Nutrients

28 pages, 2285 KiB

Open AccessReview

The Impact of Flavonoids and Omega-3 in Mitigating Frailty Syndrome to Improve Treatment Outcomes in Peripheral Artery Disease (PAD) Patients

by Sanaz Jamshidi, Zahra Eskandari, Amirhossein Faghih Ojaroodi, Shayan Keramat and Agata Stanek

Nutrients 2025, 17(14), 2303; https://doi.org/10.3390/nu17142303 (registering DOI) - 12 Jul 2025

Abstract

Peripheral artery disease (PAD) is a common vascular disorder in the elderly, often accompanied by frailty syndrome, which is associated with increased inflammation, oxidative stress, and functional decline. Nutritional strategies, particularly those involving bioactive compounds like flavonoids and omega-3 fatty acids, have been [...] Read more.

Peripheral artery disease (PAD) is a common vascular disorder in the elderly, often accompanied by frailty syndrome, which is associated with increased inflammation, oxidative stress, and functional decline. Nutritional strategies, particularly those involving bioactive compounds like flavonoids and omega-3 fatty acids, have been suggested as potential approaches to modulate these pathological processes. This narrative review summarizes current evidence regarding the anti-inflammatory and antioxidant effects of flavonoids and omega-3 fatty acids, and their possible roles in mitigating frailty syndrome in patients with PAD. We examine mechanistic pathways including NF-κB, AMPK, PI3K/Akt/mTOR, and Nrf2, which are implicated in chronic inflammation, endothelial dysfunction, and muscle wasting. Although studies in general and aging populations suggest beneficial effects of these compounds on vascular and muscle health, specific evidence in PAD patients remains limited. Flavonoids may reduce pro-inflammatory cytokine production and enhance antioxidant responses, while omega-3 fatty acids have shown potential in modulating inflammatory signaling and supporting vascular repair. Current data provide a basis for further investigation into the dietary modulation of frailty syndrome in PAD. Understanding the impact of these nutrients may offer insights into adjunctive strategies for improving patient outcomes. Full article

(This article belongs to the Special Issue Featured Reviews on Geriatric Nutrition)

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17 pages, 1864 KiB

Open AccessArticle

The Neurological Metabolic Phenotype in Prolonged/Chronic Critical Illness: Propensity Score Matched Analysis of Nutrition and Outcomes

by Levan B. Berikashvili, Alexander E. Shestopalov, Petr A. Polyakov, Alexandra V. Yakovleva, Mikhail Ya. Yadgarov, Ivan V. Kuznetsov, Mohammad Tarek S. M. Said, Ivan V. Sergeev, Andrey B. Lisitsyn, Alexey A. Yakovlev and Valery V. Likhvantsev

Nutrients 2025, 17(14), 2302; https://doi.org/10.3390/nu17142302 (registering DOI) - 12 Jul 2025

Abstract

Background: Brain injuries, including stroke and traumatic brain injury (TBI), pose a major healthcare challenge due to their severe consequences and complex recovery. While ischemic strokes are more common, hemorrhagic strokes have a worse prognosis. TBI often affects young adults and leads [...] Read more.

Background: Brain injuries, including stroke and traumatic brain injury (TBI), pose a major healthcare challenge due to their severe consequences and complex recovery. While ischemic strokes are more common, hemorrhagic strokes have a worse prognosis. TBI often affects young adults and leads to long-term disability. A critical concern in these patients is the frequent development of chronic critical illness, compounded by metabolic disturbances and malnutrition that hinder recovery. Objective: This study aimed to compare changes in nutritional status parameters under standard enteral nutrition protocols and clinical outcomes in prolonged/chronic critically ill patients with TBI or stroke versus such a population of patients without TBI or stroke. Methods: This matched prospective–retrospective cohort study included intensive care unit (ICU) patients with TBI or stroke from the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology and patients without these conditions from the eICU-CRD database. Inclusion criteria comprised age 18–74 years, ICU stay >5 days, and enteral nutrition. Patients with re-hospitalization, diabetes, acute organ failure, or incomplete data were excluded. Laboratory values and clinical outcomes were compared between the two groups. Propensity score matching (PSM) was used to balance baseline characteristics (age, sex, and body mass index). Results: After PSM, 29 patients with TBI or stroke and 121 without were included. Univariate analysis showed significant differences in 21 laboratory parameters and three hospitalization outcomes. On day 1, the TBI/stroke group had higher hemoglobin, hematocrit, lymphocytes, total protein, and albumin, but lower blood urea nitrogen (BUN), creatinine, and glucose. By day 20, they had statistically significantly lower calcium, BUN, creatinine, and glucose. This group also showed less change in lymphocytes, calcium, and direct bilirubin. Hospitalization outcomes showed longer mechanical ventilation duration (p = 0.030) and fewer cases of acute kidney injury (p = 0.0220) in the TBI/stroke group. Conclusions: TBI and stroke patients exhibit unique metabolic patterns during prolonged/chronic critical illness, differing significantly from other ICU populations in protein/glucose metabolism and complication rates. These findings underscore the necessity for specialized nutritional strategies in neurocritical care and warrant further investigation into targeted metabolic interventions. Full article

(This article belongs to the Section Nutrition and Metabolism)

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44 pages, 468 KiB

Open AccessReview

Mapping the Published Evidence on Childhood Obesity Prevalence and Related Policies in Greece: A Scoping Review

by Raffaella Sibilio, Christos Triantafyllou, Tania Cardona, Joao Breda and Giancarlo Icardi

Nutrients 2025, 17(14), 2301; https://doi.org/10.3390/nu17142301 (registering DOI) - 12 Jul 2025

Abstract

Background/Objectives: Childhood obesity is a global epidemic. Addressing the modifiable risk factors with effective policies is crucial for both prevention and intervention. This scoping review aims to provide a situational analysis of childhood obesity in Greece by mapping the available evidence on the [...] Read more.

Background/Objectives: Childhood obesity is a global epidemic. Addressing the modifiable risk factors with effective policies is crucial for both prevention and intervention. This scoping review aims to provide a situational analysis of childhood obesity in Greece by mapping the available evidence on the prevalence of obesity among Greek children and adolescents and exploring the existing policies implemented to address this issue. Methods: A systematic literature search was conducted on September 15, 2023, using the PubMed, Scopus, and IATROTEK-online databases to identify studies related to childhood obesity and policies in Greece. Keyword groups were developed for “childhood obesity”, “Greece”, and either “prevalence” or “policies”. Additional sources, including Google and Google Scholar, were screened to ensure comprehensiveness. Results: A total of 66 studies were included: 61 on obesity prevalence (≤18 years of age) and 5 on existing policies tackling childhood obesity, all in Greece. The collective prevalence was observed to lie within the subsequent range of values: 2.8–21.2%. Regarding both genders, the observed prevalence ranged from 2.8% to 26.7% in males, and between 1.3% and 33.7% in females. The policies adopted in Greece cover various domains (healthy nutrition, public preferences, physical activity, school policies, and programs related to childhood obesity). Conclusions: Childhood obesity in Greece is a major challenge. Greece currently uses some policies and strategies to combat childhood obesity. There is still work to be done: policies play a pivotal role as a key tool to influence lifestyle habits on a broad scale and exert a considerable impact on the reduction in this prevalent health concern. Full article

(This article belongs to the Section Nutrition and Obesity)

23 pages, 371 KiB

Open AccessArticle

Eating Disorders in the Workplace

by Nicola Magnavita, Igor Meraglia and Lucia Isolani

Nutrients 2025, 17(14), 2300; https://doi.org/10.3390/nu17142300 (registering DOI) - 12 Jul 2025

Abstract

Background/Objectives: Although eating disorders (EDs) affect a large portion of the population and have a significant impact on health and productivity, they are understudied in the workplace. We assessed the frequency of EDs and studied the relationship between EDs and occupational and [...] Read more.

