Nutrients

15 pages, 408 KB

Open AccessArticle

Ultra-Processed Food Consumption and Subclinical Cardiac Biomarkers: A Cross-Sectional Analysis of U.S. Adults in NHANES 2001–2004

by Jiahuan Helen He, Shutong Du, Valerie K. Sullivan, Lauren Bernard, Vanessa Garcia-Larsen, Eurídice Martínez-Steele, Ana Luiza Curi Hallal, Julia A. Wolfson, Mika Matsuzaki, Amelia S. Wallace, Mary R. Rooney, Michael Fang, John W. McEvoy, Elizabeth Selvin and Casey M. Rebholz

Nutrients 2025, 17(20), 3294; https://doi.org/10.3390/nu17203294 (registering DOI) - 20 Oct 2025

Abstract

Background/Objectives: Ultra-processed food consumption has been shown to be linked with clinical cardiovascular disease. This study aims to examine the associations of ultra-processed food consumption with biomarkers for subclinical-level myocardial damage [high-sensitivity cardiac troponin I and T (hs-cTnI and hs-cTnT)] and myocardial stretch [...] Read more.

Background/Objectives: Ultra-processed food consumption has been shown to be linked with clinical cardiovascular disease. This study aims to examine the associations of ultra-processed food consumption with biomarkers for subclinical-level myocardial damage [high-sensitivity cardiac troponin I and T (hs-cTnI and hs-cTnT)] and myocardial stretch (NT-proBNP) in U.S. adults. Methods: We used data from 6615 U.S. adults aged ≥20 years without prevalent cardiovascular disease from the National Health and Nutrition Examination Survey 2001–2004. We identified ultra-processed food by applying the Nova classification to dietary recall data, and we divided participants into quartiles based on their consumption, expressed as a proportion of total daily energy (%kcal) and gram intakes (%grams). We defined elevated cardiac biomarkers as hs-cTnI > 12 ng/L in men and >10 ng/L in women, hs-cTnT ≥ 14 ng/L for all participants, and NT-proBNP ≥ 125 pg/mL for age < 75 y and ≥450 pg/mL for age ≥ 75 y. We used multivariable logistic regression with adjustment for socio-demographic, total energy intake, behavioral, and clinical characteristics. Results: Higher ultra-processed food intake in %grams was associated with elevated NT-proBNP [odds ratio (OR) for quartile 4 vs. 1: 1.27, 95% CI: 1.00–1.61] when socio-demographic characteristics and total energy intake were adjusted for, but this was not the case with hs-cTnI or hs-cTnT. Further adjusting for clinical characteristics attenuated the association with NT-proBNP (OR: 1.26, 95% CI: 0.98, 1.61). There was no consistent association between ultra-processed food in %kcal and elevated NT-proBNP, hs-cTnT, or hs-cTnI. Conclusions: Ultra-processed food consumption is associated with subclinical myocardial stretch, a precursor to early heart failure. This supports the potential risks of subclinical cardiovascular disease associated with consuming ultra-processed food. Full article

(This article belongs to the Topic Ultra Processed Foods and Human Health)

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14 pages, 1446 KB

Open AccessArticle

Reliability of a Modified 24 h Dietary Recall and Veggie Meter to Assess Fruit and Vegetable Intake in New Zealand Children

by Varshika V. Patel, Thalagalage Shalika Harshani Perera, Elaine Rush, Sarah McArley, Carol Wham and David S. Rowlands

Nutrients 2025, 17(20), 3293; https://doi.org/10.3390/nu17203293 - 20 Oct 2025

Abstract

Adequate intake of fruits and vegetables (F + V) supports healthy growth and development in children, yet many New Zealand children do not meet national dietary recommendations, and methods to evaluate intake require good reliability. Objectives: To establish the validity and reliability of [...] Read more.

