Nutrients

27 pages, 8877 KiB

Open AccessArticle

Targeted Sodium Acetate Liposomes for Hepatocytes and Kupffer Cells: An Oral Dual-Targeted Therapeutic Approach for Non-Alcoholic Fatty Liver Disease Alleviation

by Yichao Hou, Xilong Gao, Jiahui Gong, Xinrui Dong, Yanling Hao, Zhengyuan Zhai, Hao Zhang, Ming Zhang, Rong Liu, Ran Wang and Liang Zhao

Nutrients 2025, 17(5), 930; https://doi.org/10.3390/nu17050930 - 6 Mar 2025

Viewed by 1099

Abstract

Background/Objectives: Sodium acetate (NaA) has demonstrated potential in improving non-alcoholic fatty liver disease (NAFLD) by targeting hepatocytes and Kupffer cells. However, its clinical application is hindered by low oral bioavailability and insufficient liver concentrations. Liposomes, with their capacity to encapsulate water-soluble drugs and [...] Read more.

Background/Objectives: Sodium acetate (NaA) has demonstrated potential in improving non-alcoholic fatty liver disease (NAFLD) by targeting hepatocytes and Kupffer cells. However, its clinical application is hindered by low oral bioavailability and insufficient liver concentrations. Liposomes, with their capacity to encapsulate water-soluble drugs and be surface-modified, offer a promising solution for targeted oral drug delivery. Methods: We designed NaA-loaded liposomes modified with sodium cholate (SC) and mannose (MAN) (NaA@SC/MAN-LPs) to target hepatocytes and Kupffer cells. Results: The NaA@SC/MAN-LPs had a mean diameter of approximately 100 nm with a positive surface charge. Compared to free NaA, NaA@SC/MAN-LPs significantly extended the serum half-life from 2.85 h to 15.58 h, substantially improving in vivo bioavailability. In vivo distribution studies revealed that NaA@SC/MAN-LPs extended the acetate peak time in the liver from 15 min to 60 min and increased hepatic acetate accumulation to 3.75 times that of free NaA. In in vitro cell experiments, NaA@SC/MAN-LPs significantly reduced the lipid droplet, triglycerides (TG), and total cholesterol (TC) in a fatty acid-induced hepatocyte steatosis model and suppressed proinflammation in a lipopolysaccharide (LPS)-activated Kupffer cell inflammation model. Free NaA effectively improved hepatic lipid deposition in NAFLD mice. Furthermore, NaA@SC/MAN-LPs decreased hepatic TG, TC, and the relative area of lipid droplets by 30.44%, 15.26%, and 55.83%, compared to free NaA. Furthermore, the liposomes reduced macrophage infiltration and pro-inflammatory response. Conclusions: The NaA@SC/MAN-LPs demonstrated effective dual targeting effects on hepatocytes and Kupffer cells, significantly improving the pathogenesis of NAFLD, compared to free NaA. This study provides a new strategy for developing effective and safe oral drugs for NAFLD. Full article

(This article belongs to the Section Clinical Nutrition)

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23 pages, 2159 KiB

Open AccessArticle

The Short- and Long-Term Effects of a Short Course of Sauerkraut Supplementation on the Gut Microbiota of Active Athletes: A Pilot Follow-Up Study

by Jadran Zonjić, Andrija Karačić, Ivona Brodić, Antonio Starčević, Ira Renko, Željko Krznarić, Matija Ivančić, Ana-Marija Liberati Pršo and Zvonimir Šatalić

Nutrients 2025, 17(5), 929; https://doi.org/10.3390/nu17050929 - 6 Mar 2025

Viewed by 1390

Abstract

Objectives: The application of whole fermented foods in sports nutrition for gut microbiota personalization is a promising area of investigation. Sauerkraut, a traditional fermented food, has not been extensively studied in this context. This study aimed to replicate earlier findings of a [...] Read more.

Objectives: The application of whole fermented foods in sports nutrition for gut microbiota personalization is a promising area of investigation. Sauerkraut, a traditional fermented food, has not been extensively studied in this context. This study aimed to replicate earlier findings of a proof-of-concept study on the potential of sauerkraut for gut microbiota personalization in active athletes. Methods: A pilot follow-up study was conducted on active recreational athletes who consumed 250 g of organic pasteurized sauerkraut daily for 10 days. Changes in gut microbiota composition and functionality were assessed using 16S rRNA sequencing and metabolic pathway analysis across three time points: pre-intervention, postintervention, and one-month postintervention. Laboratory parameters, bowel function, and side effects were monitored throughout the study. Results: In total, 11 male participants with an average age of 30 years completed the study. The pilot follow-up study did not replicate the original study’s findings on sauerkraut’s short-term effects on β-diversity and taxonomic and functional groups. However, long-term effects of sauerkraut supplementation were demonstrated, including a significant reduction in α-diversity variance and increased gut microbiota composition similarity (β-diversity) as well as several significant changes in bacterial taxa and metabolic pathways after a washout period. The intervention also induced a transient decrease in B12 vitamin levels and a short- and long-term increase in leukocyte concentrations. The probability for physiological types of stools increased after one week of sauerkraut supplementation as well as the incidence of gastrointestinal side effects, such as bloating, diarrhea, pain, nausea, and constipation. Conclusions: This study suggests that the short-term effects on the gut microbiota of sauerkraut supplementation depend on its baseline status, but it can induce long-term effects. Sauerkraut supplementation requires a seven-day adaptation period. Further research is needed to explore the mechanisms behind the short- and long-term effects of sauerkraut supplementation. Full article

(This article belongs to the Special Issue Food First: A New Perspective on Sports Nutrition)

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26 pages, 1347 KiB

Open AccessArticle

Communication Intervention to Improve Young Adults’ Food Safety Practices: The Benefits of Using Congruent Framing

by Michela Vezzoli, Valentina Carfora and Patrizia Catellani

Nutrients 2025, 17(5), 928; https://doi.org/10.3390/nu17050928 - 6 Mar 2025

Viewed by 840

Abstract

Background/Objectives: Improving food safety practices among young adults is critical to public health, but effective communication strategies are under-researched. This study investigated the effectiveness of a 12-day message-based intervention to promote safe food handling practices using a randomised controlled trial. Methods: A total [...] Read more.

Background/Objectives: Improving food safety practices among young adults is critical to public health, but effective communication strategies are under-researched. This study investigated the effectiveness of a 12-day message-based intervention to promote safe food handling practices using a randomised controlled trial. Methods: A total of 588 participants (aged 18 to 35 years) were randomly assigned to one of four experimental conditions or to a control group. Participants in the intervention groups received daily messages via a mobile app, while the control group received no messages. The intervention combined belief-based content to raise awareness with skill-based content to teach practical food handling, framed by either positive or negative emotional appeals. The experimental conditions differed in message congruence, with belief-based and skill-based content framed either consistently (both positive or both negative) or inconsistently (one positive, one negative). To assess the impact of the intervention, self-reported adherence to food safety practices, food safety awareness, and self-efficacy were measured at baseline and post-intervention. Results: The results showed that the intervention significantly improved food safety practices, especially when the messages were congruent in valence. Pre-intervention self-efficacy moderated the effects, with higher self-efficacy increasing receptivity to certain messages, while lower self-efficacy benefited from a different framing. Self-efficacy, but not awareness, mediated behaviour change, highlighting its key role in the success of the intervention. Conclusions: These results emphasise the importance of message valence congruence and individual self-efficacy levels in designing effective food safety interventions. Future research should investigate long-term intervention effects, adaptive mHealth strategies, and tailored communication approaches to maximise engagement and sustained behaviour change. Full article

(This article belongs to the Special Issue Precision Nutrition for Sustainable Health: Advancing Food Safety and Personalized Dietary Interventions)

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11 pages, 489 KiB

Open AccessArticle

Nutritional Status and Its Impact on Treatment Tolerance in Non-Small-Cell Lung Cancer Patients Receiving Osimertinib

by Claudia Barca-Díez, Regina Palmeiro-Carballa, Susana Castro-Luaces, Maria Susana Fortes-González, Silvia Vazquez-Blanco, Noemi Martínez-López-De-Castro and Natividad Lago-Rivero

Nutrients 2025, 17(5), 927; https://doi.org/10.3390/nu17050927 - 6 Mar 2025

Viewed by 859

Abstract

Background/Objectives: Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases and is a leading cause of morbidity and mortality worldwide. Between 35% and 65% of NSCLC patients experience nutritional problems or malnutrition, which significantly affects their prognosis and [...] Read more.

