Search Results (82)

Multiple sclerosis (MS) is a chronic, immune-mediated neurological disorder with increasing global prevalence. Emerging evidence underscores the role of lifestyle interventions (particularly diet and physical activity) in modulating disease progression and improving quality of life. This narrative review synthesizes current scientific literature on the effects of dietary interventions, including the Mediterranean, ketogenic, Swank, Wahls, gluten-free, and fasting-based diets, alongside various physical activity regimens. The Mediterranean and ketogenic diets show promise in reducing inflammation, enhancing neuroprotection, and improving metabolic health. Similarly, structured physical activity (including aerobic, resistance, sensorimotor, and mind–body exercises) demonstrates benefits in mobility, fatigue, and mental well-being. The review highlights the need for personalized, sustainable approaches that integrate nutritional and exercise-based strategies for optimal MS management in the long term. Full article

Background/Objectives: Long-term obesity management consistently fails due to two major barriers: poor adherence, exacerbated by ultra-processed foods with addictive potential, and post-weight loss metabolic adaptation that reduces energy expenditure by approximately 500 kcal/day. Current paradigms—static diets and GLP-1 receptor agonists—address these barriers only partially. The objectives of this thesis-driven review are: (1) to conduct a focused evidence-mapping of Ketogenic–Mediterranean Diet (KMD) protocols; (2) to analyze why existing protocols have not explicitly countered metabolic adaptation; and (3) to present the Adaptive Ketogenic–Mediterranean Protocol (AKMP). Methods: Hybrid methodology—an argumentative narrative review anchored by a structured evidence-mapping search (PRISMA-style flow for transparency). Results: We identified 29 studies implementing KMD protocols with significant weight loss and superior adherence. However, none of the published protocols explicitly implement anti-adaptive strategies, despite an estimated ketogenic metabolic advantage (≈100–300 kcal/day), context-dependent and more consistently observed in longer trials and during weight-maintenance settings. Conclusions: Unlike GLP-1 receptor agonists—which primarily suppress appetite, require ongoing pharmacotherapy, and do not directly mitigate the decline in energy expenditure—the AKMP couples a Mediterranean foundation for adherence with a ketogenic metabolic advantage and a biomarker-guided adjustment system explicitly designed to counter metabolic adaptation, aiming to improve the durability of weight loss and patient self-management. As a theoretical construct, the AKMP requires confirmation in prospective, controlled studies; accordingly, we outline a pragmatic 24-week pilot design in “Pragmatic Pilot Trial to Validate the AKMP–Incretin Sequencing”. Full article

Psoriasis is a chronic inflammatory autoimmune disease that causes significant deterioration of the quality of life, and due to its multifactorial causes, it is often difficult to manage. Apart from genetic and environmental components, an important part of its pathophysiology comprises an oxidative stress induction that the standard antioxidative mechanisms of the human body cannot compensate for. Moreover, in many psoriatic patients, there is a documented imbalance between antioxidant and pro-oxidative factors. Usually, psoriasis is evaluated using the Psoriasis Area and Severity Index (PASI) score. It has been demonstrated that dietary choices can lead to significant modification of PASI scores. Hypocaloric diets that are rich in antioxidants are highly effective in this regard, especially when focusing on vegetables and restricting consumption of animal-derived protein. Specific dietary regimens, namely the Mediterranean diet and potentially the ketogenic diet, are very beneficial, in the former case owing in large part to the omega-three fatty acids it provides and its ability to alter gut microbiome, a factor which seems to play a notable role in the pathogenesis of the disease. Another option is the topical application of vitamin D and its analogues, combined with corticosteroids, which can ameliorate the manifestations of psoriasis at the level of the skin. Finally, oral vitamin D supplementation has a positive impact on psoriatic arthritis and can mitigate the risk of associated comorbidities. Full article

