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Impact of Diet, Physical Activity and Sedentary Behavior on Non-Communicable Disease Development

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: 25 September 2026 | Viewed by 13407

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Dr. Jennifer Frediani

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Guest Editor

Department of Academic Advancement, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA
Interests: physical activity; nutrition; cardiometabolic diseases; exercise science; diabetes

Special Issue Information

Dear Colleagues,

Non-communicable diseases (NCDs), including cardiovascular disease, type 2 diabetes, cancer, and chronic respiratory conditions, are the leading causes of morbidity and mortality worldwide. Modifiable lifestyle factors—particularly, diet, physical activity, and sedentary behavior—play a central role in the development and progression of NCDs. Nutritional quality, energy balance, and dietary patterns influence metabolic risk, inflammation, and gut microbiota, while physical activity levels and sedentary behavior impact insulin sensitivity, cardiovascular function, and overall metabolic health. This Special Issue seeks original research, systematic reviews, and meta-analyses that explore mechanisms, epidemiology, interventions, and outcomes related to diet and movement behaviors in the context of NCD prevention and management. Studies that incorporate innovative methodologies, behavioral frameworks, or population-specific insights—especially those with implications for policy or clinical practice—are particularly encouraged. Our goal is to deepen the understanding of how lifestyle behaviors interact to influence chronic disease risk and to inform evidence-based strategies for promoting long-term health.

Dr. Jennifer Frediani
Guest Editor

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Keywords

diet
nutrition
intuitive eating
dietary patterns
energy balance
gut microbiota
lifestyle
physical activity
sedentary behavior
weight neutral
non-communicable diseases
cardiovascular disease
type 2 diabetes
cancer
chronic respiratory
inflammation

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Published Papers (3 papers)

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Research

16 pages, 647 KB

Open AccessArticle

BMI and Prognostic Nutritional Index Are Independently and Positively Associated with Three Year Glycemic Change in Non-Diabetic Adults: A Community-Based Cohort Study

by Yuting Yu, Li Chen, Wei Zhang, Lihua Jiang, Chunmin Zhang, Xiaoying Ni, Jianguo Yu and Yonggen Jiang

Nutrients 2026, 18(9), 1459; https://doi.org/10.3390/nu18091459 - 1 May 2026

Viewed by 302

Abstract

Background/Objectives: Both adiposity and nutritional–inflammatory status influence glucose metabolism; however, their longitudinal associations with glycemic changes in non-diabetic populations remain unclear. We examined the independent, interactive, and joint associations of body mass index (BMI) and prognostic nutritional index (PNI) with the 3-year change in HbA1c (ΔHbA1c). PNI, a composite marker of serum albumin and peripheral lymphocyte count, reflects both protein nutritional status and systemic immune competence. We hypothesized that BMI and PNI would each independently predict ΔHbA1c and that their joint profiling would identify higher-risk subgroups. Methods: A total of 9414 non-diabetic adults from the Shanghai Suburban Adult Cohort were included. Participants with diabetes at baseline (defined as fasting plasma glucose ≥ 7.0 mmol/L, 2-h post-load glucose ≥ 11.1 mmol/L, HbA1c ≥ 6.5%, or self-reported physician diagnosis of diabetes or use of glucose-lowering medications) were excluded. BMI was measured, and PNI was calculated as serum albumin + 5 × lymphocyte count. ΔHbA1c was assessed over a 3-year period. Multivariable linear regression, interaction testing, and joint stratification were performed. Covariate selection was guided by prior biological plausibility, and model adequacy was evaluated using the Akaike Information Criterion (AIC). Results: Both BMI (β = 0.013% per kg/m², 95% CI: 0.011–0.016, p < 0.001) and PNI (β = 0.002% per unit, 95% CI: 0.000–0.004, p = 0.019) were independently and positively associated with ΔHbA1c. No significant interaction was observed (p = 0.431). High BMI (≥24 kg/m²) was associated with glycemic worsening irrespective of PNI level (β ≈ 0.075%, p < 0.001). Among normal-weight individuals, higher PNI was associated with a modest increase in ΔHbA1c (β = 0.031%, p = 0.007). Conclusions: Although the absolute effect sizes were modest at the individual level, BMI was consistently and independently associated with glycemic deterioration therefore, even small per-unit increases may translate into meaningful risk at the population level given the high prevalence of overweight and obesity. PNI showed a small positive association, suggesting that in relatively healthy populations a higher PNI may partly capture subtle pro-glycemic factors—such as low-grade inflammation or higher protein intake—rather than representing unambiguous nutritional benefit. The absence of interaction suggests that BMI and PNI act through largely independent pathways. These findings extend prior evidence by demonstrating that PNI provides modest additional glycemic information beyond BMI in non-diabetic community-dwelling adults, particularly among those of normal weight. Full article

(This article belongs to the Special Issue Impact of Diet, Physical Activity and Sedentary Behavior on Non-Communicable Disease Development)

