measured at multiple time points to evaluate diurnal patterns. Results: Nine patients completed the study. Over the 12-week period, participants showed a significant reduction in body weight, with median values decreasing from 93.8 kg [83.1–106.5] to 82.6 kg [76.9–100.3] (p = 0.011). Body mass index (BMI) also declined from 37.6 kg/m² [34.2–39.7] to 34.4 kg/m² [32.6–38.3] (p = 0.012). No statistically significant changes were observed in fasting glucose, HbA1c, or lipid parameters. Notably, 24 h urinary free cortisol levels significantly decreased (p = 0.01), and serum cortisol showed a downward trend at all measured time points, with the most pronounced reductions during mid-day and evening hours. No clinical or biochemical evidence of CD relapse was observed during the 12-month follow-up. Conclusions: Time-restricted eating is a feasible and well-tolerated dietary approach for patients with CD in remission, promoting weight loss and modest improvements in metabolic markers and cortisol rhythmicity. Full article

Leptin receptor-deficient WBN/Kob-Lepr fa/fa (WKF) rats spontaneously developed chronic pancreatitis and severe diabetes with obesity. Here, we evaluated the protective effects of diet restriction and chronic exercise against fatty and inflammation-induced disorders in the vulnerable pancreas of WKF rats. Six-week-old male WKF rats were divided into obese control (Obese), diet restriction (DR), and diet restriction + exercise (DR + Ex) groups. WBN/Kob (WK) rats were used as lean control (Lean). Lean and Obese rats had free access to food, whereas food intake for DR and DR + Ex rats was restricted to 69% and 70% of the Obese level, respectively. The DR + Ex rats exercised voluntarily on a wheel ergometer daily. After six weeks, the rats were euthanized with isoflurane after overnight fasting. Obese rats exhibited diabetes, early stages of pancreatitis, diffuse pancreatic islets, and ultrastructural deteriorations in the pancreatic acinar cells, such as lipid droplet accumulation and swollen mitochondria with destroyed cristae, whereas Lean rats did not. DR rats exhibited improved glucose metabolism and serum triglyceride levels, effectively preventing inflammatory processes in the pancreas. However, DR rats exhibited no amelioration in the serum free fatty acids (FFAs) level, and limited improvements in ultrastructural deterioration in pancreatic cells. Chronic exercise combined with diet restriction (DR + Ex) improved serum FFA levels, the boundary of pancreatic islets, and the ultrastructure of subcellular organelles. These results demonstrate that diet restriction suppresses pancreatic inflammation, and further additional exercise effectively improves fatty pancreas-related deterioration by skeletal muscle activity linked through the circulatory network in WKF rats. Full article

Background/Objectives: At the international level, harmonized networks of dementia clinical studies are available, but Italian participation remains limited. This systematic review aims to define harmonization rules to facilitate the inclusion of Italian clinical studies in existing networks and to propose standardized data collection methods to enable comparison of the study results. Methods: A systematic review was conducted (January 2019–December 2024) to identify Italian clinical studies evaluating Alzheimer’s disease and other dementias as outcomes. Eight modifiable risk factors were extracted: BMI, arterial hypertension, diabetes, dietary patterns, alcohol consumption, smoking habits, depressive symptomatology, and physical activity. WHO definitions and internationally accepted criteria were used as reference standards. Variable harmonization potential was assessed using the DataSHaPER methodology and classified as complete, partial, or impossible, considering information loss across studies. Results: Of 365 records identified, 18 studies met the inclusion criteria. Obesity assessed via BMI showed the highest harmonization potential (44% complete, 33% partial), along with dietary habits measured by food frequency questionnaires (44% complete). Diabetes and physical inactivity followed (33% complete), assessed through fasting glucose or pharmacological treatment and the IPAQ, respectively. Smoking habits classified as current, former, or never smokers were reported in 28% of studies. Depression (assessed by GDS or CES-D) and hypertension (blood pressure measurement or antihypertensive treatment) showed complete harmonization in only 22% of studies. Conclusions: Italian studies show substantial limitations in the harmonization of modifiable risk factor data for Alzheimer’s disease, mainly due to heterogeneous and non-standardized data collection methods, highlighting the need for uniform research protocols. Full article

