Search Results (1,208)

Background/Objectives: The prevalence of allergic diseases has markedly increased in developed countries, with environmental and dietary factors considered important contributors. Folic acid is an essential micronutrient involved in one-carbon metabolism and DNA methylation, playing a key role in epigenetic regulation of immune function. Both high and low folate exposure have been associated with allergic outcomes, but the data on postnatal folate status in paediatric populations remain limited. This study aimed at assessing serum folate status in children with atopic diseases compared with children without chronic allergic disease in Croatia. Methods: This cross-sectional study included 292 paediatric patients from the University Hospital in Split and a paediatric primary care practice between January 2024 and January 2025. Serum folic acid concentrations were measured using electrochemiluminescence immunoassay. Additional laboratory parameters included vitamin B12, total IgE levels, and eosinophil counts. Demographic and clinical data were obtained from medical records. Statistical analyses included Chi-square tests, Mann–Whitney U tests, linear regression modelling, and analysis of covariance with statistical significance set at p < 0.05. Results: Folic acid deficiency was present in 66.4% of all participants. Children with atopic diseases were significantly more likely to have folate deficiency and had lower mean serum folate concentrations compared to children without allergic disease. There were no significant differences in folate levels between children with and without asthma. Lower folate levels were associated with higher IgE levels, higher eosinophil counts, and older age. When controlling for the effects of age on folic acid levels, the differences between participants with and without atopic diseases remained significant. Conclusions: Folic acid deficiency is highly prevalent among children in the Mediterranean region of Croatia and is significantly associated with atopic diseases and markers of allergic inflammation. These findings highlight a potential role of folate status in paediatric allergic disease and support the need for longitudinal studies to clarify causality and potential clinical implications. Full article

Iodine is an essential trace element for thyroid hormone synthesis, metabolic homeostasis, and fetal neurodevelopment. During pregnancy, maternal iodine requirements increase substantially, yet global recommendations are primarily based on population-level biomarkers rather than individualized physiological data. In this review, we examine current international guidelines for iodine adequacy in pregnancy, evaluate the limitations of population-based metrics—such as urinary iodine concentration (UIC) and serum thyroglobulin (Tg)—and highlight emerging evidence on physiological adaptations, functional biomarkers, and individualized risk factors. We incorporated data from population surveillance studies, mechanistic investigations of thyroid adaptation, and clinical outcome research identified through a literature search of PubMed/MEDLINE and Scopus (2016–2025). Evidence indicates that the widely adopted WHO range for iodine intake in pregnant women may overestimate the actual needs of gestation. There is a U-shaped relationship between iodine intake and thyroid outcomes, meaning both low and high iodine exposure adversely affect maternal thyroid function and fetal neurodevelopment, highlighting the narrow optimal intake window. Individualized considerations—including autoimmune thyroid disease, supplementation practices, environmental exposures, and coexisting micronutrient deficiencies—further modulate iodine requirements. Functional indices, such as the Thyroid Feedback Quantile-based Index (TFQI), may offer complementary tools for assessing iodine adequacy beyond traditional biomarkers. Full article

Microaeration has been applied to enhance anaerobic digestion (AD), although the underlying mechanisms remain unclear. This work proposes that improving methanogenic activity can be achieved by alleviating micronutrient deficiencies and enhancing digestibility. The microaeration technique was employed to enhance the methanogenic activity of cassava wastewater (CW) both with and without added cassava residue (CR) and to improve CR digestibility in a continuous stirred tank reactor (CSTR) at 37 °C. The sole CW had the optimal COD loading rate of 1.71 kg/m³d. The addition of CR at 1000 mg/L to the CW resulted in the greatest methanogenic improvement of 88% compared with the sole CW and provided the greatest digestibility of CR. Under the optimal specific O₂ dosage rate (3 mL/LRd), the improvements in CH₄ yields were 251% and 140% in comparison to those of the sole CW and the CW with added CR, respectively. Additionally, it achieved substantial improvements in digestibility for the cellulose (59%), hemicellulose (61%), and remaining starch (67%) fractions of added CR. However, lignin degradation remained unaffected, a potential area for future optimization. This work opens new avenues for enhancing biogas production from wastewater by adding agricultural residue in conjunction with microaeration. Full article

