Nutrients

25 pages, 5079 KB

Open AccessArticle

Saussurea involucrata Cultures for High-Altitude Illness: Enhancing Hypoxia Tolerance and Protecting Against Acute/Chronic Hypoxic Injury

by Jinyu Zhao, Yutong Li, Fan Wang, Kangjie Jia, Ge Lou, Huihui Shao, Mingji Jin, Zhonggao Gao, Xianfu Wu and Shuangqing Wang

Nutrients 2026, 18(4), 556; https://doi.org/10.3390/nu18040556 (registering DOI) - 7 Feb 2026

Abstract

Objective: To systematically evaluate the potential of Saussurea involucrata cultures (SICs) against high-altitude illness under hypobaric hypoxia and establish a progressive experimental evidence chain covering acute hypoxia tolerance enhancement and acute/chronic hypoxic injury protection. Methods: A tiered experimental strategy was employed. Key [...] Read more.

Objective: To systematically evaluate the potential of Saussurea involucrata cultures (SICs) against high-altitude illness under hypobaric hypoxia and establish a progressive experimental evidence chain covering acute hypoxia tolerance enhancement and acute/chronic hypoxic injury protection. Methods: A tiered experimental strategy was employed. Key findings were derived from primary rat models of acute (5500 m, 8 h) and chronic intermittent (5500 m, 8 h/d, 4–8 weeks) hypobaric hypoxia. A mouse acute tolerance model (10,000 m lethality, closed-system endurance) provided supplementary verification. Comprehensive analyses included survival, hemorheology, multi-organ function, and core mechanistic indicators of endothelial function and oxidative stress. Diamox, Rhodiola, and Compound Danshen Dripping Pills served as positive controls. Normoxic/hypoxic blank groups served as negative controls. Results: SICs significantly enhanced acute hypoxia tolerance in mice. In the rat models, SICs demonstrated dose-dependent and selective regulation of the endothelial–oxidative stress/hemorheology axis. Specifically, it downregulated endothelin-1, upregulated nitric oxide, enhanced total antioxidant capacity, and improved chronic hypoxia-induced blood hyperviscosity. Medium doses showed consistent optimal efficacy. SICs had limited effects on macroscopic organ remodeling. Conclusions: The core protective effect of SICs lies in enhancing hypoxic tolerance and selectively modulating the interconnected pathways of endothelial function, oxidative stress, and microcirculatory health. This mechanistic profile supports its potential as a preventive or early adjuvant intervention for high-altitude illness, providing a systematic preclinical foundation for translational development. Full article

(This article belongs to the Special Issue Functional Foods in the Prevention and Treatment of Metabolic Disorders)

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17 pages, 1155 KB

Open AccessReview

Using Plant-Derived Polysaccharides in the Management of Cognitive Disorders: Molecular and Clinical Perspectives

by Yandong Li, Linlin Du, Mengyuan Wang, Xingyu He, Zongsuo Liang and Jingling Liu

Nutrients 2026, 18(4), 555; https://doi.org/10.3390/nu18040555 (registering DOI) - 7 Feb 2026

Abstract

Background: Cognitive disorders are a class of neurological diseases characterized by declines in cognitive function, imposing a heavy physical and mental burden on middle-aged and elderly individuals. Since the underlying mechanisms of cognitive disorders are not yet fully understood, and different types of [...] Read more.

Background: Cognitive disorders are a class of neurological diseases characterized by declines in cognitive function, imposing a heavy physical and mental burden on middle-aged and elderly individuals. Since the underlying mechanisms of cognitive disorders are not yet fully understood, and different types of cognitive disorders may involve distinct mechanisms, the development of drugs with multi-target therapeutic and preventive effects is of great significance. Currently approved drugs for Alzheimer’s disease, such as acetylcholinesterase inhibitors and NMDA receptor antagonists, show limited efficacy and poor prognosis, highlighting the urgent need for safe and effective alternative treatments. Methods: Plant-derived polysaccharides (PDPs) possess antioxidant, anti-inflammatory, neuroprotective, and immunomodulatory activities, and polysaccharides derived from traditional Chinese medicine, in particular, show great potential for treating cognitive disorders. In recent years, interventions with plant polysaccharides that modulate the gut microbiota to affect the “gut–brain axis” and improve cognitive function have become an emerging research focus. Clinical evidence has also increasingly supported the beneficial effects of polysaccharides on cognitive disorders. Therefore, this study focuses on plant polysaccharides in the intervention of cognitive disorder-related diseases, including both in vivo and in vitro experiments, and summarizes existing findings according to different mechanisms of action. Results and Conclusions: Relevant clinical reports are incorporated to provide a theoretical basis and strong support for the development of polysaccharide-based interventions and new drug development for cognitive disorders. Full article

(This article belongs to the Section Carbohydrates)

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14 pages, 2196 KB

Open AccessArticle

Exploring the Immunomodulatory Effects of Agaricus bisporus Strains Using In Vitro and In Vivo Murine Models

by Willem Zwaan, Herman E. Popeijus, Johan J. P. Baars, Arend van Peer, Johan Garssen, Mara A. P. Diks, Betty C. A. M. van Esch, Arjen Schots and Jogchum Plat

Nutrients 2026, 18(4), 554; https://doi.org/10.3390/nu18040554 (registering DOI) - 7 Feb 2026

Abstract

Background/Objectives: This study evaluated the immunomodulatory effects of multiple A. bisporus strains, applying both in vitro and in vivo murine models and aiming to identify specific strains with immune modulatory properties. Methods: Sixteen A. bisporus strains were screened in a dendritic [...] Read more.

