Nutrients

22 pages, 884 KB

Open AccessEditor’s ChoiceReview

The Gut–Brain–Microbiota Connection and Its Role in Autism Spectrum Disorders

by Ewelina Młynarska, Ewelina Barszcz, Emilian Budny, Agata Gajewska, Kacper Kopeć, Jakub Wasiak, Jacek Rysz and Beata Franczyk

Nutrients 2025, 17(7), 1135; https://doi.org/10.3390/nu17071135 - 25 Mar 2025

Cited by 37 | Viewed by 23565

Abstract

Autism spectrum disorder (ASD) is a group of complex neurodevelopmental conditions with a heterogeneous and multifactorial etiology that is not yet fully understood. Among the various factors that may contribute to ASD development, alterations in the gut microbiota have been increasingly recognized. Microorganisms [...] Read more.

Autism spectrum disorder (ASD) is a group of complex neurodevelopmental conditions with a heterogeneous and multifactorial etiology that is not yet fully understood. Among the various factors that may contribute to ASD development, alterations in the gut microbiota have been increasingly recognized. Microorganisms in the gastrointestinal tract play a crucial role in the gut–brain axis (GBA), affecting nervous system development and behavior. Dysbiosis, or an imbalance in the microbiota, has been linked to both behavioral and gastrointestinal (GI) symptoms in individuals with ASD. The microbiota interacts with the central nervous system through mechanisms such as the production of short-chain fatty acids (SCFAs), the regulation of neurotransmitters, and immune system modulation. Alterations in its composition, including reduced diversity or an overabundance of specific bacterial taxa, have been associated with the severity of ASD symptoms. Dietary modifications, such as gluten-free or antioxidant-rich diets, have shown potential for improving gut health and alleviating behavioral symptoms. Probiotics, with their anti-inflammatory properties, may support neural health and reduce neuroinflammation. Fecal microbiota transplantation (FMT) is being considered, particularly for individuals with persistent GI symptoms. It has shown promising outcomes in enhancing microbial diversity and mitigating GI and behavioral symptoms. However, its limitations should be considered, as discussed in this narrative review. Further research is essential to better understand the long-term effects and safety of these therapies. Emphasizing the importance of patient stratification and phenotype characterization is crucial for developing personalized treatment strategies that account for individual microbiota profiles, genetic predispositions, and coexisting conditions. This approach could lead to more effective interventions for individuals with ASD. Recent findings suggest that gut microbiota may play a key role in innovative therapeutic approaches to ASD management. Full article

(This article belongs to the Special Issue Pathways Linking Nutrition with Cognitive and Mental Health)

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12 pages, 235 KB

Open AccessEditor’s ChoiceArticle

Impact of Physical Activity and Dietary Habits on Mental Well-Being in Patients with Diabetes Mellitus

by Battamir Ulambayar, Amr Sayed Ghanem, Ágnes Tóth and Attila Csaba Nagy

Nutrients 2025, 17(6), 1042; https://doi.org/10.3390/nu17061042 - 16 Mar 2025

Cited by 17 | Viewed by 5037

Abstract

Background: The prevalence of diabetes mellitus (DM) is increasing worldwide, and mental health problems such as depression, anxiety, and diabetes distress are common co-morbidities that negatively impact the quality of life, complications, and treatment outcomes of patients with DM. Objectives: In [...] Read more.

Background: The prevalence of diabetes mellitus (DM) is increasing worldwide, and mental health problems such as depression, anxiety, and diabetes distress are common co-morbidities that negatively impact the quality of life, complications, and treatment outcomes of patients with DM. Objectives: In this study, we assessed the impact of dietary patterns and physical activity on the well-being of patients with DM. Methods: A cross-sectional design and data from the European Health Interview Survey (EHIS) data collected in Hungary in 2019, and determination of the relationship between dietary habits and physical activity-related variables contained in the data and the World Health Organization-Five Well-Being Index (WHO-5 index) by suitable statistical methods. Results: Logistic regression showed higher odds of poor mental well-being in females (OR = 1.61, 95% CI: 1.08–2.42) and lower odds with daily fruit intake (OR = 0.52, 95% CI: 0.31–0.89). Infrequent white meat (OR = 3.34, 95% CI: 1.35–8.22) and dairy intake (OR = 1.60, 95% CI: 1.18–2.64) were associated with poorer well-being. Walking 4–7 days/week reduced the odds by 57% (OR = 0.43, 95% CI: 0.23–0.83). Conclusions: The results demonstrate that regular exercise and the consumption of fruits, dairy products, and white meat have beneficial effects on the mental well-being of patients with DM. Full article

(This article belongs to the Special Issue Nutritional & Lifestyle Psychiatry: The Role of Nutrition and Lifestyle in the Onset, Prevention and Management of Mental Disorders)

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12 pages, 600 KB

Open AccessEditor’s ChoiceReview

Microbiome and Pregnancy Dysbiosis: A Narrative Review on Offspring Health

by Valentina Biagioli, Mariarosaria Matera, Luca Antonio Ramenghi, Raffaele Falsaperla and Pasquale Striano

Nutrients 2025, 17(6), 1033; https://doi.org/10.3390/nu17061033 - 15 Mar 2025

Cited by 25 | Viewed by 7673

Abstract

Background: Emerging evidence suggests that the maternal microbiome plays a crucial role in shaping fetal neurodevelopment, immune programming, and metabolic health. Dysbiosis during pregnancy—whether gastrointestinal, oral, or vaginal—can significantly influence pregnancy outcomes and long-term child health. Materials and Methods: The search was [...] Read more.

Background: Emerging evidence suggests that the maternal microbiome plays a crucial role in shaping fetal neurodevelopment, immune programming, and metabolic health. Dysbiosis during pregnancy—whether gastrointestinal, oral, or vaginal—can significantly influence pregnancy outcomes and long-term child health. Materials and Methods: The search was performed using databases such as PubMed, Scopus, and Google Scholar including research published from January 2000 to January 2025. The keywords used were “Fetal Programming”, “ Maternal Immune Activation”, “Maternal microbiome”, “Microbiota–Gut–Brain Axis”, and “Pregnancy Dysbiosis”. Results: The maternal microbiome undergoes substantial changes during pregnancy, with alterations in microbial diversity and function linked to conditions such as gestational diabetes, obesity, and preeclampsia. Pregnancy-related dysbiosis has been associated with adverse neurodevelopmental outcomes, including an increased risk of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and cognitive impairments in offspring. Conclusions: Understanding the intricate relationship between maternal microbiota and fetal health is essential for developing targeted interventions. Personalized microbiome-based strategies, including dietary modifications and probiotic supplementation, hold promise in optimizing pregnancy outcomes and promoting health in offspring. Full article

(This article belongs to the Special Issue Benefits of Probiotics During Perinatal and Infant Period for Gastrointestinal Health)

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12 pages, 760 KB

Open AccessEditor’s ChoiceReview

The Epithelial Barrier Hypothesis in Food Allergies: The State of the Art

by Valentina Agnese Ferraro, Stefania Zanconato and Silvia Carraro

Nutrients 2025, 17(6), 1014; https://doi.org/10.3390/nu17061014 - 14 Mar 2025

Cited by 17 | Viewed by 6022

Abstract

Recently, the “epithelial barrier hypothesis” has been proposed as a key factor in the development of allergic diseases, such as food allergies. Harmful environmental factors can damage epithelial barriers, with detrimental effects on the host immune response and on the local microbial equilibrium, [...] Read more.