Insulin acts in the brain to promote satiety. Aging individuals may have brain insulin resistance and altered appetite perceptions. However, it is unclear if exercise impacts cerebral reward centers and appetite perception in middle-aged to older individuals. Purpose: To assess whether a single exercise bout alters cerebral blood flow (CBF) in reward centers in relation to appetite perceptions. Methods: Fifteen sedentary adults (12F; ~56 ± 2y; ~31 ± 1 kg/m²) completed a control and acute exercise condition (70% maximal oxygen consumption) in a randomized, counterbalanced order in the evening. Following an overnight fast, CBF in the accumbens, thalamus, and amygdala (pCASL MRI) was evaluated before and after intranasal insulin spray (INI, 40 IU) administration. Plasma glucose and insulin as well as an appetite visual analog scale (VAS) were assessed at fasting, 30, and 90 min post-INI, as well as at 30 min intervals of a 120 min 75 g oral glucose tolerance test (OGTT). Total area under the curve (tAUC) was calculated. Results: Exercise tended to lower blood glucose (p = 0.072) and plasma insulin (p = 0.007) tAUC, compared with rest. Exercise also raised right thalamus (p = 0.029) and left amygdala CBF (p = 0.023). The rise in fasting CBF in these regions, and the accumbens, correlated with reduced insulin tAUC (r = −0.55 to −0.73, p < 0.050). Although there was no difference in hunger, satisfaction, fullness, or prospective food consumption after exercise, changes in INI-stimulated thalamus CBF related to fullness tAUC after exercise (r = −0.57, p = 0.044). Conclusions: A single exercise bout might increase fasting CBF in some brain regions associated with appetite perception through a potential insulin-related mechanism. Full article

Background/Objectives: The mediating role of the diverse range of screen-based sedentary behaviors (SBs) remains understudied, particularly at younger ages. The present study examined the direct and indirect effects of parental BMI and education on ultra-processed food (UPF) consumption among preschoolers, testing the potential mediating role of screen time. Methods: The cross-sectional study sample comprised 919 kindergarten children (484 boys, 52.7%), with ages ranging from 2.2 to 6.8 years (mean: 4.7 ± 1.0 years). Screen-based sedentary behaviors (television viewing, smartphone use, tablet use, computer use, and playing electronic games) were measured by proxy-report fulfilled by parents, separately for weekdays and weekends. UPF consumption (drinks/yogurts, packaged/fast foods, and sweet/salty snacks) was assessed via 24 h recall scales. Path analysis mediation models tested direct effects of maternal/paternal BMI and education on UPF intake, and indirect effects through screen time, controlling for child age and sex. Results: Lower parental education and higher parental BMI were associated with increased mobile device use and UPF consumption (r = 0.10–0.28). Screen-based sedentary behaviors mediated the association between maternal BMI and UPF pathways (15–90% of total effects), particularly for sweet and salty snacks (50–90%). Parental education effects were also mediated by screen time (9–23% indirect effects), with paternal education showing stronger protection against packaged/fast foods. Conclusions: Mobile devices and watching television partially mediate intergenerational transmission of obesogenic dietary patterns from parental BMI/education to preschoolers’ UPF consumption. Findings of the current study support family-centered interventions targeting screen-time limits and UPF exposure, mainly at the weekends, to prevent early obesity trajectories. Full article