Background/Objectives: This study evaluated the immunomodulatory effects of multiple A. bisporus strains, applying both in vitro and in vivo murine models and aiming to identify specific strains with immune modulatory properties. Methods: Sixteen A. bisporus strains were screened in a dendritic cell (DC)–CD4⁺ T cell co-culture system, using cells from female C57BL/6 mice, for their capacity to induce Th1- and Th17-associated cytokine production. Based on these cytokine profiles, three potent strains (MES01856, MES01706, MES01637), one non-responder strain (MES01515), and the commercially available A15 strain were selected for investigation in a murine model, an ovalbumin (OVA)-induced allergic food allergy. In these sensitized female C3H/HeOuJ mice, ear swelling, anaphylactic shock scores, OVA-specific IgE, and serum mouse mast cell protease-1 (mMCP-1) were measured following an allergen challenge. Additionally, IL-6, IL-10, and TNF-α secretion from bone marrow-derived dendritic cells (BMDCs) was measured after stimulation with these A. bisporus fresh ground extracts (FGEs). Results: In vitro, increases in cytokine production were obtained, with MES01856, MES01706, and MES01637 identified as the most potent inducers. In vivo, OVA sensitization elicited significant ear swelling and elevated shock scores in the mice. Dietary supplementation with MES01706 or MES01515 significantly reduced ear swelling, while the other strains resulted in non-significant changes. No significant changes were observed in shock scores, OVA-specific IgE, or mMCP-1. Conclusions: Multiple different A. bisporus strains elicit specific immunomodulating effects both in vitro and in in vivo murine models, identifying the MES01706 strain as one with the highest potential to beneficially affect immune function. Full article

(This article belongs to the Section Nutritional Immunology)

23 pages, 576 KB

Open AccessReview

Single vs. Dual Agonist Pharmacotherapy for Managing Insufficient Weight Loss and Weight Regain Following Metabolic and Bariatric Surgery: A Comparative Review

by Claudia Reytor-González, Martín Campuzano-Donoso, Gerardo Sarno, Martha Montalvan, Raquel Horowitz, Gianluca Rossetti, Vincenzo Pilone, Luigi Barrea, Giovanna Muscogiuri, Luigi Schiavo and Daniel Simancas-Racines

Nutrients 2026, 18(4), 553; https://doi.org/10.3390/nu18040553 (registering DOI) - 7 Feb 2026

Abstract

Weight management after metabolic and bariatric surgery remains a persistent clinical challenge, particularly when patients experience insufficient weight loss or progressive weight regain following the postoperative nadir. In recent years, pharmacological therapies targeting gut-derived hormones have reshaped the therapeutic approach, offering nonsurgical strategies [...] Read more.

Weight management after metabolic and bariatric surgery remains a persistent clinical challenge, particularly when patients experience insufficient weight loss or progressive weight regain following the postoperative nadir. In recent years, pharmacological therapies targeting gut-derived hormones have reshaped the therapeutic approach, offering nonsurgical strategies that directly influence appetite regulation, satiety, and energy balance. Single agonists acting on the glucagon-like peptide one receptor have demonstrated meaningful reductions in body weight among postoperative patients, while dual agonists that target both the glucagon-like peptide one receptor and the glucose-dependent insulinotropic polypeptide receptor have shown even greater weight reduction in early studies, suggesting enhanced therapeutic potential. These benefits, however, must be interpreted within the unique anatomical, nutritional, and behavioral context of individuals who have undergone metabolic and bariatric procedures, as they are inherently at higher risk for micronutrient deficiencies, gastrointestinal intolerance, and maladaptive eating patterns. Successful treatment requires a balanced integration of pharmacotherapy, individualized nutritional guidance, psychological support, and a patient-centered model of long-term care. Although emerging evidence is promising, dedicated clinical trials are still needed to directly compare the efficacy, safety, and sustainability of single versus dual agonist therapies in postoperative populations. Furthermore, culturally sensitive dietary strategies and shared decision-making processes are essential to enhance adherence, optimize long-term outcomes, and ensure equitable access to treatment. Ultimately, these therapies represent a significant advance in addressing postoperative weight challenges, but their full potential will rely on comprehensive, multidisciplinary frameworks that support both biological and behavioral aspects of chronic weight management. Full article

(This article belongs to the Special Issue Diet and Nutrition in Bariatric Interventions)

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26 pages, 6577 KB

Open AccessArticle

Testing Motivational Appeals to Promote Legume-Enriched Foods

by Marco Gaetani, Valentina Carfora, Laura Picciafoco and Patrizia Catellani

Nutrients 2026, 18(4), 552; https://doi.org/10.3390/nu18040552 (registering DOI) - 7 Feb 2026

Abstract

Background/Objectives: Legume-enriched foods are conventional products reformulated with the addition of legumes and, as such, represent a sustainable alternative to animal proteins. This study investigated the effectiveness of messages based on different food choice motives to encourage search, consumption, and future intention to [...] Read more.

Background/Objectives: Legume-enriched foods are conventional products reformulated with the addition of legumes and, as such, represent a sustainable alternative to animal proteins. This study investigated the effectiveness of messages based on different food choice motives to encourage search, consumption, and future intention to consume these foods. Methods: The study involved a representative sample of 1361 Italian adults randomly assigned to one of seven experimental conditions (i.e., health, price, sensory appeal, natural content, convenience, sustainability, mood) or a control condition. Participants received three prefactual gain messages over one week. A moderated serial mediation model was estimated to test whether the effects of message exposure on future intention to consume were mediated by product search and consumption, and whether these effects varied according to participants’ baseline intention to replace animal food with plant-based alternatives (i.e., intenders vs. non-intenders). Results: Reading messages focusing on mood (B = 0.337, p = 0.021), sustainability (B = 0.441, p = 0.002), health (B = 0.333, p = 0.029), and convenience (B = 0.364, p = 0.017) were associated with increased intention to consume legume-enriched foods. However, only reading sustainability messages showed a positive serial indirect effect on intention via search and consumption (B = 0.036, p = 0.044), while reading mood messages was associated with increased intention via search only (B = 0.243, p = 0.048). Among non-intenders, reading mood and health messages were associated with increased intention only when they first stimulated search behavior. Conversely, among intenders, only reading sustainability messages was associated with increased consumption. Conclusions: These results demonstrate the persuasive power of sustainability appeals in promoting legume-enriched food consumption and support the effectiveness of using recommendation messages tailored to the recipient’s stage of change in terms of replacing animal food with plant-based alternatives. Full article

