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12 pages, 518 KB

Open AccessArticle

Association Between Dietary Intake, Meal Patterns, and Malnutrition Risk Among Community-Dwelling Elderly in Northern Thailand: A Cross-Sectional Study

by Thanawit Sathittrakun, Narumit Bankhum, Phichayut Phinyo, Tanasit Wijitraphan, Yanee Choksomngam and Nalinee Yingchankul

Nutrients 2025, 17(22), 3537; https://doi.org/10.3390/nu17223537 - 12 Nov 2025

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Abstract

Background: Malnutrition is prevalent among older adults in low- and middle-income countries (LMIC), but the roles of dietary intake and meal patterns are less understood in community settings. Objective: To investigate the associations between dietary intake, meal patterns, and malnutrition risk among community-dwelling [...] Read more.

Background: Malnutrition is prevalent among older adults in low- and middle-income countries (LMIC), but the roles of dietary intake and meal patterns are less understood in community settings. Objective: To investigate the associations between dietary intake, meal patterns, and malnutrition risk among community-dwelling older adults. Methods: We conducted a cross-sectional study including 200 adults aged ≥60 years in San Pa Tong District, Chiang Mai and used standardized questionnaires to collect sociodemographic, health, and dietary data. Nutritional status was assessed using the Mini Nutritional Assessment–Full Form (MNA-FF), with scores <24 indicated malnutrition risk. Meal patterns included overnight fasting duration, meal skipping, and eating frequency. Associations were examined using multivariable logistic regression with adjustment for confounding. Results: Overall, 23% of participants were at risk of malnutrition. Micronutrient inadequacy was widespread, and 92.5% exceeded the sodium upper limit. In multivariable models, higher vitamin E intake was independently associated with a lower likelihood of malnutrition (OR = 0.07, 95% CI: 0.01–0.45), whereas longer overnight fasting increased risk (OR = 1.94, 95% CI: 1.30–2.89) and having more eating episodes was protective (OR = 0.19, 95% CI: 0.06–0.57). Conclusions: Adequate vitamin E intake and regular meal patterns were associated with reduced malnutrition risk. Public health interventions should prioritize micronutrient adequacy, sodium reduction, and the promotion of regular eating patterns. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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15 pages, 883 KB

Open AccessArticle

Sex Differences in Associations Between Diet and Metabolic Health in Older Adults: The Roles of Vegetable Protein and Alcohol Intake

by Kayla R. Anderson, Philip A. Kern, Allison L. Steele, Brooke D. Lancaster, Madison Bee, Alyaa M. Zagzoog, Stacey A. Slone, Douglas E. Long and Jean L. Fry

Nutrients 2025, 17(21), 3460; https://doi.org/10.3390/nu17213460 - 2 Nov 2025

Viewed by 1293

Abstract

Background/Objective: Aging is associated with a decline in metabolic health, including impaired glucose regulation. Both diet and biological sex impact metabolic health, yet sexual heterogeneity in diet response is understudied. We report on exploratory analyses of sex-specific associations between diet and insulin sensitivity, [...] Read more.

Background/Objective: Aging is associated with a decline in metabolic health, including impaired glucose regulation. Both diet and biological sex impact metabolic health, yet sexual heterogeneity in diet response is understudied. We report on exploratory analyses of sex-specific associations between diet and insulin sensitivity, insulin resistance, and android and intermuscular fat composition in older adults. Methods: This secondary analysis uses baseline data from a previously completed clinical trial (n = 96), the MASTERS study. An oral glucose tolerance test (OGTT) was used to calculate insulin resistance and insulin sensitivity as measures of metabolic function, while dual-energy x-ray absorptiometry and computed tomography were used to assess body composition. Univariate analyses were used to identify sex-specific associations between metabolic health and single nutrients, as well as other dietary components. Feasible solutions algorithm (FSA) modeling was employed to identify food groups that were most associated with insulin sensitivity. Results: In men, greater intakes of vegetable protein (p < 0.0001) and whole grains (p = 0.001) were associated with higher insulin sensitivity, while refined grains (p = 0.003) and conjugated linoleic acids (p < 0.001) were negatively associated. In women, insulin sensitivity was positively associated with alcohol (p < 0.001) and xylitol (p = 0.007). FSA modeling identified whole grains, nuts, and seeds as food groups that predicted higher insulin sensitivity in men, while alcohol remained the strongest predictor in women. Conclusions: Men showed higher insulin sensitivity with plant-based diets, while alcohol intake was the dietary factor most associated with insulin sensitivity in women. The findings of these exploratory analyses support the need for sex-specific clinical trials and dietary guidance for aging populations. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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18 pages, 2379 KB