Recently, the “epithelial barrier hypothesis” has been proposed as a key factor in the development of allergic diseases, such as food allergies. Harmful environmental factors can damage epithelial barriers, with detrimental effects on the host immune response and on the local microbial equilibrium, resulting in chronic mucosal inflammation that perpetuates the dysfunction of the epithelial barrier. The increased epithelial permeability allows allergens to access the submucosae, leading to an imbalance between type 1 T-helper (Th1) and type 2 T-helper (Th2) inflammation, with a predominant Th2 response that is the key factor in food allergy development. In this article on the state of the art, we review scientific evidence on the “epithelial barrier hypothesis”, with a focus on food allergies. We describe how loss of integrity of the skin and intestinal epithelial barrier and modifications in gut microbiota composition can contribute to local inflammatory changes and immunological unbalance that can lead to the development of food allergies. Full article

(This article belongs to the Special Issue Relationship Between Food Allergy and Human Health)

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22 pages, 1591 KB

Open AccessEditor’s ChoiceReview

Clinical Efficacy and Safety of the Ketogenic Diet in Patients with Genetic Confirmation of Drug-Resistant Epilepsy

by Ji-Hoon Na, Hyunjoo Lee and Young-Mock Lee

Nutrients 2025, 17(6), 979; https://doi.org/10.3390/nu17060979 - 11 Mar 2025

Cited by 20 | Viewed by 10799

Abstract

Drug-resistant epilepsy (DRE) affects 20–30% of patients with epilepsy who fail to achieve seizure control with antiseizure medications, posing a significant therapeutic challenge. In this narrative review, we examine the clinical efficacy and safety of the classic ketogenic diet (cKD) and its variants, [...] Read more.

Drug-resistant epilepsy (DRE) affects 20–30% of patients with epilepsy who fail to achieve seizure control with antiseizure medications, posing a significant therapeutic challenge. In this narrative review, we examine the clinical efficacy and safety of the classic ketogenic diet (cKD) and its variants, including the modified Atkins diet (MAD), medium-chain triglyceride diet (MCTD), and low glycemic index treatment (LGIT), in patients with genetically confirmed drug-resistant epilepsy. These diets induce a metabolic shift from glucose to ketones, enhance mitochondrial function, modulate neurotransmitter balance, and exert anti-inflammatory effects. However, genetic factors strongly influence the efficacy and safety of the cKD, with absolute indications including glucose transporter type 1 deficiency syndrome (GLUT1DS) and pyruvate dehydrogenase complex deficiency (PDCD). Preferred adjunctive applications of the KD include genetic epilepsies, such as SCN1A-related Dravet syndrome, TSC1/TSC2-related tuberous sclerosis complex, and UBE3A-related Angelman syndrome. However, because of the risk of metabolic decompensation, the cKD is contraindicated in patients with pathogenic variants of pyruvate carboxylase and SLC22A5. Recent advancements in precision medicine suggest that genetic and microbiome profiling may refine patient selection and optimize KD-based dietary interventions. Genome-wide association studies and multiomics approaches have identified key metabolic pathways influencing the response to the cKD, and these pave the way for individualized treatment strategies. Future research should integrate genomic, metabolomic, and microbiome data to develop biomarker-driven dietary protocols with improved efficacy and safety. As dietary therapies continue to evolve, a personalized medical approach is essential to maximize their clinical utility for genetic epilepsy and refractory epilepsy syndromes. Full article

(This article belongs to the Special Issue Clinical Impact of Ketogenic Diet)

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15 pages, 274 KB

Open AccessEditor’s ChoiceReview

Clinical Insights into Non-Alcoholic Fatty Liver Disease and the Therapeutic Potential of Flavonoids: An Update

by Aleksandra Kozłowska

Nutrients 2025, 17(6), 956; https://doi.org/10.3390/nu17060956 - 9 Mar 2025

Cited by 21 | Viewed by 9149

Abstract

Non-alcoholic fatty liver disease (NAFLD) is considered a significant global health issue related to serious metabolic disorders. However, effective pharmacological treatments are still limited. Flavonoids, a wide group of polyphenol substances, exert anti-inflammatory and lipid-lowering effects in preclinical data. Thus, implementing these research [...] Read more.

Non-alcoholic fatty liver disease (NAFLD) is considered a significant global health issue related to serious metabolic disorders. However, effective pharmacological treatments are still limited. Flavonoids, a wide group of polyphenol substances, exert anti-inflammatory and lipid-lowering effects in preclinical data. Thus, implementing these research findings in clinical practice could significantly help manage NAFLD and its consequences. This narrative review assesses the therapeutic potential of flavonoids in managing NAFLD. The research collected randomized controlled trials (RCTs) and meta-analyses of RCTs from the past five years concerning the impact of flavonoids on NAFLD. A total of 20 studies were selected according to predetermined inclusion criteria, comprising thirteen randomized controlled trials (RCTs) and seven meta-analyses. The research underscores the beneficial effects of flavonoids in the management of NAFLD through the enhancement of lipid metabolism, the reduction in hepatic steatosis, and the provision of anti-inflammatory actions. Clinical trials demonstrate that interventions rich in flavonoids, including quercetin, epigallocatechin gallate, naringenin, and isoflavones, substantially reduce liver fat content and enhance liver enzyme profiles, with certain compounds exhibiting superior efficacy in particular subgroups, such as older adults and females. Nonetheless, whereas these therapies significantly diminish hepatic steatosis, their effect on fibrosis is constrained. To sum up, flavonoids exhibit significant potential as supplementary treatments for NAFLD by enhancing liver function, lipid metabolism, and inflammation. Additional extensive controlled clinical trials are necessary to create uniform treatment methods and ascertain their long-term therapeutic advantages. Full article

(This article belongs to the Special Issue Effects of Phytochemicals on Human Health)

24 pages, 1664 KB

Open AccessEditor’s ChoiceReview

Gut Microbiota Modulation Through Mediterranean Diet Foods: Implications for Human Health

by Pasquale Perrone and Stefania D’Angelo

Nutrients 2025, 17(6), 948; https://doi.org/10.3390/nu17060948 - 8 Mar 2025

Cited by 128 | Viewed by 21195

Abstract

The Mediterranean diet (MD) is widely recognized for its health benefits, particularly in modulating gut microbiota composition and reducing the risk of metabolic, cardiovascular, and neurodegenerative diseases. Characterized by a high intake of plant-based foods, monounsaturated fats, and polyphenols, primarily from extra virgin [...] Read more.

The Mediterranean diet (MD) is widely recognized for its health benefits, particularly in modulating gut microbiota composition and reducing the risk of metabolic, cardiovascular, and neurodegenerative diseases. Characterized by a high intake of plant-based foods, monounsaturated fats, and polyphenols, primarily from extra virgin olive oil, the MD fosters the growth of beneficial gut bacteria such as Bifidobacterium, Faecalibacterium prausnitzii, and Roseburia, which produce short-chain fatty acids that enhance gut barrier integrity, reduce inflammation, and improve metabolic homeostasis. Clinical and preclinical studies have proved that the MD is associated with increased microbial diversity, reduced pro-inflammatory bacteria, and improved markers of insulin sensitivity, lipid metabolism, and cognitive function. Additionally, the MD positively influences the gut microbiota in various conditions, including obesity, cardiovascular disease, and neurodegeneration, potentially mitigating systemic inflammation and enhancing neuroprotective mechanisms. Emerging evidence suggests that MD variants, such as the Green-MD, and their integration with probiotics can further optimize gut microbiota composition and metabolic parameters. While the beneficial impact of the MD on the gut microbiota and overall health is well supported, further long-term clinical trials are needed to better understand individual variability and improve dietary interventions tailored to different populations. Full article

(This article belongs to the Special Issue Physical Exercise and Nutrition on the Gastrointestinal Pathophysiology)

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17 pages, 719 KB

Open AccessEditor’s ChoiceReview

Maternal Obesity and Neurodevelopment of the Offspring

by Anna Eleftheriades, Sevasti Koulouraki, Antonios Belegrinos, Makarios Eleftheriades and Panagiota Pervanidou

Nutrients 2025, 17(5), 891; https://doi.org/10.3390/nu17050891 - 2 Mar 2025

Cited by 19 | Viewed by 9144

Abstract

Background: An increasing amount of evidence, derived from both human epidemiological studies and animal research, suggests that exposure to maternal obesity in utero is linked to adverse neurodevelopmental outcomes in the offspring. These can include attention deficit hyperactivity disorder, autism spectrum disorders, intellectual [...] Read more.

