Nutrients

16 pages, 1157 KB

Open AccessEditor’s ChoiceArticle

The Effects of Combined Scutellaria and Saffron Supplementation on Mood Regulation in Participants with Mild-to-Moderate Depressive Symptoms: A Randomized, Double-Blind, Placebo-Controlled Study

by Valérie Dormal, Marlène Suchareau, Sylvie Copine, Laurent Simar and Louise Deldicque

Nutrients 2025, 17(5), 809; https://doi.org/10.3390/nu17050809 - 26 Feb 2025

Cited by 4 | Viewed by 23338

Abstract

Background/Objectives: The global prevalence of mental health disorders, particularly anxiety and depression, has increased significantly, with rates further elevated by the COVID-19 pandemic. Conventional pharmacological treatments, while effective, often lead to side effects that can impact patient adherence and quality of life. This [...] Read more.

Background/Objectives: The global prevalence of mental health disorders, particularly anxiety and depression, has increased significantly, with rates further elevated by the COVID-19 pandemic. Conventional pharmacological treatments, while effective, often lead to side effects that can impact patient adherence and quality of life. This has driven interest in safer, natural adjunctive therapies. Crocus sativus L. (Iridaceae) (saffron) and Scutellaria baicalensis Georgi (Lamiaceae) (scutellaria) have individually shown potential, in humans and animals, respectively, as mood regulators, with bioactive compounds that modulate neurotransmitter systems and possess anti-inflammatory and anxiolytic effects. This study aimed (1) to explore the efficacy and safety of scutellaria extracts in humans and (2) to test a possible synergistic effect when combining scutellaria and saffron on mood regulation in individuals experiencing mild-to-moderate depressive symptoms. Methods: In a randomized, double-blind, placebo-controlled trial, 180 participants with mild-to-moderate depressive symptoms were assigned to receive either scutellaria extract alone (SCUTELL’UP^®), saffron extract alone (SAFFR’ACTIV^®), a combination of scutellaria and saffron extracts (SAFFR’UP^®), or a placebo for six weeks. The primary outcome was assessed using a standardized depression scale (Beck Depression Inventory). The secondary outcomes, including anxiety, emotional state, well-being level, and sleep quality, were all assessed using validated questionnaires. Safety and tolerability were evaluated throughout the study period. Results: The results confirmed the beneficial effects of saffron extract on depressive and anxious symptoms, as well as its role in improving sleep quality. For the first time in humans, scutellaria extract demonstrated a positive effect on mood regulation. Furthermore, a synergistic effect of the combination of these two extracts was identified, leading to enhanced improvements in depressive and anxious symptoms and emotional well-being among individuals with mild-to-moderate depression, compared to the placebo group. Minimal adverse effects were reported across all treatment groups. Conclusions: This natural adjunctive nutritional strategy offers a promising alternative for individuals seeking safer options for mental health support. Further research is warranted to exclude potential long-term side effects and to explore potential mechanisms of this combined supplementation. Full article

(This article belongs to the Section Nutrition and Neuro Sciences)

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13 pages, 760 KB

Open AccessEditor’s ChoiceReview

Nutrition and Lifestyle Interventions in Managing Dyslipidemia and Cardiometabolic Risk

by Hygerta Berisha, Reham Hattab, Laura Comi, Claudia Giglione, Silvia Migliaccio and Paolo Magni

Nutrients 2025, 17(5), 776; https://doi.org/10.3390/nu17050776 - 23 Feb 2025

Cited by 18 | Viewed by 15617

Abstract

Dyslipidemia, characterized by abnormal blood lipid levels, is a major public health concern due to its association with atherosclerotic cardiovascular disease (ASCVD) and other cardiometabolic disorders. In this context, appropriate nutrition patterns are pivotal as they represent the basic approach for providing a [...] Read more.

Dyslipidemia, characterized by abnormal blood lipid levels, is a major public health concern due to its association with atherosclerotic cardiovascular disease (ASCVD) and other cardiometabolic disorders. In this context, appropriate nutrition patterns are pivotal as they represent the basic approach for providing a wide range of substantial advantages. The best evidence for dyslipidemia management is offered by the Mediterranean Diet, the Plant-Based Diet, the High-Fiber Diet and the Anti-inflammatory Diet, while the DASH Diet and the Ketogenic Diet have also been shown to target additional pathological features like hypertension and other comorbidities. The bioactive compounds that are enriched in these nutrition patterns and able to manage dyslipidemia include monounsaturated fatty acids such as ω-3, polyphenols such as oleuropein, resveratrol, flavonoids, and catechins, carotenoids, phytosterols and soluble and unsoluble fibers. Diets rich in these compounds can improve lipid profile by mitigating oxidative stress, reducing low-grade chronic inflammation, modulating macronutrient absorption and other mechanisms, thereby supporting cardiovascular health. Additionally, lifestyle interventions such as regular physical activity, weight loss, reduced alcohol consumption and smoking cessation further ameliorate lipid metabolism and manage circulated lipid profile. Furthermore, emerging insights from nutrigenomics underscore the potential for proper diet to address genetic factors and optimize treatment outcomes. The pivotal role of nutrition interventions in the context of dyslipidemia and its cardiometabolic implications is discussed in this review, emphasizing evidence-based and personalized approaches. Full article

(This article belongs to the Special Issue Diet, Adipose Tissue and Diabetes)

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20 pages, 1888 KB

Open AccessEditor’s ChoiceArticle

The Cholesterol Paradox in Long-Livers from a Sardinia Longevity Hot Spot (Blue Zone)

by Alessandra Errigo, Maria Pina Dore, Michele Portoghese and Giovanni Mario Pes

Nutrients 2025, 17(5), 765; https://doi.org/10.3390/nu17050765 - 21 Feb 2025

Cited by 1 | Viewed by 27697

Abstract

Background/Objectives: Hypercholesterolemia is commonly viewed as a risk factor for coronary heart disease; however, several studies have reported an inverse relationship between cholesterol levels and cardiovascular mortality, particularly in older adults. This “cholesterol paradox” challenges the conventional understanding of lipid metabolism. Despite [...] Read more.

Background/Objectives: Hypercholesterolemia is commonly viewed as a risk factor for coronary heart disease; however, several studies have reported an inverse relationship between cholesterol levels and cardiovascular mortality, particularly in older adults. This “cholesterol paradox” challenges the conventional understanding of lipid metabolism. Despite often being dismissed as a result of reverse causality, the precise causes of this paradox remain poorly understood. This study aimed to investigate the potential existence of the cholesterol paradox in a long-lived population from central Sardinia, Italy. Methods: We recruited 168 baseline nonagenarians (81 males, 87 females) from the longevity Blue Zone area in 2018 and followed them until December 2024. The lipid profile was determined for all participants according to current guidelines, and its impact on survival was analyzed with Kaplan–Meier curves and Cox proportional hazards regression models. Results: The median total cholesterol was 199.5 (range 89–314) mg/dL in males and 202.5 (range 89–324) mg/dL in females. Survival time was significantly longer in participants with LDL cholesterol (LDL-C) above 130 mg/dL compared to that in nonagenarians with LDL-C lower than 130 mg/dL (3.82 ± 1.88 years vs. 2.79 ± 1.56 years, p < 0.0001). Cox regression analysis revealed a significant reduction in the hazard ratio (HR) for mortality in participants with mild hypercholesterolemia (LDL-C ≥ 130 mg/dL) compared to that in those with normal cholesterol (OR 0.600, 95%CI 0.405–0.891). Conclusions: In the long-lived population examined, the cholesterol paradox was unlikely to be a reflection of reverse causality. Our results challenge the common view that longevity is invariably associated with low cholesterol levels. Furthermore, moderate hypercholesterolemia does not preclude the oldest adult from attaining advanced ages, contrary to common belief. Full article

(This article belongs to the Section Geriatric Nutrition)

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19 pages, 664 KB

Open AccessEditor’s ChoiceArticle

In Vitro Evaluation of Bioavailability of Mg from Daily Food Rations, Dietary Supplements and Medicinal Products from the Polish Market

by Piotr Bawiec, Agnieszka Jaworowska, Jan Sawicki, Marcin Czop, Radosław Szalak and Wojciech Koch

Nutrients 2025, 17(5), 748; https://doi.org/10.3390/nu17050748 - 20 Feb 2025

Cited by 1 | Viewed by 18720

Abstract

Background: Nutrients consumed with food undergo the digestion process, and only some of them are absorbed from the gastrointestinal tract (GI) and enter the bloodstream. Minerals, including Mg, are crucial for maintaining the body’s homeostasis, but their beneficial effect depends on their bioavailability, [...] Read more.

Background: Nutrients consumed with food undergo the digestion process, and only some of them are absorbed from the gastrointestinal tract (GI) and enter the bloodstream. Minerals, including Mg, are crucial for maintaining the body’s homeostasis, but their beneficial effect depends on their bioavailability, i.e., the part that can be absorbed and used by the body. The bioavailability of nutrients taken in pharmaceutical form is usually higher than the same nutrients contained in food, because their absorption requires prior release from the food matrix. Objectives: The main objective of the conducted research was to assess the bioavailability of Mg from dietary supplements and medicinal products, considering the influence of the type of diet and pharmaceutical form on bioavailability. Methods: The experiments were conducted using a previously developed and optimized two-stage in vitro digestion model using cellulose dialysis tubes and ICP-OES method. The influence of three types of diets—standard, basic and high-residue—on the bioavailability of Mg was evaluated. Results: The bioavailability of Mg from the studied diets was within the range of 48.74–52.51%. Conclusions: In the models studied, it was observed that the factors influencing bioavailability were the nutritional composition of the diets and the chemical form of Mg. Full article

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

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31 pages, 2477 KB

Open AccessEditor’s ChoiceReview

The Power of Environment: A Comprehensive Review of the Exposome’s Role in Healthy Aging, Longevity, and Preventive Medicine—Lessons from Blue Zones and Cilento

by Silvana Mirella Aliberti and Mario Capunzo

Nutrients 2025, 17(4), 722; https://doi.org/10.3390/nu17040722 - 18 Feb 2025

Cited by 10 | Viewed by 9010

Abstract

Aging and longevity are shaped by the exposome, a dynamic network of environmental, social, and biological factors. Understanding how these exposures interact with biological mechanisms can inform strategies for healthier aging. Background/Objectives: This review explores the exposome as a dynamic system encompassing [...] Read more.

Aging and longevity are shaped by the exposome, a dynamic network of environmental, social, and biological factors. Understanding how these exposures interact with biological mechanisms can inform strategies for healthier aging. Background/Objectives: This review explores the exposome as a dynamic system encompassing both protective and risk factors, with a specific focus on how beneficial environmental exposures, microbiome diversity, lifestyle behaviors, and resilience mechanisms contribute to successful aging. By analyzing high-longevity populations, such as the Blue Zones and Cilento, it aims to identify common determinants of successful aging. Methods: A mixed-method study was conducted, combining a systematic review of the English literature (2003–2024) with a comparative analysis of longevity regions. A structured search was performed in PubMed, Scopus, and Google Scholar using keywords such as “longevity”, “Blue Zones”, “Cilento”, “microbiome”, “environmental factors”, and related terms. Additionally, qualitative and quantitative analysis were applied to assess key protective factors across different aging models. Results: This study identified key factors contributing to successful aging in longevity hotspots, including sustained exposure to biodiverse natural environments, adherence to Mediterranean or plant-based diet rich in polyphenols and probiotics, regular physical activity, strong social networks, and psychological resilience. A novel aspect of this review is the role of the gut microbiome as a mediator between environmental exposures and immune–metabolic health, influencing inflammation modulation and cellular aging. Despite geographic and cultural differences, case studies reveal a shared pattern of protective factors that collectively enhance lifespan and healthspan. Conclusions: The exposome is a critical determinant of aging trajectories, acting through complex interactions between environmental and biological mechanisms. By integrating insights from high-longevity populations, this mixed-method study proposes a comprehensive framework for optimizing microbiome health, enhancing resilience, and promoting protective environmental exposures. These findings provide a translational perspective to guide future interventions in aging research and global health initiatives. Full article

(This article belongs to the Special Issue The Interdependence of Nutrition and Mental Well-Being)

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26 pages, 2854 KB

Open AccessEditor’s ChoiceReview

Magnesium and Migraine

by Ligia J. Dominguez, Nicola Veronese, Shaun Sabico, Nasser M. Al-Daghri and Mario Barbagallo

Nutrients 2025, 17(4), 725; https://doi.org/10.3390/nu17040725 - 18 Feb 2025

Cited by 8 | Viewed by 32586

Abstract

Migraine is a widespread and intricate neurological condition that involves various factors and is marked by recurring headache episodes. Migraine is among the ten neurological conditions accounting for the greatest disability in the whole population, the leading cause of disability for children and [...] Read more.

Migraine is a widespread and intricate neurological condition that involves various factors and is marked by recurring headache episodes. Migraine is among the ten neurological conditions accounting for the greatest disability in the whole population, the leading cause of disability for children and adolescents aged 5–19 years, and the second cause of disability for adults aged 20–59 years. Magnesium deficiency is also a very common condition resulting from diverse reasons, including insufficient dietary consumption or increased loss through the gastrointestinal or renal system. Accumulated evidence from case reports, case–control studies, observational studies, and randomized, placebo-controlled trials has shown the effectiveness of magnesium supplementation in alleviating migraine, both acutely and chronically. Mechanisms that may help explain these results include the potential link between magnesium deficit and spreading cortical depression, vascular changes, oxidative stress, chronic inflammation, nervous excitation, neurotransmitter release, and electrolyte imbalances. This article aims to provide a comprehensive review of the available evidence on the links between magnesium and migraine, considering the role of magnesium in the pathogenesis of migraine and the utility of magnesium in its prevention and treatment. Full article

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

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17 pages, 315 KB

Open AccessEditor’s ChoiceArticle

Adherence to the Mediterranean Diet in Spanish University Students: Association with Lifestyle Habits, Mental and Emotional Well-Being

by Gloria Tomás-Gallego, Josep María Dalmau-Torres, Raúl Jiménez-Boraita, Javier Ortuño-Sierra and Esther Gargallo-Ibort

Nutrients 2025, 17(4), 698; https://doi.org/10.3390/nu17040698 - 15 Feb 2025

Cited by 11 | Viewed by 3817

Abstract

Background: The Mediterranean Diet is recognized as one of the healthiest dietary patterns; however, in recent years, a decline in adherence has been observed in Mediterranean countries. University students represent a particularly vulnerable population, as starting university introduces new influences and responsibilities [...] Read more.