Open AccessArticle

Cardiometabolic Phenotypes and Dietary Patterns in Albanian University-Enrolled Young Adults: Cross-Sectional Findings from the Nutrition Synergies WHO-Aligned Sentinel Platform

by Vilma Gurazi, Sanije Zejnelhoxha, Megisa Sulenji, Lajza Koxha, Herga Protoduari, Kestjana Arapi, Elma Rexha, Flavia Gjata, Orgesa Spahiu and Erand Llanaj

Nutrients 2025, 17(21), 3395; https://doi.org/10.3390/nu17213395 - 29 Oct 2025

Viewed by 918

Abstract

Background: Albania is undergoing rapid nutrition transition, yet cardiometabolic (CM) risk in young adults is poorly characterized. We report baseline, cross-sectional findings from a WHO-aligned sentinel study examining diet, physical activity and early CM phenotypes, with fat quality examined as a modifiable [...] Read more.

Background: Albania is undergoing rapid nutrition transition, yet cardiometabolic (CM) risk in young adults is poorly characterized. We report baseline, cross-sectional findings from a WHO-aligned sentinel study examining diet, physical activity and early CM phenotypes, with fat quality examined as a modifiable exposure. Methods: Young adults recruited on campus (n = 262; median age, 21 years; 172 women, 90 men) underwent standardized anthropometry, seated blood pressure (BP) and fasting glucose (FG). Diet was assessed by two interviewer-administered 24 h recalls and activity outlined by the IPAQ-short form. We derived potential renal acid load (PRAL) and a MASLD-oriented nutrient score, computed a composite CM risk score (cCMRS: sex-standardized mean of WHtR, mean arterial pressure, FG) and fitted prespecified energy-partition models for isocaloric +5% of energy substitutions (SFA → PUFA; SFA → MUFA) with Benjamini–Hochberg false discovery rate (FDR) control. Results: Despite normal average BMI (23.4), risk clustering was common: elevated BP in 63% of men and 30% of women, impaired FG (100–125 mg/dL) in almost one third and central adiposity (WHtR ≥ 0.5) in 51% of men and 24% of women. Diets were SFA-rich (~17–19%E), sodium-dense and low in fiber and several micronutrients (e.g., vitamin D, folate, potassium). In isocaloric models, SFA → PUFA was associated with more favorable nutrient signatures: MASLD-oriented score −28% (p < 0.001; FDR-significant) and PRAL −33% (p = 0.007; FDR-borderline/suggestive). Conclusions: A waist-centric CM subphenotype—central adiposity co-occurring with upward BP shifts and intermittent dysglycemia—was detectable in young adults despite normal average BMI, against a background of poor diet quality and low activity. These baseline surveillance signals are not causal effects. Integration into routine with WHO-aligned NCD surveillance is feasible. Prospective follow-up (biomarker calibration, device-based activity, repeated waves) will refine inferences and inform scalable proactive prevention. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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16 pages, 552 KB

Open AccessArticle

Association Between Mediterranean Diet Consumption and the Physical and Mental Components of HRQL in Community-Dwelling Older Adults in Valencia

by Pilar Pérez-Ros, Ayde Rios-Corral and Omar Cauli

Nutrients 2025, 17(20), 3243; https://doi.org/10.3390/nu17203243 - 15 Oct 2025

Viewed by 880

Abstract

Background/Objectives: The relationship between health-related quality of life (HRQL) in community-dwelling older adults and the consumption of foods typical of the Mediterranean diet (MD) has not been studied. The main objective of this study was to determine which MD foods, as well as [...] Read more.