(This article belongs to the Special Issue Innovative Methodologies in Dietary Monitoring and Interventions: Technological Perspectives)

18 pages, 3644 KB

Open AccessReview

Adherence to the Mediterranean Diet and Dietary Potassium Intake: A Narrative Review of Epidemiological Evidence

by Lanfranco D’Elia, Saverio Stranges, Francesco P. Cappuccio, Pasquale Strazzullo and Ferruccio Galletti

Nutrients 2026, 18(4), 551; https://doi.org/10.3390/nu18040551 (registering DOI) - 7 Feb 2026

Abstract

Background. The Mediterranean dietary pattern (MDP) is recognised as one of the most evidence-based dietary models for the prevention of non-communicable diseases (NCDs). Its plant-rich composition suggests an inherently high potassium intake, yet epidemiological findings on the association between MDP adherence and potassium [...] Read more.

Background. The Mediterranean dietary pattern (MDP) is recognised as one of the most evidence-based dietary models for the prevention of non-communicable diseases (NCDs). Its plant-rich composition suggests an inherently high potassium intake, yet epidemiological findings on the association between MDP adherence and potassium intake remain heterogeneous. The present review aims to summarise and critically evaluate the available evidence on the association between adherence to the MDP and dietary potassium intake in the adult population. Methods. We conducted a narrative review of observational, longitudinal and interventional studies evaluating the relationship between MDP adherence and dietary potassium intake (self-reported assessment and/or 24 h urinary potassium). MEDLINE/PubMed was searched from inception to 30 October 2025, additional studies were identified by reference screening. Results. From a total of 263 studies retrieved, 10 eligible studies (7 cross-sectional, 1 longitudinal, 2 randomised controlled trials) from Europe, Asia and North America were synthesised. Questionnaire-based studies consistently indicated higher potassium intake with greater MDP adherence, whereas biomarker-based findings were more variable and often attenuated, particularly in studies relying on single or unvalidated 24 h urine collections and selected samples. Overall risk of bias was high for most observational studies, while randomised trials were generally rated as having some concerns. Conclusions. Higher MDP adherence is generally associated with higher potassium intake, but estimates vary by how MDP adherence is defined and scored, the potassium assessment method, and population context. Current evidence remains insufficient to quantify potassium’s potential contribution as a candidate mediator without formal mediation analyses and robust exposure assessment, including repeated validated 24 h urine collections. Standardised scoring, routine reporting of potassium, sodium, and the Na/K ratio, and triangulation across dietary, biomarker and intervention evidence are key priorities to strengthen inference. Full article

(This article belongs to the Special Issue Potassium Intake: Mechanisms and Health Outcomes)

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15 pages, 284 KB

Open AccessArticle

Association Between Fruit and Vegetable Intake and Skin Carotenoid Levels Among Japanese Adults in the Workplace

by Emiko Okada and Hidemi Takimoto

Nutrients 2026, 18(3), 550; https://doi.org/10.3390/nu18030550 - 6 Feb 2026

Abstract

Background/Objectives: Skin carotenoid measurements have been proposed as an indicator to reflect of fruit and vegetable intake, but evidence from occupational settings remains limited. The primary aim of this study was to assess the association between fruit and vegetable intake and skin carotenoid [...] Read more.

Background/Objectives: Skin carotenoid measurements have been proposed as an indicator to reflect of fruit and vegetable intake, but evidence from occupational settings remains limited. The primary aim of this study was to assess the association between fruit and vegetable intake and skin carotenoid levels in the workplace. The secondary aim was to examine the association of skin carotenoid levels with blood glucose levels and blood pressure (BP). Methods: This cross-sectional study included Japanese workers aged ≥20 years between 2022 and 2023. Skin carotenoid levels were measured, dietary intake was assessed using self-administered questionnaires, and data from workplace health check-up records were collected. Multiple regression analysis was conducted to examine the association between skin carotenoid levels and fruit and vegetable intake in 210 participants. Associations between skin carotenoid levels and log-transformed glycated haemoglobin (HbA1c), fasting blood glucose (FBG), systolic BP, and diastolic BP levels were examined in 162, 158, and 183 participants, respectively. Results: Skin carotenoid levels were positively associated with the number of vegetable dishes consumed and the frequency of fruit intake. A slight positive association was observed with HbA1c levels (partial regression coefficient = 0.00012), whereas no associations were found with FBG or BP. Conclusions: Skin carotenoid levels reflect self-reported fruit and vegetable intake, supporting their potential use as a non-invasive dietary assessment tool in workplace nutrition education. However, the associations observed with HbA1c were very small and of limited clinical significance, and the results should be interpreted with caution. Full article

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

22 pages, 10006 KB

Open AccessArticle

Hepatic UGT2B-Mediated Testosterone Clearance Promotes Lipid Accumulation in High-Fat-Diet-Induced MASLD

by Liping Zhou, Yingzhuan Zheng, Yujie Qiao, Xin Xu, Duoli Zhang, Yongqiong Shi, Yuanmeng Huang, Hongxiang Zeng, Ting Zeng, Xi Li and Linqiang Zhang

Nutrients 2026, 18(3), 549; https://doi.org/10.3390/nu18030549 - 6 Feb 2026

Abstract

Background and Objective: Male individuals diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) frequently present with decreased blood testosterone concentrations concomitant with increased levels of hepatic cholesterol, the fundamental substrate for testosterone synthesis; however, the mechanistic relationship between these phenomena remains inadequately [...] Read more.

