Nutrients

27 pages, 1426 KB

Open AccessArticle

Unintentional Underfuelling and Protein Prioritisation: A Multi-Methods Exploration of Nutrition Practices and Behaviours in Female Endurance Athletes

by Harvey O. Fortis, Colum J. Cronin, Kelsie O. Johnson, Sam O. Shepherd, Anthony C. Hackney and Juliette A. Strauss

Nutrients 2025, 17(23), 3773; https://doi.org/10.3390/nu17233773 (registering DOI) - 30 Nov 2025

Abstract

Background/Objectives: Despite increasing awareness of best sports nutrition practices, discrepancies persist between knowledge and behaviour amongst female endurance athletes. Methods: To understand this discrepancy study investigated dietary practices, macronutrient intakes, and influ-encing factors using a multi-method approach. Seventy-two female endurance athletes (42 ± [...] Read more.

Background/Objectives: Despite increasing awareness of best sports nutrition practices, discrepancies persist between knowledge and behaviour amongst female endurance athletes. Methods: To understand this discrepancy study investigated dietary practices, macronutrient intakes, and influ-encing factors using a multi-method approach. Seventy-two female endurance athletes (42 ± 9 y) completed four-day weighed food diaries, and a subset of twenty athletes (40 ± 10 y) then participated in semi-structured interviews. Quantitative analysis revealed that athletes met the lower end of carbohydrate (CHO) guidelines on rest days (3.0 g·kg−1), but intake fell short on training days, with deficits increasing as training volume rose (moderate: −1.4 g·kg−1, high: −3.5 g·kg−1, very high: −5.5 g·kg−1). Despite awareness of CHO’s role in performance, athletes unintentionally underfuelled, leading to a cumu-lative energy deficit. Energy intake increased by 473 kcal·day−1 per 1000 kcal·day−1 of exercise energy expenditure. In contrast, protein intake was prioritised, with mean in-takes of 1.7 ± 0.7 g·kg−1·day−1 aligning with recommendations. Results: Qualitative findings iden-tified barriers to CHO intake, including time constraints, diet culture influences and body image concerns. Social and environmental factors, such as household environments and professional nutrition guidance, played a critical role in behaviours. Conclusions: These findings highlight the need for practical, evidence-based nutrition interventions to support fe-male endurance athletes. Personalised education addressing CHO requirements, the psychology/emotions around nutrition, and the influence of social environments may bridge the gap between knowledge and practice, optimising both performance and long-term health outcomes. Full article

(This article belongs to the Special Issue Nutrition, Exercise, and Health: Nutritional Supplements, Exercise Training, Skeletal Muscle Health, and Performance)

28 pages, 2643 KB

Open AccessArticle

Effects of Lifestyle, Diet, and Body Composition on Free Testosterone and Cortisol Levels in Young Men

by Dominika Mazurkiewicz, Robert Gajda, Jagoda Ambrozik-Haba, Wiktoria Bożek, Maja Ceremuga and Paweł Serek

Nutrients 2025, 17(23), 3772; https://doi.org/10.3390/nu17233772 (registering DOI) - 30 Nov 2025

Abstract

Background/Objectives: Testosterone and cortisol are key regulators of metabolic, psychological, and physiological responses to environmental and lifestyle factors. This study aimed to analyze the relationship between free testosterone and cortisol concentrations and dietary patterns, stress levels, sleep quality, physical activity, and body [...] Read more.

Background/Objectives: Testosterone and cortisol are key regulators of metabolic, psychological, and physiological responses to environmental and lifestyle factors. This study aimed to analyze the relationship between free testosterone and cortisol concentrations and dietary patterns, stress levels, sleep quality, physical activity, and body composition in healthy young men (aged 18–35 years). Methods: This study included 40 volunteers who met our inclusion criteria. They underwent anthropometric measurements, body composition analysis, and biochemical determination of serum free testosterone and cortisol concentrations. Additionally, participants completed a set of validated questionnaires: a questionnaire regarding the frequency of consumption of specific foods and stimulants, a 3-day food diary, the PSS-10, the Holmes and Rahe Scale, the PSQI, and the Baecke Physical Activity Questionnaire. Results: Free testosterone concentration in blood was negatively correlated with body fat content and positively correlated with the percentage of energy, protein, fat, sodium, and folic acid requirements. Morning blood cortisol levels negatively correlated with body weight and height. Higher intakes of cholesterol, folic acid, and vitamin A resulted in statistically significant reductions in cortisol levels. A significant correlation was identified between poor sleep quality and low cortisol levels, particularly among men aged < 26 years. A positive correlation was also found between leisure-time physical activity and testosterone levels, particularly in the older group. Furthermore, a higher body weight and greater muscle mass were correlated with lower cortisol levels. Conclusions: These results provide a starting point for further research on neuroendocrine mechanisms in active individuals exposed to environmental stress. Full article

(This article belongs to the Special Issue Dietary Patterns and Nutritional Challenges in Adolescents and Young Adults: Implications for Health and Disease)

21 pages, 3084 KB

Open AccessArticle

Rhubarb-Derived Extracellular Vesicles Mitigate Oxidative Stress and Metabolic Dysfunction in an Alzheimer’s Cellular Model

by Eleonora Calzoni, Gaia Cusumano, Agnese Bertoldi, Husam B. R. Alabed, Roberto Maria Pellegrino, Sandra Buratta, Lorena Urbanelli, Gokhan Zengin and Carla Emiliani

Nutrients 2025, 17(23), 3771; https://doi.org/10.3390/nu17233771 (registering DOI) - 30 Nov 2025

Abstract

Background/Objectives: Extracellular vesicles derived from edible plants have emerged as bioactive nanostructures with potential therapeutic and nutraceutical properties and are currently being investigated as natural carriers for the treatment of oxidative stress-induced damage and oxidative stress-related diseases, including neurodegenerative disorders such as Alzheimer’s [...] Read more.