Background/Objectives: The relationship between health-related quality of life (HRQL) in community-dwelling older adults and the consumption of foods typical of the Mediterranean diet (MD) has not been studied. The main objective of this study was to determine which MD foods, as well as overall MD adherence, are associated with HRQL in community-dwelling older adults, taking into account both physical and mental components. Methods: A cross-sectional study was conducted including community-dwelling older adults aged 60 years or over. Sociodemographic variables, the Spanish version of the SF-12v2 quality-of-life questionnaire (physical and mental component scores), and data on the consumption of MD foods and adherence to the Mediterranean Diet Adherence Screener (MEDAS) were collected. Two binary logistic regression models, adjusted for age and sex, were fitted to analyse which food types included in the MEDAS questionnaire were significantly associated with a higher probability of having good physical and mental components of HRQL. Results: A total of 285 participants were recruited, with a mean age of 74.97 (SD 5.75) years, predominantly female (87.7%, n = 250) and 36.3% (n = 104) lived alone. The sample showed low physical quality of life [PCS-12: 42.88 IQR (33.61–51.09)], moderately good mental quality of life [MCS-12: 51.09 (39.97–57.42)] and good adherence to the Mediterranean diet [MEDAS: 9 (8–10)]. Binary logistic regression for PCS-12 showed that younger age, the joint consumption of less than one serving of butter per day, less than one cup of sugar-sweetened beverages per day and two or more servings of vegetables per day were significantly (p < 0.05) associated with good physical quality of life. Similarly, living alone, four or more tablespoons of olive oil per day and less than 2 servings of desserts per week were associated with good mental quality of life (MCS-12). Conclusions: The Mediterranean diet is related to physical and mental quality of life in older adults, with the consumption of specific foods within the MD showing significant associations in multivariate analyses. Identifying the items that are most closely related to good physical and mental health is key to promoting healthy lifestyle habits that are directly linked to improving quality of life from a holistic perspective. Understanding the associations between quality of life and consumption or avoidance of certain foods could help inform future nutritional interventions aimed at improving both physical and mental health in older adults. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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14 pages, 1209 KB

Open AccessArticle

A Cross-Cultural Comparison of Dietary Intake in University Students from the United Arab Emirates and the United Kingdom

by Sarah Dalibalta, Yara Elmashak, Aseel Amer, Yousef Abusaker, Andrea McNeilly and Gareth W. Davison

Nutrients 2025, 17(19), 3094; https://doi.org/10.3390/nu17193094 - 29 Sep 2025

Cited by 1 | Viewed by 1034

Abstract

Background/Objectives: The occurrence of non-communicable diseases (NCDs) globally is rising rapidly, largely due to modifiable risk factors such as unhealthy diets. Studies have shown that poor dietary habits are prevalent among university students and may persist in later life, increasing the risk [...] Read more.

Background/Objectives: The occurrence of non-communicable diseases (NCDs) globally is rising rapidly, largely due to modifiable risk factors such as unhealthy diets. Studies have shown that poor dietary habits are prevalent among university students and may persist in later life, increasing the risk of chronic health conditions. The objective of this study was to evaluate the diet of two different groups of university students, in the United Arab Emirates (UAE) and United Kingdom (UK), with the aim of identifying areas for intervention to improve overall health and wellbeing. Methods: Detailed 7-day diet diaries were collected from undergraduate university participants in the UAE and UK. Diet diaries were quantitatively assessed using Nutritics software generating reports on mean intakes for energy, macro- and micronutrients. Independent sample t-tests were utilized to compare nutrient intake between cohorts in the two different regions. Results: A total of 158 students participated in this study. Results showed significant differences in intake levels in most macronutrients and micronutrients (p ≤ 0.05). Upon comparison, UK participants consumed diets higher in sugar (+9.4 g/day), saturated fat (+4.2 g/day), cholesterol (+90 mg/day), and sodium (+307 mg/day) compared to their UAE counterparts, placing them at risk of cardiovascular diseases (CVDs). Cholesterol intake was oversufficient in both UAE and UK males by 40% and 57%, respectively. In UAE females, there were notable deficiencies in protein intake, omega 3, vitamin D, iron, iodine, and folic acid (p ≤ 0.05), placing them at risk of CVDs, anemia, diabetes, and cancer. Interestingly, both UAE males and females were 100% deficient in dietary vitamin D intake. Conclusions: Nutritional imbalances should be addressed through campus-based nutrition education programs. This study also highlights the importance of dietary guidelines targeted at specific populations accounting for cultural differences. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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13 pages, 360 KB

Open AccessArticle

The Impact of Physical Education Attendance and Diet on Bone Mineralization in Adolescents

by Agata Przytula and Joanna Popiolek-Kalisz

Nutrients 2025, 17(18), 3016; https://doi.org/10.3390/nu17183016 - 20 Sep 2025

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Abstract

Background: Bone mineralization can be influenced by physical activity and dietary factors; however, the relative contributions of these factors are not well defined. Physical activity in adolescents can be implemented with physical education (PE) classes and there is no reported data on [...] Read more.

