Nutrients

11 pages, 357 KiB

Open AccessArticle

Nutritional Screening During Pregnancy: Women’s Views of Weight Monitoring as Part of This Process

by Catherine R. Knight-Agarwal, Lorna Munro, Stacy Morgan, Ashley Gschwend, Cassie Fekete and Michelle Minehan

Nutrients 2025, 17(9), 1516; https://doi.org/10.3390/nu17091516 (registering DOI) - 29 Apr 2025

Abstract

Background: Worldwide, appropriate weight maintenance is one of the most important elements of human health, and this is especially true for pregnancy. Gestational weight gain below or above the recommended range is associated with numerous adverse outcomes. In addition, it may induce [...] Read more.

Background: Worldwide, appropriate weight maintenance is one of the most important elements of human health, and this is especially true for pregnancy. Gestational weight gain below or above the recommended range is associated with numerous adverse outcomes. In addition, it may induce epigenetic changes leading to an increased risk of developing future chronic disease, such as obesity and type 2 diabetes, in both the woman and her offspring. Despite this, little is known of the views and experiences of pregnant women regarding weight monitoring and advice during the antenatal period. Methods: A qualitative study using individual interviews was undertaken in south-eastern Australia. Sixteen women with varying body mass index participated. Interviews were audio recorded and transcribed verbatim. Data was analyzed using interpretative phenomenological analysis. In any phenomenological study, the researcher’s objective is to elicit the participant’s views on their lived experiences. Results: Three major themes emerged: (1) The physiological perspective of weight monitoring during pregnancy; (2) The psychological perspective of weight monitoring during pregnancy; (3) The sociological perspective of weight monitoring during pregnancy. Conclusions: The findings from this study may assist the future development and support of weight monitoring information and practices for pregnant women. Women want more individualized support regarding weight monitoring during pregnancy. Full article

(This article belongs to the Special Issue Dietary Patterns and Lifestyles for Maternal–Infant Health)

11 pages, 517 KiB

Open AccessArticle

Food Literacy as an Instrument for Health Promotion Among Hospital Workers: The “ABCibi Project”

by Samar El Sherbiny, Valeria Bellisario, Elena Lenta, Giacomo Scaioli, Giulia Squillacioti, Anna Rovera, Patrizia Lemma, Cloè Dalla Costa and Roberto Bono

Nutrients 2025, 17(9), 1515; https://doi.org/10.3390/nu17091515 (registering DOI) - 29 Apr 2025

Abstract

Background: Health literacy (HL) promotes the achievement of skills and information useful to endorse health. Food Literacy (FL) is a subtype of HL related to the knowledge necessary to achieve a healthy diet. Methods: This pilot study aimed to assess and [...] Read more.

Background: Health literacy (HL) promotes the achievement of skills and information useful to endorse health. Food Literacy (FL) is a subtype of HL related to the knowledge necessary to achieve a healthy diet. Methods: This pilot study aimed to assess and improve FL of hospital workers through a survey before and after an educational intervention consisting of nutrition courses, infographics, and updates to the canteen service. FL was evaluated with a questionnaire, and Kruskal–Wallis, Friedman and Wilcoxon test was performed to assess group differences. Results: Of 897 participants, 375 (T1) completed both surveys, while 522 completed only T0. A pairwise comparison stratified by role, age and education revealed a significant improvement in FL scores in the T1 group. Improvements were observed in the T1 group, with overall scores rising from 6.2 ± 2.7 to 6.9 ± 2.1 (p-value < 0.001). An upgrade was noted in healthcare workers (T0 = 6.5 ± 2.2 vs. T1 = 7 ± 2, p-value < 0.001), administrative workers (T0 = 5.5 ± 2.5 vs. T1 = 6.2 ± 2.4, p-value = 0.008), all age groups (T0 = 6.3 ± 2.4 vs. T1 = 6.8 ± 2, p-value = 0.03, T0 = 6.2 ± 2.3 vs. T1 = 6.7 ± 2.2, p-value = 0.02, T0 = 6.2 ± 2.3 vs. T1 = 7 ± 2, p-value = 0.003), low and high education (T0 = 5.7 ± 2.3 vs. T1 = 6.6 ± 2.1, p-value < 0.001, T0 = 6.6 ± 2.3 vs. T1 = 7.1 ± 2 p-value = 0.03). Conclusions: Our survey highlights the efficacy of a multifactorial intervention in enhancing FL and proves the importance of food health promotion within workplaces. Full article

(This article belongs to the Special Issue Addressing the Health Impacts of Dietary Exposure: Enhancing Public Health Through Dietary Literacy and Experimental Methodologies)

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Graphical abstract

10 pages, 343 KiB

Open AccessArticle

NSAIDs, Ileal Inflammation, and Glucose Metabolism: Insights from a Large Retrospective Cohort

by Stephanie Hosanna Rodriguez, Gilles Jadd Hoilat, Nikash Pradhan, Carolina Gonzalez Bravo, Marcelo L. G. Correia and Mohamad Mokadem

Nutrients 2025, 17(9), 1514; https://doi.org/10.3390/nu17091514 (registering DOI) - 29 Apr 2025

Abstract

Background/Objectives: Ileitis, or inflammation of the terminal ileum, is often linked to inflammatory bowel disease (IBD), especially Crohn’s disease, but may also arise from non-steroidal anti-inflammatory drug (NSAID) use. While NSAIDs are known to cause gastrointestinal injury, their role in ileitis and downstream [...] Read more.

