Nutrients

16 pages, 598 KB

Open AccessArticle

Combined Fried Frailty Scale and Mini Nutritional Assessment Identifies Cardiovascular Patients with Reduced Protein/Albumin Plasma Levels: A Cross-Sectional Study

by Julia Cieśla, Marcin Schulz, Michał Krawiec, Michał Janik, Paweł Wojciechowski, Iga Dajnowska, Dominika Szablewska, Jakub Bartoszek, Brygida Przywara-Chowaniec and Andrzej Tomasik

Nutrients 2025, 17(17), 2786; https://doi.org/10.3390/nu17172786 - 27 Aug 2025

Abstract

Background: Frailty syndrome significantly worsens the prognosis of elderly people. Sarcopenia and malnutrition are integral parts of aging, but there is a lack of knowledge about the overlap of these states, as well as their diagnostic methods and treatments. This study aimed to [...] Read more.

Background: Frailty syndrome significantly worsens the prognosis of elderly people. Sarcopenia and malnutrition are integral parts of aging, but there is a lack of knowledge about the overlap of these states, as well as their diagnostic methods and treatments. This study aimed to assess the malnutrition and sarcopenia scale in patients with frailty syndrome and the viability of evaluating the concentrations of the following potential biomarkers: albumin, total protein, and fibrinogen. Methods: A total of 170 patients >65 years were assessed for frailty using the Fried frailty scale. The risk of sarcopenia was measured using the SARC-F scale, and the risk of malnutrition was measured using the Mini Nutritional Assessment (MNA) scale. Serum albumin, protein, and fibrinogen levels were measured. The following fat-free body mass and respiratory parameters were measured: peak expiratory flow (PEF) and forced expiratory volume-one second (FEV1). Results: A total of 53 patients were classified as robust (31%), 96 as prefrail (57%), and 21 as frail (12%) according to Fried frailty criteria. Frail patients had significantly reduced serum albumin and increased fibrinogen compared to the prefrail and robust groups (p < 0.05). A total of 38% of frail patients were at risk of sarcopenia, and 52% were at risk of malnutrition. Frail patients had lower PEF and FEV1 values, with decreases in respiratory parameters correlating with fat-free body mass and muscle strength. Conclusions: Frail patients are at substantial risk of malnutrition and sarcopenia. The MNA and SARC-F scales, combined with routine screening of elderly patients with frailty, may effectively identify patients with the highest risk. Full article

(This article belongs to the Special Issue Nutritional Assessment in Epidemiological Studies)

12 pages, 663 KB

Open AccessArticle

Association Between Dietary Polyphenol Intake and Semen Quality: Insights from the FERTINUTS Study

by Hamza Mostafa, Javier Mateu-Fabregat, Asmae Benchohra, Nil Novau-Ferré, Laura Panisello and Mònica Bulló

Nutrients 2025, 17(17), 2785; https://doi.org/10.3390/nu17172785 - 27 Aug 2025

Abstract

Background/Objectives: Low semen quality and male infertility are critical global health issues. Emerging research highlights that nutritional factors could play a significant role in determining reproductive outcomes. Understanding and optimizing these dietary influences, including the role of polyphenols, is crucial for developing targeted [...] Read more.

Background/Objectives: Low semen quality and male infertility are critical global health issues. Emerging research highlights that nutritional factors could play a significant role in determining reproductive outcomes. Understanding and optimizing these dietary influences, including the role of polyphenols, is crucial for developing targeted strategies to improve male fertility. We aimed to explore the relationship between the intake of different classes of polyphenols and semen quality indicators in a cohort of healthy young males. Methods: This is a secondary analysis involving 106 male individuals, aged 18–35 years, from the FERTINUTS trial. Dietary intake was assessed using 3-day dietary records, and semen quality parameters were analyzed. Multivariable linear regression analysis was employed to evaluate the associations between dietary polyphenol consumption and semen quality indicators. Results: Our findings revealed both positive and negative associations between polyphenol consumption and sperm morphology parameters. A higher intake of total polyphenols was associated with a lower percentage of abnormalities in sperm heads but a higher rate of abnormalities in the principal piece. Similar results were observed for lignan and flavonoid intake. Additionally, a higher intake of flavonoids was also associated with a greater percentage of normal sperm forms. In contrast, a higher dietary intake of stilbenes was associated with a higher percentage of combined abnormalities. Conclusions: Higher intake of polyphenols, particularly flavonoids and lignans, was associated with improved sperm head morphology but also with increased tail abnormalities, although no associations with motility or vitality were observed. These results suggest that specific polyphenol classes may have both beneficial and adverse effects on sperm structure, warranting consideration of compound type and dosage in dietary recommendations. Further studies are needed to determine whether these morphological changes impact fertilization outcomes and reproductive potential. Full article

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

13 pages, 598 KB

Open AccessArticle

Acute L-Carnitine Supplementation Does Not Improve CrossFit^® Performance: A Randomized, Double-Blind, Placebo-Controlled Crossover Study

by Asli Devrim-Lanpir, Lucero Salazar Velasco, Fanny Guadalupe Ramirez Lara, Azucena Ojeda Sanchez, Rachel Kimble, Reza Zare, Fatma Esra Gunes, Beat Knechtle, Katja Weiss, Thomas Rosemann and Katie Heinrich

Nutrients 2025, 17(17), 2784; https://doi.org/10.3390/nu17172784 (registering DOI) - 27 Aug 2025

Abstract

Background: L-carnitine supplementation is thought to enhance exercise performance, particularly in moderate and high-intensity activities, but evidence supporting this is mixed. This study aimed to assess whether acute L-carnitine tartrate supplementation could improve CrossFit^® performance, specifically during the “Cindy” workout, a high-intensity [...] Read more.