Background: Bone mineralization can be influenced by physical activity and dietary factors; however, the relative contributions of these factors are not well defined. Physical activity in adolescents can be implemented with physical education (PE) classes and there is no reported data on their impact on bone mineralization. This study investigates the relationship between PE class attendance, dietary factors, and bone mineralization in adolescents. Methods: 57 adolescents (median age 17.00 [16.00–17.00] years) were enrolled in this study. Bone mineralization was assessed with bioelectrical impedance analysis (BIA) and dietary knowledge and selected foods intakes were assessed with a validated questionnaire. Results: PE attendance and dietary knowledge were positively associated with bone mineralization in the multivariate models (R² = 0.85, p < 0.001 for the best model, and R² = 0.81, p < 0.001 for the simplified model), and PE attendance was the dominant positive factor among the modifiable ones (B = 0.20, p = 0.02, and B = 0.25, p = 0.004, respectively). The impact of calcium sources intake was diminished when controlled for PE class attendance. Conclusions: PE attendance is one of the key factors of bone mineralization in adolescents. Our study showed that the role of calcium sources intake was diminished when acknowledging physical activity data, however dietary knowledge remained a significant predictor. Enhancing dietary knowledge and promoting physical activity are key targets for improving bone health. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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16 pages, 2329 KB

Open AccessArticle

Unveiling the Growth Impact of Probiotics in Neonates: To BEgin or Not to BEgin?

by Mustafa Törehan Aslan, Yasemin Ersözlü and Metehan Özen

Nutrients 2025, 17(11), 1867; https://doi.org/10.3390/nu17111867 - 29 May 2025

Viewed by 1923

Abstract

Background/Objectives: This study aimed to evaluate the supportive role of probiotic supplementation in neonatal weight gain through a meta-analysis of published studies. Given the conflicting results in the literature, the objective was to determine the overall effect size and assess the influence of [...] Read more.

Background/Objectives: This study aimed to evaluate the supportive role of probiotic supplementation in neonatal weight gain through a meta-analysis of published studies. Given the conflicting results in the literature, the objective was to determine the overall effect size and assess the influence of regional and intervention-specific factors. Methods: A total of 20 studies published between 2011 and 2022 were included, comprising a combined sample size of 3929 neonates. A random-effects model was used to calculate the pooled standardized mean difference (SMD) in neonatal weight gain attributable to probiotic supplementation. Heterogeneity among studies was assessed using the I² statistic. Subgroup analyses were conducted based on geographic region, probiotic strain, dosage, and treatment duration. Results: The pooled analysis demonstrated a modest but non-significant positive effect on neonatal weight gain (SMD: 0.27; 95% CI: −0.06 to 0.61), with substantial heterogeneity across studies (I² = 91%). Subgroup analyses indicated that regional variations, particularly in studies conducted in China, were associated with a more favorable effect. However, not all studies reported a benefit; some found no difference or even negative effects, particularly in discharge weight outcomes. Conclusions: Probiotic supplementation shows potential for improving neonatal weight gain, but findings remain inconsistent and heterogeneous. Strain selection, dosage, and treatment duration appear to be critical variables influencing outcomes. Future large-scale, multicenter randomized controlled trials are necessary to develop standardized, evidence-based guidelines for probiotic use in neonatal care. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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19 pages, 655 KB

Open AccessArticle

The Impact of Dietary Habits and Nutrition Knowledge on Harmful Alcohol Use and Nicotine Dependence Among Medical Students: A Single-Center, Cross-Sectional Study

by Aureliusz Andrzej Kosendiak, Bartosz Bogusz Adamczak, Zofia Kuźnik, Szymon Makles and Weronika Hariasz

Nutrients 2025, 17(11), 1788; https://doi.org/10.3390/nu17111788 - 24 May 2025

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Abstract

Background: Harmful alcohol use and nicotine dependence are major public health concerns. One group particularly at risk may be medical students, who might resort to substance use as a coping mechanism for stress. Various factors may influence these behaviors, either positively or negatively—among [...] Read more.

Background: Harmful alcohol use and nicotine dependence are major public health concerns. One group particularly at risk may be medical students, who might resort to substance use as a coping mechanism for stress. Various factors may influence these behaviors, either positively or negatively—among them, dietary knowledge and eating habits. Methods: In this study, we used the KOMPAN questionnaire to assess dietary habits and nutrition knowledge, the AUDIT questionnaire to evaluate problematic alcohol consumption, and the Fagerström Test to assess nicotine dependence. A total of 2801 medical students participated in this study, including 2374 alcohol users and 379 smokers. Results: Smoking students demonstrated significantly lower dietary quality (p < 0.0001) and nutrition knowledge (p = 0.0004). Among alcohol users, lower levels of problematic alcohol consumption were observed in individuals with better dietary quality (p = 0.0006) and higher nutrition knowledge (p < 0.0001). Conclusions: Future research should explore additional factors contributing to the clustering of unhealthy behaviors and the underlying causes of alcohol consumption and poor dietary habits among healthcare professionals. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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17 pages, 789 KB