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15 pages, 495 KB

Open AccessArticle

Dietary Determinants of Diabetes Prevalence: A Cross-Sectional Study in the Hungarian Population

by Zsuzsa Emma Hajzer, Flóra Mária Petróczki, Eszter Vargáné Faludi, Csaba Oláh, József Prokisch and Amr Sayed Ghanem

Nutrients 2026, 18(5), 731; https://doi.org/10.3390/nu18050731 - 25 Feb 2026

Cited by 1 | Viewed by 688

Abstract

Background/Objectives: Diabetes mellitus represents a major public health burden in Hungary and is associated with sociodemographic and lifestyle characteristics. This study examined cross-sectional associations between habitual dietary intake and self-reported diabetes prevalence in a nationally representative Hungarian sample. Methods: Data from 5603 participants aged ≥15 years in the 2019 European Health Interview Survey (EHIS) were analyzed. Survey-weighted logistic regression models assessed associations between dietary variables and self-reported diabetes, adjusting for age, sex, body mass index (BMI), education, income, employment, and physical activity. Dietary variables were energy-adjusted using the residual method. Results: Higher odds of diabetes were observed among individuals who reported obesity (OR: 2.70; 95% CI: 1.96–3.72), lower educational attainment (OR: 0.73 for high school vs. <high school; 95% CI: 0.55–0.99), and unemployment (OR: 0.66 for employed vs. unemployed; 95% CI: 0.46–0.95). Lower odds were observed among participants reporting regular physical activity (OR: 0.59; 95% CI: 0.43–0.81) and less frequent processed meat consumption (OR: 0.53; 95% CI: 0.37–0.76). Inverse associations were also observed for moderate dessert consumption, whereas strong positive associations were identified for adherence to special diets (OR: 9.24; 95% CI: 7.09–12.06) and dietitian consultation (OR: 6.30; 95% CI: 4.13–9.61). Conclusions: In this nationally representative cross-sectional analysis, dietary patterns and sociodemographic factors were statistically associated with diabetes prevalence. The results should be interpreted cautiously, as observed associations may reflect behavioral changes following diagnosis rather than causal relationships. Prospective studies are required to clarify temporal direction and underlying mechanisms. Full article

(This article belongs to the Special Issue Impact of Diet, Physical Activity and Sedentary Behavior on Non-Communicable Disease Development)

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16 pages, 2981 KB

Open AccessArticle

Beyond MIND and Mediterranean Diets: Designing a Diet to Optimize Parkinson’s Disease Outcomes

by Laurie K. Mischley and Magdalena Murawska

Nutrients 2025, 17(14), 2330; https://doi.org/10.3390/nu17142330 - 16 Jul 2025

Cited by 3 | Viewed by 11787

Abstract

Background: A growing body of evidence suggests that diet can modify Parkinson’s disease (PD) outcomes, although there is disagreement about what should be included and excluded in such a diet. Existing evidence suggests that adherence to the MIND and Mediterranean (MEDI) diets are associated with reduced PD symptoms, but only a few variables from the adherence scales are responsible for the statistically observed improvement. Objectives: The goal was to use patient-reported outcomes in a large cohort to identify the foods and dietary patterns (PRO diet) most strongly associated with the fewest PD symptoms over time, and to develop a composite adherence scale to enable comparisons between MEDI, MIND, and PRO. Methods: Data were obtained from the prospective longitudinal natural history study and from Modifiable Variables in Parkinsonism (MVP)—a study designed to identify behaviors associated with patient-reported outcomes (PRO-PD). Upon the completion of the binary and food frequency data collection, using various predictive models and considering congruence with historical data, the PRO diet was created via an iterative process. Our goal was to create a new scale and compare its performance to the existing MIND and MEDI scores. The comparison was made at baseline, using the regression models for PRO-PD and the different scales as the predictors. The models were compared via the Akaike Information Criterion (AIC). To examine whether baseline adherence levels predicted subsequent symptom trajectories, the baseline PRO diet adherence and subsequent slope of progression were evaluated. Results: Data from 2290 individuals with PD were available for this analysis. The Mediterranean and MIND diets showed almost identical effects. For both the diets, the effect they had on non-motor symptoms was about twice the effect on motor symptoms. The slopes for the total PRO-PD for MEDI, MIND, and PRO-21 were −64.20467, −64.04220, and −28.61995, respectively. The AIC value differences were substantial (>2), indicating meaningful improvements in the model fit for total PRO-PD, as follows: MEDI: 28,897.24, MIND: 28,793.08, and PRO-21: 27,500.71. The subset of individuals who were most adherent to the PRO-21 diet at baseline had the slowest subsequent progression, as measured by a 43% reduced PRO-PD slope, compared to the less adherent groups. Conclusions: The PRO-21 outperformed the MIND and MEDI diets in the model fit, overcoming the ceiling effects and showing orders of magnitude and superior explanatory power for variance in PD outcomes, despite the smaller per-unit effect sizes. However, its rigorous demands may introduce barriers related to cost, feasibility, and sustainability, underscoring the need for future intervention trials to assess real-world feasibility, adherence, side effects, and clinical impact. Full article

(This article belongs to the Special Issue Impact of Diet, Physical Activity and Sedentary Behavior on Non-Communicable Disease Development)

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