Background: L-carnitine supplementation is thought to enhance exercise performance, particularly in moderate and high-intensity activities, but evidence supporting this is mixed. This study aimed to assess whether acute L-carnitine tartrate supplementation could improve CrossFit^® performance, specifically during the “Cindy” workout, a high-intensity exercise protocol. Methods: In a randomized, double-blind, placebo-controlled crossover design, 20 trained male recreational CrossFit^® athletes completed the “Cindy” workout within a 20 min period after ingesting either 3 g of L-carnitine tartrate or a placebo 90 min before exercise. Performance was measured by total repetitions completed. Secondary outcomes included ratings of perceived exertion (RPE), gastrointestinal issues, and blood pressure (BP) measurements. Results: The results showed that L-carnitine supplementation did not significantly affect the number of repetitions performed (202.4 ± 69.9 vs. 204.5 ± 78.8, p = 0.810) compared to the placebo. There were also no significant differences in RPE (6.3 ± 1.5 vs. 6.9 ± 1.4, p = 0.180) or BP changes between groups. However, 10% of participants reported difficulty sleeping after L-carnitine supplementation. Conclusions: The findings suggest that 3 g of L-carnitine tartrate does not enhance CrossFit^® performance in recreational athletes. Further research is needed to clarify its potential benefits, especially with larger samples and consideration of factors like sex and carbohydrate co-ingestion. Full article

(This article belongs to the Special Issue Nutritional Supplements and Diet in Athletic Performance)

17 pages, 748 KB

Open AccessArticle

Interactive and Joint Effects of Obesity and Insulin Resistance on Hypertension in Adolescents and the Mediating Role of Insulin Resistance—Five Provinces, China

by Haiyuan Zhu, Zebang Zhang, Yumei Feng, Qiqi Wu, Runquan Zhang, Tao Liu, Dan Liu, Xiongfei Chen and Xiaomei Dong

Nutrients 2025, 17(17), 2783; https://doi.org/10.3390/nu17172783 - 27 Aug 2025

Abstract

Background: The global prevalence of pediatric hypertension is on the rise. Adolescence is a period of high prevalence of childhood hypertension. Obesity and insulin resistance (IR) are important risk factors in the development of hypertension, but their interaction and combined effects on adolescent [...] Read more.

Background: The global prevalence of pediatric hypertension is on the rise. Adolescence is a period of high prevalence of childhood hypertension. Obesity and insulin resistance (IR) are important risk factors in the development of hypertension, but their interaction and combined effects on adolescent hypertension remain unclear. Methods: This cross-sectional study utilized data from the China National Nutrition and Health Surveillance of Children and Lactating Mothers (2016–2017). A total of 7031 adolescents aged 12–17 years from five provinces were included. The triglyceride-glucose index (TyG) was used as an indicator of IR. Multivariable logistic regression and generalized linear mixed-effect models were used to assess the interaction and joint effects of IR and obesity (measured by body mass index [BMI] and waist circumference [WC]) on hypertension. Relative excess risk due to interaction (RERI), proportion attributable to interaction (AP), and synergy index (SI) were calculated to evaluate additive interactive effects. Mediation analysis explored the potential mediating role of the TyG in the association between obesity and hypertension. Results: IR and obesity were positively associated with adolescent hypertension (p < 0.001). Interaction analyses revealed a robust synergistic interaction between obesity and IR on hypertension, with the AP being approximately 40% (p < 0.001). TyG significantly mediated the association between obesity and adolescent hypertension (6.30% for high BMI and 8.54% for high WC, both p < 0.001). Conclusions: This study suggests that obesity and IR could synergistically contribute to the prevalence of hypertension in adolescents. For the primary prevention and management of hypertension in adolescents, strategies targeting both factors should be considered. Full article

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

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15 pages, 423 KB

Open AccessArticle

Changes in Teenagers’ Dietary Choices in Smart School Canteens: A Pre-Post Single-Arm (Quasi-Experimental) Study of a Digital Nudge Intervention

by Zuoyi Liang, Mingshi Hao, Rui Fan, Xuerui Wang, Wenli Zhu and Zhaofeng Zhang

Nutrients 2025, 17(17), 2782; https://doi.org/10.3390/nu17172782 - 27 Aug 2025

Abstract

Background/Objectives: Adequate adolescent nutrition is vital for lifelong health, yet traditional school meal programs often emphasize processed foods. Digital nudges, subtle digital changes, may help promote healthier food choices. This study aimed to evaluate the impact of a digital nudge intervention in [...] Read more.

Background/Objectives: Adequate adolescent nutrition is vital for lifelong health, yet traditional school meal programs often emphasize processed foods. Digital nudges, subtle digital changes, may help promote healthier food choices. This study aimed to evaluate the impact of a digital nudge intervention in a smart school canteen on students’ food choices and nutrient intake over three months. Methods: A pre-post single-arm (quasi-experimental) study was conducted among 502 high school students (aged 15–17) in Shenyang, China. In August 2023, the school implemented a smart canteen with a mobile mini-program for meal pre-ordering. Embedded digital nudges included improved visibility of healthy options, nutritional information, and default settings favoring nutritious choices. Dietary intake was assessed using a 3-day 24 h dietary record and a food frequency questionnaire. Paired t-tests, Wilcoxon signed-rank, and chi-square tests were used for analysis. Results: Post-intervention, the weekly consumption frequency of coarse grains (p = 0.017), fruits (p < 0.001), seafood (p < 0.001), and soy products (p < 0.001) significantly increased, while sweets (p = 0.033), sugary drinks (p = 0.015), fast food, and eating out (both p < 0.001) decreased. Daily calcium intake rose from 683.00 mg to 804.11 mg (p < 0.1), and the proportion meeting recommendations increased from 39.3% to 50.9%. No significant change was observed in vitamin C intake (p = 0.192). Conclusions: The digital nudge intervention in the smart school canteen effectively improved students’ dietary choices, particularly increasing the consumption frequency of healthy foods and dietary calcium intake. Full article

(This article belongs to the Special Issue Nutritional Surveys and Assessment of Unhealthy Eating Behaviors)

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56 pages, 7566 KB

Open AccessArticle

Gut Microbiota and Autism Spectrum Disorders: Neurodevelopmental, Behavioral, and Gastrointestinal Interactions

by Zuzanna Lewandowska-Pietruszka, Magdalena Figlerowicz and Katarzyna Mazur-Melewska

Nutrients 2025, 17(17), 2781; https://doi.org/10.3390/nu17172781 - 27 Aug 2025

Abstract

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication deficits, repetitive behaviors, and frequent gastrointestinal comorbidities. Emerging research suggests gut microbiota alterations contribute to ASD symptoms and gastrointestinal dysfunction, but detailed microbial profiles and clinical correlations remain underexplored. [...] Read more.