Open AccessArticle

Daily Sugar-Sweetened Beverage Intake and Its Association with Undiagnosed Non-Communicable Diseases Among Malaysian Adults: Findings from a Nationally Representative Cross-Sectional Study

by Shi-Hui Cheng, Sumarni Mohd-Ghazali, Chee-Cheong Kee and Lay-Kim Tan

Nutrients 2025, 17(10), 1740; https://doi.org/10.3390/nu17101740 - 20 May 2025

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Abstract

Background/objective: We examined the prevalence of daily sugar-sweetened beverage (SSB) intake, identifying its sociodemographic determinants and exploring its potential association with undiagnosed non-communicable diseases (NCDs) among Malaysian adults. Methods: This cross-sectional study analyzed data from 6596 Malaysian adults participating in the 2019 National [...] Read more.

Background/objective: We examined the prevalence of daily sugar-sweetened beverage (SSB) intake, identifying its sociodemographic determinants and exploring its potential association with undiagnosed non-communicable diseases (NCDs) among Malaysian adults. Methods: This cross-sectional study analyzed data from 6596 Malaysian adults participating in the 2019 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to examine the association between daily SSB intake and the risk of undiagnosed diabetes, hypertension, hypercholesterolemia, and obesity while adjusting for potential confounders. Results: The prevalence of daily SSB intake was 53.6%, with higher intake observed among females, older adults, Indians, and unemployed individuals. After adjusting for confounders, daily SSB intake was not significantly associated with undiagnosed diabetes (adjusted OR: 1.01, 95% CI: 0.80–1.29), undiagnosed hypertension (adjusted OR: 0.99, 95% CI: 0.81–1.22), undiagnosed hypercholesterolemia (adjusted OR: 0.99, 95% CI: 0.83–1.18), or obesity (adjusted OR: 1.08, 95% CI: 0.91–1.27). Conclusions: This study highlights the high prevalence of daily SSB intake among Malaysian adults, driven by sociodemographic factors. While a lack of direct associations with undiagnosed NCDs was observed, the high prevalence of SSB intake raises concerns about long-term health impacts. Targeted public health interventions are essential to address the cultural and economic determinants of SSB intake, as well as future research adopting longitudinal designs to explore how sustained reductions in SSB intake influence the risk of developing NCDs. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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18 pages, 478 KB

Open AccessArticle

Is There an Association Between Hydration Status, Beverage Consumption Frequency, Blood Pressure, Anthropometric Characteristics, and Urinary Biomarkers in Adults?

by Joanna Frąckiewicz and Kacper Szewczyk

Nutrients 2025, 17(6), 952; https://doi.org/10.3390/nu17060952 - 9 Mar 2025

Cited by 1 | Viewed by 3092

Abstract

Objectives: Hydration is essential for overall health; therefore, this study aimed to identify associations between hydration status and beverage consumption, anthropometric measures, and urine biochemical analyses in Polish adults. Poland was chosen due to potential regional dietary habits and hydration patterns that may [...] Read more.

Objectives: Hydration is essential for overall health; therefore, this study aimed to identify associations between hydration status and beverage consumption, anthropometric measures, and urine biochemical analyses in Polish adults. Poland was chosen due to potential regional dietary habits and hydration patterns that may influence hydration status. Methods: A total of 337 participants completed a beverage frequency questionnaire (FFQ). Blood pressure (BP), anthropometric parameters, and body composition were measured. Urine samples were analyzed for specific gravity (USG), osmolality (Uosm), and potential hydrogen value (pH). Hydration status was assessed using the WUT model (weight, urine color, thirst level), classifying participants into two groups: dehydrated (2-3 WUT components) and properly hydrated (0-1 WUT component). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: Approximately 50% of participants (n = 165) exhibited dehydration symptoms, including higher thirst levels, darker urine, and elevated USG and Uosm (p ≤ 0.05). Dehydrated individuals more frequently reported fatigue (p = 0.009), headaches (p = 0.024), and heavy legs (p = 0.002). Higher BMI (OR: 1.49), waist circumference (OR: 1.79), USG (OR: 2.29), and Uosm (OR: 1.75) increased dehydration risk. Conversely, greater consumption of tea (OR: 0.52) and non-carbonated mineral water (OR: 0.45), higher total body water (OR: 0.49), and handgrip strength (OR: 0.81) were linked to lower dehydration risk. Four dietary patterns were identified: Reasonable, Unhealthy, Minimalist, and Loving Sweet Beverages. Conclusions: Multifactorial hydration assessment, combined with preventive strategies such as regular fluid intake and weight management, may improve hydration. The WUT model and Venn diagram provide a practical tool for hydration assessment in clinical and public health. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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15 pages, 315 KB