Background: Melanoma, one of the most aggressive forms of skin cancer, has seen significant therapeutic advances with immune checkpoint inhibitors (ICIs). However, many patients fail to respond or develop resistance, creating the need for adjunct strategies. Objective: The objective of this study is to critically evaluate how specific dietary patterns and nutrient-derived metabolites modulate melanoma metabolism and immunotherapy outcomes, emphasizing translational implications. Methods: We performed an integrative review of preclinical and clinical studies investigating dietary interventions in melanoma models and ICI-treated patients. Mechanistic insights were extracted from studies on nutrient transport, immunometabolism, and microbiome–immune interactions, including data from ongoing nutritional clinical trials. Results: Diets rich in fermentable fibers, plant polyphenols, and unsaturated lipids, such as Mediterranean and ketogenic diets, seem to contribute to the reprogramming of tumor metabolism and enhance CD8+ T-cell activity. Fasting-mimicking and methionine-restricted diets modulate T-cell fitness and tumor vulnerability via nutrient stress sensors (e.g., UPR, mTOR). High fiber intake correlates with favorable gut microbiota and improved ICI efficacy, while excess protein, methionine, or refined carbohydrates impair immune surveillance via lactate accumulation and immunosuppressive myeloid recruitment. Several dietary molecules act as network-level modulators of host and microbial proteins, with parallels to known drug scaffolds. Conclusions: Integrating dietary interventions into melanoma immunotherapy can significantly influence metabolic reprogramming by targeting metabolic vulnerabilities and reshaping the tumor–immune–microbiome axis. When combined with AI-driven nutrient–protein interaction mapping, this approach offers a precision nutrition paradigm that supports both physicians and patients, emerging as a novel layer to enhance and consolidate existing therapeutic strategies. Full article

Food systems interact through multiple dimensions including food security, nutrition, and planetary health. This study aims to associate different dietary patterns with sustainable lifestyles in Latin America and Spain. This was an observational, analytical, multicenter, cross-sectional survey study, with a total of 6412 participants. A self-administered questionnaire was developed in an online format in the Google Docs interface. The questionnaire was divided into sections: (1) sociodemographic background: country of residence, age, sex, educational level, socioeconomic aspects, and place of residence; (2) body mass index classification; (3) dietary patterns (Western, vegetarian, vegan, ketogenic, Mediterranean, prudent, or paleolithic diets); and (4) the Sustainable Lifestyles Survey. Multivariate models were applied to adjust for potential confounding factors. The mean age of the participants was 35.2 years (SD 12.7). The majority of participants identified their dietary pattern as omnivorous (41.5%), followed by the Western diet (21.7%) and the Mediterranean diet (12.7%). Plant-based, vegan (β: 14.90; 95% CI: 9.75–20.05), and lacto egg (β: 12.08; 95% CI: 8.57–15.58) diets are significantly associated with a higher sustainability score compared to an omnivorous diet. In contrast, a Western diet is inversely associated (β: −5.63; 95% CI: −7.20 to −4.06). Finally, a vegan (Sub-score 1: β: 6.19; 95% CI: 4.43–7.96) diet is consistently associated with higher levels of sustainability in all areas assessed. In contrast, the Western diet shows a significant negative association with sustainability in all subcomponents assessed. Conclusions: Plant-based dietary patterns were shown to be associated with sustainable lifestyles, with the vegan diet having the greatest association, while the Western dietary pattern was inversely associated. Full article

Cardiovascular diseases (CVDs) remain the leading global cause of death, with obesity acting as a significant contributing factor through mechanisms such as chronic inflammation, insulin resistance, and endothelial dysfunction. Molecular pathways at the interface of obesity, diet, and CVDs reveal how altered lipid metabolism, oxidative stress, and inflammatory signaling contribute to CVD progression. Despite advancements in treatment, effective management of CVDs, particularly in the context of obesity, remains a challenge. This review addresses the gap in understanding the relationship between obesity, nutritional status, and CVD progression, evaluating the impact of dietary interventions such as low-carb, Mediterranean, ketogenic, and Dietary Approaches to Stop Hypertension diets on cardiovascular health. Key findings indicate that adipokines, interleukins, and tumor necrosis factor alpha play significant roles in inflammatory responses and insulin resistance, further exacerbating cardiovascular dysfunction. Furthermore, optimized dietary strategies have been shown to modulate several molecular pathways, improving cardiovascular risk factors and enhancing metabolic health. This review underscores the significance of understanding molecular metabolic pathways in the intricate relationship between obesity, diet, and CVDs. It highlights the role of personalized nutrition and comprehensive dietary patterns in the management of CVDs and advocates for further research to optimize dietary strategies for sustained cardiovascular health. Full article

