Journal Description
Nutrients
Nutrients
is an international, peer-reviewed, open access journal of human nutrition published semimonthly online by MDPI. The Asia Pacific Nutrigenomics Nutrigenetics Organisation (APNNO), Italian Society for Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP), Nutrition Society of New Zealand (NSNZ), Ocular Wellness & Nutrition Society (OWNS) and others are affiliated with Nutrients and their members receive discounts on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, MEDLINE, PMC, Embase, PubAg, AGRIS, and other databases.
- Journal Rank: JCR - Q1 (Nutrition and Dietetics) / CiteScore - Q1 (Nutrition and Dietetics)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 15 days after submission; acceptance to publication is undertaken in 2.4 days (median values for papers published in this journal in the second half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journal: Dietetics.
- Journal Cluster of Food, Nutrition, and Health Science: Beverages, Dietetics, Foods, Nutraceuticals, Nutrients and Obesities.
Impact Factor:
5.0 (2024);
5-Year Impact Factor:
6.0 (2024)
Latest Articles
The Ketogenic Diet in Type 2 Diabetes and Obesity: A Narrative Review of Clinical Evidence
Nutrients 2026, 18(3), 397; https://doi.org/10.3390/nu18030397 (registering DOI) - 25 Jan 2026
Abstract
Type 2 diabetes mellitus (T2DM) and obesity represent a growing global public health challenge, strongly associated with excess body weight, unhealthy dietary habits, and a sedentary lifestyle. The ketogenic diet (KD), characterized by very low carbohydrate intake, moderate protein intake, and high fat
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Type 2 diabetes mellitus (T2DM) and obesity represent a growing global public health challenge, strongly associated with excess body weight, unhealthy dietary habits, and a sedentary lifestyle. The ketogenic diet (KD), characterized by very low carbohydrate intake, moderate protein intake, and high fat consumption, induces a metabolic state known as ketosis, in which the body switches from glucose to fat as its primary energy source. KD has gained increasing interest as a strategy to improve glycemic control, reduce body weight, and improve lipid profiles in individuals with obesity and T2DM. The purpose of this narrative review is to summarize the current scientific evidence on the effects of KD on key metabolic parameters, including blood glucose levels, glycated hemoglobin (HbA1c), body weight, and body composition. The analysis is based on peer-reviewed articles retrieved from PubMed, Embase, and Scopus with particular emphasis on clinical studies that provide robust evidence on the efficacy and safety of KD in the treatment of metabolic disorders.
Full article
(This article belongs to the Special Issue Endocrine Disturbances and Nutritional Therapies)
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Open AccessReview
Diet–Oral Microbiota Interactions and Salivary Biomarkers of Nutritional Health: A Narrative Review
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Liliana Anchidin-Norocel, Andrei Lobiuc and Mihai Covasa
Nutrients 2026, 18(3), 396; https://doi.org/10.3390/nu18030396 (registering DOI) - 25 Jan 2026
Abstract
Diet plays a central role in shaping the composition and metabolic activity of the oral microbiota, thereby influencing both oral and systemic health. Disturbances in this delicate host–microbe balance, triggered by dietary factors, smoking, poor oral hygiene, or antibiotic use, can lead to
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Diet plays a central role in shaping the composition and metabolic activity of the oral microbiota, thereby influencing both oral and systemic health. Disturbances in this delicate host–microbe balance, triggered by dietary factors, smoking, poor oral hygiene, or antibiotic use, can lead to microbial dysbiosis and increase the risk of oral diseases such as periodontitis, as well as chronic systemic disorders including diabetes, cardiovascular disease, Alzheimer’s disease, and certain cancers. Among dietary contaminants, exposure to toxic heavy metals such as cadmium (Cd), lead (Pb), mercury (Hg), nickel (Ni), and arsenic (As) represents an underrecognized modifier of the oral microbial ecosystem. Even at low concentrations, these elements can disrupt microbial diversity, promote inflammation, and impair metabolic homeostasis. Saliva has recently emerged as a promising, non-invasive biofluid for monitoring nutritional status and early metabolic alterations induced by diet and environmental exposures. Salivary biomarkers, including metabolites, trace elements, and microbial signatures, offer potential for assessing the combined effects of diet, microbiota, and toxicant exposure. This review synthesizes current evidence on how diet influences the oral microbiota and modulates susceptibility to heavy metal toxicity. It also examines the potential of salivary biomarkers as integrative indicators of nutritional status and metabolic health, highlights methodological challenges limiting their validation, and outlines future research directions for developing saliva-based tools in personalized nutrition and precision health.
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(This article belongs to the Special Issue Probiotics and Prebiotics for Oral Health Improvement)
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Open AccessArticle
The Prognostic Nutritional Index and Glycemic Status Synergistically Predict Early Renal Function Decline in Type 2 Diabetes: A Community-Based Cohort Study
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Yuting Yu, Jianguo Yu, Jing Li, Jiedong Xu, Yunhui Wang, Lihua Jiang, Genming Zhao and Yonggen Jiang
Nutrients 2026, 18(3), 395; https://doi.org/10.3390/nu18030395 (registering DOI) - 25 Jan 2026
Abstract
Background/Objectives: The Prognostic Nutritional Index (PNI), which integrates serum albumin and lymphocyte count, reflects both nutritional and inflammatory status. However, its role in early renal function decline among patients with type 2 diabetes (T2D), particularly in relation to glycemic control, remains unclear.