Background and Objective: Male individuals diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) frequently present with decreased blood testosterone concentrations concomitant with increased levels of hepatic cholesterol, the fundamental substrate for testosterone synthesis; however, the mechanistic relationship between these phenomena remains inadequately elucidated. This study aimed to examine the involvement of hepatic cholesterol biosynthesis and testosterone metabolism in the pathogenesis of MASLD. Methods: An MASLD model was established in male C57BL/6J mice subjected to a high-fat diet (HFD). Comprehensive analyses, including hepatic transcriptomics, metabolomics, enzyme-linked immunosorbent assay, Western blotting, and quantitative polymerase chain reaction, were conducted. Additionally, in vitro experiments were performed using AML-12 hepatocytes treated with oleic acid and testosterone, with or without the presence of a uridine diphosphate-glucuronosyltransferase family 2 member B (UGT2B) enzyme inhibitor. Results: The HFD elevated cholesterol levels and activated cholesterol synthesis and testosterone metabolic pathways, notably characterized by upregulation of UGT2B enzymes and their transcriptional regulator, the aryl hydrocarbon receptor (AHR). Blood testosterone increased initially but decreased after 24 weeks of HFD. In vitro, testosterone alone did not affect oleic acid-induced lipid accumulation, but inhibiting UGT2B enabled testosterone levels to reduce lipid deposition and downregulate lipid uptake and synthesis pathways. Conclusions: The HFD induces dynamic, UGT2B-mediated hepatic testosterone metabolism. Compensatory early testosterone increase is offset by enhanced UGT2B-mediated clearance, resulting in eventual testosterone depletion and the loss of its protective effects against hepatic lipid accumulation. This explains the clinical paradox and suggests targeting the hepatic UGT2B enzymes as a potential MASLD treatment. Full article

(This article belongs to the Section Nutrition and Metabolism)

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17 pages, 3820 KB

Open AccessArticle

Dietary Polyphenols Curcumin and Resveratrol Exert Selective Anticancer Effects in Melanoma Cells

by Moon-Kyun Cho, Yeji Lee, Ki Dam Kim, Min Hyuk Choi, Sang-Han Lee, Dongsic Choi, Hae-Seon Nam and Yoon-Jin Lee

Nutrients 2026, 18(3), 548; https://doi.org/10.3390/nu18030548 - 6 Feb 2026

Abstract

Background/Objectives: Although curcumin (CUR) and resveratrol (RSV) are natural polyphenolic compounds with reported anticancer and anti-inflammatory properties, their combined anticancer effects in melanoma cells remain incompletely characterized. This study aimed to evaluate the anticancer efficacy of CUR and RSV, individually, and in combination, [...] Read more.

Background/Objectives: Although curcumin (CUR) and resveratrol (RSV) are natural polyphenolic compounds with reported anticancer and anti-inflammatory properties, their combined anticancer effects in melanoma cells remain incompletely characterized. This study aimed to evaluate the anticancer efficacy of CUR and RSV, individually, and in combination, in melanoma cells compared to normal melanocytes. Methods: Cell viability and intracellular ATP levels were quantified, and dose–response analyses performed. Cellular morphology and nuclear alterations were examined by phase-contrast microscopy and DAPI staining. Cell cycle distribution and apoptosis were analyzed by Muse™ Cell Analyzer with dedicated assay kits. Survival- and death-related signaling proteins were evaluated by Western blotting. Results: Combined treatment with CUR (60 μM) and RSV (40 μM) for 48 h synergistically reduced melanoma cell viability and markedly depleted intracellular ATP levels, while exerting minimal cytotoxic effects on normal melanocytes. CUR/RSV co-treatment induced pronounced morphological and nuclear alterations, significantly increased apoptotic cell populations, and modulated key signaling pathways regulating cell survival and programmed cell death in melanoma cells. Conclusions: These findings demonstrate that combined CUR and RSV treatment exerts enhanced, melanoma-selective anticancer activity while sparing normal melanocytes. The results provide a strong experimental rationale for further in vivo validation of CUR/RSV-based combination strategies as a potential therapeutic approach for melanoma. Full article

(This article belongs to the Special Issue Anti-Cancer and Anti-Inflammatory Effects of Antioxidant-Rich Natural Food)

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35 pages, 1564 KB

Open AccessReview

Cinnamon-Derived Phytonutrients as Modulators of Ion Channels and G Protein-Coupled Receptor Signaling in Metabolic Diseases

by Raymond Rubianto Tjandrawinata, Bayu Perkasa Rosari, Rony Abdi Syahputra, Reggie Surya and Fahrul Nurkolis

Nutrients 2026, 18(3), 547; https://doi.org/10.3390/nu18030547 - 6 Feb 2026

Abstract

Metabolic diseases such as type 2 diabetes and obesity are increasingly recognized as disorders of dysregulated cellular communication rather than solely enzymatic or transcriptional dysfunction. While conventional therapies primarily target metabolic enzymes and nuclear receptors, growing evidence highlights ion channels and G protein-coupled [...] Read more.

