Dietetics

Accurate assessment of sodium intake and its dietary sources is essential for developing effective sodium reduction strategies. This study estimated total dietary sodium intake (DSI) and source-specific contributions using questionnaire-based methods, validated against urinary sodium excretion (USE). Two cross-sectional surveys were conducted in 2023 among adults aged 15–59 years in Burkina Faso (N = 749) and Senegal (N = 1340), selected through stratified sampling. USE was estimated from spot urine samples, calibrated using 24 h urine collections in a sub-sample (eUSE). DSI was assessed using three complementary methods: (1) household purchasing/adult male equivalent (AME) for small-commodity foods and discretionary salt, (2) 24 h recall for sodium-rich foods consumed in and outside the home, and (3) a food frequency questionnaire for composite dishes eaten outside the home. Median DSI from dietary methods (2.6 g/day) closely matched estimates from eUSE (2.7 g/day) in Burkina Faso but was overestimated in Senegal (5.4 vs. 3.1 g/day), mainly due to difficulty estimating discretionary salt use in households buying large quantities. The country-specific validation of spot urine showed good agreement with 24 h collections. Combining complementary dietary intake methods offers a feasible approach to estimating total and source-specific sodium intake in settings with frequent small salt purchases. In settings with large salt purchases and salt being used for purposes other than human consumption, the salt purchasing/AME method to quantify the use of discretionary salt at the household level should be replaced by the salt disappearance method. Full article

Background: Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for severe obesity, achieving substantial weight loss and metabolic improvement. Beyond weight, assessing body composition and functional markers is essential. Phase angle (PA), obtained through bioelectrical impedance, is a relevant indicator of cellular integrity and nutritional status. The rise of glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide (GLP-1 and GLP-1/GIP) agonists makes comparison with surgical outcomes increasingly important. This study aimed to evaluate changes in fat mass, lean mass, hydration, and PA after RYGB and compare these findings with evidence from pharmacological therapies. Methods: A retrospective observational study was conducted in 15 patients (18–50 years, BMI > 35 kg/m²) at Quirón Salud Hospital Torrevieja. Body composition was assessed using multifrequency bioelectrical impedance (TANITA BC-980) before surgery and at 3 and 12 months. All patients received structured nutritional follow-up. Repeated-measures ANOVA and the Friedman test were applied. Results: After 12 months, weight decreased by 40.06 ± 11.86 kg; fat mass by 30.43 ± 10.81 kg; and fat-free mass by 9.64 ± 5.31 kg. PA declined 11% during the first 3 months and then stabilized. Women lost more fat mass; men lost more lean mass. Conclusions: RYGB combined with nutritional support produces high-quality weight loss with relative preservation of lean tissue and stabilization of PA, which proves valuable for postoperative monitoring. Full article

The global seafood industry generates millions of tons of by-products each year, creating environmental and economic challenges but also presenting a valuable opportunity for resource recovery. These by-products, rich in bioactive compounds such as proteins, omega-3 fatty acids, collagen, chitin, and antioxidants, have traditionally been underutilized due to inefficient and energy-intensive conventional extraction processes. Pulsed electric field (PEF) technology has emerged as a promising, non-thermal, and environmentally friendly method for valorizing seafood by-products by enhancing the permeability of biological membranes through electroporation, thereby facilitating the efficient extraction of high-value compounds. This manuscript critically reviews the scientific principles underpinning PEF, including dielectric breakdown and transmembrane potential generation, and explores its mechanisms for improving mass transfer during extraction and dehydration. Applications of PEF for recovering proteins, lipids, and antioxidants from diverse seafood side streams are comprehensively discussed, with emphasis on its advantages such as reduced energy consumption, preservation of thermolabile compounds, and improved product quality compared to conventional methods. Despite demonstrated laboratory-scale successes, industrial adoption of PEF remains limited due to challenges in process optimization, economic feasibility, and regulatory frameworks. This review synthesizes current knowledge and provides guidance for future research to advance the industrial implementation of PEF as a sustainable and efficient tool for seafood by-product valorization. Full article