Background/Objectives: Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases and is a leading cause of morbidity and mortality worldwide. Between 35% and 65% of NSCLC patients experience nutritional problems or malnutrition, which significantly affects their prognosis and quality of life. This study aims to describe the nutritional status and body composition of NSCLC patients treated with osimertinib, an oral tyrosine kinase inhibitor, while also assessing the prevalence of sarcopenia, presarcopenia, and dynapenia. Additionally, we explore the relationship between dose-limiting toxicities (DLTs) and nutritional status, as well as the impact of nutritional status on quality of life using the EQ-5D scale. Methods: A cross-sectional, observational study was conducted in 25 adult patients diagnosed with NSCLC treated with osimertinib under pharmacotherapeutic follow-up in the Pharmacy Consultations of a tertiary-level hospital. Anthropometric parameters, body composition (via bioimpedance analysis), and muscle functionality (via dynamometry) were assessed. Quality of life was evaluated using the EQ-5D scale. Results: The results showed that 36% of patients were malnourished, 4% had sarcopenia, 8% were presarcopenic, and 20% had dynapenia. Patients with DLTs exhibited significantly lower values of fat-free mass and the fat-free mass index, suggesting a relationship between low muscle mass and increased toxicities. Conclusions: These findings underscore the importance of early, individualized nutritional interventions in NSCLC patients treated with osimertinib to improve nutritional status and optimize oncological outcomes. Further research with larger cohorts and longitudinal designs is necessary to confirm these findings. Full article

(This article belongs to the Section Clinical Nutrition)

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20 pages, 2401 KiB

Open AccessArticle

Precision Medicine in Cardiovascular Disease Prevention: Clinical Validation of Multi-Ancestry Polygenic Risk Scores in a U.S. Cohort

by Małgorzata Ponikowska, Paolo Di Domenico, Alessandro Bolli, George Bartholomew Busby, Emma Perez and Giordano Bottà

Nutrients 2025, 17(5), 926; https://doi.org/10.3390/nu17050926 - 6 Mar 2025

Viewed by 1186

Abstract

Background: Polygenic risk score (PRS) quantifies the cumulative effects of common genetic variants across the genome, including both coding and non-coding regions, to predict the risk of developing common diseases. In cardiovascular medicine, PRS enhances risk stratification beyond traditional clinical risk factors, offering [...] Read more.

Background: Polygenic risk score (PRS) quantifies the cumulative effects of common genetic variants across the genome, including both coding and non-coding regions, to predict the risk of developing common diseases. In cardiovascular medicine, PRS enhances risk stratification beyond traditional clinical risk factors, offering a precision medicine approach to coronary artery disease (CAD) prevention. This study evaluates the predictive performance of a multi-ancestry PRS framework for cardiovascular risk assessment using the All of Us (AoU) short-read whole-genome sequencing dataset comprising over 225,000 participants. Methods: We developed PRSs for lipid traits (LDL-C, HDL-C, triglycerides) and cardiometabolic conditions (type 2 diabetes, hypertension, atrial fibrillation) and constructed two metaPRSs: one integrating lipid and cardiometabolic PRSs (risk factor metaPRS) and another incorporating CAD PRSs in addition to these risk factors (risk factor + CAD metaPRS). Predictive performance was evaluated separately for each trait-specific PRS and for both metaPRSs to assess their effectiveness in CAD risk prediction across diverse ancestries. Model predictive performance, including calibration, was assessed separately for each ancestry group, ensuring that all metrics were ancestry-specific and that PRSs remain generalizable across diverse populations Results: PRSs for lipids and cardiometabolic conditions demonstrated strong predictive performance across ancestries. The risk factors metaPRS predicted CAD risk across multiple ancestries. The addition of a CAD-specific PRS to the risk factors metaPRS improved predictive performance, highlighting a genetic component in CAD etiopathology that is not fully captured by traditional risk factors, whether clinically measured or genetically inferred. Model calibration and validation across ancestries confirmed the broad applicability of PRS-based approaches in multi-ethnic populations. Conclusion: PRS-based risk stratification provides a reliable, ancestry-inclusive framework for personalized cardiovascular disease prevention, enabling better targeted interventions such as pharmacological therapy and lifestyle modifications. By incorporating genetic information from both coding and non-coding regions, PRSs refine risk prediction across diverse populations, advancing the integration of genomics into precision medicine for common diseases Full article

(This article belongs to the Special Issue Impact of Lipids on Cardiovascular Health)

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19 pages, 4793 KiB

Open AccessArticle

Evaluating the Components, Nutrients, and Antioxidant and Anti-Inflammatory Properties of Centranthera grandiflora Benth Extracts

by Wenjuan Yuan, Xinlan Liu, Xinting Wang, Zejin Nian, Xiaoyun Wu, Chengting Zi, Sha Xu, Xiaojing Shen and Xuanjun Wang

Nutrients 2025, 17(5), 925; https://doi.org/10.3390/nu17050925 - 6 Mar 2025

Viewed by 782

Abstract

Background: Centranthera grandiflora Benth is commonly utilized in China to take advantage of its purported health benefits. Methods: Here, the chemical composition, nutritional value, and bioactivity of C. grandiflora Benth extract (CGE) are characterized, and the mechanisms through which it functions were explored. [...] Read more.

Background: Centranthera grandiflora Benth is commonly utilized in China to take advantage of its purported health benefits. Methods: Here, the chemical composition, nutritional value, and bioactivity of C. grandiflora Benth extract (CGE) are characterized, and the mechanisms through which it functions were explored. Results: CGE was found to exhibit a favorable nutritional and biosafety profile, especially due to its high amino acid and mineral contents. A UPLC-ESI-Q-TOF/MS approach identified 20 compounds. Through network pharmacology analyses, the antioxidant activity of CGE was found to be mediated through the PI3K/Akt pathway, with molecular docking results providing support for mussaenoside and azafrin as important bioactive compounds. At the cellular level, antioxidant activity of key protective antioxidants including GSH-Px and SOD while suppressing ROS accumulation, levels of damage-related factors (MDA, NO, TNF-α, IL-1β, and IL-6), and iNOS and COX-2 in RAW264.7 cells treated with LPS. These findings offer potential evidence for using CGE to lower oxidative stress and inflammation. Further analyses demonstrated the ability of CGE to promote Nrf2 and HO-1 upregulation, whereas Keap1 levels were suppressed, as were PI3K/Akt/NF-κB proteins. In light of these results, CGE appears to be able to act via simultaneously enhancing Nrf2/HO-1 activity and reducing that of PI3K/Akt/NF-κB. Conclusions: CGE, as a rich source of iridoid glycosides and other nutrients, may thus be a valuable dietary supplement for use in food applications. Full article

(This article belongs to the Section Phytochemicals and Human Health)

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11 pages, 494 KiB

Open AccessPerspective

Potential Roles of Exogenous Proteases and Lipases as Prebiotics

by Yongshou Yang, Thanutchaporn Kumrungsee, Yukako Okazaki, Toshiro Watanabe, Junji Inoue, Takafumi Iguchi, Shinji Fukuda, Manabu Kuroda, Kyoichi Nishio, Shotaro Yamaguchi and Norihisa Kato

Nutrients 2025, 17(5), 924; https://doi.org/10.3390/nu17050924 - 6 Mar 2025

Viewed by 1308

Abstract

Digestive enzymes, such as proteases and lipases, are widely recognized for their crucial roles in the ripening and production of fermented foods. Digestive enzymes are also used as supplements in nonruminant livestock to enhance feed digestion and promote animal growth. However, information on [...] Read more.

Digestive enzymes, such as proteases and lipases, are widely recognized for their crucial roles in the ripening and production of fermented foods. Digestive enzymes are also used as supplements in nonruminant livestock to enhance feed digestion and promote animal growth. However, information on the effects of exogenous digestive enzymes on gut health and disease remains limited. Notably, recent studies show that consuming proteases and lipases can increase the levels of beneficial bacteria and short-chain fatty acids in rodent gut. These findings led us to hypothesize that intestinal proteases and lipases play beneficial roles by enriching beneficial bacteria. To examine this hypothesis, we reviewed recent studies on the potential effects of exogenous digestive enzymes on gut microbiota composition and overall health. Consistent with the hypothesis, all 13 studies in this review reported significant improvements in animal gut microbiota composition with the dietary supplementation of proteases and lipases. Additionally, the possible mechanisms of the prebiotic-like effects of the enzymes through increased nutrient digestion were discussed. This review explores how exogenous proteases and lipases influence gut microbiota composition and overall health. This is the first review to provide insights into the potential roles of exogenous digestive enzymes as prebiotics. Full article

(This article belongs to the Special Issue Prebiotics, Probiotics, and Gut Microbiota with Chronic Disease—2nd Edition)

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14 pages, 2395 KiB

Open AccessArticle

Milk Exosome-Based Delivery System for Probiotic Encapsulation That Enhances the Gastrointestinal Resistance and Adhesion of Probiotics

by Linlin Hao, Yinxue Liu, Ignatius Man-Yau Szeto, Haining Hao, Tai Zhang, Tongjie Liu and Huaxi Yi

Nutrients 2025, 17(5), 923; https://doi.org/10.3390/nu17050923 - 6 Mar 2025

Viewed by 1333

Abstract

The oral administration of probiotics is a promising strategy to regulate the host–intestinal flora balance and improve health. Nevertheless, adverse gastrointestinal (GI) conditions affect the activity of free native probiotics. In this study, a novel probiotic encapsulation system based on milk exosomes (mExos) [...] Read more.