Background and Objective: Dietary interventions are the first-line treatment for overweight individuals (OW) and individuals with obesity (OB) with high-normal blood pressure (BP) or grade I hypertension, especially when at low-to-moderate cardiovascular risk (CVR). However, current guidelines do not specify the most effective dietary approach for optimising cardiovascular and metabolic outcomes in this population. This study aimed to compare the effects of a low-calorie, high-protein ketogenic diet (KD) vs. a low-calorie, low-sodium, and high-potassium Mediterranean diet (MD) on BP profiles assessed via ambulatory BP monitoring (ABPM), as well as on anthropometric measures, metabolic biomarkers, and body composition evaluated by bioelectrical impedance analysis (BIA). Methods: This prospective observational bicentric pilot study included 26 non-diabetic adult outpatients with central OW status or OB status (body mass index, BMI > 27 kg/m²) and high-normal BP (≥130/85 mmHg) or grade I hypertension (140–160/90–100 mmHg), based on office BP measurements. All participants had low-to-moderate CVR according to the second version of the systemic coronary risk estimation (SCORE2) and were selected and categorized as either KD (n = 15) or MD (n = 11). Comprehensive blood analysis, BIA, and ABPM were conducted at baseline and after three months. Results: At baseline, no significant differences were observed between the groups. Following three months of dietary intervention, both groups exhibited substantial reductions in body weight (KD: 98.6 ± 13.0 to 87.3 ± 13.4 kg; MD: 93.8 ± 17.7 to 86.1 ± 19.3 kg, p < 0.001) and waist circumference. Mean 24 h systolic BP (SBP) and diastolic BP (DBP) significantly declined in both groups (24 h mean SBP decreased from 125.0 ± 11.3 to 116.1 ± 8.5 mmHg (p = 0.003) and 24 h mean DBP decreased from 79.0 ± 8.4 to 73.7 ± 6.4 mmHg (p < 0.001)). Fat-free mass (FFM) increased, whereas fat mass (FM), blood lipid levels, and insulin concentrations decreased significantly. The ΔFM/ΔFFM correlates with ABP improvements. However, no significant between-group differences were detected at follow-up. Conclusions: The KD and the MD mediated weight loss and body composition changes, effectively improving bio-anthropometric and cardiovascular parameters in individuals with OW status or OB status and high BP. Although more extensive studies are warranted to elucidate potential long-term differences, our findings suggest the manner in which these two different popular dietary approaches may equally confer metabolic and cardiovascular benefits, emphasising the importance of weight and FM loss. Full article

Metabolic syndrome (MetS) is characterized by central obesity, insulin resistance, hypertension, dyslipidemia, and chronic inflammation, significantly increasing the risk of cardiovascular disease and type 2 diabetes. Effective management of MetS is critical, with exercise being a key intervention. This review analyzed the effects of different exercise intensities—low, moderate, and high-intensity interval training (HIIT)—on metabolic health, oxidative stress (OS), inflammation, and cardiovascular function. A search of Medline, PEDro, and EBSCO identified 2251 articles, with 159 studies published between 1999 and 2025 included after screening. Low-intensity exercise improved insulin sensitivity, reduced OS markers (e.g., MDA, 8-OHdG), and enhanced antioxidant enzyme activity. Moderate-intensity exercise showed similar benefits with notable reductions in inflammatory markers (e.g., IL-1β, TNF-α). HIIT promoted fat loss and improved metabolic markers but temporarily increased OS and inflammation. Dietary strategies also play a critical role. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diets are well established, emphasizing nutrient-dense foods like unsaturated fats and fiber to reduce inflammation and manage weight. The ketogenic diet (KD), a high-fat, low-carbohydrate approach, has recently gained attention for its metabolic benefits. KD induces ketosis, improving insulin sensitivity, reducing triglycerides, and enhancing fat oxidation. Studies show KD effectively reduces body weight and glucose levels, though long-term adherence and nutrient deficiencies remain challenges. Intermittent fasting also showed potential benefits, though effects on glucose metabolism were inconsistent. This review underscores the need for tailored approaches combining exercise, diet, and fasting to optimize MetS outcomes, offering integrative strategies for prevention and management. Full article