Background/Objectives: Extracellular vesicles derived from edible plants have emerged as bioactive nanostructures with potential therapeutic and nutraceutical properties and are currently being investigated as natural carriers for the treatment of oxidative stress-induced damage and oxidative stress-related diseases, including neurodegenerative disorders such as Alzheimer’s disease (AD). Recent studies suggest that PDEVs exhibit high stability within the gastrointestinal tract and selective tissue-targeting abilities, facilitating the efficient delivery of bioactive molecules. Methods: This study investigates the antioxidant effects of Rheum rhabarbarum-derived EVs by assessing the antioxidant activity through different in vitro assays and their effects on oxidative stress and energy metabolism in the cellular model of Alzheimer’s disease. Results: Rhubarb-derived EVs showed measurable antioxidant capacity in chemical assays and were non-toxic under the tested conditions. Treatment reduced intracellular ROS levels and modulated oxidative stress-related proteins, suggesting a potential protective effect against oxidative damage. Moreover, metabolic analysis revealed a decrease in glycolytic activity, indicating a potential restoration of cellular bioenergetic homeostasis. Conclusions: These results provide preliminary evidence supporting the nutraceutical interest of rhubarb-derived EVs in counteracting oxidative stress, while further studies will be needed to confirm their biological relevance and therapeutic potential. Full article

(This article belongs to the Special Issue The Effect of Natural Extracts on Aging and Neurodegenerative Diseases)

10 pages, 287 KB

Open AccessArticle

The Real Danger for Milk Protein Allergy: Developing a Scale for Family Doctors on Introducing Diet Diversity to Infants with Cow’s Milk Protein Allergy

by Celina Silvia Stafie

Nutrients 2025, 17(23), 3770; https://doi.org/10.3390/nu17233770 (registering DOI) - 30 Nov 2025

Abstract

Background: Cow’s milk protein allergy (CMPA) is one of the most common food allergies in infants, with a reported prevalence between 0.54% and 4.9%. In Europe, 1% of children are affected by CMPA in the first 2 years of life. Overdiagnosis leads [...] Read more.

Background: Cow’s milk protein allergy (CMPA) is one of the most common food allergies in infants, with a reported prevalence between 0.54% and 4.9%. In Europe, 1% of children are affected by CMPA in the first 2 years of life. Overdiagnosis leads to unnecessary dietary restrictions, with additional costs, while neglecting the diagnosis of CMPA has long-term repercussions on growth and development or, in the case of an acute reaction, may involve a life-threatening risk. The aim of this study is to develop a scale for family doctors to assess their practical knowledge of allergic pathology in newborns. Materials and methods: To develop the scale, seven family doctors, each with over 10 years of practical experience, reached a consensus on the 20 items. The items were based on the guidelines of the European Academy of Allergology and Clinical Immunology on the prevention of food allergies in infants and young children. To verify the validity and internal structure of the scale, we conducted a pilot study on family doctors (N = 45), with a predominantly pediatric population, from one of the four university centers in Romania (Iași region). The results showed a good internal structure of the items in our scale. Content validity showed an I-CVI = 0.79 and an S-CVI = 0.91, which means that the scale can be considered excellent in terms of content. Discussion: The results of our study suggest that the new scale designed to assess the practical knowledge of family physicians in the field of allergic pathology in newborns, particularly with regard to cow’s milk protein allergy (CMPA), has solid psychometric properties. The excellent content validity, indicated by an item content validity index (I-CVI) of 0.79 and a scale content validity index (S-CVI) of 0.91, reflects strong agreement among experts on the relevance and comprehensiveness of the items included. Conclusions: The designed scale demonstrates excellent content validity and good internal structure, indicating that it is a reliable tool for assessing the practical knowledge of family physicians in the field of allergic pathology in newborns. This scale can support the improvement of the identification and management of cow’s milk protein allergy in primary health care. Full article

(This article belongs to the Special Issue Interactions Between Early Nutrition, Early Environment, and Immunity)

16 pages, 646 KB

Open AccessReview

Tracking Evidences of Dandelion for the Treatment of Cancer: From Chemical Composition, Bioactivity, Signaling Pathways in Cancer Cells to Perspective Study

by Anqi Wang, Wugui Xiong, Cui Cheng, Liang Zou, Bei Niu and Ying Liu

Nutrients 2025, 17(23), 3769; https://doi.org/10.3390/nu17233769 (registering DOI) - 30 Nov 2025

Abstract

Cancer has become the second leading cause of death globally and is a big threat to human health. The development of new anticancer drugs and the elucidation of the signaling pathways of bioactive compounds are still effective strategies to address the current challenges [...] Read more.

Cancer has become the second leading cause of death globally and is a big threat to human health. The development of new anticancer drugs and the elucidation of the signaling pathways of bioactive compounds are still effective strategies to address the current challenges in the clinical treatment of cancer. Dietary compounds are composed of a variety of effective ingredients, which have become an important source for the development of novel candidates for the treatment of cancer. These bioactive ingredients often carry the characteristics of low side effects, multi-target, and economic savings and hence attract more and more scholars’ research interests in them. Dandelion, one of the important medicinal and edible plants, is effective in anticancer, inhibition of bacterial growth, hypoglycemic, and anti-inflammation, as well as antioxidant. Growing evidences from modern pharmacological research demonstrate the notable anticancer effects of dandelion. Bioactive components from dandelion are effective in inhibiting the occurrence and progression of various cancers, such as breast, lung, and liver cancers. Hence, the chemical composition, anticancer activities, and signaling pathways in cancer cells treated with bioactive components from dandelion are summarized in this review. We aim to provide more pharmacological evidence and scientific references for further research and development of dandelion for cancer treatment. Meanwhile, we anticipate that some novel candidates with high efficacy and low toxicity for anticancer might be developed from dandelion in future research on this plant. Full article

(This article belongs to the Special Issue Modulation of Signaling Pathways in Cancer Cells and Tumors by Dietary Bioactive Compounds)

12 pages, 318 KB

Open AccessArticle

Epidemiological Characteristics of Pediatric Patients with Intestinal Failure in Spain: Data from the REPAFI Registry

by Marta Germán-Díaz, Rocío González-Sacristán, Vanessa Cabello, Javier Blasco-Alonso, Alejandro Rodríguez, Mariela de los Santos, José Vicente Arcos-Machancoses, Mercedes Murray-Hurtado, Ruth García-Romero, Rafael Galera-Martínez, Cristina Martín-Arriscado, Susana Redecillas-Ferreiro, José Manuel Moreno-Villares and Esther Ramos-Boluda

Nutrients 2025, 17(23), 3768; https://doi.org/10.3390/nu17233768 (registering DOI) - 30 Nov 2025

Abstract

Background: The paucity of data on the epidemiology of chronic intestinal failure (CIF) in pediatric patients is a matter of particular concern. The objective of this article is to provide a comprehensive description of the epidemiology of CIF in Spain, encompassing its incidence, [...] Read more.