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication deficits, repetitive behaviors, and frequent gastrointestinal comorbidities. Emerging research suggests gut microbiota alterations contribute to ASD symptoms and gastrointestinal dysfunction, but detailed microbial profiles and clinical correlations remain underexplored. Methods: This study analyzed gut microbiota in 45 children aged 2–18 years diagnosed with ASD. Stool samples underwent 16S rRNA gene sequencing. Clinical assessments included ASD diagnostic subtype, adaptive functioning using the Vineland Adaptive Behavior Scale, gastrointestinal symptoms as per the Rome IV criteria, dietary patterns, and demographic variables. Statistical analyses correlated microbiota profiles with clinical features. Results: Gut microbiota composition was significantly influenced by delivery mode, age, sex, and diet. Vaginally delivered children had higher beneficial SCFA-producing bacteria, whereas Cesarean section was linked to increased pathogenic Clostridiales. High-calorie and protein-rich diets correlated with shifts toward pro-inflammatory taxa. Microbial diversity and specific genera correlated with adaptive behavior domains (communication, socialization, motor skills) and severity of gastrointestinal symptoms. Both pro-inflammatory and anti-inflammatory bacteria variably impacted neurodevelopmental outcomes. Conclusions: Gut microbiota composition in children with ASD is shaped by multifactorial influences and connected to neurobehavioral and gastrointestinal phenotypes. The findings of this study support the potential of microbiota-targeted interventions to ameliorate ASD-associated symptoms and improve quality of life. Full article

(This article belongs to the Special Issue The Impact of Gut Microbiota and Their Metabolites on Chronic Diseases)

19 pages, 1580 KB

Open AccessArticle

Effects of Paprika Xanthophyll Intake on Endurance and Cognitive Function in College Students: A Crossover Randomized Controlled Trial

by Donghyun Kim and Tsuyoshi Wadazumi

Nutrients 2025, 17(17), 2780; https://doi.org/10.3390/nu17172780 - 27 Aug 2025

Abstract

Background/Objective: Paprika xanthophylls (PXs) have potent antioxidant properties and are believed to improve oxygen delivery (DO₂) efficiency by enhancing red blood cell (RBC) deformability. This study investigated whether PX ingestion improves endurance performance and subsequently enhances cognitive function by improving brain [...] Read more.

Background/Objective: Paprika xanthophylls (PXs) have potent antioxidant properties and are believed to improve oxygen delivery (DO₂) efficiency by enhancing red blood cell (RBC) deformability. This study investigated whether PX ingestion improves endurance performance and subsequently enhances cognitive function by improving brain microcirculation. Methods: A crossover design was used to compare the effects of PX ingestion and a control condition in 21 healthy college students (18 males, 3 females). Each participant served as their own control, completing both conditions in a randomized order with a one-month washout period to eliminate any carryover effects. The participants underwent an incremental load test, a constant load test, the Trail Making Test Type B (TMT-B), and the Stroop test (ST). Results: In the incremental tests, the PX group showed a significantly lower heart rate (p = 0.032) and higher exercise efficiency (EE) (p = 0.004). In the constant load test, heart rate was lower (p = 0.020), and EE was higher (p = 0.030). No significant between-group differences were found in the cognitive tests; however, the PX group showed significant improvements in the TMT-B (p = 0.034) and ST interference rate I (p = 0.040). Conclusions: It is speculated that PX intake may improve DO₂ efficiency, which could contribute to the observed enhancements in endurance performance and, in turn, positively affect cognitive function by optimizing the brain’s oxygenation state. However, due to the absence of a placebo control group and unmeasured RBC deformability and cerebral blood flow, as well as a significant male predominance, this study’s results should be interpreted with caution. Full article

(This article belongs to the Special Issue Improving Athletic Performance with Dietary Supplements: Fuel Substrate Availability and Neurologic Function)

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15 pages, 3183 KB

Open AccessArticle

Octenyl Succinic Anhydride Starch Alleviates Alcoholic Liver Disease by Modulating Gut Microbiota and Metabolism

by Chang Liu, Tangqian Liu, Rongrong Ma, Xiaohua Pan and Yaoqi Tian

Nutrients 2025, 17(17), 2779; https://doi.org/10.3390/nu17172779 - 27 Aug 2025

Abstract

Background/Objectives: Alcoholic liver disease (ALD) is intricately linked to gut microbiota dysbiosis and metabolic disturbances along the gut–liver axis. Octenyl succinic anhydride (OSA) starch escapes digestion in the small intestine and ferments in the colon, modulating gut microbiota and metabolism. This study [...] Read more.