The oral administration of probiotics is a promising strategy to regulate the host–intestinal flora balance and improve health. Nevertheless, adverse gastrointestinal (GI) conditions affect the activity of free native probiotics. In this study, a novel probiotic encapsulation system based on milk exosomes (mExos) and DSPE-PEG-PBA was developed. mExos acted as a shield to protect probiotics from harsh GI environments, and DSPE-PEG-PBA served as a bridge between mExos and probiotics. The coated probiotics were characterized by transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR), and intrinsic fluorescence spectra. The results showed three probiotics (Akkermansia muciniphila (AKK), Bifidobacterium animalis subsp. lactis BB-12 (BB12), and Lactiplantibacillus plantarum Q7 (Q7)) were coated with mExos@DSPE-PEG-PBA, with encapsulation rates of 90.37 ± 0.45%, 84.47 ± 1.22%, and 70.93 ± 2.39%, respectively. This encapsulation not only preserved the growth activity of the probiotics but also provided robust protection against the detrimental effects of acidic pH, bile salts, and digestive enzymes. The encapsulated strains Q7, BB12, and AKK demonstrated survival rates of 80.99 ± 0.41%, 85.28 ± 0.20%, and 94.53 ± 0.26%, respectively, in an in vitro simulated GI environment. The mExos@DSPE-PEG-PBA-encapsulated probiotics exhibited enhanced hydrophobicity and auto-aggregation capacity, accompanied by a significant improvement in mucoadhesive properties, which collectively potentiated their colonization potential within the gastrointestinal tract. These findings substantiate the potential of mExos as an encapsulation platform for probiotics, providing valuable insights into the selection of exosomes as encapsulating agents to enhance probiotic viability and mucoadhesive capacity. Full article

(This article belongs to the Special Issue Prebiotics and Probiotics in Metabolism Disorder—2nd Edition)

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35 pages, 534 KiB

Open AccessReview

Exploring the Efficacy and Safety of Nutritional Supplements in Alzheimer’s Disease

by Paola Gualtieri, Giulia Frank, Rossella Cianci, Lucilla Ciancarella, Leonardo Romano, Moreno Ortoman, Giulia Bigioni, Francesco Nicoletti, Mario Isidoro Falco, Giada La Placa and Laura Di Renzo

Nutrients 2025, 17(5), 922; https://doi.org/10.3390/nu17050922 - 6 Mar 2025

Cited by 1 | Viewed by 2601

Abstract

Background: Alzheimer’s disease (AD) represents one of the major challenges of modern medicine, with a growing impact on public health and healthcare systems. In recent years, dietary supplements use has been the subject of increasing interest as a complementary strategy for the prevention [...] Read more.

Background: Alzheimer’s disease (AD) represents one of the major challenges of modern medicine, with a growing impact on public health and healthcare systems. In recent years, dietary supplements use has been the subject of increasing interest as a complementary strategy for the prevention and treatment of the disease. Materials and Methods: A Review of reviews was conducted following PRISMA guidelines and REAPPRAISED checklist to evaluate the efficacy and safety of supplement use in AD. The search, performed across major scientific databases, identified 54 relevant articles, including 53 reviews and one mini-review, after applying specific inclusion criteria and removing duplicates. Results: The growing body of evidence suggests that some supplements may help reduce cognitive decline, inflammation, and target mechanisms behind AD. However, many of these supplements are still under investigation, with mixed results highlighting the need for high-quality research. A key challenge is the lack of data on optimal dosages, administration duration, and long-term safety, which limits clinical guidelines. Some studies have reported positive effects from specific regimens, such as curcumin (800 mg/day), omega-3 fatty acids (2 g/day), and resveratrol (600 mg/day). Other supplements, like phosphatidylserine (300 mg/day), multinutrient formulations, probiotics, vitamin E (2000 IU/day), and melatonin (3–10 mg/day), also show benefits, though study variability makes conclusions uncertain. Conclusions: While certain supplements show potential in mitigating cognitive decline in AD, inconsistent findings and gaps in dosage and safety data highlight the need for rigorous, large-scale trials. Future research should focus on personalized, multimodal strategies integrating targeted supplementation, dietary patterns, and microbiota-gut-brain interactions for enhanced neuroprotection. Full article

(This article belongs to the Special Issue Dietary Supplements and Chronic Diseases)

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20 pages, 3416 KiB

Open AccessArticle

Host Transcriptome and Microbial Variation in Relation to Visceral Hyperalgesia

by Christopher J. Costa, Stephanie Prescott, Nicolaas H. Fourie, Sarah K. Abey, LeeAnne B. Sherwin, Bridgett Rahim-Williams, Paule V. Joseph, Hugo Posada-Quintero, Rebecca K. Hoffman and Wendy A. Henderson

Nutrients 2025, 17(5), 921; https://doi.org/10.3390/nu17050921 - 6 Mar 2025

Viewed by 808

Abstract

Background: Chronic visceral hypersensitivity is associated with an overstressed pain response to noxious stimuli (hyperalgesia). Microbiota are active modulators of host biology and are implicated in the etiology of visceral hypersensitivity. Objectives: we studied the association between the circulating mRNA transcriptome, the intensity [...] Read more.

Background: Chronic visceral hypersensitivity is associated with an overstressed pain response to noxious stimuli (hyperalgesia). Microbiota are active modulators of host biology and are implicated in the etiology of visceral hypersensitivity. Objectives: we studied the association between the circulating mRNA transcriptome, the intensity of induced visceral pain (IVP), and variation in the oral microbiome among participants with and without baseline visceral hypersensitivity. Methods: Transcriptomic profiles and microbial abundance were correlated with IVP intensity. Host mRNA and microbes associated with IVP were explored, linking variation in the microbiome to host RNA biology. Results: 259 OTUs were found to be associated with IVP through correlation to differential expression of 471 genes in molecular pathways related to inflammation and neural mechanisms, including Rho and PI3K/AKT pathways. The bacterial families Lachnospiraceae, Prevotellaceae, and Veillonellaceae showed the highest degree of association. Oral microbial profiles with reduced diversity were characteristic of participants with visceral hypersensitivity. Conclusions: Our results suggest that the oral microbiome may be involved in systemic immune and inflammatory effects and play a role in nervous system and stem cell pathways. The interactions between visceral hypersensitivity, differentially expressed molecular pathways, and microbiota described here provide a framework for further work exploring the relationship between host and microbiome. Full article

(This article belongs to the Special Issue Diet and Microbiota–Gut–Brain Axis: A Novel Nutritional Therapy)

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7 pages, 188 KiB

Open AccessEditorial

Magnesium Homeostasis and Magnesium Transporters in Human Health

by Man Liu and Samuel C. Dudley, Jr.

Nutrients 2025, 17(5), 920; https://doi.org/10.3390/nu17050920 - 6 Mar 2025

Viewed by 999

Abstract

Magnesium (Mg²⁺) used to be considered only as a passive cation associated with ATP, but this special issue reinforces the idea that Mg²⁺ has many more roles [...] Full article

(This article belongs to the Special Issue Magnesium Homeostasis and Magnesium Transporters in Human Health)

12 pages, 1011 KiB

Open AccessArticle

Prognostic Impact of Malnutrition Evaluated via Bioelectrical Impedance Vector Analysis (BIVA) in Acute Ischemic Stroke: Findings from an Inverse Probability Weighting Analysis

by Simone Dal Bello, Laura Ceccarelli, Yan Tereshko, Gian Luigi Gigli, Lucio D’Anna, Mariarosaria Valente and Giovanni Merlino

Nutrients 2025, 17(5), 919; https://doi.org/10.3390/nu17050919 - 6 Mar 2025

Cited by 1 | Viewed by 709

Abstract

Background. The association between malnutrition and poor outcomes in stroke patients has, to date, been evaluated using composite scores derived from laboratory measurements. However, Bioelectrical Impedance Analysis (BIA) and its advanced application, Bioelectrical Impedance Vector Analysis (BIVA), offer a non-invasive, cost-efficient, and rapid [...] Read more.