Background: The paucity of data on the epidemiology of chronic intestinal failure (CIF) in pediatric patients is a matter of particular concern. The objective of this article is to provide a comprehensive description of the epidemiology of CIF in Spain, encompassing its incidence, geographical distribution, underlying causes, and demographic and clinical characteristics. These findings are based on data collected from the multicentre REPAFI registry. Methods: This is a national, multicentre, ambispective cohort study including patients who initiated home parenteral nutrition (HPN) between January 2015 and January 2025. The data collected encompassed various demographic details, underlying diagnoses, the type of HPN utilized, and the nutritional status of the subjects at the commencement of HPN treatment. Results: The study included 163 patients (55.2% male) from 10 hospitals. The principal cause of CIF was short bowel syndrome (SBS) in 77.3% of cases, followed by severe motility disorders (12.9%), congenital enteropathies (CE) (5.5%), and other causes (4.3%). Among patients diagnosed with SBS, necrotizing enterocolitis was identified as the most prevalent underlying cause (32.5%). The most prevalent anatomical configuration was identified as type 2 (jejuno-colic anastomosis). A significant proportion, amounting to 62.7%, exhibited a lack of an ileocecal valve (ICV), while 23% demonstrated a residual bowel length (RBL) of less than 15 centimetres. The median RBL was 35 cm (IQR: 15.7–52.5). Patients diagnosed with SBS exhibited a lower gestational age and birthweight compared with the other groups (p < 0.05). Patients diagnosed with SBS and CE exhibited a lower mean age at the onset of HPN (p < 0.05). Furthermore, patients with CE exhibited the lowest weight-for-age Z-score at the initiation of HPN (p < 0.05). Conclusions: The present study provides the first epidemiological data on the state of pediatric CIF in Spain. The most prevalent cause of CIF was SBS, with a younger age at the initiation of HPN in comparison to other published studies. Patients with CE exhibited the most severe degree of malnutrition at the initiation of HPN. Full article

(This article belongs to the Section Nutrition Methodology & Assessment)

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Graphical abstract

26 pages, 2139 KB

Open AccessArticle

Dietary Benefits of Pistachio Consumption in Mexico Modeled Using National Health Survey System (ENSANUT) 2012 and 2016 Data

by Alfonso Mendoza Velázquez, Sonia Rodríguez-Ramírez, Ana Elena Pérez Gómez, María Concepción Medina-Zacarias, Leonardo Mendoza Martínez and Adam Drewnowski

Nutrients 2025, 17(23), 3767; https://doi.org/10.3390/nu17233767 (registering DOI) - 30 Nov 2025

Abstract

Background: Energy-dense non-essential snacks are subject to 8% excise tax in Mexico. Objectives: To model the impact on diet quality of (1) replacing energy-dense snacks with pistachios and (2) adding small amounts of pistachios to the diet. Methods: Data came from [...] Read more.

Background: Energy-dense non-essential snacks are subject to 8% excise tax in Mexico. Objectives: To model the impact on diet quality of (1) replacing energy-dense snacks with pistachios and (2) adding small amounts of pistachios to the diet. Methods: Data came from the Mexico National Health and Nutrition survey (ENSANUT, by its Spanish acronym) 2012 (n = 7132) and 2016 (n = 14,764). Dietary intakes were collected using a semi-quantitative food frequency questionnaire. Substitution analyses replaced energy-dense snack foods with equicaloric amounts of pistachios (Model 1) or with mixed nuts/seeds (Model 2). Additional analyses (Model 3) added small amounts of pistachios (10–28 g) to the daily diet. Added sugars, sodium, and saturated fat along with protein fiber, vitamins, and minerals were the main nutrients of interest. Dietary nutrient density was assessed using the Nutrient-Rich Food (NRF9.3) Index. Separate modeling analyses were performed for ENSANUT 2012 and 2016 and for children and adults. Results: Energy-dense foods, mostly sweet, accounted for about 20% of daily energy. Modeled diets with pistachios and mixed nuts/seeds were much lower in added sugars (<8% of dietary energy) and in sodium (<550 mg/day) and were higher in protein, fiber, mono- and polyunsaturated fats, potassium, and magnesium (p < 0.05). Significant improvements in dietary quality held across all socio-demographic strata. Adding small amounts of pistachios (10–28 g) to the diet (Model 3) increased calories but also led to better diets and higher NRF9.3 dietary nutrient density scores. Conclusions: Modeled diets with pistachios replacing energy-dense snack foods had less added sugars and sodium and more protein, fiber, vitamins, and minerals. Adding small amounts of pistachios also led to better diets. Pistachios are a healthy snack and can be an integral component of healthy diets. Full article

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

12 pages, 549 KB

Open AccessReview

Breastfeeding as a Strategic Driver for One Health: A Narrative Review

by Vanessa Machado, Simone Cecílio Hallak Regalo, Luciano Maia Alves Ferreira, Roberta Lopes de Castro Martinelli, Luciana Vitaliano Voi Trawitzki, Selma Siéssere, José João Mendes and João Botelho

Nutrients 2025, 17(23), 3766; https://doi.org/10.3390/nu17233766 (registering DOI) - 30 Nov 2025

Abstract

Breastfeeding is a renewable biological system that simultaneously advances human, environmental, and societal health. Human milk provides unparalleled nutrition and immunological protection, improving infant survival, neurodevelopment, and long-term metabolic outcomes, while reducing maternal risk of breast and ovarian cancer. However, and despite decades [...] Read more.