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Background/Objectives: The Prognostic Nutritional Index (PNI), which integrates serum albumin and lymphocyte count, reflects both nutritional and inflammatory status. However, its role in early renal function decline among patients with type 2 diabetes (T2D), particularly in relation to glycemic control, remains unclear. This study aimed to: (1) characterize the dose–response relationship between PNI and early renal function decline in type 2 diabetes using restricted cubic splines; (2) identify whether glycemic control (HbA1c) modifies the PNI–renal decline association; and (3) evaluate the clinical utility of combining PNI and HbA1c for risk stratification. Methods: We analyzed data from 1711 community-based participants with T2D who had preserved renal function at baseline. The PNI was calculated as serum albumin (g/L) + 5 × lymphocyte count (×109/L). The primary outcome was a composite of rapid estimated glomerular filtration rate (eGFR) decline (>3 mL/min/1.73 m2 per year) or incident chronic kidney disease (CKD) stage 3. Restricted cubic spline models, multivariable regression, and Johnson–Neyman analyses were used to examine non-linearity and effect modification by glycated hemoglobin (HbA1c). Results: A consistent inverse linear association was observed between PNI and the rate of eGFR decline (P for non-linearity > 0.05). Johnson–Neyman analysis further demonstrated that the protective association of PNI was statistically significant within an HbA1c range of 7.24% to 8.71%. Stratification by clinical cut-offs revealed a significant effect modification by glycemic status. The inverse linear association between PNI and renal risk was most pronounced under hyperglycemic stress, as evidenced by the markedly elevated incidence (50.0%) among individuals with both poor glycemic control (HbA1c ≥ 8%) and low PNI (<50). Conversely, under good glycemic control (HbA1c < 8%), this inverse association was substantially attenuated, with a lower incidence observed in the low-PNI subgroup (6.7%) than in the high-PNI subgroup (15.9%). These findings indicate that the protective role of PNI is conditional upon the glycemic milieu. Conclusions: The PNI demonstrates a stable linear association with early renal function decline in T2D, with its protective effect most pronounced at suboptimal HbA1c levels. Combining PNI and HbA1c effectively identifies a high-risk subgroup characterized by synergistic risk, underscoring the need for integrated nutritional and glycemic management.
Full article
(This article belongs to the Special Issue Advances in Diabetology: Nutritional Aspects for Diabetic Complications)
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Open AccessSystematic Review
Nutrition Assistance Programs and Pediatric Weight Outcomes: A Systematic Review
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Dan Ferris, Genevieve Davison, Tyler Frank, Amanda Gilbert, Fanice Thomas, Sydney Rothman, Kim Lipsey and Sarah Moreland-Russell
Nutrients 2026, 18(3), 394; https://doi.org/10.3390/nu18030394 (registering DOI) - 25 Jan 2026
Abstract
Background/Objectives. Food insecurity and pediatric obesity have increased concurrently in the U.S., raising questions about the role of Federal Nutrition Assistance Programs (FNAPs) in shaping weight outcomes. This systematic review examined evidence on relationships between FNAP participation and pediatric weight outcomes. Methods. Six
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Background/Objectives. Food insecurity and pediatric obesity have increased concurrently in the U.S., raising questions about the role of Federal Nutrition Assistance Programs (FNAPs) in shaping weight outcomes. This systematic review examined evidence on relationships between FNAP participation and pediatric weight outcomes. Methods. Six databases were searched for U.S.-based, peer-reviewed studies published through July 2024 that assessed FNAP participation and pediatric weight outcomes. Results. Seventy-five studies met the inclusion criteria, and no consistent pattern indicated that any single FNAP or program type (educational setting-based or direct financial support) reliably reduced or increased childhood overweight or obesity risk. Twenty studies found statistically significant beneficial relationships between FNAP participation and pediatric weight outcomes. Most studies reported mixed findings (n = 32), typically varying by subgroup (e.g., age, grade level, gender, race or ethnicity, or program characteristics). Sixteen studies found no relationship between participation and weight. Seven studies found an adverse relationship. Most studies relied on non-randomized quantitative designs and secondary data, and adverse findings were more common in lower quality studies. Among 18 studies that evaluated the effects of policy changes (e.g., the Healthy Hunger-Free Kids Act (2010), 2009 WIC package change), nearly all identified associations between the policy change and weight outcomes, with eight beneficial and nine reporting mixed results. Conclusions. The findings indicate a complex non-causal relationship between FNAP participation and weight that varies across populations, programs, and study designs. Overall, evidence does not support broad adverse weight effects of FNAPs, and policy changes that strengthen nutrition standards may contribute to healthier weight outcomes. These findings have implications for nutrition policy, program design, and future research.
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(This article belongs to the Special Issue The Relationship Between Food Insecurity, Nutritional Environment and Human Health)
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Open AccessReview
Beneficial Effects of Fisetin, a Senotherapeutic Compound, in Women’s Reproductive Health and Diseases: Evidence from In Vitro to Clinical Studies
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Samya El Sayed, D’leela Saiyed, Valeria I. Macri, Awurakua Asamoah-Mensah, James H. Segars and Md Soriful Islam
Nutrients 2026, 18(3), 393; https://doi.org/10.3390/nu18030393 (registering DOI) - 25 Jan 2026
Abstract
Fisetin is a naturally occurring flavonoid, a type of polyphenol found in fruits and vegetables such as strawberries, apples, persimmons, and onions. It has gained increasing attention for its antioxidant properties (enhancement of SOD1 and CAT activity and reduction of ROS), anti-inflammatory effects
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Fisetin is a naturally occurring flavonoid, a type of polyphenol found in fruits and vegetables such as strawberries, apples, persimmons, and onions. It has gained increasing attention for its antioxidant properties (enhancement of SOD1 and CAT activity and reduction of ROS), anti-inflammatory effects (suppression of NF-κB signaling), and senotherapeutic activity (senolytic and senomorphic effects). Although numerous studies have examined fisetin in the context of aging and chronic diseases, its role in women’s reproductive health has not been systematically explored. Mechanistically, fisetin regulates several pathophysiological processes, including ovarian aging, fibrosis, angiogenesis, and hormonal regulation, suggesting its potential relevance to female reproductive health and disease. Indeed, emerging evidence indicates that fisetin may support ovarian function and hormonal balance, modulate fibrosis and metabolism in benign gynecologic conditions, and suppress cell growth in gynecologic cancers. Early-phase clinical studies in non-gynecologic conditions suggest an acceptable safety profile, although evidence in reproductive health remains absent. This review summarizes current experimental and clinical evidence, identifies critical gaps in mechanistic understanding, and discusses future directions for advancing fisetin as a promising non-hormonal therapeutic option in reproductive health and diseases.