Background. The association between malnutrition and poor outcomes in stroke patients has, to date, been evaluated using composite scores derived from laboratory measurements. However, Bioelectrical Impedance Analysis (BIA) and its advanced application, Bioelectrical Impedance Vector Analysis (BIVA), offer a non-invasive, cost-efficient, and rapid alternative. These methods enable precise assessment of body composition, nutritional status, and hydration levels, making them valuable tools in the clinical evaluation of stroke patients. Objective. This study aimed to compare the ordinal distribution of modified Rankin Scale (mRS) scores at 90 days following an acute ischemic stroke, stratifying patients based on their nutritional status at the time of Stroke Unit admission, as determined by the Bioelectrical Impedance Vector Analysis (BIVA) malnutrition parameter. Methods. We conducted a single-centre prospective observational study on all consecutive patients admitted for acute ischemic stroke to our Stroke Unit between 1 April 2024, and 30 September 2024. We applied the IPW (Inverse Probability Weighting) statistical technique and ordinal logistic regression to compare mRS scores in malnourished and non-malnourished patients. Results. Overall, our study included 195 patients with ischemic stroke assessed using BIVA. Of these, 37 patients (19%) were malnourished. After IPW, we found that malnourished patients had significantly lower rates of favorable 90-day functional outcomes (cOR 3.34, 95% CI 1.74–6.41; p = 0.001). Even after accounting for relevant covariates, malnutrition remained an independent predictor of unfavorable outcomes (acOR 2.79, 95% CI 1.37–5.70; p = 0.005), along with NIHSS score at admission (acOR 1.19, 95% CI 1.11–1.28; p < 0.001), intravenous thrombolysis (acOR 0.28, 95% CI 0.15–0.52; p < 0.001), absolute lymphocyte count (cOR 1.01, 95% CI 1.00–1.02; p = 0.027), and albumin concentration (cOR 0.82, 95% CI 0.75–0.89; p < 0.001). Conclusions. Malnutrition, assessed through Bioelectrical Impedance Vector Analysis (BIVA) at the time of admission to the Stroke Unit, is associated with worse clinical outcomes at 90 days following the ischemic cerebrovascular event. Full article

(This article belongs to the Section Nutrition and Neuro Sciences)

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22 pages, 2619 KiB

Open AccessReview

A Review of Carbohydrate Supplementation Approaches and Strategies for Optimizing Performance in Elite Long-Distance Endurance

by Wei Cao, Yong He, Ronghua Fu, Yiru Chen, Jiabei Yu and Zihong He

Nutrients 2025, 17(5), 918; https://doi.org/10.3390/nu17050918 - 6 Mar 2025

Viewed by 6266

Abstract

Carbohydrate supplementation is a common practice among endurance athletes participating in long-distance competitions. However, glycogen storage regulation, in-competition blood glucose levels, and their relationship with athletic performance are influenced by multiple factors. This review summarizes the recent research progress on carbohydrate supplementation, addressing [...] Read more.

Carbohydrate supplementation is a common practice among endurance athletes participating in long-distance competitions. However, glycogen storage regulation, in-competition blood glucose levels, and their relationship with athletic performance are influenced by multiple factors. This review summarizes the recent research progress on carbohydrate supplementation, addressing its applications in the pre-, during-, and post-competition phases. It explores variables that influence the effectiveness of carbohydrate supplementation and provides a summary of strategies, based on six key aspects: carbohydrate properties, multi-nutrient interactions, gastrointestinal function, individual differences (such as age and gender), environmental conditions, and psychological factors. The combination of different types, ratios, and concentrations of carbohydrates has been demonstrated to enhance the efficiency of carbohydrate digestion and absorption. The synergistic combination of protein, sodium, and caffeine intake demonstrates enhanced efficacy in carbohydrate supplementation strategies. Gastrointestinal tolerance training for carbohydrate supplementation has been identified as an effective measure to alleviate gastrointestinal discomfort during high-dose carbohydrate intake. The adjustment of the carbohydrate-to-fat ratio and the type of carbohydrate intake has been found to mitigate the impact of gender and menstrual cycles on glycogen storage and substrate utilization. Modifying the timing of glycogen storage and regulating the concentration and temperature of carbohydrate solutions during competition have been demonstrated to facilitate coping with the elevated energy expenditure and metabolic substrate shift from fat to carbohydrates, triggered by a combination of environmental and psychological factors, including special environmental and climatic conditions (e.g., high altitude, high temperature, high humidity, and cold) and emotional states (e.g., pre-competition stress and anxiety during the competition). To achieve precise carbohydrate supplementation for athletes in major events under various competitive environments, it is necessary to quantitatively assess the effects of carbohydrate supplementation, supported by mechanistic studies. This can be achieved by utilizing wearable devices to monitor the entire competition, coupled with data collection technologies, such as high-throughput profiling. Furthermore, emerging data analytics techniques, such as machine learning and causal inference, should be leveraged to refine supplementation strategies. Full article

(This article belongs to the Special Issue The Role of Protein and Carbohydrate Supplementation in Improving Athletic Performance)

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16 pages, 1801 KiB

Open AccessArticle

Hydrogen and Methane Detection in Breath in Response to Two Different Types of Dietary Fiber and Its Relationship to Postprandial Glucose Concentration in Obese Patients with Type 2 Diabetes and Normoglycemic Subjects

by Inna Misnikova, Yulia Kovaleva, Svetlana Shokur, Tyler W. LeBaron, Oxana Povarova and Oleg Medvedev

Nutrients 2025, 17(5), 917; https://doi.org/10.3390/nu17050917 - 6 Mar 2025

Cited by 1 | Viewed by 900

Abstract

Background: The aim of this study was to investigate the relationship between postprandial glycemic levels based on flashmonitoring and the production of intestinal hydrogen (H₂) and methane (CH₄) gases based on the measurement of the amount of these gases [...] Read more.

Background: The aim of this study was to investigate the relationship between postprandial glycemic levels based on flashmonitoring and the production of intestinal hydrogen (H₂) and methane (CH₄) gases based on the measurement of the amount of these gases in exhaled air. Materials and Methods: We studied 14 subjects with type 2 diabetes mellitus (T2DM) and 14 individuals without diabetes (control) with two food load tests, including two types of dietary fiber (inulin and guar gum), with the simultaneous determination of gases in exhaled air and the assessment of glucose levels. Results: All subjects in the control group had a significant increase in exhaled H₂. OR for increased hydrogen production in patients with T2DM was 0.17 (95% CI 0.031–0.93, p = 0.043). The level of H₂ in exhaled breath after food load in patients with T2DM was lower than in normoglycemic subjects. There was an inverse correlation between maximum glucose rise and maximum H₂ in exhaled air after food load in normoglycemic subjects (r = −0.569, p = 0.034). Patients with T2DM had direct correlations between the level of CH₄ in exhaled air and the parameters of postprandial glycemia in the lactulose test (p < 0.05). Conclusions: The confirmation of a causal relationship between decreased H₂ production, increased intestinal CH₄ production, and more severe postprandial glycemia may identify new therapeutic targets in the correction of postprandial glycemia in patients with T2DM. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

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20 pages, 658 KiB

Open AccessArticle

Gene–Lifestyle Interactions in Renal Dysfunction: Polygenic Risk Modulation via Plant-Based Diets, Coffee Intake, and Bioactive Compound Interactions

by Meiling Liu, Da-Sol Kim and Sunmin Park

Nutrients 2025, 17(5), 916; https://doi.org/10.3390/nu17050916 - 6 Mar 2025

Viewed by 882

Abstract

Background: This study aimed to investigate genetic variants associated with the estimated glomerular filtration rate (eGFR) and their interactions with lifestyle factors and bioactive compounds in large hospital-based cohorts, assessing their impact on renal dysfunction risk. Methods: Participants were categorized into two groups [...] Read more.

Background: This study aimed to investigate genetic variants associated with the estimated glomerular filtration rate (eGFR) and their interactions with lifestyle factors and bioactive compounds in large hospital-based cohorts, assessing their impact on renal dysfunction risk. Methods: Participants were categorized into two groups based on eGFR: High-GFR (control; n = 51,084) and Low-GFR (renal dysfunction; n = 7617), using an eGFR threshold of 60 mL/min/1.73 m². Genetic variants were identified through a genome-wide association analysis, and their interactions with lifestyle factors were assessed a using generalized multifactor dimensionality reduction (GMDR) analysis. Additionally, interactions between polygenic risk scores (PRS) and nutrient intake were examined. Results: Low eGFR was associated with higher urinary protein levels (4.67-fold) and correlated with a Western-style diet and with saturated fat, arginine, and isoleucine intakes but not sodium intake. The genetic model for low eGFR included variants linked to energy production and amino acid metabolism, such as rs1047891_CPS1, rs3770636_LRP2, rs5020545_SHROOM3, rs3812036_SLC34A1, and rs4715517_HCRTR2. A high PRS was associated with a 1.78-fold increased risk of low eGFR after adjusting for sociodemographic and lifestyle factors. The PRS from the 6-SNP model interacted with plant-based diets (PBDs) and coffee intake, where individuals with higher PBD and coffee consumption had a lower risk of renal dysfunction. Additionally, CPS1 rs1047891 interacted with vitamin D intake (p = 0.0436), where the risk allele was linked to lower eGFR with low vitamin D intake but not with high intake. Molecular docking showed that vitamin D3 had a lower binding energy to the CPS1 mutant type (−9.9 kcal/mol) than the wild type (−7.5 kcal/mol), supporting a potential gene–nutrient interaction influencing renal function. Conclusions: Middle-aged and elderly individuals with a high genetic risk for renal dysfunction may benefit from a plant-based diet, moderate coffee consumption, and sufficient vitamin D intake. Full article

(This article belongs to the Special Issue The Role of Foods and Nutritional and Botanical Supplements for the Enhancement of Human Health and Performance)

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23 pages, 2928 KiB

Open AccessArticle

Short-Term Magnesium Supplementation Has Modest Detrimental Effects on Cycle Ergometer Exercise Performance and Skeletal Muscle Mitochondria and Negligible Effects on the Gut Microbiota: A Randomized Crossover Clinical Trial

by Matthew C. Bomar, Taylor R. Ewell, Reagan L. Brown, David M. Brown, Beatrice S. Kwarteng, Kieran S. S. Abbotts, Hannah M. Butterklee, Natasha N. B. Williams, Scott D. Wrigley, Maureen A. Walsh, Karyn L. Hamilton, David P. Thomson, Tiffany L. Weir and Christopher Bell

Nutrients 2025, 17(5), 915; https://doi.org/10.3390/nu17050915 - 6 Mar 2025

Cited by 1 | Viewed by 3591

Abstract

Background/Objectives: Although the importance of magnesium for overall health and physiological function is well established, its influence on exercise performance is less clear. The primary study objective was to determine the influence of short-term magnesium supplementation on cycle ergometer exercise performance. The hypothesis [...] Read more.