Breastfeeding is a renewable biological system that simultaneously advances human, environmental, and societal health. Human milk provides unparalleled nutrition and immunological protection, improving infant survival, neurodevelopment, and long-term metabolic outcomes, while reducing maternal risk of breast and ovarian cancer. However, and despite decades of evidence, only 48% of infants under six months are exclusively breastfed worldwide, and breastfeeding remains absent from most sustainability and One Health strategies. This narrative review synthesizes evidence demonstrating that breastfeeding functions as a low-carbon, zero-waste food system that avoids greenhouse gas emissions, land conversion, water consumption, and biodiversity loss linked to commercial milk formula production. At the societal level, breastfeeding reduces health-system costs, strengthens emergency resilience when supply chains fail, and generates long-term economic returns. By integrating evidence across human health, environmental impact and social determinants, this review positions breastfeeding as a strategic One Health intervention and a high-value investment for achieving multiple Sustainable Development Goals. Strengthening policy support—including protection against formula marketing, workplace accommodations, and expansion of baby-friendly systems—is essential to unlock breastfeeding’s potential for planetary and public health. Full article

(This article belongs to the Section Pediatric Nutrition)

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28 pages, 1380 KB

Open AccessSystematic Review

Dairy Intake and Iodine Status in Pregnant and Lactating Women: A Systematic Review and Meta-Analysis

by Elham Razmpoosh, Katrina Geronimo, Caroline Gauntlett, Isabella Vicente, Patricia Pham, Aarsh Shah and Kathy Musa-Veloso

Nutrients 2025, 17(23), 3765; https://doi.org/10.3390/nu17233765 (registering DOI) - 30 Nov 2025

Abstract

Background/Objectives: Despite salt iodization, iodine deficiency during pregnancy and lactation is re-emerging in many industrialized countries, necessitating an evaluation of the role of dairy in supporting iodine status during these critical periods. Methods: We conducted a systematic review and meta-analysis in [...] Read more.

Background/Objectives: Despite salt iodization, iodine deficiency during pregnancy and lactation is re-emerging in many industrialized countries, necessitating an evaluation of the role of dairy in supporting iodine status during these critical periods. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines. Ten databases were searched through March 2025 using ProQuest Dialog™ (Version 75.0). Study quality was assessed using either the Quality Evaluation for Observational Studies tool or the Risk of Bias 2 tool, depending on study design. Random-effects models were applied, with certainty of evidence rated using the GRADE framework. Publication bias, sensitivity analyses, and subgroup analyses were also performed. Results: Fifty-one publications met the eligibility criteria, including 50 publications of observational studies and 1 publication of a randomized controlled trial (RCT), with most studies conducted on pregnant women. Higher dairy intake was associated with significantly greater urinary iodine concentration (UIC), (23 studies; standardized mean difference: 0.326; 95% confidence interval [CI]: 0.228, 0.424; p < 0.001; I² = 57.31%; low-certainty), and significantly lower odds of iodine deficiency (11 studies; odds ratio: 0.58; 95% CI: 0.48, 0.70; p < 0.001; I² = 0%; moderate-certainty). Associations were stronger in studies conducted during later pregnancy, in higher-quality studies, and when the dairy food was specifically milk. Dairy contributed to ~27% of iodine intake from foods. Breast milk iodine concentration (BMIC) findings were inconsistent, though in one RCT, iodine-fortified milk improved BMIC and UIC. Conclusions: Dairy intake supports adequate iodine status during pregnancy and lactation. RCTs would be valuable in further investigating the role of dairy in supporting iodine status, particularly in lactating women. (PROSPERO CRD420251054576) Full article

(This article belongs to the Special Issue Nutritional Requirements of Pregnant and Lactating Women)

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13 pages, 1206 KB

Open AccessArticle

Inhibitory Effect of Canavalia gladiata Extract on Aggregatibacter actinomycetemcomitans LPS Induced Nitric Oxide in Macrophages

by Eun-Sook Kim, Yun-Seong Lee, Jooyi Kang, Kang-Ju Kim and Yong-Ouk You

Nutrients 2025, 17(23), 3764; https://doi.org/10.3390/nu17233764 (registering DOI) - 30 Nov 2025

Abstract

Objectives: Canavalia gladiata (Jacq.) DC. (C. gladiata) has been used in traditional medicine to treat suppurative inflammatory conditions. Its antibacterial activity against oral pathogens and potential use as a non-alcoholic mouthwash have also been reported. This study aimed to elucidate [...] Read more.

Objectives: Canavalia gladiata (Jacq.) DC. (C. gladiata) has been used in traditional medicine to treat suppurative inflammatory conditions. Its antibacterial activity against oral pathogens and potential use as a non-alcoholic mouthwash have also been reported. This study aimed to elucidate the biological activity of Con A from C. gladiata, evaluate nitric oxide (NO) production induced by Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), and as-sess its potential association with periodontal inflammation. Methods: In this study, a 0.5 M NaCl extract of C. gladiata (CGE_Na) was prepared, and its protein content was quantified. The Concanavalin A equivalent (Con Aeq.) of CGE_Na was determined via a hemagglutination assay, and its effect on NO production was evaluated in RAW 264.7 macrophages stimulated with lipopolysaccharide (LPS-A.a.) derived from A. actinomycetemcomitans. LPS was extracted from six A. actinomycetemcomitans strains and used to induce inflammatory activation. Result: CGE_Na treatment significantly inhibited LPS-induced NO production at concentrations below 6.25 μg/mL without cytotoxic effects, suggesting an anti-inflammatory potential associated with lectin-like components. Conclusions: These results suggest that C. gladiata extract suppresses LPS-A.a.-mediated macrophage activation. Further studies are required to determine whether Con A specifically mediates this response and to evaluate its therapeutic relevance in the context of periodontal inflammation. Full article