Full article
(This article belongs to the Special Issue Linking Fruit and Vegetable Bioactives to Human Health and Wellness)
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Open AccessArticle
Iron Deficiency Inhibits the Proliferation of Intestinal Stem Cells and Induces Their Differentiation to Enterocytes
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Yecheng Xu, Jing Zhao, Shouchuan Jiang, Yu Han, Yi Zheng, Xi Qiao, Xin Wen, Yuanyuan Zhang, Yunqin Li, Jingxia Kong and Huahua Du
Nutrients 2026, 18(3), 392; https://doi.org/10.3390/nu18030392 (registering DOI) - 24 Jan 2026
Abstract
Objectives: Iron deficiency impairs intestinal mucosal structure and function, yet its impact on intestinal stem cells (ISCs) remains unclear. This study was therefore designed to examine how iron deficiency affects the proliferation and differentiation of ISCs. Methods: Iron-deficient mouse and enteroid models were
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Objectives: Iron deficiency impairs intestinal mucosal structure and function, yet its impact on intestinal stem cells (ISCs) remains unclear. This study was therefore designed to examine how iron deficiency affects the proliferation and differentiation of ISCs. Methods: Iron-deficient mouse and enteroid models were established. Expression of key cell markers was analyzed using Western blot, qPCR, and immunofluorescence. Results: Iron deficiency led to structural impairment of the intestinal mucosa, characterized by decreased small intestinal villus height. In iron-deficient mice, expression of ChrA (enteroendocrine cell marker), Lyz (Paneth cell marker), and Muc2 (goblet cell marker) was significantly downregulated across duodenum, jejunum and ileum, whereas Vil1 (enterocyte marker) expression increased. Moreover, both Lgr5 (an ISC marker) expression and the number of Ki67-positive proliferating cells were significantly reduced, along with a decrease in Ki67 transcriptional levels under iron-deficient conditions. Similarly, deferoxamine (DFO)-treated enteroids showed fewer Lgr5-positive ISCs, downregulation of Lgr5, Lyz and Muc2, and upregulation of Vil1. RNA-seq further confirmed that iron deficiency skews ISC differentiation toward absorptive lineage. This shift was associated with modulation of the Notch signaling pathway: upregulation of the ligand Dll1, receptors Notch2 and Notch3, and the protease ADAM10, alongside downregulation of the negative regulator Atoh1. These findings indicate that Notch pathway activation promotes enterocyte differentiation under iron deprivation. Conclusions: Iron deficiency suppressed the proliferation of ISCs and induced their differentiation toward enterocytes, which is associated with the modulation of the Notch signaling pathway, providing a mechanistic insights for impaired intestinal repair and the potential for nutrient-targeted therapies.
Full article
(This article belongs to the Special Issue Iron Supplements and Intestinal Health)
Open AccessArticle
Obesity Treatment Application Implications of Temporally Sequenced Paths of Theory-Driven Psychological Changes Toward Improvements in Physical Activity and Dietary Behaviors in Women
by
James J. Annesi
Nutrients 2026, 18(3), 391; https://doi.org/10.3390/nu18030391 (registering DOI) - 24 Jan 2026
Abstract
Background/Objectives: Obesity has a high prevalence and is associated with many health risks. Minimal effects from behavioral obesity treatments might be linked to their atheoretical dependence on simply educating participants on healthy eating and increased physical activity/exercise, rather than evolving behavior-change methods through
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Background/Objectives: Obesity has a high prevalence and is associated with many health risks. Minimal effects from behavioral obesity treatments might be linked to their atheoretical dependence on simply educating participants on healthy eating and increased physical activity/exercise, rather than evolving behavior-change methods through theory-based research. The use of pharmacologic interventions has recently overtaken bariatric surgery in medically based efforts to obtain greater weight losses than through behavioral means. Methods: The present longitudinal observational study aimed to extend earlier treatment-associated findings concerned with the order of emphasizing 3-, 6-, and 9-month changes in the theory-driven psychosocial constructs of self-regulation, self-efficacy, and mood associated with 12-month improvements in weight-loss behaviors. The “parent study” of women with obesity (N = 106) found significant paths through changes in self-regulation → mood → self-efficacy and mood → self-regulation → self-efficacy. In the present extension of that investigation, only those participants who did not already complete recommended physical activity amounts and consume recommended portions of fruits/vegetables at baseline were included (N = 73). Results: Only paths from changes in mood → self-regulation → self-efficacy were significantly associated with 12-month improvements in both physical activity and dietary behaviors. A mean weight change of −5.2 kg, or −5.5% from baseline weight, was found. Baseline scores in emotional eating and anxiety significantly moderated the mood–self-regulation change relationships within the significant paths. Conclusions: Findings suggested that future treatment contents focus on early physical activity-associated improvement in mood because of its association with increased usage of treatment-developed self-regulatory skills. Those skills should then be leveraged because of their association with feelings of ability (i.e., self-efficacy) to overcome lifestyle barriers to weight-loss behavior changes. Further improvements in behavioral obesity treatments should be reconsidered as either stand-alone modalities or, after appropriate testing, as an adjunct to medical means.
Full article
(This article belongs to the Section Nutrition in Women)
Open AccessReview
Nutritional and Metabolic Interventions to Prevent and Treat Protein–Energy Wasting in Nondialysis CKD—Narrative Review
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Patrícia Kleinová, Blichová Tímea, Vnučák Matej, Karol Graňák, Kollár Andrej, Ševčíková Katarína and Ivana Dedinská
Nutrients 2026, 18(3), 390; https://doi.org/10.3390/nu18030390 (registering DOI) - 24 Jan 2026
Abstract
Background: Protein–energy wasting (PEW) is a major predictor of morbidity and mortality in patients with chronic kidney disease (CKD), even before the initiation of dialysis. Its multifactorial pathogenesis includes reduced dietary intake, chronic inflammation, metabolic acidosis, hormonal disturbances, and dysbiosis of the gut
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Background: Protein–energy wasting (PEW) is a major predictor of morbidity and mortality in patients with chronic kidney disease (CKD), even before the initiation of dialysis. Its multifactorial pathogenesis includes reduced dietary intake, chronic inflammation, metabolic acidosis, hormonal disturbances, and dysbiosis of the gut microbiota. Early recognition and targeted management are crucial for preventing muscle loss, functional decline, and adverse outcomes. Methods: This narrative review summarises and integrates current evidence from the literature on nutritional and metabolic interventions to prevent and treat protein–energy wasting in patients with nondialysis chronic kidney disease. Relevant clinical trials, meta-analyses, and experimental studies published up to date were evaluated, focusing on dietary strategies, metabolic modulation, physical exercise, and gut microbiome-targeted therapies. Results: Adequate energy and protein intake remain the cornerstone of PEW management, based on available clinical and observational evidence. Individualised diets emphasising high-quality and plant-based proteins, oral nutritional supplements, and ketoanalogues can attenuate muscle wasting. Correction of metabolic acidosis and inflammation enhances protein anabolism and nitrogen balance. Physical exercise acts synergistically with dietary interventions to preserve muscle mass and function. Novel approaches—such as modulating the gut–kidney axis with pre-, pro-, and postbiotics or supplementing with short-chain fatty acids—show promise in improving metabolic and inflammatory profiles. Conclusions: The management of PEW in nondialysis CKD requires a personalised approach that integrates nutrition, physical activity, metabolic correction and microbiome modulation. Early, coordinated intervention may help to slow the progression of CKD and improve patient survival and quality of life.