Background/Objectives: Although the importance of magnesium for overall health and physiological function is well established, its influence on exercise performance is less clear. The primary study objective was to determine the influence of short-term magnesium supplementation on cycle ergometer exercise performance. The hypothesis was that magnesium would elicit an ergogenic effect. Methods: A randomized, double-blind, placebo-controlled, two-period crossover design was used to study men and women who were regular exercisers. Fifteen participants ingested either a placebo or magnesium chloride (MgCl₂ 300 mg) twice per day, for 9 days, separated by a 3-week washout. During days 8 and 9, participants completed a battery of cycle ergometer exercise tests, and whole blood, vastus lateralis, and stools were sampled. The primary outcomes were the maximal oxygen uptake (VO_2max), a simulated 10 km time trial, and the sprint exercise performance. Additional outcomes included skeletal muscle mitochondrial respiration, and, on account of the known laxative effects of magnesium, the gut microbiota diversity. Results: Compared with a placebo, MgCl₂ supplementation increased the circulating ionized Mg concentration (p < 0.03), decreased the VO_2max (44.4 ± 7.7 vs. 41.3 ± 8.0 mL/kg/min; p = 0.005), and decreased the mean power output during a 30 s sprint (439 ± 88 vs. 415 ± 88 W; p = 0.03). The 10 km time trial was unaffected (1282 ± 126 vs. 1281 ± 97 s; p = 0.89). In skeletal muscle, MgCl₂ decreased mitochondrial respiration in the presence of fatty acids at complex II (p = 0.04). There were no significant impacts on the gut microbiota richness (CHAO1; p = 0.68), Shannon’s Diversity (p = 0.23), or the beta-diversity (Bray–Curtis distances; p = 0.74). Conclusions: In summary, magnesium supplementation had modest ergolytic effects on cycle ergometer exercise performance and mitochondrial respiration. We recommend that regular exercisers, free from hypomagnesemia, should not supplement their diet with magnesium. Full article

(This article belongs to the Special Issue Nutritional Supplementation in Health and Sports Performance)

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14 pages, 1860 KiB

Open AccessArticle

Anti-Stress Effects of Tremella fuciformis Berk. Enzymatic Extracts: A Preclinical Study

by Gahye Moon, Nodir Rustamov, Junhang Park, Hanseul Park, Kumju Park, Eun Hye Choi and Yoon-Seok Roh

Nutrients 2025, 17(5), 914; https://doi.org/10.3390/nu17050914 - 6 Mar 2025

Cited by 1 | Viewed by 1094

Abstract

Background/Objectives: Chronic stress disrupts neurochemical balance, triggers inflammation, and compromises neuronal integrity, contributing to the development of stress-related disorders. This study aimed to evaluate the preventative effects of Tremella fuciformis Berk (TF) enzymatic extracts on chronic restraint stress (CRS)-induced behavioral, neurochemical, and inflammatory [...] Read more.

Background/Objectives: Chronic stress disrupts neurochemical balance, triggers inflammation, and compromises neuronal integrity, contributing to the development of stress-related disorders. This study aimed to evaluate the preventative effects of Tremella fuciformis Berk (TF) enzymatic extracts on chronic restraint stress (CRS)-induced behavioral, neurochemical, and inflammatory dysfunctions in mice. Methods: Male C57BL/6N mice were administered TF at doses of 50 mg/kg and 100 mg/kg daily via oral gavage for 21 days during CRS exposure. Behavioral assessments, including anxiety and depression-like behavior tests, were conducted. Neurochemical and inflammatory markers were analyzed using PCR and ELISA, while histological examinations of hippocampal regions were performed to assess neuronal integrity. In vitro assays evaluated neuronal cell viability, protection against corticosterone (CORT)-induced cytotoxicity, and inhibition of monoamine oxidase (MAO) activity. Results: TF supplementation alleviated CRS-induced weight loss, normalized serum CORT levels, increased locomotor activity, reduced immobility time, and decreased anxiety-like behaviors. TF upregulated brain-derived neurotrophic factor (BDNF) mRNA, downregulated pro-inflammatory markers (CXCL2, iNOS, IFNG), and mitigated neuronal apoptosis in the hippocampus. In vitro, TF improved neuronal cell viability, protected against CORT-induced cytotoxicity, and significantly inhibited MAO activity, particularly MAO-A. Conclusions: These findings demonstrate the neuroprotective and anti-stress effects of Tremella fuciformis Berk enzymatic extracts, supporting its potential as a natural therapeutic intervention for stress-related disorders. Full article

(This article belongs to the Special Issue Impact of Nutritional Supplementation on Cognition and Neuroinflammation)

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17 pages, 6452 KiB

Open AccessArticle

The Impact of Tartrazine on DNA Methylation, Histone Deacetylation, and Genomic Stability in Human Cell Lines

by Afshin Zand, John M. Macharia, Istvan Szabó, Gellért Gerencsér, Ádám Molnár, Bence L. Raposa and Timea Varjas

Nutrients 2025, 17(5), 913; https://doi.org/10.3390/nu17050913 - 6 Mar 2025

Viewed by 1109

Abstract

Background/Objectives: Tartrazine (TRZ), a synthetic red azo dye derived from coal tar, is widely used as a food colorant in various food products, pharmaceuticals, and cosmetics. This study aims to investigate the impact of TRZ on the expression levels of DNA methyltransferases ( [...] Read more.

Background/Objectives: Tartrazine (TRZ), a synthetic red azo dye derived from coal tar, is widely used as a food colorant in various food products, pharmaceuticals, and cosmetics. This study aims to investigate the impact of TRZ on the expression levels of DNA methyltransferases (DNMT1, DNMT3a, and DNMT3b) and histone deacetylases (HDAC5 and HDAC6). Additionally, we evaluate genomic DNA stability using the alkaline comet assay in three human cell lines: immortalized human keratinocyte (HaCaT), human hepatocellular carcinoma (HepG2), and human lung adenocarcinoma (A549). The research question focuses on whether TRZ exposure alters epigenetic regulation and DNA integrity, potentially implicating its role in carcinogenesis. Methods: The selected human cell lines were exposed to different concentrations of TRZ (20 µM, 40 µM, and 80 µM), with DMBA serving as a positive control. After treatment, we quantified the expression levels of DNMT1, DNMT3a, DNMT3b, HDAC5, and HDAC6 using quantitative real-time PCR. Additionally, we assessed DNA fragmentation via the alkaline comet assay to determine the extent of DNA damage resulting from TRZ exposure. Results: Our findings indicate that TRZ significantly upregulates the expression of HDAC5, HDAC6, DNMT1, DNMT3a, and DNMT3b in comparison to the control group. Furthermore, TRZ exposure leads to a notable increase in DNA damage, as evidenced by elevated tail moments across all examined human cell lines. Conclusions: These results suggest that TRZ may play a role in carcinogenesis and epigenetic modifications. The observed upregulation of DNMTs and HDACs, coupled with increased DNA damage, highlights the potential risks associated with TRZ exposure. Further research is necessary to explore these mechanisms and assess their implications for human health. Full article

(This article belongs to the Special Issue Advances in Gene–Diet Interactions and Human Health)

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16 pages, 1739 KiB

Open AccessArticle

Dietary Behavioural Preferences of Spanish and German Adults and Their Translation to the Dietary Recommendations of a Personalised Nutrition App in the Framework of the Stance4Health Project

by Daniel Hinojosa-Nogueira, Beatriz Navajas-Porras, Silvia Pastoriza, Adriana Delgado-Osorio, Ángela Toledano-Marín, Sascha Rohn, José Ángel Rufián-Henares and José Javier Quesada-Granados

Nutrients 2025, 17(5), 912; https://doi.org/10.3390/nu17050912 - 6 Mar 2025

Cited by 1 | Viewed by 1205

Abstract

Background/Objectives: The influence of individual differences in the selection of food portions can have a deep effect on recommendations for personalised nutrition. In addition to typical aspects such us energy density and nutrient composition, portion size is important for dietary recommendations. This [...] Read more.