The reciprocal relationship between genes and nutrients, known as nutrigenetics and nutrigenomics, has been established in many studies. However, current investigations of maternal and neonatal nutrition using a precision nutrition approach focused on genomics are limited, especially in the Middle East and North Africa (MENA) region. This review aims to summarize the impacts of the dietary micronutrients, folic acid, thiamine, and cobalamin on optimal health outcomes during pregnancy, fetal development, lactation, and infant growth. In this review, the roles of folic acid, thiamine, and cobalamin are discussed in the context of various aspects of pregnancy, such as preconception, fetal development, and lactation, highlighting how genetic events occurring during developmental periods can have consequential impacts on health outcomes later in life. Deficiency rates and related health consequences as well as the prevalence of genetic mutations related to these nutrients of interest in the MENA region are also elaborated on. How to advance knowledge and applications of precision nutrition, how genes interact with the neurochemical changes during pregnancy, and how this interaction impacts maternal eating behaviors, and consequently fetal development and infant and child growth and health, should be further explored in future studies. This includes taking advantage of cutting-edge technologies and the role of artificial intelligence in this endeavor. Full article

Complementary feeding influences infant growth and health. Māori and Pacific infants in Aotearoa New Zealand experience disproportionate nutrition-related disease, yet complementary feeding data are limited. Caregivers of 625 infants (7–10 months) completed a questionnaire on timing of introduction, baby-led weaning (BLW), and baby food pouch use. Ethnicity was total response; infants not Māori or Pacific were classified as ‘other’. Complementary foods were introduced at around six months for 56.5% of Māori, 62.2% of Pacific, and 80.9% of others; before five months for 40.5%, 34.2%, and 17.3%. BLW prevalence was 29.2% (Māori), 17.1% (Pacific), and 27.3% (other). Although pouches were uncommon when complementary feeding began, by 7–10 months about two-thirds of Māori and Pacific infants were fed pouches sometimes or frequently. Frequent pouch use with mostly or always nozzle feeding occurred in 12.2% of Māori infants, 12.2% of Pacific infants, and 2.7% of other infants. Vegetables and purée were the most common first food and texture. By six months, over half consumed red meat and about half consumed iron-fortified baby rice. These feeding practices have implications for nutrition-related health inequities among Māori and Pacific infants, highlighting the need for culturally centered public health approaches to support whānau with feeding. Full article

Background: Incretin-based therapies, including glucagon-like peptide-1 (GLP-1) receptor agonists and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor co-agonists, advance obesity treatment by promoting weight loss and lowering the risk of type 2 diabetes and cardiovascular disease. Methods: This narrative review synthesizes clinical evidence to highlight the role of dietitians in obesity management when incretin-based therapies are used. Results: GLP-1 receptor agonists and dual GLP-1/GIP receptor co-agonists achieve 15–21% weight loss and reduce cardiometabolic risk. Their effectiveness and safety are optimized when integrated with medical nutrition therapy (MNT) and personalized nutrition strategies. In Italy’s aging population, the rising burden of sarcopenic obesity requires dietitian-led care to preserve fat-free mass while reducing fat mass. Dual GLP-1/GIP co-agonists show superior reductions in visceral adiposity, but effects on fat-free mass remain inconclusive, underscoring the need for dietitian oversight to prevent adverse body-composition changes. Sarcopenic obesity is associated with increased mortality and functional decline. Dietitians are uniquely qualified to ensure adequate protein intake and protect muscle during pharmacologic interventions. In Italy, role clarity in clinical nutrition remains limited; however, under national law (DM 744/94; Law 42/1999), dietitians are recognized as the professionals authorized to provide medical nutrition therapy (MNT). Conclusions: The dietitian’s expertise maximizes therapeutic efficacy, minimizes adverse effects, and safeguards long-term outcomes. Integrating dietitians into pharmacological treatment pathways is essential to optimize outcomes, ensure patient safety, and safeguard long-term metabolic health. Full article

Human breast milk evolves beyond simple nutrition to function as a complex signaling system that promotes neonatal development. This review analyzes the bioactive components, delineating how its specific constituents compensate for the physiological vulnerabilities of the neonate. Additionally, the distinct roles of colostral and mature milk are in fortifying the immature immune system and promoting gastrointestinal maturation. Focus is placed on the prevention of necrotizing enterocolitis, where milk oligosaccharides and microbiome function to maintain mucosal integrity and symbiosis, while preventing pathogens’ adhesion. Furthermore, how breastfeeding duration is linked to long-term metabolic and immunological programming is evaluated. MicroRNAs and bioactive lipids actively modulate gene expression and immune responses, thereby reducing the incidence of metabolic diseases and childhood malignancies. By integrating findings, this article underscores the irreplaceable role of breast milk in clinical dietetics and pediatric care. Full article