Open AccessArticle

The Importance of Self-Identities and Habitual Behavior for Eating More Plant Foods

by Marzena Jeżewska-Zychowicz, Marta Sajdakowska, Jerzy Gębski, Małgorzata Kosicka-Gębska and Krystyna Gutkowska

Nutrients 2024, 16(23), 4063; https://doi.org/10.3390/nu16234063 - 26 Nov 2024

Cited by 3 | Viewed by 2171

Abstract

Objectives: This study aimed to identify the predictors of eating more plant-based foods and legumes in terms of previous changes in consumption, habitual frequency of consumption, intention to reduce the amount of meat consumed, and health and environmental identities. Methods: A cross-sectional survey [...] Read more.

Objectives: This study aimed to identify the predictors of eating more plant-based foods and legumes in terms of previous changes in consumption, habitual frequency of consumption, intention to reduce the amount of meat consumed, and health and environmental identities. Methods: A cross-sectional survey was conducted between June and September 2023 in 881 Polish adults. Based on two self-descriptors, four groups of respondents were identified: no health identity and no environmental identity (nHI-nEI), health identity but no environmental identity (HI-nEI), no health identity but environmental identity (nHI-EI), and both health identity and environmental identity (HI-EI). A logistic regression analysis was used to verify associations between habitual eating of red meat, white meat, and legumes, changes in their intake over the past two years, familiarity with plant-based substitutes for animal products, health, and environmental identity, declared intentions to eat less meat, and the intentions to eat more plant-based food and eat more legumes next year. Results: Individuals were more likely to increase their consumption of plant foods (OR: 1.99, p = 0.001), including legumes (OR: 1.79, p = 0.045), when they represented the HI-EI group, had increased their consumption of legumes in the past two years (OR: 2.91, p = 0.009, and OR: 2.15, p = 0.017, respectively), declared an intention to reduce meat (OR: 8.02, p < 0.001, and OR: 12.08, p < 0.001, respectively), but also occasionally consumed plant-based meat substitutes (OR: 1.76, p = 0.002, and OR: 2.61, p < 0.001, respectively). However, individuals were more likely to increase their consumption of plant foods, but not legumes, if they currently consumed legumes frequently (OR: 1.36, p = 0.009, and OR: 1.22, p = 0.111, respectively) and had previously limited their consumption of red meat (OR: 2.40, p < 0.001, and OR: 1.09, p = 0.717, respectively). Conclusions: The habitual frequency of eating red and white meat did not predict the increased consumption of plant foods in the future. It is equally important to increase people’s awareness of the impact of the food they consume on health and the environment to support their health and pro-environmental motivation for food choices. Public health and sustainability campaigns should develop new methods to reach populations less willing to change. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

10 pages, 631 KB

Open AccessArticle

Associations Between Dietary Patterns and Quality of Life in a Longitudinal Cohort of Colorectal Cancer Survivors

by Kristen S. Smith, Lisa M. Gudenkauf, Aasha I. Hoogland, Xiaoyin Li, Rachel Hoobler, Mary C. Playdon, Biljana Gigic, Brent J. Small, Brian D. Gonzalez, Laura B. Oswald, Doratha A. Byrd, K. Leigh Greathouse, Cornelia M. Ulrich, Christopher I. Li, David Shibata, Adetunji T. Toriola, Anita R. Peoples, Erin M. Siegel, Jane C. Figueiredo, Heather S. L. Jim and Sylvia L. Crowder Show full author list Hide full author list

Nutrients 2024, 16(22), 3860; https://doi.org/10.3390/nu16223860 - 12 Nov 2024

Cited by 4 | Viewed by 2981

Abstract

Purpose: To characterize dietary patterns and examine associations with cross-sectional and longitudinal changes in quality of life (QOL) over approximately one year after colorectal cancer (CRC) diagnosis. Methods: The ColoCare Study is an international, multi-center, prospective cohort study of newly diagnosed CRC survivors [...] Read more.

