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Nutrients, Volume 17, Issue 10 (May-2 2025) – 143 articles

Cover Story (view full-size image): Mental health disorders such as depression and Alzheimer’s disease affect women disproportionately, especially during midlife. The menopause marks a critical window, as hormonal changes impact brain function and are linked to mood, sleep, and dietary disturbances. These changes can lead to increased intake of high-glycemic, low-nutrient foods, promoting chronic low-grade inflammation. Combined with a Western diet, this factor may worsen gut–brain axis dysfunction and elevate the risk of mental and cognitive disorders. In this review, we explore how menopause-related physiological changes can increase vulnerability through diet-induced inflammation, highlighting the need for integrated prevention strategies. View this paper

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14 pages, 2237 KiB  
Article
Sex-Specific Associations of Gut Microbiota Composition with Sarcopenia Defined by the Asian Working Group for Sarcopenia 2019 Consensus in Older Outpatients: Prospective Cross-Sectional Study in Japan
by Daisuke Asaoka, Kazuya Toda, Shin Yoshimoto, Noriko Katsumata, Toshitaka Odamaki, Noriyuki Iwabuchi, Miyuki Tanaka, Jin-Zhong Xiao, Yuriko Nishikawa, Osamu Nomura, Tsutomu Takeda, Akihito Nagahara, Shigeo Koido, Toshifumi Ohkusa and Nobuhiro Sato
Nutrients 2025, 17(10), 1746; https://doi.org/10.3390/nu17101746 - 21 May 2025
Viewed by 326
Abstract
Background/Objectives: Sarcopenia (SA), an age-related impairment in skeletal muscle mass and function, is related to gut microbiota (GM) through inflammation and short-chain fatty acid (SCFA) generation. However, data on this relationship in older Japanese adults remain limited. We investigated the relationship of GM [...] Read more.
Background/Objectives: Sarcopenia (SA), an age-related impairment in skeletal muscle mass and function, is related to gut microbiota (GM) through inflammation and short-chain fatty acid (SCFA) generation. However, data on this relationship in older Japanese adults remain limited. We investigated the relationship of GM composition with SA, based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, among elderly Japanese outpatients. Methods: Between June 2022 and January 2023, this prospective cross-sectional study enrolled 356 community-dwelling outpatients aged ≥ 65 years at the Department of Gastroenterology, Juntendo Tokyo Koto Geriatric Medical Center. SA was determined based on the AWGS 2019 consensus criteria. GM was analyzed using 16S rRNA gene sequencing, and alpha/beta diversity, taxonomic composition, detection rates, and correlations with skeletal muscle mass index (SMI), grip strength, and gait speed were investigated. Results: Among 356 (144 males, 212 females) participants, 50 (35 males, 15 females) had SA. Differences in GM diversity and composition were primarily noted among male participants. Men with SA had lower alpha diversity and distinct beta diversity profiles. Six bacterial genera—Eubacterium I, Fusicatenibacter, Holdemanella, Unclassified Lachnospira, Enterococcus H, and Bariatricus—had lower abundances in the SA group. Several of these genera showed positive correlations with SMI, grip strength, and gait speed. Conversely, no differences in GM characteristics were seen among females. Conclusions: GM composition was associated with SA among older Japanese men. These sex-specific differences emerged consistently, highlighting the potential of microbiota-based strategies for SA prevention in older males. Full article
(This article belongs to the Section Geriatric Nutrition)
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18 pages, 2124 KiB  
Article
Structural Characterization and Efficacy in Alleviating Lung Inflammation of Sialylated Glycopeptides from Edible Bird’s Nest
by Qiushi Li, Chenxi Zhang, Guandong Fang, Shuang Qiu, Man Yuan, Nan Qian, Dongliang Wang and Xiangrong Cheng
Nutrients 2025, 17(10), 1745; https://doi.org/10.3390/nu17101745 - 21 May 2025
Viewed by 92
Abstract
Objectives: This study aimed to characterize the basic structure of sialylated glycopeptide (SCP) from edible bird’s nest, and to explore the intervention effect and mechanism of SCP based on a mouse lung inflammation model induced by lipopolysaccharide (LPS). Methods: C57BL/6 mice were randomly [...] Read more.
Objectives: This study aimed to characterize the basic structure of sialylated glycopeptide (SCP) from edible bird’s nest, and to explore the intervention effect and mechanism of SCP based on a mouse lung inflammation model induced by lipopolysaccharide (LPS). Methods: C57BL/6 mice were randomly divided into the control group (CON), model group (LPS), EBN group, SCP group, and SA group. Results: The results showed that SCP had the typical structures of polypeptides and carbohydrates. SCP effectively intervened in the lung inflammation response. The number of neutrophils (Neu) in BALF decreased by 41.3%, the level of tumor necrosis factor-α (TNF-α) decreased by 36.4%, and the W/D ratio of lung tissues decreased by 27.2%, effectively preventing pathological changes in lung tissues. A total of 40 differential metabolites such as choline, linolenic acid, and xanthine were screened between the SCP group and the LPS group. These differential metabolites were mainly enriched in the metabolic pathways of glycerophospholipids, alpha-linolenic acid, and purines. Conclusions: The research results support that SCP, as the active substance of edible bird’s nest, can effectively improve lung inflammation, providing theoretical guidance for the development of functional edible bird’s nest products. Full article
(This article belongs to the Special Issue Food Functional Factors and Nutritional Health)
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23 pages, 342 KiB  
Review
Advancements in the Diagnosis and Treatment of Eating Disorders in Children and Adolescents: Challenges, Progress, and Future Directions
by Omer Horovitz
Nutrients 2025, 17(10), 1744; https://doi.org/10.3390/nu17101744 - 21 May 2025
Viewed by 115
Abstract
Eating disorders (EDs) in children and adolescents pose significant diagnostic and therapeutic challenges due to their early onset, developmental complexity, and frequent psychiatric comorbidities. This narrative review identifies key clinical and systemic challenges, including difficulties in early detection, overlapping symptomatology, limited pharmacological options, [...] Read more.
Eating disorders (EDs) in children and adolescents pose significant diagnostic and therapeutic challenges due to their early onset, developmental complexity, and frequent psychiatric comorbidities. This narrative review identifies key clinical and systemic challenges, including difficulties in early detection, overlapping symptomatology, limited pharmacological options, and unequal access to specialized care. Recent progress includes revisions in diagnostic criteria (e.g., DSM-5 and ICD-11), advancements in psychometric assessment tools tailored for pediatric populations, and increasing evidence supporting psychotherapeutic interventions such as cognitive behavioral therapy, family-based therapy, and digital health approaches. Future directions involve long-term outcome studies on treatment efficacy, developing culturally sensitive and personalized care models, and implementing integrated multidisciplinary treatment frameworks. By synthesizing empirical literature from 2018 to 2024, this review underscores the urgent need for developmentally informed, evidence-based strategies to enhance the early detection, treatment, and recovery outcomes for young individuals affected by EDs. Full article
(This article belongs to the Special Issue Advances in Eating Disorders in Children and Adolescents)
18 pages, 693 KiB  
Review
The Role of the Mediterranean Diet in the Prevention of Sarcopenia and Frailty in Older Adults: A Narrative Review
by Marta Arroyo-Huidobro, Magali Amat, Aina Capdevila-Reniu, Ariana Chavez, Martina Pellicé, Andrea Ladino, Constanza Sepúlveda and Emilio Sacanella
Nutrients 2025, 17(10), 1743; https://doi.org/10.3390/nu17101743 - 21 May 2025
Viewed by 176
Abstract
Background/Objectives: Sarcopenia and frailty are interrelated conditions and have a high incidence in older adults. They contribute to increased morbidity and mortality and poor quality of life. There is emerging evidence that healthy diets such as the Mediterranean diet could delay the [...] Read more.