COVID-19 disrupted daily routines, altering eating patterns. However, it could encourage individuals to adopt healthier behaviors. While extensive research documented changes in dietary behaviors during the COVID-19 lockdown, few studies explored whether they persisted over time. This study aimed to identify the long-term effects of the pandemic on lifestyle and eating behaviors of families from a private primary school in Funes County, Rosario, Argentina. A total of 51 families (192 individuals) completed an anonymous survey on food intake and perceived dietary and lifestyle changes since the pandemic began. Multiple correspondence analysis revealed increased consumption of fast/processed foods, larger portion sizes, and snacking linked to eating from boredom, stress, or tiredness. Increased home-cooked meals, physical activity, interest in healthy habits, and leisure time enjoyment were also found. Dietary analysis revealed that higher intake of fruits, vegetables, legumes, and water was inversely associated with consumption of refined grains, cold cuts, pastries, and sugary drinks. Boredom, stress, or tiredness led to unfavorable changes. Interest in health, changes in home routines, spending more time together, and preparing meals with family resulted in healthier behaviors that remained present at the time of this study. Full article

Objective: To examine the proportion of drinks and snacks offered by the largest coffee shop chains in the UK that exceed the NHS and Public Health England maximum recommended intakes for energy and sugar. Design: Observational study design where nutritional information for drinks and snacks was gathered from the official coffee shop chain website. Data were compared with the maximum recommended intakes of 200 kcal per drink or snack and 30 g of free sugar per day. Direct comparisons between mean values were performed using analysis of variance (ANOVA). Subjects: A total of 2707 drinks and 434 snacks across eight leading coffee shop chains in the United Kingdom. Results: Overall, 47.0% of drinks and 66.8% of snacks exceed the recommended energy intake, while 32.5% of drinks and 45.3% of snacks surpass the recommended daily free sugar intake. ‘Hot chocolates and other speciality drinks’ contain the most energy (255.6 ± 5.78 kcal) of all drink categories. Snacks contain significantly more energy than drinks (p < 0.001), with all three snack categories exceeding the recommended intake of energy. Variations in nutritional content were observed in dairy-alternative milk options and specific chains. Conclusions: The high energy and sugar content of drinks and snacks in major UK coffee chains may contribute to excessive energy intake, with almost half of all drinks and snacks exceeding the maximum recommended levels. Healthier choices, such as avoiding flavoured drinks or limiting the consumption of snacks, may be necessary to help mitigate weight gain and combat obesity and T2DM rates in the UK. Full article

(1) Background: Acidogenic Western-style diets disrupt gut bacteria promoting obesity-related diseases. Here, we investigated whether long-term feeding of alkalinized dietary casein as a protein source (ammonium hydroxide enhancement, AHE) modulates microbiome structure/functions under high-fat conditions, and normal diets, and whether these responses are sex-dimorphic. (2) Methods: C3H/HeJ mice (N = 256; equal sex distribution) received either control casein (CC), AHE casein (CCN), high-fat casein (HFC), or AHE high-fat casein (HFCN) diets from 6 to 18 months. Body mass and survival were tracked; fecal samples collected at 16 months were sequenced and underwent shotgun metagenomics. (3) Results: Diet and sex jointly shaped host metrics. AHE diets taxonomically showed an abundance of Verrucomicrobiota phyla predominating in most cohorts, notably Akkermansia muciniphila. Within Pseudomonadota, Christensenella was identified, along with other taxa associated with beneficial health outcomes, including Lactococcus lactis, Lactococcus cremoris, Pediococcus acidilactici, and families Lachnospiraceae/Oscillospiraceae. Additionally, sex- and diet-dependent advantageous enriched functions associated with AHE that enhanced electron transport, B-vitamin cofactor pathways, and mucosal/redox support were observed. (4) Conclusions: In the long term, pH-directed protein chemistry is a tractable lever for gut ecology during high-fat feeding, enriching and promoting the balance of beneficial taxa, providing a mechanistic bridge between dietary acid load and microbiome remodeling. Full article