Background/Objectives: Aging is associated with physiological, biochemical, and psychosocial changes that can significantly affect nutritional status and overall health. In Sub-Saharan Africa (SSA), older adults face unique age-related challenges that may compromise healthy aging, yet evidence remains fragmented. This systematic review synthesized the existing literature on the nutritional status, age-related challenges, and strategies to promote healthy aging of older adults in SSA. Methods: A systematic literature search was conducted on PubMed, Scopus, ScienceDirect, and Cochrane Library to identify relevant studies published up to 10 December 2025. Results: Fifty-five studies met the inclusion criteria, with most of the studies coming from South Africa, Ghana, and Nigeria. Amongst community-dwelling populations, approximately 30–65% of the older adults were either malnourished or at risk of malnutrition, while hospital-based studies reported markedly higher burdens, with malnutrition prevalence exceeding 70% in some settings. Undernutrition, micronutrient deficiencies, and the coexistence of overweight and obesity were frequently observed, reflecting the region’s ongoing nutrition transition. Frailty emerged as the predominant age-related challenge, with prevalence ranging around 10–60%. Other common challenges included sarcopenia, reduced muscle strength, functional disability, cognitive impairment, and dysphagia, all of which were closely related to poor nutritional status, food insecurity, multimorbidity, and reduced quality of life. Few studies reported on healthy aging strategies, with the limited evidence suggesting that nutrition education, physical activity, and psychosocial interventions may enhance nutritional and functional outcomes. Conclusions: The need for context-specific, nutrition-sensitive interventions, and stronger health and social support systems is warranted to promote healthy aging in SSA older adults. Full article

Anemia is a major global public health problem and is most commonly associated with iron deficiency; however, deficiencies in other micronutrients, including vitamin B₁₂, may also contribute to its development. Increasing evidence suggests that Helicobacter pylori infection may influence the occurrence of anemia through several mechanisms related to alterations in the gastric environment. Chronic gastric inflammation and increased gastric pH associated with H. pylori infection may impair the absorption of non-heme iron and reduce the concentration of vitamin C in gastric juice. Since vitamin C enhances iron bioavailability by reducing ferric iron (Fe³⁺) to the more absorbable ferrous form (Fe²⁺), decreased levels of this vitamin may further limit iron absorption. At the same time, the increase in gastric pH may hinder the release of vitamin B₁₂ from food proteins, potentially contributing to disturbances in its absorption. This review aimed to present an integrated overview of the relationships between H. pylori infection, alterations in the gastric environment, and mechanisms that may contribute to the development of anemia, including disturbances in vitamin B₁₂ absorption, with particular emphasis on the potential role of vitamin C. Full article

Background: School feeding programs aim to improve child nutrition, and they may influence weight outcomes insofar as program modalities and household responses alter children’s total energy intake. This is especially relevant in countries facing the double burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with rising overweight and obesity. This study estimates the effect of Peru’s former National School Feeding Program on obesity and excess weight among children aged 36 to 59 months under a selection-on-observables identification strategy and assesses whether impacts differ across operational modalities, particularly breakfast-only versus breakfast plus lunch and ready-to-eat rations versus foods delivered for preparation. Methods: We use repeated cross-sectional microdata from the Demographic and Health Survey (ENDES) pooled over 2014 to 2018 and link them to administrative information. The sample includes 18,959 children aged 36 to 59 months. To improve comparability, we estimate propensity score weights targeting the average treatment effect on the treated (ATT) using a machine learning generalized boosted model (GBM), and assess covariate balance using standardized mean differences and Kolmogorov–Smirnov statistics. Identification assumes conditional independence given observed covariates and overlap (common support). Main estimates rely on weighted probit models with fixed effects, progressively adding exposure duration, modality indicators, and controls. Distributional effects are examined using quantile regression on the continuous weight-for-height z-score. Results: Without differentiating modalities, beneficiary status is not associated with a statistically significant change in obesity, while pooled baseline estimates indicate a statistically significant higher probability of excess weight. Modality-specific results show that obesity declines only when Qali Warma is delivered as breakfast plus lunch through products to be prepared (approximately −1.0 percentage point in parsimonious models and −0.4 percentage points after controls). Evidence for excess weight is directionally consistent by modality but less conclusive once controls are included. Conclusions: Qali Warma’s effects on early-childhood weight outcomes depend on implementation modality. Evaluations of school feeding programs should incorporate operational heterogeneity, particularly during program redesign. Full article