Background: The Mediterranean Diet is recognized as one of the healthiest dietary patterns; however, in recent years, a decline in adherence has been observed in Mediterranean countries. University students represent a particularly vulnerable population, as starting university introduces new influences and responsibilities that directly impact their lifestyle and health. Objective: Analyze adherence to the Mediterranean Diet among university students and its association with other lifestyle habits and mental and physical health indicators. Methods: A cross-sectional study was conducted with a sample of 1268 students (23.65 ± 7.84 years) from a university in northern Spain between November 2020 and March 2021. An online questionnaire was administered to assess Mediterranean Diet adherence along with variables such as perceived stress, self-esteem, life satisfaction, suicidal behavior, emotional and behavioral problems, emotional intelligence, physical activity, sedentary behavior, alcohol consumption, and compulsive internet use. Results: 29.26% of students had high adherence to the Mediterranean Diet. Regression analysis indicated that high adherence was associated with higher levels of emotional intelligence, as well as lower levels of suicidal ideation, emotional problems, and compulsive internet use. Conclusions: The associations found between Mediterranean Diet and other indicators and lifestyle habits highlight the need for interdisciplinary promotion strategies within the university ecosystem. Full article

(This article belongs to the Special Issue The Impact of Children’s and Adolescents’ Diet, Nutrition and Lifestyle Habits on Physical and Mental Health: From the Latest Perspective)

12 pages, 983 KB

Open AccessEditor’s ChoiceSystematic Review

Umbrella Review of Systematic Reviews and Meta-Analyses on the Consumption of Different Food Groups and the Risk of Overweight and Obesity

by Emilie Kristoffersen, Sofie Lassen Hjort, Lise M. Thomassen, Elaheh Javadi Arjmand, Matteo Perillo, Rajiv Balakrishna, Anindita Tasnim Onni, Ida Sofie Karlsen Sletten, Antonello Lorenzini and Lars T. Fadnes

Nutrients 2025, 17(4), 662; https://doi.org/10.3390/nu17040662 - 13 Feb 2025

Cited by 11 | Viewed by 8125

Abstract

Background/Objectives: Dietary choices play an essential role in energy balance and weight gain. This systematic umbrella review investigates the association between the intake of various food groups (whole grains, refined grains, fruits, vegetables, nuts, legumes, fish, eggs, total dairy, red meat, white meat, [...] Read more.

Background/Objectives: Dietary choices play an essential role in energy balance and weight gain. This systematic umbrella review investigates the association between the intake of various food groups (whole grains, refined grains, fruits, vegetables, nuts, legumes, fish, eggs, total dairy, red meat, white meat, processed meat, added sugar, and sugar-sweetened beverages) and their associations to the risk of obesity and being overweight. Methods: We systematically searched Medline, Embase, Web of Science, and Epistemonikos for systematic reviews and meta-analyses. A total of 2925 articles were screened, and 13 articles were included in our analysis. Results: For each food group, data included a mean of 166,100 participants and 36,760 cases, ranging from 19,885 participants and 7183 cases for red meat to 520,331 participants and 91,256 cases for nuts. Heterogeneity was high for most of the food groups except for whole grains and sugar-sweetened beverages. The quality of the most comprehensive meta-analyses was high for all food groups, except for processed meats, which was of low quality. High intakes of whole grains, legumes, nuts, and fruits are associated with a reduced risk of overweight and obesity. In contrast, high intakes of red meat and sugar-sweetened beverages are associated with increased risk of overweight and obesity. No significant results were found for the remaining food groups, and no meta-analysis was found for fish, eggs, white meat, and added sugars. Conclusions: Diets rich in whole grains, legumes, nuts, and fruits are associated with a lower risk of developing obesity and being overweight. In contrast, diets high in red meat and sugar-sweetened beverages are associated with an increased risk of overweight and obesity. Full article

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

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43 pages, 9268 KB

Open AccessEditor’s ChoiceReview

L-Arginine and Nitric Oxide in Vascular Regulation—Experimental Findings in the Context of Blood Donation

by Natalia Kurhaluk and Halina Tkaczenko

Nutrients 2025, 17(4), 665; https://doi.org/10.3390/nu17040665 - 13 Feb 2025

Cited by 22 | Viewed by 18697

Abstract

This narrative review provides an analysis of the role of nitric oxide (NO) and its precursors, particularly L-arginine, in vascular regulation and health, with an emphasis on findings from our experimental research in animal models. NO serves as a critical mediator of vascular [...] Read more.

This narrative review provides an analysis of the role of nitric oxide (NO) and its precursors, particularly L-arginine, in vascular regulation and health, with an emphasis on findings from our experimental research in animal models. NO serves as a critical mediator of vascular function, contributing to vasodilation, the regulation of blood flow, and the prevention of thrombosis. As a primary precursor of NO, L-arginine is essential for maintaining endothelial integrity, modulating mitochondrial function, and reducing oxidative damage. This review synthesises the data and contextualises these findings within the physiological challenges faced by blood donors, such as repeated blood donation and associated oxidative stress. It examines the effects of L-arginine supplementation on mitochondrial respiration, lipid peroxidation, and microsomal oxidation in different conditions, including differences in age, gender, and dietary interventions. The mechanisms by which L-arginine enhances NO production, improves vascular elasticity, and alleviates endothelial dysfunction caused by reduced NO bioavailability are also investigated. By integrating experimental findings with insights from the existing literature, this review provides a perspective on the potential of L-arginine supplementation to address the specific physiological needs of blood donors. It highlights the importance of personalised nutritional approaches in enhancing donor recovery and vascular resilience. In addition, this review assesses the wider implications of L-arginine supplementation in mitigating oxidative stress and preserving vascular function. The interplay between NO bioavailability, dietary factors, and physiological adaptation in blood donors is highlighted, along with the identification of current knowledge gaps and recommendations for future research. By presenting both original experimental evidence and a critical synthesis of the literature, this article highlights the therapeutic potential of NO precursors, particularly L-arginine, in promoting vascular health in the context of blood donation. Full article

(This article belongs to the Section Proteins and Amino Acids)

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21 pages, 1410 KB

Open AccessEditor’s ChoiceReview

The Influence of Physical Exercise, Ketogenic Diet, and Time-Restricted Eating on De Novo Lipogenesis: A Narrative Review

by Antonio Paoli

Nutrients 2025, 17(4), 663; https://doi.org/10.3390/nu17040663 - 13 Feb 2025

Cited by 11 | Viewed by 14465

Abstract

De novo lipogenesis (DNL) is a metabolic pathway that converts carbohydrates into fatty acids, primarily occurring in the liver and, to a lesser extent, in adipose tissue. While hepatic DNL is highly responsive to dietary carbohydrate intake and regulated by insulin via transcription [...] Read more.

De novo lipogenesis (DNL) is a metabolic pathway that converts carbohydrates into fatty acids, primarily occurring in the liver and, to a lesser extent, in adipose tissue. While hepatic DNL is highly responsive to dietary carbohydrate intake and regulated by insulin via transcription factors like SREBP-1c, adipose DNL is more modest and less sensitive to dietary overfeeding. Dysregulated DNL contributes to metabolic disorders, including metabolic dysfunction-associated steatotic liver disease (MASLD). Lifestyle interventions, such as physical exercise, ketogenic diets, and time-restricted eating (TRE) offer promising strategies to regulate DNL and improve metabolic health. Physical exercise enhances glucose uptake in muscles, reduces insulin levels, and promotes lipid oxidation, thereby suppressing hepatic DNL. Endurance and resistance training also improve mitochondrial function, further mitigating hepatic triglyceride accumulation. Ketogenic diets shift energy metabolism toward fatty acid oxidation and ketogenesis, lower insulin, and directly downregulate lipogenic enzyme activity in the liver. TRE aligns feeding with circadian rhythms by optimizing AMP-activated protein kinase (AMPK) activation during fasting periods, which suppresses DNL and enhances lipid metabolism. The combined effects of these interventions demonstrate significant potential for improving lipid profiles, reducing hepatic triglycerides, and preventing lipotoxicity. By addressing the distinct roles of the liver and adipose DNL, these strategies target systemic and localized lipid metabolism dysregulation. Although further research is needed to fully understand their long-term impact, these findings highlight the transformative potential of integrating these approaches into clinical practice to manage metabolic disorders and their associated complications. Full article

(This article belongs to the Special Issue Effect of Dietary, Nutrition and Physical Activity on Body Composition)

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42 pages, 684 KB

Open AccessEditor’s ChoiceReview

The Influence of Dietary Patterns on Polycystic Ovary Syndrome Management in Women: A Review of Randomized Controlled Trials with and Without an Isocaloric Dietary Design

by Yeonjeong Choi, Kyeonghoon Kang, Minkyung Je, Young-Min Lee and Yoona Kim

Nutrients 2025, 17(4), 674; https://doi.org/10.3390/nu17040674 - 13 Feb 2025

Cited by 1 | Viewed by 16507

Abstract

Polycystic ovary syndrome (PCOS) is an endocrine disorder that causes cardiometabolic and reproductive disorders in women of reproductive age. Women with PCOS are more likely to have obesity, type 2 diabetes mellitus, and cardiovascular disease. There is an inconclusive consensus on which dietary [...] Read more.

Polycystic ovary syndrome (PCOS) is an endocrine disorder that causes cardiometabolic and reproductive disorders in women of reproductive age. Women with PCOS are more likely to have obesity, type 2 diabetes mellitus, and cardiovascular disease. There is an inconclusive consensus on which dietary modification could be most effective in PCOS prevention and treatment. This review aimed to examine the effects of diverse dietary patterns on PCOS in women according to randomized controlled trials (RCTs) with and without an isocaloric dietary design. A literature search was performed in the PubMed^®®/MEDLINE^®® database up to 14 November 2024. A total of 21 RCTs were reviewed after screening the records, including 15 RCTs with a calorie-restricted dietary design and 6 RCTs with a non-calorie-restricted dietary design. This review found beneficial effects of the calorie-restricted Dietary Approaches to Stop Hypertension (DASH) diet on weight loss and glucose control in women with PCOS in four RCTs with an isocaloric dietary design. The calorie-restricted low-glycemic index (GI) diets from three RCTs and high-protein diets from four RCTs with an isocaloric dietary design showed no significant differences in anthropometric parameters, glucose control, lipids, and gonadal parameters compared with the control diet in women with PCOS. Non-calorie-restricted low-carbohydrate diets from four RCTs with an isocaloric dietary design showed similar results to the calorie-restricted low-GI diets and high-protein diets. However, the existing number of RCTs is insufficient to conclude the association between dietary patterns and PCOS in women. Further, well-designed dietary intervention studies are needed to assess the role of dietary patterns in PCOS beyond calorie restriction. Full article

(This article belongs to the Section Nutrition in Women)

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28 pages, 3110 KB

Open AccessEditor’s ChoiceReview

The Role of Dairy in Human Nutrition: Myths and Realities

by Laura Sanjulián, Salvador Fernández-Rico, Nerea González-Rodríguez, Alberto Cepeda, José Manuel Miranda, Cristina Fente, Alexandre Lamas and Patricia Regal

Nutrients 2025, 17(4), 646; https://doi.org/10.3390/nu17040646 - 11 Feb 2025

Cited by 11 | Viewed by 15912

Abstract

Milk is a highly complex food that contains all the nutrients necessary for the development of mammalian offspring. For millennia, humans have included milk and milk products as major components of their diet. However, the effect of the consumption of dairy products on [...] Read more.

Milk is a highly complex food that contains all the nutrients necessary for the development of mammalian offspring. For millennia, humans have included milk and milk products as major components of their diet. However, the effect of the consumption of dairy products on health has been a concern in recent years in terms of myths and realities. This review briefly describes the composition of bovine milk, the positive and negative effects that have been related to dairy products, and those aspects where the scientific evidence is still inconclusive. In addition to being nutritional, dairy products are a source of bioactive peptides, prebiotics and probiotics, fatty acids such as CLA, and fat globule membranes or have a protective effect against certain diseases. Negative effects include milk protein allergy or lactose intolerance. The effects of dairy products on certain cancers, such as prostate cancer, and their role in type II diabetes mellitus or weight gain are still inconclusive. Although the role of dairy products in cardiovascular risk is still inconclusive, recent meta-analyses have shown that dairy products may have a protective effect. Full article

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

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12 pages, 731 KB

Open AccessEditor’s ChoiceArticle

Impact of Polyphenol-Rich Nutraceuticals on Cognitive Function and Neuroprotective Biomarkers: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

by Juan Ángel Carrillo, Raúl Arcusa, Raquel Xandri-Martínez, Begoña Cerdá, Pilar Zafrilla and Javier Marhuenda

Nutrients 2025, 17(4), 601; https://doi.org/10.3390/nu17040601 - 7 Feb 2025

Cited by 16 | Viewed by 9689

Abstract

Background: Recent studies have highlighted the neuroprotective effects of polyphenols, particularly their role in enhancing brain-derived neurotrophic factor (BDNF) and cAMP response element-binding protein (CREB) activity. This study aimed to evaluate the relationship between BDNF and CREB levels and cognitive performance in individuals [...] Read more.

Background: Recent studies have highlighted the neuroprotective effects of polyphenols, particularly their role in enhancing brain-derived neurotrophic factor (BDNF) and cAMP response element-binding protein (CREB) activity. This study aimed to evaluate the relationship between BDNF and CREB levels and cognitive performance in individuals undergoing a polyphenol-rich dietary intervention. Methods: A randomized, crossover, double-blind, placebo-controlled clinical trial was conducted with 92 participants. The intervention involved the daily intake of an encapsulated concentrate of fruit, vegetable, and berry juice powders (Juice Plus+ Premium^®) over two 16-week periods, separated by a 4-week washout phase. Cognitive function was assessed using the Stroop Test, Trail Making Test, and Reynolds Intellectual Screening Test (RIST). The plasma levels of CREB and BDNF were measured using ELISA. Results: The polyphenol-rich product significantly improved cognitive performance, as evidenced by higher scores in the Stroop Test and RIST, compared to the placebo. Additionally, the plasma levels of CREB and BDNF were notably elevated in the product condition, indicating enhanced neuroprotective activity. Conclusions: The findings suggest that polyphenol-rich nutraceuticals can modulate neurobiological mechanisms underlying cognitive improvements, primarily through the reduction of oxidative stress and the regulation of signaling pathways associated with synaptic plasticity. These results support the potential of dietary polyphenols in promoting cognitive health and preventing neurodegenerative diseases. Full article

(This article belongs to the Special Issue Sensory Nutrition and Health Impact on Metabolic and Brain Disorders)

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15 pages, 890 KB

Open AccessEditor’s ChoiceArticle

An Evaluation of ChatGPT for Nutrient Content Estimation from Meal Photographs

by Cathal O’Hara, Gráinne Kent, Angela C. Flynn, Eileen R. Gibney and Claire M. Timon

Nutrients 2025, 17(4), 607; https://doi.org/10.3390/nu17040607 - 7 Feb 2025

Cited by 12 | Viewed by 10285

Abstract

Background/Objectives: Advances in artificial intelligence now allow combined use of large language and vision models; however, there has been limited evaluation of their potential in dietary assessment. This study aimed to evaluate the accuracy of ChatGPT-4 in estimating nutritional content of commonly [...] Read more.