Adequate intake of fruits and vegetables (F + V) supports healthy growth and development in children, yet many New Zealand children do not meet national dietary recommendations, and methods to evaluate intake require good reliability. Objectives: To establish the validity and reliability of a modified 24 h multiple pass recall (MPR) for evaluating F + V and carotenoid intakes in children aged 9–13 years. The reliability of the Veggie Meter^® (VM^®), a non-invasive reflection spectrometer to estimate skin carotenoid scores and derive blood carotenoid concentrations, was also examined. Methods: Thirty-two children (20 boys, 12 girls) completed three 24 h MPRs and parent-assisted weighed food diaries (WFDs) on randomised weekdays and weekends. Skin carotenoid scores were assessed using the VM^®. The validity of the MPR was evaluated against WFDs using log-transformed Pearson correlations and mean x-axis bias. The reliability was assessed by the coefficient of variation (CV) and Pearson correlations. Results: Participants did not meet recommended F + V intakes (5–5.5 servings/day): MPR (mean fruit 1.3 servings/day; vegetables 2.0), WFD (fruit 1.3; vegetables 1.9). The MPR was a valid tool to estimate fruit and vegetable daily servings (combined-day Pearson coefficients > 0.71) with only trivial–small standardized mean bias-offset vs. WFD; however, the reliability was poor for the MPR-estimated carotenoid intake (CV 126%) and F + V intake. In contrast, the VM^® was reliable (Pearson correlation 0.97–0.99) with low measurement error (CV 4.0–5.2%). Conclusions: The modified 24 h MPR was valid but unreliable for estimating F + V and carotenoid intake. The VM^® demonstrated high reliability as a biomarker of skin carotenoid status in children. Full article

(This article belongs to the Section Pediatric Nutrition)

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14 pages, 714 KB

Open AccessArticle

Associations Between Vitamin D Deficiency and Sarcopenia in South Korean Adults: Based on the 2022 Korea National Health and Nutrition Examination Survey

by Sunhye Shin and Mi Joung Kim

Nutrients 2025, 17(20), 3292; https://doi.org/10.3390/nu17203292 - 20 Oct 2025

Abstract

Background/Objectives: Although vitamin D has been associated with sarcopenia in older adults, evidence across age groups remains limited. This study evaluated the relationship between vitamin D deficiency (VDD) and muscle health in Korean adults aged ≥19 years. Methods: Data utilized in [...] Read more.

Background/Objectives: Although vitamin D has been associated with sarcopenia in older adults, evidence across age groups remains limited. This study evaluated the relationship between vitamin D deficiency (VDD) and muscle health in Korean adults aged ≥19 years. Methods: Data utilized in this study were obtained from the 2022 Korea National Health and Nutrition Examination Survey IX-1. Serum 25-hydroxyvitamin D [25(OH)D] levels were analyzed in relation to appendicular skeletal muscle mass (ASM), grip strength, and sarcopenia using multivariable regression models. Results: Among 3,920 participants, 46.5% had VDD, with the highest prevalence observed in younger adults. After adjusting for age, body mass index, energy intake, and other confounding factors, serum 25(OH)D levels showed a positive association with ASM in middle-aged men (β = 0.005; p = 0.007) and with maximal handgrip strength in young men (β = 0.097; p = 0.048). Among older men, those with VDD had significantly higher odds of low muscle mass (OR = 1.82; 95% CI: 1.10–3.02) and sarcopenia (OR = 2.30; 95% CI: 1.03–5.16) than those without VDD, after adjusting for potential confounders. No significant associations were observed in women. Conclusions: These results suggest that maintaining adequate vitamin D levels may benefit muscle health in men. Further prospective or interventional studies are needed to more accurately assess the effects of vitamin D on muscle health. Full article

(This article belongs to the Special Issue Vitamin D and Age-Related Diseases)

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11 pages, 585 KB

Open AccessBrief Report

Can Vitamin D Reduce Glucocorticoid-Induced Adverse Effects in Patients with Giant Cell Arteritis? Results from 1568 Patients in the Spanish ARTESER Registry

by Gastón A. Ghio, Marta Domínguez-Álvaro, Iñigo Hernández Rodríguez, Elisa Fernández-Fernández, Maite Silva-Díaz, Joaquín M. Belzunegui, Clara Moriano, Julio Sánchez Martín, Javier Narváez, Eva Galíndez Agirregoikoa, Anne Riveros Frutos, Francisco Ortiz Sanjuán, Tarek C. Salman Monte, Margarida Vasques Rocha, Carlota L. Iñiguez, Alicia García Dorta, Clara Molina Almela, María Alcalde Villar, José L. Hernández, Santos Castañeda and Ricardo Blanco Show full author list Hide full author list

Nutrients 2025, 17(20), 3291; https://doi.org/10.3390/nu17203291 - 20 Oct 2025

Abstract

Objective: To determine whether oral vitamin D supplementation reduces the risk of glucocorticoid (GC)-associated severe adverse events (SAEs) in patients with giant cell arteritis (GCA) included in the Spanish ARTESER registry. Methods: The ARTESER registry collected data from patients diagnosed with GCA across [...] Read more.