Metabolic diseases such as type 2 diabetes and obesity are increasingly recognized as disorders of dysregulated cellular communication rather than solely enzymatic or transcriptional dysfunction. While conventional therapies primarily target metabolic enzymes and nuclear receptors, growing evidence highlights ion channels and G protein-coupled receptors (GPCRs) at the cell membrane as critical upstream regulators of glucose homeostasis, energy expenditure, and inflammation. Cinnamon (Cinnamomum spp.), a widely consumed nutraceutical, has demonstrated consistent antidiabetic and antiobesity effects; however, its actions at the membrane signaling interface remain underappreciated. This review synthesizes emerging evidence that cinnamon-derived phytonutrients, particularly cinnamaldehyde, eugenol, and polyphenolic compounds, modulate key ion channels and GPCR pathways involved in metabolic regulation. We discuss how cinnamon influences calcium signaling, transient receptor potential (TRP) channels, and metabolite- and hormone-sensing GPCRs, thereby affecting insulin secretion, incretin release, appetite control, thermogenesis, and inflammatory tone. A central highlight of this review is the crosstalk between ion channels and GPCRs in metabolic tissues, illustrating a systems-level mechanism through which cinnamon exerts pleiotropic metabolic benefits. Translational implications are explored, including the potential of cinnamon to complement existing antidiabetic therapies and its relevance within precision nutrition frameworks. By focusing on the cell membrane as an integrative signaling hub, this review reframes cinnamon as a membrane-active nutraceutical capable of restoring metabolic balance through coordinated modulation of ion channel GPCR networks. Full article

(This article belongs to the Special Issue Nutritional Attributes and Health Implications of Novel, Non-Conventional, and Reformulated Foods)

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18 pages, 1042 KB

Open AccessArticle

Dietary and Lifestyle Factors Associated with Self-Esteem in Adolescents: An Exploratory Questionnaire-Based Study

by Andreea Sălcudean, Bianca-Eugenia Osz, Dora-Mihaela Cîmpian, Ramona-Amina Popovici, Cristina-Raluca Bodo, Sarolta Torok, Diana-Mihaela Corodan-Comiati, Raluca Dumache, Andreea-Mihaela Kiș, Mădălina-Gabriela Cincu, Lorena-Mihaela Grebenișan and Elena-Gabriela Strete

Nutrients 2026, 18(3), 546; https://doi.org/10.3390/nu18030546 - 6 Feb 2026

Abstract

Background: Self-esteem plays a central role in adolescent psychological health and may be shaped by everyday health behaviors such as eating patterns and engagement in physical activity. However, evidence from Eastern European youth remains comparatively limited. Lower levels of self-worth during adolescence have [...] Read more.

Background: Self-esteem plays a central role in adolescent psychological health and may be shaped by everyday health behaviors such as eating patterns and engagement in physical activity. However, evidence from Eastern European youth remains comparatively limited. Lower levels of self-worth during adolescence have been linked to increased vulnerability to maladaptive behaviors, including substance use. The present study aimed to explore preliminary associations between lifestyle behaviors, nutritional practices, and self-esteem in a sample of Romanian adolescents. Methods: A cross-sectional design was used, involving 113 participants aged 14–18 years. Self-esteem was assessed using the Rosenberg Self-Esteem Scale, while lifestyle behaviors were evaluated through a standardized questionnaire. Body mass index was calculated based on self-reported height and weight. Statistical analyses included Pearson correlation coefficients and multiple linear regression models. Results: Higher self-esteem scores were strongly associated with greater participation in physical activity and adherence to a balanced diet, while inverse relationships were observed with unhealthy dietary habits and higher BMI values. Physical activity emerged as the most influential predictor of self-esteem, accounting for over three-quarters of the variance in Rosenberg scale scores. Conclusions: In this preliminary analysis, physical activity and healthier dietary behaviors were associated with higher self-esteem scores among adolescents. Given the exploratory nature of the study, these findings should be interpreted with caution. They primarily serve to generate hypotheses and highlight the need for future studies with validated instruments, larger samples, and appropriate control for potential confounding factors to better elucidate the relationship between lifestyle behaviors and adolescent self-esteem. Full article

(This article belongs to the Special Issue Nutrition in Children's Growth and Development: 2nd Edition)

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24 pages, 3163 KB

Open AccessArticle

Eco-Anxiety Profiles, Religiosity, and Sustainable Nutrition in Turkish Adults: A Latent Profile and Network Analysis

by Sedat Arslan, Hande Ongun Yilmaz and Salim Yilmaz

Nutrients 2026, 18(3), 545; https://doi.org/10.3390/nu18030545 - 6 Feb 2026

Abstract

Background: Eco-anxiety is increasingly viewed as a multidimensional response to the climate crisis, but its links with religiosity and sustainable nutrition behaviors in highly religious settings are unclear. We identified eco-anxiety profiles in Turkish adults; compared religiosity, sustainable nutrition behaviors, and body mass [...] Read more.

Background: Eco-anxiety is increasingly viewed as a multidimensional response to the climate crisis, but its links with religiosity and sustainable nutrition behaviors in highly religious settings are unclear. We identified eco-anxiety profiles in Turkish adults; compared religiosity, sustainable nutrition behaviors, and body mass index (BMI) across profiles; and examined the multivariate network connecting these domains. Methods: This cross-sectional online survey in Türkiye included 1105 adults (69.3% women; age 25.8 ± 8.4 years; BMI 23.5 ± 4.5 kg/m²). Participants completed the Eco-anxiety Scale, Duke University Religion Index, and Behaviors Scale Toward Sustainable Nutrition. Latent profile analysis used four eco-anxiety subscales. Between-profile differences were tested using canonical discriminant analysis and Kruskal–Wallis tests. A Gaussian graphical model estimated with EBICglasso assessed network connectivity. Results: Four profiles emerged: High (11.9%), Moderate (54.8%), Affective-dominant (8.3%), and Low (24.9%). Compared with the Low profile, the High profile showed higher sustainable nutrition scores for food preference, seasonal/local nutrition, and food purchasing (all p < 0.05); however, effect sizes were small (η²_H = 0.008–0.014), indicating modest practical differences. BMI did not differ across profiles (p = 0.211). In the network, seasonal/local nutrition had the highest strength centrality, whereas BMI was peripheral and weakly connected to other nodes. Conclusions: Eco-anxiety was heterogeneous and showed modest associations with sustainable nutrition behaviors at the group level, without differences in BMI. These preliminary findings suggest that eco-anxiety may co-occur with more sustainable food-related choices, generating hypotheses for future replication. Full article