Background/Objectives: Although eating disorders (EDs) affect a large portion of the population and have a significant impact on health and productivity, they are understudied in the workplace. We assessed the frequency of EDs and studied the relationship between EDs and occupational and individual factors. Methods: All workers undergoing health surveillance were invited to fill in the Eating Disorder Examination Questionnaire, short form (EDE-QS) and, before their routine medical examination that included metabolic tests, measure their level of health literacy, stress, quality of sleep, anxiety, depression, and happiness. Out of a total of 2085 workers, 1912 (91.7%) participated. Results: Suspected EDs affected 4.9% (CI95% 3.9; 5.9) of workers, with no notable difference in gender (5.3% CI95% 4.1; 6.7 in female workers vs. 4.2%, CI95% 2.9; 5.9 in male). Cases were significantly associated with trauma and emotional factors (anxiety, depression, unhappiness), but also with work-related stress and poor sleep quality, and negatively associated with health literacy. Using a hierarchical logistic regression model, suspected cases of EDs were significantly predicted in Model II by life trauma (OR 2.21 CI95% 1.40; 3.48, p < 0.001) and health literacy (OR 0.94 CI95% 0.90; 0.98, p < 0.001), in Model III also by work-related stress (OR 2.57 CI95% 1.68; 3.94, p < 0.001), and in Model IV by depression (OR 1.19 CI95% 1.02; 1.38, p < 0.05) and happiness (OR 0.88 CI95% 0.78; 0.99, p < 0.05). An association was also found between EDs and overweight, obesity, increased abdominal circumference, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, arterial hypertension, atherogenic index of plasma, and metabolic syndrome. Conclusions: The workplace is an ideal setting for the prevention of EDs and their consequences. Occupational health intervention should promote health literacy, improve sleep quality, and reduce work-related stress. Full article

(This article belongs to the Special Issue Nutritional Behaviour and Cardiovascular Risk Factor Modification)

12 pages, 1773 KiB

Open AccessArticle

Dietary, Body Composition, and Blood Leptin Variations in Fit-Model Female Athletes During the Pre-Competition Period

by Ramutis Kairaitis, Petras Minderis, Inga Lukonaitienė, Gediminas Mamkus, Tomas Venckūnas and Sigitas Kamandulis

Nutrients 2025, 17(14), 2299; https://doi.org/10.3390/nu17142299 (registering DOI) - 12 Jul 2025

Abstract

Background: The Fit-Model in bodybuilding is a relatively new category designed for women seeking a balanced physique, avoiding excessive muscularity and extreme leanness. This study examined the dietary strategies, body composition changes, and plasma leptin fluctuations of Fit-Model athletes during a seven-week pre-competition [...] Read more.

Background: The Fit-Model in bodybuilding is a relatively new category designed for women seeking a balanced physique, avoiding excessive muscularity and extreme leanness. This study examined the dietary strategies, body composition changes, and plasma leptin fluctuations of Fit-Model athletes during a seven-week pre-competition phase. Methods: Twelve females (age: 27.6 ± 4.4 years, body mass: 60.0 ± 6.2 kg) preparing for a national championship were monitored for energy and macronutrient intakes, total, lean, and fat mass, plasma leptin levels, and menstrual cycle characteristics. The five highest-ranked athletes were selected to compete at the world championship, allowing for comparisons between national and international athletes. Results: Low carbohydrate intake was reported, and total energy intake decreased from 1700 to 1520 kcal/day approaching the contest day. Athletes experienced an average body mass loss of 4.2 kg, with no clear relationship between final weight or fat mass and competitive success. Plasma leptin levels were markedly low during all 7 weeks of preparation with a further decline before the contest, but did not correlate with either changes in body composition and weight or energy or macronutrient intakes. Menstrual cycle disturbances were prevalent, with only two athletes maintaining regular cycles by the end of the preparation. Conclusions: Fit-Model athletes undergo a considerable decline in body weight and fat mass during the final weeks before the contest, yet these changes do not appear to be decisive for performance outcomes. Persistently low leptin levels and menstrual irregularities call for strategies that balance physique optimization with endocrine health to support both the performance and well-being of athletes. Full article

(This article belongs to the Special Issue Performance in Sports, Physical Activity, Exercise: Nutrition, Fatigue and Recovery)

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20 pages, 400 KiB

Open AccessArticle

Beyond Conventional: Italian Consumer Perceptions, Purchasing Habits, and Willingness to Pay for Ancient Grain Pasta

by Concetta Nazzaro, Anna Uliano and Marcello Stanco

Nutrients 2025, 17(14), 2298; https://doi.org/10.3390/nu17142298 - 11 Jul 2025

Abstract

Background/Objectives: Ancient grains are increasingly recognized for their nutritional value, environmental sustainability, and connection to traditional agriculture. This study examines Italian consumers’ awareness, purchasing habits, and willingness to pay (WTP) for ancient grain pasta, focusing on the influence of product origin, price, and [...] Read more.

Background/Objectives: Ancient grains are increasingly recognized for their nutritional value, environmental sustainability, and connection to traditional agriculture. This study examines Italian consumers’ awareness, purchasing habits, and willingness to pay (WTP) for ancient grain pasta, focusing on the influence of product origin, price, and flour type on preferences. Methods: An online survey was conducted with 3020 Italian household grocery shoppers. Descriptive statistics assessed awareness and purchasing behavior, while conjoint analysis (CA) evaluated the relative importance of key product attributes (origin, price, and flour type) in pasta choices. The sample was segmented based on consumer knowledge of ancient grains. Results: A significant portion of respondents reported familiarity with ancient grains, perceiving them as “less refined” and “more digestible”; pasta emerged as the most purchased product. CA results indicated product origin as the most influential factor, followed by price, with flour type having comparatively lower influence. Notably, consumers more familiar with ancient grains showed a slight preference for ancient flour types and were less sensitive to price. Conclusions: While origin and price are primary drivers for pasta choices, knowledgeable consumers show greater valuation for flour type and accept higher prices. These findings provide strategic insights for stakeholders seeking to promote traditional, sustainable agri-food products through targeted marketing and transparent value communication. Full article

(This article belongs to the Special Issue Future Prospects for Sustaining a Healthier Food System)

16 pages, 609 KiB

Open AccessArticle

Comparison of Food Compound Intake Between Food-Allergic Individuals and the General Population

by Meike E. Vos, Marie Y. Meima, Sabina Bijlsma, W. Marty Blom, Thuy-My Le, André C. Knulst and Geert F. Houben

Nutrients 2025, 17(14), 2297; https://doi.org/10.3390/nu17142297 - 11 Jul 2025

Abstract

Background: Individuals with food allergies typically need to avoid specific allergens, leading to distinct dietary choices. Their food product intake may therefore vary from that of the general population, potentially leading to differences in their intake of nutrients and other food compounds. Methods: [...] Read more.

Background: Individuals with food allergies typically need to avoid specific allergens, leading to distinct dietary choices. Their food product intake may therefore vary from that of the general population, potentially leading to differences in their intake of nutrients and other food compounds. Methods: We compared food compound and nutrient group intakes between the general Dutch adult population (n = 415) and food allergic Dutch adult patients with either milk and/or egg allergies (n = 16), peanut and/or tree nut allergies (n = 35) or a combination of milk/egg and peanut/tree nut allergies (n = 22). We translated 24-hour dietary recall data into food compound intake values. We used a mixed effects ANOVA model and considered compound intakes statistically significantly different at FDR-corrected p < 0.05. Additionally, compounds with uncorrected p < 0.01 were explored for potential relevance. Results: A total of 489 compounds or nutrient groups were included in the statistical analysis. Milk/egg and mixed allergic patients had significantly lower intakes of beta-lactose, butyric acid, caproic acid, caprylic acid, capric acid, lauric acid, myristic acid, myristoleic acid, conjugated linoleic acid, and remainder saturated fatty acids (p < 0.05, FDR corrected), with mean intake factors of 1.6–3.2 and 1.3–2.9 lower, respectively, than the general population. In addition, 36 other compounds showed intake differences with a p < 0.01 without FDR correction. There were no statistically significant differences between the peanut/tree nut allergy group and the general population. Conclusions: Our study shows significantly lower intakes of 10 mainly dairy-derived compounds by the milk/egg and mixed-allergic patients, presenting the potential for long-term health consequences and the need for supplementation a relevant consideration, warranting further research. Full article

(This article belongs to the Section Nutritional Immunology)

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26 pages, 1301 KiB

Open AccessArticle

Synergistic Effects of Probiotic and Omega-3 Supplementation with Ultra-Short Race Pace Training on Sprint Swimming Performance

by Ideh Maymandinejad, Mohammad Hemmatinafar, Ralf Jäger, Babak Imanian, Maryam Koushkie Jahromi and Katsuhiko Suzuki

Nutrients 2025, 17(14), 2296; https://doi.org/10.3390/nu17142296 - 11 Jul 2025

Abstract

Background: Optimal nutrition and training regimens are essential for athletes to maximize performance and recovery. Probiotic supplementation, through the modulation of the gut microbiota, and omega-3 fatty acids, known for their anti-inflammatory properties, may enhance physiological adaptations when combined with targeted training. [...] Read more.