Background/Objectives: Advances in artificial intelligence now allow combined use of large language and vision models; however, there has been limited evaluation of their potential in dietary assessment. This study aimed to evaluate the accuracy of ChatGPT-4 in estimating nutritional content of commonly consumed meals using meal photographs derived from national dietary survey data. Methods: Meal photographs (n = 114) were uploaded to ChatGPT and it was asked to identify the foods in each meal, estimate their weight, and estimate the nutrient content of the meals for 16 nutrients for comparison with the known values using precision, paired t-tests, Wilcoxon signed rank test, percentage difference, and Spearman correlation (r_s). Seven dietitians also estimated energy, protein, and carbohydrate content of thirty-eight meal photographs for comparison with ChatGPT using intraclass correlation (ICC). Results: Comparing ChatGPT and actual meals, ChatGPT showed good precision (93.0%) for correctly identifying the foods in the photographs. There was good agreement for meal weight (p = 0.221) for small meals, but poor agreement for medium (p < 0.001) and large (p < 0.001) meals. There was poor agreement for 10 of the 16 nutrients (p < 0.05). Percentage difference from actual values was >10% for 13 nutrients, with ChatGPT underestimating 11 nutrients. Correlations were adequate or good for all nutrients with r_s ranging from 0.29 to 0.83. When comparing ChatGPT and dietitians, the ICC ranged from 0.31 to 0.67 across nutrients. Conclusions: ChatGPT performed well for identifying foods, estimating weights of small portion sizes, and ranking meals according to nutrient content, but performed poorly for estimating weights of medium and large portion sizes and providing accurate estimates of nutrient content. Full article

(This article belongs to the Special Issue New Advances in Dietary Assessment)

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40 pages, 673 KB

Open AccessEditor’s ChoiceSystematic Review

Mediterranean Diet and Quality of Life in Adults: A Systematic Review

by Justyna Godos, Monica Guglielmetti, Cinzia Ferraris, Evelyn Frias-Toral, Irma Domínguez Azpíroz, Vivian Lipari, Andrea Di Mauro, Fabrizio Furnari, Sabrina Castellano, Fabio Galvano, Licia Iacoviello, Marialaura Bonaccio and Giuseppe Grosso

Nutrients 2025, 17(3), 577; https://doi.org/10.3390/nu17030577 - 5 Feb 2025

Cited by 44 | Viewed by 23939

Abstract

Background/Objectives: With the increasing life expectancy and, as a result, the aging of the global population, there has been a rise in the prevalence of chronic conditions, which can significantly impact individuals’ health-related quality of life, a multidimensional concept that comprises an individual’s [...] Read more.

Background/Objectives: With the increasing life expectancy and, as a result, the aging of the global population, there has been a rise in the prevalence of chronic conditions, which can significantly impact individuals’ health-related quality of life, a multidimensional concept that comprises an individual’s physical, mental, and social wellbeing. While a balanced, nutrient-dense diet, such as Mediterranean diet, is widely recognized for its role in chronic disease prevention, particularly in reducing the risk of cardiovascular diseases and certain cancers, its potential benefits extend beyond these well-known effects, showing promise in improving physical and mental wellbeing, and promoting health-related quality of life. Methods: A systematic search of the scientific literature in electronic databases (Pubmed/Medline) was performed to identify potentially eligible studies reporting on the relation between adherence to the Mediterranean diet and health-related quality of life, published up to December 2024. Results: A total of 28 studies were included in this systematic review, comprising 13 studies conducted among the general population and 15 studies involving various types of patients. Overall, most studies showed a significant association between adherence to the Mediterranean diet and HRQoL, with the most significant results retrieved for physical domains of quality of life, suggesting that diet seems to play a relevant role in both the general population and people affected by chronic conditions with an inflammatory basis. Conclusions: Adherence to the Mediterranean diet provides significant benefits in preventing and managing various chronic diseases commonly associated with aging populations. Furthermore, it enhances the overall health and quality of life of aging individuals, ultimately supporting more effective and less invasive treatment approaches for chronic diseases. Full article

(This article belongs to the Special Issue Mediterranean Diet and Chronic Diseases)

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36 pages, 2145 KB

Open AccessEditor’s ChoiceReview

Nutrients and Nutraceuticals from Vitis vinifera L. Pomace: Biological Activities, Valorization, and Potential Applications

by Cecilia Prata, Chiara Zalambani, Francesca Rossi, Simone Rossello, Teresa Cerchiara, Concettina Cappadone and Emil Malucelli

Nutrients 2025, 17(3), 583; https://doi.org/10.3390/nu17030583 - 5 Feb 2025

Cited by 11 | Viewed by 3715

Abstract

Grape pomace, also known as wine pomace, is a by-product of winemaking that has traditionally been discarded. However, recent studies have highlighted its rich nutritional and bioactive potential, positioning it as a promising resource for various applications in the functional food, pharmaceutical, and [...] Read more.

Grape pomace, also known as wine pomace, is a by-product of winemaking that has traditionally been discarded. However, recent studies have highlighted its rich nutritional and bioactive potential, positioning it as a promising resource for various applications in the functional food, pharmaceutical, and cosmetic sectors. This review explores the nutrient and nutraceutical contents of grape pomace, including its high levels of polyphenols, dietary fiber, vitamins, minerals, and melatonin. The biological activities of grape pomace, such as antioxidant, anti-inflammatory, antimicrobial, and anticancer effects, are also discussed, emphasizing its potential as raw material endowed with multifunctional properties. Additionally, the valorization of grape pomace as a food supplement and for the development of cosmetics is examined, focusing on its incorporation into dietary products and skincare formulations. The growing interest in the sustainable utilization of grape pomace is underscored, highlighting its significant role in promoting human health and contributing to a circular economy. Full article

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

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28 pages, 3873 KB

Open AccessEditor’s ChoiceReview

Management of Fibromyalgia: Novel Nutraceutical Therapies Beyond Traditional Pharmaceuticals

by Antonella Antonelli, Marzia Bianchi, Elizabeth Jane Fear, Luca Giorgi and Luigia Rossi

Nutrients 2025, 17(3), 530; https://doi.org/10.3390/nu17030530 - 31 Jan 2025

Cited by 8 | Viewed by 13352

Abstract

The pathophysiology of fibromyalgia, a condition that causes chronic pain throughout the body, involves abnormal pain signaling, genetic predispositions, and abnormal neuroendocrine function, significantly impairing quality of life. Fibromyalgia is commonly characterized by musculoskeletal pain, chronic fatigue, and severe sleep alterations. Changes in [...] Read more.

The pathophysiology of fibromyalgia, a condition that causes chronic pain throughout the body, involves abnormal pain signaling, genetic predispositions, and abnormal neuroendocrine function, significantly impairing quality of life. Fibromyalgia is commonly characterized by musculoskeletal pain, chronic fatigue, and severe sleep alterations. Changes in the central processing of sensory input and defects in endogenous pain inhibition could be the basis of enhanced and persistent pain sensitivity in individuals with fibromyalgia. The term central sensitivity syndrome was chosen as an umbrella term for fibromyalgia and related illnesses, including myalgic encephalomyelitis/chronic fatigue syndrome, migraine, and irritable bowel syndrome. Given the substantial impact of fibromyalgia on health, there is a need for new prevention and treatment strategies, particularly those involving bioavailable nutraceuticals and/or phytochemicals. This approach is particularly important considering the adverse effects of current fibromyalgia pharmaceutical treatments, such as antidepressants and anticonvulsants, which can lead to physical dependence and tolerance. Natural products have recently been considered for the design of innovative analgesics and antinociceptive agents to manage fibromyalgia pain. Polyphenols show promise in the management of neuropathic pain and fibromyalgia, especially considering how anti-inflammatory treatments, including corticosteroids and nonsteroidal medical drugs, are effective only when inflammatory processes coexist and are not recommended as the primary treatment for fibromyalgia. Full article

(This article belongs to the Special Issue The Role of Food Supplements in Human Health)

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17 pages, 948 KB

Open AccessEditor’s ChoiceReview

Consumption of Red Versus White Wine and Cancer Risk: A Meta-Analysis of Observational Studies

by Rachel K. Lim, Jongeun Rhee, Megan Hoang, Abrar A. Qureshi and Eunyoung Cho

Nutrients 2025, 17(3), 534; https://doi.org/10.3390/nu17030534 - 31 Jan 2025

Cited by 5 | Viewed by 17575

Abstract

Background/Objectives: While alcoholic beverage consumption increases cancer risk, red wine has been touted as a healthier option. To address this unexplored question, we conducted a meta-analysis to summarize evidence from observational studies. Methods: A literature search of PubMed and EMBASE through December 2023 [...] Read more.

Background/Objectives: While alcoholic beverage consumption increases cancer risk, red wine has been touted as a healthier option. To address this unexplored question, we conducted a meta-analysis to summarize evidence from observational studies. Methods: A literature search of PubMed and EMBASE through December 2023 identified studies examining wine and cancer risk. A random-effects meta-analysis was performed to estimate relative risks (RRs) and 95% confidence intervals (CIs) for an association between wine intake and overall cancer risk. Results: A total of 20 cohort and 22 case–control studies were included. Wine intake was not associated with overall cancer risk (n = 95,923) when comparing the highest vs. lowest levels of consumption, with no differences observed by wine type (red: summary RR = 0.98 [95% CI = 0.87, 1.10], white: 1.00 [0.91, 1.10]; P_difference = 0.74). However, white wine intake was significantly associated with an increased risk of cancer among women (white: 1.26 [1.05, 1.52], red: 0.91 [95% CI: 0.72, 1.16], P_difference = 0.03) and in analyses restricted to cohort studies (white: 1.12 [1.03, 1.22], red: 1.02 [95% CI: 0.96, 1.09], P_difference = 0.02). For individual cancer sites, there was a significant difference in associations between red and white wine intake only in skin cancer risk [6 studies, white: 1.22 (1.14, 1.30), red: 1.02 (0.95, 1.09); P_difference = 0.0003]. Conclusions: We found no differences in the association between red or white wine consumption and overall cancer risk, challenging the common belief that red wine is healthier than white wine. Our significant results related to white wine intake in subgroup analyses warrant further investigation. Full article

(This article belongs to the Special Issue Nutritional Epidemiology of Non-communicable Diseases—Feature Papers)

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26 pages, 861 KB

Open AccessEditor’s ChoiceReview

Health Effects and Therapeutic Potential of the Gut Microbe Akkermansia muciniphila

by Ezinne Aja, Amber Zeng, Weston Gray, Kaden Connelley, Anil Chaganti and Jonathan P. Jacobs

Nutrients 2025, 17(3), 562; https://doi.org/10.3390/nu17030562 - 31 Jan 2025

Cited by 17 | Viewed by 12826

Abstract

Akkermansia muciniphila is a bacterium commonly found in the human gastrointestinal tract that has received considerable interest as a potential probiotic for the improvement of gut health and overall metabolic function. A. muciniphila is enriched in the mucus layer of the intestinal lining, [...] Read more.

Akkermansia muciniphila is a bacterium commonly found in the human gastrointestinal tract that has received considerable interest as a potential probiotic for the improvement of gut health and overall metabolic function. A. muciniphila is enriched in the mucus layer of the intestinal lining, where it degrades mucin and plays a significant role in gut barrier maintenance and immune regulation. A higher abundance of A. muciniphila has been observed in the gut of healthy individuals relative to those with metabolic disorders, and multiple metabolic benefits, including improved glucose management, reduced body fat, and reduced inflammation have been linked to A. muciniphila. Current research on A. muciniphila primarily relies on mouse models, with limited human interventional studies available. While these animal studies offer valuable insights into the potential roles of A. muciniphila in health and disease, further clinical investigations in humans are needed to fully understand its impact. Here, we explore the current scope of A. muciniphila research and its potential as a therapeutic agent to improve gut and metabolic health while also emphasizing the need to optimize techniques to further improve studies of this organism. Full article

(This article belongs to the Section Prebiotics and Probiotics)

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10 pages, 764 KB

Open AccessEditor’s ChoiceArticle

Egg Consumption: Trends Over 48 Years, Patterns Across the Lifespan, and Predictors of Intake

by Donna Kritz-Silverstein and Ricki Bettencourt

Nutrients 2025, 17(3), 533; https://doi.org/10.3390/nu17030533 - 31 Jan 2025

Cited by 1 | Viewed by 11352

Abstract

Background/Objectives: Eggs are an excellent nutritional source. However, historical associations of dietary cholesterol with serum cholesterol and cardiovascular disease, along with restrictive dietary guidelines may have been barriers to egg consumption. This study examines trends over time, patterns, and predictors of egg consumption [...] Read more.

Background/Objectives: Eggs are an excellent nutritional source. However, historical associations of dietary cholesterol with serum cholesterol and cardiovascular disease, along with restrictive dietary guidelines may have been barriers to egg consumption. This study examines trends over time, patterns, and predictors of egg consumption in individuals followed for 48 years, and current barriers to usage. Methods: Participants were 6326 men and women enrolled in the Rancho Bernardo Study in 1972–1974 when asked about the number of eggs consumed/week. Subsequent egg intake was collected with food frequency questionnaires during clinic visits in 1988–1991 (n = 1627) and 1992–1996 (n = 1385), and with the original question on a 2021 mailed survey (n = 710), when barriers to intake were also queried. Results: The mean (±SD) number of eggs consumed was 3.6 ± 3.0 in 1972–1974, 1.8 ± 2.1 in 1988–1991, 1.8 ± 2.2 in 1992–1996, and 3.4 ± 3.5 in 2021. Comparisons within 5-year categories of enrollment age (<20, 20–24, 25–29, 30–34, 35–39, >40) showed no differences in egg intake between 1972 and 1974, and when older in 2021. Men consumed more eggs than women at all timepoints (p’s < 0.0001). High cholesterol and taking cholesterol-lowering medication were associated with lower egg consumption in 1972–1974 (p’s < 0.0001), but were not associated in 2021. Over 22% reported limiting egg intake in 2021; the majority cited cholesterol content of eggs or having high cholesterol as barriers. Conclusions: Egg consumption was responsive to dietary guidelines, decreasing over time then increasing by 2021 to levels similar to those of the early 1970s. Despite the abandonment of these guidelines, they continue to have a negative impact for a segment of society, suggesting the need for additional education on the health benefits of eggs. Full article

(This article belongs to the Section Nutritional Epidemiology)

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17 pages, 13800 KB

Open AccessEditor’s ChoiceReview

Low-FODMAP Diet for Irritable Bowel Syndrome: Insights from Microbiome

by Haoshuai Zhang and Qi Su

Nutrients 2025, 17(3), 544; https://doi.org/10.3390/nu17030544 - 31 Jan 2025

Cited by 6 | Viewed by 19601

Abstract

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder characterized by chronic abdominal pain, bloating, and altered bowel habits. Low-FODMAP diets, which involve restricting fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, have emerged as an effective dietary intervention for alleviating IBS symptoms. This review [...] Read more.

