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Integration of the IDDSI Scale into 3D Food Printing: A Strategy to Improve Food Safety and Quality of Life for People with Dysphagia

  • Daniel García-Gutiérrez,
  • Bartomeu Ayala Márquez and
  • Xavier Gironés García
  • + 4 authors

Background: Dysphagia negatively impacts quality of life and requires diets with specifically modified textures. The IDDSI (International Dysphagia Diet Standardization Initiative) scale provides standardized criteria to ensure food safety. This research aims to explore and validate the IDDSI scale adapted to the consumption of foods developed with 3D printing in patients with dysphagia. Methodology: Different dishes were designed and validated using 3D printing and were evaluated by both healthcare professionals and people with dysphagia. In the second phase, participants analyzed their texture using the IDDSI scale. A mixed methodological approach was applied, combining quantitative data (from validated scales) and qualitative data (obtained through interviews and focus groups), ensuring methodological triangulation. Methods: In the first phase of the study, different dishes were cooked and designed using 3D printing technology and were previously evaluated by both healthcare professionals and people with dysphagia. In the second phase, all the dishes validated in the first phase were analyzed and classified according to their texture using the IDDSI. Results: A total of 24 dishes, backed by 204 validations, were determined to be suitable for people with dysphagia and compatible with 3D printing. According to the IDDSI analysis, 36% of these dishes were classified as level 3 (soft texture) and 64% as level 4 (thick purée), levels internationally recognized as safe and suitable for people with dysphagia and suitable for 3D printing. The application of the IDDSI scale eliminated ambiguities in the description of textures, facilitating clear communication between healthcare professionals, caregivers, people with dysphagia, and companies that produce 3D-printed foods, as well as the standardization of 3D food printing processes related to textures. The application of the IDDSI scale eliminated ambiguities in the description of textures, facilitating clear communication between healthcare professionals, caregivers, people with dysphagia, and companies producing 3D-printed food products. This enabled the standardization of 3D food printing processes and the definition of their textures. At the same time, 3D printing proved to be a viable and effective tool for customizing meals that are safe, appropriate, and sensorially appealing. Conclusions: The feasibility of combining the IDDSI scale with 3D printing to develop diets tailored to the needs of people with dysphagia is confirmed. This integrative approach represents an innovation in the field of nutrition for people with swallowing problems, especially in contexts with limited scientific evidence, combining the validation of modified textures with 3D printing technology. There are effective tools for producing safe, suitable and sensorially appealing meals.

15 December 2025

Relationship between texture levels and the dishes analyzed.

Knowledge and Use of Bee Products in Lithuania

  • Juozas Labokas and
  • Gintarė Kleibaitė

Background/Objective: In recent years, there has been a growing public interest in natural products, including those derived from bees. While most scientific research on bee products has focused on their pharmacological properties, insufficient attention has been given to consumer knowledge, consumption habits and attitudes. The aim of this study was to estimate the popularity of use of different bee products and assess consumer knowledge about them in Lithuania. Methods: An online survey was carried out of the general adult population of Lithuania with 421 respondents included. Results: The study revealed that honey, beeswax and royal jelly were the best-known bee products, while bee venom was the least known one. Knowledge levels varied by age and occupation of respondents—older people and those working in pharmacy, healthcare, cosmetology, agriculture, beekeeping and food production showed better perception. Honey was most often used for treating colds (78.9%), prevention (78.1%) and reducing fever (65.3%). Dietary use of honey depended on demographic factors and was generally low—28.3% consumed it only a few times per year or less. For cosmetics, propolis was the most used product (34.2%). Conclusions: Older individuals and professionals in pharmacy, healthcare, cosmetology, agriculture, beekeeping and food production, demonstrated better knowledge of bee products. Although honey was rarely consumed as part of the diet, older people tended to use it more often than younger individuals. Men were more likely to use honey for treating digestive and circulatory issues and as an ingredient in food and beverages, whereas women were more inclined to use it for respiratory illnesses and cosmetic treatments.