Background: An increasing amount of evidence, derived from both human epidemiological studies and animal research, suggests that exposure to maternal obesity in utero is linked to adverse neurodevelopmental outcomes in the offspring. These can include attention deficit hyperactivity disorder, autism spectrum disorders, intellectual disability, and cerebral palsy. Methods: A thorough search in Medline/PubMed and Google Scholar databases was performed by two independent reviewers in order to investigate the link between the exposure to maternal obesity and neurodevelopmental outcomes in the offspring. A list of keywords, including maternal obesity, maternal overweight, maternal diet, neurodevelopment, and neuropsychiatric disorders, was used in the search algorithm. Results: The existing evidence regarding the potential mechanisms through which maternal obesity may impact offspring neurodevelopment and programming, such as inflammation, hormone dysregulation, alterations to the microbiome, and epigenetics, as well as evidence from animal studies, was summarized in this narrative review. Conclusions: Maternal obesity seems to be overall associated with various neuropsychiatric and neurodevelopmental disorders. However, more robust data from future studies are needed to establish this association, which will take into account the role of potential confounders such as genetic factors and gene–environment interactions. Full article

(This article belongs to the Section Nutrition in Women)

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28 pages, 1378 KB

Open AccessEditor’s ChoiceReview

Resveratrol and Physical Activity: A Successful Combination for the Maintenance of Health and Wellbeing?

by Mario Ruggiero, Maria Letizia Motti, Rosaria Meccariello and Filomena Mazzeo

Nutrients 2025, 17(5), 837; https://doi.org/10.3390/nu17050837 - 28 Feb 2025

Cited by 17 | Viewed by 10301

Abstract

Physical exercise is an essential component of human health. In recent years, scientific research has focused on identifying natural compounds and formulating new supplements aimed at enhancing athletic performance, accelerating muscle recovery, and minimizing the damage caused by physical exertion. The use of [...] Read more.

Physical exercise is an essential component of human health. In recent years, scientific research has focused on identifying natural compounds and formulating new supplements aimed at enhancing athletic performance, accelerating muscle recovery, and minimizing the damage caused by physical exertion. The use of antioxidants to counteract the formation of reactive oxygen species (ROS) following physical activity (PA) is already a widely adopted practice. Resveratrol (RES), a polyphenol belonging to the stilbene class, is well known for its potent antioxidant activity and anti-inflammatory effects primarily attributed to the activation of sirtuins. RES possesses multiple nutraceutical properties used for the prevention and treatment of inflammatory, cardiovascular, neoplastic, and infectious diseases, thus attracting attention to study its use in combination with physical exercise to promote well-being. Animal trials combining RES and PA have mainly reported improvements in muscle, energy, and cardiovascular functions. The data presented and discussed in this narrative review are from Pubmed, Scopus, and the Human Gene Database (search limited to 2011 to 2025 with the keywords RES, sirtuins, and physical activity altogether or in combination with each other). This review gathers several studies on RES focusing on its nutraceutical properties, epigenetic activities via sirtuins, and the potential benefits of combining RES with PA in maintaining health and well-being based on trials performed first in animals and later in humans. Human studies have been conducted on various populations, including active adults, sedentary individuals, patients with diseases, and elderly individuals. Some studies have confirmed the benefits of RES observed in animal experiments. However, in some cases, no substantial differences were found between RES supplementation and the control group. In conclusion, the benefits of RES on PA reported in the literature are still not fully evident, given the contrasting studies and the still limited number of trials, but both RES and PA are successful tools for the maintenance of health and wellbeing. Full article

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

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14 pages, 266 KB

Open AccessEditor’s ChoiceReview

Gut over Mind: Exploring the Powerful Gut–Brain Axis

by Stefana-Maria Petrut, Alexandra Maria Bragaru, Alice Elena Munteanu, Adina-Diana Moldovan, Cosmin-Alec Moldovan and Elena Rusu

Nutrients 2025, 17(5), 842; https://doi.org/10.3390/nu17050842 - 28 Feb 2025

Cited by 42 | Viewed by 26946

Abstract

Background: The human gastrointestinal tract is home to a wide variety of microorganisms. For some decades now, bacteria known as probiotics have been added to various foods because of their beneficial effects for human health. Evidence indicates that probiotics significantly regulate gut microbiota, [...] Read more.

Background: The human gastrointestinal tract is home to a wide variety of microorganisms. For some decades now, bacteria known as probiotics have been added to various foods because of their beneficial effects for human health. Evidence indicates that probiotics significantly regulate gut microbiota, which is vital for digestion, metabolism, immune function, and mental health. Methods: We conducted a narrative review of available original research published in PubMed for the past ten years focusing on recent advancements that provide a thorough understanding of the relationship between the gastrointestinal system and the brain. Results: Recent advances in research have focused on the importance of gut microbiota in influencing mental health. The microbiota–gut–brain axis is a complex, bidirectional communication network linking the central nervous system and the gastrointestinal tract, which highlights how the gut and brain are deeply interconnected and influence each other in ways that affect our overall health, emotions, and behavior. This powerful link is a major area of research as scientists discover more about how gut health can impact mental well-being. Conclusions: A comprehensive understanding of microbiota composition and mechanisms involved in these interactions between the gut and the brain could shape future medical and therapeutic approaches. It would balance scientific explanation with clinical relevance, offering insights into how understanding the brain–gut axis can revolutionize our approach to treating mental health and gastrointestinal disorders. Full article

(This article belongs to the Special Issue Nutrition, Gut Microbiota and Immunity)

21 pages, 330 KB

Open AccessEditor’s ChoiceReview

The Role of the Planetary Diet in Managing Metabolic Syndrome and Cardiovascular Disease: A Narrative Review

by Aleksandra Muszalska, Julia Wiecanowska, Joanna Michałowska, Katarzyna Magdalena Pastusiak-Zgolińska, Izabela Polok, Kinga Łompieś and Paweł Bogdański

Nutrients 2025, 17(5), 862; https://doi.org/10.3390/nu17050862 - 28 Feb 2025

Cited by 16 | Viewed by 4973

Abstract

Introduction: The planetary health diet, introduced by the EAT–Lancet Commission, aims to address global health and sustainability challenges by promoting a plant-based diet with reduced consumption of animal-sourced foods. This diet not only contributes to environmental sustainability but also offers significant health benefits, [...] Read more.