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder characterized by chronic abdominal pain, bloating, and altered bowel habits. Low-FODMAP diets, which involve restricting fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, have emerged as an effective dietary intervention for alleviating IBS symptoms. This review paper aims to synthesize current insights into the impact of a low-FODMAP diet on the gut microbiome and its mechanisms of action in managing IBS. We explore the alterations in microbial composition and function associated with a low-FODMAP diet and discuss the implications of these changes for gut health and symptom relief. Additionally, we examine the balance between symptom improvement and potential negative effects on microbial diversity and long-term gut health. Emerging evidence suggests that while a low-FODMAP diet can significantly reduce IBS symptoms, it may also lead to reductions in beneficial microbial populations. Strategies to mitigate these effects, such as the reintroduction phase and the use of probiotics, are evaluated. This review highlights the importance of a personalized approach to dietary management in IBS, considering individual variations in microbiome responses. Understanding the intricate relationship between diet, the gut microbiome, and IBS symptomatology will guide the development of more effective, sustainable dietary strategies for IBS patients. Full article

(This article belongs to the Special Issue Nutritional Therapy of Intestinal Diseases and Intestinal Microecology)

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27 pages, 4544 KB

Open AccessEditor’s ChoiceSystematic Review

Dietary Patterns, Oxidative Stress, and Early Inflammation: A Systematic Review and Meta-Analysis Comparing Mediterranean, Vegan, and Vegetarian Diets

by Sara Ilari, Stefania Proietti, Francesca Milani, Laura Vitiello, Carolina Muscoli, Patrizia Russo and Stefano Bonassi

Nutrients 2025, 17(3), 548; https://doi.org/10.3390/nu17030548 - 31 Jan 2025

Cited by 22 | Viewed by 14995

Abstract

Background: Dietary habits influenced by lifestyle and cultural factors play a critical role in health by modulating oxidative stress and inflammation. While diets offer significant benefits, they may also pose risks, such as nutrient deficiencies, emphasizing the need for a balanced approach. Exploring [...] Read more.

Background: Dietary habits influenced by lifestyle and cultural factors play a critical role in health by modulating oxidative stress and inflammation. While diets offer significant benefits, they may also pose risks, such as nutrient deficiencies, emphasizing the need for a balanced approach. Exploring Mediterranean and plant-based diet effects on oxidative stress and inflammation biomarkers may help improve health outcomes and disease prevention strategies. Methods: This study analyzed 65 studies following PRISMA guidelines to evaluate the effects of Mediterranean and plant-based diets on biomarkers of oxidative stress and inflammation in healthy individuals. Results: The Mediterranean diet was weakly associated with reductions in oxidative stress markers, including MDA (ROM: 0.80; 95% CI: 0.57–1.13; p = 0.2092) and 8OHdG (ROM: 0.81; 95% CI: 0.59–1.11; p = 0.1847), as well as inflammation markers such as CRP (ROM: 0.72; 95% CI: 0.42–1.23; p = 0.1545) and IL-6 (ROM: 1.23; 95% CI: 0.97–1.55; p = 0.08). The vegetarian diet significantly reduced CRP (ROM: 0.82; 95% CI: 0.69–0.98; p = 0.0297), while the vegan diet showed a borderline reduction (ROM: 0.81; 95% CI: 0.56–1.17; p = 0.2544), suggesting lower systemic inflammation compared to omnivorous diets. Conclusions: Although all three diets demonstrate potential in reducing oxidative stress and inflammation, the antioxidant effects—especially for the Mediterranean diet—are lower than anticipated, indicating alternative mechanisms. Further research is essential to confirm these findings and clarify the underlying mechanisms to enhance preventive health strategies. Full article

(This article belongs to the Section Nutritional Epidemiology)

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17 pages, 1840 KB

Open AccessEditor’s ChoiceArticle

Mango Consumption Is Associated with Increased Insulin Sensitivity in Participants with Overweight/Obesity and Chronic Low-Grade Inflammation

by Katherine D Pett, Peter Geevarghese Alex, Casey Weisfuss, Amandeep Sandhu, Britt Burton-Freeman and Indika Edirisinghe

Nutrients 2025, 17(3), 490; https://doi.org/10.3390/nu17030490 - 29 Jan 2025

Cited by 5 | Viewed by 18732

Abstract

Background/Objectives: Chronic low-grade inflammation is associated with insulin resistance and poor glycemic control, leading to the development of type 2 diabetes mellitus (T2DM). The present study investigated the effect of regular mango intake on inflammation and insulin sensitivity in participants with overweight or [...] Read more.

Background/Objectives: Chronic low-grade inflammation is associated with insulin resistance and poor glycemic control, leading to the development of type 2 diabetes mellitus (T2DM). The present study investigated the effect of regular mango intake on inflammation and insulin sensitivity in participants with overweight or obesity and chronic low-grade inflammation. Methods: A human clinical study was performed using a randomized, controlled, two-arm, parallel design with a 2 h oral glucose tolerance test (OGTT) administered before and after 4 weeks (4 W) of mango or control product intake (1 cup/twice a day). Fasting and time course blood sampling for 2 h post-OGTT were analyzed for effects on plasma metabolic and inflammation endpoints using analysis of covariance and repeated-measure approaches (SAS 9.4). Results: Forty-eight adults (37.6 ± 2.8 years, 30.5 ± 4.1 BMI kg/m²) completed the study. Markers of inflammation (IL-6, TNFα, hs-CRP) were not different at the end of 4 W (p > 0.05). The intervention did not significantly influence fasting glucose concentrations; however, insulin was significantly lowered with the mango compared to the control intervention (8.2 ± 1.2 vs. 15.3 ± 1.2 µIU/mL respectively, p = 0.05). Furthermore, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), along with the disposition index (DI), was significantly improved in the mango compared to the control interventions (HOMA-IR, 2.28 ± 1.19 vs. 4.67 ± 1.21, p = 0.03; DI, 2.76 ± 1.02 vs. 5.37 ± 1.03, p = 0.04). Mean insulin concentrations were also significantly lower at W4 compared to W0 after the OGTT in the mango vs. control intervention (intervention × week effect, p = 0.04). Relative expression of nuclear factor erythroid 2-related factor 2 (Nrf-2), a gene regulating endogenous antioxidant defense, was non-significantly increased twofold in the mango intervention (W4 vs. W0). Conclusions: Collectively, the data suggest that mango intake increased insulin sensitivity in individuals with chronic low-grade inflammation, possibly through activating Nrf-2 genes and increasing cellular antioxidant status. The data warrant further research on consuming mango fruit as part of a dietary pattern to address insulin resistance and the mechanisms underpinning the actions of mango intake. Full article

(This article belongs to the Special Issue Diet and Disease Development: Mechanisms, Prevention and Treatment—2nd Edition)

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16 pages, 596 KB

Open AccessEditor’s ChoiceArticle

Ultra-Processed Food Consumption and Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD): A Longitudinal and Sustainable Analysis

by Silvia García, Margalida Monserrat-Mesquida, Lucía Ugarriza, Miguel Casares, Cristina Gómez, David Mateos, Escarlata Angullo-Martínez, Josep A. Tur and Cristina Bouzas

Nutrients 2025, 17(3), 472; https://doi.org/10.3390/nu17030472 - 28 Jan 2025

Cited by 10 | Viewed by 3835

Abstract

Background: The rising prevalence of metabolic-dysfunction-associated steatotic liver disease (MASLD) is a significant health challenge, and the consumption of ultra-processed foods (UPFs) could play a key role. Aim: The aim is assess the impact of UPF consumption changes on the development and progression [...] Read more.

Background: The rising prevalence of metabolic-dysfunction-associated steatotic liver disease (MASLD) is a significant health challenge, and the consumption of ultra-processed foods (UPFs) could play a key role. Aim: The aim is assess the impact of UPF consumption changes on the development and progression of MASLD in adults. Design: This is a longitudinal study to assess how changes in UPF consumption affect liver fat and MASLD parameters over 6 months in 70 participants. Methods: Dietary intake was assessed using a validated food frequency questionnaire, and foods were classified according to the NOVA system. Participants were divided into three groups based on UPF consumption changes: maximum (T1), medium (T2), and minimum reduction (T3). Fatty liver parameters were assessed with magnetic resonance imaging and ultrasonography. Mediterranean diet (Med-diet) adherence and sociodemographic parameters were also recorded. The General Linear Model was used to determine relationships between UPF consumption, fatty liver disease parameters, and diet. Results: Participants in T1 experienced a 7.7% reduction in intrahepatic fat content (IFC) compared to 2.6% in T3. T1 showed increased Med-diet adherence and decreased meat and sweets consumption. The energy intake decreased by 605.3 kcal/day in T1, while T3 showed an increase of 209.5 kcal/day. Conclusions: Reducing UPF consumption leads to a decrease in IFC, associated with high Med-diet adherence and low calorie intake. Adopting these dietary patterns aligns with global sustainability goals and could further benefit MASLD patients by addressing environmental challenges alongside improving liver health. Full article

(This article belongs to the Special Issue Sustainability of Optimal Diets)

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20 pages, 677 KB

Open AccessEditor’s ChoiceReview

Dietary Habits, Obesity, and Bariatric Surgery: A Review of Impact and Interventions

by Mădălina Maxim, Radu Petru Soroceanu, Vlad Ionuț Vlăsceanu, Răzvan Liviu Platon, Mihaela Toader, Ancuța Andreea Miler, Alina Onofriescu, Irina Mihaela Abdulan, Bogdan-Mihnea Ciuntu, Gheorghe Balan, Felicia Trofin and Daniel Vasile Timofte

Nutrients 2025, 17(3), 474; https://doi.org/10.3390/nu17030474 - 28 Jan 2025

Cited by 14 | Viewed by 7111

Abstract

Eating behavior encompasses the psychological, physiological, and environmental factors influencing food intake. Dysregulation in eating behavior, such as emotional eating, binge eating, or loss of satiety signals, contributes to excessive caloric intake and weight gain. These behaviors are often linked to hormonal imbalances, [...] Read more.

Eating behavior encompasses the psychological, physiological, and environmental factors influencing food intake. Dysregulation in eating behavior, such as emotional eating, binge eating, or loss of satiety signals, contributes to excessive caloric intake and weight gain. These behaviors are often linked to hormonal imbalances, stress, or genetic predisposition. Obesity is a chronic, multifactorial disease characterized by excessive body fat accumulation, with a body mass index (BMI) ≥ 30 kg/m² often used for diagnosis. It is associated with significant morbidity, including type 2 diabetes, cardiovascular disease, and obstructive sleep apnea. Pathophysiological mechanisms underlying obesity include insulin resistance, leptin dysregulation, and altered gut microbiota, which perpetuate metabolic derangements. Lifestyle interventions remain first-line treatment, but sustained weight loss is challenging for many patients. Bariatric surgery is a therapeutic option for individuals with severe obesity (BMI ≥ 40 kg/m² or ≥35 kg/m² with comorbidities) who have failed conservative management. Procedures such as Roux-en-Y gastric bypass and sleeve gastrectomy alter gastrointestinal anatomy, promoting weight loss through restriction, malabsorption, and hormonal modulation (e.g., increased GLP-1 secretion). Bariatric surgery improves obesity-related comorbidities and enhances quality of life. However, it requires lifelong medical follow-up to address potential nutritional deficiencies and ensure sustainable outcomes. Full article

(This article belongs to the Special Issue Nutrition Support in Bariatric Surgery)

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28 pages, 928 KB

Open AccessEditor’s ChoiceSystematic Review

Dietary Supplementation for Fatigue Symptoms in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systematic Review

by Marie Celine Dorczok, Gloria Mittmann, Nilufar Mossaheb, Beate Schrank, Lucie Bartova, Matthias Neumann and Verena Steiner-Hofbauer

Nutrients 2025, 17(3), 475; https://doi.org/10.3390/nu17030475 - 28 Jan 2025

Cited by 4 | Viewed by 16581

Abstract

Background/Objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex neuroimmunological disorder with limited treatment options. Despite the widespread use of Dietary Supplements (DSs) among ME/CFS patients to alleviate fatigue and associated symptoms, evidence remains inconclusive. This systematic review aims to provide an [...] Read more.

Background/Objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex neuroimmunological disorder with limited treatment options. Despite the widespread use of Dietary Supplements (DSs) among ME/CFS patients to alleviate fatigue and associated symptoms, evidence remains inconclusive. This systematic review aims to provide an updated synthesis of the efficacy of DS interventions and explore possible mechanisms underlying their therapeutic effects. Methods: This systematic review was conducted according to PRISMA guidelines. Several databases (Ebsco Host, PubMed, Scopus, Google Scholar) were used for the systematic search, which was based on the broad search terms ME/CFS and DS with a focus on publications between 1994 and 2024. The primary outcome was fatigue, with additional considerations including psychological well-being, physical activity, and biochemical markers. Two independent researchers screened the studies for eligibility in a multi-stage process and assessed quality and bias using Cochrane’s risk of bias tools (RoB-2, ROBINS-I). Results: Fourteen studies (N = 809) of heterogeneous designs were included, showing a high risk of bias, mostly due to missing data and selection bias. While some interventions (L-carnitine and guanidinoacetic acid, oxaloacetate, CoQ10–selenium combination, NADH and NADH-CoQ10 combination) showed significant reductions in fatigue, methodological limitations, like small sample sizes and missing data, prevent firm conclusions. Mixed results were reported for secondary outcomes like cognitive function and inflammatory markers. Six studies noted adverse effects, including nausea and insomnia. Conclusions: Though some DSs showed potential in reducing fatigue in ME/CFS, methodological limitations and inconsistent results hinder definitive conclusions. Future research should improve diagnostic criteria and include more diverse populations. Full article

(This article belongs to the Section Clinical Nutrition)

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21 pages, 3591 KB

Open AccessEditor’s ChoiceArticle

Effects of Vegetable and Fruit Juicing on Gut and Oral Microbiome Composition

by Maria Luisa Savo Sardaro, Veronika Grote, Jennifer Baik, Marco Atallah, Katherine Ryan Amato and Melinda Ring

Nutrients 2025, 17(3), 458; https://doi.org/10.3390/nu17030458 - 27 Jan 2025

Cited by 4 | Viewed by 36528

Abstract

Background: In recent years, juicing has often been promoted as a convenient way to increase fruit and vegetable intake, with juice-only diets marketed for digestive cleansing and overall health improvement. However, juicing removes most insoluble fiber, which may diminish the health benefits of [...] Read more.