(This article belongs to the Special Issue Mega-Trend: Sustainable Nutrition and Human Health)

21 pages, 1294 KB

Open AccessSystematic Review

Preoperative Nutrition-Based Interventions in Children Undergoing Cardiac Surgeries—A Systematic Review and Meta-Analysis

by Agata Stróżyk, Piotr Halicki, Maciej Kołodziej, Andrea Horvath, Michał Buczyński and Radosław Pietrzak

Nutrients 2026, 18(3), 544; https://doi.org/10.3390/nu18030544 - 6 Feb 2026

Abstract

Objective: This systematic review aimed to evaluate the efficacy and safety of preoperative nutrition-based interventions on pre-, intra-, and postoperative outcomes in children undergoing cardiac surgical procedures. Methods: CENTRAL, MEDLINE, and EMBASE were systematically searched for interventional and observational studies comparing [...] Read more.

Objective: This systematic review aimed to evaluate the efficacy and safety of preoperative nutrition-based interventions on pre-, intra-, and postoperative outcomes in children undergoing cardiac surgical procedures. Methods: CENTRAL, MEDLINE, and EMBASE were systematically searched for interventional and observational studies comparing any nutritional preoperative intervention with a control or alternative strategy in pediatric patients undergoing cardiac surgery, up to July 2025. The main outcome was the postoperative length of stay in the intensive care unit (ICU). The certainty of evidence was assessed using the GRADE approach. Results: Nineteen studies were included (8 randomized controlled trials [RCTs], 1 non-randomized trial, and 10 observational studies), evaluating heterogeneous interventions or exposures, including fatty acids, vitamin D supplementation, and structured preoperative nutritional protocols. Two RCTs demonstrated shorter ICU and hospital stays with extended preoperative nutritional support (2 weeks vs. 1 week; n = 40; and 1 month vs. no support; n = 80). Observational data indicated an association between preoperative nutritional support and reduced hospital length of stay (meta-analysis of four studies; n = 278), as well as fewer days to achieve full enteral feeding postoperatively (meta-analysis of three studies; n = 138). No significant difference in postoperative ICU stay was observed between groups (meta-analysis of two studies; n = 175). No intervention-related serious adverse events were reported. The overall certainty of evidence was very low. Conclusions: This systematic review provides very low-certainty evidence suggesting that preoperative nutrition-based interventions in children undergoing cardiac surgery are safe and may offer clinical benefits. Substantial heterogeneity across studies underscores the need for well-designed trials and standardized preoperative nutritional protocols. PROSPERO number: CRD420251085196. Full article

(This article belongs to the Special Issue Perioperative Nutritional Intervention: Its Scope and Influence)

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24 pages, 442 KB

Open AccessReview

Multimodal Therapeutic Strategies for the Management of Sarcopenia and Frailty in Chronic Obstructive Pulmonary Disease: A Narrative Review

by Saoussen Naas, Monika Fekete, Gabriella Szendro, Tamas Komaromi, Zsolt Rozgonyi, Erik Palmer, Lorinc Polivka, Regina Bakos, Borbala Szalai, Veronika Muller and Janos Tamas Varga

Nutrients 2026, 18(3), 543; https://doi.org/10.3390/nu18030543 - 6 Feb 2026

Abstract

Introduction: Sarcopenia and frailty are prevalent yet under-recognized contributors to disability, impaired quality of life, and adverse outcomes in chronic obstructive pulmonary disease (COPD). Shared mechanisms, including systemic inflammation, hormonal dysregulation, malnutrition, and physical inactivity, render these syndromes important targets for multimodal intervention. [...] Read more.

Introduction: Sarcopenia and frailty are prevalent yet under-recognized contributors to disability, impaired quality of life, and adverse outcomes in chronic obstructive pulmonary disease (COPD). Shared mechanisms, including systemic inflammation, hormonal dysregulation, malnutrition, and physical inactivity, render these syndromes important targets for multimodal intervention. This review summarizes current evidence on exercise-based, nutritional, pharmacological, and adjunctive strategies for their management in COPD. Materials and Methods: This narrative review is based on a structured literature search of PubMed, Scopus, and Embase to identify relevant studies published between January 2000 and May 2025. Eligible publications included randomized controlled trials, meta-analyses, systematic reviews, and observational studies involving adults with COPD and documented sarcopenia and/or frailty. Interventions were categorized by modality, and outcomes included muscle mass, strength, physical performance, quality of life, and hospitalizations. Data were synthesized thematically. Results: Resistance and combined exercise training consistently improved muscle strength and physical function, while endurance training enhanced cardiorespiratory capacity, particularly within pulmonary rehabilitation programs. Nutritional interventions, especially protein, leucine, or β-hydroxy-β-methylbutyrate supplementation, supported gains in lean mass and exercise tolerance. Pharmacological strategies, including anabolic hormones and myostatin inhibitors, showed early promise but require further evaluation regarding safety and long-term efficacy. Adjunctive therapies, such as neuromuscular electrical stimulation and oxygen supplementation, benefited patients unable to participate in conventional exercise training. Conclusions: An integrated, multimodal approach combining structured exercise training and targeted nutritional support should be considered a cornerstone of COPD management to prevent and treat sarcopenia and frailty. Personalized rehabilitation strategies can substantially improve functional outcomes and quality of life, while future research should prioritize biomarker-guided personalization and long-term intervention studies. Full article

(This article belongs to the Special Issue Optimizing Respiratory Health Through Nutrition: From Prevention to Management)

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23 pages, 1031 KB

Open AccessReview

Fermented Foods and the Gut–Liver Axis: Modulation of MASLD Through Gut Microbiota

by Agnieszka Wesołek-Leszczyńska, Dawid Rosiejka, Kalina Bogdańska and Paweł Bogdański

Nutrients 2026, 18(3), 542; https://doi.org/10.3390/nu18030542 - 6 Feb 2026

Abstract

Background/Objectives: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a prevalent condition defined by hepatic fat accumulation, inflammation, and metabolic dysregulation. Current evidence demonstrates that gut microbiota and their metabolites are associated with MASLD pathogenesis. Fermented foods, rich in live microbes and bioactive [...] Read more.