Introduction: The planetary health diet, introduced by the EAT–Lancet Commission, aims to address global health and sustainability challenges by promoting a plant-based diet with reduced consumption of animal-sourced foods. This diet not only contributes to environmental sustainability but also offers significant health benefits, including prevention and management of abdominal obesity, carbohydrate metabolism disorders, dyslipidemia, and elevated blood pressure. These metabolic disorders are components of metabolic syndrome, a cluster of risk factors for cardiovascular disease. Objectives: This narrative review aims to gather the most recent findings on the impact of the planetary diet on individual components of metabolic syndrome and on the prevention and treatment of cardiovascular disease. Methods: The available research on the topic was identified via searches in PubMed, Scopus, and Google Scholar. Results: Abdominal obesity, a major risk factor for a range of chronic diseases, can be effectively mitigated by adhering to plant-based dietary patterns, which have been shown to reduce waist circumference and improve overall cardiometabolic health. Furthermore, the planetary diet plays a crucial role in reducing the risk of type-2 diabetes and improving glycemic control, with specific dietary components such as whole grains and fiber, demonstrating positive effects on blood glucose levels. This diet is additionally associated with favorable lipid profiles, including lower levels of LDL cholesterol and total cholesterol, which are critical in the prevention of atherosclerosis and cardiovascular diseases. Conclusions: These multiple benefits highlight that the planetary diet may be an effective strategy for managing and preventing metabolic syndrome and cardiovascular disease. However, further research is needed to confirm its long-term efficacy and applicability across diverse populations. Full article

(This article belongs to the Special Issue Effects of Nutrient Intake on Cardiovascular Disease)

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35 pages, 1868 KB

Open AccessEditor’s ChoiceReview

Impact of Vegan and Vegetarian Diets on Neurological Health: A Critical Review

by Vicente Javier Clemente-Suárez, Laura Redondo-Flórez, Alexandra Martín-Rodríguez, Agustín Curiel-Regueros, Alejandro Rubio-Zarapuz and José Francisco Tornero-Aguilera

Nutrients 2025, 17(5), 884; https://doi.org/10.3390/nu17050884 - 28 Feb 2025

Cited by 38 | Viewed by 50022

Abstract

Background/Objectives: The global shift towards vegan and vegetarian diets has garnered attention for their ethical, environmental, and potential health benefits. These diets are often rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein [...] Read more.

Background/Objectives: The global shift towards vegan and vegetarian diets has garnered attention for their ethical, environmental, and potential health benefits. These diets are often rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6), suggesting a potential protective effect against systemic inflammation and oxidative stress. However, despite these benefits, concerns remain regarding their impact on neurological health due to the possible deficiencies of critical nutrients such as vitamin B12, DHA, EPA, and iron. This review critically evaluates the influence of these dietary patterns on neurological outcomes, emphasizing their nutritional composition, potential deficiencies, and their interplay with inflammation and oxidative stress. Methods: A systematic review of the literature published between 2010 and 2023 was conducted, focusing on studies that explore the relationship between vegan and vegetarian diets and neurological health. Key nutrients such as vitamin B12, omega-3 fatty acids, iron, and zinc were analyzed alongside antinutritional factors and their effects on the nervous system. Results: Evidence suggests that vegan and vegetarian diets, when well planned, can be rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6). These findings indicate a potential role in reducing systemic inflammation and oxidative stress, both of which are linked to neurodegenerative diseases. However, deficiencies in critical nutrients such as vitamin B12, DHA, EPA, and iron have been consistently associated with an increased risk of cognitive decline, mood disturbances, and neurodegenerative disorders. Additionally, the presence of antinutritional factors like phytates and oxalates may further impair nutrient absorption, necessitating careful dietary planning and supplementation. Conclusions: While plant-based diets provide anti-inflammatory and antioxidant benefits, their neurological implications depend on nutrient adequacy. Proper planning, supplementation, and food preparation techniques are essential to mitigate risks and enhance cognitive health. Further research is needed to explore long-term neurological outcomes and optimize dietary strategies. Full article

(This article belongs to the Special Issue Neuro-Nutrition in Sports: Advances in Functional Neurology and Metabolic Care)

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18 pages, 2532 KB

Open AccessEditor’s ChoiceReview

Vitamin D: Beyond Traditional Roles—Insights into Its Biochemical Pathways and Physiological Impacts

by Vlad Mihai Voiculescu, Andreea Nelson Twakor, Nicole Jerpelea and Anca Pantea Stoian

Nutrients 2025, 17(5), 803; https://doi.org/10.3390/nu17050803 - 26 Feb 2025

Cited by 28 | Viewed by 16765

Abstract

Background: It is true that vitamin D did not earn its title as the “sunshine vitamin” for nothing. In recent years, however, there has been a shift in the perception surrounding vitamin D to a type of hormone that boasts countless bioactivities and [...] Read more.

Background: It is true that vitamin D did not earn its title as the “sunshine vitamin” for nothing. In recent years, however, there has been a shift in the perception surrounding vitamin D to a type of hormone that boasts countless bioactivities and health advantages. Historically, vitamin D has been known to take care of skeletal integrity and the calcium–phosphorus balance in the body, but new scientific research displays a much larger spectrum of actions handled by this vitamin. Materials and Methods: A systematic literature search was performed using the following electronic databases: PubMed, Scopus, Web of Science, Embase, and Cochrane Library. Results: Many emerging new ideas, especially concerning alternative hormonal pathways and vitamin D analogs, are uniformly challenging the classic “one hormone–one receptor” hypothesis. To add more context to this, the vitamin D receptor (VDR) was previously assumed to be the only means through which the biologically active steroid 1,25-dihydroxyvitamin D3 could impact the body. Two other molecules apart from the active hormonal form of 1,25(OH)2D3 have gained interest in recent years, and these have reinvigorated research on D3 metabolism. These metabolites can interact with several other nuclear receptors (like related orphan receptor alpha—RORα, related orphan receptor gamma—RORγ, and aryl hydrocarbon receptor—AhR) and trigger various biological responses. Conclusions: This paper thus makes a case for placing vitamin D at the forefront of new holistic and dermatological health research by investigating the potential synergies between the canonical and noncanonical vitamin D pathways. This means that there are now plentiful new opportunities for manipulating and understanding the full spectrum of vitamin D actions, far beyond those related to minerals. Full article

(This article belongs to the Special Issue Assessment of Vitamin D Status and Intake in Human Health)

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13 pages, 1700 KB

Open AccessEditor’s ChoiceArticle

#WhatIEatinaDay: The Quality, Accuracy, and Engagement of Nutrition Content on TikTok

by Michelle Zeng, Jacqueline Grgurevic, Rayan Diyab and Rajshri Roy

Nutrients 2025, 17(5), 781; https://doi.org/10.3390/nu17050781 - 24 Feb 2025

Cited by 37 | Viewed by 29361

Abstract

Background: Social media platforms such as TikTok are significant sources of nutrition information for adolescents and young adults, who are vulnerable to unregulated, algorithm-driven content. This often spreads nutrition misinformation, impacting adolescent and young adult health and dietary behaviors. Objectives: While previous research [...] Read more.

Background: Social media platforms such as TikTok are significant sources of nutrition information for adolescents and young adults, who are vulnerable to unregulated, algorithm-driven content. This often spreads nutrition misinformation, impacting adolescent and young adult health and dietary behaviors. Objectives: While previous research has explored misinformation on other platforms, TikTok remains underexamined, so this study aimed at evaluating the landscape of nutrition-related content on TikTok. Methods: This study evaluated TikTok nutrition-related content by (1) identifying common nutrition topics and content creator types; (2) assessing the quality and accuracy of content using evidence-based frameworks, and (3) analyzing engagement metrics such as likes, comments, and shares. Results: The most common creators were health and wellness influencers (32%) and fitness creators (18%). Recipes (31%) and weight loss (34%) dominated the list of topics. When evaluating TikTok posts for quality, 82% of applicable posts lacked transparent advertising, 77% failed to disclose conflicts of interest, 63% promoted stereotypical attitudes, 55% did not provide evidence-based information, 75% lacked balanced and accurate content, and 90% failed to point out the risk and benefits of the advice presented. A total of 36% of posts were considered completely accurate, while 24% were mostly inaccurate, and 18% completely inaccurate. No statistical significance was associated between the level of accuracy or evidence and engagement metrics (p > 0.05). Conclusions: TikTok prioritizes engagement over accuracy, exposing adolescents to harmful nutrition misinformation. Stricter moderation and evidence-based nutrition content are essential to protect adolescent and young adult health. Future research should explore interventions to reduce the impact of misinformation on adolescent dietary behaviors and mental well-being. Full article

(This article belongs to the Special Issue The Impact of Social Media on Eating Behavior)

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13 pages, 810 KB

Open AccessEditor’s ChoiceReview

Vitamin D Supplementation: Practical Advice in Different Clinical Settings

by Giulia Bendotti, Emilia Biamonte, Paola Leporati, Umberto Goglia, Rosaria Maddalena Ruggeri and Marco Gallo

Nutrients 2025, 17(5), 783; https://doi.org/10.3390/nu17050783 - 24 Feb 2025

Cited by 17 | Viewed by 11791

Abstract

A global deficiency in vitamin D is now widely prevalent. Extensive scientific research has provided compelling evidence of the detrimental effects of vitamin D deficiency on the skeletal system. Furthermore, vitamin D supplementation not only helps prevent bone fractures but may also slow [...] Read more.