Background/Objectives: Alcoholic liver disease (ALD) is intricately linked to gut microbiota dysbiosis and metabolic disturbances along the gut–liver axis. Octenyl succinic anhydride (OSA) starch escapes digestion in the small intestine and ferments in the colon, modulating gut microbiota and metabolism. This study explored the protective effects of OSA starch against ALD and elucidated the underlying gut microbiota–metabolite interactions. Methods: A chronic ethanol-fed mouse model was conducted to evaluate the protective effects of OSA starch against ALD, and multi-omics analyses integrating 16S rRNA sequencing, PICRUSt2 functional predictions, and metabolomics were used to reveal potential mechanism. Results: OSA starch supplementation in ALD mice significantly reduced liver fat accumulation, lowered the liver index to 4.11%, and restored serum transaminase levels closer to normal. Multi-omics analyses revealed that OSA starch enriched beneficial gut bacteria such as Faecalibaculum rodentium and Bifidobacterium adolescentis. OSA starch also enhanced microbial metabolic functions, including pyruvate, butanoate, and propanoate metabolism. These shifts were accompanied by regulation of fecal and serum metabolites, including pyruvate, 2-hydroxybutanoic acid, and lactic acid. Structural equation modeling further confirmed that OSA starch ameliorates ALD via coordinated modulation of gut microbiota, microbial functions, metabolites, and serum markers. Conclusions: OSA starch protects against alcoholic liver injury by remodeling the gut–liver metabolic network, presenting a promising dietary strategy for ALD. Full article

(This article belongs to the Special Issue Diet and Nutrition: Metabolic Diseases(2nd Edition))

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23 pages, 1598 KB

Open AccessArticle

Lights and Shadows of a Primary School-Based Nutrition Education Program in Italy: Insights from the LIVELY Project

by Sara Basilico, Maria Vittoria Conti, Ilaria Ardoino, Chiara Breda, Federica Loperfido, Francesca Orsini, Maria Luisa Ojeda Fernandez, Laura Pierini, Stefano Conca Bonizzoni, Elisabetta Modena, Federica Villa, Hellas Cena, Marta Baviera and Carlotta Franchi

Nutrients 2025, 17(17), 2778; https://doi.org/10.3390/nu17172778 - 27 Aug 2025

Abstract

Background/Objectives: Childhood obesity represents a pressing global health challenge, demanding coordinated, long-term strategies. Schools and families are pivotal environments for shaping children’s lifestyle behaviors. The LIVELY project aimed to assess overweight/obesity prevalence and associated factors in primary school children, and to implement [...] Read more.

Background/Objectives: Childhood obesity represents a pressing global health challenge, demanding coordinated, long-term strategies. Schools and families are pivotal environments for shaping children’s lifestyle behaviors. The LIVELY project aimed to assess overweight/obesity prevalence and associated factors in primary school children, and to implement a multidimensional educational intervention promoting healthy, sustainable lifestyles. Methods: This single-arm study was conducted from October 2023 to October 2024 in a primary school in Milan. The intervention included age and culturally tailored lessons, games, and activities. Anthropometric measures, dietary adherence, and lifestyle habits were assessed before and after the intervention. Satisfaction surveys were administered to children, families, and teachers. Results: The project involved 227 children across 14 classes (mean age 8.9, SD 1.2 years). The prevalence of overweight/obesity was 23.4%. Adherence to the Mediterranean Diet was moderate, limited by low intake of vegetables, nuts, and dairy. Physical activity was low, screen time excessive, and sleep insufficient. No statistically significant improvements in anthropometrics or diet adherence were observed post-intervention, but positive trends emerged for physical activity, sleep, and hydration. Over half of the children passed the nutritional knowledge test. Despite these challenges, high satisfaction levels have been shared by children, parents, and teachers. Conclusions: The limited duration of the intervention and challenges engaging families in a low socio-economic context may have constrained the impact of the program, and caution is advised in generalizing the findings. The LIVELY project highlights the complexity of tackling childhood obesity in multicultural settings and emphasizes the need for longer, continuous, and culturally tailored programs that actively involve families to promote sustainable healthy behaviors. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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25 pages, 1980 KB

Open AccessReview

Unraveling Future Trends in Free School Lunch and Nutrition: Global Insights for Indonesia from Bibliometric Approach and Critical Review

by Muhammad Naufal Putra Abadi, Ray Wagiu Basrowi, William Ben Gunawan, Mutiara Putri Arasy, Felasiana Nurjihan, Tonny Sundjaya, Dessy Pratiwi, Hardinsyah Hardinsyah, Nurpudji Astuti Taslim and Fahrul Nurkolis

Nutrients 2025, 17(17), 2777; https://doi.org/10.3390/nu17172777 - 27 Aug 2025

Abstract

Background: School lunch programs play a crucial role in shaping the nutritional status and academic performance of children, making them a cornerstone of public health initiatives worldwide. Objective: To elucidate emerging trends and propose a comprehensive framework for free school lunch as a [...] Read more.

Background: School lunch programs play a crucial role in shaping the nutritional status and academic performance of children, making them a cornerstone of public health initiatives worldwide. Objective: To elucidate emerging trends and propose a comprehensive framework for free school lunch as a nutrition policy through a combined bibliometric approach and critical review. Methods: A bibliometric analysis was performed to identify key thematic areas, influential research, and knowledge gaps from global literature databases, followed by a critical review synthesizing insights on nutritional adequacy, socio-cultural considerations, policy effectiveness, and innovative practices in free school meal programs. Results: The analysis revealed an increasing focus on sustainability, food waste management, and integration of nutrition education within school curricula, alongside notable disparities in implementation and accessibility, particularly in low-income regions. Conclusions: We propose a future-oriented framework emphasizing stakeholder collaboration, culturally adaptive meal designs, and utilization of technology for personalized nutrition strategies, contributing to the optimization of school lunch programs and advancement of sustainable development goals, particularly Zero Hunger and Quality Education. Full article

(This article belongs to the Special Issue Nutrition Policy and Programs in Educational Settings: Equitable Approaches to Food Security)

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11 pages, 475 KB

Open AccessArticle

Analysis of the Perception of Nutrigenetics in Conventional Nutritional Practice: A Survey-Based Study Applied to Dietitians from Mexico

by Diana Alejandra Vela-Vásquez, Ivan Delgado-Enciso, Janet Diaz-Martinez and Ana María Sifuentes-Rincón

Nutrients 2025, 17(17), 2776; https://doi.org/10.3390/nu17172776 - 27 Aug 2025

Abstract

Background/Objectives: Nutrigenetics has emerged as a promising tool to advance personalized nutrition strategies. This study aimed to analyze the scope and perception of Mexican dietitians regarding nutritional genomics with an emphasis on nutrigenetics’ use in clinical practice. Methods: A survey was conducted online [...] Read more.