Background: Optimal nutrition and training regimens are essential for athletes to maximize performance and recovery. Probiotic supplementation, through the modulation of the gut microbiota, and omega-3 fatty acids, known for their anti-inflammatory properties, may enhance physiological adaptations when combined with targeted training. This study evaluated the effects of probiotics and omega-3 supplementation, alongside ultra-short race pace training (USRPT), on performance metrics in competitive sprint swimmers. Methods: In this double-blind, placebo-controlled study, 60 male sprint swimmers (age: 19.2 ± 3.6 years; height: 182.2 ± 5.2 cm; weight: 81.6 ± 4.4 kg) with a minimum of five years of training experience, were randomly assigned to six groups (n = 10 per group): (1) Control (CON), (2) USRPT only, (3) Placebo + USRPT (PLA + USRPT), (4) Probiotics + USRPT (PRO + USRPT), (5) Omega-3 + USRPT (OMEGA + USRPT), and (6) Probiotics + Omega-3 + USRPT (PRO + OMEGA + USRPT). Over the eight-week intervention, the participants in PRO + USRPT consumed one multi-strain probiotic capsule daily (4.5 × 10¹¹ CFU) and a placebo capsule. Those in OMEGA + USRPT ingested 1000 mg of fish oil after lunch (500 mg EPA and 180 mg DHA per capsule) paired with a placebo capsule. The combined supplementation group (PRO + OMEGA + USRPT) received both probiotic and omega-3 capsules. The PLA + USRPT group consumed two starch capsules daily. The USRPT protocol was implemented across all the training groups, where the swimmers performed 17 sets of 25 m and 12.5 m sprints based on weekly recorded race times. Performance assessments included pre- and post-test measurements of sprint times (50 m and 100 m freestyle), vertical jump tests (both in water and on dry land), and other strength and endurance metrics (reaction time, agility T-test, sprint index, fatigue index, and velocity). Results: The combined intervention of probiotics and omega-3 with USRPT produced the greatest improvements in performance. The PRO + OMEGA + USRPT group reduced 50 m freestyle time by 1.92% (p = 0.002, pEta² = 0.286) and 100 m freestyle time by 2.48% (p = 0.041, pEta² = 0.229), demonstrating significant Time × Group interactions consistent with a synergistic effect. Additionally, the sprint index improved (pEta² = 0.139, p = 0.013) and reaction time decreased (pEta² = 0.241, p = 0.009) in the combined group, indicating enhanced anaerobic capacity and neuromuscular responsiveness compared to single interventions. Conclusions: This study suggests that combining probiotics and omega-3 supplementation with USRPT leads to synergistic improvements in sprint swimming performance, enhancing anaerobic power and recovery beyond what is achieved with individual interventions. This integrated approach may provide a practical strategy for competitive swimmers seeking to optimize their performance. Future studies should incorporate mechanistic markers, longer intervention durations, and diverse athlete populations to clarify further and extend these findings. Full article

(This article belongs to the Special Issue Nutritional Supplements to Optimize Exercise Performance)

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15 pages, 365 KiB

Open AccessArticle

Delayed Bone Age and Osteoprotegerin Levels in Pediatric Celiac Disease: A Three-Year Case–Control Study

by Ruzha Pancheva, Yoana Dyankova, Niya Rasheva, Krassimira Koleva, Violeta Iotova, Mariya Dzhogova, Marco Fiore and Miglena Georgieva

Nutrients 2025, 17(14), 2295; https://doi.org/10.3390/nu17142295 - 11 Jul 2025

Abstract

Introduction: Celiac disease (CD) impairs bone development in children through inflammation and nutrient malabsorption. Osteoprotegerin (OPG), a decoy receptor for RANKL, plays a role in bone remodeling and is increasingly recognized as a potential biomarker of bone metabolism and inflammation. However, its clinical [...] Read more.

Introduction: Celiac disease (CD) impairs bone development in children through inflammation and nutrient malabsorption. Osteoprotegerin (OPG), a decoy receptor for RANKL, plays a role in bone remodeling and is increasingly recognized as a potential biomarker of bone metabolism and inflammation. However, its clinical significance in pediatric CD remains unclear. Aim: To evaluate the relationship between OPG levels, growth parameters, and delayed bone age in children with CD, and to assess OPG’s potential as a biomarker of bone health and disease activity. Methods: This three-year case–control study included 146 children: 25 with newly diagnosed CD (Group A), 54 with established CD on a gluten-free diet (Group B), and 67 healthy controls (Group C). Participants underwent clinical, anthropometric, and laboratory assessments at baseline and after 6 months (Groups A and B). OPG and osteocalcin were measured, and bone age was assessed radiologically. Statistical analyses included ANOVA, Spearman’s correlations, and binomial logistic regression. Results: OPG levels were highest in newly diagnosed children (Group A), showing a non-significant decrease after gluten-free diet initiation. OPG correlated negatively with age and height in CD patients and controls, and positively with hemoglobin and iron in Group B. Logistic regression revealed no significant predictive value of OPG for delayed bone age, although a trend was observed in Group B (p = 0.091). Children in long-term remission exhibited bone maturation patterns similar to healthy peers. Conclusions: OPG levels reflect disease activity and growth delay in pediatric CD but lack predictive power for delayed bone age. While OPG may serve as a secondary marker of bone turnover and inflammatory status, it is not suitable as a standalone biomarker for skeletal maturation. These findings highlight the need for integrative biomarker panels to guide bone health monitoring in children with CD. Full article

(This article belongs to the Special Issue Nutritional Deficiency and Celiac Disease)

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22 pages, 5061 KiB

Open AccessArticle

Urolithin A Exhibits Antidepressant-like Effects by Modulating the AMPK/CREB/BDNF Pathway

by Yaqian Di, Rui Xue, Xia Li, Zijia Jin, Hanying Li, Lanrui Wu, Youzhi Zhang and Lei An

Nutrients 2025, 17(14), 2294; https://doi.org/10.3390/nu17142294 - 11 Jul 2025

Abstract

Background/Objectives: Urolithin A (UA), a gut-derived metabolite of ellagitannins or ellagic acid, has recently gained attention for its potential benefits to brain health. The present research aimed to assess the antidepressant-like properties of UA in both in vitro and in vivo models and [...] Read more.

Background/Objectives: Urolithin A (UA), a gut-derived metabolite of ellagitannins or ellagic acid, has recently gained attention for its potential benefits to brain health. The present research aimed to assess the antidepressant-like properties of UA in both in vitro and in vivo models and explored the molecular mechanisms underlying these effects. Methods: We investigated the antidepressant effects and mechanisms of UA in a model of corticosterone-induced damage to PC12 cells and in a model of chronic socially frustrating stress. Results: Our results demonstrate that UA treatment (5 and 10 μM) significantly alleviated cellular damage and inflammation in corticosterone (CORT)-treated PC12 cells. Furthermore, UA administration (50 and 100 mg/kg) significantly reduced immobility time in the mouse tail suspension test (TST) and forced swim test (FST), indicating its antidepressant-like activity. Additionally, treatment with UA led to the activation of the cAMP response element-binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling cascade and triggered the activation of adenosine monophosphate-activated protein kinase (AMPK) during these processes. Importantly, pretreatment with AMPK-specific inhibitor Compound C abolished UA’s cytoprotective effects in PC12 cells, as well as its behavioral efficacy in the FST and TST, and its neurotrophic effects, highlighting the critical role of AMPK activation in mediating these effects. Furthermore, in the chronic social defeat stress (CSDS) mouse model, UA treatment (50 and 100 mg/kg) significantly alleviated depression-like behaviors, including reduced sucrose preference in the sucrose preference test, increased social avoidance behavior in the social interaction test, and anxiety-like behaviors, including diminished exploration, in the elevated plus maze test, suggesting the antidepressant-like and anxiolytic-like activities of UA. Moreover, UA treatment reversed elevated serum stress hormone levels, hippocampal inflammation, and the decreased AMPK/CREB/BDNF signaling pathway in the hippocampus of CSDS mice. Conclusions: Together, these results provide compelling evidence for UA as a viable dietary supplement or therapeutic option for managing depression. Full article

(This article belongs to the Special Issue The Role of Bioactive Compounds in Neuroprotection and Neurodegenerative Disease)

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17 pages, 539 KiB

Open AccessArticle

Energy Density and Level of Processing of Packaged Food and Beverages Intended for Consumption by Australian Children

by Sally MacLean, Kristy A. Bolton, Sarah Dickie, Julie Woods and Kathleen E. Lacy

Nutrients 2025, 17(14), 2293; https://doi.org/10.3390/nu17142293 - 11 Jul 2025

Abstract

Background/Objectives: Higher energy density (ED; kJ/g) and higher levels of processing of foods and beverages have been associated with childhood obesity and reduced diet quality. This study described and examined the distribution of ED and levels of processing of new food and [...] Read more.