A global deficiency in vitamin D is now widely prevalent. Extensive scientific research has provided compelling evidence of the detrimental effects of vitamin D deficiency on the skeletal system. Furthermore, vitamin D supplementation not only helps prevent bone fractures but may also slow the progression of various conditions, such as diabetes, autoimmune disorders, and cardiovascular disease. Achieving optimal circulating vitamin D levels can be challenging, particularly in certain clinical scenarios. Moreover, the effect of vitamin D supplementation varies depending on factors such as body weight, pregnancy status, absorption capacity, metabolic rate, and renal function. This review aims to explore which vitamin D formulations are most effective in specific clinical contexts where reaching adequate vitamin D levels may not be straightforward. Full article

(This article belongs to the Special Issue Nutrition 3.0: Between Tradition and Innovation)

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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 52 | Viewed by 26796

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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15 pages, 998 KB

Open AccessEditor’s ChoiceReview

Beneficial Effects of Butyrate on Kidney Disease

by Tram N. Diep, Haoxin Liu and Liang-Jun Yan

Nutrients 2025, 17(5), 772; https://doi.org/10.3390/nu17050772 - 22 Feb 2025

Cited by 20 | Viewed by 5410

Abstract

The gut microbiota influences and contributes to kidney health and disease. Butyrate, a short-chain fatty acid molecule generated via the fermentation of gut bacterial catabolism of nondigestible dietary fiber, has been shown to exert numerous beneficial effects on kidney disorders. The objective of [...] Read more.

The gut microbiota influences and contributes to kidney health and disease. Butyrate, a short-chain fatty acid molecule generated via the fermentation of gut bacterial catabolism of nondigestible dietary fiber, has been shown to exert numerous beneficial effects on kidney disorders. The objective of this review was to discuss the latest findings on the protective effects of butyrate on a variety of animal models of kidney injury. We conducted a PubMed search using the title word “butyrate” and keyword “kidney” to generate our literature review sources. The animal models covered in this review include ischemia–reperfusion renal injury, cisplatin- and folic acid-induced kidney injury, septic kidney injury, diabetic kidney disease (DKD), high-fat diet (HFD)-induced glomerulopathy, adenine-induced chronic kidney disease (CKD), high-salt-induced renal injury, and T-2 toxin-induced kidney injury in birds. The protective mechanisms of butyrate that are most shared among these animal model studies include antioxidative stress, anti-fibrosis, anti-inflammation, and anti-cell death. This review ends with suggestions for future studies on potential approaches that may modulate gut microbiota butyrate production for the well-being of kidneys with the kidney disorders covered in this review. Full article

(This article belongs to the Special Issue Effects of Diet and Nutrition on Chronic Kidney Disease (CKD)—"Greedy Kidney" in Health and Diseases)

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45 pages, 9570 KB

Open AccessEditor’s ChoiceReview

Much More than Nutrients: The Protective Effects of Nutraceuticals on the Blood–Brain Barrier in Diseases

by Anna E. Kocsis, Nóra Kucsápszky, Ana Raquel Santa-Maria, Attila Hunyadi, Mária A. Deli and Fruzsina R. Walter

Nutrients 2025, 17(5), 766; https://doi.org/10.3390/nu17050766 - 21 Feb 2025

Cited by 16 | Viewed by 8661

Abstract

The dysfunction of the blood–brain barrier (BBB) is well described in several diseases, and is considered a pathological factor in many neurological disorders. This review summarizes the most important groups of natural compounds, including alkaloids, flavonoids, anthocyanidines, carotenoids, lipids, and vitamins that were [...] Read more.

The dysfunction of the blood–brain barrier (BBB) is well described in several diseases, and is considered a pathological factor in many neurological disorders. This review summarizes the most important groups of natural compounds, including alkaloids, flavonoids, anthocyanidines, carotenoids, lipids, and vitamins that were investigated for their potential protective effects on brain endothelium. The brain penetration of these compounds and their interaction with BBB efflux transporters and solute carriers are discussed. The cerebrovascular endothelium is considered a therapeutic target for natural compounds in diseases. In preclinical studies modeling systemic and central nervous system diseases, nutraceuticals exerted beneficial effects on the BBB. In vivo, they decreased BBB permeability, brain edema, astrocyte swelling, and morphological changes in the vessel structure and basal lamina. At the level of brain endothelial cells, nutraceuticals increased cell survival and decreased apoptosis. From the general endothelial functions, decreased angiogenesis and increased levels of vasodilating agents were demonstrated. From the BBB functions, elevated barrier integrity by tightened intercellular junctions, and increased expression and activity of BBB transporters, such as efflux pumps, solute carriers, and metabolic enzymes, were shown. Nutraceuticals enhanced the antioxidative defense and exerted anti-inflammatory effects at the BBB. The most important signaling changes mediating the increased cell survival and BBB stability were the activation of the WNT, PI3K-AKT, and NRF2 pathways, and inhibition of the MAPK, JNK, ERK, and NF-κB pathways. Nutraceuticals represent a valuable source of new potentially therapeutic molecules to treat brain diseases by protecting the BBB. Full article

(This article belongs to the Special Issue Dietary Strategies for Cerebrovascular Health: Prevention, Treatment, and Risk Factors)

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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 26 | Viewed by 13113

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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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 23 | Viewed by 5560

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)

10 pages, 192 KB

Open AccessEditor’s ChoiceReview

The Role of the Gut Microbiome and Probiotics in Sports Performance: A Narrative Review Update

by Harry Jarrett, Sophie Medlin and James C. Morehen

Nutrients 2025, 17(4), 690; https://doi.org/10.3390/nu17040690 - 14 Feb 2025

Cited by 15 | Viewed by 14979

Abstract

Background/Objectives: Gut microbiome modulation through probiotics is a growing area of research, with several investigations reporting beneficial health outcomes for the host. Physical exercise has been shown to impact gut microbiome diversity. Emerging evidence suggests that probiotic supplementation can affect exercise performance. However, [...] Read more.

Background/Objectives: Gut microbiome modulation through probiotics is a growing area of research, with several investigations reporting beneficial health outcomes for the host. Physical exercise has been shown to impact gut microbiome diversity. Emerging evidence suggests that probiotic supplementation can affect exercise performance. However, the mechanisms and domain-specific effects of gut microbiome modulation on performance remain to be elucidated. This narrative review aims to investigate the potential mechanisms underpinning the ergogenic benefits of probiotics and further define the current evidence base for specific performance domains. Discussion: The literature suggests that improved recovery after intense training regimes, enhanced nutrient absorption, alleviation of gastrointestinal symptoms, and improved immune function may underpin the beneficial effects of probiotics on sporting performance. A small number of trials also suggest that probiotic supplementation may improve symptoms of performance anxiety. However, further research is warranted on this topic. The evidence is most substantial for improvements in endurance performance, whilst only a few trials have investigated the impact upon power performance, albeit with promising results. Conclusions/Future Perspectives: In summary, probiotic supplementation has been shown to improve sporting performance; future research may wish to further explore the impact on power performance and investigate specific mechanisms of action. Full article

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

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 23 | Viewed by 20122

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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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 61 | Viewed by 28600

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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18 pages, 1038 KB

Open AccessEditor’s ChoiceReview

Dietary Lipids, Gut Microbiota, and Their Metabolites: Insights from Recent Studies

by Farzad Mohammadi and Iwona Rudkowska

Nutrients 2025, 17(4), 639; https://doi.org/10.3390/nu17040639 - 11 Feb 2025

Cited by 20 | Viewed by 9910

Abstract

Dietary lipid intake can influence the gut microbiota (GM) and their metabolites, such as short-chain fatty acids (SCFA) and bile acids, which are key mediators of health. The objective is to examine how dietary lipids’ quantity and quality influence the GM and metabolite [...] Read more.