Background/Objectives: The influence of individual differences in the selection of food portions can have a deep effect on recommendations for personalised nutrition. In addition to typical aspects such us energy density and nutrient composition, portion size is important for dietary recommendations. This study examined the dietary behaviours and portion size selection of 224 subjects in Spain and Germany to use such information to improve dietary adherence to a personalised nutrition app. Methods: An online questionnaire administered to adults in Spain and Germany collected sociodemographic data and dietary habits. The measurement of portion sizes was derived from a classification ranging from XXS to XL across 22 food groups, with assistance from a photographic atlas. Results: Significant differences across dimensions were found. Dietary habits showed that omnivores were the majority in both countries, with significant differences in the consumption of bread, desserts, and beverages. The Mediterranean diet was significantly followed by the Spanish group, reflecting cultural differences. Body mass index (BMI) was slightly higher among Germans, although both populations fell within the normal ranges. Portion size comparisons revealed statistically significant differences in the consumption of various food items between the two countries. Spaniards consumed higher amounts of rice, meat, and legumes, while Germans consumed larger portions of stews, lasagne, and pizza. These variations highlight differing dietary habits influenced by cultural preferences and dietary guidelines. Conclusions: The findings support the development of novel personalised nutrition apps that consider user preferences and enhance dietary adherence, thereby contributing to improved dietary recommendations and health outcomes. Full article

(This article belongs to the Special Issue Public Health, Nutritional Behavior and Nutritional Status—2nd Edition)

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19 pages, 895 KiB

Open AccessArticle

Developing and Testing a User-Focused, Web GIS-Based Food Asset Map for an Under-Resourced Community in Northeastern Connecticut

by Xiran Chen, Manije Darooghegi Mofrad, Sydney Clements, Kate Killion, Thess Johnson, Xiang Chen, Donna Zigmont, Daniela C. Avelino, Brenda Lituma-Solis, Michael J. Puglisi, Valerie B. Duffy and Ock K. Chun

Nutrients 2025, 17(5), 911; https://doi.org/10.3390/nu17050911 - 6 Mar 2025

Viewed by 877

Abstract

Background/Objectives: Access to healthy and affordable food remains a challenge for under-resourced communities due to uneven food distribution and the need for reliable transportation. This study developed and evaluated an interactive Geographic Information System (GIS)-based food asset map for a low-income community in [...] Read more.

Background/Objectives: Access to healthy and affordable food remains a challenge for under-resourced communities due to uneven food distribution and the need for reliable transportation. This study developed and evaluated an interactive Geographic Information System (GIS)-based food asset map for a low-income community in Windham, Connecticut to improve awareness of food resources and expand opportunities for fresh food access. Methods: Using the human-centered design (HCD) framework and the Asset-Based Community Development (ABCD) model, the map integrates food locations, transportation routes, and assistance eligibility. Internal pilot testing (n = 8) identified usability issues, leading to updates such as mobile compatibility and user guides. Usability testing (n = 74) assessed navigation performance and user feedback through task-based evaluations and surveys. Categorical map usability, sociodemographic, diet, and health characteristics were tested for participants with food security (yes/no) or digital literacy (passed/failed). Results: Food-secure participants showed higher usability success than food-insecure individuals (p < 0.05), while those relying on food assistance faced greater challenges (p < 0.05). Individuals rating their diet as “very good/excellent” were most likely to pass the map usability testing (p < 0.05), whereas younger, college-educated, employed participants and those with vehicles trended toward passing (p < 0.1). Participants generally reported the map easy to navigate, especially those with food security. Conclusions: The asset map promotes food resource awareness and addresses barriers such as limited public transportation information. Additional efforts are needed to support food-insecure users in utilizing digital food access resources. This study contributes to initiatives to improve food access, digital inclusion, and community engagement in under-resourced communities. Full article

(This article belongs to the Special Issue Community-Engaged Strategies to Improve Food Access, Food Security, and Health Outcomes)

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14 pages, 964 KiB

Open AccessSystematic Review

Clinical Predictors and Prevalence of Enteral Nutrition Intolerance in Acute Pancreatitis: An Updated Systematic Review and Meta-Analysis

by Wei Xiao, Yue Zeng, Lianzhong Ai, Guangqiang Wang and Yang Fu

Nutrients 2025, 17(5), 910; https://doi.org/10.3390/nu17050910 - 5 Mar 2025

Viewed by 1256

Abstract

Background: Acute pancreatitis (AP) leads to severe inflammation and nutritional deficits, with 80% of severe cases experiencing critical protein loss. Timely enteral nutrition is essential for recovery. This study systematically reviews and analyzes the incidence and predictors of enteral nutrition intolerance (ENI) in [...] Read more.

Background: Acute pancreatitis (AP) leads to severe inflammation and nutritional deficits, with 80% of severe cases experiencing critical protein loss. Timely enteral nutrition is essential for recovery. This study systematically reviews and analyzes the incidence and predictors of enteral nutrition intolerance (ENI) in AP patients. Methods: Web of Science, Embase, Cochrane Library, and PubMed were searched up to May 2024. Studies reporting on ENI incidence and predictors in AP patients were included based on predefined criteria. Bias was assessed using standardized tools, and meta-analyses provided summary estimates with confidence intervals. Results: From the 2697 screened studies, 28 involving 4853 patients met the inclusion criteria. The pooled incidence of ENI was 26%. Significant predictors included comorbid diabetes, pancreatic necrosis, elevated pre-refeeding serum lipase levels, peri-pancreatic fluid collections, and systemic inflammatory response syndrome at admission. Higher ENI rates were observed in Europe, among patients with severe acute pancreatitis (SAP), those receiving nasoenteric feeding, and in prospective study cohorts. Conclusions: ENI affects approximately one-quarter of AP patients and is not significantly associated with age, sex, or the cause of AP. Its incidence varies by region, disease severity, feeding method and study design. Identifying predictors, such as comorbid diabetes and pancreatic necrosis, may help clinicians reduce the risk of ENI. The limitations of this study include the heterogeneity of the included studies and inconsistent ENI diagnostic criteria. Full article

(This article belongs to the Section Clinical Nutrition)

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12 pages, 257 KiB

Open AccessArticle

Changing Food in a Changing World: Assessing Compliance to Insects, Cultivated Meat, and Soil-Less Products Among Italian Undergraduates

by Francesca Gallè, Federica Valeriani, Jole Del Prete, Patrizia Calella, Annalisa Bargellini, Aida Bianco, Lavinia Bianco, Salvatore Borzì, Anastasia Cataldo, Maria Eugenia Colucci, Laura Dallolio, Osvalda De Giglio, Chiara de Waure, Gabriella Di Giuseppe, Pasqualina Laganà, Giuseppe La Spada, Francesca Licata, Isabella Marchesi, Alice Masini, Maria Teresa Montagna, Christian Napoli, Stefania Oliva, Giovanna Paduano, Stefania Paduano, Cesira Pasquarella, Concetta Paola Pelullo, Michela Persiani, Ivano Pindinello, Vincenzo Romano Spica, Rossella Sacchetti, Giacomo Scaioli, Concetta Arianna Scicchitano, Roberta Siliquini, Francesco Triggiano, Licia Veronesi and Carmela Protano Show full author list Hide full author list

Nutrients 2025, 17(5), 909; https://doi.org/10.3390/nu17050909 - 5 Mar 2025

Viewed by 940

Abstract

Background/Objectives: In recent decades, the need for sustainable alternatives to traditional foods for the global population has become urgent. To this aim, edible insects, cultivated meat, and vegetables produced through soil-less farming have been proposed. This cross-sectional study was aimed at exploring [...] Read more.

Background/Objectives: In recent decades, the need for sustainable alternatives to traditional foods for the global population has become urgent. To this aim, edible insects, cultivated meat, and vegetables produced through soil-less farming have been proposed. This cross-sectional study was aimed at exploring willingness to eat these novel foods and its possible correlates in young Italian adults. Methods: An electronic questionnaire was administered to the student populations of 13 universities throughout the Italian territory. Results: The results show that insects and cultivated meat were widely acknowledged as possible food, while soil-free cultivation seems to be less known. Indeed, the percentage of participants who have heard of insects, cultivated meat, and soil-free cultivation was respectively equal to 91.5%, 84.7%, and 32.9%. However, the majority of respondents were uncertain about the sustainability of all the proposed products (52.6% for insects, 39.5% for cultivated meat, and 58.0% for soil-free cultivation, respectively), and the propensity to try and eat insects (9.5%) was lower than that declared for synthetic meat (22.8%) and products from soil-free cultivation (19.2%). However, the regression analysis showed that the propensity to eat these foods regularly is positively related to the confidence in their sustainability (p < 0.001). Willingness to try each of the proposed foods positively correlated with that declared for the others (p < 0.001). Conclusions: These findings highlight the need to implement interventions aimed at increasing awareness about the use of these products as alternatives to less sustainable foods and the importance of identifying consumer groups to which these interventions should be addressed. Full article

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

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11 pages, 881 KiB

Open AccessArticle

Revising BMI Cut-Off Points for Overweight and Obesity in Male Athletes: An Analysis Based on Multivariable Model-Building

by Chiara Milanese, Leila Itani, Valentina Cavedon, Dana Saadeddine, Silvia Raggi, Elisa Berri and Marwan El Ghoch

Nutrients 2025, 17(5), 908; https://doi.org/10.3390/nu17050908 - 5 Mar 2025

Viewed by 1410

Abstract

Background: Body composition in athletes is characterized by pronounced muscle mass and low body fat (BF). Over and excessive adiposity are thus expected in athletes at higher body mass index (BMI) levels than those suggested by the World Health Organization (WHO). Therefore, we [...] Read more.