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(This article belongs to the Special Issue Prevention and Treatment of Malnutrition and Its Complications in Chronic Kidney Disease)
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Longitudinal Assessment of Changes in Lifestyle Behaviors and Body Weight from Precollege to Adulthood
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Sujata Dixit-Joshi, Christina D. Economos, Peter J. Bakun, Caitlin P. Bailey, Jeanne P. Goldberg, Erin Hennessy, Nicola M. McKeown, Susan B. Roberts, Gail T. Rogers and Daniel P. Hatfield
Nutrients 2026, 18(3), 389; https://doi.org/10.3390/nu18030389 (registering DOI) - 24 Jan 2026
Abstract
Background/Objective: Lifestyle behaviors evolve with age and are driven by biological requirements (e.g., growth and development) and environmental changes (e.g., living and working situations), and they interact bidirectionally with health. Few studies have tracked these behaviors from emerging adulthood into later adulthood.
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Background/Objective: Lifestyle behaviors evolve with age and are driven by biological requirements (e.g., growth and development) and environmental changes (e.g., living and working situations), and they interact bidirectionally with health. Few studies have tracked these behaviors from emerging adulthood into later adulthood. This study examines changes in lifestyle behavior patterns from precollege to adulthood and their association with weight trajectories. Methods: Between 1998 and 2007, 4783 incoming undergraduate students at a northeastern US university completed a health survey. In 2018, 970 completed a follow-up alumni survey. Latent class analysis (LCA) was used to categorize respondents into five lifestyle patterns: stable healthy, stable moderately healthy, stable minimally healthy, worsened, or improved. BMI trajectories were similarly classified into five weight status patterns. Associations between LCA lifestyle patterns and weight were examined using ANCOVA. Results: The most common lifestyle pattern was stable moderately healthy (36.7%). Over 11–20 years, 31.7% of respondents experienced a decline in lifestyle behaviors, and 18.6% improved. During this period, the prevalence of overweight more than doubled (12% to 26%), and obesity quadrupled (2% to 8%). Transitioning to a higher BMI category was noted in 34.9% of those with a stable minimally healthy lifestyle compared with 15.9% among those with a stable healthy lifestyle. Conclusions: Early lifestyle behaviors have long-term implications for weight status. Initiatives that promote the adoption and maintenance of healthy behaviors from precollege through adulthood might reduce obesity risk.
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(This article belongs to the Section Nutrition and Public Health)
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Assessing Nutraceuticals for Hepatic Steatosis: A Standardized In Vitro Approach
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Victoria E. J. M. Palasantzas, Dicky Struik, Trijnie Bos, Sebo Withoff, Jingyuan Fu, Johan W. Jonker and Joanne A. Hoogerland
Nutrients 2026, 18(3), 388; https://doi.org/10.3390/nu18030388 (registering DOI) - 24 Jan 2026
Abstract
Background/Objectives: Nutraceuticals, including short-chain fatty acids (SCFAs) and antioxidants (AOXs), are nutrient-derived bioactive compounds considered as potential treatments for metabolic-associated steatotic liver disease (MASLD). However, in vitro studies of their effects are limited by inconsistent experimental conditions, including differences in cell lines, methods
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Background/Objectives: Nutraceuticals, including short-chain fatty acids (SCFAs) and antioxidants (AOXs), are nutrient-derived bioactive compounds considered as potential treatments for metabolic-associated steatotic liver disease (MASLD). However, in vitro studies of their effects are limited by inconsistent experimental conditions, including differences in cell lines, methods of steatosis induction, and culture media, and by reliance on qualitative rather than quantitative assessments. Here, we systematically evaluate the anti-steatotic potential of eight commonly used nutraceuticals—three SCFAs (butyrate, acetate, and propionate) and five AOXs (resveratrol, curcumin, berberine, chlorogenic acid, and vitamin E)—using a standardized in vitro approach. Methods: Following a systematic literature review to identify common experimental conditions, we developed an assay to validate steatosis induction and quantified the effects of the nutraceuticals. For our studies we used the HepG2 liver cancer cell line and the Fa2N-4 immortalized hepatocyte cell line. Steatosis was modeled by stimulating cells with free fatty acids and fructose for 48 h. Nutraceuticals were added either concurrently with steatotic stimulation, to assess preventive effects, or after 24 h to assess therapeutic effects. Anti-steatotic drugs (resmetirom, semaglutide, obeticholic acid, and a DGAT2 inhibitor) were included as positive controls. Intracellular triglyceride levels were measured to quantify steatosis. Results: A systematic review of 46 studies revealed large differences in culture conditions, steatosis induction, and nutraceutical assessment. In our experiments, most nutraceuticals did not reduce intracellular triglycerides, with the exception of vitamin E. Surprisingly, butyrate, berberine, and curcumin increased triglyceride accumulation. Resmetirom was the only drug that significantly decreased triglycerides, while obeticholic acid, semaglutide, and the DGAT2 inhibitor showed minimal or inconsistent effects. Fa2N-4 cells were generally more sensitive than HepG2 cells, showing larger absolute changes in triglyceride levels in response to both nutraceuticals and resmetirom. Conclusions: We established a standardized in vitro assay to evaluate the anti-steatotic potential of nutraceuticals. Using this system, we found that SCFAs and AOXs did not consistently reduce intracellular triglycerides, highlighting the need for quantitative assessments and careful validation when studying anti-steatotic interventions in vitro.