Background/Objectives: Ileitis, or inflammation of the terminal ileum, is often linked to inflammatory bowel disease (IBD), especially Crohn’s disease, but may also arise from non-steroidal anti-inflammatory drug (NSAID) use. While NSAIDs are known to cause gastrointestinal injury, their role in ileitis and downstream metabolic consequences remains unclear. This study evaluated the relationship between NSAID use, biopsy-confirmed ileitis, and glucose metabolism abnormalities in patients with and without IBD. Methods: We conducted a retrospective cohort study of 3725 adults who underwent ileal biopsy between 2009 and 2022 at a tertiary care center. Patients were stratified based on histologic evidence of ileitis. Collected data included demographics, IBD status, NSAID and steroid use, hemoglobin A1C, fasting glucose, and diagnoses of abnormal glucose metabolism. Multivariable logistic and linear regression models adjusted for age, BMI, sex, steroid use, and IBD. Results: Of 3725 patients, 876 had biopsy-confirmed ileitis. NSAID use—categorized as current, historical, or inpatient—was not significantly associated with ileitis after adjustment. In contrast, IBD was the strongest independent predictor (p < 0.05). Although unadjusted analyses showed lower A1C in the ileitis group (p = 0.003), this was not significant after controlling for confounders (p = 0.084). No significant associations were found between ileitis and fasting glucose or abnormal glucose metabolism. Age and BMI were the dominant predictors of glycemic abnormalities. Conclusions: NSAID use was not associated with biopsy-confirmed ileitis or impaired glucose metabolism. Traditional metabolic risk factors were stronger predictors of glycemic abnormalities than localized ileal inflammation. Full article

(This article belongs to the Section Nutrition and Diabetes)

19 pages, 1632 KiB

Open AccessArticle

Dietary Fiber Intake Improves Osteoporosis Caused by Chronic Lead Exposure by Restoring the Gut–Bone Axis

by Ruijian Wang, Jin Shen, Chunqing Han, Xiaodong Shi, Yan Gong, Xiping Hu, Zhongtang Jia, Miaomiao Wang and Yu Wu

Nutrients 2025, 17(9), 1513; https://doi.org/10.3390/nu17091513 (registering DOI) - 29 Apr 2025

Abstract

Background: Lead (Pb), a pervasive environmental toxicant with specific toxicity to bone, has been recognized as a significant etiological factor in the pathogenesis of osteoporosis. While dietary fiber (DF) demonstrates anti-osteoporotic potential, its protective role against Pb-induced bone loss remains unexplored. Methods [...] Read more.

Background: Lead (Pb), a pervasive environmental toxicant with specific toxicity to bone, has been recognized as a significant etiological factor in the pathogenesis of osteoporosis. While dietary fiber (DF) demonstrates anti-osteoporotic potential, its protective role against Pb-induced bone loss remains unexplored. Methods: This study analyzed the association between dietary fiber, blood lead, and osteoporosis based on the NHANES database, and validated it by constructing a lead exposed mouse model. Micro CT was used to evaluate bone microstructure, ELISA was used to detect bone markers, q-PCR/Western blot was used to measure intestinal tight junction protein, flow cytometry was used to analyze Treg cells in colon/bone tissue, GC-MS was used to detect short chain fatty acids, and 16S rRNA sequencing was used to analyze changes in gut microbiota. The regulatory mechanism of dietary fiber on bone metabolism and intestinal barrier in lead exposed mice was systematically evaluated. Results: Based on NHANES data analysis, it was found that dietary fiber can reduce the risk of osteoporosis in lead exposed populations. Animal experiments have shown that dietary fiber intervention significantly increases bone density, improves bone microstructure and metabolic indicators, repairs intestinal barrier damage caused by lead exposure, and regulates immune balance in lead exposed mice. At the same time, it promotes the generation of short chain fatty acids and the proliferation of beneficial gut microbiota. Conclusion: These findings indicate that DF mitigates Pb-induced osteoporosis through gut barrier restoration, SCFA-mediated immunomodulation, and microbiota-driven Treg cell expansion along the gut–bone axis. Full article

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

17 pages, 833 KiB

Open AccessSystematic Review

The Role of Vitamin D Supplementation in Enhancing Muscle Strength Post-Surgery: A Systemic Review

by James Jia-Dong Wang, Glenys Shu-Wei Quak, Hui-Bing Lee, Li-Xin Foo, Phoebe Tay, Shi-Min Mah, Cherie Tong and Frederick Hong-Xiang Koh

Nutrients 2025, 17(9), 1512; https://doi.org/10.3390/nu17091512 (registering DOI) - 29 Apr 2025

Abstract

Background: Vitamin D is vital for musculoskeletal health, with emerging evidence highlighting its role in muscle function. While its preoperative and postoperative benefits for bone health are well documented, the effect of vitamin D supplementation on post-surgical muscle recovery remains underexplored. This [...] Read more.

Background: Vitamin D is vital for musculoskeletal health, with emerging evidence highlighting its role in muscle function. While its preoperative and postoperative benefits for bone health are well documented, the effect of vitamin D supplementation on post-surgical muscle recovery remains underexplored. This systematic review consolidates current evidence on the impact of vitamin D supplementation in enhancing muscle strength following surgery. Methods: This review adhered to PRISMA guidelines and was registered on PROSPERO. A systematic search of PubMed, EMBASE, and Cochrane databases was conducted, covering articles from inception to 15 January 2025. Studies evaluating the effect of vitamin D supplementation on muscle strength in surgical contexts were included. Data extraction focused on study design, population demographics, vitamin D dosage, timing, and measured outcomes. A narrative synthesis was performed due to heterogeneity in study designs and outcomes. Results: From 701 initial records, 10 studies met the inclusion criteria. The findings indicate that vitamin D supplementation, particularly high-dose regimens administered preoperatively or early postoperatively, significantly improves muscle strength and functional outcomes in orthopaedic surgeries, such as hip and knee replacements, and bariatric surgeries. The benefits varied by surgical type, baseline vitamin D levels, and supplementation strategy. However, inconsistent dosing regimens and limited long-term follow-up studies hinder conclusive evidence. Conclusions: Vitamin D supplementation demonstrates potential in enhancing post-surgical muscle recovery and functional outcomes. Tailored supplementation strategies, based on patient-specific needs and surgical context, are essential. Future research should address optimal dosing regimens and evaluate long-term impacts on recovery and quality of life. Full article