Background/Objectives: Higher energy density (ED; kJ/g) and higher levels of processing of foods and beverages have been associated with childhood obesity and reduced diet quality. This study described and examined the distribution of ED and levels of processing of new food and beverage products intended for Australian children (0–4 years, 5–12 years). Methods: This study used 2013–2023 data from the Mintel Global New Products Database. Products were classified by ED (low ≦ 4.184 kJ/g, medium > 4.184 kJ/g and <12.552 kJ/g, or high ≧ 12.552 kJ/g) and level of processing (using the NOVA classification system; unprocessed/minimally processed foods; processed culinary ingredients; processed foods; ultra-processed foods (UPFs)). Non-parametric statistics were used to examine ED and level of processing by age and ‘Food’ and ‘Drink’ groups. Results: Of the 1770 products analysed, 56% were classified as high-ED and 81% as UPF. Among ‘Food’ products intended for children ‘5–12 years’, 93% were classified as UPFs. The differences in ED classification between non-UPFs and UPFs were significant for ‘Food’ products intended for children aged ‘0–4 years’ (p < 0.001) but not for children aged ‘5–12 years’ (p = 0.149). Conclusions: The prevalence of high-ED and UPFs in the Australian packaged food supply demonstrates the need to tighten regulations around products intended for children. The regulation of low-ED UPFs (i.e., recognised by Australian Dietary Guidelines as ‘healthy’) may also be required. Full article

(This article belongs to the Section Nutrition and Public Health)

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13 pages, 574 KiB

Open AccessFeature PaperArticle

Determinants of the Association Between Maternal Anemia and Neonatal Hemoglobin

by Rebecca K. Campbell, Nicole K. Tanna, Julie Hartwig, Catalin S. Buhimschi and Irina A. Buhimschi

Nutrients 2025, 17(14), 2292; https://doi.org/10.3390/nu17142292 - 11 Jul 2025

Abstract

Background/Objectives: Iron stores accrued in utero are critical for fetal and infant neurodevelopment. Low neonatal hemoglobin (Hb) may indicate inadequate iron capture and storage. Prior studies differ on whether and under what conditions maternal anemia predicts neonatal Hb; whether sex differences are present [...] Read more.

Background/Objectives: Iron stores accrued in utero are critical for fetal and infant neurodevelopment. Low neonatal hemoglobin (Hb) may indicate inadequate iron capture and storage. Prior studies differ on whether and under what conditions maternal anemia predicts neonatal Hb; whether sex differences are present is unknown. Methods: Maternal and neonatal Hb and sociodemographic and health characteristics were abstracted from electronic medical records for biorepository participants at a tertiary academic medical center. Maternal anemia was defined as Hb < 11 g/dL in trimesters T1 and T3 and Hb < 10.5 g/dL in T2. Adjusted linear regression models were used to estimate associations of maternal anemia with neonatal Hb. Sex differences were evaluated with product terms and stratification. Results: In 228 participants with maternal Hb measured, the prevalence of prenatal (pre-delivery) and delivery anemia was 54% and 44%, respectively. Maternal race and ethnicity but no other sociodemographic characteristics were associated with maternal anemia. Neonatal hematology was available for 114 newborns < 7 days old (50%; 52% male). The median (IQR) neonatal Hb was 16.7 g/dL (14.9, 18.0) and did not differ by sex, but it was lower among infants of mothers with vs. without delivery anemia (15.9 vs. 17.1, p = 0.032) and those identifying as Black vs. Hispanic or other (16.0, 17.9, 17.0, respectively; p = 0.003). Independent associations of maternal anemia and race and ethnicity with neonatal Hb were stronger in males and attenuated to null in females. Conclusions: Maternal anemia was highly prevalent and associated sex-specifically with neonatal Hb independent of maternal race and ethnicity. Future studies to replicate these findings with a more comprehensive panel of iron biomarkers are needed. Functional consequences of greater susceptibility to risk factors for low neonatal Hb in male infants need to be further investigated. Full article

(This article belongs to the Special Issue The Impact of Perinatal Nutrition on the Health and Development of the Infant)

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45 pages, 4730 KiB

Open AccessReview

Hydration Meets Regulation: Insights into Bicarbonate Mineral Water and Acid–Base Balance

by Katharina Mansouri, Thierry Hanh and Andreas Hahn

Nutrients 2025, 17(14), 2291; https://doi.org/10.3390/nu17142291 - 10 Jul 2025

Abstract

Acid–base balance is critical to human health and can be significantly influenced by dietary choices. The Western diet, characterized by high meat and cheese consumption, induces excess acidity, highlighting the need for strategies to mitigate this. Recent studies have focused on bicarbonate-rich mineral [...] Read more.

Acid–base balance is critical to human health and can be significantly influenced by dietary choices. The Western diet, characterized by high meat and cheese consumption, induces excess acidity, highlighting the need for strategies to mitigate this. Recent studies have focused on bicarbonate-rich mineral water as a viable solution. In this context, the present narrative review synthesizes the findings from recent scientific studies on bicarbonate-rich mineral water, specifically those with bicarbonate levels over 1300 mg/L and medium or low PRAL values. This water has been shown to exert beneficial effects on both urinary and blood parameters. The key effects include an increase in the urine pH and a profound reduction in net acid excretion as a sign for a reduced acid load. Additionally, bicarbonate mineral water has been shown to decrease the excretion of nephrolithiasis-related constituents, including calcium and oxalates, as well as inhibitory substances such as magnesium and citrates. In blood, bicarbonate-rich water has been demonstrated to stabilize pH and increase bicarbonate levels, thereby enhancing systemic buffering capacity. Clinically, these changes have been associated with a lowered risk of calcium oxalate stone formation and improved kidney health. Furthermore, bicarbonate-rich water has been shown to support bone health by reducing bone resorption markers. Consequently, the integration of bicarbonate-rich mineral water into the diet has the potential to enhance urinary and blood parameters, mitigate the risk of kidney stones, and strengthen skeletal integrity, thereby serving as a promising strategy for health promotion and disease prevention. While promising, these findings underscore the need for further research to establish long-term recommendations. Future interventional studies should be designed with rigorous randomization, larger sample sizes, cross-over methodologies, and comprehensive dietary assessments to address the methodological limitations of previous research. Full article

(This article belongs to the Section Nutrition and Public Health)

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23 pages, 5768 KiB

Open AccessArticle

Effect of Peanut Shell Extract and Luteolin on Gut Microbiota and High-Fat Diet-Induced Sequelae of the Inflammatory Continuum in a Metabolic Syndrome-like Murine Model

by Hemalata Deshmukh, Roberto Mendóza, Julianna M. Santos, Sathish Sivaprakasam, Moamen M. Elmassry, Jonathan M. Miranda, Patrick Q. Pham, Zarek Driver, Matthew Bender, Jannette M. Dufour and Chwan-Li Shen

Nutrients 2025, 17(14), 2290; https://doi.org/10.3390/nu17142290 - 10 Jul 2025

Abstract

Background: Metabolic syndrome (MetS) is characterized by chronic inflammation, oxidative stress, and mitochondrial dysfunction. MetS is associated with increased intestinal permeability and dysbiosis. The objective of this study was to investigate the effects of peanut shell extract (PSE) and luteolin (LUT) on the [...] Read more.

Background: Metabolic syndrome (MetS) is characterized by chronic inflammation, oxidative stress, and mitochondrial dysfunction. MetS is associated with increased intestinal permeability and dysbiosis. The objective of this study was to investigate the effects of peanut shell extract (PSE) and luteolin (LUT) on the kidneys, colon, and ileum in a MetS-like murine model. Methods: Thirty-six male Slc6a14^y/− mice were divided into four groups: low-fat diet (LFD), high-fat diet (HFD), HFD + 200 mg PSE/kg BW (PSE, p.o.), and HFD + 100 mg LUT/kg BW (LUT, p.o.) for 4 months. Outcome measures included glucose homeostasis, intestinal permeability, gut microbiome composition, and mRNA gene expression of mitochondrial homeostasis and inflammation/oxidative stress in the kidneys, colon, and ileum. Results: HFD resulted in glucose dysregulation with hyperglycemia and insulin resistance. PSE and LUT improved insulin tolerance and beta-cell function. PSE and LUT mitigated HFD-increased serum lipopolysaccharide-binding protein concentration. Perturbations in the gut microbiome were associated with HFD, and PSE or LUT reversed some of these changes. Specifically, Phocaeicola vulgatus was depleted by HFD and reverted by PSE or LUT. Relative to the LFD group, the HFD group (1) upregulated mitochondrial fusion (MFN1, MFN2, OPA1), mitophagy (TLR4, PINK1, LC3B), and inflammation (NFκB, TNFα, IL6), and (2) downregulated mitochondrial fission (FIS1, DRP1), biosynthesis (PGC1α, NRF1, NRF2, TFAM), electron transport chain (complex I), and antioxidant enzyme (SOD1) in the kidneys, colon, and ileum. Conclusions: PSE and LUT reversed such HFD-induced changes in the aforementioned gene expression levels. Full article

(This article belongs to the Special Issue Effects of Plant Extracts on Human Health—2nd Edition)

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12 pages, 217 KiB

Open AccessArticle

Oral Feeding of NICU Infants: A Global Survey of Current Practices and the Potential of Cold Milk Feeding Intervention

by Zeyar T. Htun, Louisa Ferrara-Gonzalez, Ranjith Kamity and Nazeeh Hanna

Nutrients 2025, 17(14), 2289; https://doi.org/10.3390/nu17142289 - 10 Jul 2025

Abstract

Background/Objectives: Infants admitted to neonatal intensive care units (NICUs) face challenges in achieving successful oral feedings. During oral feedings, these infants commonly present with suck–swallow–breathe incoordination, with approximately 30% developing dysphagia, leading to feeding aversion, prolonged hospitalization, and increased parental stress. Cold [...] Read more.