Background/Objectives: Nutrigenetics has emerged as a promising tool to advance personalized nutrition strategies. This study aimed to analyze the scope and perception of Mexican dietitians regarding nutritional genomics with an emphasis on nutrigenetics’ use in clinical practice. Methods: A survey was conducted online among dietitians in Mexico to assess their educational background, awareness of nutrigenetic testing, use in practice, and interest in further training through 33 questions. Results: One hundred and thirty participants from states across six Mexican regions completed the survey, and most of respondents had a bachelor’s degree. The analysis showed that while most respondents were familiar with the concepts of nutrigenomics and nutrigenetics, 92.3% did not incorporate genetic testing into their practice; the main barriers of their use were misinformation, limited access to reliable resources, and ethical concerns surrounding genetic testing. Although 86.2% expressed interest in learning about nutrigenetics, only 31.5% were willing to invest in further training. Social media and non-academic sources were important sources of information, raising concerns about their inaccurate content and highlighting their importance in completing the curricula. Patients’ demand for genetic testing is limited and directed by disease prevention interests. Conclusions: Nutrigenetics is currently an area with limited practical application among Mexican dietitians; however, it is perceived as a valuable tool for future daily practice. The gap between perception and application underscores the need to integrate nutrigenetics into undergraduate curricula and to provide accessible, evidence-based professional development; these are essential to promote the ethical and effective use of nutrigenetics and support the transition toward personalized nutrition. Full article

(This article belongs to the Special Issue Current Insights into Genome-Based Personalized Nutrition Technology)

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18 pages, 3653 KB

Open AccessArticle

Changes in Quality of Life Among Glaucoma Patients Following Six Months of Niacinamide Supplementation

by Constantin Alin Nicola, Maria Cristina Marinescu, Anne Marie Firan, Georgica Tartea, Mihaela Simona Naidin, Radu Constantin Ciuluvica, Marina Daniela Dimulescu, Nicoleta Mirela Voicu, Carmen Marinela Mihailescu, Andreea-Daniela Meca, Maria Bogdan and Adina Turcu-Stiolica

Nutrients 2025, 17(17), 2775; https://doi.org/10.3390/nu17172775 - 27 Aug 2025

Abstract

Background/Objectives: Glaucoma is the primary cause of irreversible blindness worldwide, with enormous impact on quality of life and activities of daily living. Since one pathogenic mechanism of glaucoma is mitochondrial dysfunction at the retinal ganglion cell level, niacin has been proposed as an [...] Read more.

Background/Objectives: Glaucoma is the primary cause of irreversible blindness worldwide, with enormous impact on quality of life and activities of daily living. Since one pathogenic mechanism of glaucoma is mitochondrial dysfunction at the retinal ganglion cell level, niacin has been proposed as an adjuvant treatment, with encouraging results. The objective of this prospective, non-randomized, single-arm clinical trial was to investigate the effect of oral supplementation with niacin on the quality of life of a cohort of glaucoma patients in Romania. Methods: Fifty-eight patients diagnosed with primary open angle glaucoma, under topical hypotensive treatment, were evaluated before and after a 6-month period of daily administration of 500 mg of oral niacinamide. Evaluation involved a complete ophthalmological exam and QoL quantification using the Glaucoma Quality of Life-15 (GQL-15) Questionnaire. Results: We found strong evidence that niacin supplementation for 6 months led to a statistically significant improvement in QoL scores among glaucoma patients (mean difference = −2.10, 95% CI: [−2.89, −1.32], p < 0.0001), including central and near vision (mean difference = −2.16, 95% CI: [−3.91, −0.4], p = 0.017), peripheral vision (mean difference = −2.66, 95% CI: [−0.23, −0.08], p < 0.001), and the glare and dark adaptation (mean difference = −5.24, 95% CI: [−0.33, −0.14], p < 0.001). In addition, B3 treatment resulted in a significant reduction in intraocular pressure in both eyes over 6 months (mean difference = 0.53, 95% CI: [0.21, 0.86] in the left eye and mean difference = 0.36, 95% CI: [0.04, 0.68] in the right eye), indicating potential clinical benefits. Conclusions: The observed GQL-15 score reductions suggest that B3 may be of benefit in glaucoma management. Further research with larger sample sizes and placebo-controlled designs is needed to confirm B3 potential impact on disease progression and quality of life. Trial Registration at clinicaltrials.gov: NCT07007260. Full article

(This article belongs to the Special Issue Effects of Dietary Intake and Lifestyle on Eye Health and Ophthalmic Diseases)

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12 pages, 560 KB

Open AccessArticle

The Role of Binge Eating in a Sequential Mediation Model of Stress, Emotional Eating, and BMI

by Kwangyeol Baek

Nutrients 2025, 17(17), 2774; https://doi.org/10.3390/nu17172774 - 27 Aug 2025

Abstract

Background/Objectives: Chronic stress contributes to obesity through maladaptive eating behaviors, including emotional eating (eating due to negative emotions) and binge eating (consuming large amounts of food with a loss of control). A theoretical model suggests that emotional eating can escalate to binge eating [...] Read more.