Choline is an essential nutrient whose physiological importance has not yet been sufficiently recognized by many European nutrition authorities. Despite convincing evidence of its crucial role in liver lipid export, one-carbon metabolism, cell membrane integrity, and nervous system development, explicit dietary recommendations for choline are still lacking in most European countries. In contrast, its importance has long been recognized in the national guidelines of the United States, Australia, China, and other regions. The current and rapidly spreading dietary shifts toward plant-based and vegan diets—characterized by a lower proportion of animal foods, the main sources of choline—increase the risk of suboptimal intake in broad segments of the population. Given the considerable interindividual differences in endogenous choline biosynthesis, which are influenced by sex hormones, physical activity, nutrient interactions, and genetic polymorphisms, adequate dietary intake is essential to meet physiological needs, especially during periods of increased demand such as pregnancy, lactation, and high-performance sports. This narrative review summarizes the evidence for the essentiality of choline, outlines the rationale for deriving intake recommendations for different life stages, and identifies an urgent need for coordinated action by European nutrition societies to address the growing risk of population-wide undersupply. Full article

Food insecurity is a considerable challenge for university students globally. While food pantries are a primary response, their impact on psychological well-being remains unclear. Here, we aimed to investigate effects of providing hot meals during community food-pantry events on participant satisfaction and self-reported loneliness among financially challenged university students in Tokyo. A non-randomized pre-post design was used to compare events with (n = 87) and without (n = 41) a hot meal. Participant satisfaction was assessed using a questionnaire; loneliness was measured using the University of California, Los Angeles (UCLA) Loneliness Scale. Hot-meal events had a 100% satisfaction rate. Notably, satisfaction with the café space was significantly higher in hot-meal events than in non-meal events (p = 0.003). However, analysis of covariance indicated that the adjusted mean difference in post-event loneliness scores was not statistically significant. Hot meals enhanced participant satisfaction and the perception of the venue, suggesting it is a key component of the food-utilization dimension of food security. Although a significant reduction in loneliness was not observed, the high appreciation of the dining environment suggests that future programs should integrate hot meals with strategies to maximize social interaction, aiming for a more holistic impact on student well-being. Full article

Small-intestinal bacterial overgrowth (SIBO) is defined by an excessive microbial presence in the small intestine and is associated with a range of gastrointestinal symptoms. Its management remains complex due to diagnostic limitations and high recurrence rates following treatment. A narrative review was conducted using MEDLINE (PubMed) and Cochrane databases to identify relevant studies published between 1984 and 2024. Search terms included small intestinal bacterial overgrowth SIBO, FODMAP, probiotics, prebiotics, synbiotics, and low-carbohydrate diets. Reference lists were also screened for additional studies. Antibiotics, particularly rifaximin, are commonly used for SIBO treatment but recurrence is frequent. Dietary strategies, such as low-FODMAP and low-carbohydrate diets, may help reduce symptoms, especially in patients with complications like D-lactic acidosis. Evidence for biotic agents (probiotics, prebiotics, synbiotics) is mixed, with limited high-quality studies and inconsistent outcomes. Some probiotic strains show symptom improvement, but effects on breath-test results are variable. A tailored, multidisciplinary approach combining dietary and medical therapies may offer optimal symptom control in SIBO. However, heterogeneity in study designs and limited evidence highlight the need for further research to inform standardised, evidence-based clinical practice. Full article