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12 pages, 295 KiB

Open AccessArticle

The Effects of a Multidisciplinary Residential Program on the Risk Factors of Sarcopenic Obesity: An Open-Label Trial Study in a Cohort of Institutionalized Italian Adults with Obesity

by Mariangela Rondanelli, Clara Gasparri, Alessia Moroni, Elisa Genovese, Eugenio Marzio Valentini, Giorgia Leone, Simone Perna and Giuseppe Mazzola

Nutrients 2025, 17(9), 1511; https://doi.org/10.3390/nu17091511 (registering DOI) - 29 Apr 2025

Abstract

Background: Sarcopenic obesity, characterized by excess fat and reduced muscle mass/function, is linked to chronic inflammation and metabolic dysfunction. Methods: This study aimed to evaluate the efficacy of a 2-month multidisciplinary residential program (MRP) on the clinical and functional outcomes associated with the [...] Read more.

Background: Sarcopenic obesity, characterized by excess fat and reduced muscle mass/function, is linked to chronic inflammation and metabolic dysfunction. Methods: This study aimed to evaluate the efficacy of a 2-month multidisciplinary residential program (MRP) on the clinical and functional outcomes associated with the risk of sarcopenia in 61 institutionalized Italian adults with obesity (mean age of 60; 36 women and 25 men; BMI ≥ 30 with metabolic comorbidities). The MRP included personalized nutrition, physical activity, and psychological support. Outcomes included anthropometric, biochemical, body composition, and physical performance measures (via Short Physical Performance Battery [SPPB]), with sarcopenia risk evaluated using EWGSOP2 criteria. Results: Post-intervention, significant improvements were observed in SPPB scores (+0.93 units, p < 0.001), weight (−6.4 kg), BMI (−2.45 kg/m²), fat mass (−3.9 kg), visceral adipose tissue (−314.2 g), and fat-free mass index (−285.54 g; all p < 0.01). Glycemic control improved, with reductions in fasting glucose (−16.4 mg/dL), HbA1c (−0.81%), insulin (−2.77 mcU/mL), and HOMA-IR (−0.95; p < 0.05). Lipid profiles also improved, including total cholesterol (−21.32 mg/dL), LDL (−12.10 mg/dL), and triglycerides (−39.07 mg/dL; all p < 0.001). Conclusions: The MRP effectively enhanced body composition, metabolic health, and physical function, underscoring its potential as a preferred strategy for managing sarcopenic obesity in institutional settings. Full article

(This article belongs to the Special Issue Diet and Muscle Metabolism)

16 pages, 1005 KiB

Open AccessArticle

Motivators and Facilitators of Fruit and Vegetable Intake in Tongan Adults

by Emily Mitchell, Crystal Áke, Steven Underhill and Sarah Burkhart

Nutrients 2025, 17(9), 1510; https://doi.org/10.3390/nu17091510 - 29 Apr 2025

Abstract

Background/Objectives: Changes to food systems and food environments across the Pacific Islands region have influenced dietary behaviors. While dietary intake is limited, it is believed that fruit and vegetable consumption is low within these populations. Given the benefits of fruit and vegetable consumption, [...] Read more.

Background/Objectives: Changes to food systems and food environments across the Pacific Islands region have influenced dietary behaviors. While dietary intake is limited, it is believed that fruit and vegetable consumption is low within these populations. Given the benefits of fruit and vegetable consumption, this exploratory study aimed to identify the motivators and facilitators of fruit and vegetable intake in a subset of Tongan adults. Methods: Semi-structured, 30 min interviews were conducted in Tongan with 12 participants (5 fieldworkers and 3 female community members who were interviewed separately and 4 women who took part in a small group interview). The responses were translated into English and were analyzed using thematic analysis. Results: Most participants thought that low fruit and vegetable consumption was of concern in Tongan communities. All participants agreed that diverse fruit and vegetable consumption is a priority for Tongan people and that communities are motivated to consume more fruits and vegetables. A total of 12 themes were derived from the results: 6 motivational and 6 facilitating, including determinants such as dietary patterns (taste and culture), community engagement/working in groups, and financial factors. Conclusions: While using a small sample size from Tongatapu, this provides a valuable insight from the Tongan communities’ perspectives on motivators and facilitators of fruit and vegetable consumption. The results offer policymakers, government, and NGOs contextually relevant and up-to-date data that can be used when developing health and nutrition programs. Full article

(This article belongs to the Special Issue Nutrition and Food Systems for Health in the Pacific: Towards Healthy Islands)

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19 pages, 506 KiB

Open AccessArticle

Feasibility of a Pre-Operative Morphofunctional Assessment and the Effect of an Intervention Program with Oral Nutritional Supplements and Physical Exercise

by Natalia Mudarra-García, Fernando Roque-Rojas, Almudena Nieto-Ramos, Visitación Izquierdo-Izquierdo and Francisco Javier García-Sánchez

Nutrients 2025, 17(9), 1509; https://doi.org/10.3390/nu17091509 (registering DOI) - 29 Apr 2025

Abstract

Background: Surgical patients often experience nutritional imbalances due to their underlying condition and the forthcoming surgical procedure. These imbalances can increase the risk of post-operative complications. To mitigate such risks, a comprehensive nutritional assessment—also known as morphofunctional assessment—should be conducted. This includes evaluating [...] Read more.