Introduction: Migraine is a prevalent neurological disorder characterized by recurrent headaches with autonomic and neurological symptoms, significantly impacting quality of life globally. Its pathogenesis involves genetic, neurological, inflammatory, and metabolic factors, with insulin resistance and metabolic dysfunction increasingly recognized as important contributors. Historically, it has been known that certain foods can trigger migraine attacks, which led for many years to the recommendation of elimination diets—now understood to primarily target histamine-rich foods. Over the past two decades, attention has shifted toward underlying metabolic disturbances, leading to the development of dietary approaches specifically aimed at addressing these dysfunctions. Methods: A scoping literature review was conducted using PubMed and Embase to evaluate the relationships among migraine, insulin-related mechanisms, neurogenic inflammation, and dietary interventions. Initial searches focused on “MIGRAINE AND (neurogenic inflammation)” (2019–15 April 2025), followed by expanded searches from 1950 onward using terms such as “MIGRAINE AND (insulin, insulin resistance, hyperinsulinism)”, and “MIGRAINE AND (diet, dietary, nutrition, nutritional)”. A specific search also targeted “(INSULIN OR insulin resistance OR hyperinsulinism) AND (neurogenic inflammation)”. Abstracts were screened, full texts were retrieved, and duplicates or irrelevant publications were excluded. No filters were applied by article type or language. Systematic reviews and meta-analyses were prioritized when available. Results: Migraine pathogenesis involves trigeminovascular system activation, neurogenic inflammation mediated by CGRP and PACAP, immune dysregulation, mast cell activation, and cortical spreading depression (CSD). Emerging evidence highlights significant associations between migraine, insulin resistance, and hyperinsulinism. Hyperinsulinism contributes to migraine through TRPV1 sensitization, increased CGRP release, oxidative stress, mitochondrial dysfunction, and systemic inflammation. Metabolic dysfunction, including obesity and insulin resistance, exacerbates migraine severity and frequency. Dietary interventions, particularly anti-inflammatory, Mediterranean, and ketogenic diets, show promise in reducing migraine frequency and severity through mechanisms involving reduced inflammation, oxidative stress, improved mitochondrial function, and glucose metabolism stabilization. Conclusions: The interplay between insulin resistance, metabolic dysfunction, and neuroinflammation is crucial in migraine pathophysiology. Targeted dietary interventions, including ketogenic and Mediterranean diets, demonstrate significant potential in managing migraines, emphasizing the need for personalized nutritional strategies to optimize therapeutic outcomes. Full article

Background: Trimethylamine N-oxide (TMAO) is a gut- and food-derived molecule. Elevated TMAO concentrations have been associated with an increased risk of cardiovascular disease (CVD) and all-cause mortality, highlighting its significance as a potential biomarker for adverse health outcomes. Given these associations, it is hypothesized that lifestyle interventions, such as healthy dietary patterns and exercise, could reduce TMAO concentrations. The aim of this systematic–narrative hybrid literature review was to evaluate the relationship between various lifestyle interventions and TMAO. Methods: MEDLINE (via PubMed^®), Scopus^®, and grey literature were searched until July 2024 for eligible clinical trials. Case reports, case series, case studies and observational studies were excluded, as well as studies that investigated food products, nutraceuticals, dietary supplements or have been conducted in the pediatric population. Results: In total, 27 studies were included in this review. While some dietary interventions, such as plant-based, high-dairy, very low-calorie ketogenic diet or the Mediterranean diet, were associated with lower TMAO concentrations, others—including high-protein and high-fat diets—were linked to an increase in TMAO concentrations. Studies that incorporated a combination of nutrition and exercise-based intervention presented neutral results. Conclusions: The relationship between dietary interventions and TMAO concentration remains controversial. While certain interventions show promise in reducing TMAO levels, others yield mixed or contradictory outcomes. Further research, including well-structured RCTs, is needed to investigate the aforementioned associations. Full article

Psoriasis is a chronic immune-mediated skin disease characterized by cytokine dysregulation. Pro-inflammatory mediators, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-17, and IL-23, play pivotal roles in the pathogenesis of psoriasis. Emerging evidence suggests that dietary interventions can modulate cytokine activity, providing a complementary approach to standard therapies. This narrative review examines the impact of various dietary strategies, including a Mediterranean diet, ketogenic diet, gluten-free diet, and fasting-mimicking diet, on cytokine profiles and clinical outcomes in psoriasis. Research insights reveal that dietary components such as omega-3 fatty acids, polyphenols, and short-chain fatty acids influence immune signaling pathways. These pathways include nuclear factor-kappa B (NF-κB) and Signal Transducer and Activator of Transcription 3 (STAT3). Additionally, these dietary components promote anti-inflammatory effects mediated by gut microbiota. Clinical studies demonstrate significant reductions in psoriasis severity, improved quality of life, and modulation of key cytokines associated with disease activity. Despite these advancements, significant challenges persist in effectively integrating these findings into clinical practice. These challenges include variability in patient responses, adherence issues, and the need for robust biomarkers to monitor efficacy. Future directions emphasize the potential of personalized nutrition and precision medicine approaches to optimize dietary interventions tailored to individual cytokine profiles and genetic predispositions. Integrating these strategies into psoriasis care could transform treatment paradigms by simultaneously addressing both systemic inflammation and comorbid conditions. Full article