Dietary lipid intake can influence the gut microbiota (GM) and their metabolites, such as short-chain fatty acids (SCFA) and bile acids, which are key mediators of health. The objective is to examine how dietary lipids’ quantity and quality influence the GM and metabolite profiles. A literature review of 33 studies in animals and humans was performed on the effects of saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), trans-fatty acids (TFAs), and sterols on GM composition and gut-derived metabolites. The results show that diets rich in MUFAs, n-3 PUFAs, and short-chain FAs have the potential to enhance beneficial bacteria and metabolites. In addition, trans-palmitoleic acid, conjugated linoleic acid, and phytosterols may also have potentially beneficial effects on GM, but more research is needed. Medium-chain FAs and n-6 PUFAs have variable effects on the GM. Conversely, intakes of high-fat diets, long-chain SFAs, industrial TFAs, and cholesterol disrupt GM balance. In conclusion, animal studies clearly demonstrate that dietary fats influence the GM and related metabolites. Yet, human studies are limited. Therefore, well-designed human studies that consider the whole diet and baseline health status are needed to better understand the effects of dietary lipids on GM. Full article

(This article belongs to the Special Issue The Role of Fatty Acids in Diet, Gut Microbiota, and Metabolic Health)

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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 33 | Viewed by 24503

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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38 pages, 2054 KB

Open AccessEditor’s ChoiceReview

Polyphenol-Based Prevention and Treatment of Cancer Through Epigenetic and Combinatorial Mechanisms

by Neha Singaravelan and Trygve O. Tollefsbol

Nutrients 2025, 17(4), 616; https://doi.org/10.3390/nu17040616 - 8 Feb 2025

Cited by 41 | Viewed by 11258

Abstract

Polyphenols have been shown to be utilized as an effective treatment for cancer by acting as a DNMT or HDAC inhibitor, reducing inflammatory processes, and causing cell cycle arrest. While there have been many studies demonstrating the anti-cancerous potential of individual polyphenols, there [...] Read more.

Polyphenols have been shown to be utilized as an effective treatment for cancer by acting as a DNMT or HDAC inhibitor, reducing inflammatory processes, and causing cell cycle arrest. While there have been many studies demonstrating the anti-cancerous potential of individual polyphenols, there are limited studies on the combinatorial effects of polyphenols. This review focuses on how combinations of different polyphenols can be used as a chemotherapeutic treatment option for patients. Specifically, we examine the combinatorial effects of three commonly used polyphenols: curcumin, resveratrol, and epigallocatechin gallate. These combinations have been shown to induce apoptosis, prevent colony formation and migration, increase tumor suppression, reduce cell viability and angiogenesis, and create several epigenetic modifications. In addition, these anti-cancerous effects were synergistic and additive. Thus, these findings suggest that using different combinations of polyphenols at the appropriate concentrations can be used as a better and more efficacious treatment against cancer as compared to using polyphenols individually. Full article

(This article belongs to the Special Issue Polyphenols and Plant Extracts for the Prevention of Cancer)

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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 36 | Viewed by 12608

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 29 | Viewed by 14324

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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16 pages, 1466 KB

Open AccessEditor’s ChoiceReview

Vitamin D Enhancement of Adipose Biology: Implications on Obesity-Associated Cardiometabolic Diseases

by Mi-Jeong Lee

Nutrients 2025, 17(3), 586; https://doi.org/10.3390/nu17030586 - 6 Feb 2025

Cited by 33 | Viewed by 9397

Abstract

Vitamin D is activated into 1α,25(OH)₂D through two hydroxylation steps that are primarily catalyzed by 25-hydroxylase in the liver and 1α-hydroxylase in the kidneys. The active form of vitamin D regulates myriads of cellular functions through its nuclear receptor, vitamin D [...] Read more.

Vitamin D is activated into 1α,25(OH)₂D through two hydroxylation steps that are primarily catalyzed by 25-hydroxylase in the liver and 1α-hydroxylase in the kidneys. The active form of vitamin D regulates myriads of cellular functions through its nuclear receptor, vitamin D receptor (VDR). Vitamin D metabolizing enzymes and VDR are expressed in adipose tissues and vitamin D regulates multiple aspects of adipose biology including the recruitment and differentiation of adipose stem cells into adipocytes and metabolic, endocrine, and immune properties. Obesity is associated with low vitamin D status, which is thought to be explained by its sequestration in large mass of adipose tissues as well as dysregulated vitamin D metabolism. Low vitamin D status in obesity may negatively impact adipose biology leading to adipose tissue dysfunctions, the major pathological factors for cardiometabolic diseases in obesity. In this review, the current understanding of vitamin D metabolism and its molecular mechanisms of actions, focusing on vitamin D–VDR regulation of adipose biology with their implications on obesity-associated diseases, is discussed. Whether improving vitamin D status leads to reductions in adiposity and risks for cardiometabolic diseases is also discussed. Full article

(This article belongs to the Special Issue Vitamin D in Relation to Diet-Related Diseases)

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15 pages, 238 KB

Open AccessEditor’s ChoiceArticle

Investigating the Consumer Choices of Gen Z: A Sustainable Food System Perspective

by Ewa Halicka, Joanna Kaczorowska, Krystyna Rejman and Marta Plichta

Nutrients 2025, 17(3), 591; https://doi.org/10.3390/nu17030591 - 6 Feb 2025

Cited by 28 | Viewed by 22774

Abstract

Background/Objectives: Developing nutrition-oriented and more responsible consumer behaviors is crucial for the well-being of current and future generations. Food choice determinants and concerns of Gen Zs—also referred to as Post-Millennials, or Zoomers—were explored from a sustainable food system perspective to identify factors encouraging [...] Read more.

Background/Objectives: Developing nutrition-oriented and more responsible consumer behaviors is crucial for the well-being of current and future generations. Food choice determinants and concerns of Gen Zs—also referred to as Post-Millennials, or Zoomers—were explored from a sustainable food system perspective to identify factors encouraging young people to be on the front line of this much-needed transformation. Methods: Quantitative data were collected with the use of the CAWI method from 650 adults representing Generation Z living in Polish cities. Statistical analysis identified three consumer segments, and cluster (CL) means were statistically contrasted using a one-way ANOVA with Scheffé tests for post hoc comparisons. Results: The research results indicate that the key considerations of food choice in the studied Gen Z sample are taste, price, and health. External factors, such as social media influencers and consumer trends, play a relatively minor role in decision-making. Gen Zs were more aware of the link between their eating patterns and health than the link between their eating habits and the natural environment. Members of the biggest cluster (CL3), constituting 48.3% of the total sample, declared the highest level of agreement with statements referring to links between diet, environment, and health from the food system perspective. This most allo-centered (community-oriented, altruistic) consumer segment, differing significantly with gender to other CLs was more concerned about climate change and protecting the natural environment and open to changing its dietary habits. Conclusions: Implementing research-based policy measures focusing on Generation Z, especially young women, as potential leaders and drivers of food system change is recommended. Full article

(This article belongs to the Special Issue Transition towards Sustainable Healthy Diets: A Complex Journey)

14 pages, 451 KB

Open AccessEditor’s ChoiceArticle

Unlocking the Predictive Power of Nutritional Scores in Septic Patients

by Arianna Toscano, Federica Bellone, Noemi Maggio, Maria Cinquegrani, Francesca Spadaro, Francesca Maria Bueti, Giuseppe Lorello, Herbert Ryan Marini, Alberto Lo Gullo, Giorgio Basile, Giovanni Squadrito, Giuseppe Mandraffino and Carmela Morace

Nutrients 2025, 17(3), 545; https://doi.org/10.3390/nu17030545 - 31 Jan 2025

Cited by 22 | Viewed by 3607

Abstract

Background: Sepsis is a critical condition characterized by severe immune dysregulation, ranking among the leading causes of morbidity and mortality in intensive care and internal medicine units. Nutritional status plays a pivotal role in modulating these responses, as when inadequate it can [...] Read more.