(This article belongs to the Special Issue The Effect of Dietary Bioactive Compounds on Inflammation-Related Diseases)

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13 pages, 644 KB

Open AccessArticle

Sleep Irregularity and Short Sleep Duration Are Associated with Less Favorable Cardiometabolic Profiles in Healthy Adults: A Cross-Sectional Study

by Sofia Lotti, Antonia Napoletano, Monica Dinu, Elisabetta Picchi, Ugo Faraguna, Ilaria Giangrandi, Francesca Cesari, Rossella Marcucci, Francesco Sofi and Barbara Colombini

Nutrients 2025, 17(23), 3763; https://doi.org/10.3390/nu17233763 (registering DOI) - 30 Nov 2025

Abstract

Background/Objectives: The aim of this study is to evaluate the relation between sleep quantity (TST), efficiency (SE) and regularity (SRI) and cardiometabolic parameters and eating habits. Methods: Seventy clinically healthy adults (74% females; mean age 28.3 ± 10.1 years) were recruited [...] Read more.

Background/Objectives: The aim of this study is to evaluate the relation between sleep quantity (TST), efficiency (SE) and regularity (SRI) and cardiometabolic parameters and eating habits. Methods: Seventy clinically healthy adults (74% females; mean age 28.3 ± 10.1 years) were recruited at the Clinical Nutrition Unit of Careggi University Hospital, Florence, between October 2023 and December 2024. Sleep was monitored for 7 days using a Fitbit Alta HR actigraphy. Cardiometabolic health was assessed via bioimpedance and blood samples. Dietary habits were evaluated through 3-day food diaries and the Medi-Lite questionnaire. Results: Participants had an average TST of 7.4 ± 1.1 h, SE of 84.9 ± 6.9%, and SRI of 62.2 ± 19.9. Lower SRI (≤41, 1st quintile) was associated with higher fat mass (19.9 ± 6.7 vs. 15.2 ± 6.6%), higher total cholesterol (183.9 ± 20.9 vs. 155.0 ± 26.8 mg/dL), and lower folate (3.6 ± 1.6 vs. 5.6 ± 2.5 ng/mL) compared to higher SRI (≥80, 5th quintile). Sleeping <7 h/night was linked to higher BMI (22.6 ± 2.1 vs. 21.5 ± 2.0 kg/m²) and homocysteine (11.4 ± 2.3 vs. 10.4 ± 3.3 μmol/L). Weak but significant inverse correlations emerged between TST and BMI (R = −0.26, p = 0.02) and between SRI and cholesterol (R = −0.28, p = 0.01), but these associations disappeared in the multivariable linear regression adjusted model. Conclusions: These findings underscore the role of sleep duration and regularity in shaping body composition and cardiometabolic health, supporting its relevance as a modifiable public health priority. Full article

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13 pages, 687 KB

Open AccessArticle

Probiotic Supplementation Can Alter Inflammation Parameters and Self-Reported Sleep After a Marathon: A Randomized, Double-Blind, Placebo-Controlled Study

by Valdir Aquino-Lemos, Geovana S. F. Leite, Edgar T. Silva, Helena A. P. Batatinha, Ayane S. Resende, Antônio H. Lancha-Junior, José C. R. Neto, Sergio Tufik and Ronaldo V. Thomatieli-Santos

Nutrients 2025, 17(23), 3762; https://doi.org/10.3390/nu17233762 (registering DOI) - 29 Nov 2025

Abstract

Background: Sleep is essential for athletes’ physical performance and recovery. However, strenuous exercise has the potential to increase inflammation and worsen sleep. This study evaluated the effect of probiotic supplementation on self-reported sleep quality, daytime sleepiness, and inflammatory profile 24 h after a [...] Read more.

Background: Sleep is essential for athletes’ physical performance and recovery. However, strenuous exercise has the potential to increase inflammation and worsen sleep. This study evaluated the effect of probiotic supplementation on self-reported sleep quality, daytime sleepiness, and inflammatory profile 24 h after a marathon. Methods: 27 marathon male runners were divided into the Probiotic group (Probiotic n = 14) or the Placebo group (Placebo n = 13). The Probiotic group consumed 1 × 10¹⁰ CFU of Lactobacillus acidophilus, 1 × 10¹⁰ CFU of Bifidobacterium lactis + 5 g/day maltodextrin for 30 days prior to the marathon. The Placebo group received a sachet of 5 g/day maltodextrin during the same period. Sleep and inflammatory status were assessed before supplementation, before the marathon, and 1 h and 24 h after the marathon. Data were analyzed using Statistic 13.3 and expressed as mean ± standard deviation. Tukey’s post hoc test was followed by a two-way ANOVA with repeated measures. The level of significance was set at p ≤ 0.05. Results: In the Placebo group, daytime sleepiness, sleep latency, and global sleep score increased 24 h after the marathon, while total sleep time and sleep efficiency decreased. In the Probiotic group, daytime sleepiness, sleep latency, and global sleep scores were lower 24 h after the marathon compared to the Placebo group. Total sleep time and sleep efficiency were higher in the Probiotic group compared to the Placebo group 24 h after the marathon. IL-1β and TNF-α concentrations decreased compared to Basal in both groups. IL-1β levels were lower 24 h after treatment compared to pre-treatment in the Placebo group. IL-6 was lower 24 h after the marathon in both groups. LPS concentrations were lower 1 h and 24 h after the marathon in the Probiotic group compared to the Basal group. There was no difference in cytokines and LPS between the groups. Conclusions: Supplementation with Lactobacillus acidophilus and Bifidobacterium lactis for 30 days changes self-reported sleep and reduces LPS concentration after the marathon. Full article

(This article belongs to the Special Issue Nutrition–Sleep Interactions in Sports and Exercise: Timing, Recovery, and Adaptation)

27 pages, 1216 KB

Open AccessArticle

Exploration of Homocysteine Metabolism and Genetics in Autism Spectrum Disorder

by Melissa Rouphael, Tania Bitar, Hugo Alarcan, Perla Gerges, Yonna Sacre, Christian R. Andres and Walid Hleihel

Nutrients 2025, 17(23), 3761; https://doi.org/10.3390/nu17233761 (registering DOI) - 29 Nov 2025

Abstract

Background: Understanding the genetic and metabolic profiles of individuals diagnosed with Autism Spectrum Disorder (ASD) is important for clarifying the biological characteristics of this complex disorder. Objectives: Given the limited data available for the Lebanese population, this case–control study aimed to investigate the [...] Read more.