Background/Objectives: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a prevalent condition defined by hepatic fat accumulation, inflammation, and metabolic dysregulation. Current evidence demonstrates that gut microbiota and their metabolites are associated with MASLD pathogenesis. Fermented foods, rich in live microbes and bioactive compounds, actively modulate the gut–liver axis and influence disease progression. This narrative review provides a comprehensive summary of current evidence on the impact of fermented foods on gut microbiota, intestinal barrier function, and gut–liver interactions, and demonstrates their potential role in preventing or mitigating MASLD. Methods: A comprehensive literature search of preclinical and clinical studies was conducted. Specifically, the review focused on fermented-food interventions, modulation of gut microbiota, metabolite production, and effects on hepatic metabolism and inflammation. Results: This review found that fermented foods provide probiotics, prebiotics, short-chain fatty acid (SCFAs), and bioactive compounds that enhance microbial diversity, improve intestinal barrier integrity, reduce endotoxemia, and modulate bile acid and lipid metabolism. Evidence from animal and human studies indicates that fermented food consumption can attenuate hepatic steatosis, inflammation, and metabolic dysregulation, with variability depending on individual microbiome composition. Conclusions: Altogether, these findings suggest that fermented foods represent a promising adjunctive dietary strategy for MASLD by modulating the gut–liver axis and supporting metabolic and hepatic health. Personalized approaches and further long-term clinical trials are required to optimize interventions and establish evidence-based recommendations. Full article

(This article belongs to the Special Issue Functional Foods in the Prevention and Treatment of Metabolic Disorders)

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13 pages, 837 KB

Open AccessArticle

High-Dose Zinc Supplementation Therapy Does Not Improve Survival Rates in Severe Trauma Patients: A Single-Center Retrospective Observational Study

by Ryota Tsushima, Takaaki Maruhashi, Muneyoshi Kim and Yasushi Asari

Nutrients 2026, 18(3), 541; https://doi.org/10.3390/nu18030541 - 6 Feb 2026

Abstract

Background/Objectives: Hypozincemia associated with severe trauma contributes to immune dysfunction and poor prognosis; however, the clinical utility and optimal dosage of zinc supplementation remain unclear. In particular, it is unclear whether high-dose administration exceeding standard recommendations improves prognosis. Thus, we aimed to verify [...] Read more.

Background/Objectives: Hypozincemia associated with severe trauma contributes to immune dysfunction and poor prognosis; however, the clinical utility and optimal dosage of zinc supplementation remain unclear. In particular, it is unclear whether high-dose administration exceeding standard recommendations improves prognosis. Thus, we aimed to verify this in patients with severe trauma requiring mechanical ventilation. Methods: This single-center retrospective observational study included patients with severe trauma (Injury Severity Score [ISS] > 15) requiring mechanical ventilation admitted to our emergency intensive care unit (ICU) between April 2015 and March 2023. Patients were classified into three groups based on their mean daily zinc supplementation dose: low (<15 mg), medium (15–50 mg), and high (>50 mg). The primary outcome was the 30-day survival rate. Secondary outcomes included the 90-day survival rate, length of ICU stay, and hospital-acquired pneumonia. Multivariable regression evaluated the association between high-dose zinc supplementation and clinical outcomes after adjusting for confounding factors. Results: Of 196 patients, 86, 16, and 94 were in the low-, medium-, and high-dose groups, respectively. The high-dose group had significantly poorer nutritional status and lower serum zinc levels, whereas no significant differences were observed in severity scores or study outcomes. High-dose zinc supplementation showed no significant association with improved 30-day survival in adjusted analyses. Conclusions: In patients with severe trauma requiring mechanical ventilation, high-dose zinc supplementation did not improve 30-day survival or other clinical outcomes compared with standard doses. These results do not support the use of high-dose zinc supplementation for severe trauma. Full article

(This article belongs to the Section Clinical Nutrition)

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16 pages, 234 KB

Open AccessArticle

Perspectives on Universal Free School Meals Among Rural Middle and High School Students: A Mixed-Methods Study

by Ashley Kesack, Michele Polacsek, Alexis Schneider and Juliana F. W. Cohen

Nutrients 2026, 18(3), 540; https://doi.org/10.3390/nu18030540 - 6 Feb 2026

Abstract

Background/Objectives: School meals play an important role in ensuring reliable, healthy access to food, but there are many barriers to participation, especially for rural students. This study examined the perceived impact of UFSM policies and the perceptions of school meals among students [...] Read more.