Background: In recent years, juicing has often been promoted as a convenient way to increase fruit and vegetable intake, with juice-only diets marketed for digestive cleansing and overall health improvement. However, juicing removes most insoluble fiber, which may diminish the health benefits of whole fruits and vegetables. Lower fiber intake can alter the microbiota, affecting metabolism, immunity, and mental health, though little is known about juicing’s specific effects on the microbiota. This study addresses this gap by exploring how juicing impacts gut and oral microbiome composition in an intervention study. Methods: Fourteen participants followed one of three diets—exclusive juice, juice plus food, or plant-based food—for three days. Microbiota samples (stool, saliva, and inner cheek swabs) were collected at baseline, after a pre-intervention elimination diet, immediately after juice intervention, and 14 days after intervention. Moreover, 16S rRNA gene amplicon sequencing was used to analyze microbiota taxonomic composition. Results: The saliva microbiome differed significantly in response to the elimination diet (unweighted UniFrac: F = 1.72, R = 0.06, p < 0.005; weighted UniFrac: F = 7.62, R = 0.23, p-value = 0.0025) with a significant reduction in Firmicutes (p = 0.004) and a significant increase in Proteobacteria (p = 0.005). The juice intervention diets were also associated with changes in the saliva and cheek microbiota, particularly in the relative abundances of pro-inflammatory bacterial families, potentially due to the high sugar and low fiber intake of the juice-related products. Although no significant shifts in overall gut microbiota composition were observed, with either the elimination diet or the juice intervention diets, bacterial taxa associated with gut permeability, inflammation, and cognitive decline increased in relative abundance. Conclusions: These findings suggest that short-term juice consumption may negatively affect the microbiota. Full article

(This article belongs to the Section Prebiotics and Probiotics)

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28 pages, 2730 KB

Open AccessEditor’s ChoiceReview

Minerals and Human Health: From Deficiency to Toxicity

by Mohammed S. Razzaque and Sunil J. Wimalawansa

Nutrients 2025, 17(3), 454; https://doi.org/10.3390/nu17030454 - 26 Jan 2025

Cited by 48 | Viewed by 31505

Abstract

Minerals are essential nutrients that play critical roles in human health by regulating various physiological functions. Examples include bone development, enzyme function, nerve signaling, and the immune response. Both the deficiencies and toxicities of minerals can have significant health implications. Deficiencies in macrominerals [...] Read more.

Minerals are essential nutrients that play critical roles in human health by regulating various physiological functions. Examples include bone development, enzyme function, nerve signaling, and the immune response. Both the deficiencies and toxicities of minerals can have significant health implications. Deficiencies in macrominerals such as calcium, magnesium, and phosphate can lead to osteoporosis (associated with falls and fractures), cardiovascular events, and neuromuscular dysfunction. Trace mineral deficiencies, such as iron and zinc. Selenium deficiency impairs oxygen transport, immune function, and antioxidant defenses, contributing to anemia, delaying wound healing, and increasing susceptibility to infectious diseases. Conversely, excessive intake of minerals can have severe health consequences. Hypercalcemia can cause kidney stones and cardiac arrhythmias as well as soft-tissue calcification, whereas excessive iron deposition can lead to oxidative stress and organ/tissue damage. Maintaining adequate mineral levels through a balanced diet, guided supplementation, and monitoring at-risk populations is essential for good health and preventing disorders related to deficiencies and toxicities. Public health interventions and education about dietary sources of minerals are critical for minimizing health risks and ensuring optimal well-being across populations. While a comprehensive analysis of all macro and micronutrients is beyond the scope of this article, we have chosen to focus on calcium, magnesium, and phosphate. We summarize the consequences of deficiency and the adverse events associated with the overconsumption of other minerals. Full article

(This article belongs to the Special Issue Mineral Nutrition on Human Health and Disease)

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16 pages, 1059 KB

Open AccessEditor’s ChoiceSystematic Review

Effects of Chewing Gum on Satiety, Appetite Regulation, Energy Intake, and Weight Loss: A Systematic Review

by Claudia Jiménez-ten Hoevel, Elisabet Llauradó, Rosa M. Valls, Maria Besora-Moreno, Judit Queral, Rosa Solà and Anna Pedret

Nutrients 2025, 17(3), 435; https://doi.org/10.3390/nu17030435 - 25 Jan 2025

Cited by 3 | Viewed by 15509

Abstract

Background: New approaches for the management of obesity, a worldwide problem and a major determinant of disability and mortality, are needed. Mastication influences appetite and satiety mechanisms via actual food or sham feeding. However, the effect of mastication of chewing gum, a type [...] Read more.

Background: New approaches for the management of obesity, a worldwide problem and a major determinant of disability and mortality, are needed. Mastication influences appetite and satiety mechanisms via actual food or sham feeding. However, the effect of mastication of chewing gum, a type of sham feeding, on appetite regulation has not yet been elucidated. Objectives: Our aim was to evaluate the influence of chewing gum on appetite regulation, satiety, energy intake, and weight loss via randomized controlled Trials. Methods: This study was conducted in accordance with the 2020 PRISMA guidelines, and the protocol was registered in PROSPERO (CRD42023432699). Electronic databases MEDLINE^®/PubMed, Scopus, and Cochrane Central Register of Controlled Trials were searched from July 2023 to September 2024. The quality of each included study was assessed using the Cochrane risk of bias tool, RoB 2. Results: A total of eight articles with nine RCTs were included in this systematic review. Seven out of nine RCTs evaluated appetite regulation. Five out of seven RCTs reported a significant suppressing effect of hunger, three out of five RCTs reported a significant reduction in desire to eat, and three out of four reported a significant reduction in the desire to eat a sweet snack, all of them compared to the control group. However, the effects on satiety, energy intake, and weight loss are not conclusive. Conclusions: Chewing gum could be a promising non-pharmacological tool for obesity management through appetite regulation; however, further research, with sustained RCTs evaluating the sustained effects of gum chewing on appetite and weight management, is needed. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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22 pages, 637 KB

Open AccessEditor’s ChoiceReview

Protective Effects of Sulforaphane Preventing Inflammation and Oxidative Stress to Enhance Metabolic Health: A Narrative Review

by Inês Alves, Edilene Maria Queiroz Araújo, Louise T. Dalgaard, Sharda Singh, Elisabet Børsheim and Eugenia Carvalho

Nutrients 2025, 17(3), 428; https://doi.org/10.3390/nu17030428 - 24 Jan 2025

Cited by 16 | Viewed by 17266

Abstract

The worldwide obesity epidemic has led to a drastic increase in diabetes and cardiovascular disease in younger generations. Further, maintaining metabolic health during aging is frequently a challenge due to poor diets and decreased mobility. In this setting, bioactive nutrients that are naturally [...] Read more.

The worldwide obesity epidemic has led to a drastic increase in diabetes and cardiovascular disease in younger generations. Further, maintaining metabolic health during aging is frequently a challenge due to poor diets and decreased mobility. In this setting, bioactive nutrients that are naturally occurring antioxidants, such as sulforaphane (SFN), are of high nutritional interest. SFN, a bioactive compound that is present in cruciferous vegetables, is a molecule that protects cells from cytotoxic damage and mitigates oxidative stress, protecting against disease. It exerts its action through the activation of the transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2). Many studies have been performed in animals and humans to evaluate its effects on cancer, brain health, and neurodegenerative disorders. However, fewer clinical studies have been performed to evaluate its effects on insulin resistance and the development of type 2 diabetes mellitus (T2DM) across the lifespan. Given that, in some parts of the world, particularly in Europe, the population is growing older at a significant rate, it is crucial to promote healthy habits (healthy foods, dietary pattern, precision nutrition, and physical activity) from an early stage in life and across the lifespan to avoid debilitating health conditions occurring during adulthood and aging. Thus, in this narrative review, we discuss the protective effects of SFN supplementation on inflammatory and oxidative stress pathways and relate them to metabolic disease. Full article

(This article belongs to the Special Issue Anti-inflammatory and Anti-obesity Properties of Food Bioactive Components)

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23 pages, 877 KB

Open AccessEditor’s ChoiceArticle

Nutritional Status of Vitamin E and Its Association with Metabolic Health in Adults

by Kacper Szewczyk, Joanna Bryś, Rita Brzezińska and Magdalena Górnicka

Nutrients 2025, 17(3), 408; https://doi.org/10.3390/nu17030408 - 23 Jan 2025

Cited by 10 | Viewed by 7527

Abstract

Background: Vitamin E is one of the key dietary antioxidants. However, current evidence remains insufficient to establish a definitive relationship between circulating vitamin E levels, body fat content, and their influence on metabolic health. This study aimed to assess and compare the vitamin [...] Read more.

Background: Vitamin E is one of the key dietary antioxidants. However, current evidence remains insufficient to establish a definitive relationship between circulating vitamin E levels, body fat content, and their influence on metabolic health. This study aimed to assess and compare the vitamin E nutritional status in adults with normal and excess body fat and its determinants. Methods: Concentrations of vitamin E isoforms (α- and γ-tocopherols, α- and γ-tocotrienols) were assessed in 127 individuals. Body fat content and other anthropometric indices, as well as biochemical markers such as lipid profile, plasma fatty acid concentration and C-reactive protein, were identified as markers of metabolic health. Participants were divided into two groups: with normal and excess body fat (defined as more than 30% in women and more than 25% in men). Results: The determinants of higher α-tocopherol concentrations were lower body fat content and higher levels of circulating lipids as HDL and LDL (R² = 0.221, p < 0.001 in a model of multivariate linear regression). The level of circulating vitamin E isoforms correlated with the concentration of CRP (r = −0.464 for α-T, r = −0.453 for αT3, r = −0.270 for γ-T, r = −0.355 for γ-T3). Similarly, elevated concentrations of vitamin E isoforms are linked to lower adipose tissue content, which may contribute to lower inflammation and improved metabolic health (r = −0.359 for α-T, r = −0.333 for αT3, r = −0.276 for γ-T3, no significant correlation for γ-T). Conclusions: These results reveal that the vitamin E status of adults with excess body fat may be inadequate and linked to poorer metabolic health. We found that the determinants of lower plasma vitamin E were higher BF and lower TC and its fraction, with the strongest correlations being found for HDL. Full article

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

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24 pages, 1625 KB

Open AccessEditor’s ChoiceReview

Nitric Oxide in Parkinson’s Disease: The Potential Role of Dietary Nitrate in Enhancing Cognitive and Motor Health via the Nitrate–Nitrite–Nitric Oxide Pathway

by Gianluca Tripodi, Mauro Lombardo, Sercan Kerav, Gilda Aiello and Sara Baldelli

Nutrients 2025, 17(3), 393; https://doi.org/10.3390/nu17030393 - 22 Jan 2025

Cited by 13 | Viewed by 6113

Abstract

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta, leading to motor symptoms such as tremor, rigidity, and bradykinesia. The pathological hallmarks of PD include Lewy bodies and mechanisms [...] Read more.

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta, leading to motor symptoms such as tremor, rigidity, and bradykinesia. The pathological hallmarks of PD include Lewy bodies and mechanisms like oxidative/nitrosative stress, chronic inflammation, and mitochondrial dysfunction. Nitric oxide (NO), produced by nitric oxide synthase (NOS) isoforms, plays a dual role in neuroprotection and neurodegeneration. Excessive NO production exacerbates neuroinflammation and oxidative/nitrosative damage, contributing to dopaminergic cell death. This review explores NO’s role in PD pathogenesis and investigates dietary nitrate as a therapeutic strategy to regulate NO levels. Methods: A literature review of studies addressing the role of NO in PD was conducted using major scientific databases, including PubMed, Scopus, and Web of Science, using keywords such as “nitric oxide”, “NOSs”, “Parkinson’s disease”, and “nitrate neuroprotection in PD”. Studies on nitrate metabolism via the nitrate–nitrite–NO pathway and its effects on PD hallmarks were analyzed. Studies regarding the role of nitrosamine formation in PD, which are mainly formed during the nitrification process of amines (nitrogen-containing compounds), often due to chemical reactions in the presence of nitrite or nitrate, were also examined. In particular, nitrate has been shown to induce oxidative stress, affect the mitochondrial function, and contribute to inflammatory phenomena in the brain, another factor closely related to the pathogenesis of PD. Results: Excessive NO production, particularly from iNOS and nNOS, was strongly associated with neuroinflammation and oxidative/nitrosative stress, amplifying neuronal damage in PD. Dietary nitrate was shown to enhance NO bioavailability through the nitrate–nitrite–NO pathway, mitigating inflammation and oxidative/nitrosative damage. Conclusions: Dysregulated NO production contributes significantly to PD progression via inflammatory and oxidative/nitrosative pathways. Dietary nitrate, by modulating NO levels, offers a promising therapeutic strategy to counteract these pathological mechanisms. Further clinical trials are warranted to establish its efficacy and optimize its use in PD management. Full article

(This article belongs to the Special Issue Dietary Nitrate in Health and Diseases: Pathways from Nitrate and NOS to Nitric Oxide and Beyond)

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58 pages, 871 KB

Open AccessEditor’s ChoiceReview

Effects of Trace Elements on Endocrine Function and Pathogenesis of Thyroid Diseases—A Literature Review

by Łukasz Bryliński, Katarzyna Kostelecka, Filip Woliński, Olga Komar, Agata Miłosz, Justyna Michalczyk, Jan Biłogras, Anna Machrowska, Robert Karpiński, Marcin Maciejewski, Ryszard Maciejewski, Gabriella Garruti, Jolanta Flieger and Jacek Baj

Nutrients 2025, 17(3), 398; https://doi.org/10.3390/nu17030398 - 22 Jan 2025

Cited by 17 | Viewed by 7007

Abstract

The thyroid gland is an endocrine organ whose hormones enable the proper functioning of the organism. The normal function of this organ is influenced by internal and external factors. One of the external factors is trace elements. Trace elements in appropriate concentrations are [...] Read more.