Background/Objectives: Sarcopenia and frailty are interrelated conditions and have a high incidence in older adults. They contribute to increased morbidity and mortality and poor quality of life. There is emerging evidence that healthy diets such as the Mediterranean diet could delay the onset of sarcopenia and frailty. This review aims to evaluate the role of the MD in preventing these conditions. Methods: A literature search was conducted on PubMed (MEDLINE, NCBI) for English-language articles published within the last 10 years (2014–2024) using the search terms “Mediterranean diet”, “frailty”, “sarcopenia”, and “old people”. A total of 111 articles were identified, of which 36 were excluded during the initial screening. Subsequently, 75 manuscripts were assessed for eligibility. Subsequently, a further 62 articles were excluded (narrative reviews, articles not focused on the elderly population, or articles with different outcomes). Finally, 13 articles were included in the review. Results: The 13 selected studies comprised seven observational studies, three systematic reviews and meta-analyses, and three clinical trials. The findings suggest that adherence to the Mediterranean diet (MD), particularly when combined with physical activity, may improve body composition and cardiometabolic health and reduce indicators of sarcopenia in obese older adults. Furthermore, MD-based nutritional interventions were associated with improved physical functions such as balance, gait, fall risk, flexibility, and muscle strength (p < 0.05, all). The MD also demonstrated a preventive effect against frailty, particularly in pre-frail individuals. Conclusions: High adherence to the Mediterranean diet (MD) may delay the onset of sarcopenia and improve muscle function in older adults. However, the available scientific evidence is of low to moderate quality. Well-designed prospective intervention studies are needed to confirm whether the MD can modify the natural history of sarcopenia and/or frailty in older adults. Full article
(This article belongs to the Special Issue Nutritional Status of the Older People)
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18 pages, 1347 KiB  
Article
Association Between Dietary Betaine Intake and Dyslipidemia in Chinese Children and Adolescents: A Cross-Sectional Study
by Peiliang Chen, Zhitong Xu, Chengping Li, Lianlong Yu, Qianrang Zhu, Zhihao Li, Tao Liu, Dan Liu and Chen Mao
Nutrients 2025, 17(10), 1742; https://doi.org/10.3390/nu17101742 - 21 May 2025
Viewed by 84
Abstract
Background: Evidence remains limited on the effects of dietary betaine intake and dyslipidemia. We aim to investigate the association between dietary betaine intake and dyslipidemia in Chinese children and adolescents and illustrate the differences in these associations stratified by different food sources. Methods: [...] Read more.
Background: Evidence remains limited on the effects of dietary betaine intake and dyslipidemia. We aim to investigate the association between dietary betaine intake and dyslipidemia in Chinese children and adolescents and illustrate the differences in these associations stratified by different food sources. Methods: Based on a national cross-sectional study from the China National Nutrition and Health Surveillance of Children and Lactating Mothers, 11,452 individuals aged 6–17 years were enrolled between October 2016 and December 2018. Participants were divided into quartiles according to residual energy-adjusted dietary betaine intake. The associations of dietary betaine with dyslipidemia and lipid profiles were estimated using restricted cubic spline regression and logistic regression analysis. Results: Among the 11,452 participants, 2577 (22.5%) individuals were found to have dyslipidemia. The median (IQR) intake of dietary betaine was 56.35 (25.77, 207.66) mg/day. Negative dose-dependent associations were found between residual energy-adjusted dietary betaine intake and dyslipidemia. Compared with participants in the lowest quartile (Q1) of residual energy-adjusted betaine intake, participants in the fourth quartile (Q4) had lower odds of high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), high non-high-density lipoprotein cholesterol (non-HDL-C), high remnant cholesterol (RC), and dyslipidemia, with odds ratios (OR) and 95% confidence intervals (95% CI) of 0.56 (0.45, 0.70), 0.65 (0.48, 0.87), 0.53 (0.41, 0.68), 0.42 (0.28, 0.61), and 0.79 (0.69, 0.91), respectively. Furthermore, reduced odds of high TC, high LDL-C, high non-HDL-C, high RC, and dyslipidemia were observed in dietary betaine from plant-source foods but not in animal-source foods. Conclusions: High intake of dietary betaine (56.35–207.66 mg/day) was associated with reduced odds of dyslipidemia, including elevated TC, LDL-C, non-HDL-C, and RC, and dietary betaine from plant-source foods revealed significant benefits for dyslipidemia in Chinese children and adolescents. Full article
(This article belongs to the Section Nutritional Epidemiology)
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23 pages, 1843 KiB  
Article
Fish Oil Supplementation Attenuates Offspring’s Neurodevelopmental Changes Induced by a Maternal High-Fat Diet in a Rat Model
by Yasna Muñoz, Heidy Kaune, Alexies Dagnino-Subiabre, Gonzalo Cruz, Jorge Toledo, Rodrigo Valenzuela, Renato Moraga, Luis Tabilo, Cristian Flores, Alfredo Muñoz, Nicolás Crisosto, Juan F. Montiel and Manuel Maliqueo
Nutrients 2025, 17(10), 1741; https://doi.org/10.3390/nu17101741 - 21 May 2025
Viewed by 105
Abstract
Background/Objectives: A maternal high-fat diet (HFD) impairs brain structure in offspring. In turn, fish oil (FO) rich in n-3 polyunsaturated fatty acids (PUFAs) has neuroprotective effects. Therefore, we investigated whether maternal HFD exposure affected the neurological reflexes, neuron morphology, and n-3 [...] Read more.
Background/Objectives: A maternal high-fat diet (HFD) impairs brain structure in offspring. In turn, fish oil (FO) rich in n-3 polyunsaturated fatty acids (PUFAs) has neuroprotective effects. Therefore, we investigated whether maternal HFD exposure affected the neurological reflexes, neuron morphology, and n-3 PUFA levels in the cerebral cortex of the offspring and whether these effects were mitigated by maternal FO consumption. Methods: Female Sprague Dawley rats received a control diet (CD, 10% Kcal fat) or HFD (45% Kcal fat) five weeks before mating and throughout pregnancy and lactation. From mating, a subgroup of HFD was supplemented with 11.4% FO into the diet (HFD-FO). Neurological reflexes were evaluated from postnatal day (PND) 3 until PND20. Brains were removed at PND22 for neuron morphology analysis. Moreover, fatty acid composition and transcripts of genes encoding for factors associated with synapse transmission (SNAP-25), plasticity (BDNF), transport of DHA (MFSD2a), and inflammation (NF-κB and IL-1β) were quantified in prefrontal, motor, and auditory cortices. Results: FO diminished the effects of HFD on the number of thin and mushroom-shaped dendritic spines in the cerebral cortex in both sexes. It also reversed the HFD effects on the motor and auditory reflexes in female and male offspring, respectively. In males, FO up-regulated Bdnf transcript levels in the motor cortex compared with CD and HFD. In females, n-3 PUFAs were higher in HFD and HFD-FO than in CD in the auditory cortex. Conclusions: Our results highlight the protective role of maternal dietary n-3 PUFAs in counteracting the effects induced by HFD on the acquisition of neurological reflexes and neuronal morphology in the cerebral cortex of the offspring of both sexes. Full article
(This article belongs to the Special Issue Dietary Fatty Acids and Metabolic Health)
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17 pages, 789 KiB  
Article
Daily Sugar-Sweetened Beverage Intake and Its Association with Undiagnosed Non-Communicable Diseases Among Malaysian Adults: Findings from a Nationally Representative Cross-Sectional Study
by Shi-Hui Cheng, Sumarni Mohd-Ghazali, Chee-Cheong Kee and Lay-Kim Tan
Nutrients 2025, 17(10), 1740; https://doi.org/10.3390/nu17101740 - 20 May 2025
Viewed by 136
Abstract
Background/objective: We examined the prevalence of daily sugar-sweetened beverage (SSB) intake, identifying its sociodemographic determinants and exploring its potential association with undiagnosed non-communicable diseases (NCDs) among Malaysian adults. Methods: This cross-sectional study analyzed data from 6596 Malaysian adults participating in the 2019 National [...] Read more.