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(This article belongs to the Section Nutrition and Public Health)
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Open AccessArticle
Loneliness, Aloneness, and Adherence to the Mediterranean Diet in Southern Italian Individuals
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Justyna Godos, Giuseppe Caruso, Marco Antonio Olvera-Moreira, Francesca Giampieri, Kilian Tutusaus, Melannie Toral-Noristz, Raynier Zambrano-Villacres, Alice Leonardi, Rosa M. G. Balzano, Fabio Galvano, Sabrina Castellano and Giuseppe Grosso
Nutrients 2026, 18(3), 387; https://doi.org/10.3390/nu18030387 (registering DOI) - 24 Jan 2026
Abstract
Background/Objectives: Research across multiple disciplines has explored how nutrition is shaped by social isolation and feelings of loneliness, especially in the elderly population. Evidence from neuroscience highlights that loneliness may alter eating patterns, encouraging emotional eating or other compensatory food behaviors. Conversely, isolation
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Background/Objectives: Research across multiple disciplines has explored how nutrition is shaped by social isolation and feelings of loneliness, especially in the elderly population. Evidence from neuroscience highlights that loneliness may alter eating patterns, encouraging emotional eating or other compensatory food behaviors. Conversely, isolation from social contexts is often linked to a reduced variety of nutrient intake. This study set out to examine how psychosocial aspects, particularly social connectedness and feeling alone, relate to adherence to the Mediterranean diet among older adults residing in Sicily, southern Italy. Methods: Dietary habits of 883 adults were collected through food frequency questionnaires and assessed for adherence to the Mediterranean diet. Loneliness was measured through a targeted question from a standardized tool designed to capture depressive symptoms. Direct questions asked whether participants were engaged in social networks, such as family, friends and neighborhoods, or religious communities, in order to assess objective aloneness. Logistic regression analyses were performed to assess associations between variables of interest. Results: After accounting for potential confounders, both loneliness and aloneness showed an association with stronger adherence to the Mediterranean diet. Specifically, individuals experiencing loneliness and aloneness were less likely to have high adherence to the Mediterranean diet (OR = 0.28, 95% CI: 0.15, 0.51, and OR = 0.26, 95% CI: 0.12, 0.54, respectively). Conclusions: These findings underscore the importance of fostering social engagement among older populations, who may particularly benefit from maintaining active social ties to support healthier eating behaviors.
Full article
(This article belongs to the Special Issue Nutrition for the Prevention and Control of Chronic Degenerative Diseases)
Open AccessReview
Dietary Lithium, Silicon, and Boron: An Updated Critical Review of Their Roles in Metabolic Regulation, Neurobiology, Bone Health, and the Gut Microbiome
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Eleni Melenikioti, Eleni Pavlidou, Antonios Dakanalis, Constantinos Giaginis and Sousana K. Papadopoulou
Nutrients 2026, 18(3), 386; https://doi.org/10.3390/nu18030386 (registering DOI) - 24 Jan 2026
Abstract
Background/Objectives: Lithium (Li), silicon (Si), and boron (B) are proposed nutritional trace elements with potential roles in metabolic, neurobiological, endocrine, inflammatory, and bone-related processes. This review provides a critical synthesis of data on Li–Si–B, emphasizing (i) physiological and mechanistic pathways, (ii) human clinical
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Background/Objectives: Lithium (Li), silicon (Si), and boron (B) are proposed nutritional trace elements with potential roles in metabolic, neurobiological, endocrine, inflammatory, and bone-related processes. This review provides a critical synthesis of data on Li–Si–B, emphasizing (i) physiological and mechanistic pathways, (ii) human clinical relevance, (iii) shared biological domains, and (iv) safety considerations. Methods: A narrative review was conducted across PubMed, Scopus, and Web of Science from inception to January 2025. Predefined search strings targeted dietary, environmental, and supplemental exposures of lithium, silicon, or boron in relation to metabolism, endocrine function, neurobiology, inflammation, bone health, and the gut microbiome. Inclusion criteria required peer-reviewed studies in English. Data extraction followed a structured template, and evidence was stratified into human, animal, cellular, and ecological tiers. Methodological limitations were critically appraised. Results: Li, Si, and B influence overlapping molecular pathways including oxidative stress modulation, mitochondrial stability, inflammatory signaling, endocrine regulation, and epithelial/gut barrier function. Human evidence remains limited: Li is supported primarily by small trials; Si by bone-related observational studies and biomarker-oriented interventions; and B by metabolic, inflammatory, and cognitive studies of modest sample size. Convergence across elements appears in redox control, barrier function, and neuroimmune interactions, but mechanistic synergism remains hypothetical. Conclusions: Although Li–Si–B display compelling mechanistic potential, current human data are insufficient to justify dietary recommendations or supplementation. Considerable research gaps—including exposure assessment, dose–response characterization, toxicity thresholds, and controlled human trials—must be addressed before translation into public health policy.
