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

Deadline for manuscript submissions: 15 May 2025 | Viewed by 10301

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Dr. Evridiki Patelarou

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Guest Editor

Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
Interests: epidemiology; public health; health promotion; disease prevention; evidence-based practice
Special Issues, Collections and Topics in MDPI journals

Dr. Konstantinos Giakoumidakis

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Guest Editor

Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
Interests: clinical nursing; cardiovascular nursing; chronic disease management
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Special Issue "Nutrition and Quality of Life for Patients with Chronic Disease" examines the intricate relationship between dietary practices and the general well-being of people with chronic diseases. It explores how individualized dietary therapies might improve physical and mental health outcomes, reduce symptoms, and possibly even stop the course of the disease, significantly improving the quality of life for these individuals. This topic encompasses the impact of specific diets on illnesses such as diabetes, heart disease, and chronic kidney disease, along with the role of micronutrients and dietary supplements. In addition, it examines the psychological elements of dieting and emphasizes the need for patient education to help people make long-lasting lifestyle changes. This Special Issue aims to provide medical practitioners with useful insights for improving patient care through nutritional treatment.

Dr. Evridiki Patelarou
Dr. Konstantinos Giakoumidakis
Guest Editors

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Keywords

cardiovascular disease
chronic disease
chronic kidney disease
diabetes
dietary adherence
dietary patterns
dietary supplements
mental health
micronutrients
nutrition
patient education
personalized nutrition
physical health
quality of life
symptom management
epidemiology
public health
disease prevention

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Published Papers (8 papers)

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18 pages, 2025 KiB

Open AccessArticle

Contribution of Food, Energy, Macronutrients and Fiber Consumption Patterns to Obesity and Other Non-Communicable Disease Risks in the Indonesian Population

by Fifi Retiaty, Nuri Andarwulan, Nurheni Sri Palupi, Fitrah Ernawati, Renata Kazimierczak and Dominika Średnicka-Tober

Nutrients 2025, 17(9), 1459; https://doi.org/10.3390/nu17091459 - 26 Apr 2025

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Abstract

Background: Obesity, characterized by excess body fat, has been recognized as one of the main global health problems of the current times. This article, based on the data from the Cohort study of risk factors for non-communicable diseases in Indonesia (FRPTM), aims to analyze the food consumption patterns and their association with the risk of obesity and related non-communicable diseases (NCDs) in the Indonesian population. Methods: The article presents data collected from 867 respondents aged 25 years and above observed for 5 years: 2011, 2013, 2015, 2017 and 2019. It includes sociodemographic characteristics, consumption (1 × 24-h recall), anthropometry, and biomedical data (lipid profile, blood glucose, blood pressure). Results: The study identified cereals as the food group consumed in the largest amount and the largest contributor to energy, protein, carbohydrates and fiber intake. The fats and oils group exceeded the recommended intake, while vegetable and fruit consumption, and consequently the fiber intake, were far below the recommendations. The energy and macronutrient intake, and the percentage of respondents with excessive intake levels, were consequently increasing during the studied years. The consumption patterns were associated with the incidence of obesity, which increased from 43.9% in 2011 to 69.9% (central obesity) and 67.9% (BMI-based obesity) in 2019. Conclusions: The dynamics of the consumption patterns clearly impacted the obesity prevalence. At the same time, the NCDs biomarkers measured remained relatively stable despite increasing obesity and macronutrient intake over the study period. The study provides important insights into diet-related risks for obesity in Indonesia, with a potential to inform public health policies and relevant intervention strategies. Full article

(This article belongs to the Special Issue Nutrition and Quality of Life for Patients with Chronic Disease)

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16 pages, 690 KiB

Open AccessArticle

Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese

by Miguel García Samuelsson, Pedro Juan Tárraga López, Ángel Arturo López-González, Hernán Paublini, Emilio Martínez-Almoyna Rifá and José Ignacio Ramírez-Manent

Nutrients 2025, 17(8), 1345; https://doi.org/10.3390/nu17081345 - 14 Apr 2025

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Abstract

Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters—including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure—were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions. Full article