Background/objective: We examined the prevalence of daily sugar-sweetened beverage (SSB) intake, identifying its sociodemographic determinants and exploring its potential association with undiagnosed non-communicable diseases (NCDs) among Malaysian adults. Methods: This cross-sectional study analyzed data from 6596 Malaysian adults participating in the 2019 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to examine the association between daily SSB intake and the risk of undiagnosed diabetes, hypertension, hypercholesterolemia, and obesity while adjusting for potential confounders. Results: The prevalence of daily SSB intake was 53.6%, with higher intake observed among females, older adults, Indians, and unemployed individuals. After adjusting for confounders, daily SSB intake was not significantly associated with undiagnosed diabetes (adjusted OR: 1.01, 95% CI: 0.80–1.29), undiagnosed hypertension (adjusted OR: 0.99, 95% CI: 0.81–1.22), undiagnosed hypercholesterolemia (adjusted OR: 0.99, 95% CI: 0.83–1.18), or obesity (adjusted OR: 1.08, 95% CI: 0.91–1.27). Conclusions: This study highlights the high prevalence of daily SSB intake among Malaysian adults, driven by sociodemographic factors. While a lack of direct associations with undiagnosed NCDs was observed, the high prevalence of SSB intake raises concerns about long-term health impacts. Targeted public health interventions are essential to address the cultural and economic determinants of SSB intake, as well as future research adopting longitudinal designs to explore how sustained reductions in SSB intake influence the risk of developing NCDs. Full article
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17 pages, 1274 KiB  
Article
Low-Calorie, High-Protein Ketogenic Diet Versus Low-Calorie, Low-Sodium, and High-Potassium Mediterranean Diet in Overweight Patients and Patients with Obesity with High-Normal Blood Pressure or Grade I Hypertension: The Keto–Salt Pilot Study
by Matteo Landolfo, Lucia Stella, Alessandro Gezzi, Francesco Spannella, Paolo Turri, Lucia Sabbatini, Sofia Cecchi, Beatrice Lucchetti, Massimiliano Petrelli and Riccardo Sarzani
Nutrients 2025, 17(10), 1739; https://doi.org/10.3390/nu17101739 - 20 May 2025
Viewed by 323
Abstract
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 [...] Read more.
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
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20 pages, 1641 KiB  
Article
The Protective Effects of Pectic Polysaccharides on Dextran Sulfate Sodium-Induced Colitis in Drosophila melanogaster and Their Structure–Function Relationships
by Zhenou Sun, Tianyu Qi, Boyu Cheng, Yingxiao Guo, Dima Atehli, Steve W. Cui, Ji Kang and Qingbin Guo
Nutrients 2025, 17(10), 1738; https://doi.org/10.3390/nu17101738 - 20 May 2025
Viewed by 181
Abstract
Background: Pectic polysaccharides exhibit therapeutic potential against intestinal inflammation. However, the influence of structural variations on their efficacy remains largely unexplored. Methods: This study investigated the structural and anti-inflammatory relationships of okra pectin (OP), citrus pectin (CP), apple pectin (AP), and hawthorn pectin [...] Read more.
Background: Pectic polysaccharides exhibit therapeutic potential against intestinal inflammation. However, the influence of structural variations on their efficacy remains largely unexplored. Methods: This study investigated the structural and anti-inflammatory relationships of okra pectin (OP), citrus pectin (CP), apple pectin (AP), and hawthorn pectin (HP). Based on FT-IR spectra, CP was identified as a high-methoxyl pectin, with a degree of methyl esterification (DM) of 72.07 ± 3.86%. OP, AP, and HP were low-methoxyl pectins with the following DM values: 19.34 ± 3.04%, 32.11 ± 1.71%, and 38.67 ± 2.75%, respectively. Results: Monosaccharide composition analysis revealed that OP exhibited the highest abundance of RG-I regions among all the samples. Homogalacturonan (HG) was the predominant structural region in AP and HP, while CP contained both of the aforementioned structural regions. Our findings demonstrated that OP and CP significantly ameliorated dextran sulfate sodium (DSS)-induced colitis in the wild-type Drosophila melanogaster strain w1118, as evidenced by improved intestinal morphology, reinforced intestinal barrier function, and enhanced locomotor and metabolic activity. These effects were mediated by the inhibition of JAK/STAT signaling and the activation of the Nrf2/Keap1 pathway. Notably, reducing the molecular weight of CP to 18.18 kDa significantly enhanced its therapeutic efficacy, whereas a reduction in OP molecular weight to 119.12 kDa extended its median lifespan. Conclusions: These findings first suggest that abundant RG-I structures and low molecular weight endowed pectins with significant anti-inflammatory activity. Full article
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21 pages, 537 KiB  
Review
Managing Food Allergies in Dining Establishments: Challenges and Innovative Solutions
by George N. Konstantinou, Ourania Pampoukidou, Daniel Sergelidis and Maria Fotoulaki
Nutrients 2025, 17(10), 1737; https://doi.org/10.3390/nu17101737 - 20 May 2025
Viewed by 265
Abstract
Background: Food allergies represent a growing public health concern, with accidental exposures in dining establishments posing significant risks. Although various guidelines and interventions have been proposed, practical implementation remains challenging. Objectives: This narrative review aims to synthesize current evidence on major hazards in [...] Read more.
Background: Food allergies represent a growing public health concern, with accidental exposures in dining establishments posing significant risks. Although various guidelines and interventions have been proposed, practical implementation remains challenging. Objectives: This narrative review aims to synthesize current evidence on major hazards in allergen management within dining settings and to evaluate emerging solutions designed to protect allergic consumers. Methods: A comprehensive literature search of peer-reviewed articles, surveillance reports, guidelines, and policy documents published in April 2025 was undertaken in PubMed, Scopus, and Web of Science. Studies were selected based on relevance to allergen management in dining establishments. An inductive thematic synthesis was performed, and a basic quality appraisal was conducted to prioritize stronger evidence. Results: Three major hazard themes—hidden allergens, cross-contamination during food preparation, and poor communication between staff and allergic consumers—were identified from the reviewed literature. Emerging interventions included enhanced staff training, improved allergen labeling practices, and the application of digital technologies such as smartphone apps and rapid allergen detection devices. However, inconsistencies in implementation and a lack of systematic validation limit the effectiveness of these approaches. Conclusions: Mitigating food allergy risk in dining establishments requires an integrated approach that combines strict kitchen controls with continuous staff education, transparent labeling, clear communication, and supportive policies. While promising interventions exist, more research is required to validate their effectiveness and to encourage standardized, widespread implementation to ensure the safety of individuals with food allergies. Full article
(This article belongs to the Special Issue Nutrients: 15th Anniversary)
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20 pages, 725 KiB  
Review
CONUT Score as a Predictor of Mortality Risk in Acute and Chronic Heart Failure: A Meta-Analytic Review
by Diana Andreea Fărcaș, Anda Cerghizan, Raluca Maior, Andreea-Cornelia Mîndrilă and Monica Tarcea
Nutrients 2025, 17(10), 1736; https://doi.org/10.3390/nu17101736 - 20 May 2025
Viewed by 679
Abstract
Heart failure (HF) is a major global health burden and a leading cause of morbidity and mortality. Nutritional status has emerged as an essential factor influencing outcomes in HF, with the Controlling Nutritional Status (CONUT) score gaining attention as a simple, objective marker [...] Read more.
Heart failure (HF) is a major global health burden and a leading cause of morbidity and mortality. Nutritional status has emerged as an essential factor influencing outcomes in HF, with the Controlling Nutritional Status (CONUT) score gaining attention as a simple, objective marker derived from serum albumin, total cholesterol, and lymphocyte count. This meta-analysis evaluated the prognostic value of the CONUT score in predicting all-cause mortality in patients with acute and chronic heart failure. A systematic search was conducted in the PubMed, MEDLINE, Google Scholar, and Cochrane Library databases for the past ten years, using combinations of keywords such as “heart failure”, “CONUT score”, “malnutrition”, and “mortality”. Studies were included if they reported hazard ratios (HRs) for all-cause mortality in relation to CONUT score categories in adult HF populations. Eight eligible studies comprising 15,761 patients were included. Pooled analysis showed that higher CONUT scores were significantly associated with increased all-cause mortality (pooled HR = 1.47; 95% CI: 1.30–1.66). Despite substantial heterogeneity (I2 = 80%), the direction of effect was consistent across studies. The CONUT score is a useful prognostic marker in acute and chronic heart failure patients. Further research should explore the effects of targeted nutritional interventions in high-risk HF patients identified by elevated CONUT scores and efforts to standardize malnutrition cut-offs in clinical practice. Full article
(This article belongs to the Special Issue Nutritional Aspects of Cardiovascular Disease Risk Factors)
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14 pages, 249 KiB  
Article
Development and Preliminary Validation of the PC-FCQ: The Parent and Carer Food Choice Questionnaire
by Alex McKenna, Rachael L. Thurecht, Libby Swanepoel, Georgia Blair and Fiona E. Pelly
Nutrients 2025, 17(10), 1735; https://doi.org/10.3390/nu17101735 - 20 May 2025
Viewed by 170
Abstract
Background: Poor nutrition in childhood can have irreversible impacts on development and health, potentially resulting in cognitive impairments and an increased risk of chronic disease later in life. Aim: This study aimed to develop and validate the Parent Carer-Food Choice Questionnaire [...] Read more.