Purpose: To characterize dietary patterns and examine associations with cross-sectional and longitudinal changes in quality of life (QOL) over approximately one year after colorectal cancer (CRC) diagnosis. Methods: The ColoCare Study is an international, multi-center, prospective cohort study of newly diagnosed CRC survivors of any stage. A subset of participants with CRC in the United States completed patient-reported outcome measures at 6- and 12-months post-enrollment, including the Food Frequency Questionnaire (FFQ) and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Dietary patterns at 6 months (around the time of treatment completion) were identified using Principal Component Analysis (PCA) with varimax rotation. Adherence scores were calculated for participants within each dietary pattern, with higher scores indicating higher adherence. Mixed models were used to examine the effect of each dietary pattern on changes in QOL at 6- and 12-month follow-ups, controlling for cancer stage, biological sex, body mass index (BMI), smoking status, and age. Results: Participants (N = 174) were, on average, 56 ± 14 years old and were mostly female (51.5%), stage III or IV (51.7%), never smokers (60.2%), non-Hispanic (97.1%), and White (83.3%) with a BMI of 27.9 ± 6.1 kg/m². PCA revealed two emerging dietary patterns: “Western diet”, characterized by processed meats, refined grains, and sugars, and “Prudent diet” characterized by lean proteins, fruits, and vegetables. Higher adherence to a Western diet was associated with worse social functioning at 6-month follow-up (FE = −12.6, p = 0.010). Loss of appetite from 6 to 12 months was associated with higher adherence to both the Western and Prudent dietary patterns (FE = 1.5, p = 0.044; FE = 1.3, p = 0.046, respectively). Neither dietary pattern was associated with global QOL score at 6- or 12-month follow-up (p’s > 0.05). Conclusions: Among CRC survivors in the United States, the Western diet was concurrently associated with worse social functioning. Loss of appetite was reported by CRC survivors following both dietary patterns, suggesting that loss of appetite may be a global experience for CRC survivors during this timeframe. Further research is needed to understand specific social challenges experienced by CRC survivors and develop supportive care interventions to address appetite and nutritional concerns. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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12 pages, 1102 KB

Open AccessArticle

Diet Quality and Eating Frequency Were Associated with Insulin-Taking Status among Adults

by Luotao Lin, Yue Qin, Emily Hutchins, Alexandra E. Cowan-Pyle, Jiangpeng He, Fengqing Zhu, Edward J. Delp and Heather A. Eicher-Miller

Nutrients 2024, 16(20), 3441; https://doi.org/10.3390/nu16203441 - 11 Oct 2024

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Abstract

Objective: This pilot cross-sectional study explored differences in dietary intake and eating behaviors between healthy adults and a group of adults taking insulin to manage diabetes. Methods: A characteristic questionnaire and up to four Automated Self-Administered 24-Hour dietary recalls were collected from 152 [...] Read more.

Objective: This pilot cross-sectional study explored differences in dietary intake and eating behaviors between healthy adults and a group of adults taking insulin to manage diabetes. Methods: A characteristic questionnaire and up to four Automated Self-Administered 24-Hour dietary recalls were collected from 152 adults aged 18–65 years (96 healthy and 56 adults taking insulin) from Indiana and across the U.S. from 2022 to 2023. The macronutrient intake, diet quality via the Healthy Eating Index (HEI)-2015, eating frequency, and consistency of timing of eating were calculated and compared between the two groups using adjusted linear or logistic regression models. Results: The total mean HEI scores were very low, at 56 out of 100 and 49 out of 100 for the healthy and insulin-taking groups, respectively. Insulin-taking adults had significantly lower HEI total (p = 0.003) and component scores compared to the healthy group for greens and beans (2.0 vs. 3.0, p = 0.02), whole fruit (2.1 vs. 2.9, p = 0.05), seafood and plant proteins (2.1 vs. 3.3, p = 0.004), and saturated fats (3.7 vs. 5.4, p = 0.05). Eating frequency was significantly lower in the insulin-taking group than in the healthy group (3.0 vs. 3.4 eating occasions/day, p = 0.05). Conclusion: Evidence of the low diet quality and eating frequency of insulin takers may help inform and justify nutrition education to control and manage diabetes. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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21 pages, 1277 KB

Open AccessArticle

Fluctuations in Mediterranean Diet Adherence Pre- and Post-Pandemic: A Study of Portuguese Cohorts 2019–2024

by Vanda Lopes de Andrade and Paula Pinto

Nutrients 2024, 16(19), 3372; https://doi.org/10.3390/nu16193372 - 3 Oct 2024

Cited by 3 | Viewed by 2711

Abstract

Background/Objectives: The Mediterranean Diet (MD) is a lifestyle offering numerous health benefits. Nevertheless, the adherence to the MD is moderate even in Mediterranean countries. While sociodemographic factors influence MD adherence, additional impacts occurred due to the COVID-19 pandemic. This cross-sectional longitudinal study with [...] Read more.