Objective: To determine whether oral vitamin D supplementation reduces the risk of glucocorticoid (GC)-associated severe adverse events (SAEs) in patients with giant cell arteritis (GCA) included in the Spanish ARTESER registry. Methods: The ARTESER registry collected data from patients diagnosed with GCA across 26 Spanish public hospitals between June 2013 and March 2019. SAEs were defined as fatal, life-threatening, or requiring hospitalization. Patients were categorized according to the use or non-use of oral vitamin D supplements. Incidence rates (IRs) of SAEs were expressed per person-year with 95% confidence intervals (CIs). Cox proportional hazards models assessed vitamin D supplementation and its interaction with cumulative glucocorticoid dose. Results: Of 1568 patients (mean age 76.9 ± 8.1 years; 70.1% women) receiving GC, 120 (7.6%) experienced SAEs (IR 0.039; 95% CI 0.033–0.047). Vitamin D supplementation was documented in 1186 (75.6%) compared with 382 (24.4%) non-supplemented patients. SAE incidence was similar in supplemented (n = 89; 7.5%; IR 0.038, 95% CI 0.030–0.046) and non-supplemented patients (n = 31; 8.1%; IR 0.045, 95% CI 0.031–0.064) (p = 0.387). Multivariable Cox regression showed a significant interaction between vitamin D supplementation and cumulative glucocorticoid dose (interaction term HR 0.90; p = 0.033), consistent with a dose-dependent protective effect. Conclusions: Vitamin D supplementation was not independently associated with a lower incidence of GC-related SAEs, likely due to residual confounding factors. However, the interaction with cumulative GC exposure suggests a modulatory effect. Prospective studies incorporating stratified baseline vitamin D assessments are warranted. Full article

(This article belongs to the Section Nutritional Immunology)

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11 pages, 677 KB

Open AccessArticle

Improving Oxidative Stress Through a Wheat Aleurone-Rich Diet: Are Short-Chain Fatty Acids Possible Mediators?

by Roberta Testa, Dominic Salamone, Angela A. Rivellese, Gabriele Riccardi, Marilena Vitale, Rosalba Giacco and Giuseppina Costabile

Nutrients 2025, 17(20), 3290; https://doi.org/10.3390/nu17203290 - 20 Oct 2025

Abstract

Background/Objectives: Dietary fibers from cereals promote the production of short-chain fatty acids (SCFA), which have been linked to improved glucose and lipid metabolism, reduced inflammation, and decreased oxidative stress. Wheat aleurone, a bran fraction enriched in fermentable fibers and bioactive compounds, may [...] Read more.

Background/Objectives: Dietary fibers from cereals promote the production of short-chain fatty acids (SCFA), which have been linked to improved glucose and lipid metabolism, reduced inflammation, and decreased oxidative stress. Wheat aleurone, a bran fraction enriched in fermentable fibers and bioactive compounds, may enhance SCFA production, but clinical evidence remains limited. This study investigated whether a wheat aleurone-rich diet, compared with a refined wheat diet, modulates circulating SCFA concentrations and their relationship with oxidative stress in individuals at elevated cardio-metabolic risk. Methods: In a randomized, cross-over trial, 23 adults with abdominal obesity and at least one additional metabolic syndrome feature consumed isoenergetic diets enriched with wheat aleurone or refined wheat for 8 weeks. Fasting and postprandial serum SCFA concentrations were measured over 3 h following standardized test meals using the gas chromatography method. Urinary 8-isoprostane excretion was assessed as a biomarker of oxidative stress using the ELISA method. SCFA values are reported as changes (increase/decrease) from fasting values, calculated by subtracting the fasting value from that of each time point. Results: Compared with refined wheat, the wheat aleurone diet significantly increased postprandial butyrate response (p = 0.005, time × meal interaction), with higher values observed at 150 min (p = 0.027) and 180 min (p = 0.001). The mean change in postprandial butyrate was also greater after the wheat aleurone diet (+0.95 ± 1.92 vs. −0.32 ± 2.01 µmol/L; p = 0.040). Importantly, butyrate at 180 min was inversely correlated with urinary 8-isoprostane (r = −0.618, p = 0.019). No significant differences were found for acetate or propionate. Conclusions: A wheat aleurone-rich diet enhances postprandial butyrate production and is associated with lower oxidative stress, suggesting a role of butyrate in mediating the antioxidant benefits of wheat aleurone in individuals with cardio-metabolic risk. This study is registered under ClinicalTrials.gov Identifier no. NCT02150356. Full article