The thyroid gland is an endocrine organ whose hormones enable the proper functioning of the organism. The normal function of this organ is influenced by internal and external factors. One of the external factors is trace elements. Trace elements in appropriate concentrations are necessary for the proper functioning of the thyroid. Fe, Cu, Mn, I, Zn, and Se are part of the enzymes involved in oxidative stress reduction, while Cd, Hg, and Pb can increase ROS production. Cu and Fe are necessary for the correct TPO synthesis. An imbalance in the concentration of trace elements such as Fe, Cu, Co, I, Mn, Zn, Ag, Cd, Hg, Pb, and Se in thyroid cells can lead to thyroid diseases such as Graves’ disease, Hashimoto’s thyroiditis, hypothyroidism, autoimmune thyroiditis, thyroid nodules, thyroid cancer, and postpartum thyroiditis. Lack of adequate Fe levels may lead to hypothyroidism and cancer development. The thyroid gland’s ability to absorb I is reversibly reduced by Co. Adequate levels of I are required for correct thyroid function; both deficiency and excess can predispose to the development of thyroid disorders. High concentrations of Mn may lead to hypothyroidism. Furthermore, Mn may cause cancer development and progression. Insufficient Zn supplementation causes hypothyroidism and thyroid nodule development. Cd affecting molecular mechanisms may also lead to thyroid disorders. Hg accumulating in the thyroid may interfere with hormone secretion and stimulate cancer cell proliferation. A higher risk of thyroid nodules, cancer, autoimmune thyroiditis, and hypothyroidism were linked to elevated Pb levels. Se deficiency disrupts thyroid cell function and may lead to several thyroid disorders. On the other hand, some of the trace elements may be useful in the treatment of thyroid diseases. Therefore, the effects of trace elements on the thyroid require further research. Full article

(This article belongs to the Section Nutrition and Metabolism)

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16 pages, 760 KB

Open AccessEditor’s ChoiceArticle

Tying Food Addiction to Uncontrolled Eating: The Roles of Eating-Related Thoughts and Emotional Eating

by Alessandro Alberto Rossi

Nutrients 2025, 17(3), 369; https://doi.org/10.3390/nu17030369 - 21 Jan 2025

Cited by 12 | Viewed by 4934

Abstract

Background. Food addiction is often linked to overeating and difficulty in controlling eating habits. At the same time, food addiction is often associated with intense eating-related thoughts and emotional eating behaviors. However, despite extensive research on food addiction, the psychological processes that [...] Read more.

Background. Food addiction is often linked to overeating and difficulty in controlling eating habits. At the same time, food addiction is often associated with intense eating-related thoughts and emotional eating behaviors. However, despite extensive research on food addiction, the psychological processes that contribute to these outcomes have not been fully examined. Consequently, this study aims to fill that gap by investigating the influence of eating-related thoughts, as well as emotional eating behaviors that may precede episodes of uncontrolled eating. Methods. A cross-sectional design was used. A sample of 467 individuals was enrolled from the general population. Participants completed a battery of self-report questionnaires. A sequential mediation analysis with latent variables (i.e., structural equation modeling; SEM) using 5000 bootstrap samples and observed variables was performed. Results. The proposed model provides good fit indices. Indeed, food addiction predicts uncontrolled eating behaviors through eating-related thoughts (p < 0.001), which were also significantly associated with the emotion-driven eating patterns (p < 0.001), revealing a fully mediated model explaining 61.6% of the outcome variance (R² = 0.616). Discussion. The findings underscore the critical influence of cognitive factors (i.e., eating-related thoughts) in driving maladaptive coping mechanisms like emotional eating. Moreover, emotional eating may act as a precursor to behaviors associated with overeating, which are often rooted in food addiction. Conclusions. Recognizing the central role of thoughts and emotions can help clinicians develop more targeted psychological interventions for those experiencing food addiction symptoms. Full article

(This article belongs to the Special Issue Nutrition, Disordered Eating and Mental Health)

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29 pages, 2118 KB

Open AccessEditor’s ChoiceReview

Dietary Interventions, Supplements, and Plant-Derived Compounds for Adjunct Vitiligo Management: A Review of the Literature

by Michael J. Diaz, Jasmine T. Tran, Drake Rose, Aria Wei, Deepak Lakshmipathy and Shari R. Lipner

Nutrients 2025, 17(2), 357; https://doi.org/10.3390/nu17020357 - 20 Jan 2025

Cited by 5 | Viewed by 15688

Abstract

Vitiligo is a chronic autoimmune pigmentation disorder shaped by a complex interplay of genetic predispositions and environmental triggers. While conventional therapies—phototherapy, corticosteroids, and immunosuppressants—can be effective, their benefits are often partial and temporary, with recurrence common once treatment stops. As such, there is [...] Read more.

Vitiligo is a chronic autoimmune pigmentation disorder shaped by a complex interplay of genetic predispositions and environmental triggers. While conventional therapies—phototherapy, corticosteroids, and immunosuppressants—can be effective, their benefits are often partial and temporary, with recurrence common once treatment stops. As such, there is increasing interest in exploring complementary approaches that may offer a more sustainable impact. Emerging evidence suggests that macronutrient and micronutrient-level changes could be beneficial for managing progression and, in some cases, facilitating repigmentation. Antioxidant-rich foods, such as apples, green tea, Indian gooseberry, onions, and peppers, may help mitigate oxidative stress, while inflammatory foods, such as gluten and high-phenol nuts and berries, may exacerbate the condition. Certain supplements, including high-dose vitamin D, vitamin C, vitamin E, and selenium, may enhance phototherapy outcomes. Omega-3 and other unsaturated fatty acids, in addition to prebiotics and probiotics, are under active investigation for their roles in gut health and immune regulation. Notably, plant-derived compounds, i.e., Ginkgo biloba, have demonstrated promise in promoting repigmentation and managing disease progression. However, it must be emphasized that these nutritional interventions remain exploratory, and more research is needed to establish their efficacy, safety, and optimal usage before they can be recommended as part of a standard treatment regimen. Full article

(This article belongs to the Special Issue Relationships between Dietary Factors and Inflammatory Skin Diseases)

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18 pages, 2893 KB

Open AccessEditor’s ChoiceArticle

Exploring Gender Differences in the Effects of Diet and Physical Activity on Metabolic Parameters

by Stefania Gorini, Elisabetta Camajani, Alessandra Feraco, Andrea Armani, Sercan Karav, Tiziana Filardi, Giovanni Aulisa, Edda Cava, Rocky Strollo, Elvira Padua, Massimiliano Caprio and Mauro Lombardo

Nutrients 2025, 17(2), 354; https://doi.org/10.3390/nu17020354 - 20 Jan 2025

Cited by 12 | Viewed by 6292

Abstract

Background: Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults. Methods: A prospective cohort study was [...] Read more.

Background: Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults. Methods: A prospective cohort study was conducted in an obesity clinic in Rome, Italy, involving overweight adults (BMI ≥ 25 kg/m²) motivated to improve their lifestyle. Participants (n = 205; 107 men and 98 women) self-selected into physical activity groups (aerobic, anaerobic, combined or no activity). Gender-specific metabolic changes were assessed, including lipid profiles, liver markers and fasting glucose. Results: Significant gender differences in metabolic results were observed. Men showed greater reductions in total cholesterol (TC) and LDL, as well as significant reductions in alanine aminotransferase (ALT). Women showed a significant increase in HDL cholesterol. Fasting blood glucose decreased significantly in both sexes, with no differences between the sexes. Activity-specific analysis revealed that anaerobic activity significantly improved lipid metabolism in men, while aerobic activity produced the greatest benefits in women, including increased HDL and improved liver marker profiles. Conclusions: Therapeutic strategies combining MD and physical activity must take into account gender-specific physiological differences and the type of sport activity to optimise metabolic benefits. Personalised approaches may improve the management of cardiovascular risk factors in overweight individuals. Study registration: This study is registered on ClinicalTrials.gov (NCT06661330). Full article

(This article belongs to the Special Issue Eating Behaviors, Body Composition and Neuro Vulnerability in Energy Metabolism Regulation—2nd Edition)

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21 pages, 1920 KB

Open AccessEditor’s ChoiceReview

Effects of the Mediterranean Diet on the Components of Metabolic Syndrome Concerning the Cardiometabolic Risk

by Stefania Scaglione, Tiziana Di Chiara, Mario Daidone and Antonino Tuttolomondo

Nutrients 2025, 17(2), 358; https://doi.org/10.3390/nu17020358 - 20 Jan 2025

Cited by 23 | Viewed by 22224

Abstract

Metabolic syndrome is a cluster of risk factors, including abdominal obesity, insulin resistance, hypertension, dyslipidemia (intended as an increase in triglyceride levels and a reduction in HDL cholesterol levels), and elevated fasting glucose, that increase the risk of cardiovascular disease and type 2 [...] Read more.

Metabolic syndrome is a cluster of risk factors, including abdominal obesity, insulin resistance, hypertension, dyslipidemia (intended as an increase in triglyceride levels and a reduction in HDL cholesterol levels), and elevated fasting glucose, that increase the risk of cardiovascular disease and type 2 diabetes. With the rising prevalence of metabolic syndrome, effective dietary interventions are essential in reducing these health risks. The Mediterranean diet, rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil and moderate in fish and poultry, has shown promise in addressing metabolic syndrome and its associated components. This diet’s anti-inflammatory and antioxidant properties, primarily due to its unsaturated fats, polyphenols, and fiber, have improved blood pressure, lipid levels, and insulin sensitivity. Adherence to the Mediterranean diet has been linked to reductions in central obesity and insulin resistance, both key elements in managing metabolic syndrome. Regarding lipid management, the Mediterranean diet lowers triglyceride levels and low-density lipoprotein (LDL) cholesterol while raising high-density lipoprotein (HDL) cholesterol, enhancing lipid profiles. It also helps regulate blood glucose levels, reducing the likelihood of developing type 2 diabetes. Additionally, the diet promotes weight loss and improves body composition, particularly by decreasing visceral fat, a primary driver of metabolic syndrome according to IDF classification. The Mediterranean diet offers a holistic approach to managing metabolic syndrome and reducing the risk of related chronic diseases. Its positive impact on metabolic health, combined with lifestyle changes like increased physical activity, provides a sustainable method for addressing the global burden of this syndrome. This review aimed to summarize the positive effects of the Mediterranean diet on the component of the metabolic syndrome with subsequent positive effects on cardiometabolic risk profile. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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16 pages, 1033 KB

Open AccessEditor’s ChoiceArticle

The Association Between Adherence to the Mediterranean Diet and Depression and Anxiety Symptoms in University Students: The Mediating Role of Lean Mass and the Muscle Strength Index

by Sofía Alfaro-González, Miriam Garrido-Miguel, Carlos Pascual-Morena, Diana P. Pozuelo-Carrascosa, Rubén Fernández-Rodríguez, José Alberto Martínez-Hortelano, Arthur E. Mesas and Vicente Martínez-Vizcaíno

Nutrients 2025, 17(2), 346; https://doi.org/10.3390/nu17020346 - 18 Jan 2025

Cited by 9 | Viewed by 3777

Abstract

Background/objectives: recent studies have suggested that components typical of the Mediterranean diet (MedDiet) are associated with depression and anxiety prevention. In this sense, the main objective of this study was to analyse the associations between adherence to the MedDiet and depression and anxiety [...] Read more.

Background/objectives: recent studies have suggested that components typical of the Mediterranean diet (MedDiet) are associated with depression and anxiety prevention. In this sense, the main objective of this study was to analyse the associations between adherence to the MedDiet and depression and anxiety symptoms and to examine whether this relationship is mediated by lean mass and the muscle strength index (MSI). Methods: a cross-sectional study (based on data obtained from the Nuts4Brain-Z study) was conducted from 2023–2024, involving 428 university students, aged 18–30 years, from a Spanish public university. Depression was assessed using the Beck Depression Inventory (BDI-II), and anxiety was assessed via the General Anxiety Disorder-7 (GAD-7) tool. Adherence to the MedDiet was assessed using the MEDAS questionnaire. Lean mass was assessed via bioimpedance, and MSI was measured via a dynamometer. ANCOVA models were used to test the mean differences in depression and anxiety scores using MEDAS categories (low adherence < 9 points vs high adherence ≥ 9 points). Serial multiple mediation models, adjusted for the main confounders, were used to explore the role of lean mass and MSI in the relationships between adherence to the MedDiet and depression and anxiety symptoms. Results: university students with high adherence to the MedDiet exhibited lower scores for depression and anxiety symptoms (p < 0.05) than did students with low adherence to the MedDiet. The mediation analysis preliminarily revealed that both lean mass and MSI acted as mediators of the relationships between adherence to the MedDiet and depression and anxiety. Conclusion:adherence to the MedDiet in university students per se does not appear to have a direct effect on depression and anxiety symptoms because these associations are partially (for depression) or entirely (for anxiety) explained by lean mass and MSI. Full article

(This article belongs to the Special Issue Dietary Habits and Body Composition of Children, Adolescents and Young Adults)

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58 pages, 856 KB

Open AccessEditor’s ChoiceSystematic Review

Dietary Intake, Mediterranean and Nordic Diet Adherence in Alzheimer’s Disease and Dementia: A Systematic Review

by Christiana C. Christodoulou, Michalis Pitsillides, Andreas Hadjisavvas and Eleni Zamba-Papanicolaou

Nutrients 2025, 17(2), 336; https://doi.org/10.3390/nu17020336 - 17 Jan 2025

Cited by 11 | Viewed by 9187

Abstract

Background/Objectives: Dementia is not a single disease but an umbrella term that encompasses a range of symptoms, such as memory loss and cognitive impairments, which are severe enough to disrupt daily life. One of the most common forms of dementia is Alzheimer’s Disease [...] Read more.