(This article belongs to the Special Issue Nutrition and Quality of Life for Patients with Chronic Disease)

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16 pages, 1747 KiB

Open AccessArticle

Metabolic Syndrome in the Amazon: Customizing Diagnostic Methods for Urban Communities

by José M. Alcaide-Leyva, Manuel Romero-Saldaña, María García-Rodríguez, Rafael Molina-Luque, María del Rocío Jiménez-Mérida and Guillermo Molina-Recio

Nutrients 2025, 17(3), 538; https://doi.org/10.3390/nu17030538 - 31 Jan 2025

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Abstract

Background/Objectives: Metabolic syndrome is a significant public health issue, particularly in urbanizing regions like the Peruvian Amazon, where lifestyle changes have increased the prevalence of metabolic disorders. This study aimed to develop and validate a simple, cost-effective diagnostic model for early detection of metabolic syndrome in the urban population of San Juan Bautista, Iquitos. Methods: A cross-sectional study was conducted with 251 adults aged over 18 years. Data collection included anthropometric measurements, body composition analysis, and biochemical assessments. Logistic regression analyses identified key predictors of metabolic syndrome, and clinical decision trees were developed to enhance diagnostic accuracy. Results: The prevalence of metabolic syndrome was 47.9%. Systolic blood pressure, triglycerides, and very-low-density lipoprotein cholesterol were the strongest predictors. The most effective diagnostic model, combining very-low-density lipoprotein cholesterol and systolic blood pressure, achieved a sensitivity of 91.6% and a specificity of 78.5%, demonstrating high diagnostic accuracy. Conclusions: The proposed model offers a practical, low-cost tool for early detection of metabolic syndrome in resource-limited urban settings. However, its findings are limited by the small sample size and the lack of external validation, requiring further studies to confirm its generalizability and applicability to other populations. Its implementation in primary healthcare could facilitate timely interventions, reducing the risk of chronic diseases in vulnerable populations. Full article

(This article belongs to the Special Issue Nutrition and Quality of Life for Patients with Chronic Disease)

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17 pages, 3776 KiB

Open AccessArticle

Anti-Fatigue Activity of Corn Protein Hydrolysate Fermented by Lactic Acid Bacteria

by Nan Hu, Jingyi Sun, Yujia Cao, Hongji Zhao, Meng Sun, Guanlong Li, Xiaolan Liu and Shanzi Cong

Nutrients 2025, 17(2), 199; https://doi.org/10.3390/nu17020199 - 7 Jan 2025

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Abstract

Objectives: This study aimed to clarify the effect of lactic acid bacteria-fermented corn protein hydrolysate (FCH) on fatigue in mice and explore the connection between fatigue-related indicators and intestinal microbial flora. Methods: The fatigue model of mice was constructed by exercise endurance experiment. The anti-fatigue level of FCH was evaluated by measuring physiological and biochemical indexes in mouse serum, liver and skeletal muscle. The relationship between FCH, intestinal flora and fatigue was explored through the analysis of intestinal microbial diversity in mice, and the anti-fatigue mechanism of FCH was further analyzed. Results: The results showed that the weight-bearing swimming time of mice was prolonged by 1.96 times, and the running time of mice was prolonged by 2.63 times in the high-dose FCH (FCH-H) group. Moreover, the lactic acid contents in the blood were reduced by 16.00%, and lactate dehydrogenase activity and urea nitrogen contents basically returned to the normal level. Meanwhile, the malondialdehyde contents were reduced by 31.24%, and superoxide dismutase activity and glutathione contents were increased by 1.84 times and 1.72 times, respectively. In addition, the glycogen contents of the body were restored, and the muscle glycogen and liver glycogen were increased by 1.81 and 5.81 times, respectively. Analysis of intestinal microbial flora diversity in mice showed that the highest relative abundance was Lactobacillus, and the FCH group could recover and even increase its relative abundance. Lactobacillus was significantly positively correlated with muscle glycogen and SOD. Conclusions: FCH can alleviate fatigue by regulating fatigue-related indicators and improving the intestinal microbial flora of the organism. Full article