Background: Body composition in athletes is characterized by pronounced muscle mass and low body fat (BF). Over and excessive adiposity are thus expected in athletes at higher body mass index (BMI) levels than those suggested by the World Health Organization (WHO). Therefore, we aimed to test the validity of WHO BMI cut-off points for overweight and obesity, respectively (i.e., ≥25 kg/m² and 30 kg/m²) in young male athletes from different sport disciplines in Italy. Methods: This study includes 622 male young adult athletes of mean age 25.7 ± 4.7 years who were initially categorized according to the WHO BMI classification, and then re-categorized by adiposity status based on total BF% as measured by dual-energy X-ray absorptiometry (DXA). A predictive equation has been developed utilizing multivariable model-building to predict the best BMI cut-offs for identifying overweight and obesity in this population. The agreement between the different classification systems was assessed with the kappa statistic (κ). Results: According to the WHO BMI classification, 451 (72.5%) individuals were of normal weight, 148 (23.8%) were with overweight and 23 (3.7%) were with obesity, but based on the total BF%, 598 (96.1%) were of normal weight, and only 19 (3.1%) were with overweight and 5 (0.8%) were with obesity, revealing a weak agreement between the two classification systems (WHO BMI vs. BF%; κ = 0.169). On the other hand, new BMI cut-off points were identified (BMI ≥ 28.2 kg/m² for overweight and 33.7 kg/m² for obesity) and showed good agreement with the BF% classification system (κ = 0.522). Conclusions: The currently used WHO BMI cut-offs are not suitable for determining weight status in young male athletes, and since the newly proposed ones demonstrated a good performance, these should be implemented in new guidelines. Full article

(This article belongs to the Section Nutrition and Obesity)

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21 pages, 4422 KiB

Open AccessArticle

A Sweet Almond Globulin Multifunctional Peptide: Identification, In Silico Screening, Restraint Mechanisms to Keap1 and ACE, and Antihypertensive and Ferrous Transport Efficiency

by Bufan Xu, Peiyao Long, Yajun Zheng, Chen Feng, Yongliang Zhuang, Xinyi Wu, Siyin Zheng, Xinyu Liu and Yiheng Gao

Nutrients 2025, 17(5), 907; https://doi.org/10.3390/nu17050907 - 5 Mar 2025

Viewed by 684

Abstract

Background: Sweet almond expeller is an abundant protein resource, but there are few studies on multifunctional peptides. The purpose of this study is to improve its application in food and medical industries. Methods: This study investigated the identification, screening, and action mechanisms of [...] Read more.

Background: Sweet almond expeller is an abundant protein resource, but there are few studies on multifunctional peptides. The purpose of this study is to improve its application in food and medical industries. Methods: This study investigated the identification, screening, and action mechanisms of antihypertensive peptides with antioxidant and ferrous binding activities derived from sweet almond globulin hydrolysates using intergrade in vitro and in silico methods and an animal model. Results: Eight novel oligopeptides were identified in sweet almond globulin hydrolysates subfraction D; of them, Pro-Met-Tyr-Gly-Gly-Gly-Met-Val (PMYGGGMV) exhibited ACE inhibitory activity (IC₅₀: 121.16 μmol/L), ferrous binding ability (11.01 mg/g), and quenching capacities on hydroxyl (93.06%) and ABTS radicals (83.67%). The phenolic hydroxyl, amino, and carboxyl groups of PMYGGGMV were linked to Lys511, Tyr520, and Tyr523 in ACE’s substrate binding center through four short hydrogen bonds. PMYGGGMV can inhibit the Kelch-like ECH-Associated Protein 1 (Keap1)-nuclear factor erythroid 2-related factor 2 (Nrf2) interaction by binding to seven residues of Keap1 (including a key residue, Arg415). The ACE inhibitory and antioxidant activities of PMYGGMY were stable during gastrointestinal digestion. Ferrous chelation did not alter the ACE inhibitory and antihypertensive effects of PMYGGMY, but it reduced its ABTS and hydroxyl radical scavenging ability (p < 0.05). Additionally, PMYGGGMV reduced blood pressure of spontaneous hypertension rates and improved iron absorption across Caco-2 cells (p < 0.05). Conclusions: PMYGGGMV has the potential to prevent oxidative stress, hypertension, and iron deficiency. Full article

(This article belongs to the Section Phytochemicals and Human Health)

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14 pages, 1268 KiB

Open AccessArticle

Low Mediterranean Diet Adherence Is Associated with Poor Socioeconomic Status and Quality of Life: A Cross-Sectional Analysis

by Carolina Duarte, Andrea Campos, Telmo Pereira and João P. M. Lima

Nutrients 2025, 17(5), 906; https://doi.org/10.3390/nu17050906 - 5 Mar 2025

Viewed by 933

Abstract

Background: Health-related quality of life (HRQoL) can be impacted by various environmental factors: lifestyle habits, food insecurity, social–economic status, and dietary patterns. The Mediterranean diet (MedDiet) has been associated with a healthier lifestyle and better health outcomes. The aim of this study was [...] Read more.

Background: Health-related quality of life (HRQoL) can be impacted by various environmental factors: lifestyle habits, food insecurity, social–economic status, and dietary patterns. The Mediterranean diet (MedDiet) has been associated with a healthier lifestyle and better health outcomes. The aim of this study was to determine whether greater adherence to the MedDiet was associated with better HRQoL in communities with low social and economic statuses living in two social neighborhoods, “Bairro da Rosa” and “Ingote”, in Portugal. Methods: A cross-sectional analysis was performed on 102 citizens currently receiving government social support and attending the “Health Kiosk”, a community center created within the Europe Enabling Smart Healthy Age-Friendly Environments (EU_SHAFE) project enhancing educative sessions and screening by health professionals. The participants answered a 36-item questionnaire about their HRQoL (SF-36) and a 14-item questionnaire about their adherence to the Mediterranean diet (MEDAS). Spearman correlation analysis between variables and multiple linear regression models were used to estimate the effect of the baseline characteristics and MedDiet adherence on HRQoL scores (SF-36). Results: No statistically significant correlation was found between MedDiet adherence and total HRQoL scores across the eight health concepts. However, age was shown to negatively influence HRQoL, whereas daily physical activity had a positive impact on health. SF-36 physical health concepts exhibited a linear trend with respect to MedDiet adherence, while emotional health concepts showed inconsistent patterns across adherence groups. Education and waist circumference influence HRQoL, with higher levels of education correlating with better quality of life and greater waist circumference being negatively associated with aspects such as energy and vitality. These findings suggest that factors beyond dietary patterns, such as physical activity, education, and body composition, play pivotal roles in shaping HRQoL in disadvantaged communities, emphasizing the need for multifaceted public health interventions. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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10 pages, 201 KiB

Open AccessReview

The Impact of Home Parenteral Nutrition on Survival and Quality of Life in Patients with Intestinal Failure and Advanced Cancer: A Comprehensive Review

by Miroslaw Perlinski and Jacek Sobocki

Nutrients 2025, 17(5), 905; https://doi.org/10.3390/nu17050905 - 5 Mar 2025

Viewed by 856

Abstract

Background and Aims: Home parenteral nutrition (HPN) is essential in the management of chronic intestinal failure (CIF) and malignant bowel obstruction (MBO), particularly in cases where enteral feeding is not feasible. This review examines the evidence from 34 studies to evaluate the impact [...] Read more.

Background and Aims: Home parenteral nutrition (HPN) is essential in the management of chronic intestinal failure (CIF) and malignant bowel obstruction (MBO), particularly in cases where enteral feeding is not feasible. This review examines the evidence from 34 studies to evaluate the impact of HPN on survival and quality of life (QoL) in patients with MBO, CIF, and advanced cancer, as well as to identify clinical predictors of survival and address psychosocial challenges. Methods: A comprehensive review was conducted of 34 studies, focusing on the use of HPN in patients with MBO, CIF, and advanced cancer. Data were analyzed for survival outcomes, QoL metrics, and predictors of survival, including performance status, albumin levels, and the continuation of chemotherapy. The psychosocial aspects of HPN therapy were also assessed, particularly its influence on patient’s daily lives and mental health. Results: Key predictors of improved survival included good performance status, higher albumin levels, and the ability to continue chemotherapy. While HPN extended survival in many cases, its impact on QoL varied significantly. Psychosocial challenges, including lifestyle disruption and mental health strain, were common among long-term HPN patients, underscoring the need for comprehensive patient support. Conclusions: HPN can be a life-sustaining therapy for patients with CIF, MBO, and advanced cancer, but its success depends on careful patient selection and management. Identifying predictors of survival helps optimize outcomes, while addressing psychosocial challenges is crucial to minimizing the negative impact on QoL. This review highlights the need for a balanced approach to maximize the benefits of HPN. Full article

(This article belongs to the Special Issue Nutrition and Quality of Life for Patients with Chronic Disease)

16 pages, 1077 KiB

Open AccessArticle

One-Year Mortality After Percutaneous Endoscopic Gastrostomy: The Prognostic Role of Nutritional Biomarkers and Care Settings

by Nermin Mutlu Bilgiç, Güldan Kahveci, Ekmel Burak Özşenel and Sema Basat

Nutrients 2025, 17(5), 904; https://doi.org/10.3390/nu17050904 - 5 Mar 2025

Viewed by 790

Abstract

Background/Objectives: This study aimed to evaluate the clinical outcomes, complications, and one-year mortality of patients undergoing percutaneous endoscopic gastrostomy (PEG) in different care settings (hospital, nursing home, and home). Additionally, we investigated the comparative prognostic role of the prognostic nutritional index (PNI) [...] Read more.