Background/Objectives: Infants admitted to neonatal intensive care units (NICUs) face challenges in achieving successful oral feedings. During oral feedings, these infants commonly present with suck–swallow–breathe incoordination, with approximately 30% developing dysphagia, leading to feeding aversion, prolonged hospitalization, and increased parental stress. Cold liquid feeding has demonstrated benefits in improving feeding safety in adults with dysphagia; however, its application in neonates is relatively limited. This study aimed to examine global neonatal feeding practices, with a specific emphasis on cold milk feeding as an intervention for dysphagia. Methods: A cross-sectional global electronic survey was distributed via professional society listservs and closed online professional group forums targeting neonatal providers and feeding therapists from June 2023 to June 2024. The survey assessed institutional feeding protocols, oral feeding practices, and the use of cold milk for infants with dysphagia. Responses were analyzed descriptively. Results: A total of 210 complete responses were received from level IV (51%), level III (42%), and level II (5%) NICUs. While 30% of the respondents were aware of cold milk feeding as a dysphagia intervention, only 15% of the total respondents reported using it in practice. Among the 32 institutions implementing cold milk practices, only one had an established protocol. Additionally, 72% reported having a feeding protocol in place, often incorporating cue-based tools. Most respondents (87.5%) did not allow oral feeding during nasal continuous positive airway pressure (nCPAP), whereas 78% permitted it during high-flow nasal cannula (HFNC) support. Conclusions: Although the awareness of cold milk feeding in neonates is increasing, its implementation remains limited and lacks standardization. Significant variability exists in oral feeding practices, particularly regarding feeding during respiratory support. This underscores the need for further research and evidence-based guidelines to ensure safe and consistent care for preterm infants. Full article

(This article belongs to the Special Issue Lactation and Breast Milk—the Appropriate System for Postnatal Programming and Disease Prevention)

16 pages, 1511 KiB

Open AccessArticle

Genotype–Drug–Diet Interactions in Metabolic Regulation: CYP1A2 rs762551 Modulates the Effect of Caffeine on Lipid and Glucose Profiles in the Context of Pharmacotherapy

by Laura Claudia Popa, Ahmed Abu-Awwad, Simona Sorina Farcas, Simona-Alina Abu-Awwad and Nicoleta Ioana Andreescu

Nutrients 2025, 17(14), 2288; https://doi.org/10.3390/nu17142288 - 10 Jul 2025

Abstract

Background/Objectives: Inter-individual metabolic responses to caffeine are shaped by CYP1A2 clearance rate and by concurrent lipid- or glucose-lowering drugs. We investigated how habitual caffeine intake relates to serum cholesterol and fasting glucose under different CYP1A2 rs762551 genotypes and statin or oral antidiabetic [...] Read more.

Background/Objectives: Inter-individual metabolic responses to caffeine are shaped by CYP1A2 clearance rate and by concurrent lipid- or glucose-lowering drugs. We investigated how habitual caffeine intake relates to serum cholesterol and fasting glucose under different CYP1A2 rs762551 genotypes and statin or oral antidiabetic (OAD) use. Methods: A prospective cross-sectional analysis was performed on 358 adults (AA = 65, AC = 163, CC = 130) with recorded genotype, daily caffeine intake, total cholesterol, fasting glucose, and medication status. Multivariable linear regression tested the main and interaction effects of caffeine (mg day⁻¹), genotype, and therapy. Results: Caffeine intake was positively associated with cholesterol levels (β = 0.30; p < 0.001). A significant genotype × caffeine interaction (β = 0.27; p < 0.001) revealed the steepest rise in fast metabolisers (AA) not on statins, an effect largely blunted by statin therapy. For glucose, the genotype × caffeine term was also significant (β = 0.30; p < 0.001). Among slow metabolisers (CC) without OADs, caffeine correlated positively with glycaemia (r = 0.34; p = 0.028), whereas in fast metabolisers on OADs the association reversed (r = −0.36; p = 0.015). No meaningful associations occurred in AC carriers. Conclusions: Caffeine’s metabolic impact depends jointly on CYP1A2 genotype and medication. It raises cholesterol in fast metabolisers lacking statins and elevates glucose in slow metabolisers without OADs, yet may lower glucose when rapid metabolisation coincides with antidiabetic therapy. Accounting for this gene–diet–drug interplay could refine caffeine guidance within precision nutrition frameworks. Full article

(This article belongs to the Section Nutrition and Metabolism)

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18 pages, 426 KiB

Open AccessArticle

Exploratory Study on Microbiota and Immune Responses to Short-Term L. paracasei CNCM I-1518 Consumption in Healthy Adults

by Fernando Rivero-Pino, Maria José Castro, Paz Redondo del Río, Eloina Gutierrez, Agustín Mayo-Iscar, Mercedes Nocito and Alfredo Corell

Nutrients 2025, 17(14), 2287; https://doi.org/10.3390/nu17142287 - 10 Jul 2025

Abstract

Background/Objectives: The gut microbiota and immune system are interconnected, with targeted nutritional interventions offering potential to modulate immune function. This study aimed to evaluate the short-term immunomodulatory effects of Lacticaseibacillus paracasei subspecies paracasei CNCM I-1518 (L. paracasei CNCM I-1518) in healthy adults. [...] Read more.

Background/Objectives: The gut microbiota and immune system are interconnected, with targeted nutritional interventions offering potential to modulate immune function. This study aimed to evaluate the short-term immunomodulatory effects of Lacticaseibacillus paracasei subspecies paracasei CNCM I-1518 (L. paracasei CNCM I-1518) in healthy adults. Methods: A 15-day dietary intervention was conducted involving healthy adults. Nutritional status, dietary habits, and systemic immune biomarkers were assessed, alongside changes in gut microbiota composition. Results: The results revealed significant effects on both cellular and humoral immunity. Cellular immunity was enhanced through increased circulating B lymphocytes, absolute monocyte counts, and leukocyte numbers, alongside reduced eosinophil levels, potentially mitigating allergic responses. Humoral immunity was improved by elevated serum IgG1, IgG2, and IgG4 levels, enhancing defenses against pathogenic antigens, and increased serum complement proteins C3 and C4, supporting innate immunity. Microbiota analysis showed a reduction in Clostridium and the Clostridium/Escherichia coli ratio, with a notable increase in the Lactobacillus/Clostridium ratio, highlighting the strain’s ability to reshape intestinal bacterial balance. Conclusions: A short-term intake of L. paracasei CNCM I-1518 can simultaneously modulate immune function and gut microbiota composition, supporting its potential as a targeted dietary intervention to promote immune health. Full article

(This article belongs to the Section Nutritional Immunology)

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30 pages, 932 KiB

Open AccessReview

The Therapeutic Potential of Butyrate and Lauric Acid in Modulating Glial and Neuronal Activity in Alzheimer’s Disease

by Rathnayaka Mudiyanselage Uththara Sachinthanie Senarath, Lotta E. Oikari, Prashant Bharadwaj, Vijay Jayasena, Ralph N. Martins and Wanakulasuriya Mary Ann Dipika Binosha Fernando

Nutrients 2025, 17(14), 2286; https://doi.org/10.3390/nu17142286 - 10 Jul 2025

Abstract

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder marked by amyloid-β plaque accumulation, tau tangles, and extensive neuroinflammation. Neuroinflammation, driven by glial cells like microglia and astrocytes, plays a critical role in AD progression. Initially, these cells provide protective functions, such as debris [...] Read more.