Background: Poor nutrition in childhood can have irreversible impacts on development and health, potentially resulting in cognitive impairments and an increased risk of chronic disease later in life. Aim: This study aimed to develop and validate the Parent Carer-Food Choice Questionnaire (PC-FCQ) to determine the key factors influencing the parental food choices of children aged between two and five years. Methods: A sample of 737 Australian parents and carers completed the questionnaire consisting of 98 items on a 10-point frequency of influence anchored at 1 never to 10 always. Principal component analysis (PCA) was employed to identify the key factors and refine the questionnaire. Results: The PCA extracted 65 items organized into 12 factors explaining 62.8% of the total variance. The factors were named ethical concerns, nutritional attributes, child preferences, child mood, awareness, parent sensory, convenience, situation, culture, professional advice, accessibility and weight control. The final Kaiser–Meyer–Olkin measure was 0.93, and the Bartlett test of sphericity was statistically significant X2(4753) = 39,643.87, p < 0.001. Moderate intercorrelations were detected between seven factors. Conclusions: This research resulted in a PC-FCQ that includes factors specifically relevant to parental food choice. The PC-FCQ will enable researchers and clinicians to more effectively provide nutrition education and dietary interventions to suit the parent and child. The next phase of this research will be to test the accuracy and reliability of the PC-FCQ in an independent sample via confirmatory factor analysis. Full article
(This article belongs to the Section Nutrition Methodology & Assessment)
20 pages, 3688 KiB  
Article
Rutin–Whey Protein Nanoparticles Inhibit D-Galactose-Induced Skeletal Muscle Dysfunction by Modulating Gut Microbiota and Metabolic Pathways
by Yijing Ren, Lianyan Wang, Danyang Wang, Jian Huang, Ou Wang and Gangqiang Ding
Nutrients 2025, 17(10), 1734; https://doi.org/10.3390/nu17101734 - 20 May 2025
Viewed by 191
Abstract
Background: Rutin (R) is a bioactive compound with antioxidant and anti-inflammatory properties, but its low bioavailability limits its application. To address this problem, R was encapsulated with whey protein (W) as nanoparticles, and the potential effect and mechanism of rutin–whey protein nanoparticles [...] Read more.
Background: Rutin (R) is a bioactive compound with antioxidant and anti-inflammatory properties, but its low bioavailability limits its application. To address this problem, R was encapsulated with whey protein (W) as nanoparticles, and the potential effect and mechanism of rutin–whey protein nanoparticles (RW) on skeletal muscle dysfunction was investigated in D-galactose induced mice. Methods: R was encapsulated with W to form RW, and its characteristics like particle size, encapsulation efficiency, and bioaccessibility were evaluated. In the in vivo study, male C57BL/6J mice were treated with R, W or RW, respectively. The muscle function, hepatic antioxidant capacity, serum inflammatory levels, gut microbiota, and metabolomic profiles of mice were evaluated. Results: RW showed a uniform particle size, with an encapsulation efficiency of 68.7%. In the RW, the bioaccessibility of rutin was approximately 3.3 times that of free rutin. This in vivo study indicated that in comparison with D-galactose induced mice (model group), R, W and RW treatments could enhance hepatic antioxidative capacity and regulate inflammation levels, while W and RW could also increase muscle strength. Among these, RW treatment significantly elevated the hepatic GSH-PX activity and decreased the serum MSTN, TNF-α, and IL-6 levels, which were all markedly better than those of the individual effect of R or W. Such effects of R, W, and RW may be achieved through the modulation of gut microbiota that produced short-chain fatty acids or involved in anti-inflammatory function and the regulation of metabolic profiles associated with amino acid metabolism, aminoacyl-tRNA biosynthesis, etc. Conclusions: RW was found to enhance the bioaccessibility of rutin, and exhibited positive effects on skeletal muscle dysfunction via the modulation of gut microbiota and metabolic pathways. The results of this study may provide new scientific strategy for the utilization of rutin to achieve its health benefits. Full article
(This article belongs to the Section Nutrition and Metabolism)
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21 pages, 553 KiB  
Review
Sweet Drinks, Sour Consequences: The Impact of Sugar-Sweetened Beverages on Sperm Health, a Narrative Review
by Winnie Khine Yi Win, Maverick Wenhao Wong, Paula Benny and Zhongwei Huang
Nutrients 2025, 17(10), 1733; https://doi.org/10.3390/nu17101733 - 20 May 2025
Viewed by 342
Abstract
Introduction: The rising global consumption of sugar-sweetened beverages (SSBs) has paralleled a concerning decline in sperm quality, raising concern about potential dietary impacts on male fertility. Sperm health parameters, including count, motility, and morphology, are critical indicators of reproductive potential and may be [...] Read more.
Introduction: The rising global consumption of sugar-sweetened beverages (SSBs) has paralleled a concerning decline in sperm quality, raising concern about potential dietary impacts on male fertility. Sperm health parameters, including count, motility, and morphology, are critical indicators of reproductive potential and may be adversely affected by excessive sugar intake. This narrative review consolidates the current evidence on the association between SSB consumption and sperm health, highlighting potential biological mechanisms. Methods: A targeted literature search across PubMed, Scopus, and Google Scholar was conducted, utilising keywords “sugar-sweetened beverages”, “sperm health”, and related terms. A total of 11 eligible observational and cohort studies were selected. Studies focusing solely on animal models or unrelated dietary factors were excluded. Results: The primary research consistently reports a negative association between high SSB consumption and sperm parameters, including reduced count and motility, and increased DNA fragmentation. Potential mechanisms include oxidative stress, hormonal dysregulation, and metabolic dysfunction linked to obesity and insulin resistance. However, variability in study design, exposure assessment, and population demographics limits generalisability of the results. Conclusions: The current evidence suggests that regular SSB consumption adversely affects male reproductive health through oxidative damage and hormonal imbalances. These findings underscore the importance of public health strategies to reduce SSB intake, especially among young men of reproductive age. Further longitudinal studies with standardised methodologies, particularly in underrepresented populations such as Asian cohorts, are necessary to establish causal relationships and guide clinical recommendations. Full article
(This article belongs to the Special Issue Impact of Diet, Nutrition and Lifestyle on Reproductive Health)
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11 pages, 817 KiB  
Article
The Role of High-Sensitivity C-Reactive Protein in Activities of Daily Living Among Middle-Aged and Older Adults: A Prospective Cohort Study
by Shu-Min Lai, Ling Kuang, Xu-Lian Tang, Cheng-Shen Qiu, Hong-Xuan Huang, Dan-Qing Liao, Hong-Min Li, Li-Ying Du, Zhi-Yuan Xiong, Bing-Yun Zhang, Hao-Jie Chen and Zhi-Hao Li
Nutrients 2025, 17(10), 1732; https://doi.org/10.3390/nu17101732 - 20 May 2025
Viewed by 148
Abstract
Background: The association between high-sensitivity C-reactive protein (hsCRP) and activities of daily living (ADL) disability remains unclear. Our study aimed to comprehensively explore the relationship between hsCRP concentrations and the risk of ADL disability, while also identifying potential modifiers of this association [...] Read more.
Background: The association between high-sensitivity C-reactive protein (hsCRP) and activities of daily living (ADL) disability remains unclear. Our study aimed to comprehensively explore the relationship between hsCRP concentrations and the risk of ADL disability, while also identifying potential modifiers of this association in middle-aged and older adults. Methods: We conducted a prospective study involving 16,342 participants aged 50 years and older (mean age: 64 ± 10 years) from the Health and Retirement Study. To investigate the longitudinal association between hsCRP and the risk of ADL disability, we employed Cox proportional hazard regression models, adjusting for a wide range of potential confounders. Subgroups analyses were further conducted to examine interactions across factors such as gender, age, body mass index, smoking status, and drinking status. Results: This study involved a follow-up of 125,858 person-years (median of 8 years; interquartile range: 4–12 years), revealing a total of 4579 incidents of ADL disability. The highest hsCRP concentration was significantly associated with ADL disability after adjustment for covariates (hazard ratio [HR] = 1.25; confidence interval [CI] = 1.14–1.36). The associations between hsCRP and the risk of ADL disability seemed to be somewhat stronger among individuals aged < 65 years and with a BMI ≥ 30 kg/m2 (both p for interaction < 0.05). Conclusions: Our findings indicated that elevated hsCRP concentrations are associated with an increased risk of ADL disability in middle-aged and older adults. HsCRP appears to serve as a biomarker for ADL disability, particularly among individuals with obesity and middle-aged adults. Full article
(This article belongs to the Section Geriatric Nutrition)
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19 pages, 3189 KiB  
Article
Ultra-Processed Foods in the Food Supply: Prevalence, Nutritional Composition and Use of Voluntary Labelling Schemes
by Edvina Hafner, Maša Hribar and Igor Pravst
Nutrients 2025, 17(10), 1731; https://doi.org/10.3390/nu17101731 - 20 May 2025
Viewed by 262
Abstract
Background: Ultra-processed foods (UPFs) represent a substantial part of modern diets, with a growing prevalence in food environments worldwide. Their unfavourable nutritional composition and adverse health effects present growing public health concerns. Methods: This study examines the prevalence of UPFs in the Slovenian [...] Read more.