Background: Hyperuricemia is a well-known problem in end-stage kidney disease. Currently, the end-stage kidney disease patients may be treated with comprehensive conservative management, hemodialysis, or peritoneal dialysis, which impact uric acid levels distinctly. We assessed the impact of these strategies on uric acid control and identified the factors that influence it. Methods: We conducted a preliminary case–control study comparing patients in comprehensive conservative management, hemodialysis and peritoneal dialysis. For each patient, we evaluated demographic characteristics, comorbidities, body mass index, protein intake, urine output and blood test results. Results: In the entire population, uric acid levels were slightly higher in the comprehensive conservative management group. Furthermore, uric acid control was influenced primarily by body mass index (β = −0.005, p = 0.03) and treatment modality (β = −0.0026, p = 0.05). In comprehensive conservative management, body mass index (β = −0.007, p = 0.02) and urine urea excretion (β = 0.014, p = 0.04) were independent predictors of uric acid level. Conversely, only the suggested protein intake (β = 0.16, p = 0.05), potassium levels (β = −0.046, p = 0.04) and allopurinol therapy (β = −0.073, p = 0.03) were independent predictors of uric acid in hemodialysis patients. Finally, only the recommended protein intake (B = −0.005, p = 0.03) was associated with uric acid levels in patients undergoing peritoneal dialysis. Conclusions: In our series, uric acid control correlates with the treatment modality used for end-stage kidney disease and dietary protein intake. Full article

Negative body image is a widespread phenomenon among women in Western cultures. Appearance-related social media trends such as “thinspiration” and “fitspiration” have been found to be related to poor body image, and recent research suggests that food-related social media may also impact women’s body dissatisfaction, though this literature is in its infancy. The current study examined the impact of diet- and food-related social media among undergraduate women. Participants (N = 256) were randomized to view either “What I Eat in a Day” (WIEIAD) or interior design TikTok videos, with or without a depiction of a “thin-ideal” body. They completed measures of body image before and immediately after viewing the video, and a measure of dieting intentions after viewing. Results indicated a worsened body image among those who watched WIEIAD videos depicting thin-ideal bodies, which was significantly greater than the change reported by those who viewed either interior design videos (with or without thin-ideal bodies depicted). This finding suggests a possible detrimental effect of WIEIAD videos on body image; however, they did not appear to affect dieting intentions, as no significant group differences were found in this outcome between WIEIAD and interior design video groups. Considering WIEIAD videos are common across social media platforms, it is important for young women to be aware of the potential adverse impact of the social media they are exposed to. Full article

Background: Calcium (Ca) and magnesium (Mg) are essential micronutrients integral to metabolic processes and cardiovascular health. Emerging evidence suggests that the dietary Ca:Mg ratio may influence chronic disease risk, yet variability in this ratio across diverse demographic groups and its relationship to body composition and vitamin D status remain unclear. Methods: Dietary intakes of Ca and Mg were assessed using validated Food Frequency Questionnaires (FFQs) and body composition was quantified via Dual-energy X-ray Absorptiometry (DXA) scans. Relationships between dietary Ca:Mg ratios and demographics, body composition parameters (lean and fat mass), and vitamin D and parathyroid hormone (PTH) levels were examined statistically using SPSS ver. 29.0 and R ver. 4.5.1 (2025) employing Kruskal–Wallis, regression, and moderated mediation analyses. Results: We examined 155 healthy adults with a mean age of 36.6 ± 12.5 years. Only 16.8% had adequate intakes of Mg compared with 45.8% who had adequate dietary Ca intakes. Significant differences in the Ca:Mg ratio were observed across racial groups (p = 0.023) and age groups (p = 0.017). South Asian Indians exhibited the highest median Ca:Mg ratio (4.83), whereas African Americans exhibited the lowest (2.67). Interestingly, our moderated mediation analysis indicated that African Americans were the most sensitive to the impact of PTH changes on the balance of Ca:Mg (indirect effect = −0.762, 95% CI [−1.298, −0.234]), indicating that even slight shifts in their Ca:Mg balances cause significant elevation in the PTH, which, in turn, leads to lowering of their vitamin D levels. Young adults (ages 18–29) had the highest median Ca:Mg ratio (4.73). No statistically significant differences were detected based on Gender (p = 0.425 and BMI (p = 0.744) on Ca:Mg ratios. Additionally, dietary Ca:Mg ratios were positively associated with sPTH in males (r = 0.203, p < 0.05), but not with body composition. Conclusion: Important variations in dietary Ca:Mg ratios exist across racial and age demographics, notably among young adults, and specific ethnic groups exhibited elevated ratios. Tailored nutritional interventions may be necessary for these populations to optimize Ca:Mg balance and support metabolic and cardiovascular health outcomes in these populations. Full article