Full article
(This article belongs to the Section Micronutrients and Human Health)
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Open AccessReview
Digital and Technology-Based Nutrition Interventions, Including Medically Tailored Meals (MTMs) for Older Adults in the U.S.—A Scoping Review
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Nishat Tabassum, Lesli Biediger-Friedman, Cassandra Johnson, Michelle Lane and Seanna Marceaux
Nutrients 2026, 18(3), 385; https://doi.org/10.3390/nu18030385 (registering DOI) - 24 Jan 2026
Abstract
Background/Objectives: Older adults often face nutrition challenges due to mobility issues, chronic conditions, and limited access to adequate nutrition. Digital and technology-based interventions, including those with nutrition education, nutrition counseling and Medically Tailored Meals [MTMs], can help address these barriers. However, the extent
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Background/Objectives: Older adults often face nutrition challenges due to mobility issues, chronic conditions, and limited access to adequate nutrition. Digital and technology-based interventions, including those with nutrition education, nutrition counseling and Medically Tailored Meals [MTMs], can help address these barriers. However, the extent and characteristics of such programs in the United States remain unclear. This scoping review aimed to map the existing evidence on digital and technology-based (“digi-tech”) nutrition interventions for older adults in the United States, with particular attention to the presence, characteristics, and gaps related to MTMs. Methods: This scoping review followed the PRISMA-ScR framework to map existing evidence on technology-enabled nutrition care interventions for older adults aged ≥ 60 years in the United States. Systematic searches were conducted across multiple databases, yielding 18,177 records. Following title and abstract screening, full-text review, and eligibility assessment, 16 intervention studies were included. Study designs comprised randomized controlled trials, quasi-experimental and non-randomized studies, mixed-methods feasibility studies, pilot studies, and one retrospective longitudinal cohort study. Data were extracted on study design, population characteristics, intervention components, technology modalities, outcomes, feasibility, acceptability, and reported barriers. Results: Interventions varied in duration [8 weeks to ≥12 months] and content. Foci ranged from remote nutrition education and mobile app-based tracking to multicomponent interventions integrating exercise, nutrition counseling, health literacy, and meal delivery. Telehealth was the most commonly used technology modality, followed by mobile health applications, wearable devices, and online educational platforms. Most interventions reported high feasibility and acceptability, with improvements in diet quality, adherence to healthy eating patterns, clinical measures such as HbA1c and blood pressure, and functional performance. Common implementation barriers included declining technology use over time, digi-tech literacy, and access to devices or the internet. Notably, no studies evaluated a digi-tech-based MTMs intervention exclusively for older adults in the U.S. Conclusions: Digital and technology-based nutrition interventions show promise for improving dietary and health outcomes in older adults, but there is insufficient empirical evidence. Future research might develop and evaluate hybrid digi-tech intervention models that leverage the potential of digi-tech tools while addressing barriers to technology adoption among older adults.
Full article
(This article belongs to the Special Issue Nutrition and Health Throughout the Lifespan)
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Open AccessArticle
Anthocyanin-Rich Dark Sweet Cherry Phenolics Drive Context-Dependent Modulation of the Nrf2–Keap1–p62 Pathway in Drug-Resistant Triple Negative Breast Cancer Cells: An In Vitro Study
by
Ana Nava-Ochoa, Rodrigo San-Cristobal, Susanne U. Mertens-Talcott and Giuliana D. Noratto
Nutrients 2026, 18(3), 384; https://doi.org/10.3390/nu18030384 (registering DOI) - 24 Jan 2026
Abstract
Background/Objectives: Triple negative breast cancer (TNBC) is an aggressive subtype treated primarily with chemotherapy, which often leads to drug resistance (DR) and reduced effectiveness. Phytochemicals, including anthocyanins from dark sweet cherry (ACN), have emerged as potential adjuvants to overcome DR, though mechanisms
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Background/Objectives: Triple negative breast cancer (TNBC) is an aggressive subtype treated primarily with chemotherapy, which often leads to drug resistance (DR) and reduced effectiveness. Phytochemicals, including anthocyanins from dark sweet cherry (ACN), have emerged as potential adjuvants to overcome DR, though mechanisms remain unclear. This study examines ACN effects on canonical and non-canonical antioxidant pathways (Nrf2-Keap1 and p62) as a mechanism to overcome DR in 4T1 TNBC cells with acquired DR. Methods: Two conditions were tested: ACN with basal doxorubicin (DOX) as resistance-maintaining conditions and ACN with DOX at IC50 to induce oxidative stress (OS). Results: Under resistance-maintaining conditions, ACNs activated the canonical Nrf2-Keap1 pathway at high doses, which can potentially contribute to DR development due to its cellular protection effects. However, at a low dose, ACN did not trigger an antioxidant response linked to GST and GGT enzyme activities and instead impaired autophagy, increasing OS. Under OS, ACN activated the non-canonical antioxidant pathway mediated by p62 while deactivating Nrf2, leading to autophagy-induced cell death and further impairing autophagy at a low dose. Notably, inflammation persisted at both treatment levels without being relieved, keeping stress signaling active. At both conditions, ACN at doses likely attainable under physiological conditions effectively impaired autophagy and elevated OS, resulting in cell death. Conclusions: These results underscore the context-dependent dual function of polyphenols in cancer therapy, demonstrating their potential to enhance cellular sensitivity to chemotherapy and providing guidance for their strategic use as adjuvants in treating TNBC and overcoming DR. However, this study was limited to a single cell line derived from a murine model. Future research should include comparative studies using human TNBC cell lines to validate these findings and better assess their translational relevance.
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(This article belongs to the Section Phytochemicals and Human Health)
Open AccessArticle
Optimizing Malnutrition Risk Detection in Inflammatory Bowel Disease: A Longitudinal Analysis of Serial Nutritional Screening Tools
by
Agnese Favale, Valentina Orrù, Nicola Lutzu, Amalia Di Petrillo, Mauro Demurtas, Ivan Ibba, Angelo Italia, Massimo Claudio Fantini and Sara Onali
Nutrients 2026, 18(3), 383; https://doi.org/10.3390/nu18030383 (registering DOI) - 24 Jan 2026
Abstract
Background: Malnutrition is frequently under-investigated during remission in patients with Inflammatory Bowel Disease (IBD), despite its significant impact on clinical outcomes and quality of life. This study aimed to evaluate the increase in diagnostic performance of five nutritional screening tools (NSTs) when serially
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Background: Malnutrition is frequently under-investigated during remission in patients with Inflammatory Bowel Disease (IBD), despite its significant impact on clinical outcomes and quality of life. This study aimed to evaluate the increase in diagnostic performance of five nutritional screening tools (NSTs) when serially administered to IBD outpatients in sustained clinical remission. Methods: In this prospective, single-center cohort study, NSTs were administered, and body composition analysis was performed in IBD patients at baseline and after six months. At both time points, the sensitivity, specificity, predictive values, and accuracy of NSTs in detecting malnutrition and persistent malnutrition per ESPEN and GLIM criteria were evaluated, comparing repeated to single-point assessments. A sensitivity analysis using low FFMI as a reference was also performed. Results: Sixty-six IBD patients (32 Crohn’s disease; 34 ulcerative colitis) were enrolled. At baseline, 25.7% and 9% of patients were malnourished according to ESPEN and GLIM criteria, respectively, with 7.5% exhibiting low FFMI. Malnutrition prevalence increased over time to 53%, 16.6%, and 16.6%, respectively. Among NSTs, MUST and SaskIBD-NR consistently exhibited the highest specificity for malnutrition detection at baseline, at 6 months, and for persistent malnutrition for ESPEN, GLIM and low FFMI. Serial (repeated) NST administration markedly improved the specificity of all tools, compared to single-point assessments. Conclusions: Serial nutritional screening with MUST or SaskIBD-NR significantly enhances the specificity of malnutrition risk detection in IBD patients in remission, supporting the incorporation of repeated nutritional assessments into clinical practice to offer a practical strategy to enhance screening effectiveness in IBD outpatient care.