(This article belongs to the Special Issue Dietary Components, Oxidative Stress and Metabolic Diseases)

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17 pages, 3106 KB

Open AccessFeature PaperArticle

Hydrogel-Based Finger Foods: Enhancing Nutritional Intake and Swallowing Safety in Older Persons with Dysphagia

by Enrika Lazickaitė, Milda Keršienė, Viktorija Eisinaitė, Ina Jasutienė, Gytė Damulevičienė and Daiva Leskauskaitė

Nutrients 2025, 17(20), 3289; https://doi.org/10.3390/nu17203289 - 20 Oct 2025

Abstract

Background: Dysphagia is a common problem in older adults, characterized as a swallowing disorder that prevents food from passing from the mouth to the esophagus. Besides impairing dietary intake and leading to malnutrition, dysphagia also severely restricts water intake. Purpose: This study aimed [...] Read more.

Background: Dysphagia is a common problem in older adults, characterized as a swallowing disorder that prevents food from passing from the mouth to the esophagus. Besides impairing dietary intake and leading to malnutrition, dysphagia also severely restricts water intake. Purpose: This study aimed to develop polysaccharide-based hydrogels as dysphagia-friendly finger foods designed to provide high water content and enable controlled vitamin delivery to older persons with dysphagia. Procedures: Agar–carboxymethylcellulose (Agar-CMC) composite hydrogels with incorporated vitamins C, B₉, B, and D₃ were developed and tested for their textural and rheological properties, vitamin stability during storage, and vitamin release under simulated gastrointestinal conditions. Finally, a fiberoptic endoscopic swallowing assessment and sensory evaluation were conducted. Main Findings: Increasing the agar concentration in Agar-CMC hydrogels improved their internal structure and handling properties as finger foods, while still being easily breakable during swallowing. Agar-CMC hydrogels’ structure protected vitamins during processing and six weeks of storage. Vitamin release started immediately and remained steady in the gastric phase, with a noticeable increase at the beginning of the intestinal phase, resulting in 70–100% vitamin release by the end of this phase. The Fiberoptic Endoscopic Swallowing Evaluation confirmed their suitability for individuals with mild to moderate oropharyngeal dysphagia, with a low risk of aspiration (1 point on the Penetration-Aspiration Scale out of 8). Principal Conclusions: The developed Agar-CMC hydrogels present a promising dysphagia-friendly finger food alternative with high water content. They effectively deliver essential vitamins throughout the gastrointestinal tract, and notably demonstrate a low aspiration risk, making them suitable for individuals with mild to moderate oropharyngeal dysphagia. Full article

(This article belongs to the Special Issue The Role of Nutrition and Lifecare on Malnutrition)

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16 pages, 300 KB

Open AccessReview

The Relationship Between Social Media Use and Disordered Eating in Young Adults Aged 18–30: A Narrative Review

by Danai Athanasoula, Aikaterini Salpa, Fotini Sonia Apergi and Ilias I. Vlachos

Nutrients 2025, 17(20), 3288; https://doi.org/10.3390/nu17203288 - 20 Oct 2025

Abstract

Background/Objectives: Social media use has become ubiquitous, with governmental bodies and researchers expressing a growing concern about its impact on mental health. This review aims to examine the relationship between social media use and disordered eating in individuals aged 18–30. Specifically, we aim [...] Read more.