Background/Objectives: Chronic stress contributes to obesity through maladaptive eating behaviors, including emotional eating (eating due to negative emotions) and binge eating (consuming large amounts of food with a loss of control). A theoretical model suggests that emotional eating can escalate to binge eating along a severity continuum, but this sequential pathway from stress to higher body mass index (BMI) has remained empirically untested. Therefore, this study examined a serial mediation model in which perceived stress predicts BMI sequentially through emotional eating and then binge eating. Methods: In this cross-sectional study, 272 Korean adults completed the Perceived Stress Scale, the Dutch Eating Behavior Questionnaire (emotional eating subscale), and the Binge Eating Scale. The serial mediation model was tested using PROCESS macro model 6, with age, gender, and education as covariates. Results: The serial mediation pathway (stress → emotional eating → binge eating → BMI) was statistically significant (indirect effect B = 0.071, 95% CI [0.041, 0.112]). A separate simple mediation path through binge eating alone was also significant (B = 0.056, 95% CI [0.018, 0.102]), whereas the path through emotional eating alone was not significant. The total indirect effect (B = 0.108, 95% CI [0.052, 0.172]) was significant, indicating that the influence of stress on BMI was fully mediated by the eating behaviors modeled. Conclusions: This study provides the first empirical evidence supporting a sequential pathway from stress to elevated BMI via the progression from emotional to binge eating. The findings support the overeating continuum model and highlight binge eating as a pivotal mediator. This behavioral progression suggests that emotional and binge eating are distinct stages, offering crucial opportunities for tailored prevention and intervention. Full article

(This article belongs to the Section Nutrition and Obesity)

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13 pages, 580 KB

Open AccessArticle

The Impact of 5-Hydroxytryptophan Supplementation on Cognitive Function and Mood in Singapore Older Adults: A Randomized Controlled Trial

by Shuqi Li, Clarinda Nataria Sutanto, Xuejuan Xia and Jung Eun Kim

Nutrients 2025, 17(17), 2773; https://doi.org/10.3390/nu17172773 - 27 Aug 2025

Abstract

Objectives: Concurrent with global aging epidemics, cognitive decline has become an increasing public health concern. Dietary supplementation may offer neuroprotective benefits, and 5-hydroxytryptophan (5-HTP) has gained interest due to its role in serotonin synthesis, thereby regulating cognitive function and mood. However, there is [...] Read more.

Objectives: Concurrent with global aging epidemics, cognitive decline has become an increasing public health concern. Dietary supplementation may offer neuroprotective benefits, and 5-hydroxytryptophan (5-HTP) has gained interest due to its role in serotonin synthesis, thereby regulating cognitive function and mood. However, there is limited evidence on its effect on cognitive function, especially among older Asian adults. Therefore, the study aimed to investigate the effects of 5-HTP supplementation on cognitive function and mood in Singaporean older adults. Methods: This was a single-blinded, 12-week randomized controlled trial, and 30 participants (66 ± 3 years) were randomly assigned to consume 100 mg of 5-HTP daily or not consume it. Cognitive function and mood were assessed via the Montreal Cognitive Assessment (MoCA), Geriatric Anxiety Inventory (GAI), and Geriatric Depression Scale (GDS). Cognitive function-related blood biomarkers, including amyloid beta (Aβ)40, Aβ42, gamma-aminobutyric acid, and serotonin, were also determined. Results: A significant time effect was observed in the MoCA score, which was mainly explained by a significant increase in the 5-HTP group (week 0 vs. week 12: 26.6 ± 1.4 a.u. vs. 27.6 ± 1.4 a.u., p < 0.05). Moreover, the 5-HTP group showed a significant increase in serum serotonin levels. Additionally, the GDS score improved in the 5-HTP group (week 0 vs. week 8: 1.2 ± 1.7 a.u. vs. 0.7 ± 1.2 a.u., p < 0.05). However, no effects on GAI and other biomarkers were observed. Conclusions: 5-HTP supplementation can enhance cognitive performance and reduce symptoms of depression in Singaporean older adults, potentially through serotonergic modulation. However, given the relatively small sample size (n = 30) and short-term (12-week) intervention, these findings should be interpreted cautiously, and further long-term studies with a larger sample size are warranted to confirm these preliminary results. Full article

(This article belongs to the Special Issue Nutritional Interventions for Age-Related Diseases)

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16 pages, 1797 KB

Open AccessArticle

Gut Microbiota Alterations in Patients with Panic Disorder: A Case-Control Study

by Tomasz Grąźlewski, Jolanta Kucharska-Mazur, Jerzy Samochowiec, Artur Reginia, Paweł Liśkiewicz, Anna Michalczyk, Błażej Misiak, Mariusz Kaczmarczyk and Ewa Stachowska

Nutrients 2025, 17(17), 2772; https://doi.org/10.3390/nu17172772 - 27 Aug 2025

Abstract

Background/Objectives: Recent evidence suggests that gut microbiota plays an important role in anxiety and stress-related disorders through interactions along the gut–brain axis. Our aim was to determine the microbiological diversity of intestinal microorganisms in individuals with acute and remission phases of PD when [...] Read more.

Background/Objectives: Recent evidence suggests that gut microbiota plays an important role in anxiety and stress-related disorders through interactions along the gut–brain axis. Our aim was to determine the microbiological diversity of intestinal microorganisms in individuals with acute and remission phases of PD when compared to healthy individuals. Another aim was also to analyze the differences in the metabolic pathways occurring in the intestinal microbiota of individuals from the three analyzed groups. Methods: A diagnosis was established using the Mini-International Neuropsychiatric Interview (M.I.N.I). The gut’s microbiota composition was analyzed through bacterial 16S rRNA gene sequencing (V1–V2 regions). The clinical evaluations included a BMI measurement, Short Form-36 Health Survey (SF-36), Hamilton Anxiety Scale (HAM-A), Montgomery–Åsberg Depression Rating Scale (MADRS), Columbia-Suicide Severity Rating Scale (C-SSRS), and State-Trait Anxiety Inventory (STAI). Results: We recruited 62 participants (31 PD and 31 controls). After conducting quality control filtering, data from 54 participants were analyzed (25 PD, 11 acute, 14 remission, and 29 controls). Observed richness was lower in the acute PD (63) group than in the control (74) and remission (66) (p = 0.038) groups, whereas the Shannon and Simpson indices and beta diversity (PERMANOVA) were not significantly different. The Ruminococcus gnavus group was enriched in acute PD; no other deconfounded differences in microbial composition were detected. Predicted functional differences were detected by edgeR only and included the pathways that are related to steroid biosynthesis and innate immune signaling. Conclusions: Distinct gut microbial signatures were associated with PD, implicating both the metabolic and inflammatory pathways in disease pathophysiology. Full article