Background: Ultra-processed foods (UPFs) represent a substantial part of modern diets, with a growing prevalence in food environments worldwide. Their unfavourable nutritional composition and adverse health effects present growing public health concerns. Methods: This study examines the prevalence of UPFs in the Slovenian food supply, their nutritional quality and the use of different food symbols and labelling schemes on food packaging. A cross-sectional analysis was conducted using the representative Slovenian branded foods database. A total of 23,173 prepacked foods and beverages were categorised into levels of processing according to the NOVA classification system. The nutritional composition of UPFs was compared to less processed products within 16 narrow subcategories. Additionally, the prevalence in the use of front-of-package nutrition labelling (FOPNL) and subjectively nutrition-related elements (SNREs) (such as EU Organic, Vegan labels etc.) were assessed across different food categories and processing levels. Results: Results show that UPFs represent 54.5% of the available products in the Slovenian food supply, with the highest prevalence in Confectionery (93%), Bread and bakery products (83%), Meat, meat products and alternatives (77%) and Convenience foods (74%). Comparison of nutritional composition indicated that UPFs had significantly poorer nutritional composition compared to less processed counterparts, including higher levels of sugar, salt and saturated fats, and a lower protein content. Breakfast cereals, Snack foods, Meat alternatives and Pre-prepared salads and sandwiches showed the most significant differences between UPFs and less processed counterparts. Analysis of the prevalence of symbols and labelling schemes revealed that 33.8% of products carried at least one FOPNL (15.0%) or SNRE (19.1%), with SNREs being more prevalent on less processed products and FOPNL predominantly used on UPFs (p < 0.05). The most prevalent SNRE was the EU Organic logo (12.7%), followed by the Vegan (4.7%) and Non-GMO (3.1%) logos, whereas the most frequent FOPNL was Reference Intakes (RI), presenting only energy value RI-Energy (12.5%), followed by nutrient-specific RI (1.6%), while other FOPNL were scarce and limited to certain categories. An additional comparison of visual presentation highlighted the potentially selective use of voluntary FOPNL to improve product framing. This raises concerns about their role in guiding consumer choices versus serving as marketing tools, especially when it comes to UPFs. Conclusions: Our findings highlight the need for monitoring UPFs in the food supply together with harmonised, mandatory labelling regulations to ensure transparency and empower consumers to make healthier choices. Full article
(This article belongs to the Special Issue Ultra-Processed Foods, Dietary Quality and Human Health)
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24 pages, 624 KiB  
Review
The Maternal and Fetal Consequences of Metabolic Dysfunction-Associated Fatty Liver Disease and Gestational Diabetes Mellitus
by Thora Y. Chai, Jacob George, Dharmintra Pasupathy, Ngai Wah Cheung and Victoria L. Rudland
Nutrients 2025, 17(10), 1730; https://doi.org/10.3390/nu17101730 - 20 May 2025
Viewed by 210
Abstract
Both metabolic dysfunction-associated fatty liver disease (MAFLD) and gestational diabetes mellitus (GDM) during pregnancy are emerging as an adverse synergistic relationship of growing concern. This narrative review focuses on the maternal and fetal consequences associated with women who have MAFLD and/or GDM during [...] Read more.
Both metabolic dysfunction-associated fatty liver disease (MAFLD) and gestational diabetes mellitus (GDM) during pregnancy are emerging as an adverse synergistic relationship of growing concern. This narrative review focuses on the maternal and fetal consequences associated with women who have MAFLD and/or GDM during pregnancy, including an exploration of long-term cardiometabolic risks for postpartum maternal and childhood health. We conclude that implementation of a life course approach to management of these high-risk women remains paramount. Full article
(This article belongs to the Special Issue Maternal Gestational Diabetes and Its Impact on Fetal Health)
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16 pages, 3614 KiB  
Article
Weizmannia Coagulans BC99 Prevents Loperamide-Induced Functional Constipation in Mice Through Increased Intestinal Peristalsis and Modulation of Gut Microbiota Dysbiosis
by Cheng Li, Ying Wu, Hua Liang, Yao Dong, Shuguang Fang, Pan-Young Jeong, Hye-Rim Kim and Shaobin Gu
Nutrients 2025, 17(10), 1729; https://doi.org/10.3390/nu17101729 - 20 May 2025
Viewed by 157
Abstract
Objectives: Constipation is one of the most prevalent gastrointestinal disorders worldwide. Recent studies have demonstrated that probiotics may alleviate constipation by restoring gut microbiota balance. Methods: This study investigated the effects of Weizmannia coagulans BC99 (formerly Bacillus coagulans BC99) on gut microbiota and [...] Read more.
Objectives: Constipation is one of the most prevalent gastrointestinal disorders worldwide. Recent studies have demonstrated that probiotics may alleviate constipation by restoring gut microbiota balance. Methods: This study investigated the effects of Weizmannia coagulans BC99 (formerly Bacillus coagulans BC99) on gut microbiota and intestinal function in a loperamide-induced mouse model of functional constipation. BALB/c mice were randomly divided into six groups: control, model, phenolphthalein, BC99-L (2 × 107 CFU/day), BC99-M (2 × 108 CFU/day), and BC99-H (2 × 109 CFU/day). After 14 days of supplementation, constipation was induced in mice via loperamide administration. Results: BC99 significantly increased fecal water content, gastrointestinal transit rate, microbial metabolic activity, and butyric acid production, while decreasing the abundance of inflammation-related metabolic pathways. Moreover, BC99 improved levels of gastrointestinal regulatory peptides, including motilin and somatostatin. The Firmicutes-to-Bacteroidetes ratio was elevated in the BC99-M and the BC99-H group compared to the model group, indicating that BC99 effectively modulated gut microbiota composition and host biosynthetic pathways. Conclusions:  Weizmannia coagulans BC99 alleviated and prevented loperamide-induced functional constipation in mice by enhancing intestinal peristalsis and restoring gut microbial homeostasis. Full article
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3 pages, 150 KiB  
Correction
Correction: Shu et al. Relationship between Circulating 25-Hydroxyvitamin D and Metabolic Syndrome in Chinese Adults: A Large Nationwide Longitudinal Study. Nutrients 2024, 16, 1480
by Mi Shu, Yue Xi, Jie Wu, Lai-Bao Zhuo, Yan Yan, Yi-Duo Yang, Yue-Yue Feng, Hua-Qiao Tan, Hui-Fang Yang and Yu-Ming Chen
Nutrients 2025, 17(10), 1728; https://doi.org/10.3390/nu17101728 - 20 May 2025
Viewed by 111
Abstract
The following two errors were identified in the main text [1]: In the Results section (3 [...] Full article
5 pages, 191 KiB  
Editorial
Diet and Muscle Metabolism
by Domenico Azzolino, Vincenzo Gianturco and Riccardo Calvani
Nutrients 2025, 17(10), 1727; https://doi.org/10.3390/nu17101727 - 20 May 2025
Viewed by 369
Abstract
Advancing age is associated with a progressive loss of muscle mass and strength/function, termed sarcopenia, which leads to a wide spectrum of adverse outcomes including falls, institutionalization, loss of independence, and mortality [...] Full article
(This article belongs to the Special Issue Diet and Muscle Metabolism)
19 pages, 693 KiB  
Article
Evaluating Prevalence of Preterm Postnatal Growth Faltering Using Fenton 2013 and INTERGROWTH-21st Growth Charts with Logistic and Machine Learning Models
by Ioanna Kakatsaki, Nicolina Hilda Anagnostatou, Theano Roumeliotaki, Eleftherios Panteris, Theodoros Liapikos, Styliani Papanikolaou and Eleftheria Hatzidaki
Nutrients 2025, 17(10), 1726; https://doi.org/10.3390/nu17101726 - 20 May 2025
Viewed by 225
Abstract
Background/Objectives: Postnatal growth faltering (PGF) significantly affects premature neonates, leading to compromised neurodevelopment and an increased risk of long-term health complications. Methods: This retrospective study at a level III NICU of a tertiary hospital analyzed 650 preterm neonates born before 33 weeks. Postnatal [...] Read more.