Background: Adolescence is a critical developmental period during which dietary habits are formed and may influence long-term health outcomes. Monitoring changes in adolescents’ eating behaviors and nutrition-related knowledge over time is important for developing effective health promotion strategies. The aim of this study was to compare adolescents’ (Lower Silesia, Poland) dietary habits and nutritional knowledge between two study periods (2011 and 2023) using comparable survey methods. Methods: A repeated cross-sectional comparison of two independent cohorts was conducted using an identical questionnaire in both study periods. The 2023 cohort included 14-year-old primary school students (n = 100; 48 girls and 52 boys), while the comparison group consisted of adolescents aged 13–15 years assessed in 2011 (n = 377; 202 girls and 175 boys). Anthropometric measurements and self-reported data on dietary habits and nutritional knowledge were analyzed using descriptive statistics and group comparison tests. Results: The findings indicate changes in selected dietary behaviors and levels of nutritional knowledge among adolescents over the studied period. A higher percentage of students in 2023 reported eating four meals per day and obtaining information about healthy eating from the Internet rather than from television. Students in 2023 were also more likely to recognize the relationship between diet and attention, identify the harmful effects of energy drinks and excessive fast-food consumption, and provide correct answers regarding proper nutrition. Nutritional knowledge improved over time, with a mean percentage of correct responses of 71.9% in 2023 compared with 63.7% in 2011. Although nutritional awareness improved in several areas, certain unhealthy eating habits remained prevalent, including irregular breakfast consumption and frequent intake of sweets. Changes in the distribution of body weight categories were also observed, with gender-specific differences between cohorts. Conclusions: The results suggest that improvements in nutritional knowledge alone may not be sufficient to ensure positive changes in dietary behavior among adolescents. Continued monitoring of adolescent nutrition and the development of comprehensive health promotion strategies addressing both knowledge and environmental influences remain necessary. Full article

Background/Objectives: Schools, as structured social environments, are important settings for shaping lifelong eating habits, and teachers play a mediating role in nutrition education. This study aimed to assess nutrition knowledge among public school teachers, examine their perceptions of the school food environment, and identify factors associated with knowledge scores. Methods: A stratified cross-sectional survey was conducted among 736 teachers from 12 public schools during the fall of 2025. A structured questionnaire based on the Knowledge–Attitudes–Practice model was used to evaluate nutrition knowledge, teaching practices, perceived school food environment, and teachers’ observations of student food-related behaviors. Group differences were examined using t-tests and ANOVA, and multivariable logistic regression was applied to identify factors associated with low nutrition knowledge. Results: The mean knowledge score was 6.26 ± 2.64 out of 12, with 23.6% of teachers classified as having low knowledge, 59.9% satisfactory, and 16.4% good. Primary school teachers scored significantly higher than subject teachers (7.27 vs. 5.64; p < 0.001). Regular conduct of nutrition classes was associated with lower odds of low knowledge (adjusted OR 0.10, 95% CI 0.05–0.23, p < 0.001). A sensitivity analysis using continuous knowledge scores confirmed this pattern, with the absence of nutrition teaching predicting a 1.40-point reduction in scores (95% CI −1.86 to −0.94, p < 0.001). Teachers rated school meal quality moderately high, and frequently observed student refusal of canteen food and purchase of sweets or fast food outside school. Conclusions: This study found that public school teachers in Karaganda, Kazakhstan showed satisfactory overall nutrition knowledge, with gaps in applied understanding and common dietary myths. Primary teachers and those actively teaching nutrition had higher knowledge scores, indicating an association between pedagogical engagement and content knowledge. To help optimize the school food environment, educational policies would benefit from the development of cross-curricular instructional materials fitted specifically for secondary school subject teachers. Full article

The threat of plant diseases in economically significant crops of the Solanaceae family, especially tomatoes and potatoes, is a significant challenge to global food security, highlighting the necessity of fast and convenient diagnostic methods. This paper introduces an enhanced MobileNetV2 model to perform automated disease classification through the use of a domain-specific self-supervised learning (SSL) pretraining approach. The model was first trained on 54,303 unlabeled plant images to learn basic botanical representations, followed by fine-tuning under six experimental conditions to optimize disease classification performance. Findings show that SSL pretrained weights consistently outperform traditional ImageNet-based transfer learning, achieving 0.9158 overall accuracy and a weighted F1-score of 0.9143 in joint tomato and potato classification. The model demonstrates strong cross-crop generalization, correctly identifying Early Blight and Late Blight with accuracies of 0.9600 and 0.9359, respectively, and effectively separating disease-specific visual symptoms from host morphology. Confusion matrix analysis further indicates a reduction in misclassification of visually similar necrotic lesions, a common challenge in supervised models. Overall, the proposed SSL architecture enhances the performance of lightweight convolutional neural networks (CNNs) to a large extent, providing a strong, computationally efficient solution for field-deployable diagnostics in precision agriculture, particularly for tomato and potato crops. Full article