Background/Objectives: This study aimed to evaluate the clinical outcomes, complications, and one-year mortality of patients undergoing percutaneous endoscopic gastrostomy (PEG) in different care settings (hospital, nursing home, and home). Additionally, we investigated the comparative prognostic role of the prognostic nutritional index (PNI) and the CRP-to-albumin ratio (CAR) in predicting mortality among these patients. Methods: A retrospective analysis of 236 adult patients who underwent PEG placement between January 2022 and December 2023 was performed. Demographic, clinical, and laboratory data were collected. The PNI was calculated according to the following formula: PNI = 10 × (albumin) + 0.005 × (lymphocyte count). The CAR was obtained by the ratio of the CRP level to the albumin level. Patients were categorized based on their post-PEG care settings. Results: Neurologic disorders were the most common indication for PEG (69.9%). The one-year mortality was 32.2%, with a median survival of 38 weeks (95% CI: 35–41). In the multivariable model, a lower PNI (HR = 0.93, 95% CI: 0.89–0.97, p < 0.001), as well as being followed in a hospital setting, emerged as independent predictors of mortality. Patients with timely PEG tube replacement showed a reduced mortality risk. The ROC analysis showed that the PNI had a higher AUROC (0.78 ± 0.04) compared to the CAR (0.69 ± 0.04), indicating superior prognostic accuracy for predicting one-year mortality. Conclusions: Care settings significantly influence survival outcomes, with better mortality rates observed in nursing homes and home environments. The PNI was superior to the CAR in predicting one-year mortality, emphasizing its clinical utility in risk stratification for PEG patients. Proactive tube management and individualized care strategies are critical for improving the prognosis in this population. Full article

(This article belongs to the Section Clinical Nutrition)

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20 pages, 744 KiB

Open AccessArticle

Association Between Mediterranean Diet and Other Healthy Habits and Sociodemographic Variables with the Values of Vascular and Heart Age in Spanish Workers

by Natalia Montero Muñoz, Pedro Juan Tárraga López, Ángel Arturo López-González, Hernán Paublini, Cristina Martorell Sánchez, Emilio Marínez-Almoyna Rifá and José Ignacio Ramírez-Manent

Nutrients 2025, 17(5), 903; https://doi.org/10.3390/nu17050903 - 5 Mar 2025

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Abstract

Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through [...] Read more.

Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through indicators such as vascular age (VA) and heart age (HA). Objective: This study aimed to investigate the relationship between sociodemographic factors, lifestyle behaviors, and their impact on VA and HA. Materials and Methods: A dual study design, encompassing both cross-sectional and longitudinal retrospective approaches, was conducted among a cohort of employees. The variables assessed included sociodemographic characteristics (age, sex, and socioeconomic status) and health-related habits (smoking, physical activity, adherence to the Mediterranean diet, and alcohol consumption). Results: The findings revealed that all analyzed variables were significantly associated with elevated VA and HA values. Among these, age demonstrated the strongest association, with odds ratios (OR) of 114.91 (95% CI: 100.45–131.43) for high HA and 34.48 (95% CI: 31.41–37.56) for high VA. Conclusions: The profile of individuals most at risk for elevated VA and HA encompasses males of advanced age, characterized by low socioeconomic status, a sedentary lifestyle, poor adherence to the Mediterranean diet, and regular alcohol consumption. Full article

(This article belongs to the Special Issue Public Health, Nutritional Behavior and Nutritional Status—2nd Edition)

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15 pages, 1514 KiB

Open AccessArticle

Exploring the Association Between Childhood Emotional Maltreatment and Eating Disorder Symptoms During Pregnancy: A Moderated Mediation Model with Prenatal Emotional Distress and Social Support

by Giulia Costanzo, Nadia Barberis, Marco Cannavò, Maria Rita Infurna, Eleonora Bevacqua, Claudia Guarneri, Jada Sottile, Elena Tomba and Giorgio Falgares

Nutrients 2025, 17(5), 902; https://doi.org/10.3390/nu17050902 - 5 Mar 2025

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Abstract

Background/Objectives: Pregnancy is a critical period marked by significant transformations that can trigger or exacerbate eating disorder symptoms. Childhood emotional maltreatment, including abuse and neglect, is a known risk factor for disordered eating, yet its specific impact during pregnancy remains unexplored. For this [...] Read more.

Background/Objectives: Pregnancy is a critical period marked by significant transformations that can trigger or exacerbate eating disorder symptoms. Childhood emotional maltreatment, including abuse and neglect, is a known risk factor for disordered eating, yet its specific impact during pregnancy remains unexplored. For this reason, this study aimed to examine the link between childhood emotional maltreatment and eating disorder symptoms in pregnant women, also focusing on the potential mediating and moderating variables involved in this association. Specifically, this study explored the mediating role of prenatal emotional distress, whereas prenatal social support was investigated as a protective factor able to moderate the effects of past trauma on disordered eating during this sensitive period. Methods: Participants were 272 Italian pregnant women (aged 18–48, M_age = 31.21, SD = 4.95) who were asked to respond to four self-report instruments: Childhood Trauma Questionnaire—Short Form; Eating Disorder Examination—Questionnaire Short; Perinatal Assessment of Maternal Affectivity; and Maternity Social Support Scale. Results and Conclusions: The results showed that prenatal emotional distress totally mediated the association between childhood emotional maltreatment and eating disorder symptoms in pregnant women (β = 0.20; SE = 0.06; 95% CI: 0.08, 0.33; p < 0.001). Moreover, moderation analysis showed that prenatal social support only moderated the direct link between childhood emotional maltreatment and disordered eating, so higher levels of childhood emotional maltreatment were predictive of higher levels of eating disorder symptoms only among pregnant women with low levels of prenatal social support (b = 0.17; SE = 0.06; t = 2.73; 95% CI: 0.05, 0.30; p < 0.01). The limitations and clinical implications are discussed. Full article

(This article belongs to the Special Issue Nutrition, Disordered Eating and Mental Health)

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13 pages, 397 KiB

Open AccessArticle

Development and Validation of the Italian Pregnancy Nutrition Knowledge Questionnaire (ItPreNKQ): A Nutrition Knowledge Questionnaire for Pregnant Italian Women

by Silvia Callegaro, Elena Bertolotti, Christine Tita Kaihura, Andrea Dall’Asta, Francesca Scazzina and Alice Rosi

Nutrients 2025, 17(5), 901; https://doi.org/10.3390/nu17050901 - 4 Mar 2025

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Abstract

Background/Objectives: Maternal nutrition during pregnancy exerts a significant influence on both maternal and foetal health, as well as long-term child development. Despite its importance, adherence to dietary guidelines among pregnant women remains low. The present study aimed to develop and validate the [...] Read more.

Background/Objectives: Maternal nutrition during pregnancy exerts a significant influence on both maternal and foetal health, as well as long-term child development. Despite its importance, adherence to dietary guidelines among pregnant women remains low. The present study aimed to develop and validate the Italian Pregnancy Nutrition Knowledge Questionnaire (ItPreNKQ), based on national dietary guidelines for the pregnant Italian population, assessing its reliability and validity. Methods: The ItPreNKQ comprised 15 questions covering key topics on nutrition during pregnancy. The questionnaire was validated through item analysis (difficulty and discrimination indices), construct validity, internal consistency, and reliability tests. Results: A total of 145 pregnant Italian women participated in the study. The reliability of the questionnaire was confirmed through a Pearson’s correlation of R = 0.790 and a Cronbach’s alpha of 0.682, indicating strong temporal stability and acceptable internal consistency. Despite good overall performance, the mean knowledge score was 10.6 ± 2.5 out of 15, indicating significant knowledge gaps in specific topics. Conclusions: The ItPreNKQ has been demonstrated to be a reliable and valid tool for the assessment of nutrition knowledge among pregnant Italian women. The tool could be used for assessing nutritional knowledge in prenatal education settings and could be administered in future studies aimed at evaluating the impact of nutritional interventions among pregnant women. Full article

(This article belongs to the Special Issue Diet, Maternal Nutrition and Reproductive Health)

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Nutrients, Volume 17, Issue 5 (March-1 2025) – 191 articles

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