Background/Objectives: Postnatal growth faltering (PGF) significantly affects premature neonates, leading to compromised neurodevelopment and an increased risk of long-term health complications. Methods: This retrospective study at a level III NICU of a tertiary hospital analyzed 650 preterm neonates born before 33 weeks. Postnatal growth was evaluated using the Fenton2013 and INTERGROWTH-21st growth charts, with changes in weight z-scores from birth to discharge classified as normal growth (ΔZ ≥ −1), non-severe PGF (−2 ≤ ΔZ < −1), and severe PGF (ΔZ < −2). Results: Mean gestational and postmenstrual age at discharge was 30 weeks (SD 1.9) and 37.1 weeks (SD 2.7), respectively. Fenton2013 growth curves revealed a higher prevalence of non-severe and severe PGF (43% and 14.6%) compared to INTERGROWTH-21st (24.5% and 10.3%). A more rapid establishment of full enteral feeds was strongly associated with reduced severe PGF prevalence in both growth charts (p < 0.001), as was shorter hospitalization. Late-onset sepsis was associated with an increased risk of severe PGF, while being small for gestational age (SGA) was protective against severe PGF across both growth charts (p < 0.001). A trend of decreasing PGF prevalence was noted over the study years, most probably attributed to the implementation of updated nutritional guidelines. Interestingly, when machine learning classification models were evaluated in our Greek cohort, a notable decline in predictive accuracy depending on the growth standard applied was observed. Conclusions: Our study highlights the need for standardizing PGF definition in an attempt to enhance nutritional management and further investigate the long-term impacts of nutritional interventions on growth, neurodevelopment, and overall health outcomes. Full article
(This article belongs to the Special Issue Nutrition, Diet and Metabolism in Pregnancy)
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4 pages, 175 KiB  
Editorial
The Power of Databases in Unraveling the Nutrition–Health Connection
by Andreu Farran-Codina and Mireia Urpí-Sardà
Nutrients 2025, 17(10), 1725; https://doi.org/10.3390/nu17101725 - 20 May 2025
Viewed by 106
Abstract
Human activities across different sectors produce large volumes of relevant nutritional information [...] Full article
(This article belongs to the Special Issue Databases, Nutrition and Human Health)
17 pages, 825 KiB  
Article
Assessment of the Diet Quality Index and Its Constituents in Preschool Children Diagnosed with a Food Allergy as Part of the “Living with an Allergy” Project
by Malgorzata Kostecka, Julianna Kostecka, Paulina Kawecka and Magdalena Sawic
Nutrients 2025, 17(10), 1724; https://doi.org/10.3390/nu17101724 - 20 May 2025
Viewed by 186
Abstract
Pediatric food allergies (FAs) are health conditions that adversely impact the quality of life of children and their caregivers. Aim: The primary objective of the present study was to assess the quality of the diets administered to allergic children based on the Healthy [...] Read more.
Pediatric food allergies (FAs) are health conditions that adversely impact the quality of life of children and their caregivers. Aim: The primary objective of the present study was to assess the quality of the diets administered to allergic children based on the Healthy Diet Index (HID-10), to determine the influence of parental knowledge about FAs and the elimination diet, and to identify the factors that contribute to healthy food choices. Material and Methods: This study was conducted as part of the “Living with an Allergy” research and educational program for preschool children, which was implemented between June 2021 and June 2023 in the city of Lublin. Results: Food allergies were diagnosed and confirmed in 241 children, including 106 boys (44%). A higher number of unhealthy dietary factors (DQI-1) was significantly associated with gender, and lower DQI values were more often noted in boys (p < 0.05). In turn, a higher number of health-promoting dietary factors (DQI-3) was significantly associated with a younger age in children (OR 1.54; 95%CI 1.17–1.74, p < 0.01) and with an older age in parents (OR 1.43; 95%CI 1.2–1.67, p < 0.05). Conclusions: Children whose diets, including the necessary modifications, were recommended by a physician or a dietitian were characterized by significantly higher DQI values and a higher number of health-promoting dietary factors. The diets of children with FAs should consist mainly of unprocessed foods to control the intake of unhealthy products that suppress immunity. Full article
(This article belongs to the Special Issue Dietary and Nutritional Assessment in Children)
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24 pages, 538 KiB  
Systematic Review
Impact of Mediterranean Diet Adherence During Pregnancy on Preeclampsia, Gestational Diabetes Mellitus, and Excessive Gestational Weight Gain: A Systematic Review of Observational Studies and Randomized Controlled Trials
by Sukshma Sharma, Simona Esposito, Augusto Di Castelnuovo, Alessandro Gialluisi, Paola De Domenico, Giovanni de Gaetano, Marialaura Bonaccio and Licia Iacoviello
Nutrients 2025, 17(10), 1723; https://doi.org/10.3390/nu17101723 - 20 May 2025
Viewed by 256
Abstract
Background/Objectives: There is limited evidence on the association between maternal Mediterranean diet (MD) adherence and risks of preeclampsia, gestational diabetes mellitus (GDM), and excessive gestational weight gain (eGWG), and hence a systematic review of observational studies and randomized controlled trials was conducted. Methods: [...] Read more.
Background/Objectives: There is limited evidence on the association between maternal Mediterranean diet (MD) adherence and risks of preeclampsia, gestational diabetes mellitus (GDM), and excessive gestational weight gain (eGWG), and hence a systematic review of observational studies and randomized controlled trials was conducted. Methods: A total of 30,930 articles from the Scopus, EMBASE, PubMed, MEDLINE, and Google Scholar databases were identified, published between January 2000 and April 2025. The National Institutes of Health Quality Assessment Tool and the Cochrane Risk of Bias Tool 2.0 were used to assess the quality of seven studies (one each were case-control and cross-sectional, three were RCTs, and two were prospective cohort studies). Results: Overall, the studies examined the risks of preeclampsia (four studies), GDM (five studies), and eGWG (three studies). Only one prospective cohort study out of four reported that MD adherence was associated with lower risk of preeclampsia (OR 0.78; 95% CI: 0.64 to 0.96 for highest vs. lowest tertile). MD adherence was associated with decreased risk of GDM in the intervention groups in four studies (two RCTs (OR: 0.75, 95% CI 0.57 to 0.98 and OR: 0.72, 95% CI 0.50 to 0.97) and one each of cross-sectional (OR: 2.32; 95% CI 2.13 to 2.57 for a 1-point decrease in the dietary score) and case-control studies (high Vs. low MD adherence: OR: 0.20, 95% CI 0.50 to 0.70)). MD adherence was associated with decreased risk of eGWG in two studies: one RCT (RR: 0.91, 95% CI 0.86 to 0.96 for a 1-point increment in the MD score) and one cross-sectional study (OR: 1.78; 95% CI 1.51 to 2.02 for a 1-point decrease in the MD score). Conclusions: Findings indicated the protective associations between MD adherence and GDM and eGWG risks but not for preeclampsia. Full article
(This article belongs to the Section Nutrition in Women)
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20 pages, 1085 KiB  
Article
Nutritional and Physical Rehabilitation in Post-Critical Coronavirus Disease 2019 (COVID-19) Ambulatory Patients: The NutriEcoMuscle Study
by Clara Joaquín, Irene Bretón, María Julia Ocón-Bretón, Alba Zabalegui, Diego Bellido, Pilar Matía Martín, Miguel Ángel Martínez-Olmos, Ana Zugasti, María Riestra, Francisco Botella and José Manuel García-Almeida
Nutrients 2025, 17(10), 1722; https://doi.org/10.3390/nu17101722 - 20 May 2025
Viewed by 267
Abstract
Background: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes [...] Read more.