(This article belongs to the Special Issue Intestinal Microbiota and Homeostasis: New Advances in Digestive System Function and Health)

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14 pages, 1567 KB

Open AccessArticle

Substrate Oxidation Does Not Influence Middle Distance Running Performance: A Randomized Controlled Crossover Trial

by Alex Buga, Jeffrey D. Buxton, Emma Plank, James D. Minor, Micah T. Sterrett, Christopher A. Brooks, Tanner R. Niemann, Margaret P. Troxel, Anthony Bryarly, Zachary Furry, Clarra Hannon, Jason Muench, Daniel Stone, Dominic P. D’Agostino, Jeff S. Volek, Andrew P. Koutnik and Philip J. Prins

Nutrients 2025, 17(17), 2771; https://doi.org/10.3390/nu17172771 - 27 Aug 2025

Abstract

Objective: Recent work has challenged the notion that preferred substrate oxidation is a key determinant of exercise performance. This investigation tested middle-distance running performance, in the fed state, to control for glycogen and exercise-induced hypoglycemia (EIH) confounders. Methods: In a randomized crossover fashion, [...] Read more.

Objective: Recent work has challenged the notion that preferred substrate oxidation is a key determinant of exercise performance. This investigation tested middle-distance running performance, in the fed state, to control for glycogen and exercise-induced hypoglycemia (EIH) confounders. Methods: In a randomized crossover fashion, all while controlling dietary intake, activity, and body weight, recreational distance runners completed either a 5K (n = 15; VO_2max: 58.3 ± 6.2 mL/kg/min) or a 10K (n = 15; VO_2max: 54.51 ± 5.9 mL/kg/min) middle-distance run after consuming isocaloric low-carbohydrate high-fat (LCHF) and high-carbohydrate low-fat (HCLF) pre-exercise meals. Time trial (TT) performance (sec), carbohydrate/fat substrate oxidation, blood metabolites, heart rate (HR), ratings of perceived exertion (RPE), and subjective fullness and thirst were measured throughout. Results: LCHF pre-exercise nutrition reliably altered substrate oxidation and metabolite profiles compared to HCLF, evidenced by significant increases in fat oxidation (77% higher) and reductions in RER (5% lower), with corresponding shifts in carbohydrate oxidation. Despite distinct preferred substrate oxidation profiles during exercise, the 5 and 10 km TT performances were similar between conditions (p = 0.646/p = 0.118). RER was significantly lower (p = 0.002) after the LCHF condition compared to HCLF. Capillary R-βHB increased modestly after LCHF, while blood glucose increased after HCLF only. The LCHF meal was 35% more filling than the HCLF meal. Preferred substrate oxidation did not significantly modulate middle-distance running performance. Conclusion: This work supports recent findings that substrate oxidation is not a primary determinant of aerobic performance, as previously conceived. Full article

(This article belongs to the Special Issue Nutritional Supplements for Endurance Exercise)

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16 pages, 446 KB

Open AccessArticle

Malnutrition and Nutrition Impact Symptoms in Kuwaiti Colorectal Cancer Patients: Validation of PG-SGA Short Form

by Raghad Obaid and Dalal Alkazemi

Nutrients 2025, 17(17), 2770; https://doi.org/10.3390/nu17172770 - 27 Aug 2025

Abstract

Background/Objectives: Malnutrition is a common but underrecognized complication in colorectal cancer (CRC), contributing to poor treatment outcomes and reduced quality of life. Regional data from the Gulf remains limited. This study assessed the prevalence of malnutrition and nutrition impact symptoms (NISs) among CRC [...] Read more.

Background/Objectives: Malnutrition is a common but underrecognized complication in colorectal cancer (CRC), contributing to poor treatment outcomes and reduced quality of life. Regional data from the Gulf remains limited. This study assessed the prevalence of malnutrition and nutrition impact symptoms (NISs) among CRC patients in Kuwait. It evaluated the diagnostic performance of the PG-SGA Short Form (PG-SGA SF) in comparison to the full PG-SGA and the Malnutrition Screening Tool (MST). Methods: A cross-sectional study was conducted among 65 CRC outpatients at the Kuwait Cancer Control Center. Nutritional status was assessed using the full PG-SGA, PG-SGA SF, and MST. Dietary intake, anthropometry, biochemical parameters, and NISs were collected. Logistic regression identified independent predictors of malnutrition, and the performance of the tool was evaluated using kappa statistics and diagnostic accuracy metrics. Results: Malnutrition (PG-SGA B/C) was identified in 61.4% of patients. Loss of appetite, dry mouth, and nausea were significantly associated with malnutrition (p < 0.00385); dry mouth independently predicted malnutrition (OR: 17.65, 95% CI: 2.02–154.19, p = 0.009). BMI was not predictive, but reduced mid-arm circumference was significantly associated. PG-SGA SF showed strong agreement with the full PG-SGA (κ = 0.75), with high sensitivity (87.2%) and specificity (88.5%), outperforming MST (κ = 0.38). Only 23.5% of moderately malnourished patients were referred to a dietitian. Conclusions: Malnutrition and NIS are highly prevalent among Kuwaiti CRC patients. PG-SGA SF is a valid and efficient screening tool that should replace MST in oncology settings. Symptom-informed screening and structured referral protocols are crucial for enhancing nutrition care. Full article

(This article belongs to the Section Clinical Nutrition)

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21 pages, 958 KB

Open AccessArticle

Asthma and Multi-Food Allergy Are Risk Factors for Oral Food Challenge Failure—A Single-Center Experience

by Liliana Klim, Maria Michalik, Ewa Cichocka-Jarosz and Urszula Jedynak-Wąsowicz

Nutrients 2025, 17(17), 2769; https://doi.org/10.3390/nu17172769 - 27 Aug 2025

Abstract

Background: Diagnosing food allergy (FA) typically involves a detailed clinical history and confirmation of allergen-specific IgE. Oral food challenges (OFCs) remain the gold standard in FA diagnosis. This study aimed to present our experience in performing OFCs in pediatric patients with particular focus [...] Read more.