Background: Understanding the genetic and metabolic profiles of individuals diagnosed with Autism Spectrum Disorder (ASD) is important for clarifying the biological characteristics of this complex disorder. Objectives: Given the limited data available for the Lebanese population, this case–control study aimed to investigate the association between common MTHFR variants and ASD risk and to examine differences in homocysteine metabolism between Lebanese individuals with ASD and neurotypical controls. Methods: From June 2022 to June 2023, 86 individuals with ASD and 86 controls matched for age and sex were recruited. Genotyping of the rs1801133 and rs1801131 variants and biochemical measurements were performed, followed by comparative statistical analyses. Results: Our results showed no significant association between the rs1801133 or rs1801131 variants and ASD risk (p > 0.05). However, the sample size was not sufficient to rule out small genetic effects. Metabolic analyses revealed significantly higher homocysteine concentrations and lower vitamin B9 levels in the ASD group (p < 0.0001), while vitamin B12, fasting glucose, and lipid profiles did not differ significantly between groups (p > 0.05). Among individuals with ASD, the TT genotype of rs1801133 was associated with elevated homocysteine concentrations (OR = 9.10, p = 0.014), whereas neither MTHFR variant was associated with vitamin B12 or B9 levels in ASD or control participants. Conclusions: Future research directions could focus on exploring the role of key enzymes associated with hyperhomocysteinemia in individuals with ASD and on replicating these preliminary findings in larger, adequately powered cohorts. Full article

(This article belongs to the Section Proteins and Amino Acids)

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15 pages, 534 KB

Open AccessArticle

How Family and Individual Physical Activity Environments Relate to Obesity Transition in Chinese Children and Adolescents

by Ziyue Sun, Yang Yang, Xia Zhong, Jiajia Dang, Shan Cai, Yunfei Liu, Jiaxin Li, Tianyu Huang, Xiaoqian Zhang, Mei Xue, Jing Li, Zhixin Zhang and Yi Song

Nutrients 2025, 17(23), 3760; https://doi.org/10.3390/nu17233760 (registering DOI) - 29 Nov 2025

Abstract

Background: Overweight and obesity have emerged as major public health challenges in China, with rising prevalence rates posing substantial burdens on healthcare systems. This study is a secondary analysis of data from the 2019 Chinese National Survey on Students’ Constitution and Health [...] Read more.

Background: Overweight and obesity have emerged as major public health challenges in China, with rising prevalence rates posing substantial burdens on healthcare systems. This study is a secondary analysis of data from the 2019 Chinese National Survey on Students’ Constitution and Health (CNSSCH), aimed to investigate the association of family and individual physical activity (PA) environments with overweight and obesity transition among children and adolescents, and to analyze subgroup differences by sex and urban–rural location as well as potential mechanisms. Methods: This was a one-year longitudinal study based on the 2019–2020 follow-up of 5008 children and adolescents. Family and individual physical activity environments were assessed as main exposures, and transitions to overweight and obesity were defined as outcomes. Multivariate logistic regression was applied to evaluate the association between family and individual PA environments and transitions to overweight and obesity, while also examining their moderating effects on unhealthy lifestyle behaviors. Results: A favorable family and individual PA environment was significantly associated with a reduced risk of obesity transition (OR = 0.78, p = 0.016). Subgroup analyses indicated that males (OR = 0.69, p = 0.009) and rural children and adolescents (OR = 0.70, p = 0.021) were more sensitive to supportive family and individual PA environments. Furthermore, a favorable environment was significantly correlated with a reduction in unhealthy behaviors such as skipping daily breakfast and consuming sugar-sweetened beverages (p < 0.001). Conclusions: A supportive family and individual PA environment was associated with a lower risk of obesity transition in children and adolescents, with more pronounced associations observed among males and those in rural areas. Full article

(This article belongs to the Section Pediatric Nutrition)

24 pages, 835 KB

Open AccessArticle

Knowledge, Beliefs and Preventive Practices Regarding Osteoporosis: A Cross-Sectional Study in Community Pharmacies in Tunis

by Cristina Merlan, Simona Buda, Alexandru Oancea, Narcisa Jianu, Teodor Nicolae Onea, Bianca Tot, Lucreția Udrescu, Vlad Groza, Mihai Udrescu, Adelina Lombrea, Denisa Maria Nițu, Alexandru Ciolofan, Farah Ben Jabeur, Cristina Adriana Dehelean and Valentina Oana Buda

Nutrients 2025, 17(23), 3759; https://doi.org/10.3390/nu17233759 (registering DOI) - 29 Nov 2025

Abstract

Background/Objectives: Osteoporosis represents a major yet underdiagnosed public health concern in developing countries, including Tunisia. Limited awareness, delayed diagnosis, and suboptimal adoption of preventive strategies contribute to increased risk of fragility fractures in aging populations. This study aimed to assess post-pandemic knowledge, [...] Read more.