Background: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes in nutritional and functional status in post-ICU COVID-19 patients following nutritional and physical rehabilitation interventions. Secondary aims included assessing adherence to and tolerance of the oral nutritional supplement (ONS) used in the nutritional intervention. Methods: The study enrolled adults who had been admitted to the ICU due to severe COVID-19. At hospital discharge, the patients underwent a nutritional intervention based on oral nutritional supplements (ONSs) with 100% serum lactoprotein enriched with leucine and vitamin D and a physical rehabilitation program. They were followed up during three months. Performed assessments included Subjective Global Assessment (SGA), Global Leadership Initiative on Malnutrition (GLIM) criteria, Barthel index (BI), handgrip strength and Timed Up and Go test, bioelectrical impedance analysis (BIA), nutritional ultrasound (US), and tolerance and adherence to ONS. Sample size was calculated based on handgrip strength, and parametric and non-parametric tests were used to assess differences between the baseline and three-month outcomes. Results: The study included 96 patients (71.9% male, mean age 58.8 years, mean body mass index (BMI) of 28.8 kg/m2, 36.5% obese). A total of 85 patients (62 men and 23 women) completed the 90-day follow-up. The mean weight gain after the intervention was 6.8 (SD 5.2) kg (similar in men and women; p = 0.263). The proportion of patients with malnutrition according to the SGA or GLIM criteria decreased from 100% to 11.8% and 36.4%, respectively (p < 0.00001 in both cases). The proportion of patients with functional limitations by BI decreased from 66.7% to 27.0% (p < 0.0001). Handgrip strength increased more than 40% in both men and women (p < 0.00001). The time to perform the Timed Up and Go (TUG) test decreased more than 40% in both men and women (p < 0.00001). According to BIA, the mean fat mass did not increase significantly in either men or women. The mean fat-free mass index (FFMI) increased significantly in both men and women. There were also significant increases in body cell mass, skeletal muscle mass index, and appendicular skeletal muscle mass index. The phase angle (PhA) increased significantly in both men (26.5%) and women (17.4%). In a multivariate analysis, age and baseline PhA were related to the PhA increase (adjusted R2 = 0.5573). The US study showed a significant increase in the mean measurements of muscle area, muscle circumference, X-axis, and Y-axis in the rectus femoris. Regarding abdominal fat, there were no significant increases in total, superficial, or preperitoneal adipose tissue by US. Participants engaged in a median interquartile range (IQR) of 70 (0–120) min/week of strength exercise and 60 (0–120) min/week of moderate physical exercise. The supplement was well tolerated, and poor adherence (less than 50%) was low (4% of the participants). Conclusions: A three-month intervention, including ONS and physical rehabilitation, is associated with a significant improvement in nutritional and functional status. Patients gained weight primarily by increasing their muscle mass. There was no significant increase in fat mass, as measured by BIA or US. The intervention was well tolerated and had good adherence. Full article
(This article belongs to the Section Nutritional Epidemiology)
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20 pages, 2800 KiB  
Article
Exogenous Ketone Supplementation Enhances the Anti-Epileptic Effect of Levetiracetam in Wistar Albino Glaxo/Rijswijk Rats
by Enikő Rauch, Csilla Ari, Dominic P. D’Agostino and Zsolt Kovács
Nutrients 2025, 17(10), 1721; https://doi.org/10.3390/nu17101721 - 20 May 2025
Viewed by 227
Abstract
Background: It has been demonstrated that levetiracetam can decrease absence epileptic activity in both human patients and different types of animal models of absence epilepsy, such as the genetically absence epileptic Wistar Albino Glaxo/Rijswijk (WAG/Rij) rat. It was also suggested previously that exogenous [...] Read more.
Background: It has been demonstrated that levetiracetam can decrease absence epileptic activity in both human patients and different types of animal models of absence epilepsy, such as the genetically absence epileptic Wistar Albino Glaxo/Rijswijk (WAG/Rij) rat. It was also suggested previously that exogenous ketone supplements (EKSs)-evoked ketosis not only decreases the number of spike-wave discharges (SWDs) but also enhances the anti-absence epileptic effect of pyrimidine nucleoside uridine in WAG/Rij rats. These findings suggest that EKSs may enhance the efficacy of clinically used anti-epileptic drugs, such as levetiracetam. Methods: We investigated the effect of not only levetiracetam (intraperitoneal/i.p. 200 mg/kg) alone and KEKS supplemented food (containing 10% ketone ester/KE and 10% ketone salt/KS in a normal rat chow) alone, but also the combination of levetiracetam and KEKS supplemented food on SWD number and SWD time for 5 days in WAG/Rij rats. For evaluation of SWDs, electroencephalographic (EEG) recordings were performed every day. Moreover, for the measurement of blood glucose and R-beta-hydroxybutyrate (R-βHB) levels, the blood was taken from the tail vein of rats after EEG registration. Results: It was demonstrated that the administration of both levetiracetam alone and KEKS food alone decreased the SWD number and time spent in SWD, compared to control. Moreover, after combined administration of levetiracetam with KEKS food, enhanced anti-absence epileptic effect was observed, compared to levetiracetam alone. Blood R-βHB level significantly increased after administration of both KEKS food alone and KEKS food in combination with levetiracetam. Nevertheless, these treatments did not significantly change the blood glucose levels. Conclusions: We can conclude that EKSs may be able to enhance the anti-epileptic effect of different drugs, and this combined treatment method may represent a promising new approach and effective therapy against epileptic seizures, especially in treatment-resistant patients. Full article
(This article belongs to the Section Nutrition and Metabolism)
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24 pages, 2654 KiB  
Article
Short-Term Beetroot Juice Supplementation Enhances Strength, Reduces Fatigue, and Promotes Recovery in Physically Active Individuals: A Randomized, Double-Blind, Crossover Trial
by Atef Salem, Achraf Ammar, Mohamed Kerkeni, Mohamed Ali Boujelbane, Ayse Merve Uyar, Leonard Moritz Köbel, Saranya Selvaraj, Reza Zare, Katie M. Heinrich, Haitham Jahrami, Slim Tounsi, Piotr Zmijewski, Wolfgang I. Schöllhorn, Khaled Trabelsi and Hamdi Chtourou
Nutrients 2025, 17(10), 1720; https://doi.org/10.3390/nu17101720 - 19 May 2025
Viewed by 395
Abstract
Background/Objectives: Beetroot juice (BJ), a natural source of dietary nitrate, has gained increasing attention for its potential to improve exercise performance and cardiovascular function. While its benefits are well documented in endurance contexts, less is known about its short-term effects on resistance training [...] Read more.
Background/Objectives: Beetroot juice (BJ), a natural source of dietary nitrate, has gained increasing attention for its potential to improve exercise performance and cardiovascular function. While its benefits are well documented in endurance contexts, less is known about its short-term effects on resistance training performance and recovery. Thus, this study investigated the effects of short-term BJ supplementation on strength performance, cardiovascular responses, muscle oxygenation, and post-exercise recovery in resistance-trained males. Methods: Twelve healthy men (age: 21.3 ± 1.9 years; body mass index: 21.42 ± 2.36 kg/m2) completed two supplementation protocols involving BJ, providing 450 mg of nitrate per day, and a nitrate-free placebo (PLA). Each protocol consisted of two laboratory visits, one to assess the acute ergogenic effects and another to evaluate recovery after 72 h, resulting in a total of four sessions over a two-week period. During the three consecutive days of supplementation, participants ingested a single 900 mL dose (15 g BJ powder/PLA) 2 h before the first session, followed by three daily 300 mL doses (5 g BJ each/PLA) over the next two days, and a final dose (15 g BJ powder/PLA) taken 2 h before the second session (72 h post-first session). Each testing session involved incremental back squat (BS) and bench press (BP) exercises at 60%, 70%, and 80% of the one-repetition maximum (1RM) performed to failure, with three-minute rest intervals between sets. Repetition to failure, movement velocity, peak power, peak heart rate (HR), and muscle oxygenation (SmO2) were recorded during BP and BS exercises. Heart rate variability (HRV) and blood lactate were assessed before and after each training session. Lower-limb strength (CMJ and SJ) and delayed-onset muscle soreness (DOMS) were assessed daily during the 3-day supplementation period. Results: BJ significantly increased repetitions completed at 80% 1RM during BP and BS (p < 0.05) compared to the PLA. Peak movement velocity improved across all intensities using BJ with higher values compared to the PLA at 60–80% 1RM (p < 0.05). SmO2 was higher in BJ at 70–80% 1RM) and further improved after 72 h of BJ supplementation (p < 0.05). Cardiovascular strain was reduced in BJ, evidenced by lower peak HRs and smaller post-exercise declines in HRV indices (p < 0.05). Post-exercise recovery favored BJ, with faster recovery in jump performance at 24 h and reduced upper-limb DOMS at 24–48 h (p < 0.05). Conclusions: Short-term BJ supplementation enhances high-intensity resistance performance, improves muscle oxygenation, attenuates cardiovascular strain, and accelerates neuromuscular recovery. These benefits highlight its potential as a practical strategy for athletes seeking to optimize training performance and recovery during periods of intense resistance training. Full article
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15 pages, 991 KiB  
Article
A Greater Adherence to the Mediterranean Diet Supplemented with Extra Virgin Olive Oil and Nuts During Pregnancy Is Associated with Improved Offspring Health at Six Years of Age
by Laura del Valle, Verónica Melero, Andrés Bodas, Rocío Martín O’Connor, Ana Ramos-Levi, Ana Barabash, Johanna Valerio, Paz de Miguel, José Ángel Díaz Pérez, Cristina Familiar Casado, Inmaculada Moraga Guerrero, Inés Jiménez-Varas, Clara Marcuello Foncillas, Mario Pazos, Miguel A. Rubio-Herrera, Bricia López-Plaza, Isabelle Runkle, Pilar Matía-Martín and Alfonso L. Calle-Pascual
Nutrients 2025, 17(10), 1719; https://doi.org/10.3390/nu17101719 - 19 May 2025
Viewed by 463
Abstract
Background/Objectives: Children’s health may be influenced by maternal eating habits during pregnancy. A Mediterranean diet (MedDiet)-based pattern has been associated with benefits in infectious disease and allergies in children. Methods: From a total 2228 pregnant women evaluated between 2015 and 2017 in the [...] Read more.