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(This article belongs to the Special Issue Nutritional Monitoring and Intervention in Inflammatory Bowel Diseases)
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Open AccessArticle
Structural Relationships of Socioeconomic Factors Influencing Diet, Lifestyle Habits, Having a Dentist, and Health Factors That Impact Healthy Life Longevity for the Elderly
by
Tanji Hoshi
Nutrients 2026, 18(3), 382; https://doi.org/10.3390/nu18030382 - 23 Jan 2026
Abstract
Background: “Healthy Life Longevity” (a latent variable) is defined as the number of survival days, along with recommended subjective health and long-term care needs. This study aimed to clarify the structural relationships among several related factors. Methods: In September 2001, a postal survey
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Background: “Healthy Life Longevity” (a latent variable) is defined as the number of survival days, along with recommended subjective health and long-term care needs. This study aimed to clarify the structural relationships among several related factors. Methods: In September 2001, a postal survey using a self-administered questionnaire was conducted among 16,462 elderly residents of Tokyo. In a cohort study, 8162 individuals with confirmed survival after six years were examined. We analyzed data to evaluate the need for long-term care three years after the initial survey. Additionally, the number of days survived was calculated from the third year after the initial survey. Covariance structure analysis was used to explore the structural relationships. Results: The direct effects of lifestyle habits, including a healthy diet, dental care rather than physician care, and socioeconomic factors, were minimal in improving “Healthy Life Longevity.” However, a structural relationship was established: desirable lifestyles, including diet and dental care, were selected based on socioeconomic status, thereby influencing mental, physical, and social health and reducing disease incidence. This relationship ultimately enhanced “Healthy Life Longevity.” Socioeconomic factors were identified as confounders in the association between preferred lifestyle choices, including diet, and Healthy Life Longevity. The determination coefficient of “Healthy Life Longevity” is 83%. Conclusions: Although healthy longevity can be achieved by improving mental, physical, and social health, and reducing disease burden, the relevant structure is shaped by socioeconomic status. Additionally, socioeconomic status is associated with healthy longevity by facilitating the choice of a preferred lifestyle, including diet, and the selection of a dentist. Future randomized intervention studies focused on socioeconomic status should explore ways to promote healthy longevity.
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(This article belongs to the Section Geriatric Nutrition)
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Study on Association Between Gut Microbiota, Serum Metabolism and Gestational Diabetes Mellitus Based on Metagenomic and Metabolomics Analysis
by
Wenduo Yu, Kun Tang, Rongjing An, Sujuan Ma, Hongzhuan Tan and Mengshi Chen
Nutrients 2026, 18(3), 381; https://doi.org/10.3390/nu18030381 - 23 Jan 2026
Abstract
Background/Objectives: This study aimed to explore the association between maternal gut microbiota and metabolic profiles in the first trimester and the subsequent risk of gestational diabetes mellitus (GDM), as well as to characterize association patterns linking gut microbiota, serum metabolites, and metabolic traits.
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Background/Objectives: This study aimed to explore the association between maternal gut microbiota and metabolic profiles in the first trimester and the subsequent risk of gestational diabetes mellitus (GDM), as well as to characterize association patterns linking gut microbiota, serum metabolites, and metabolic traits. Methods: A nested case–control study was conducted among women with GDM (n = 47) and those without GDM (n = 94). Metagenomic sequencing was applied to analyze fecal microbiota, and liquid chromatography–mass spectrometry (LC–MS) was used for non-targeted plasma metabolomics. Differential microbiota and metabolites between groups were identified, and correlation analyses were conducted to assess their associations with clinical indicators. Results: Women who later developed GDM showed lower alpha diversity and higher beta diversity. Eleven differential species were identified, with Collinsella aerofaciens and Clostridium bartlettii enriched in GDM, while nine species such as Alistipes putredinis and Bacteroidales bacterium ph8 were enriched in controls. Sixty-four plasma metabolites differed between groups, including increased glycerol-3-phosphate, aromatic amino acids, and glycerophosphocholine, and decreased cysteine, tryptophan, niacinamide, and stearic acid. Correlation analyses revealed significant relationships between Alistipes putredinis, Eubacterium eligens, and Bacteroidales bacterium ph8 with metabolic and clinical indicators (e.g., TG, TC, LDL). Conclusions: In this nested case–control study, women who later developed GDM exhibited reduced gut microbial diversity and altered metabolic profiles during the first trimester of pregnancy. Several microbial taxa and microbiota–metabolite associations were observed in relation to subsequent GDM status, highlighting early-pregnancy microbial and metabolic features that may be relevant to GDM-related metabolic changes.