Background: Surgical patients often experience nutritional imbalances due to their underlying condition and the forthcoming surgical procedure. These imbalances can increase the risk of post-operative complications. To mitigate such risks, a comprehensive nutritional assessment—also known as morphofunctional assessment—should be conducted. This includes evaluating body composition (muscle and fat mass), muscle strength, and functional capacity. Methods: We conducted an observational, prospective, pre-post interventional study involving 138 patients undergoing major elective surgery. Each patient received a morphofunctional assessment and an individualized prehabilitation program, including nutritional supplementation, physical exercise, and comorbidity optimization for 21 days before surgery and one month afterward. Outcomes were assessed through bioimpedance (muscle mass), muscle ultrasound (QRF thickness), dynamometry (strength), and visceral fat ultrasound (fat reduction). Results: The patient’s morphofunctional assessment and subsequent nutritional and physical exercise optimization performed during the month before surgery in the prehabilitation consultation led to an increase in muscle mass (measured by bioimpedance analysis, p = 0.001), and muscle ultrasound, (QRF thickness: p < 0.001) and dinamometry (muscle strength: p = 0.014); a reduction in preperitoneal visceral fat thickness (reduction p < 0.001); and an improvement in the patients’ nutritional status, with a decrease in malnutrition rates (64.8% vs. 31.8%). As a result, post-operative complications were effectively prevented (p < 0.001). Conclusions: Pre-operative patient optimization by means of a prehabilitation program led to increased muscle strength, improved muscle mass, reduced complication rates, and shorter hospital stays. In addition, patients maintained their quality of life and functional capacity following surgery. Full article

(This article belongs to the Section Clinical Nutrition)

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15 pages, 693 KiB

Open AccessArticle

Temporal Trends and Clinical Impact of Malnutrition on In-Hospital Outcomes Among Patients with Advanced Chronic Kidney Disease: A Nationwide Inpatient Analysis

by Wannasit Wathanavasin, Charat Thongprayoon, Wisit Kaewput, Supawit Tangpanithandee, Supawadee Suppadungsuk and Wisit Cheungpasitporn

Nutrients 2025, 17(9), 1508; https://doi.org/10.3390/nu17091508 (registering DOI) - 29 Apr 2025

Abstract

Background/Objectives: Malnutrition is a prevalent yet under-recognized condition in patients with advanced chronic kidney disease (CKD), contributing to increased morbidity, mortality, and healthcare burden. The aim of this study is to determine the prevalence and trends of malnutrition and investigate the impact of [...] Read more.

Background/Objectives: Malnutrition is a prevalent yet under-recognized condition in patients with advanced chronic kidney disease (CKD), contributing to increased morbidity, mortality, and healthcare burden. The aim of this study is to determine the prevalence and trends of malnutrition and investigate the impact of malnutrition on in-hospital outcomes, treatments, and resource utilization in hospitalized patients with advanced CKD. Methods: This study utilized the National Inpatient Sample (NIS) database to identify hospitalized patients with advanced CKD from 2016 to 2021. This study investigated temporal trends in the prevalence and in-hospital mortality across different degrees of malnutrition in advanced CKD patients. Multivariable regression models were used to assess the association between malnutrition and in-hospital outcomes. Results: Out of 1,244,415 advanced CKD patients, 67,587 (5.4%) had mild to moderate malnutrition, and 63,785 (5.1%) had severe malnutrition. Malnourished patients exhibited significantly higher in-hospital mortality, with adjusted odds ratios of 1.70 (95% confidence interval (CI), 1.64–1.75) for mild to moderate cases and 2.67 (95% CI, 2.60–2.75) for severe cases. Severely malnourished patients were associated with longer mean hospital stay by 7.0 days and higher hospitalization costs by $97,767 compared with non-malnourished patients. The prevalence of severe malnutrition showed a significant uptrend from 4.2% in 2016 to 5.5% in 2021 (p for trend < 0.001). Conclusions: Malnutrition in advanced CKD is an increasingly prevalent condition linked to worsened in-hospital outcomes and heightened healthcare resource utilization. The rising trend of severe malnutrition underscores the need for early nutritional screening and the need for future interventional studies to mitigate adverse clinical outcomes in this high-risk population. Full article

(This article belongs to the Special Issue Nutritional Status and the Risk of Malnutrition in People with Kidney Failure)

12 pages, 469 KiB

Open AccessArticle

Emerging Methods for Integrative Management of Chronic Diseases: Utilizing mHealth Apps for Lifestyle Interventions

by Alina Spinean, Alexandra Mladin, Simona Carniciu, Ana Maria Alexandra Stănescu and Cristian Serafinceanu

Nutrients 2025, 17(9), 1506; https://doi.org/10.3390/nu17091506 - 29 Apr 2025

Abstract

Background/Objectives: Mobile health (mHealth) apps have become a revolutionary tool in managing and treating chronic diseases, providing numerous advantages for both patients and healthcare providers. These apps leverage technology to offer a variety of functions that support the monitoring, management, and enhancement of [...] Read more.

Background/Objectives: Mobile health (mHealth) apps have become a revolutionary tool in managing and treating chronic diseases, providing numerous advantages for both patients and healthcare providers. These apps leverage technology to offer a variety of functions that support the monitoring, management, and enhancement of a patient’s health. Methods: We performed an observational study with 147 participants, using a questionnaire to evaluate the impact of mHealth applications on lifestyle changes in individuals managing chronic health conditions, including diabetes, obesity, and hypertension. Results: The study found that 40% of participants used the app daily, with a further 24.39% using it weekly and 14.63% using it occasionally. The positive health impact of the app was evident, with improvements in key health metrics such as glucose levels (73.42%), weight (62.02%), and adherence to dietary recommendations (71.31%). Conslussions: These findings aligned with studies on the effectiveness of mHealth apps in managing chronic conditions like diabetes. These broad health improvements reported by users suggested that the app was effective in promoting healthier behaviors. The high levels of user satisfaction and engagement highlighted how effective the app was. All in all, our study found that mHealth apps are valuable tools for people managing chronic health conditions, helping to motivate users and improve their health. Full article

(This article belongs to the Section Nutritional Epidemiology)

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30 pages, 3212 KiB

Open AccessReview

Modulating Gut Microbiota with Dietary Components: A Novel Strategy for Cancer–Depression Comorbidity Management

by Haochen Dai, Haiyi Yang, Rui Wang, Xuanpeng Wang and Xin Zhang

Nutrients 2025, 17(9), 1505; https://doi.org/10.3390/nu17091505 - 29 Apr 2025

Abstract

Background: Gut microbiota play a critical role in mediating the bidirectional association between cancer and depression. Emerging evidence indicates that adjusting the dietary component intake can significantly alter gut microbiota composition, thereby influencing the host’s metabolism and immune function. Changes in gut [...] Read more.