Background/Objectives: School meals play an important role in ensuring reliable, healthy access to food, but there are many barriers to participation, especially for rural students. This study examined the perceived impact of UFSM policies and the perceptions of school meals among students in rural areas of Maine. Methods: This mixed-methods study included surveys with n = 61 middle and high school students and interviews with n = 11 middle and high school students between 2023 and 2024. The surveys and interviews focused on potential impacts of UFSM policies as well as general barriers and facilitators to participation in school meals. Quantitative surveys were analyzed using logistic regression, adjusting for demographic characteristics. Interviews were analyzed using principles of content analysis. Results: Students reported that UFSM had multiple benefits, and many students perceived that providing free school meals for all helped reduce the stigma associated with school meals, in part through increased participation. Students liked the variety of foods offered, but many did not perceive school meals, especially breakfast, to be “fresh” or “healthy”. Additionally, many students perceived there to be long lunch lines and insufficient time to eat their meals. Conclusions: While students perceived multiple benefits to UFSM, opportunities to further improve the quality of school meals, as well as policies to ensure sufficient lunch period lengths, may be important complements to increase participation and consumption of school meals among rural students. Full article

(This article belongs to the Special Issue Shaping Healthy Nutrition and Lifestyles in Youth: Evidence from Schools, Camps and Community Programs)

21 pages, 1433 KB

Open AccessArticle

Effect of 21-Day Omega-3 Polyunsaturated Fatty Acid Supplementation on Exercise-Induced Secretory Factors and Inflammation Status in Young Men: A Randomized Double-Blind Trial

by Magdalena Konert, Paulina Brzezińska, Andrzej Kochanowicz, Elżbieta Piskorska, Błażej Stankiewicz, Ewa Polkowska, Tomasz Sledzinski, Adriana Mika, Jędrzej Antosiewicz and Jan Mieszkowski

Nutrients 2026, 18(3), 539; https://doi.org/10.3390/nu18030539 - 6 Feb 2026

Abstract

Objectives: The objective of this study was to evaluate the effect of 21-day dietary omega-3 fatty acid supplementation on the levels of postexercise inflammation response, oxidative stress, and selected exerkine secretion among physically active young men. Methods: In a randomized double-blind [...] Read more.

Objectives: The objective of this study was to evaluate the effect of 21-day dietary omega-3 fatty acid supplementation on the levels of postexercise inflammation response, oxidative stress, and selected exerkine secretion among physically active young men. Methods: In a randomized double-blind study, 24 physically active men were assigned to two groups: a supplementation group (n = 12), receiving 3250 mg of n-3 polyunsaturated fatty acids (PUFAs) daily, and a placebo group (n = 12). Blood samples were collected before and after twenty-one days of dietary supplementation to measure total fatty acids and inflammatory markers, including IL-1β, IL-6, IL-10, BDNF, and FGF23. Results: After 21 days of n-3 fatty acid supplementation, there were no significant changes in anaerobic performance parameters. However, significant interactions were found in the systemic immune-inflammation index (SII), FGF-23, IL-1β, IL-1Ra, IL-6, and IL-10 in response to exercise and supplementation. Conclusions: 21 days of n-3 fatty acid supplementation modified PUFA content and influenced inflammation status, but did not affect maximal anaerobic performance. Full article

(This article belongs to the Special Issue Omega-3 Polyunsaturated Fatty Acids in Human Health and Disease)

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22 pages, 1804 KB

Open AccessArticle

Green Ethanolic Repercolation of Larix decidua Needles: Phytochemical Profiling and In Vivo Modulation of the Oxidative–Nitrosative Axis in Acute Sterile Inflammation

by Dinu Bolunduț, Alina Elena Pârvu, Cristina Moldovan, Florica Ranga, Marcel Pârvu, Ciprian Ovidiu Dalai, Mădălina Țicolea, Andra Diana Cecan and Raluca Maria Pop

Nutrients 2026, 18(3), 538; https://doi.org/10.3390/nu18030538 - 5 Feb 2026

Abstract

Background/Objectives: Larix decidua has been used in traditional medicine for the treatment of various inflammatory conditions. Although their use has been recognized in alternative medicine, the scientific documentation of the antioxidant and anti-inflammatory potential of ethanolic extracts from its needles remains insufficiently [...] Read more.

Background/Objectives: Larix decidua has been used in traditional medicine for the treatment of various inflammatory conditions. Although their use has been recognized in alternative medicine, the scientific documentation of the antioxidant and anti-inflammatory potential of ethanolic extracts from its needles remains insufficiently characterized. The present study aimed to characterize the phytochemical profile of the ethanolic L. decidua extract, evaluate its in vitro antioxidant capacity, and investigate its therapeutic and prophylactic effects on oxidative–nitrosative stress and inflammation. Methods: L. decidua needles were extracted using a modified Squibb repercolation method. Polyphenol and flavonoid content were quantified, and individual phenols were identified by HPLC-DAD-ESI⁺. The in vitro antioxidant activity was evaluated using DPPH, FRAP, H₂O₂, and NO scavenging assays. The therapeutic and prophylactic in vivo potential was evaluated in a model of acute inflammation induced with turpentine in male Wistar rats. Serum oxidative markers (TOS, TAC, OSI, MDA, AOPP, 8-OHdG, NO, 3-NT, SH) and inflammatory markers (NFκB-p65, IL-1β, IL-18) were quantified. Results: The extract contained high levels of flavonols and hydroxybenzoic acids; kaempferol glycosides and catechin were the dominant constituents. In vitro, the extract exhibited radical scavenging activities. In vivo, L. decidua attenuated oxidative and nitrosative stress, restored antioxidant defense, and reduced NFκB-p65, IL-1β, and IL-18 levels in a concentration-dependent manner. The L100 concentration most closely approximated the values produced by Trolox and diclofenac. Conclusions: The ethanolic Larix decidua needle extract exerted antioxidant and anti-inflammatory effects in a rat model of acute sterile inflammation, attenuating systemic oxidative–nitrosative stress and pro-inflammatory mediators in a concentration-dependent manner. These preclinical findings support further investigation of standardized L. decidua needle preparations as polyphenol-rich nutraceutical/functional ingredient candidates within preventive and adjunct nutrition strategies targeting oxidative stress-driven inflammation. Full article

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

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