Background/Objectives: Osteoporosis represents a major yet underdiagnosed public health concern in developing countries, including Tunisia. Limited awareness, delayed diagnosis, and suboptimal adoption of preventive strategies contribute to increased risk of fragility fractures in aging populations. This study aimed to assess post-pandemic knowledge, attitudes, and preventive practices regarding osteoporosis in the Tunisian general population. Methods: A cross-sectional survey was conducted between February and April 2024 in six randomly selected community pharmacies in Tunis. Adults ≥ 40 years old completed a validated 31-item questionnaire assessing socio-demographic factors, osteoporosis knowledge, risk factors, screening practices, and preventive behaviors. A total of 160 fully completed questionnaires were analyzed using SPSS v22. Results: Only 60.6% of respondents reported awareness of osteoporosis. Knowledge levels were significantly higher in men (8.37 vs. 7.40; p = 0.043), urban residents (8.22 vs. 7.21; p = 0.036), participants with higher education (8.73 vs. 7.00; p < 0.001), those with a family history (8.58 vs. 7.49; p = 0.033), and individuals already diagnosed (9.19 vs. 7.63; p = 0.025). Screening rates were low: only 11.3% had ever undergone DXA testing, despite 18.8% reporting prior fractures. Preventive behaviors were inadequate: 80% did not supplement calcium, 88.1% did not use vitamin D, and 58.8% did not engage in <30 min of daily activity. Osteoporosis was reported by 13.1% of participants and 95.2% of diagnosed cases received treatment, predominantly bisphosphonates (75%). Comorbidities were significantly associated with osteoporosis (24.5% vs. 7.5%; p = 0.003). Conclusions: This study reveals suboptimal awareness, limited access to screening, and insufficient preventive behaviors regarding osteoporosis in Tunisia. Targeted educational initiatives, expansion of DXA availability, adoption of national osteoporosis guidelines, and multidisciplinary stakeholder involvement are critical to improve early detection, prevention, and management in the aging Tunisian population. Furthermore, promoting balanced nutrition that includes calcium- and vitamin D-rich foods, along with appropriate dietary supplementation when needed, is an essential preventive strategy to support optimal bone health and reduce osteoporosis risk in the general population. Full article

(This article belongs to the Section Geriatric Nutrition)

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31 pages, 2601 KB

Open AccessArticle

Dietary Influences on Nitrogen and Phosphorus Footprints in Indian Food Systems: A State and Union Territory-Level Analysis

by Aurup Ratan Dhar, Azusa Oita, Himadri Kaushik, Ananta Narayan Panda, Tapan Kumar Adhya and Kazuyo Matsubae

Nutrients 2025, 17(23), 3758; https://doi.org/10.3390/nu17233758 (registering DOI) - 29 Nov 2025

Abstract

Background/Objectives: Nitrogen (N) and phosphorus (P) are essential macronutrients for crop production. However, their losses throughout the agri-food system pose significant environmental and public health risks. India, with its diverse dietary cultures and large agricultural sector, presents a unique context for evaluating nutrient [...] Read more.

Background/Objectives: Nitrogen (N) and phosphorus (P) are essential macronutrients for crop production. However, their losses throughout the agri-food system pose significant environmental and public health risks. India, with its diverse dietary cultures and large agricultural sector, presents a unique context for evaluating nutrient footprints. This study aims to provide the first sub-national assessment of food-related N and P footprints across Indian states and union territories, evaluating how vegetarian and non-vegetarian diets influence these footprints. Methods: This study employed a diet-sensitive bottom-up approach using national dietary consumption statistics from 2011–2012 to estimate food N and P footprints. The analysis incorporated regional dietary profiles and nutrient use efficiencies in crop production, along with food waste data, to quantify the affecting factors. Results: The national average food footprints were estimated at 13.11 kg-N capita⁻¹ year⁻¹ and 1.16 kg-P capita⁻¹ year⁻¹, with sub-national variation ranging from 52% to 144% of the national average for N, and 46% to 166% for P. Regions with prevalent non-vegetarian diets exhibited significantly higher footprints than those with vegetarian diets. Low nutrient use efficiencies (NUE 19%, PUE 31%) and consumer-level food waste (contributing nearly 4%) were also identified as key drivers of elevated footprints. Conclusions: The findings indicate that dietary choices, agricultural nutrient management, and food waste practices collectively contribute to the nutrient-related risks in India. Enhancing nutrient use efficiency, promoting plant-based diets, and improving waste management in culturally and regionally sensitive ways are crucial for reducing N and P losses. These findings provide actionable insights for the development of sustainable nutrition and agro-environmental policies. Full article

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

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25 pages, 2286 KB

Open AccessSystematic Review

Is Vitamin D Fortification of Dairy Products Effective for Improving Vitamin D Status? A Systematic Review and Meta-Analysis of Randomised Controlled Trials

by Cheuk Lun Wong, D. Ian Givens, Anu M. Turpeinen, Xinyue Liu and Jing Guo

Nutrients 2025, 17(23), 3757; https://doi.org/10.3390/nu17233757 (registering DOI) - 29 Nov 2025

Abstract

Background/objectives: Given the suboptimal vitamin D intake and status among the United Kingdom population, the Scientific Advisory Committee on Nutrition is seeking suitable food vehicles for vitamin D fortification. Thus, this study aimed to examine the efficacy of vitamin D-fortified dairy products [...] Read more.

Background/objectives: Given the suboptimal vitamin D intake and status among the United Kingdom population, the Scientific Advisory Committee on Nutrition is seeking suitable food vehicles for vitamin D fortification. Thus, this study aimed to examine the efficacy of vitamin D-fortified dairy products in improving serum 25-hydroxyvitamin D [25(OH)D] concentration using data from randomised controlled trials (RCTs). Methods: PubMed, Embase, and Web of Science were searched from inception until October 2024. Studies were included if they were RCTs with intervention groups administered vitamin D-fortified dairy products and control groups administered unfortified dairy products, as well as examining the effects on serum 25(OH)D concentration. Results: There were 35 RCTs eligible for inclusion, involving 4965 participants (intervention: 2526; control: 2439). The results showed that serum 25(OH)D concentrations were significantly increased by vitamin D₃-fortified milk/milk powder (n = 15, mean difference (MD): 18.31 nmol/L, 95% confidence interval (CI): 13.30–23.33 nmol/L, I² = 95%), vitamin D₃-fortified yoghurt/yoghurt drinks (n = 11, MD: 26.22 nmol/L, 95% CI: 18.67–33.77 nmol/L, I² = 97%), vitamin D₂-fortified milk/milk powder (n = 3, MD: 11.61 nmol/L, 95% CI: 9.31–13.91 nmol/L, I² = 0%), vitamin D-fortified (type not specified) milk/milk powder (n = 8, MD: 13.59 nmol/L, 95% CI: 8.54–18.64, I² = 98%), and vitamin D-fortified (type not specified) yoghurt/yoghurt drinks (n = 4, MD: 27.74 nmol/L, 95% CI: 16.83–38.64 nmol/L, I² = 91%), but insignificantly increased by vitamin D₃-fortified cheese (n = 5, MD: 16.78 nmol/L, 95% CI: −3.61–37.16, I² = 99%). However, the results of vitamin D₃-fortified cheese became significant when leave-one-out analysis was performed by omitting one RCT (MD: 24.13 nmol/L, 95% CI: 4.69–43.58, I² = 90%). Conclusions: These findings provide evidence that vitamin D-fortified dairy products have the potential to improve serum 25(OH)D concentrations in populations. Full article