Background: Gut microbiota play a critical role in mediating the bidirectional association between cancer and depression. Emerging evidence indicates that adjusting the dietary component intake can significantly alter gut microbiota composition, thereby influencing the host’s metabolism and immune function. Changes in gut microbiota and their metabolites may represent key factors in preventing cancer–depression comorbidity. Methods: English publications were searched in databases including the Web of Science, Scopus, and PubMed using a series of keywords: “cancer”, “depression”, “gut microbiota”, “dietary components”, and related terms, individually or in combination. The search focused on preclinical and clinical studies describing the regulatory effects of dietary component interventions. Results: This narrative review summarizes the associations among gut microbiota, cancer, and depression, and synthesizes current evidence on the modulatory effects and mechanisms of specific dietary component interventions, including dietary patterns, probiotics, prebiotics, and diet-derived phytochemicals, on gut microbiota. On the one hand, these interventions inhibit abnormal proliferation signals in the tumor microenvironment and enhance anticancer immune responses; on the other hand, they modulate neurotransmitter homeostasis, suppress neuroinflammation, and improve mood behaviors through the gut–brain axis interactions mediated by microbial metabolites. Conclusions: The complex associations among cancer, depression, and gut microbiota require further clarification. Modulating gut microbiota composition through dietary components represents a novel therapeutic strategy for improving cancer–depression comorbidity. Regulated gut microbiota enhance immune homeostasis and intestinal barrier function, while their metabolites bidirectionally modulate one another via systemic circulation and the gut–brain axis, thereby improving both the tumor microenvironment and depressive-like behaviors in cancer patients while reducing the adverse effects of cancer. Full article

(This article belongs to the Special Issue Diet, Gut Health, and Clinical Nutrition)

26 pages, 3274 KiB

Open AccessSystematic Review

Exercise, Nutrition, and Neuromuscular Electrical Stimulation for Sarcopenic Obesity: A Systematic Review and Meta-Analysis of Management in Middle-Aged and Older Adults

by Shan Xu, Siying Tu, Xiaoyu Hao, Xiangjun Chen, Da Pan, Wang Liao, Ruipeng Wu, Ligang Yang, Hui Xia, Shaokang Wang and Guiju Sun

Nutrients 2025, 17(9), 1504; https://doi.org/10.3390/nu17091504 - 29 Apr 2025

Abstract

Background/Objective: Sarcopenic obesity (SO), a pathological syndrome characterized by the co-existence of diminished muscle mass and excessive adipose accumulation, significantly compromises the quality of life in older adults. The purpose of this study was to systematically evaluate the efficacy of exercise, nutritional interventions, [...] Read more.

Background/Objective: Sarcopenic obesity (SO), a pathological syndrome characterized by the co-existence of diminished muscle mass and excessive adipose accumulation, significantly compromises the quality of life in older adults. The purpose of this study was to systematically evaluate the efficacy of exercise, nutritional interventions, and neuromuscular electrical stimulation (NMES) in preventing and managing SO in middle-aged and older adults. Methods: A comprehensive search was conducted across PubMed, Web of Science, Embase, Cochrane Library, and CNKI for randomized controlled trials (RCTs) until January 2025. Meta-analyses were performed using the random-effects model and fixed-effects model based on the degree of heterogeneity and calculating the mean differences (MD) with 95% confidence intervals (CI). Subgroup analyses compared the intervention types. Results: Twenty-nine RCTs (1622 participants) were included. Exercise interventions significantly reduced the body fat percentage (MD = −2.79%, 95% CI: −3.94, −1.64, p < 0.001, I² = 74%), fat mass (MD = −6.77 kg, 95% CI: −11.48, −2.06, p = 0.005, I² = 98%), waist circumference (MD = −2.05 cm, 95% CI: −3.64, −0.46, p = 0.01, I² = 0%) and LDL-C (MD: −7.45 mg/dL, 95% CI: −13.82, −1.07, p = 0.02, I² = 0%), while improving handgrip strength (MD = 2.35 kg, 95% CI: 1.99, 2.70, p < 0.001, I² = 52%) and gait speed (MD = 0.19 m/s, 95% CI: 0.13, 0.24, p < 0.001, I² = 89%). Mixed training outperformed resistance-only regimens in reducing the body fat percentage and enhancing functional outcomes. NMES reduced the body fat percentage (MD = −2.01%, 95% CI: −3.54, −0.48, p = 0.01, I² = 93%) and waist circumference (MD = −1.72 cm, 95% CI: −2.35, −1.09, p < 0.001, I² = 0%) while increasing the Skeletal Muscle Index (MD = 0.26 kg/m², 95% CI: 0.22, 0.29, p < 0.001, I² = 38%). Synergy with nutritional supplementation amplified these effects. Nutritional interventions modestly improved total fat-free mass (MD = 0.77 kg, 95% CI: 0.04, 1.50, p = 0.04, I² = 0%) and handgrip strength (MD = 1.35 kg, 95% CI: 0.71, 2.00, p < 0.001, I² = 0%) but showed no significant impact on the metabolic markers (TG, TC, glucose, hemoglobin, and HOMA-IR). Conclusions: Exercise, particularly multimodal regimens combining aerobic and resistance training, is the cornerstone for improving body composition and physical function in SO. NMES serves as an effective adjunct for accelerating fat loss, while nutritional strategies require integration with exercise or prolonged implementation to yield clinically meaningful outcomes. Future research should prioritize standardized diagnostic criteria and long-term efficacy assessments of multimodal interventions. Full article