(This article belongs to the Special Issue Nutrition and Quality of Life for Patients with Chronic Disease)

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15 pages, 1246 KiB

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Daily Orange Consumption Reduces Hepatic Steatosis Prevalence in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease: Exploratory Outcomes of a Randomized Clinical Trial

by Maria Notarnicola, Valeria Tutino, Valentina De Nunzio, Anna Maria Cisternino, Miriam Cofano, Rossella Donghia, Vito Giannuzzi, Marianna Zappimbulso, Rosa Anna Milella, Gianluigi Giannelli and Luigi Fontana

Nutrients 2024, 16(18), 3191; https://doi.org/10.3390/nu16183191 - 20 Sep 2024

Cited by 6 | Viewed by 3920

Abstract

Background: Consumption of flavonoid-rich orange juice has been shown to reduce adiposity and liver steatosis in murine models of diet-induced obesity. However, little is known about the effects of whole orange intake, independent of body weight changes, on liver function and steatosis in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD). The goal is to understand the direct impact of orange consumption on metabolic health. Methods: Sixty-two men and women aged 30–65 with MASLD (Controlled Attenuation Parameter, (CAP) > 275 dB/m) were randomly assigned to consume either 400 g of whole oranges or non-citrus fruits daily for 4 weeks. Baseline evaluations included medical assessments, blood tests, and body composition. Liver health was assessed using transient elastography (FibroScan^®) for steatosis and fibrosis, conducted by blinded personnel. This clinical trial was registered at ClinicalTrials.gov (NCT05558592). Results: After 4 weeks of orange supplementation, liver steatosis decreased in the treatment group, with 70.9% showing steatosis compared to 100% in controls (p < 0.004), indicating a 30% reduction in liver disease prevalence. There were no significant changes in fibrosis or plasma liver enzymes, though plasma gamma glutaril transferase (GGT) levels decreased significantly. Body weight, waist circumference, body composition, lipid profile, fasting glucose, insulin, and C-reactive protein levels remained unchanged. Dietary analysis revealed no change in caloric intake, but vitamins C, A, thiamine, and riboflavin increased in the orange group. Conclusions: Our findings suggest that phytochemical-rich foods, especially whole fruits like oranges, may enhance liver function as an adjunct treatment for MASLD. The notable reduction in liver steatosis prevalence occurred independently of body weight changes. Further studies are needed to investigate the long-term effects of orange supplementation on steatosis and fibrosis progression and to identify the specific bioactive compounds and mechanisms involved. Full article

(This article belongs to the Special Issue Nutrition and Quality of Life for Patients with Chronic Disease)

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16 pages, 533 KiB

Open AccessArticle

A Qualitative Study Supporting Optimal Nutrition in Advanced Liver Disease—Unlocking the Potential for Improvement

by Shaye Ludlow, Katherine Farragher, Kelly Squires, Susan Heaney, Jessica Orman, Sarah Pullen, John Attia and Katie Wynne

Nutrients 2024, 16(15), 2403; https://doi.org/10.3390/nu16152403 - 24 Jul 2024

Viewed by 1623

Abstract

Malnutrition rates in Advanced Liver Disease (ALD) are significantly higher than those in well-compensated liver disease. In addition to its physiological impact, malnutrition is detrimental for quality of life and social, emotional, and psychological well-being. Studies within oncology and renal supportive care have identified the influence of non-physiological factors on malnutrition risk. Integrating similar factors into malnutrition screening for ALD could improve identification of at-risk patients to optimize treatment planning. This qualitative study aimed to understand the holistic factors influencing nutritional status in the ALD population. Semi-structured interviews with 21 patients, carers, and clinicians explored the experiences of malnutrition in ALD. Thematic analysis revealed five key themes: (i) appropriateness of healthcare delivery; (ii) health- and food-related factors; (iii) high symptom burden, (iv) social support impacting well-being, and (v) physical and structural supports. Current screening methods do not adequately capture all potential drivers of malnutrition in the ALD population. Adopting a more supportive approach including both physiological and non-physiological factors in ALD malnutrition screening may promote more timely and comprehensive nutritional interventions that address the complex and holistic needs of patients living with ALD. Full article