Background/Objectives: The Mediterranean Diet (MD) is a lifestyle offering numerous health benefits. Nevertheless, the adherence to the MD is moderate even in Mediterranean countries. While sociodemographic factors influence MD adherence, additional impacts occurred due to the COVID-19 pandemic. This cross-sectional longitudinal study with three cohorts of Portuguese adults analyzes MD adherence before, during, and after the COVID-19 pandemic, and explores the effect of sociodemographic variables. Methods: Sociodemographic factors, lifestyle habits, and MD adherence were assessed in the years 2019, 2021, and 2024 with an online self-filled questionnaire. MD adherence was measured with the Mediterranean Diet Adherence Screener (MEDAS). Results: MEDAS score increased significantly (p < 0.05) from 2019 to 2021 (6.2 ± 0.7 to 7.7 ± 0.1), followed by a significant (p < 0.05) decrease in 2024 (7.2 ± 0.1) relative to 2019, which was more pronounced in participants with higher income. Accordingly, a trend in healthier food choices was observed followed by a decline in 2024. Of note is the significant increase in red meat consumption (p < 0.05) in 2024 relative to 2021. Respondents who consumed more red meat were mostly men, employed, or in a stable relationship. Most respondents practiced sport “Never or occasionally” in 2019 and 2021 (59.4 and 55.2%, respectively); in 2024, this category was significantly (p < 0.05) reduced (40.9%); men or higher-income participants were more likely to meet the recommended activity levels. Conclusions: This study reveals that the improvements in MD lifestyle during the pandemic were not sustained in 2024, as healthier habits formed during confinement were not fully integrated into long-term behavior. These findings strengthen the need for targeted public health interventions to promote the MD. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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23 pages, 1557 KB

Open AccessSystematic Review

Nutritional Determinants of Type 2 Diabetes Mellitus in the European Union: A Systematic Review

by Daniela Alejandra Díaz-Benavides, Abdu Nafan Aisul Muhlis, Ghenwa Chamouni, Rita Charles, Digafe Tsegaye Nigatu, Jomana Ben Khadra, Frederico Epalanga Albano Israel, Bashar Shehab, Gabriella Laila Tarek, Aidai Sharshekeeva, Nasser Gammoh, Tulu Tefera Habte, Niyati Chandrika, F. K. Alshakhshir, Nour Mahrouseh, Carlos Alexandre Soares Andrade, Szabolcs Lovas and Orsolya Varga

Nutrients 2025, 17(22), 3507; https://doi.org/10.3390/nu17223507 - 9 Nov 2025

Viewed by 1594

Abstract

Background/Objectives: Type 2 diabetes mellitus (T2DM) represents a growing public health burden in the European Union (EU), largely driven by modifiable lifestyle factors such as diet. This systematic review aimed to synthesize observational evidence on the associations between nutritional exposures and incident [...] Read more.

Background/Objectives: Type 2 diabetes mellitus (T2DM) represents a growing public health burden in the European Union (EU), largely driven by modifiable lifestyle factors such as diet. This systematic review aimed to synthesize observational evidence on the associations between nutritional exposures and incident T2DM across the EU-28, with a focus on regional heterogeneity and implications for EU-level nutrition policy. Methods: The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42020219994). Searches were conducted in different databases (PubMed, Embase, Scopus, Web of Science) identifying 23,437 records, from which 104 observational studies were included. Eligible studies involved adults (≥18 years) without T2DM at baseline and assessed dietary exposures in relation to T2DM incidence. Data extraction and methodological quality assessment were performed in duplicate using the NHLBI tool in Covidence. Results: Most included studies were cohort studies (77.9%), primarily conducted in Western, Northern, and Southern Europe. Diets characterized by high consumption of whole and minimally processed foods, such as fruits, vegetables, legumes, whole grains, and fermented dairy, consistently showed associations with lower T2DM risk. In contrast, high intake of red and processed meats, sugar-sweetened beverages, and ultra-processed foods was linked to higher risk. Adherence to Mediterranean or plant-based dietary patterns was associated with lower risk, whereas high animal-protein dietary patterns were detrimental. Conclusions: Nutritional determinants play a decisive role in shaping T2DM risk in the EU. Evidence supports prioritizing dietary patterns rich in plant-based and minimally processed foods while reducing ultra-processed and meat-based products. Tailored region-specific policies are needed to address the T2DM epidemic and guide effective prevention strategies. Full article

(This article belongs to the Special Issue Association between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—2nd Edition)

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