(This article belongs to the Section Geriatric Nutrition)

10 pages, 464 KiB

Open AccessArticle

Effects of Caffeine Intake on Self-Administered Sleeping Quality and Wearable Monitoring of Sleep in a Cohort of Young Healthy Adults

by Jenny Schlichtiger, Stefan Brunner, Anna Strüven, John Michael Hoppe and Christopher Stremmel

Nutrients 2025, 17(9), 1503; https://doi.org/10.3390/nu17091503 - 29 Apr 2025

Abstract

Background/Objective: Chronic sleep deprivation can lead to adverse health effects and therefore represents a public health burden While caffeine is a widely used stimulant, the relationship between caffeine consumption and sleep remains uncertain. Moreover, many studies might be subject to methodological bias, as [...] Read more.

Background/Objective: Chronic sleep deprivation can lead to adverse health effects and therefore represents a public health burden While caffeine is a widely used stimulant, the relationship between caffeine consumption and sleep remains uncertain. Moreover, many studies might be subject to methodological bias, as invasive sleep measurements may themselves serve as confounders. The aim of the SleepSmart study was to assess the impact of caffeine consumption through coffee and energy drinks, utilizing both smartwatch data and questionnaire responses. Methods: The SleepSmart study is an observational cohort study conducted at LMU Hospital Munich, Germany, from July 2024 to January 2025. The study investigated two intervention groups: (1) coffee and (2) energy drink consumption. Each intervention lasted 1 week, with days 1 to 3 serving as a reference period (water consumption to adjust for increased fluid intake) and days 4 to 6 serving as the intervention period (consumption of an equivalent of 240 mg of caffeine per day, 3 h before bedtime). Data was collected through self-administered questionnaires and wearable devices. The primary endpoint was sleep duration. Objective measures of sleep (duration of light/deep sleep, duration of wake phases, heart rate) and self-assed quality of sleep (Pittsburgh Sleep Quality Index) served as secondary endpoints. Results: For the primary endpoint, we did not find a significant difference in average sleep duration (baseline [hours] 6.7, coffee 6.9, energy drink 6.7, p-value 0.183). Similarly, secondary endpoints related to sleep measures showed no significant changes in the duration of light/deep sleep (coffee [min]: 242.2, reference coffee [ref_C] 255.7 I energy drink: 237.5, reference energy drink [ref_E] 261.3), time awake (coffee 22.7, ref_C 23.4 I energy drink 21.3, ref_E 18.9), time to fall asleep/wake up (coffee 4.2, ref_C 4.0 I energy drink 4.4, ref_E 2.7), or average heart rate (coffee [bpm] 62.2, ref_C 62.1 I energy drink 62.6, ref_E 62.3)—neither between the two intervention groups nor compared to the reference period. However, self-assessed sleep quality revealed a decrease in perceived sleep quality, with reports of poor sleep increasing by 8% after coffee consumption (rather bad/very bad sleeping quality: 29.7%) and 20% after energy drink consumption (46.6%), compared to baseline data (21.6%). Conclusions: The SleepSmart study introduces wearable sleep tracking as an innovative, low-interference method for objectively recording sleep data. While wearable data did not indicate significant sleep deterioration in the group of young, healthy adults, caffeine appeared to negatively impact the subjective perception of sleep in the study cohort. Full article

(This article belongs to the Special Issue Nutrients: 15th Anniversary)

49 pages, 4393 KiB

Open AccessReview

Neuro-Nutritional Approach to Neuropathic Pain Management: A Critical Review

by Giorgia Cominelli, Francesca Sulas, Daniela Pinto, Fabio Rinaldi, Gaia Favero and Rita Rezzani

Nutrients 2025, 17(9), 1502; https://doi.org/10.3390/nu17091502 - 29 Apr 2025

Abstract

Pain is a significant global public health issue that can interfere with daily activities, sleep, and interpersonal relationships when it becomes chronic or worsens, ultimately impairing quality of life. Despite ongoing efforts, the efficacy of pain treatments in improving outcomes for patients remains [...] Read more.

Pain is a significant global public health issue that can interfere with daily activities, sleep, and interpersonal relationships when it becomes chronic or worsens, ultimately impairing quality of life. Despite ongoing efforts, the efficacy of pain treatments in improving outcomes for patients remains limited. At present, the challenge lies in developing a personalized care and management plan that helps to maintain patient activity levels and effectively manages pain. Neuropathic pain is a chronic condition resulting from damage to the somatosensory nervous system, significantly impacting quality of life. It is partly thought to be caused by inflammation and oxidative stress, and clinical research has suggested a link between this condition and diet. However, these links are not yet well understood and require further investigation to evaluate the pathways involved in neuropathic pain. Specifically, the question remains whether supplementation with dietary antioxidants, such as melatonin, could serve as a potential adjunctive treatment for neuropathic pain modulation. Melatonin, primarily secreted by the pineal gland but also produced by other systems such as the digestive system, is known for its anti-inflammatory, antioxidant, and anti-aging properties. It is found in various fruits and vegetables, and its presence alongside other polyphenols in these foods may enhance melatonin intake and contribute to improved health. The aim of this review is to provide an overview of neuropathic pain and examine the potential role of melatonin as an adjunctive treatment in a neuro-nutritional approach to pain management. Full article