Background/Objectives: Dementia is not a single disease but an umbrella term that encompasses a range of symptoms, such as memory loss and cognitive impairments, which are severe enough to disrupt daily life. One of the most common forms of dementia is Alzheimer’s Disease (AD), a complex neurodegenerative condition influenced by both genetic and environmental factors. Recent research has highlighted diet as a potential modifiable risk factor for AD. Decades of research have explored the role of dietary patterns, including the Mediterranean Diet (MD) and its components, in neuroprotection and cognitive health. Systematic review examines studies investigating the impact of the Mediterranean Diet, Mediterranean-like diets, the Nordic Diet (ND), dietary intake patterns, and specific components such as extra virgin olive oil and rapeseed oil on cognitive function, disease onset, and progression in AD and dementia. Methods: A comprehensive search of PubMed, the Directory of Open Access Journals, and the Social Science Research Network was conducted independently by two reviewers using predefined search terms. The search period included studies from 2006 to 2024. Eligible studies meeting the inclusion criteria were systematically reviewed, yielding 88 studies: 85 focused on the MD and its relationship to AD and dementia, while only 3 investigated the ND. Results: The findings suggest that adherence to the Mediterranean and Nordic diets is generally associated with improved cognitive function and delayed cognitive decline and that adherence to both these diets can improve cognitive function. Some studies identified that higher legume consumption decreased dementia incidence, while fruits and vegetables, carbohydrates, and eggs lowered dementia prevalence. Most studies demonstrated that high MD or ND adherence was associated with better cognitive function and a lower risk of poor cognition in comparison to individuals with lower MD or ND adherence. However, some studies reported no significant benefits of the MD on cognitive outcomes, while two studies indicated that higher red meat consumption was linked to better cognitive function. Conclusion: Despite promising trends, the evidence remains varying across studies, underscoring the need for further research to establish definitive associations between diet and cognitive function. These findings highlight the essential role of dietary interventions in the prevention and management of dementia and AD, therefore offering critical insights into the underlying mechanisms by which the diet may impact brain health. Full article

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

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16 pages, 2855 KB

Open AccessEditor’s ChoiceArticle

Egg Consumption and Mortality: A Prospective Cohort Study of Australian Community-Dwelling Older Adults

by Holly Wild, Danijela Gasevic, Robyn L. Woods, Joanne Ryan, Rory Wolfe, Yuquan Chen, Thara Govindaraju, John J. McNeil, Tracy McCaffrey, Lawrence J. Beilin, Dragan Ilic and Alice J. Owen

Nutrients 2025, 17(2), 323; https://doi.org/10.3390/nu17020323 - 17 Jan 2025

Cited by 2 | Viewed by 36751

Abstract

Background/Objectives: Egg consumption in adults has been linked with a modestly increased risk of all-cause and CVD mortality. However, evidence on adults aged 65 y+ is limited. The objective of this study was to investigate the association between egg intake and mortality in [...] Read more.

Background/Objectives: Egg consumption in adults has been linked with a modestly increased risk of all-cause and CVD mortality. However, evidence on adults aged 65 y+ is limited. The objective of this study was to investigate the association between egg intake and mortality in community-dwelling older adults. Methods: In this prospective cohort study, 8756 adults aged 70+ years, participants in the ASPirin in Reducing Events in the Elderly (ASPREE) Longitudinal Study of Older Persons, self-reported the frequency of their total egg intake: never/infrequently (rarely/never, 1–2 times/month), weekly (1–6 times/week), and daily (daily/several times per day). All-cause and cause-specific (cardiovascular disease [CVD] and cancer) mortality was established from at least two sources: medical records, death notices, next of kin, or death registry linkage. The association between egg intake and mortality was assessed using Cox proportional hazards regression analysis, adjusted for socio-demographic, health-related, and clinical factors and overall dietary quality. Results: Over the median 5.9-year follow-up period, a total of 1034 all-cause deaths (11.8%) were documented. A 29% lower risk of CVD mortality (HR (95% CI): 0.71 [0.54–0.92]) and a 17% (HR (95% CI): 0.83 [0.71–0.96]) lower risk of all-cause mortality were observed among those who consumed eggs weekly, compared to those who consumed eggs never/infrequently; no statistically significant association was observed for weekly consumption and cancer mortality. In contrast, compared to those that never or infrequently consumed eggs, daily consumption had slightly higher odds of mortality, though these results did not reach statistical significance. Conclusions: The consumption of eggs 1–6 times per week was associated with a lower risk of all-cause mortality and CVD mortality in community-dwelling adults aged 70 years and over. These findings may be important to inform the development of evidence-based guidelines for egg consumption. Full article

(This article belongs to the Special Issue Dietary Management and Nutritional Health for Age-Related Diseases)

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9 pages, 732 KB

Open AccessEditor’s ChoiceArticle

The Effects of Time-Restricted Eating on Inflammation and Oxidative Stress in Overweight Older Adults: A Pilot Study

by Armin Ezzati, Javier A. Tamargo, Leah Golberg, Mark D. Haub and Stephen D. Anton

Nutrients 2025, 17(2), 322; https://doi.org/10.3390/nu17020322 - 17 Jan 2025

Cited by 8 | Viewed by 10380

Abstract

Background/Objectives: Time-restricted eating (TRE) has been associated with beneficial effects for inflammation and oxidative stress; however, the effects of TRE on inflammation and oxidative stress in the aging population have not been explored. Methods: This secondary analysis tested the effects of TRE on [...] Read more.

Background/Objectives: Time-restricted eating (TRE) has been associated with beneficial effects for inflammation and oxidative stress; however, the effects of TRE on inflammation and oxidative stress in the aging population have not been explored. Methods: This secondary analysis tested the effects of TRE on pro-inflammatory (hs-CRP [high-sensitivity C-reactive protein], IL-1β [interleukin 1 beta], IL-6 [interleukin 6], TNF-α [tumor necrosis factor alpha]) and oxidative stress (8-isoprostane) biomarkers in ten overweight older adults (mean age = 77.1 ± 6.1 years; six women and four men), who followed a TRE protocol of 16 h of fasting per day and consumed food ad libitum during an 8 h window for 4 weeks. Results: TNF-α levels decreased from 43.2 (11.2) pg/mL to 39.7 (10.0) pg/mL with a Cohen’s d effect size of 0.33, and IL-1β levels decreased from 1.4 (0.8) pg/mL to 1.3 (0.6) pg/mL with a Cohen’s d effect size of 0.23, suggesting potential anti-inflammatory benefits. IL-6 and hs-CRP levels showed no substantial changes (Cohen’s d ≤ 0.03). The oxidative stress marker 8-isoprostane levels decreased slightly with a Cohen’s d effect size of 0.07. Conclusions: The findings of this pilot study provide initial insights into the potential effects of TRE on inflammatory and oxidative stress markers in older adults. Given the small sample size and short-term intervention, well-powered studies of longer duration are needed to better understand the effects of TRE on inflammation and oxidative stress in aging populations. Full article

(This article belongs to the Special Issue Chrono-Nutrition and Human Health)

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15 pages, 1424 KB

Open AccessEditor’s ChoiceReview

Micronutrient–Antioxidant Therapy and Male Fertility Improvement During ART Cycles

by Marwa Lahimer, Severine Capelle, Elodie Lefranc, Dorian Bosquet, Nadia Kazdar, Anne Ledu, Mounir Agina, Rosalie Cabry and Moncef BenKhalifa

Nutrients 2025, 17(2), 324; https://doi.org/10.3390/nu17020324 - 17 Jan 2025

Cited by 7 | Viewed by 17556

Abstract

Today, accumulating evidence highlights the impact of oxidative stress (OS) on semen quality. It is considered to be a key factor contributing to the decline in male fertility. OS is detected in 30–80% of men with infertility, highlighting its strong association with impaired [...] Read more.

Today, accumulating evidence highlights the impact of oxidative stress (OS) on semen quality. It is considered to be a key factor contributing to the decline in male fertility. OS is detected in 30–80% of men with infertility, highlighting its strong association with impaired reproductive function and with clinical outcomes following the use of assisted reproductive technologies. Spermatozoa are particularly vulnerable to oxidative damage due to their high content of polyunsaturated fatty acids (PUFAs) and limited antioxidant defense abilities. OS arises from an imbalance between the production of reactive oxygen species and the capacity to neutralize or repair their adverse effects. Evidence indicates that OS leads to lipid peroxidation, protein oxidation, mitochondrial dysfunction, and genomic instability. Micronutrient–antioxidant therapies can play a key role in infertility improvement by neutralizing free radicals and preventing cellular damage. Many different micronutrients, including L-carnitine, L-glutathione, coenzyme Q10, selenium, and zinc, as well as vitamins complexes, are proposed to improve sperm parameters and male fertility potential. This study aims to review the impact of antioxidant supplementation on semen parameters, including sperm volume, motility, concentration, morphology, genome integrity (maturity and fragmentation), and in vitro fertilization (IVF) outcomes. Antioxidant intake and a balanced lifestyle reduce oxidative stress and mitochondrial dysfunction, enhancing the spermatogenesis and spermiogenesis processes, improving sperm quality, and protecting DNA integrity. Full article

(This article belongs to the Special Issue The Role of Functional Ingredients in Regulating Health Effects)

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14 pages, 1634 KB

Open AccessEditor’s ChoiceArticle

Vitamins K2 and D3 Improve Long COVID, Fungal Translocation, and Inflammation: Randomized Controlled Trial

by Ornina Atieh, Joviane Daher, Jared C. Durieux, Marc Abboud, Danielle Labbato, Jhony Baissary, Ziad Koberssy, Kate Ailstock, Morgan Cummings, Nicholas T. Funderburg and Grace A. McComsey

Nutrients 2025, 17(2), 304; https://doi.org/10.3390/nu17020304 - 16 Jan 2025

Cited by 12 | Viewed by 26882

Abstract

Background: Long COVID (LC) is characterized by persistent symptoms at least 3 months after a SARS-COV-2 infection. LC has been associated with fungal translocation, gut dysfunction, and enhanced systemic inflammation. Currently, there is no approved treatment for this condition. The anti-inflammatory effect of [...] Read more.

Background: Long COVID (LC) is characterized by persistent symptoms at least 3 months after a SARS-COV-2 infection. LC has been associated with fungal translocation, gut dysfunction, and enhanced systemic inflammation. Currently, there is no approved treatment for this condition. The anti-inflammatory effect of vitamins K2 and D3 was shown to help attenuate the course of acute COVID-19 infection. Objective and hypothesis: This trial aims to investigate the effects of vitamins K2/D3 on LC symptoms, as well as gut and inflammatory markers, in people with established long COVID. Our hypothesis is that by attenuating systemic inflammation, vitamins K2/D3 will improve long COVID symptoms. Methods: This single-site randomized controlled study enrolled adults experiencing ≥2 moderate LC symptoms at least 3 months after a COVID-19 infection. The RECOVER Long COVID Research Index and number and type of LC symptoms were considered. Participants were randomized 2:1 to daily 240 µg K2 (pure MK-7 form) and 2000 UI vitamin D3 or standard of care (SOC) for 24 weeks. The endpoints were changes in symptomatology and in select inflammatory, metabolic, and gut biomarkers at 24 weeks. Results: We enrolled 151 participants (n = 98 received vit K2/D3 and 53 received SOC). The median age was 46 years; 71% were female and 29% were non-white. Baseline demographics were balanced between groups. At 24 weeks, the active treatment group only had a sharp increase in 25(OH) D, indicating good treatment adherence. In the vitamin K2/D3 arm, there was a 7.1% decrease in the proportion who had an LC Index ≥12 (vs. a 7.2% increase in the SOC group; p = 0.01). The average number of LC symptoms remained stable in the vitamin K2/D3 arm but increased in the SOC arm (p = 0.03). Additionally, reductions in oxidized LDL, inflammatory markers sTNF-RI and sCD163, and fungal translocation marker (1,3)-β-d-glucan were observed in the vitamin K2/D3 arm compared to the SOC arm (p < 0.01) over 24 weeks. Conclusions: Vitamins K2/D3 improved the RECOVER Long COVID Index, the number of LC symptoms, and several gut and inflammatory markers. Vitamins K2/D3 provide a promising safe intervention for people suffering from long COVID. Full article

(This article belongs to the Special Issue Dose–Response Relationships of Vitamin D Status and Vitamin D Intake with Health Outcomes—2nd Edition)

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18 pages, 326 KB

Open AccessEditor’s ChoiceReview

The Impact of Breakfast Consumption or Omission on Exercise Performance and Adaptations: A Narrative Review

by Matthew T. Stratton, Shelley L. Holden, Ray Davis and Austin T. Massengale

Nutrients 2025, 17(2), 300; https://doi.org/10.3390/nu17020300 - 15 Jan 2025

Cited by 2 | Viewed by 15736

Abstract

Background: Breakfast is often termed the most important meal of the day. However, its importance to acute and chronic adaptations to exercise is currently not well summarized throughout the literature. Methods: A narrative review of the experimental literature regarding breakfast consumption’s impact on [...] Read more.

Background: Breakfast is often termed the most important meal of the day. However, its importance to acute and chronic adaptations to exercise is currently not well summarized throughout the literature. Methods: A narrative review of the experimental literature regarding breakfast consumption’s impact on acute and chronic exercise performance and alterations in body composition prior to November 2024 was conducted. To be included in this review, the selected investigations needed to include some aspect of either endurance or resistance training performance and be conducted in humans. Results: These findings suggest that breakfast consumption may benefit acute long-duration (>60 min) but not short-duration (<60 min) morning endurance exercise. Evening time trial performance was consistently inhibited following breakfast omission despite the resumption of eating midday. No or minimal impact of breakfast consumption was found when examining acute morning or afternoon resistance training or the longitudinal adaptations to either resistance or endurance training. Favorable changes in body composition were often noted following the omission of breakfast. However, this was primarily driven by the concomitant reduced kilocalorie intake. Conclusions: Consuming breakfast may aid endurance athletes regularly performing exercise lasting >60 min in length. However, the morning meal’s impact on resistance training and changes in body composition appears to be minimal. Although, as the body of literature is limited, future investigations are needed to truly ascertain the dietary practice’s impact. Full article

(This article belongs to the Special Issue The Role of Nutrition in Exercise and Sports)

19 pages, 1476 KB

Open AccessEditor’s ChoiceReview

Sarcopenia and Cardiogeriatrics: The Links Between Skeletal Muscle Decline and Cardiovascular Aging

by Dimitrios Anagnostou, Nikolaos Theodorakis, Christos Hitas, Magdalini Kreouzi, Ioannis Pantos, Georgia Vamvakou and Maria Nikolaou

Nutrients 2025, 17(2), 282; https://doi.org/10.3390/nu17020282 - 14 Jan 2025

Cited by 23 | Viewed by 9257

Abstract

Sarcopenia, an age-related decline in skeletal muscle mass, strength, and function, is increasingly recognized as a significant condition in the aging population, particularly among those with cardiovascular diseases (CVD). This review provides a comprehensive synthesis of the interplay between sarcopenia and cardiogeriatrics, emphasizing [...] Read more.