Background/Objectives: Social media use has become ubiquitous, with governmental bodies and researchers expressing a growing concern about its impact on mental health. This review aims to examine the relationship between social media use and disordered eating in individuals aged 18–30. Specifically, we aim to identify specific patterns of use (including addictive use) that are associated with increased risk for disordered eating. Methods: A search was conducted in March 2025 using PubMed and PsycINFO. Keywords were based on social media platforms and eating behaviors. Inclusion criteria were published studies in peer-reviewed journals from 2015–2025, written in English, with participants aged 18–30, whose disordered eating outcomes were assessed using validated measures. Conclusions: 637 articles were screened, with 28 studies meeting the inclusion criteria. Most studies assessed general social media use, without specifying the platform type. The EAT-26 and EDE-Q scales were used in most research to assess disordered eating. Data were narratively synthesized based on the type of social media variables assessed. Our findings demonstrate a complex relationship between social media use and disordered eating, with more consistent associations being found when the type of content (fitspiration and thinspiration) was the independent variable. These findings align with qualitative findings, which highlighted ambivalence in relation to the effect of social media: it is viewed as both a source of support and social comparison. Avenues for future research include longitudinal studies to understand the interaction between individual factors and social media patterns of use, as well as the utilization of platform-generated data on online engagement patterns. Full article

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

15 pages, 2207 KB

Open AccessArticle

The Impact of Two Different Insulin Dose Calculation Methods on Postprandial Glycemia After a Mixed Meal in Children with Type 1 Diabetes: A Randomized Study

by Magdalena Dymińska, Emilia Kowalczyk-Korcz, Katarzyna Piechowiak and Agnieszka Szypowska

Nutrients 2025, 17(20), 3287; https://doi.org/10.3390/nu17203287 - 20 Oct 2025

Abstract

Background/Objectives: Optimal postprandial glycemic control is crucial to maintain time in range (TIR:3.9–10.0 mmol/L, 70–180 mg/dL) and time in tight range (TITR:3.9–7.8 mmol/L, 70–140 mg/dL), both important to reduce microvascular complications in type 1 diabetes mellitus (T1DM). However, insulin dosing based on [...] Read more.

Background/Objectives: Optimal postprandial glycemic control is crucial to maintain time in range (TIR:3.9–10.0 mmol/L, 70–180 mg/dL) and time in tight range (TITR:3.9–7.8 mmol/L, 70–140 mg/dL), both important to reduce microvascular complications in type 1 diabetes mellitus (T1DM). However, insulin dosing based on carbohydrate counting fails to compensate for delayed hyperglycemia from protein and fat. This study evaluated two advanced insulin dosing algorithms designed to improve postprandial control in adolescents with T1DM. Methods: In this randomized, prospective, double-blind, crossover trial, 58 adolescents with T1DM (median age 15.5 years) were enrolled, all using continuous subcutaneous insulin infusion and a continuous glucose monitoring system in non-automated mode. For two consecutive days, participants consumed standardized mixed meals for breakfast (50 g of carbohydrates, 200 kcal from protein and fat) and received an extended bolus delivered for four hours, based on the Pankowska Equation (PE, i.e., Fat-Protein Units × Insulin-to-Carbohydrate Ratio (ICR)) and the Sieradzki Equation (SE, i.e., 30% × Carbohydrate Units × ICR). Postprandial glucose was monitored for five hours using a glucometer and Continuous Glucose Monitoring (CGM). The primary outcome was the capillary blood glucose level at predefined time points. The secondary outcomes were the frequency of hypoglycemia and glycemic variability parameters. Results: Both methods kept postprandial glucose within the recommended TIR. The SE method provided longer TITR (82.51% vs. 70.49%, p = 0.6281) and fewer hypoglycemic episodes at 180 and 300 min. Glucose levels at 60 min, were higher after PE (136 ± 35.2 mg/dL vs. 124 ± 32.2 mg/dL, p = 0.016). Conclusions: Both algorithms provided effective postprandial control after a mixed meal, but SE achieved a longer TITR and fewer late hypoglycemic events. Full article

(This article belongs to the Section Nutrition and Diabetes)

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23 pages, 490 KB

Open AccessReview

Magnesium Depletion Score as an Indicator of Health Risk and Nutritional Status—A Scoping Review

by Rebecca B. Costello, Zhongqi Fan and Taylor C. Wallace

Nutrients 2025, 17(20), 3286; https://doi.org/10.3390/nu17203286 - 20 Oct 2025

Abstract

Background/Objectives: Magnesium is an essential nutrient involved in more than 600 enzymatic reactions, and nutritional status is estimated to be critical for many metabolic and biochemical processes in humans. Although magnesium deficiency and inadequacy impacts multiple chronic disease states, signs and symptoms [...] Read more.