(This article belongs to the Special Issue Effects of Natural Bioactives on Pain and Neuroinflammation)

23 pages, 2196 KiB

Open AccessReview

Bioactive Components, Pharmacological Properties, and Applications of Cistanche deserticola Y. C. Ma: A Comprehensive Review

by Xiaofeng Liu, Zichao Yang, Minjun Han, Yao Zhang, Hussain Muhammad, Hao Zhong and Rongfa Guan

Nutrients 2025, 17(9), 1501; https://doi.org/10.3390/nu17091501 - 29 Apr 2025

Abstract

Cistanche deserticola Y. C. Ma (C. deserticola), a holoparasitic desert plant traditionally revered as “desert ginseng”, has emerged as a versatile resource with significant applications in both medicinal and dietary contexts. This comprehensive review systematically explores its bioactive constituents, including phenylethanol [...] Read more.

Cistanche deserticola Y. C. Ma (C. deserticola), a holoparasitic desert plant traditionally revered as “desert ginseng”, has emerged as a versatile resource with significant applications in both medicinal and dietary contexts. This comprehensive review systematically explores its bioactive constituents, including phenylethanol glycosides (PhGs), iridoids, lignans, and polysaccharides, and elucidates their multifaceted pharmacological properties. Contemporary research substantiates the therapeutic potential of C. deserticola, demonstrating its anti-inflammatory, antioxidant, antitumor, neuroprotective, and immunomodulatory effects. Mechanism analysis elucidated its anti-fatigue and immune-enhancing activities, primarily through the modulation of pivotal signaling pathways, including NF-κB, AMPK, and TLR4. The review also highlights recent regulatory advancements in China, which have approved C. deserticola as a functional food ingredient, complementing its traditional uses in kidney yang tonification and promoting intestinal health. Despite its promising attributes, challenges related to sustainable cultivation and clinical application remain. By integrating ethnopharmacological wisdom with modern scientific evidence, this work lays a robust foundation for advancing the applications of C. deserticola in nutraceuticals and therapeutics. Full article

(This article belongs to the Special Issue Antioxidants in Diet: Metabolic Impacts and Mechanisms of Action)

12 pages, 951 KiB

Open AccessArticle

The Impact of a Prolonged Multivitamin Shortage on Home Parenteral Nutrition Patients: A Single-Center Retrospective Cohort Study with Case Reports of Wernicke’s Encephalopathy

by Chanita Unhapipatpong, Natalie C. Lam, Christopher Wang, Katherine J. P. Schwenger, Celeste Arca, Ka-Wai Chin, Ann MacGillivray, Clement Yuen, Ian Pang and Johane P. Allard

Nutrients 2025, 17(9), 1500; https://doi.org/10.3390/nu17091500 - 29 Apr 2025

Abstract

Background/Objectives: Shortages in parenteral nutrition (PN) micronutrient components can lead to deficiencies in patients heavily relying on home PN (HPN) to meet nutritional requirements. Despite monitoring, this can cause severe and even life-threatening conditions if intravenous (IV) micronutrients are not available for [...] Read more.

Background/Objectives: Shortages in parenteral nutrition (PN) micronutrient components can lead to deficiencies in patients heavily relying on home PN (HPN) to meet nutritional requirements. Despite monitoring, this can cause severe and even life-threatening conditions if intravenous (IV) micronutrients are not available for a prolonged period. Methods: We conducted a retrospective study to evaluate the effect of an IV multivitamin shortage that occurred between December 2022 and July 2023. The study included patients at high risk for multivitamin deficiencies who received HPN for at least 5 days. Patients were classified into two groups: those compliant with instructions to take additional oral multivitamin supplements to compensate for the shortage and those who were not compliant. Monitoring included tracking symptoms and routine bloodwork, which measured certain vitamins, excluding thiamine. Results: A total of 25 HPN patients were identified. Among them, 56% (n = 14) were compliant with daily oral multivitamin supplementation. No significant differences in pre- and post-shortage bloodwork were observed, but there was a significant difference in bicarbonate changes between the compliant and non-compliant groups (0 (−0.9, 1) vs. −2 (−8, −1), p = 0.04, respectively). Approximately 68% of all patients reported new symptoms during the shortage, but no significant difference was observed between groups. Three patients known to have increased gastrointestinal losses (two compliant and one non-compliant) required hospitalization: two had Wernicke’s encephalopathy reversed with thiamine infusion. Conclusions: When IV multivitamins are unavailable for an extended period, at-risk patients need to be closely monitored by the HPN team, particularly for compliance to oral supplementation and for symptoms of thiamine deficiency when blood level monitoring is not feasible. Full article

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

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24 pages, 1361 KiB

Open AccessSystematic Review

Small Intestinal Bacterial Overgrowth and Pediatric Obesity—A Systematic Review

by Ana Maria Koller, Maria Oana Săsăran and Cristina Oana Mărginean

Nutrients 2025, 17(9), 1499; https://doi.org/10.3390/nu17091499 - 29 Apr 2025

Abstract

Background/Objectives: Childhood obesity is a growing global concern linked to metabolic disorders such as nonalcoholic fatty liver disease (NAFLD). Small intestinal bacterial overgrowth (SIBO) may exacerbate these conditions by promoting systemic inflammation and metabolic dysfunction. This review evaluates the prevalence of SIBO in [...] Read more.