(This article belongs to the Special Issue Nutrition and Quality of Life for Patients with Chronic Disease)

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Ultra-Processed Food and Its Impact on Bone Health and Joint Diseases: A Scoping Review

by Jacopo Ciaffi, Luana Mancarella, Claudio Ripamonti, Andrea D’Amuri, Veronica Brusi, Federica Pignatti, Lucia Lisi and Francesco Ursini

Nutrients 2025, 17(7), 1188; https://doi.org/10.3390/nu17071188 - 28 Mar 2025

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Abstract

Background/Objectives: This scoping review explores the relationship between ultra-processed food (UPF), bone health, and joint diseases, focusing on its potential impact on bone mineral density (BMD), osteoporosis, osteoarthritis, and inflammatory arthritis, including rheumatoid arthritis (RA), gout, and spondyloarthritis. Methods: A search strategy was developed using key terms such as “ultra-processed food” and related terms like “fast food,” alongside various definitions of bone health impairment, chronic degenerative joint diseases, and inflammatory arthritis. Results: A total of 19 studies were included: 12 on bone health, 3 on osteoarthritis, and 4 on inflammatory arthritis. Preclinical studies showed that UPF consumption negatively affects bone structure and strength. In studies on children and adults, four investigations (2013–2017) found no association between fast food intake and BMD. However, more recent large-scale cross-sectional studies linked higher UPF consumption to lower BMD, increased osteoporosis risk, and greater prevalence of osteopenia, particularly in postmenopausal women. UPF intake was associated with knee osteoarthritis risk, with evidence suggesting an interaction with cartilage thickness, though no association was found for hip osteoarthritis. In inflammatory arthritis, UK Biobank data indicated a higher risk of RA and gout in UPF consumers, while a Brazilian study reported worse metabolic profiles in RA patients. No significant differences in UPF intake were found in spondyloarthritis. Conclusions: This review highlights relevant considerations about the deleterious role of UPF on bone health and joint diseases, providing additional evidence to suggest healthier dietary patterns to patients and to the general population. Full article

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10 pages, 201 KiB

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The Impact of Home Parenteral Nutrition on Survival and Quality of Life in Patients with Intestinal Failure and Advanced Cancer: A Comprehensive Review

by Miroslaw Perlinski and Jacek Sobocki

Nutrients 2025, 17(5), 905; https://doi.org/10.3390/nu17050905 - 5 Mar 2025

Viewed by 713

Abstract

Background and Aims: Home parenteral nutrition (HPN) is essential in the management of chronic intestinal failure (CIF) and malignant bowel obstruction (MBO), particularly in cases where enteral feeding is not feasible. This review examines the evidence from 34 studies to evaluate the impact of HPN on survival and quality of life (QoL) in patients with MBO, CIF, and advanced cancer, as well as to identify clinical predictors of survival and address psychosocial challenges. Methods: A comprehensive review was conducted of 34 studies, focusing on the use of HPN in patients with MBO, CIF, and advanced cancer. Data were analyzed for survival outcomes, QoL metrics, and predictors of survival, including performance status, albumin levels, and the continuation of chemotherapy. The psychosocial aspects of HPN therapy were also assessed, particularly its influence on patient’s daily lives and mental health. Results: Key predictors of improved survival included good performance status, higher albumin levels, and the ability to continue chemotherapy. While HPN extended survival in many cases, its impact on QoL varied significantly. Psychosocial challenges, including lifestyle disruption and mental health strain, were common among long-term HPN patients, underscoring the need for comprehensive patient support. Conclusions: HPN can be a life-sustaining therapy for patients with CIF, MBO, and advanced cancer, but its success depends on careful patient selection and management. Identifying predictors of survival helps optimize outcomes, while addressing psychosocial challenges is crucial to minimizing the negative impact on QoL. This review highlights the need for a balanced approach to maximize the benefits of HPN. Full article

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