Iodine is an essential micronutrient required for the synthesis of thyroid hormones and the maintenance of metabolic, neurodevelopmental and immune function. As iodine cannot be synthesized endogenously, adequate intake depends on dietary sources and environmental availability. Despite decades of progress in improving iodine supply, both iodine deficiency and excess remain significant global public health challenges. This review summarizes iodine physiology, covering both its role in thyroid hormone synthesis and emerging evidence for extrathyroidal immunomodulatory and antioxidant actions. It summarizes major dietary sources, global intake patterns and current approaches to iodine status assessment, including urinary biomarkers, salivary iodide measurement and dietary screening tools. The clinical consequences of iodine imbalance are examined, ranging from goiter, hypothyroidism and impaired neurocognitive development associated with deficiency, to iodine-induced thyroid dysfunction, autoimmunity and adverse systemic effects linked to excess intake. Special attention is given to vulnerable populations, particularly pregnant women and infants. This review further evaluates public health strategies, including salt iodization and targeted supplementation, while addressing the emerging challenge posed by salt-reduction initiatives. Achieving optimal iodine intake remains essential for thyroid health and population well-being, underscoring the need for coordinated monitoring and policy adaptation. Full article

Phosphorus (P) availability is currently a limiting factor for agricultural production, especially in tropical soils, and its interaction with cationic micronutrients can significantly affect physiological efficiency and nutrient uptake by plants. Therefore, this study aimed to evaluate the uptake kinetic parameters described by the Michaelis–Menten model (Vmax, Km, and Cmin) for P as a function of the supply of Cu, Fe, Mn, and Zn, as well as the kinetic parameters of Cu, Fe, Mn, and Zn as a function of P supply in cotton (Gossypium hirsutum L.). The experiment was conducted in a greenhouse at the experimental unit of CENA, in Piracicaba, São Paulo, Brazil, using individual pots. Phosphorus concentration and accumulation were reduced only under Fe and Zn deficiency, with reductions of up to 60% in the shoots and 85% in the roots. Zn deficiency caused a drastic reduction in P uptake capacity, with Vmax decreasing from 590 to 50.85 µmol g⁻¹ h⁻¹ (approximately a 12-fold reduction), accompanied by an increase in Cmin (from 269 to 1508 µmol L⁻¹). In terms of micronutrient kinetics, P omission reduced plant growth and affected only Fe and Zn uptake. For Fe, Km increased from 12.82 to 27.31 µmol L⁻¹ and Cmin from 1.03 to 20.51 µmol L⁻¹. For Zn, and Vmax decreased from 0.16 to 0.02 µmol g⁻¹ h⁻¹ (approximately 8-fold), while Cmin increased from 0.08 to 1.56 µmol L⁻¹. These results demonstrate a strong interaction between P, Fe, and Zn, highlighting their regulatory roles in nutrient uptake and providing mechanistic insights into plant nutritional efficiency. Full article

Background and aim: Celiac disease (CD) is a systemic autoimmune disorder triggered by gluten ingestion, and the only effective treatment is strict adherence to a gluten-free diet (GFD). Many factors, including limited dietary diversity and poor adherence, are associated with an increased risk of specific micronutrient deficiencies and malnutrition. This study aims to evaluate the relationship between adherence to GFD, celiac antibody levels, micronutrient levels, and nutritional status in children with CD. Methods: This retrospective study was conducted on 402 children aged 2–18 years with a diagnosis of CD confirmed positive by anti-tTG IgA and duodenal biopsy, all of whom had been on GFD for at least six months. Demographic, anthropometric, clinical, serological, and biochemical data (including hemogram, serum iron, ferritin, vitamin D, folate, and B12 levels), and GFD adherence were collected from medical records. Results: Most individuals are girls (64.9%), with a mean age of 10.6 ± 4.20 years. Chronic malnutrition was observed in 29.4% of patients. Acute malnutrition was identified in 27.8% of children, and wasting was observed in 6.7%. Iron deficiency anemia was the most frequently encountered micronutrient deficiency among the patients (23.9%). The prevalence of stunting was significantly higher among individuals with positive tTG-IgA levels and poor adherence to the GFD. Conclusions: Poor adherence to the GFD and positive tTG-IgA levels were associated with higher rates of stunting, underlining the need for individualized dietary follow-up and regular monitoring of both nutritional status and serological response in children with CD. Full article