Background/Objectives: Childhood obesity is a growing global concern linked to metabolic disorders such as nonalcoholic fatty liver disease (NAFLD). Small intestinal bacterial overgrowth (SIBO) may exacerbate these conditions by promoting systemic inflammation and metabolic dysfunction. This review evaluates the prevalence of SIBO in obese children, its association with inflammatory and metabolic markers, and the efficacy of diagnostic and therapeutic strategies. Methods: A systematic search of PubMed, Scopus, and Web of Science (2010–present) was conducted using Boolean operators: (‘small intestinal bacterial overgrowth’ OR ‘SIBO’) AND ‘prevalence’ AND (‘low-grade inflammatory markers’ OR ‘metabolic status’) AND ‘gut microbiome’ AND ‘dysbiosis’ AND ‘obese children’. Results: The data show that SIBO is frequently observed in obese pediatric populations and is associated with gut dysbiosis, impaired nutrient absorption, and reduced production of short-chain fatty acids. These changes contribute to increased intestinal permeability, endotoxemia, and chronic low-grade inflammation. Several microbial taxa have been proposed as biomarkers and therapeutic targets. Diagnostic inconsistencies persist, but treatments such as probiotics, prebiotics, dietary interventions, and selective antibiotics show potential, pending further validation. Conclusions: Early identification and treatment of SIBO with tailored strategies may help reduce metabolic complications and improve outcomes in children with obesity. Full article

(This article belongs to the Section Pediatric Nutrition)

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21 pages, 748 KiB

Open AccessReview

The Role of Plant-Based Nutrition and Exercise in Metabolic Syndrome: A Narrative Review

by James Stavitz, Ryan Porcelli and Jennifer Gentile

Nutrients 2025, 17(9), 1498; https://doi.org/10.3390/nu17091498 - 29 Apr 2025

Abstract

Background/Objectives: Metabolic syndrome (MetS) is a prevalent health condition characterized by central obesity, insulin resistance, hypertension, and dyslipidemia, increasing the risk of cardiovascular disease and type 2 diabetes. Lifestyle interventions, particularly plant-based nutrition and exercise, are essential for managing MetS. While both strategies [...] Read more.

Background/Objectives: Metabolic syndrome (MetS) is a prevalent health condition characterized by central obesity, insulin resistance, hypertension, and dyslipidemia, increasing the risk of cardiovascular disease and type 2 diabetes. Lifestyle interventions, particularly plant-based nutrition and exercise, are essential for managing MetS. While both strategies are well-documented independently, their synergistic effects remain less explored. This narrative review integrates findings from both domains to evaluate their combined impact on metabolic syndrome. The review examines the individual and combined impacts of plant-based nutrition and exercise on MetS-related metabolic dysfunction. Methods: A comprehensive review of 114 peer-reviewed studies was conducted to assess the role of plant-based diets and structured physical activity in improving insulin sensitivity, lipid profiles, inflammation, and weight management. Studies investigating the mechanisms through which dietary components and exercise modalities influence metabolic health were analyzed, along with behavioral and psychological factors affecting long-term adherence. Results: Plant-based diets, particularly those high in fiber, polyphenols, and healthy fats, improve glucose metabolism, reduce inflammation, and enhance cardiovascular health. Exercise complements these benefits by increasing insulin sensitivity, promoting fat oxidation, and improving lipid metabolism. When combined, plant-based nutrition and exercise provide superior metabolic outcomes, including greater reductions in visceral adiposity, improved endothelial function, and enhanced glycemic control. Conclusions: Plant-based nutrition and structured exercise are effective strategies for managing MetS. Their synergistic effects highlight the importance of integrated lifestyle interventions for long-term metabolic health. Full article

(This article belongs to the Special Issue Nutrition and Exercise in the Prevention and Treatment of Chronic Diseases)

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14 pages, 2084 KiB

Open AccessArticle

Validation of Two Portion Size Estimation Methods for Use with the Global Diet Quality Score App

by Mourad Moursi, Marieke Vossenaar, Joanne E. Arsenault, Winnie Bell, Mario Chen and Megan Deitchler

Nutrients 2025, 17(9), 1497; https://doi.org/10.3390/nu17091497 - 29 Apr 2025

Abstract

Background/Objectives: The Global Diet Quality Score (GDQS) was developed to provide crucial information on diet quality. The GDQS app standardizes the collection of GDQS data using portion size estimation at the food group level with 3D cubes of pre-defined size. Playdough was [...] Read more.

Background/Objectives: The Global Diet Quality Score (GDQS) was developed to provide crucial information on diet quality. The GDQS app standardizes the collection of GDQS data using portion size estimation at the food group level with 3D cubes of pre-defined size. Playdough was proposed as a possible alternative method. This validation study assessed whether the GDQS obtained using cubes or playdough with the GDQS app was equivalent to the GDQS estimated by weighed food records (WFRs) for the same 24 h reference period. Methods: We used a repeated measures design where 170 participants aged 18 years or older estimated portion sizes using both the WFR and the GDQS app with cubes and playdough. To assess the equivalence between the GDQS-WFR and GDQS-cubes or GDQS-playdough, we utilized the paired two one-sided t-test (TOST), with 2.5 points pre-specified as the equivalence margin. We used the Kappa coefficient to quantify agreement between WFR, risk of poor diet quality outcomes, and food group consumption using the cubes or playdough. Results: GDQS-WFR, GDQS-cubes, and GDQS-playdough were all equivalent within the pre-specified 2.5-point margin (p = 0.006 for cubes and p < 0.001 for playdough). The cubes (κ = 0.5685, p < 0.0001) and playdough (κ = 0.5843, p < 0.0001) showed moderate agreement with WFR when classifying individuals at risk of poor diet quality outcomes. There was substantial to almost perfect agreement between the cubes and playdough methods and WFR for 22 out of the 25 GDQS food groups. Liquid oils exhibited the lowest agreement (κ = 0.059, 27.7% agreement, p = 0.009). Conclusions: Using the GDQS app with cubes or playdough was equivalent to the WFR in assessing diet quality as measured by GDQS. These findings contribute to the growing body of research, validating simplified tools for dietary assessment and paving the way for more frequent evaluations of diet quality. Full article

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

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