Background/Objectives: Biorelevant in vitro dissolution testing is used increasingly to predict complex mechanisms in the gastrointestinal (GI) tract that determine oral bioavailability. However, the limited use of non-compendial systems is driven by the lack of widely accepted, standardized validation frameworks. This ongoing gap continues to restrict their adoption relative to United States Pharmacopeia (USP) apparatus. While the physiological relevance and biopredictive capabilities of the tiny-TIM and TIM-1 in vitro GI models have been demonstrated in previous studies, their inter-laboratory reproducibility has not been systematically established. Therefore, this international ring study evaluates the reproducibility of in vitro simulations of GI transit and absorption of paracetamol in fasted- and fed-state conditions in tiny-TIM and TIM-1. Methods: Three laboratories used TIM-1 and five used tiny-TIM to simulate oral administration of a 500 mg paracetamol solution to a healthy adult. Paracetamol solution was selected as a well-characterized and widely available BCS I compound to minimize formulation and solubility effects and focus on system performance, enabling the generation of a generic validation dataset for the reproducibility of TIM experiments. Results: Paracetamol bioaccessibility profiles were repeatable and reproducible (all pairwise f₂ > 50). Maximum differences in total bioaccessible paracetamol were 0.9% (TIM-1) and 2.8% (tiny-TIM) within laboratories and 3.4 and 5.9% between laboratories. Inter-lab variability at individual time points remained <4.0% (fasted) and 5.2% (fed). Both TIM models produced biopredictive metrics, correctly predicting no food effect on total paracetamol bioaccessibility and capturing delayed t_max. Gastric and intestinal environments showed repeatable pH, temperature, and GI transit characteristics, with fluctuations across transit stages that mirrored reported in vivo patterns. Conclusions: These results demonstrate that TIM systems can reproducibly simulate gastrointestinal conditions across laboratories and generate consistent measurements of drug product performance, despite the complexity of the dynamic processes involved. While this evaluation involving a single BCS I drug solution should not be directly extrapolated to experiments with poorly soluble compounds or different formulations, it supports the use of TIM systems as robust in vitro models in drug product development. This study provides a standardized, inter-laboratory, baseline performance dataset to support regulatory submissions incorporating TIM data and enable more confident interpretation of TIM experiments. Full article

Background: Parental knowledge and perceptions towards Functional Foods (FFs) play a critical role in shaping children’s dietary behaviors. This study aimed to investigate dietary habits, FFs knowledge and perceptions among Greek primary school children and their parents and to evaluate the feasibility of a one-month pilot asynchronous nutrition education program. Methods: A cross-sectional study included 374 children aged 9–11 years and 159 parents from urban (Thessaloniki) and rural (Lemnos) areas. Children completed questionnaires on dietary habits, FFs knowledge and Mediterranean Diet (MD) adherence (KIDMED score), while parents provided sociodemographic information, BMI, dietary habits, FFs knowledge and perceptions. A pilot asynchronous nutrition education intervention was delivered via pre-recorded videos on FFs, the MD, portion sizes and food label interpretation, with participation tracked and program evaluation conducted among parents. Data was analyzed using IBM SPSS Statistics (version 28). Descriptive statistics were calculated, group differences were assessed with t-tests and ANOVA and associations between variables were examined using chi-square tests and Pearson correlations (p < 0.06). Results: Children showed moderate MD adherence, frequent fast-food and soft drinks consumption and low FF knowledge, with a substantial gap between perceived and actual understanding. Parental FF knowledge was uneven, higher among normal-weight participants and largely limited to fortified products. Positive associations were found between children’s and parents’ diet quality and natural FF consumption, as well as between parental and child physical activity. The asynchronous intervention was positively rated; substantial attrition was observed across sessions and follow-up, which limited the ability to assess the intervention’s effects on behavioral change. Conclusions: This study highlights critical gaps in FFs knowledge among families and demonstrates that asynchronous, family-based nutrition education is feasible but challenged by engagement attrition. Targeted interventions are needed to clarify FF concepts and promote healthier family dietary behaviors. Full article