Introduction: Pediatric asthma is the inflammatory condition with the highest burden of chronic disease in children. Awareness of the undesirable effects of modern lifestyles, including sedentary behavior and eating habits associated with Western diets, has led to novel approaches in clinical practice. Current concerns focus on the possibility of non-pharmacological intervention to achieve better disease control and normal lung function in these children. Method: In this narrative review, we analyzed current information on the influence of dietary patterns on lung function. The aim was to clarify the extent to which current knowledge provides arguments for applying certain dietary measures to asthma patients in order to optimize lung function. We conducted research in the literature to evaluate the impact of Western diet, Mediterranean diet, and micronutrients status on lung function. We also focused on how maternal diet during pregnancy can influence lung function in offspring. Results: We found a positive impact on lung function in children who adhere to the Mediterranean diet, in contrast to the Western diet which is related to low asthma control. Deficits of micronutrients like selenium, zinc, iron, and vitamin D are linked to impaired lung function. Maternal intake of fiber, vitamin A, vitamin E, zinc, and selenium during pregnancy is correlated with better FEV1 and FVC. However, current information on this topic is controversial, and there is no clear data on intervention measures in clinical practice. Conclusions: Evaluation and clear recommendations of diet could contribute to a better management of children with asthma. Full article

The intake of vitamins and minerals has a significant impact on the health of both the expectant mother and the newborn. During gestation, the demand for micronutrients increases; therefore, modifying dietary habits and selecting foods that ensure adequate (or sufficient) intake can be challenging. Although food supplements contain substances with beneficial physiological effects and their use can improve micronutrient intake, these products cannot replace proper nutrition. Due to modern nutritional habits, intake of key micronutrients is often inadequate, and their deficiencies are known to correlate with significant clinical outcomes during pregnancy. To reduce these deficiencies, several single- and multi-component dietary supplements have been developed. This review aims to present the health effects of the bioactive compounds found in these products and to discuss interactions (i.e., synergistic, additive, and antagonistic effects) between the micronutrients that may alter their bioefficiency. In addition, with a focus on future directions, this review draws attention to the need for a reassessment of current nutritional guidelines and recommendations, the development of new approaches, and emphasises the importance of establishing harmonised amounts of vitamins and minerals used in dietary supplements for pregnant women. Full article

Chronic kidney disease (CKD) is on the rise, with sarcopenia accompanying CKD in an estimated 25% of patients, featuring as a potentially debilitating issue that should not be overlooked. Sarcopenia, characterized by a loss of skeletal muscle mass and strength, is multifactorial. The aging process, uremic toxins, systemic inflammation, oxidative stress, gut dysbiosis, hormonal dysregulation, dietary deficits, and even air pollution are among the major parameters being implicated in sarcopenia among patients with CKD. Additionally, the existence of various comorbidities, such as type 2 diabetes mellitus (T2DM), depression, and cardiovascular diseases (CVD), also contribute to the chronic low-grade inflammation associated with skeletal muscle inflammation and atrophy. The purpose of this review is to delve into the complex interplay of multiple factors being involved in the pathogenesis of sarcopenia in patients with CKD. Moreover, we aim to shed light upon nutritional aspects that could delay the development and progression of sarcopenia among patients with CKD. To address vitamin D deficiency, micronutrients and macronutrients together with physical activity remain the cornerstone of delaying the progression of sarcopenia in this sub-population. Additionally, experimental drugs exhibiting therapeutic potential are also being discussed. As sarcopenia and quality of life are interconnected, the timely recognition of sarcopenia, together with nutritional and therapeutic interventions, is of the utmost importance in our crusade for a better quality of life (QoL) in patients with CKD. Full article