Sarcopenia, an age-related decline in skeletal muscle mass, strength, and function, is increasingly recognized as a significant condition in the aging population, particularly among those with cardiovascular diseases (CVD). This review provides a comprehensive synthesis of the interplay between sarcopenia and cardiogeriatrics, emphasizing shared mechanisms such as chronic low-grade inflammation (inflammaging), hormonal dysregulation, oxidative stress, and physical inactivity. Despite advancements in diagnostic frameworks, such as the EWGSOP2 and AWGS definitions, variability in criteria and assessment methods continues to challenge standardization. Key diagnostic tools include dual-energy X-ray absorptiometry (DXA) and bioimpedance analysis (BIA) for muscle mass, alongside functional measures such as grip strength and gait speed. The review highlights the bidirectional relationship between sarcopenia and cardiovascular conditions such as heart failure, aortic stenosis, and atherosclerotic cardiovascular disease, which exacerbate each other through complex pathophysiological mechanisms. Emerging therapeutic strategies targeting the mTOR pathway, NAD+ metabolism, and senescence-related processes offer promise in mitigating sarcopenia’s progression. Additionally, integrated interventions combining resistance training, nutritional optimization, and novel anti-aging therapies hold significant potential for improving outcomes. This paper underscores critical gaps in the evidence, including the need for longitudinal studies to establish causality and the validation of advanced therapeutic approaches in clinical settings. Future research should leverage multi-omics technologies and machine learning to identify biomarkers and personalize interventions. Addressing these challenges is essential to reducing sarcopenia’s burden and enhancing the quality of life for elderly individuals with comorbid cardiovascular conditions. This synthesis aims to guide future research and promote effective, individualized management strategies. Full article

(This article belongs to the Special Issue Geriatric Malnutrition and Frailty)

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19 pages, 1716 KB

Open AccessEditor’s ChoiceReview

Efficacy of N-Acetylcysteine in Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis

by Isabel Viña, Juan R. Viña, Macarena Carranza and Gonzalo Mariscal

Nutrients 2025, 17(2), 284; https://doi.org/10.3390/nu17020284 - 14 Jan 2025

Cited by 4 | Viewed by 17098

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age and requires better treatment. N-acetylcysteine (NAC) is known to be beneficial under such conditions owing to its antioxidant potential and insulin-sensitizing properties. The effect of NAC [...] Read more.

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age and requires better treatment. N-acetylcysteine (NAC) is known to be beneficial under such conditions owing to its antioxidant potential and insulin-sensitizing properties. The effect of NAC on the reproductive outcomes of PCOS patients was examined in this meta-analysis. Methods: In accordance with PRISMA standards, this meta-analysis included studies that compared N-acetylcysteine, metformin, clomiphene citrate, and a placebo in patients with POCS. The main indicators were follicular growth, endometrial thickness, and hormone level. The risk of bias was evaluated using the Cochrane ROB2 tool. Results: Twenty-two studies (n = 2515) were included. NAC was associated with a statistically significant increase in progesterone (SMD 0.95, 95% CI: 0.13–1.77, p = 0.02) and endometrial thickness (SMD 0.58, 95% CI: 0.10–1.06, p = 0.02) compared to the placebo and other drugs (SMD 0.71, 95% CI: 0.48–0.94, p < 0.0001). LH levels were significantly increased by NAC compared to metformin (SMD 0.67, 95% CI: 0.23–1.12, p = 0.003). However, no significant differences were observed in the estradiol, SHBG, or FSH levels. Conclusions: NAC had a major effect on progesterone, endometrial thickness, and LH levels in women with PCOS. Therefore, it may be a potential treatment option. Full article

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

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18 pages, 571 KB

Open AccessEditor’s ChoiceReview

Enhanced Vitamin C Delivery: A Systematic Literature Review Assessing the Efficacy and Safety of Alternative Supplement Forms in Healthy Adults

by Philip C. Calder, Richard B. Kreider and Diane L. McKay

Nutrients 2025, 17(2), 279; https://doi.org/10.3390/nu17020279 - 14 Jan 2025

Cited by 6 | Viewed by 22915

Abstract

Vitamin C is an antioxidant and is essential for immune function and infection resistance. Supplementation is necessary when a sufficient amount of vitamin C is not obtained through the diet. Alternative formulations of vitamin C may enhance its bioavailability and retention over traditional [...] Read more.

Vitamin C is an antioxidant and is essential for immune function and infection resistance. Supplementation is necessary when a sufficient amount of vitamin C is not obtained through the diet. Alternative formulations of vitamin C may enhance its bioavailability and retention over traditional ascorbic acid. This systematic review consolidates the evidence on this and the effects on immunity and infection. A systematic literature search was conducted in October 2024 in Embase and Medline, focused on healthy adults (Population); oral forms of liposomal-encapsulated ascorbic acid, liposomal-encapsulated lipid metabolite ascorbic acid, calcium ascorbate, slow-release ascorbic acid, or lipid metabolite ascorbic acid (Intervention); compared to placebo/others (Comparison); in terms of bioavailability, absorption, vitamin C concentration in plasma, serum, and leukocytes, and impacts on tolerability, immunity, and infection (Outcome); and included randomized or non-randomized controlled trials, single-arm trials, and observational studies (Study design). Thirteen studies were included, several evaluating calcium ascorbate in combination with vitamin C metabolites, including L-threonate, referred to here as Calcium ascorbate EC (Ester C^®; n = 7). No safety or tolerability concerns were noted with Calcium ascorbate EC vs. placebo or ascorbic acid. Calcium ascorbate EC showed better tolerability and fewer epigastric adverse events, improved quality of life, and induced favorable oxalate changes vs. ascorbic acid. Four studies reported leukocyte vitamin C concentration, some showing higher concentrations with Calcium ascorbate EC vs. ascorbic acid; seven reported more favorable plasma concentrations with the alternative forms over ascorbic acid or placebo; one reported higher serum vitamin C levels with vitamin C lipid metabolites than with Calcium ascorbate EC, calcium ascorbate, and ascorbic acid. No study reported retention in tissues. One study reported a favorable impact of Calcium ascorbate EC on immune parameters, and one found an association of Calcium ascorbate EC with fewer colds and a shorter duration of severe symptoms vs. placebo. Findings suggest that alternative vitamin C forms can improve leukocyte vitamin C, sometimes without affecting plasma levels. Most studies (77%) had a low risk of bias. In conclusion, the type and delivery modality of vitamin C can impact its bioavailability and functionality. Studies highlight the advantages of Calcium ascorbate EC over traditional ascorbic acid in terms of its tolerability and its potential to increase leukocyte vitamin C concentrations, crucial for immune function and protection against infection. However, further research is required to conclusively establish its effects on immune health. Full article

(This article belongs to the Special Issue Vitamin C: Challenges and Opportunities)

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47 pages, 4285 KB

Open AccessEditor’s ChoiceReview

Protective Role of Dietary Polyphenols in the Management and Treatment of Type 2 Diabetes Mellitus

by Monika Martiniakova, Anna Sarocka, Noemi Penzes, Roman Biro, Veronika Kovacova, Vladimira Mondockova, Aneta Sevcikova, Sona Ciernikova and Radoslav Omelka

Nutrients 2025, 17(2), 275; https://doi.org/10.3390/nu17020275 - 13 Jan 2025

Cited by 22 | Viewed by 11341

Abstract

Type 2 diabetes mellitus (T2DM), a serious metabolic disorder, is a worldwide health problem due to the alarming rise in prevalence and elevated morbidity and mortality. Chronic hyperglycemia, insulin resistance, and ineffective insulin effect and secretion are hallmarks of T2DM, leading to many [...] Read more.

Type 2 diabetes mellitus (T2DM), a serious metabolic disorder, is a worldwide health problem due to the alarming rise in prevalence and elevated morbidity and mortality. Chronic hyperglycemia, insulin resistance, and ineffective insulin effect and secretion are hallmarks of T2DM, leading to many serious secondary complications. These include, in particular, cardiovascular disorders, diabetic neuropathy, nephropathy and retinopathy, diabetic foot, osteoporosis, liver damage, susceptibility to infections and some cancers. Polyphenols such as flavonoids, phenolic acids, stilbenes, tannins, and lignans constitute an extensive and heterogeneous group of phytochemicals in fresh fruits, vegetables and their products. Various in vitro studies, animal model studies and available clinical trials revealed that flavonoids (e.g., quercetin, kaempferol, rutin, epicatechin, genistein, daidzein, anthocyanins), phenolic acids (e.g., chlorogenic, caffeic, ellagic, gallic acids, curcumin), stilbenes (e.g., resveratrol), tannins (e.g., procyanidin B2, seaweed phlorotannins), lignans (e.g., pinoresinol) have the ability to lower hyperglycemia, enhance insulin sensitivity and improve insulin secretion, scavenge reactive oxygen species, reduce chronic inflammation, modulate gut microbiota, and alleviate secondary complications of T2DM. The interaction between polyphenols and conventional antidiabetic drugs offers a promising strategy in the management and treatment of T2DM, especially in advanced disease stages. Synergistic effects of polyphenols with antidiabetic drugs have been documented, but also antagonistic interactions that may impair drug efficacy. Therefore, additional research is required to clarify mutual interactions in order to use the knowledge in clinical applications. Nevertheless, dietary polyphenols can be successfully applied as part of supportive treatment for T2DM, as they reduce both obvious clinical symptoms and secondary complications. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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15 pages, 1223 KB

Open AccessEditor’s ChoiceSystematic Review

Relationship Between the Gut Microbiome, Tryptophan-Derived Metabolites, and Osteoarthritis-Related Pain: A Systematic Review with Meta-Analysis

by Erika Meléndez-Oliva, Oliver Martínez-Pozas, Pierluigi Sinatti, Carmen Martín Carreras-Presas, Juan Nicolás Cuenca-Zaldívar, Silvia Turroni and Eleuterio A. Sánchez Romero

Nutrients 2025, 17(2), 264; https://doi.org/10.3390/nu17020264 - 12 Jan 2025

Cited by 20 | Viewed by 6874

Abstract

Introduction: Osteoarthritis (OA) is the most prevalent form of arthritis and affects over 528 million people worldwide. Degenerative joint disease involves cartilage degradation, subchondral bone remodeling, and synovial inflammation, leading to chronic pain, stiffness, and impaired joint function. Initially regarded as a “wear [...] Read more.

Introduction: Osteoarthritis (OA) is the most prevalent form of arthritis and affects over 528 million people worldwide. Degenerative joint disease involves cartilage degradation, subchondral bone remodeling, and synovial inflammation, leading to chronic pain, stiffness, and impaired joint function. Initially regarded as a “wear and tear” condition associated with aging and mechanical stress, OA is now recognized as a multifaceted disease influenced by systemic factors such as metabolic syndrome, obesity, and chronic low-grade inflammation. Recent studies have focused on the gut-joint axis to investigate how the gut microbiome modulates inflammation and pain in OA. Materials and Methods: A systematic review was conducted following the PRISMA guidelines and was registered with PROSPERO (CRD42024556265). This review included studies involving adults with symptomatic OA and analyzed the relationship between the gut microbiome and OA-related pain. Randomized and non-randomized clinical trials, case reports, editorials, and pilot studies were excluded. Searches were performed in PubMed, Cochrane Library, and Web of Science without publication date restrictions, and filtered for “observational studies”. The study selection and data extraction were performed by two independent researchers, and the risk of bias was assessed using appropriate tools. Results: Five observational studies were included in the systematic review, and three were included in the meta-analysis. Two studies reported an association between different tryptophan metabolites and pain levels in patients with OA. Two other studies demonstrated a correlation between lipopolysaccharide levels and pain in OA. A fifth study confirmed the relationship between Streptococcus relative abundance of Streptococcus spp. and knee pain. These results were not supported by a meta-analysis, which found no significant association between the presence of pain in OA and the presence of bacilli of the genus Streptococcus or plasma markers of the tryptophan pathway. Conclusions: Current evidence indicates a potential link between gut microbiome dysbiosis and OA-related pain. However, methodological limitations preclude definitive conclusions. Further research using advanced techniques and larger cohorts is needed to validate and extend these findings and elucidate the underlying mechanisms. Targeted manipulation of the gut microbiome may be a valuable strategy for pain management in OA patients. Full article

(This article belongs to the Special Issue Association of the Microbiota with Neurodegenerative Diseases)

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24 pages, 540 KB

Open AccessEditor’s ChoiceReview

Does Creatine Supplementation Enhance Performance in Active Females? A Systematic Review

by Ryan Tam, Lachlan Mitchell and Adrienne Forsyth

Nutrients 2025, 17(2), 238; https://doi.org/10.3390/nu17020238 - 10 Jan 2025

Cited by 1 | Viewed by 30518

Abstract

The use of creatine as a dietary supplement is widespread. However, its reported performance benefit has been largely demonstrated in male populations. The aim was to evaluate the effectiveness of creatine supplementation in improving exercise performance in active females. A secondary aim was [...] Read more.

The use of creatine as a dietary supplement is widespread. However, its reported performance benefit has been largely demonstrated in male populations. The aim was to evaluate the effectiveness of creatine supplementation in improving exercise performance in active females. A secondary aim was to appraise the quality of research in this area. Five databases were searched from the earliest record to July 2024. Eligible studies used supplemental creatine as an intervention with physically active female participants and reported an exercise performance-related outcome. Study quality was appraised using the Critical Appraisal Skills Program randomised controlled trials checklist with four additional items related to methodological considerations for research with active females. Performance outcomes were categorised as strength/power, anaerobic, or aerobic. Of the 10,563 records identified, 27 studies were included. Participant calibre ranged from recreationally active to elite. Creatine interventions ranged from five days to 12 weeks and included a range of dosage strategies. Compared to placebo, 3/11 studies showed an improvement in strength/power outcomes, 4/17 showed an improvement in anaerobic outcomes, and 1/5 showed an improvement in aerobic outcomes. Study quality varied, but methodological considerations for research with female athletes were poorly addressed by most studies. Although some benefits were reported, most studies showed no improvement in performance compared to placebo. The heterogeneity in participant characteristics, performance tests, creatine intervention, insufficient consideration of the unique physiological characteristics of females, and an overall small evidence base limits our understanding of how creatine supplementation influences physical performance in active females. Full article

(This article belongs to the Special Issue Nutrition and Supplementation Strategies to Enhance Resistance Training Adaptations)

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