Background: Sepsis is a critical condition characterized by severe immune dysregulation, ranking among the leading causes of morbidity and mortality in intensive care and internal medicine units. Nutritional status plays a pivotal role in modulating these responses, as when inadequate it can compromise immune defenses, the body’s ability to handle stress and inflammation, and the clinical course. Malnutrition is frequently observed in septic patients and is strongly associated with worse clinical outcomes, including increased mortality, prolonged hospital stays, and greater complication rates. In this context, nutritional scoring systems have emerged as valuable tools to evaluate patients’ nutritional status and predict clinical trajectories. Objectives: Given the absence of a direct comparison of their performance in an internal medicine setting, this study aimed to assess the effectiveness of various nutritional scores as predictive tools for clinical outcomes in septic patients, emphasizing their application within the field of internal medicine. Methods and Results: A retrospective analysis was conducted on 143 patients diagnosed with sepsis or septic shock who were admitted to an internal medicine unit. Key variables included clinical and laboratory parameters, comorbidities, and nutritional scores at the time of diagnosis. The modified Glasgow Prognostic Score (mGPS), the Prognostic Nutritional Index (PNI), the Controlling Nutritional Status (CONUT) score, the modified Nutrition Risk in Critically Ill (mNUTRIC) score, and the blood urea nitrogen-to-albumin ratio (BAR) were evaluated in forecasting mortality and clinical outcomes in patients with sepsis. Among them, the mNUTRIC score emerged as the strongest independent predictor of in-hospital mortality, with a good performance and a reasonable threshold for risk stratification. Conclusions: The study highlights the mNUTRIC score’s practicality and reliability in assessing nutritional and inflammatory risks in septic patients, particularly in non-ICU settings. These findings suggest its potential utility in guiding nutritional interventions and improving clinical outcomes, emphasizing the importance of integrating nutritional assessment into sepsis management. Full article

(This article belongs to the Section Clinical Nutrition)

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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 48 | Viewed by 19360

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, Probiotics and Postbiotics)

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29 pages, 2380 KB

Open AccessEditor’s ChoiceReview

Unraveling the Connections: Eating Issues, Microbiome, and Gastrointestinal Symptoms in Autism Spectrum Disorder

by Natalia Tomaszek, Agata Dominika Urbaniak, Daniel Bałdyga, Kamila Chwesiuk, Stefan Modzelewski and Napoleon Waszkiewicz

Nutrients 2025, 17(3), 486; https://doi.org/10.3390/nu17030486 - 29 Jan 2025

Cited by 26 | Viewed by 13515

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by challenges in social communication, restricted interests, and repetitive behaviors. It is also associated with a high prevalence of eating disorders, gastrointestinal (GI) symptoms, and alterations in gut microbiota composition. One of the most [...] Read more.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by challenges in social communication, restricted interests, and repetitive behaviors. It is also associated with a high prevalence of eating disorders, gastrointestinal (GI) symptoms, and alterations in gut microbiota composition. One of the most pressing concerns is food selectivity. Various eating disorders, such as food neophobia, avoidant/restrictive food intake disorder (ARFID), specific dietary patterns, and poor-quality diets, are commonly observed in this population, often leading to nutrient deficiencies. Additionally, gastrointestinal problems in children with ASD are linked to imbalances in gut microbiota and immune system dysregulation. The aim of this narrative review is to identify previous associations between the gut–brain axis and gastrointestinal problems in ASD. We discuss the impact of the “microbiome–gut–brain axis”, a bidirectional connection between gut microbiota and brain function, on the development and symptoms of ASD. In gastrointestinal problems associated with ASD, a ‘vicious cycle’ may play a significant role: ASD symptoms contribute to the prevalence of ARFID, which in turn leads to microbiota degradation, ultimately worsening ASD symptoms. Current data suggest a link between gastrointestinal problems in ASD and the microbiota, but the amount of evidence is limited. Further research is needed, targeting the correlation of a patient’s microbiota status, dietary habits, and disease course. Full article

(This article belongs to the Special Issue Dietary Patterns: Do Children with Neurodevelopmental Disorders Eat Differently? (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 19 | Viewed by 5641

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 30 | Viewed by 9913

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, 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 143 | Viewed by 57836

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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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 39 | Viewed by 23538

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 21 | Viewed by 10853

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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27 pages, 613 KB

Open AccessEditor’s ChoiceReview

Harnessing Edible Wild Fruits: Sustainability and Health Aspects

by Lorena González-Zamorano, Rosa M. Cámara, Patricia Morales and Montaña Cámara

Nutrients 2025, 17(3), 412; https://doi.org/10.3390/nu17030412 - 23 Jan 2025

Cited by 21 | Viewed by 4919

Abstract

Our health, well-being, and development are intrinsically linked to the preservation of biodiversity. This situation has driven the establishment of numerous treaties, international agreements, and regulatory frameworks that address sustainable food systems from multiple perspectives, including agriculture, food security, biodiversity, and environmental sustainability. [...] Read more.

Our health, well-being, and development are intrinsically linked to the preservation of biodiversity. This situation has driven the establishment of numerous treaties, international agreements, and regulatory frameworks that address sustainable food systems from multiple perspectives, including agriculture, food security, biodiversity, and environmental sustainability. The objective of this study is to review the potential of wild edible fruits in terms of sustainability and implications for human health. Specifically, this work examines the contribution of these fruits to promoting biodiversity, and their support for sustainable food systems as well as their beneficial role in human health. Additionally, it considers the evolution of relevant international treaties related to the preservation of wild fruits. An in-depth review of international treaties related to the conservation of wild fruits was conducted by consulting information available on official websites of international organizations such as the United Nations and the Food and Agriculture Organization of the United Nations (FAO), among others. Next, a review of the sustainability and health benefits of edible wild fruits was performed. Results showed that although numerous studies have demonstrated the health benefits of wild edible fruits, there is still a lack of scientific evidence showing that the use of these species could have positive effects not only on human health and well-being but also on the environment and biodiversity. Thus, integrating these fruits into sustainable practices could play a key role in supporting future food security and the well-being of communities. Full article

(This article belongs to the Special Issue Advances in Sustainable Healthy Diets)

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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 25 | Viewed by 8675

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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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 20 | Viewed by 7883

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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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 73 | Viewed by 31303

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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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 23 | Viewed by 9575

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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26 pages, 8647 KB

Open AccessEditor’s ChoiceArticle

An Explainable CNN and Vision Transformer-Based Approach for Real-Time Food Recognition

by Kintoh Allen Nfor, Tagne Poupi Theodore Armand, Kenesbaeva Periyzat Ismaylovna, Moon-Il Joo and Hee-Cheol Kim

Nutrients 2025, 17(2), 362; https://doi.org/10.3390/nu17020362 - 20 Jan 2025

Cited by 38 | Viewed by 7215

Abstract

Background: Food image recognition, a crucial step in computational gastronomy, has diverse applications across nutritional platforms. Convolutional neural networks (CNNs) are widely used for this task due to their ability to capture hierarchical features. However, they struggle with long-range dependencies and global feature [...] Read more.