Background/Objectives: Magnesium is an essential nutrient involved in more than 600 enzymatic reactions, and nutritional status is estimated to be critical for many metabolic and biochemical processes in humans. Although magnesium deficiency and inadequacy impacts multiple chronic disease states, signs and symptoms are often nonspecific and nutritional status is difficult to measure. The recently developed magnesium depletion score (MDS) is a promising tool for identifying individuals at risk of magnesium deficiency or inadequacy and associated comorbidities, but its clinical applicability and validity across broad populations remains unclear. Methods: Using the Joanna Briggs Institute (JBI) and JBI Collaborating Center guidelines for conducting scoping reviews, four electronic databases (MEDLINE/ PubMed, Embase, and Scopus) were systematically searched from inception to 20 May 2025 for clinical and observational English-language studies that assessed the impact of MDS on health and/or nutritional status. The protocol was preregistered on Open Science Framework prior to data extraction. Results: 48 articles, inclusive of 39 cross-sectional and 15 prospective cohort analyses, as well as a single secondary analysis of a randomized controlled trial, were included in the scoping review. All but two analyses reported adverse associations with a high MDS. MDS was inversely correlated with dietary magnesium intake across studies. Conclusions: The MDS, particularly when utilized alongside traditional dietary intake assessment, offers promise as a tool for more rapidly identifying individuals at risk of magnesium deficiency (or insufficiency), and associated comorbidities, although large clinical trials are needed to confirm these findings. Full article

(This article belongs to the Special Issue The Role of Magnesium Status in Human Health)

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22 pages, 2222 KB

Open AccessReview

Potential of Traditional Chinese Medicine Brucea javanica in Cancer Treatment: A Review of Chemical Constituents, Pharmacology, and Clinical Applications

by Weiyin Xu, Hongmei Yang, Yanan Zhou, Rixin Guo, Jing Liu, Feng Wei and Yongqiang Lin

Nutrients 2025, 17(20), 3285; https://doi.org/10.3390/nu17203285 - 20 Oct 2025

Abstract

Brucea javanica (BJ), a key representative of traditional Chinese herbal medicine, is derived from the dried mature fruit of Brucea javanica (L.) Merr., a plant in the Simaroubaceae family. Its pharmacological activity is largely attributed to diverse chemical constituents. To date, approximately 200 [...] Read more.

Brucea javanica (BJ), a key representative of traditional Chinese herbal medicine, is derived from the dried mature fruit of Brucea javanica (L.) Merr., a plant in the Simaroubaceae family. Its pharmacological activity is largely attributed to diverse chemical constituents. To date, approximately 200 distinct chemical constituents have been isolated and identified, mainly comprising quassinoids, triterpenes, alkaloids, steroids, phenylpropanoids, and flavonoids. Contemporary pharmacological studies have demonstrated the significant activities of BJ in various areas, including anti-tumor, anti-inflammatory, and anti-parasitic effects. Notably, its oil form (Brucea javanica oil) has been extensively utilized in treating various cancer types. This review aims to systematically summarize the antitumor components, mechanisms of action, and clinical applications in cancer therapy, with the goal of providing theoretical support for further antitumor research and the development of new BJ-based drugs, highlighting its potential as an antitumor agent. Full article

(This article belongs to the Special Issue Modulation of Signaling Pathways in Cancer Cells and Tumors by Dietary Bioactive Compounds)

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18 pages, 1991 KB

Open AccessArticle

New Anthropometry-Based Formulae to Predict 24 h Sodium Excretion from Spot Urine

by Martina Zandonà, Karin Holzner, Maria Luisa Garo, Rosaria Del Giorno and Luca Gabutti

Nutrients 2025, 17(20), 3284; https://doi.org/10.3390/nu17203284 - 20 Oct 2025

Abstract

Background: Cardiovascular diseases are the leading cause of death globally, with hypertension and high sodium intake being major contributors. Accurate estimation of sodium intake is essential, but 24 h urine collection, the gold standard, is cumbersome and impractical for routine clinical use. Existing [...] Read more.