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder marked by amyloid-β plaque accumulation, tau tangles, and extensive neuroinflammation. Neuroinflammation, driven by glial cells like microglia and astrocytes, plays a critical role in AD progression. Initially, these cells provide protective functions, such as debris clearance and neurotrophic support. However, as AD progresses, chronic activation of these cells exacerbates inflammation, contributing to synaptic dysfunction, neuronal loss, and cognitive decline. Microglia release pro-inflammatory cytokines and reactive oxygen species (ROS), while astrocytes undergo reactive astrogliosis, further impairing neuronal health. This maladaptive response from glial cells significantly accelerates disease pathology. Current AD treatments primarily aim at symptomatic relief, with limited success in disease modification. While amyloid-targeting therapies like Aducanumab and Lecanemab show some promise, their efficacy remains limited. In this context, natural compounds have gained attention for their potential to modulate neuroinflammation and promote neuroprotection. Among these, butyrate and lauric acid are particularly notable. Butyrate, produced by a healthy gut microbiome, acts as a histone deacetylase (HDAC) inhibitor, reducing pro-inflammatory cytokines and supporting neuronal health. Lauric acid, on the other hand, enhances mitochondrial function, reduces oxidative stress, and modulates inflammatory pathways, thereby supporting glial and neuronal health. Both compounds have been shown to decrease amyloid-β deposition, reduce neuroinflammation, and promote neuroprotection in AD models. This review explores the mechanisms through which butyrate and lauric acid modulate glial and neuronal activity, highlighting their potential as therapeutic agents for mitigating neuroinflammation and slowing AD progression. Full article

(This article belongs to the Special Issue Dietary Supplement in Neurodegenerative Diseases: Nutritional Assessment)

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13 pages, 904 KiB

Open AccessReview

Exploring Individual Factors Affecting Endothelial Function Response Variability in Aging: Implications for Precision Nutrition

by Emily K. Woolf and Leanne M. Redman

Nutrients 2025, 17(14), 2285; https://doi.org/10.3390/nu17142285 - 10 Jul 2025

Abstract

Aging is a major non-modifiable risk factor for cardiovascular disease (CVD), in part due to its detrimental effects on vascular endothelial function. Dietary interventions, including those rich in plant-based components or following dietary patterns such as the Mediterranean Diet, have been shown to [...] Read more.

Aging is a major non-modifiable risk factor for cardiovascular disease (CVD), in part due to its detrimental effects on vascular endothelial function. Dietary interventions, including those rich in plant-based components or following dietary patterns such as the Mediterranean Diet, have been shown to improve endothelial function in older adults, assessed via brachial artery flow-mediated dilation (FMD). However, it is well recognized that FMD responses to dietary interventions often show considerable variability among individuals. This variability presents a major challenge to translating findings into effective, population-level guidance highlighting the need for more tailored approaches for CVD risk prevention. Thus, to advance these precision nutrition approaches, research must move beyond the overall group mean effects and begin to investigate the factors driving this variability. This narrative review summarizes current evidence on nutritional interventions that improve endothelial function with aging, highlights potential contributors to individual response variability, and outlines future research directions to reduce this variability to enhance clinical relevance and advance precision nutrition for the aging population. Full article

(This article belongs to the Special Issue The Potential of Personalized Diets for Healthy Living in Older Adults)

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19 pages, 2052 KiB

Open AccessArticle

Effects of Time-Restricted Eating (Early and Late) Combined with Energy Restriction vs. Energy Restriction Alone on the Gut Microbiome in Adults with Obesity

by Bernarda Habe, Tanja Črešnovar, Matjaž Hladnik, Jure Pražnikar, Saša Kenig, Dunja Bandelj, Nina Mohorko, Ana Petelin and Zala Jenko Pražnikar

Nutrients 2025, 17(14), 2284; https://doi.org/10.3390/nu17142284 - 10 Jul 2025

Abstract

Background: Early time-restricted eating combined with energy restriction (eTRE + ER) has been shown to reduce fat mass, diastolic blood pressure (DBP) and fasting glucose more effectively than late TRE with energy restriction (lTRE + ER) or energy restriction (ER) alone. Given the [...] Read more.

Background: Early time-restricted eating combined with energy restriction (eTRE + ER) has been shown to reduce fat mass, diastolic blood pressure (DBP) and fasting glucose more effectively than late TRE with energy restriction (lTRE + ER) or energy restriction (ER) alone. Given the gut microbiome’s sensitivity to circadian rhythms, we examined whether adding TRE, particularly eTRE, to ER alters gut microbiota composition beyond ER alone, and whether such effects persist during follow-up. Methods: We analysed anthropometric, biochemical and gut microbiome data from 76 participants at baseline and after a 3-month intervention (eTRE + ER: n = 33; lTRE + ER: n = 23; ER: n = 20). Follow-up microbiome data 6-months after the end of intervention were available for 43 participants. Gut microbiota composition was assessed via 16S rRNA gene sequencing of stool samples. Results: No significant between-group differences in beta diversity were observed over time. However, changes in alpha diversity differed significantly across groups at the end of the intervention (Shannon: F = 5.72, p < 0.001; Simpson: F = 6.72, p < 0.001; Richness: F = 3.99, p = 0.01) and at follow-up (Richness: F = 3.77, p = 0.02). lTRE + ER led to the greatest reductions in diversity post intervention, while ER was least favourable during follow-up. Although no significant between-group differences were observed at the phylum level either at the end of the intervention or during follow-up, only the eTRE + ER group exhibited a significant decrease in Bacillota and an increase in Bacteroidota during follow-up. At the genus level, differential abundance analysis revealed significant shifts in taxa such as Faecalibacterium, Subdoligranulum, and other genera within the Ruminococcaceae and Oscillospiraceae families. In the eTRE + ER, Faecalibacterium and Subdoligranulum increased, while in other groups decreased. Notably, the changes in Faecalibacterium were negatively correlated with fasting glucose, while the increase in Subdoligranulum was inversely associated with DBP; however, both associations were weak in strength. Conclusions: eTRE + ER may promote beneficial, lasting shifts in the gut microbiome associated with improved metabolic outcomes. These results support further research into personalized TRE strategies for treatment of obesity. Full article

(This article belongs to the Section Nutrition and Obesity)

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18 pages, 3848 KiB

Open AccessReview

Effectiveness of Baby-Friendly Hospital Initiative on Early Initiation and Exclusive Breastfeeding Practice: Systematic Review and Meta-Analysis

by Mahilet Berhanu Habte, Misra Abdulahi, Michelle Plusquin and Charlotte Cosemans

Nutrients 2025, 17(14), 2283; https://doi.org/10.3390/nu17142283 - 10 Jul 2025

Abstract

Background: The Baby-Friendly Hospital Initiative (BFHI) promotes, protects, and supports optimal breastfeeding through facility-based strategies. While prior studies have examined individual BFHI components in specific contexts, global evidence on its overall impact remains limited. This systematic review and meta-analysis aimed to evaluate [...] Read more.

Background: The Baby-Friendly Hospital Initiative (BFHI) promotes, protects, and supports optimal breastfeeding through facility-based strategies. While prior studies have examined individual BFHI components in specific contexts, global evidence on its overall impact remains limited. This systematic review and meta-analysis aimed to evaluate the BFHI’s effectiveness in improving early initiation and exclusive breastfeeding practices worldwide. Methods: A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Google for English-language studies. Eligible studies included randomized controlled trials (RCTs), cluster RCTs, and quasi-experimental designs assessing BFHI’s effect on breastfeeding outcomes. Random-effects meta-analysis models were used to estimate the pooled effects with 95% confidence intervals (CI). Heterogeneity was assessed using I² statistics and p-values. Study quality was appraised using the GRADE approach. Results: Thirty studies met the inclusion criteria. The BFHI was associated with increased early initiation of breastfeeding (pooled RR 1.43; 95% CI: 1.12–1.81; I² = 97.1%). Positive associations were also observed for exclusive breastfeeding at four months (RR 1.18, 95% CI: 1.08–1.29; I² = 61.7%) and at six months (RR 1.56, 95% CI: 1.14–2.14; I² = 82.8%). Substantial heterogeneity reflected variability in study design, BFHI implementation fidelity, and context. Conclusions: Our findings suggest that the BFHI is effective in improving breastfeeding practices globally. However, study variability and partial implementation may limit the generalizability of results. High-quality RCTs assessing full BFHI implementation are needed to strengthen evidence and guide global maternal–child health policy. Full article

(This article belongs to the Special Issue Lactation and Breast Milk—the Appropriate System for Postnatal Programming and Disease Prevention)

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14 pages, 396 KiB

Open AccessArticle

Relative Excess Risk of Metabolic Syndrome Due to Interaction Between Handgrip Strength and Dietary Patterns Among Korean Youth

by Seong Woong Yoon, Hunju Lee, Hyowon Choi and Yunkoo Kang

Nutrients 2025, 17(14), 2282; https://doi.org/10.3390/nu17142282 - 10 Jul 2025

Abstract

Background/Objectives: Metabolic syndrome (MetS) in adolescence increases chronic disease risk in adulthood. No study has explored the combined effects of skeletal muscle strength and dietary patterns in MetS. This study aimed to examine the individual and combined effects of dietary patterns and [...] Read more.