Background/Objectives: Children’s health may be influenced by maternal eating habits during pregnancy. A Mediterranean diet (MedDiet)-based pattern has been associated with benefits in infectious disease and allergies in children. Methods: From a total 2228 pregnant women evaluated between 2015 and 2017 in the St. Carlos cohort, 1292 women belonging to the intervention group (IG) undertook a MedDiet supplemented with extra virgin olive oil (EVOO) and nuts from early on in pregnancy. The control group (CG) consisted of 516 pregnant women who were advised to follow a fat-restricted MedDiet. The modified 12-point Mediterranean diet adherence screener (MEDAS) was applied. A total of 1808 (81.2%) children were analyzed at 6 years postpartum. All women from both groups received the same postpartum nutritional recommendations as the IG had during pregnancy. Results: Children from the IG showed lower rates of bronchiolitis and atopic eczema compared to the CG. Children whose mother’s MEDAS score was ≥6 at 24–28 GW vs. MEDAS scores < 6 presented lower rates of bronchiolitis [222/695 (28.8%) vs. 441/1113 (39.6%); p = 0.022] and atopic eczema [311/695 (39.0%) vs. 564/1113 (50.7%); p = 0.039]. The offspring of mothers with MEDAS scores ≥ 8 (n = 176) vs. MEDAS scores ≤ 3 (n = 564) showed a lower relative risk (RR) (95% CI) for developing bronchiolitis [0.75 (0.58–0.97)] and atopic eczema [0.82 (0.69–0.98)], with both having a p < 0.001 trend. Conclusions: A higher adherence to a MedDiet supplemented with EVOO and nuts during pregnancy is associated with health benefits in offspring at 6 years of age. Full article
(This article belongs to the Section Nutrition in Women)
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11 pages, 279 KiB  
Article
Lifestyle Habits and Anthropometric Indicators Associated with Mediterranean Diet Adherence in Spanish Youth
by Enric Conesa-Milian, Saül Aixa-Requena, Alvaro Pano-Rodriguez, Vicenç Hernández-González, Abraham Batalla-Gavaldà, Jose Vicente Beltran-Garrido, Carme Jové-Deltell, Joao Jose Albuquerque de Sousa Junior and Joaquin Reverter-Masia
Nutrients 2025, 17(10), 1718; https://doi.org/10.3390/nu17101718 - 19 May 2025
Viewed by 606
Abstract
Background: The increasing prevalence of overweight and obesity among young people poses a significant public health challenge. Childhood and adolescence are critical periods for establishing long-term health habits. Diet plays a central role in maintaining a healthy weight, and adherence to the [...] Read more.
Background: The increasing prevalence of overweight and obesity among young people poses a significant public health challenge. Childhood and adolescence are critical periods for establishing long-term health habits. Diet plays a central role in maintaining a healthy weight, and adherence to the Mediterranean diet has been consistently linked to numerous health benefits, including improved weight management and overall well-being. Understanding the factors that influence Mediterranean diet adherence in adolescents can help design effective interventions to promote healthier eating behaviors. Objectives: This study sought to explore the association between following the Mediterranean diet and key physiological factors, including age, sex, body mass index, and pubertal status. Additionally, it explored how Mediterranean diet adherence relates to lifestyle behaviors such as sleep quality and physical activity levels, using data from a sample of 668 Spanish adolescents. Method: Participants completed validated questionnaires assessing dietary habits, physical activity, sleep quality, and pubertal status (Tanner scale). Results: The findings revealed significant associations between Mediterranean diet adherence and body mass index, pubertal status, and physical activity level, while sex, age, and sleep quality showed no significant influence. Adolescents with lower body mass index tended to adhere more to the Mediterranean diet, reinforcing its role in weight management. Additionally, greater adherence was observed in later pubertal stages, suggesting increased nutritional awareness. Conclusions: Healthy eating patterns are associated with a strong promotion of physical activity, highlighting the link between an active lifestyle and adherence to the Mediterranean diet. This positive multifactorial synergy requires further research to better understand its mechanisms and to design effective strategies for promoting healthy habits among adolescents. Full article
(This article belongs to the Section Nutrition and Public Health)
10 pages, 240 KiB  
Article
Association Between the Healthy Eating Index and the Body Mass Index of Older Adults: An Analysis of Food Frequency and Preferences
by Andres Fontalba-Navas, Ruth Echeverria, Cristina Larrea-Killinger, Mabel Gracia-Arnaiz, Claudia Soar and Juan Pedro Arrebola
Nutrients 2025, 17(10), 1717; https://doi.org/10.3390/nu17101717 - 19 May 2025
Viewed by 217
Abstract
Background/Objectives: The nutritional habits of older adults are increasingly relevant to public health, particularly given the rising prevalence of obesity and its associated chronic diseases. This study aims to analyze the relationship between the Healthy Eating Index (IASE) and Body Mass Index (BMI) [...] Read more.
Background/Objectives: The nutritional habits of older adults are increasingly relevant to public health, particularly given the rising prevalence of obesity and its associated chronic diseases. This study aims to analyze the relationship between the Healthy Eating Index (IASE) and Body Mass Index (BMI) in older adults in Spain, focusing on food frequency, dietary preferences, and socioeconomic factors influencing nutritional security. Methods: The study is part of the Eating Matters project, assessing food (in)security in older adults across Andalusia and Catalonia between April 2022 and January 2024. A cross-sectional survey was conducted among 190 participants (≥65 years), recruited in primary healthcare centers. The questionnaire included three blocks: food insecurity assessment (FIES scale), diet quality with the Healthy Eating Index for the Spanish Population (IASE), and sociodemographic factors. Data analysis involved descriptive statistics, Pearson correlations, and logistic regression models to identify associated factors with overweight and obesity. Results: The average BMI was 28.5 kg/m2 (SD = 4.29), with 46.3% of participants classified as overweight and 32.1% as obese. A significant negative correlation (r = −0.79, p < 0.05) was found between healthy food consumption and BMI, while personal income showed a moderate positive correlation with adherence to a healthy diet (r = 0.42, p < 0.05). Logistic regression indicated that frequent consumption of processed meats and confectionery was a significant identify associated factors with overweight/obesity, with a model accuracy of 68% and sensitivity of 95%. Conclusions: Older adults with lower incomes and higher consumption of ultra-processed foods exhibited a higher risk of obesity. These findings highlight the need for public policies promoting food accessibility and targeted nutrition education for older adults, including guidance on balanced diets, adequate protein intake, and the prevention of sarcopenia, to encourage healthier dietary patterns in aging populations. Full article
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