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS), characterized by neurodegeneration, axonal damage, demyelination, and inflammation. Recently, gut dysbiosis has been linked to MS and other autoimmune conditions. Namely, gut microbiota has a vital role in regulating immune function by influencing immune cell development, cytokine production, and intestinal barrier integrity. While balanced microbiota fosters immune tolerance, dysbiosis disrupts immune regulation, damages intestinal permeability, and heightens the risk of autoimmune diseases. The critical factor in shaping the gut microbiota and modulating immune response is diet. Research shows that high-fat diets rich in saturated fats are associated with disease progression. Conversely, diets rich in fruits, yogurt, and legumes may lower the risk of MS onset and progression. Specific dietary interventions, such as the Mediterranean diet (MD) and ketogenic diet, have shown potential to reduce inflammation, support neuroprotection, and promote CNS repair. Probiotics, by restoring microbial balance, may also help mitigate immune dysfunction noted in MS. Personalized dietary strategies targeting the gut microbiota hold promise for managing MS by modulating immune responses and slowing disease progression. Optimizing nutrient intake and adopting anti-inflammatory diets could improve disease control and quality of life. Understanding gut-immune interactions is essential for developing tailored nutritional therapies for MS patients. Full article

Dyslipidemia, characterized by abnormal blood lipid levels, is a major public health concern due to its association with atherosclerotic cardiovascular disease (ASCVD) and other cardiometabolic disorders. In this context, appropriate nutrition patterns are pivotal as they represent the basic approach for providing a wide range of substantial advantages. The best evidence for dyslipidemia management is offered by the Mediterranean Diet, the Plant-Based Diet, the High-Fiber Diet and the Anti-inflammatory Diet, while the DASH Diet and the Ketogenic Diet have also been shown to target additional pathological features like hypertension and other comorbidities. The bioactive compounds that are enriched in these nutrition patterns and able to manage dyslipidemia include monounsaturated fatty acids such as ω-3, polyphenols such as oleuropein, resveratrol, flavonoids, and catechins, carotenoids, phytosterols and soluble and unsoluble fibers. Diets rich in these compounds can improve lipid profile by mitigating oxidative stress, reducing low-grade chronic inflammation, modulating macronutrient absorption and other mechanisms, thereby supporting cardiovascular health. Additionally, lifestyle interventions such as regular physical activity, weight loss, reduced alcohol consumption and smoking cessation further ameliorate lipid metabolism and manage circulated lipid profile. Furthermore, emerging insights from nutrigenomics underscore the potential for proper diet to address genetic factors and optimize treatment outcomes. The pivotal role of nutrition interventions in the context of dyslipidemia and its cardiometabolic implications is discussed in this review, emphasizing evidence-based and personalized approaches. Full article

Migraine is a prevalent neurological disorder characterized by significant disability and triggered by various factors, including dietary habits. This review explores the complex relationship between diet and migraine, highlighting both triggering and protective roles of dietary patterns and specific nutrients. Evidence suggests that certain foods, such as alcohol, caffeine, chocolate, MSG, nitrates, and tyramine, can trigger migraines in susceptible individuals. Conversely, dietary interventions, including carbohydrate-restricted diets, ketogenic diets, vitamin D3 supplementation, omega-3 fatty acids, Mediterranean dietary patterns, and increased water intake, have shown potential in reducing migraine frequency and severity. Observational studies also indicate that maintaining a healthy diet, rich in fruits and vegetables and low in processed foods, is associated with better migraine outcomes. The effectiveness of these interventions varies among individuals, underscoring the importance of personalized approaches. Future studies should further explore the role of diet in migraine management, focusing on randomized trials to establish causality and refine dietary recommendations for patients. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and affects nearly 30% of the adult population and 10% of the pediatric population. It is estimated that this number will double by 2030. MASLD is one of the leading causes of hepatocellular carcinoma, cirrhosis, and liver transplantation, as well as a significant risk factor for cardiovascular disease and mortality. Due to the ever-increasing number of patients, the long-term asymptomatic course of the disease, serious complications, and lack of preventive programs, as well as insufficient awareness of the disease among patients and doctors themselves, MASLD is a growing interdisciplinary problem and a real challenge for modern medicine. The main cause of MASLD is an inappropriate lifestyle—inadequate nutrition and insufficient physical activity, which lead to various components of metabolic syndrome. Lifestyle changes—appropriate diet, weight reduction, and systematic physical activity—are also the basis for the prevention and treatment of MASLD. Hence, in recent years, so much importance has been attached to lifestyle medicine, to non-pharmacological treatment as prevention of lifestyle diseases. The narrative review presents possible therapeutic options for non-pharmacological management in the prevention and treatment of MASLD. The best documented and available diets used in MASLD were discussed, focusing on the benefits and drawbacks of the Mediterranean, high-protein, ketogenic, and intermittent fasting diets. In addition, the most recent recommendations regarding physical activity are summarized. Full article