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

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18 pages, 1693 KB

Open AccessArticle

Assessment of the Isolated and Combined Impact of β-Glucan and Lacticaseibacillus rhamnosus on Cystic Fibrosis Gut Microbiota Using a SHIME^® System

by Jazmín Viteri-Echeverría, Joaquim Calvo-Lerma, Jorge García-Hernández, Ana Heredia, Ana Andrés and Andrea Asensio-Grau

Nutrients 2025, 17(23), 3756; https://doi.org/10.3390/nu17233756 (registering DOI) - 29 Nov 2025

Abstract

Background: Cystic fibrosis (CF) is a genetic disorder that disrupts gut microbiota composition, promoting dysbiosis associated with chronic inflammation, impaired nutrient absorption, and poor clinical outcomes. While modulation of the intestinal microbiota through prebiotics, probiotics, and synbiotics has been proposed as a therapeutic [...] Read more.

Background: Cystic fibrosis (CF) is a genetic disorder that disrupts gut microbiota composition, promoting dysbiosis associated with chronic inflammation, impaired nutrient absorption, and poor clinical outcomes. While modulation of the intestinal microbiota through prebiotics, probiotics, and synbiotics has been proposed as a therapeutic strategy, clinical evidence remains limited, especially in children. Objective: This study aimed to evaluate the impact of three supplementation strategies (a prebiotic (β-glucan), a probiotic (Lacticaseibacillus rhamnosus GG), and their synbiotic combination) on the gut microbiota and metabolic activity of a CF child faecal donor using a dynamic in vitro colonic fermentation model (SHIME^®). Methods: Microbial composition (16S rRNA gene sequencing), and metabolic activity (quantification of short-chain fatty acids (SCFAs), ammonia, and lactate) were analysed. Results: Results showed that the prebiotic increased alpha diversity; while both the prebiotic and probiotic treatments significantly reduced Bacillota and increased Bacteroidota, modulating the Bacillota/Bacteroidota ratio. The synbiotic treatment showed the most beneficial overall profile, including enhanced production of SCFAs, particularly butyrate and propionate, and increased abundance of Faecalibacterium and Agathobacter, which are two bacterial genera generally associated with gut health. Notably, the synbiotic also reduced the relative abundance of potentially pathogenic genera such as Veillonella, Megasphaera, and Stenotrophomonas, but paralleled with an increase in Clostridium ss 1. Although the probiotic alone showed some positive effects, it was less effective overall compared to the prebiotic and synbiotic approaches. Conclusions: These findings support the potential of synbiotic supplementation as a promising strategy to modulate gut dysbiosis in CF, though in vivo studies are needed to confirm the translational relevance of these results. Full article

(This article belongs to the Section Prebiotics and Probiotics)

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13 pages, 1200 KB

Open AccessArticle

Clinical Characteristics and Outcomes of Pediatric Vitamin C Deficiency

by Thanaporn Trangkanont, Maneerat Puwanant and Thirachit Chotsampancharoen

Nutrients 2025, 17(23), 3755; https://doi.org/10.3390/nu17233755 (registering DOI) - 29 Nov 2025

Abstract

Background: Vitamin C deficiency remains an under-recognized condition in children, especially in Southeast Asia. This study aimed to study the clinical characteristics, dietary risk factors, and outcomes of pediatric vitamin C deficiency in a tertiary hospital in Southern Thailand. Methods: This retrospective study [...] Read more.

Background: Vitamin C deficiency remains an under-recognized condition in children, especially in Southeast Asia. This study aimed to study the clinical characteristics, dietary risk factors, and outcomes of pediatric vitamin C deficiency in a tertiary hospital in Southern Thailand. Methods: This retrospective study reviewed the medical records of children aged 1 to 15 years diagnosed with vitamin C deficiency from 2004 to 2024. Diagnosis was based on serum ascorbic acid levels below 0.4 mg/dL, or clinical-radiographic findings. Data collected included demographics, developmental status, dietary history, clinical presentations, radiological and laboratory results, treatment, and outcomes. Results: Forty-six children were diagnosed; the median age was 4.8 years, and 60% were male; developmental delay was present in 54.4%. The majority had poor dietary intake, with 73% not consuming adequate fruits and vegetables; no significant differences were observed when classified by developmental status. Common clinical signs included: limb pain (76.1%), refusal to walk (52.2%), and bleeding gums (39.1%). Radiographs showed osteopenia in 73.8% and white line of Frankel in 47.6%. Serum ascorbic acid deficiency was significantly associated with low fruit and vegetable intake and excessive milk consumption over the recommendations (p < 0.05). Treatment with oral vitamin C resulted in clinical improvement; although, residual symptoms persisted in some cases. Conclusions: As pediatric vitamin C deficiency is still of concern, this study highlights the importance of early detection in at-risk children and the critical role of detailed dietary history to identify inadequate nutrition. Prompt recognition and intervention can prevent misdiagnosis and improve clinical outcomes. Hence, strengthening parental education on nutritional intake is essential to reduce future incidences. Full article

(This article belongs to the Section Pediatric Nutrition)

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