15 December 2025

Background: Malnutrition and micronutrient deficiencies remain significant public health burdens among Indonesian children under five years of age. This study assessed the relationship between growth indicators and micronutrient status of children aged 0–59 months. Methods: A cross-sectional design was performed, utilizing the 2018 Indonesian Basic Health Research (Riskesdas) data and biological specimens, including 550 samples from children aged between 0 and 59 months old. The Riskesdas data used in this study were demographic characteristics, anthropometric measurements, and nutritional status. The biological samples were used to measure micronutrients (iron, zinc, calcium, vitamin A (VA), and vitamin D (VD). Results: Overall, 23.1% of children were stunted, and 10.5% were wasted. This study also revealed that the prevalence of micronutrient deficiency was 34.2%, 38.7%, 8.2%, 7.8%, and 0.4% for ferritin, zinc, calcium, VA, and VD, respectively. Moreover, wasting was significantly higher in girls (13.5%) than in boys (8.2%, p = 0.044). Stunted children had significantly lower ferritin values, while wasted children had lower VA concentrations. In contrast, VD was lower in overweight children. Lastly, this study found that height for age Z-scores (HAZ score) and Body Mass Index (BMI) for age Z-scores (BAZ score) correlated positively with ferritin, zinc, and calcium levels. Conclusions: Stunting, wasting, and multiple micronutrient deficiencies remain prevalent among Indonesian children under five years of age. Strengthening nutrition interventions, in particular for iron, zinc, VA, and VD, is essential to improve child growth and health outcomes in this population.

15 December 2025

Background/Objectives: Acute stress is known to influence food-related motivation and decision-making, often promoting a preference for energy-dense, palatable foods. However, traditional laboratory paradigms have limited ecological validity. This study examined the relationship between stress-induced physiological changes, eating behavior traits, and food cravings using a virtual reality (VR) adaptation of the Trier Social Stress Test (VR-TSST) followed by a VR supermarket task in adolescents. Methods: Thirty-eight adolescents (mean age 15.8 ± 0.6 years) participated in the study. Physiological parameters (HR, QT, PQ intervals) were recorded pre- and post-stress using a portable ECG device (WIWE). Perceived stress and eating behavior traits were evaluated with the Perceived Stress Scale (PSS) and the Three-Factor Eating Questionnaire (TFEQ-R21C), respectively. Immediately after the VR-TSST, participants performed a VR supermarket task in which they rated cravings for sweet, fatty, and healthy foods using visual analog scales (VAS). Paired-samples t-tests examined pre–post changes in physiological parameters, partial correlations explored associations between ECG responses and eating traits, and a 2 × 3 mixed-model Repeated Measures ANOVA assessed the effects of food type (sweet, fatty, healthy) and uncontrolled eating (UE) group (low vs. high) on post-stress cravings. Results: Acute stress induced significant increases in HR and QTc intervals (p < 0.01), confirming a robust physiological stress response. The ANOVA revealed a strong main effect of food type (F(1.93, 435.41) = 168.98, p < 0.001, η2p = 0.43), indicating that stress-induced cravings differed across food categories, with sweet foods rated highest. A significant food type × UE group interaction (F(1.93, 435.41) = 16.49, p < 0.001, η2p = 0.07) showed that adolescents with high UE exhibited greater cravings for sweet and fatty foods than those with low UE. Overall, craving levels did not differ significantly between groups. Conclusions: The findings demonstrate that acute stress selectively enhances cravings for high-reward foods, and that this effect is modulated by baseline uncontrolled eating tendencies. The combined use of VR-based stress induction and VR supermarket simulation offers an innovative, ecologically valid framework for studying stress-related eating behavior in adolescents, with potential implications for personalized nutrition and the prevention of stress-induced overeating.

15 December 2025

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Nutrition and Growth of Preterm Neonates during Hospitalization
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Nutrition and Growth of Preterm Neonates during Hospitalization

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Editors: Antonios K. Gounaris, Rozeta Sokou

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Nutrients - ISSN 2072-6643