Background: Diagnosing food allergy (FA) typically involves a detailed clinical history and confirmation of allergen-specific IgE. Oral food challenges (OFCs) remain the gold standard in FA diagnosis. This study aimed to present our experience in performing OFCs in pediatric patients with particular focus on challenges performed with cow’s milk and hen’s egg. Methods: We conducted a retrospective analysis of 205 OFCs. Clinical data were evaluated and multiple logistic regression was used to identify associations between challenge outcomes, reaction severity, and comorbidities. Results: The mean age of patients was 5.7 ± 3.1 years, with 135 (65.9%) being male. The tested foods included cow’s milk protein (CMP, 103 challenges; 50.2%), hen’s egg white protein (HEWP, 84; 41.0%), peanuts (3; 1.5%), tree nuts (4; 2.0%), gluten (3; 1.5%), hen’s egg yolk (4; 2.0%), and other foods (4; 2.0%). The overall OFC failure rate was 32.2%, and five challenges (2.4%) yielded inconclusive results. The median cumulative reactive dose was 0.27 g for baked CMP and 0.58 g for baked HEWP. Most failed OFCs involved mucocutaneous symptoms (44 cases; 66.7%). Severe multisystemic reactions occurred in four patients (2.0%), all of whom required epinephrine (6.1% of positive challenges). An increased risk of OFC failure was associated with asthma (p = 0.028; 95% CI: 0.07–1.27) and multi-food allergy (p = 0.021; 95% CI: 0.14–1.67). Additionally, the coexistence of asthma and a prior history of anaphylaxis to any food was related to OFC failure (p = 0.049; 95% CI: 0.01–2.19), as was the combination of multi-food allergy and previous anaphylaxis (p = 0.043; 95% CI: 0.03–1.70). Receiver operating characteristic (ROC) curve analysis was utilized to predict outcomes of OFCs to baked milk and baked egg and determined a specific IgE (sIgE) cutoff level of 58.1 kU/L for baked milk challenges (AUC: 0.77; sensitivity: 0.588; specificity: 0.882), and 11.3 kU/L for baked egg challenges (AUC: 0.66; sensitivity: 0.692; specificity: 0.607). Conclusions: Our findings confirm that OFCs are a safe and effective tool for diagnosing FA in children. With appropriate patient selection, the risk of severe reactions remains low. Nonetheless, comorbidities such as asthma and multi-food allergy are associated with an increased likelihood of OFC failure. Full article

(This article belongs to the Special Issue Exploring the Role of Nutrition in Modulating Allergies and Allergic Reactions)

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15 pages, 427 KB

Open AccessArticle

Targeting Lymphedema in Overweight Breast Cancer Survivors: A Pilot Randomized Controlled Trial of Diet and Exercise Intervention

by Yolanda Ruiz-Molina, Marina Padial, María del Mar Martín-Bravo, María García-Olivares, Nuria Porras, Alejandro Chicharro, Javier Mora-Robles, Andrés González-Jiménez, Corina Verónica Sasso and Gabriel Olveira

Nutrients 2025, 17(17), 2768; https://doi.org/10.3390/nu17172768 - 27 Aug 2025

Abstract

Background/Objectives: Breast cancer-related lymphedema (BCRL) is more prevalent and severe in women with overweight or obesity. This study evaluated the effect of a comprehensive lifestyle intervention—comprising supervised exercise, a hypocaloric Mediterranean diet, and optional meal replacement—on lymphedema outcomes in this population. Methods [...] Read more.

Background/Objectives: Breast cancer-related lymphedema (BCRL) is more prevalent and severe in women with overweight or obesity. This study evaluated the effect of a comprehensive lifestyle intervention—comprising supervised exercise, a hypocaloric Mediterranean diet, and optional meal replacement—on lymphedema outcomes in this population. Methods: In this pilot randomized controlled trial, 112 women with BCRL and BMI 25–40 kg/m² were assigned to an intervention group—receiving supervised resistance and aerobic training, dietary counseling, and optional high-protein meal replacement—or to a control group with standard advice. The primary outcome was change in affected limb volume at 3 and 6 months. Secondary outcomes included morphofunctional parameters, muscle strength, dietary intake, and serum levels of cytokines (IL-1β, IL-6, IL-10, and TNF-α). Analyses also explored outcomes according to whether participants achieved ≥ 5% weight loss. Results: Ninety-four participants completed the trial (intervention n = 43, control n = 51). At 6 months, women who achieved ≥5% weight loss had greater reductions in affected limb volume (−664.9 ± 362.1 mL vs. −395.6 ± 596.9 mL). The intervention group showed significantly greater improvements in BMI (−1.14 ± 1.22 kg/m²), waist circumference (−3.59 ± 4.6 cm), triceps skinfold (−4.61 ± 3.02 mm), fat mass (−2.38 ± 2.75 kg), extracellular water (−0.58 ± 0.85 L), and quadriceps strength (+7.1 ± 9.7 kg). No significant changes were observed in circulating cytokines. Conclusions: In this pilot randomized controlled trial, a structured dietary and exercise intervention improved morphofunctional outcomes in overweight women with BCRL. Weight loss of ≥5% emerged as a potentially relevant therapeutic target that may inform the design of future studies aimed at optimizing lymphedema management. Full article

(This article belongs to the Section Clinical Nutrition)

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