Background/Objectives: Metabolic syndrome (MetS) in adolescence increases chronic disease risk in adulthood. No study has explored the combined effects of skeletal muscle strength and dietary patterns in MetS. This study aimed to examine the individual and combined effects of dietary patterns and HGS on MetS and its components in Korean adolescents. Methods: Using the 2014–2019 Korea National Health and Nutrition Examination Survey data, a weighted sample of approximately 3.75 million adolescents was included. Dietary patterns were derived using principal component analysis. Relative handgrip strength (HGS) was calculated. Multivariable logistic regression and relative excess risk due to interaction (RERI) were used to assess dietary patterns, HGS, and MetS, stratified by sex and adjusted for age, smoking, alcohol consumption, economic status, residential area, and physical activity. Results: Low HGS was independently associated with a high odds of developing MetS in both men (OR, 1.108; 95% CI, 1.038–1.182) and women (OR, 1.128; 95% CI, 1.047–1.216). In contrast, dietary pattern alone was not significantly associated with MetS. Men with both low HGS and unhealthy dietary patterns (processed fat or Western diet) had higher odds of developing MetS, even though the interaction was sub-additive, as indicated by negative RERI values (processed fat: −0.22; Western diet: −0.11). Conclusions: Low HGS was a significant risk factor for MetS in Korean adolescents. Although no synergistic interaction was observed, low HGS remained a significant independent risk factor for MetS, underscoring the need to promote muscular strength in adolescents even in the absence of an unhealthy diet. Full article

(This article belongs to the Special Issue Exercise and Nutrition: Implications for Weight Management and Cardiometabolic Prevention)

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4 pages, 151 KiB

Open AccessEditorial

Obesity and Cardiovascular Disease: Mechanistic Insights and Nutritional Management Strategies

by Ehud Grossman

Nutrients 2025, 17(14), 2281; https://doi.org/10.3390/nu17142281 - 10 Jul 2025

Abstract

Obesity and overweight represent a growing global epidemic [...] Full article

(This article belongs to the Special Issue Obesity and Cardiovascular Disease: Mechanistic Insights and Nutritional Management Strategies)

31 pages, 799 KiB

Open AccessArticle

Exploring Determinants of Mediterranean Lifestyle Adherence: Findings from the Multinational MEDIET4ALL e-Survey Across Ten Mediterranean and Neighboring Countries

by Achraf Ammar, Mohamed Ali Boujelbane, Atef Salem, Khaled Trabelsi, Bassem Bouaziz, Mohamed Kerkeni, Liwa Masmoudi, Juliane Heydenreich, Christiana Schallhorn, Gabriel Müller, Ayse Merve Uyar, Hadeel Ali Ghazzawi, Adam Tawfiq Amawi, Bekir Erhan Orhan, Giuseppe Grosso, Osama Abdelkarim, Mohamed Aly, Tarak Driss, Kais El Abed, Wassim Moalla, Piotr Zmijewski, Frédéric Debeaufort, Nasreddine Benbettaieb, Clément Poulain, Laura Reyes, Amparo Gamero, Marta Cuenca-Ortolá, Antonio Cilla, Nicola Francesca, Concetta Maria Messina, Enrico Viola, Björn Lorenzen, Stefania Filice, Aadil Bajoub, El-Mehdi Ajal, El Amine Ajal, Majdouline Obtel, Sadjia Lahiani, Taha Khaldi, Nafaa Souissi, Omar Boukhris, Waqar Husain, Evelyn Frias-Toral, Walid Mahdi, Hamdi Chtourou, Haitham Jahrami and Wolfgang I. Schöllhorn Show full author list Hide full author list

Nutrients 2025, 17(14), 2280; https://doi.org/10.3390/nu17142280 - 10 Jul 2025

Abstract

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and [...] Read more.

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. Full article

(This article belongs to the Special Issue The Prevalence of Adherence to Prudent Dietary Patterns and Their Association with Physical and Mental Health)

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4 pages, 149 KiB

Open AccessEditorial

The Role of Bioactive Compounds in Human Health and Diseases (2nd Edition)

by Jacqueline I. Alvarez-Leite

Nutrients 2025, 17(14), 2279; https://doi.org/10.3390/nu17142279 - 10 Jul 2025

Abstract

The increasing recognition of bioactive compounds as influential agents in human health has ushered in a new era in nutrition science [...] Full article

(This article belongs to the Special Issue The Role of Bioactive Compounds in Human Health and Diseases (2nd Edition))

14 pages, 456 KiB

Open AccessArticle

The Cost-Effectiveness of Increased Yogurt Intake in Type 2 Diabetes in Japan

by Ryota Wakayama, Michihiro Araki, Mieko Nakamura and Nayu Ikeda

Nutrients 2025, 17(14), 2278; https://doi.org/10.3390/nu17142278 - 9 Jul 2025

Viewed by 72

Abstract

Background/Objectives: A healthy diet helps prevent noncommunicable diseases, and dairy is an essential part of this diet. Multiple meta-analyses have shown an inverse association between yogurt intake and type 2 diabetes (T2D). This study aimed to develop a simulation model and evaluate [...] Read more.

Background/Objectives: A healthy diet helps prevent noncommunicable diseases, and dairy is an essential part of this diet. Multiple meta-analyses have shown an inverse association between yogurt intake and type 2 diabetes (T2D). This study aimed to develop a simulation model and evaluate the medical and economic effects of increased yogurt intake on T2D. Methods: It predicted the T2D incidence rate, T2D mortality rate, and national healthcare expenditures (NHE) over 10 years using a Markov model for the Japanese population aged 40–79 years. Results: By increasing yogurt intake to 160 g/day or 80 g/day, the incidence rate of T2D decreased by 16.1% or 5.9%, the T2D-related mortality rate decreased by 1.6% or 0.6%, and the NHE was predicted to decrease by 2.4% and 0.9%, respectively. Conclusions: Increasing yogurt intake may be an effective strategy to prevent T2D and reduce NHE. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

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15 pages, 671 KiB

Open AccessArticle

The Hypoglycaemic Effects of the New Zealand Pine Bark Extract on Sucrose Uptake and Glycaemic Responses in Healthy Adults—A Single-Blind, Randomised, Placebo-Controlled, Crossover Trial

by Wen Xin Janice Lim, Rachel A. Page, Cheryl S. Gammon and Paul J. Moughan

Nutrients 2025, 17(14), 2277; https://doi.org/10.3390/nu17142277 - 9 Jul 2025

Viewed by 52

Abstract

Background: The New Zealand pine bark has been demonstrated in vitro to inhibit digestive enzymes involved in carbohydrate digestion (alpha-amylase, alpha-glucosidase, and dipeptidyl-peptidase 4 (DPP-4)). Objective: This study aims to investigate the inhibitory effects of the New Zealand pine bark on sucrose uptake [...] Read more.

Background: The New Zealand pine bark has been demonstrated in vitro to inhibit digestive enzymes involved in carbohydrate digestion (alpha-amylase, alpha-glucosidase, and dipeptidyl-peptidase 4 (DPP-4)). Objective: This study aims to investigate the inhibitory effects of the New Zealand pine bark on sucrose uptake and glycaemic responses in humans. Methods: A single-blind, randomised, placebo-controlled, crossover trial was carried out involving healthy adults (n = 40 (M: 12, F: 28), 30.1 ± 1.3 years, BMI 23.4 ± 0.5 kg/m², HbA1c 32.5 ± 0.6 mmol/mol, FBG 4.7 ± 0.1 mmol/L). A control (75 g of sucrose powder only), and two doses of the pine bark extract (50 and 400 mg) were provided on separate occasions, with 75 g of sucrose mixed in 250 mL of water. Blood samples were collected at −10, 0, 15, 30, 45, 60, 90, and 120 min via a finger prick test. A linear mixed model for repeated measures (SPSS v30, IBM) was applied, and data presented as model-adjusted mean ± SEM. Results: Compared to control (247.5 ± 14.0 mmol/L⋅min), the iAUCglucose was significantly reduced with the 400 mg dose (211.8 ± 13.9 mmol/L⋅min, 14.4% reduction, and p = 0.037), but not with 50 mg dose (220.8 ± 14.2 mmol/L⋅min, 10.8% reduction, and p = 0.184). Compared to control (9.1 ± 0.2 mmol/L), glucose peak value was significantly reduced with the 50 mg dose (8.6 ± 0.2 mmol/L, 5.5% reduction, and p = 0.016) but not with the 400 mg dose (8.7 ± 0.2 mmol/L, 4.4% reduction, and p = 0.093). There were no statistically significant changes in postprandial insulin levels with the pine bark extract compared to control. Conclusions: The New Zealand pine bark extract attenuated sucrose uptake with improved glycaemic responses, and may therefore be useful as a hypoglycaemic adjunct to the diet. Full article