As populations age, micronutrient deficiencies increase and are linked to frailty, functional decline, cognitive impairment, anemia, and a higher healthcare burden. This review synthesizes evidence from the past five years on adults ≥65 years, comparing residents of nursing homes/assisted-living facilities with community-dwelling peers. Community-dwelling older adults show high prevalence of deficiencies—particularly vitamin D, calcium, magnesium, folate, and zinc—while vitamin B12 deficiency is less common overall but increases with age due to malabsorption. Institutionalized adults face higher risk, driven by limited dietary variety, reduced sunlight exposure, greater multimorbidity, and polypharmacy. Reported rates include vitamin D deficiency in 70–94% of institutionalized adults (≈6.3-fold higher odds), zinc deficiency in 50–66% (vs. 31–49% in the community), iodine deficiency in 67–78% (vs. 22% in the community), and a Mini Nutritional Assessment classification of severe malnutrition/at risk in 67.9% (vs. 28% in the community). Consequences encompass frailty, falls, infections, higher costs, and increased institutionalization. Recommended actions include routine biomarker screening, improving access to vitamin D (supplementation/fortification), individualized care for micronutrient deficiencies—including vitamin B12 when relevant—multidisciplinary nutrition support, and long-term targeted research to guide best practices for healthy aging and equity. Full article

Micronutrient deficiencies are commonly observed in patients with obesity and may persist or worsen following bariatric and metabolic surgery. Emerging evidence suggests that micronutrients play a fundamental role in tissue repair, collagen synthesis, immune function, and inflammatory regulation processes that are critical in postoperative healing. Therefore, deficiencies in these nutrients could be pivotal in understanding and preventing postoperative complications. However, the potential link between preoperative micronutrient status and the development of postoperative complications, such as anastomotic or gastric fistula, remains underexplored. This narrative review aims to investigate the correlation between specific micronutrient deficiencies (e.g., vitamin C, zinc, selenium, vitamin A, and iron) and the incidence of fistula after bariatric surgery. We will discuss the underlying biological mechanisms, clinical evidence, and possible preventive strategies, including preoperative screening and targeted supplementation. Our aim is to highlight the often-overlooked micronutrient deficiency as a risk factor in patients undergoing bariatric surgery, both in the pre- and postoperative periods, and to propose a more comprehensive approach to patient assessment and management. Full article

Eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED), are complex psychiatric conditions characterized by high morbidity and mortality. Increasing evidence suggests that beyond disorder-specific symptomatology, shared transdiagnostic mechanisms contribute to their onset and persistence. This narrative review synthesizes current data on neurobiological and nutritional factors implicated in EDs, with particular emphasis on trait–state interactions and starvation-induced neuroadaptations. Predisposing vulnerabilities such as heightened anxiety, cognitive rigidity, and perfectionism appear to interact with state-dependent biological alterations induced by malnutrition. Chronic dietary restriction is associated with measurable alterations in serotonergic and dopaminergic systems, altered reward processing, and persistent activation of the hypothalamic–pituitary–adrenal (HPA) axis. Experimental studies suggest that acute tryptophan depletion may transiently reduce anxiety in individuals with anorexia nervosa, suggesting that, in some individuals, food restriction may function as a biologically reinforced strategy of affect regulation. Furthermore, disturbances in leptin and ghrelin signaling, along with widespread micronutrient deficiencies—including zinc, iron, selenium, and B vitamins—may exacerbate cognitive inflexibility, mood instability, and impaired decision-making. These metabolic and endocrine adaptations may contribute to a self-perpetuating cycle in which starvation-induced neurochemical changes reinforce restrictive or dysregulated eating behaviors. Importantly, several of these mechanisms extend beyond anorexia nervosa and may represent common transdiagnostic processes across eating disorders and related mental health conditions, including anxiety, depression, and addictive behaviors. Recognition of these biological and nutritional factors has significant implications for treatment. Nutritional rehabilitation should be conceptualized not solely as weight restoration, but as a neurobiological recalibration of stress regulation, reward sensitivity, and affective processing systems. An integrative treatment approach that combines behavioral stabilization with attention to underlying neurobiological and relational mechanisms may offer a more comprehensive framework for long-term recovery. Full article