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(This article belongs to the Special Issue Diet Quality and Nutritional Status Among Pregnant Women)
Open AccessArticle
Kaempferol Inhibits MMP-1-Mediated Migration and Invasion in Gemcitabine-Resistant Pancreatic Cancer Cells
by
Saburo Sugita, Yoichi Matsuo, Masaki Ishida, Yuriko Uehara, Yuki Eguchi, Yuki Denda, Keisuke Nonoyama, Hiromichi Murase, Tomokatsu Kato, Kenta Saito, Takafumi Sato, Yushi Yamakawa, Hiroyuki Sagawa, Ryo Ogawa, Hiroki Takahashi, Akira Mitsui and Shuji Takiguchi
Nutrients 2026, 18(3), 380; https://doi.org/10.3390/nu18030380 - 23 Jan 2026
Abstract
Background: Pancreatic cancer (PaCa) has an extremely poor prognosis. This malignancy rapidly acquires resistance to gemcitabine (GEM), a key chemotherapeutic agent, yet the mechanisms underlying this resistance remain incompletely understood. We previously established GEM-resistant (GEM-R) PaCa cell lines and found that these cells
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Background: Pancreatic cancer (PaCa) has an extremely poor prognosis. This malignancy rapidly acquires resistance to gemcitabine (GEM), a key chemotherapeutic agent, yet the mechanisms underlying this resistance remain incompletely understood. We previously established GEM-resistant (GEM-R) PaCa cell lines and found that these cells exhibit constitutively increased levels of matrix metalloproteinase-1 (MMP-1), which contributes to the invasion and metastasis of PaCa. Kaempferol, a naturally occurring flavonoid found in many plant species, has been shown to exhibit antitumor effects across a range of cancers. Methods/Results: This study demonstrated that non-cytotoxic concentrations of kaempferol significantly decrease MMP-1 protein expression in GEM-R PaCa and suppress their migration and invasion capacities. Western blot analysis demonstrated that MMP-1 protein levels were upregulated in GEM-R PaCa cells and decreased upon kaempferol exposure. In Transwell migration/invasion and wound healing assays, GEM-R PaCa cell lines exhibited enhanced migration and invasion capacities compared with GEM-S cells, whereas kaempferol treatment suppressed these properties, similar to the effects observed by MMP-1 knockdown or treatment with the MMP inhibitor batimastat. Furthermore, kaempferol treatment reduced phosphorylated Akt expression and NF-κB p65 activity. Conclusions: These findings indicate that kaempferol suppresses the migratory and invasive abilities of PaCa cells by downregulating MMP-1 through negative regulation of the Akt and NF-κB signaling cascades, while kaempferol holds promise as a treatment strategy for GEM-R PaCa.
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(This article belongs to the Section Phytochemicals and Human Health)
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Open AccessReview
Rethinking Energy Availability from Conceptual Models to Applied Practice: A Narrative Review
by
Sergio Espinar, Marina A. Sánchez-Fernández, Juan J. Martin-Olmedo, Marcos Rueda-Córdoba and Lucas Jurado-Fasoli
Nutrients 2026, 18(3), 379; https://doi.org/10.3390/nu18030379 - 23 Jan 2026
Abstract
Background/Objectives: Energy availability (EA), defined as the dietary energy remaining after exercise energy expenditure (EEE), is a central determinant of both health and performance in athletes. Chronic insufficient EA leads to low energy availability (LEA), which is an underlying mechanism of Relative
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Background/Objectives: Energy availability (EA), defined as the dietary energy remaining after exercise energy expenditure (EEE), is a central determinant of both health and performance in athletes. Chronic insufficient EA leads to low energy availability (LEA), which is an underlying mechanism of Relative Energy Deficiency in Sport (REDs). This narrative review critically explores the conceptual evolution of EA and LEA, summarizes current physiological evidence, and discusses methodological and practical challenges in their assessment and application in free-living athletes. Methods: Evidence from experimental and observational studies was reviewed to describe the hormonal, metabolic, and performance outcomes associated with LEA. Screening tools, including the Low Energy Availability in Females Questionnaire (LEAF-Q) and the Low Energy Availability in Males Questionnaire (LEAM-Q), were also evaluated for their validity and applicability in different sports contexts. Results: LEA is associated with alterations in thyroid and reproductive hormones, which, in turn, contribute to reduced resting metabolic rate, lower bone mineral density, and delayed recovery. While screening questionnaires can help identify athletes at risk, their accuracy varies by sport and individual characteristics. Incorporating hormonal and metabolic biomarkers provides a more direct and sensitive method for detecting physiological stress. Measuring dietary intake, EEE, endocrine balance and body composition in real-world settings remains a major methodological challenge. Combining hormonal, metabolic, and behavioral indicators may improve the identification of athletes experiencing LEA. Conclusions: EA plays a central role in the interaction between nutrition, exercise, and athlete health, but methodological limitations in its assessment may compromise accurate diagnosis. Improving measurement techniques and adopting integrated monitoring strategies are essential to improve early detection, guide individualized nutrition, and prevent RED-related health and performance impairments.
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(This article belongs to the Section Sports Nutrition)
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Effects of Epigallocatechin Gallate Against Lung Cancer: Mechanisms of Action and Therapeutic Potential
by
Dordaneh Mirbabaei Ghafghazi, Newman Siu Kwan Sze and Evangelia Tsiani
Nutrients 2026, 18(3), 378; https://doi.org/10.3390/nu18030378 - 23 Jan 2026
Abstract
Epigallocatechin-3-gallate (EGCG), the major bioactive polyphenol in green tea, has garnered significant attention for its potential anticancer properties. This review summarizes the current evidence from in vitro, in vivo, and clinical trials examining the effects of EGCG on lung cancer. EGCG exerts its
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Epigallocatechin-3-gallate (EGCG), the major bioactive polyphenol in green tea, has garnered significant attention for its potential anticancer properties. This review summarizes the current evidence from in vitro, in vivo, and clinical trials examining the effects of EGCG on lung cancer. EGCG exerts its anticancer effects through various mechanisms, including the inhibition of cell proliferation, induction of apoptosis, suppression of metastasis, and modulation of signalling pathways such as epidermal growth factor receptor (EGFR), phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), mitogen-activated protein kinase (MAPK), and nuclear factor kappa B (NF-κB). Additionally, EGCG has been shown to enhance the efficacy of conventional chemotherapeutic agents and mitigate drug resistance. However, challenges related to its bioavailability and metabolic stability remain. Ultimately, this review aims to provide a comprehensive overview of the effects of EGCG against lung cancer.
Full article
(This article belongs to the Special Issue Editorial Board Members’ Collection Series: Dietary Patterns and Cancer)
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