(This article belongs to the Special Issue Effects of Plant Extracts on Human Health—2nd Edition)

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17 pages, 354 KiB

Open AccessArticle

Efficacy of Probiotic VITA-PB2 from Fermented Foods on Alcohol Consumption and Hangover Symptoms: A Randomized, Double-Blind, Placebo-Controlled Trial

by Chaodeng Mo, Johny Bajgai, Md. Habibur Rahman, Sofian Abdul-Nasir, Hui Ma, Thu Thao Pham, Haiyang Zhang, Buchan Cao, Seong Hoon Goh, Bomi Kim, Hongik Kim, Min Kyeong Seol, Young Geon Yu, Cheol-Su Kim, Kyu-Jae Lee and Seung-Taek Lim

Nutrients 2025, 17(14), 2276; https://doi.org/10.3390/nu17142276 - 9 Jul 2025

Viewed by 55

Abstract

Background: Modulating ethanol metabolism and attenuating alcohol-induced oxidative stress are promising therapeutic strategies for reducing the severity of hangovers and alleviating their associated physiological burden. Methods: A randomized, double-blind, placebo-controlled, crossover study was conducted to evaluate the effects of the probiotic [...] Read more.

Background: Modulating ethanol metabolism and attenuating alcohol-induced oxidative stress are promising therapeutic strategies for reducing the severity of hangovers and alleviating their associated physiological burden. Methods: A randomized, double-blind, placebo-controlled, crossover study was conducted to evaluate the effects of the probiotic strain Leuconostoc mesenteroides VITA-PB2 on ethanol metabolism, oxidative stress, and hangover-related symptoms in 28 healthy adults. The participants consumed either VITA-PB2 or a placebo before standardized alcohol intake, with a 7-day washout period and subsequent crossover. Primary outcomes included blood ethanol, acetaldehyde levels, and aldehyde dehydrogenase (ALDH) activity. Secondary outcomes measured hangover severity assessed by the Acute Hangover Scale (AHS), liver enzymes including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT), oxidative stress indicators reactive oxygen species (ROS) and nitric oxide (NO), and antioxidant responses measured by glutathione peroxidase (GPx), catalase, and 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging capacity. Results: VITA-PB2 supplementation led to a sustained reduction in blood ethanol concentrations beginning at 0.5 h post-ingestion compared with the placebo group, indicating more efficient ethanol clearance. Additionally, VITA-PB2 significantly reduced acetaldehyde levels at 1 h post-ingestion (p < 0.05) and increased ALDH activity by 42.15% at 30 min (p < 0.05). It also markedly reduced ROS levels at 1 h (p < 0.05), enhanced glutathione peroxidase (GPx) activity at 2 h (p < 0.01), and significantly improved the subjective hangover symptoms, particularly thirst (p < 0.05). Conclusions: No adverse effects were reported during the trial, indicating that Leuconostoc mesenteroides VITA-PB2 is a safe probiotic. These findings suggest its efficacy in mitigating alcohol-induced oxidative stress and alleviating hangover-related symptoms. Full article

(This article belongs to the Section Prebiotics and Probiotics)

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19 pages, 2485 KiB

Open AccessArticle

Anti-Obesity Effect of Liposomal Suspension and Extracts of Hibiscus sabdariffa and Zingiber officinale in a Murine Model Fed a Hypercaloric Diet

by Luis Edwardo Palomo-Martínez, Norma Paniagua-Castro, Gerardo Norberto Escalona-Cardoso, Diana E. Leyva-Daniel, Miguel A. A. Ibañez-Hernández, Yair Cruz-Narvaez and Liliana Alamilla-Beltrán

Nutrients 2025, 17(14), 2275; https://doi.org/10.3390/nu17142275 - 9 Jul 2025

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Abstract

Background/Objectives: Obesity is the primary risk factor for the development of chronic degenerative diseases. Multidisciplinary treatments target multiple pathologies associated with obesity. In this study, a potential adjuvant therapy was evaluated by combining extracts from Hibiscus sabdariffa and Zingiber officinale. These extracts [...] Read more.

Background/Objectives: Obesity is the primary risk factor for the development of chronic degenerative diseases. Multidisciplinary treatments target multiple pathologies associated with obesity. In this study, a potential adjuvant therapy was evaluated by combining extracts from Hibiscus sabdariffa and Zingiber officinale. These extracts were used in both a simple and liposomal suspension, the latter aimed at enhancing the activity of phenolic compounds and determining various metabolic benefits. Methods: In this research, the use of biotechnological approaches for the development of a liposomal suspension formulation with appropriate characteristics of stability, particle size, polydispersity index, concentration, and zeta potential induced an effective reduction in body weight and epididymal fat in a murine obesity model over 8 and 45 days. Results: Treatment with the liposomal suspension reduced variables in the lipid profile, aspartate aminotransferase activity, and energy expenditure, while also promoting an increase in locomotor activity. Conclusions: Therefore, it is suggested that the liposomal suspension represents an alternative for obesity treatment and the reduction of cardiovascular risks. Full article

(This article belongs to the Section Nutrition and Obesity)

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15 pages, 1325 KiB

Open AccessArticle

The OMNIVEG Study: Effects of Transitioning from a Traditional to a Vegan Mediterranean Diet on Fat Oxidation During Exercise

by Miguel López-Moreno, Ujué Fresán, Juan Del Coso, Alejandro Muñoz, Millán Aguilar-Navarro, María Teresa Iglesias-López, Francisco J. Amaro-Gahete and Jorge Gutiérrez-Hellín

Nutrients 2025, 17(14), 2274; https://doi.org/10.3390/nu17142274 - 9 Jul 2025

Viewed by 100

Abstract

Background: This study aimed to evaluate the changes in fat utilization associated with transitioning from a traditional to a vegan Mediterranean diet in healthy, physically active men during a ramp exercise test. Methods: In a controlled crossover design, fourteen healthy, physically active men [...] Read more.

Background: This study aimed to evaluate the changes in fat utilization associated with transitioning from a traditional to a vegan Mediterranean diet in healthy, physically active men during a ramp exercise test. Methods: In a controlled crossover design, fourteen healthy, physically active men followed a traditional Mediterranean diet for three weeks (baseline). Then, participants transitioned to a four-week isocaloric vegan version of the Mediterranean diet, matched for macronutrient distribution but excluding all animal foods. Immediately after each dietary intervention, participants completed an incremental exercise test (from 30% to 70% of VO_2peak) on a cycle ergometer in a fasted state to determine peak fat oxidation (PFO) and its associated exercise intensity (Fatmax). Exercise heart rate and the rating of perceived exertion were also recorded at each exercise intensity. Results: The traditional and vegan Mediterranean diets provided comparable amounts of energy (2599.6 ± 180.8 and 2634.9 ± 148.3 kcal/day, p = 0.140) and total fat (97.0 ± 17.8 and 99.0 ± 13.2 g/day; p = 0.620). However, the vegan Mediterranean diet contained a lower proportion of saturated fat (25.2 ± 6.8 vs. 13.6 ± 4.4% of total fat, p < 0.010). Still, the dietary transition was not associated with modifications in PFO (0.323 ± 0.153 and 0.347 ± 0.147 g/min; p = 0.678) or Fatmax (40.51 ± 7.30 and 40.51 ± 10.71%VO_2peak; p = 1.000) during exercise. Moreover, the dietary transition did not significantly change the response curves across exercise intensities for fat oxidation (p = 0.553), heart rate (p = 0.280), or the rating of perceived exertion (p = 0.433). Conclusions: Switching from a traditional to a vegan Mediterranean diet did not affect fat oxidation, exercise intensity at peak fat oxidation, or perceptual responses during exercise in healthy, active men. These findings suggest that physically active individuals can adopt a vegan version of the Mediterranean diet without compromising fat utilization during submaximal aerobic exercise. Clinical Trial Registry: NCT06008886. Date of registration: 28 July 2023. Full article

(This article belongs to the Special Issue Reducing the Burden of Chronic Diseases Through Plant-Based Diets)

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Nutrients, Volume 17, Issue 14 (July-2 2025) – 51 articles

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