Background: Food image recognition, a crucial step in computational gastronomy, has diverse applications across nutritional platforms. Convolutional neural networks (CNNs) are widely used for this task due to their ability to capture hierarchical features. However, they struggle with long-range dependencies and global feature extraction, which are vital in distinguishing visually similar foods or images where the context of the whole dish is crucial, thus necessitating transformer architecture. Objectives: This research explores the capabilities of the CNNs and transformers to build a robust classification model that can handle both short- and long-range dependencies with global features to accurately classify food images and enhance food image recognition for better nutritional analysis. Methods: Our approach, which combines CNNs and Vision Transformers (ViTs), begins with the RestNet50 backbone model. This model is responsible for local feature extraction from the input image. The resulting feature map is then passed to the ViT encoder block, which handles further global feature extraction and classification using multi-head attention and fully connected layers with pre-trained weights. Results: Our experiments on five diverse datasets have confirmed a superior performance compared to the current state-of-the-art methods, and our combined dataset leveraging complementary features showed enhanced generalizability and robust performance in addressing global food diversity. We used explainable techniques like grad-CAM and LIME to understand how the models made their decisions, thereby enhancing the user’s trust in the proposed system. This model has been integrated into a mobile application for food recognition and nutrition analysis, offering features like an intelligent diet-tracking system. Conclusion: This research paves the way for practical applications in personalized nutrition and healthcare, showcasing the extensive potential of AI in nutritional sciences across various dietary platforms. Full article

(This article belongs to the Special Issue Digital Transformations in Nutrition)

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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 15 | Viewed by 5424

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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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 25 | Viewed by 33906

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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19 pages, 1366 KB

Open AccessEditor’s ChoiceReview

Associations Between Adherence to the Mediterranean Diet and Incident Sarcopenia in Prospective Cohort Studies

by Ligia J. Dominguez, Nicola Veronese, Lee Smith, Francesco Saverio Ragusa, Piero Schirò, Giovanna Di Bella and Mario Barbagallo

Nutrients 2025, 17(2), 313; https://doi.org/10.3390/nu17020313 - 16 Jan 2025

Cited by 18 | Viewed by 7836

Abstract

The loss of skeletal muscle mass and strength, known as sarcopenia, is prevalent in older adults and linked to an increased risk of disability, frailty, and early mortality. Muscle health is crucial for the functionality and independence of older adults. As the aging [...] Read more.

The loss of skeletal muscle mass and strength, known as sarcopenia, is prevalent in older adults and linked to an increased risk of disability, frailty, and early mortality. Muscle health is crucial for the functionality and independence of older adults. As the aging population continuously grows, finding cost-effective strategies for preventing and treating sarcopenia is an important public health priority. While nutrition is recognized as a key factor in the development of sarcopenia, its role in preventing and treating the condition is still under investigation. In recent decades, nutritional research has shifted from a focus on individual nutrients or healthy foods to examining the combination of nutrients and foods in dietary patterns, along with their potential synergistic and antagonistic effects. A balanced diet and regular participation in physical activity are essential for maintaining musculoskeletal health. One of the healthy eating patterns with the greatest evidence of multiple health benefits is the Mediterranean diet, which has also been linked to positive effects on muscle function in observational studies. However, there is a lack of intervention studies. This review explores the updated evidence from longitudinal prospective studies on associations between adherence to the Mediterranean diet and sarcopenia in order to promote preventive and intervention strategies for healthy muscle aging. Full article

(This article belongs to the Special Issue Mediterranean Diet – Health Benefits and Advances)

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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 51 | Viewed by 15699

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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29 pages, 642 KB

Open AccessEditor’s ChoiceReview

Non-Celiac Gluten/Wheat Sensitivity—State of the Art: A Five-Year Narrative Review

by Francesca Manza, Lisa Lungaro, Anna Costanzini, Fabio Caputo, Antonio Carroccio, Pasquale Mansueto, Aurelio Seidita, Suneil A. Raju, Umberto Volta, Roberto De Giorgio, David S. Sanders and Giacomo Caio

Nutrients 2025, 17(2), 220; https://doi.org/10.3390/nu17020220 - 8 Jan 2025

Cited by 21 | Viewed by 25542

Abstract

Background: Non-celiac gluten/wheat sensitivity (NCGWS) is a syndrome for which pathogenesis and management remain debated. It is described as a condition characterized by gastrointestinal and extra-intestinal symptoms rapidly occurring after gluten ingestion in subjects who have had celiac disease or wheat allergy excluded. [...] Read more.

Background: Non-celiac gluten/wheat sensitivity (NCGWS) is a syndrome for which pathogenesis and management remain debated. It is described as a condition characterized by gastrointestinal and extra-intestinal symptoms rapidly occurring after gluten ingestion in subjects who have had celiac disease or wheat allergy excluded. To date, the diagnosis of NCGWS is challenging as no universally recognized biomarkers have been yet identified, nor has a predisposing genetic profile been described. However, the research is moving fast, and new data regarding pathogenic pathways, patients’ classification, potential candidate biomarkers, and dietary interventions are emerging. Methods: This literature review aims to address the state of the art and summarize the latest updates in this field from 2019 to date. Results and Conclusions: Clinical studies regarding NCGWS in the last five years are reported to shed light on this complex condition and to guide specialists towards a more in-depth, prompt, and objective diagnosis. Full article

(This article belongs to the Section Nutritional Immunology)

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16 pages, 452 KB

Open AccessEditor’s ChoiceArticle

The Impact of Social Media on Eating Disorder Risk and Self-Esteem Among Adolescents and Young Adults: A Psychosocial Analysis in Individuals Aged 16–25

by Sylwia Jaruga-Sękowska, Wiktoria Staśkiewicz-Bartecka and Joanna Woźniak-Holecka

Nutrients 2025, 17(2), 219; https://doi.org/10.3390/nu17020219 - 8 Jan 2025

Cited by 19 | Viewed by 29143

Abstract

Background/Objectives: Eating disorders (EDs) result from complex interactions of biological, psychological, social, and cultural factors, disproportionately affecting adolescents and young adults. Social media, peer pressure, and self-esteem issues contribute to ED prevalence. This study examines ED risk, eating behaviors, and self-esteem among individuals [...] Read more.

Background/Objectives: Eating disorders (EDs) result from complex interactions of biological, psychological, social, and cultural factors, disproportionately affecting adolescents and young adults. Social media, peer pressure, and self-esteem issues contribute to ED prevalence. This study examines ED risk, eating behaviors, and self-esteem among individuals aged 16–25, exploring differences by gender, age, and social media usage. Methods: A total of 261 participants (113 high school students, 115 college students, 33 working individuals) completed the Computer-Assisted Web Interview (CAWI) between April and June 2024. This study utilized the Eating Attitudes Test-26 (EAT-26), Rosenberg Self-Esteem Scale (SES), and My Eating Habits (MEH) questionnaires. Statistical analyses, including chi-square tests and linear regression, assessed associations between ED risk, self-esteem, and social media activity. Results: ED risk was identified in 47% (n = 123) of participants, with the highest prevalence in high school students (56.6%, n = 64). Significant gender differences were observed (p < 0.001), with males in the high school group showing elevated ED risk (64%, n = 32). Body dissatisfaction and frequent social media comparisons increased ED risk (p < 0.001); 45.7% (n = 102) of participants who often compared their bodies online reported heightened risk. Photo manipulation correlated with higher ED risk (p = 0.005). Regression analysis revealed a significant relationship between ED risk and restrictive dieting (estimate = 0.9239; p < 0.001), while self-esteem had no significant effect (estimate = 0.00503, p = 0.977). Conclusions: This study highlights high ED risk driven by social media and body dissatisfaction. Interventions should focus on body image issues, self-acceptance, and media literacy. This study focused on a specific age group (16–25) in Poland, which may limit the ability to generalize the results to other demographic or cultural groups. Future research should include more diverse populations and objective measurements. Full article

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

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