Worsening nutritional status in patients with pancreatic cancer may be associated with poorer tolerance to chemotherapy and increased complications. This retrospective cohort pilot study, conducted between October 2023 and March 2024, aimed to evaluate the association between nutritional status, weight loss, and clinical outcomes that included hospitalization, neutropenia, chemotherapy delay, and worsening laboratory changes. Patients were categorized into two groups: those with weight loss >5% of usual body weight and those with ≤5%. Of the 21 participants, 8 were male and 13 were female. Weight loss >5% was significantly associated with more patients requiring hospitalizations compared to weight loss ≤5% [6 (75%) vs. 3 (23.1%), p = 0.02], while no statistically significant differences were observed for other clinical outcomes. Risk factors associated with greater weight loss included age >72 years (crude odds ratio [COR] 9.17; 95% CI 1.15–73.24; p = 0.037), treatment with a paclitaxel plus gemcitabine regimen (COR 12.00; 95% CI 1.02–141.34; p = 0.048), and a history of hospitalization (COR 10.00; 95% CI 1.28–78.12; p = 0.028). Weight loss in pancreatic cancer is linked to poorer clinical outcomes, with older age, certain chemotherapy regimens, and hospitalization identified as risk factors. Early dietary counseling by registered dietitians may help mitigate this risk. Full article

The present work aimed to assess associations between food insecurity, WIC participation, diversity of dietary exposures, and diet quality in infancy. A secondary analysis was conducted of the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2), a national longitudinal study of WIC participation, feeding practices, and children’s health outcomes. Food security at 13 and 24 months, WIC participation at 13 and 24 months, diversity of dietary exposures between 5 and 13 months, and diet quality at 24 months were assessed in 1246 participants who had complete data on all variables of interest. Multivariable linear regression using weighted cases was used. Among families participating in WIC at 13 months, infants in families with low or very low food security had a greater diversity of dietary exposures (mean ± SE: 8.9 ± 0.3) compared to families with high or marginal food security (8.6 ± 0.2); the magnitude of this effect was small but significant (p = 0.03). In both food-insecure and -secure families, greater diversity of dietary exposures (b = 0.30, 95% CI 0.15, 0.44) and WIC participation at 24 months (b = 2.35, 95% CI 1.29, 3.40) were associated with higher diet quality at 24 months. Greater diversity of dietary exposures and participation in WIC may support improved diet quality during the first 2 years. Full article

Background: Identifying factors associated with cognitive impairment among older adults is critical. This study investigates both concurrent and longitudinal associations between sleep quality, sleep duration, and cognitive performance among older adults in China, with particular emphasis on the moderating role of fruit and/or vegetable intake (FVI), a factor rarely examined in previous research. Methods: We pooled five waves of a specially designed nationwide sample of adults aged 65 years or older (N = 64,690; mean age: 86.3 years; men: 43.5%) in 2005, 2008, 2011, 2014, and 2018 in China. Cognitive impairment was assessed by the Mini-Mental State Examination. Among the sample, 10.7% were cognitively impaired. FVI was dichotomized into frequent (almost daily) versus infrequent (other low frequencies). Sleep hours were grouped into short (≤6 h), normal (7–9 h), and long (≥10 h) durations. Both concurrent and cross-lagged analyses were performed after adjusting for a wide set of covariates (demographics, socioeconomic status, family/social connections, health practices, disability, self-rated health, and chronic conditions). Analyses were further stratified by gender, age group, and urban–rural residence. Results: When all covariates were present (the full model), good sleep quality was associated with 22% lower odds of the prevalence of cognitive impairment, whereas the long sleep duration was associated with 24% higher odds as compared with the normal sleep duration. Although the short sleep duration was not associated with the prevalence of cognitive impairment in the full model, it was associated with 8% higher odds of cognitive impairment when health condition was not controlled for. Interaction analyses revealed that frequent FVI buffered the adverse cognitive effects of poor sleep quality and both short and long sleep durations. Subgroup analyses further show similar patterns across subpopulations, with more pronounced protective associations in older women and the oldest-old. Conclusions: Good sleep quality, normal sleep durations, and frequent FVI jointly contribute to better cognitive functioning at older ages. While the observed relationships are largely concurrent rather than causal, promoting both healthy sleep and dietary habits may be important for cognitive health among older adults. Full article