Background: Cardiovascular diseases are the leading cause of death globally, with hypertension and high sodium intake being major contributors. Accurate estimation of sodium intake is essential, but 24 h urine collection, the gold standard, is cumbersome and impractical for routine clinical use. Existing spot urine-based prediction formulae lack accuracy at the individual and population level. Objective: To develop and validate population-specific formulas for estimating 24 h urinary sodium excretion from spot urine samples using data from a representative Swiss adult population. Methods: Models with and without urea and potassium were developed incorporating age, sex, and anthropometry-based, population-specific, estimated urinary creatinine excretion values. Data quality was rigorously controlled, and model performance was compared to the INTERSALT, Kawasaki, and Tanaka formulae and to a nocturnal timed urine collection used to calculate hourly creatinine excretion. Results: Models based on first morning urine demonstrated improved accuracy (AUCs: Swiss anthropometric model 0.85 (95% CI: 0.80–0.90), Swiss anthropometric model with urea 0.86 (95% CI: 0.81–0.91)) and lower bias (−5.5 mmol/24 h for the Swiss anthropometric model and −2.86 mmol/24 h for the Swiss anthropometric model with urea) compared to existing equations. Performance was consistent across clinically relevant sodium intake thresholds and the models were therefore suitable for use in clinical settings. A timed nocturnal urine collection further improves accuracy. Conclusions: These new simple and reliable formulae provide a promising and practical tool for estimating sodium intake from first morning urine spot in adult European populations, and are potentially applicable in clinical settings. Full article

(This article belongs to the Section Sports Nutrition)

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14 pages, 1066 KB

Open AccessArticle

Human Milk Electrolytes as Nutritional Biomarkers of Mammary Gland Integrity: A Study Across Ductal Conditions and Donor Milk

by Po-Yu Hsieh, Miori Tanaka, Tomoko Himi and Katsumi Mizuno

Nutrients 2025, 17(20), 3283; https://doi.org/10.3390/nu17203283 - 19 Oct 2025

Abstract

Background/Objectives: Sodium (Na) concentration and the sodium-to-potassium (Na/K) ratio in human milk reflect epithelial tight junction integrity and have been proposed as non-invasive biomarkers of lactational dysfunction, including subclinical mastitis and ductal obstruction. However, their discriminative performance across varied mammary duct conditions, [...] Read more.

Background/Objectives: Sodium (Na) concentration and the sodium-to-potassium (Na/K) ratio in human milk reflect epithelial tight junction integrity and have been proposed as non-invasive biomarkers of lactational dysfunction, including subclinical mastitis and ductal obstruction. However, their discriminative performance across varied mammary duct conditions, as well as their relevance to milk quality and nutritional integrity, remain underexplored. This study aimed to evaluate the ability of Na, K and the Na/K ratio to discriminate ductal obstruction from non-obstructed lactation—including normal, mixed, and donor milk—and to assess their applicability as nutritional and clinical screening biomarkers. Methods: The study analyzed 635 human milk samples from four groups: obstructed ducts (n = 94), mixed ducts (n = 39), normal ducts (n = 102), and donor milk (n = 400). Na and K concentrations were measured using validated handheld ion-selective electrode analyzers. Statistical analyses included Quade’s ANCOVA and receiver operating characteristic curve analysis, adjusting for infant age, gestational age, birth body weight, maternal age and storage duration. Results: Na concentrations were highest in obstructed ducts (Group A: median 810 ppm, IQR 368–1725) compared with normal ducts (Group C: 220 ppm, IQR 140–283) and donor milk (Group D: 98 ppm, IQR 80–130) (p < 0.001). A similar pattern was observed for the Na/K ratio (Group A: 1.5, IQR 0.6–3.1 vs. Group C: 0.3, IQR 0.2–0.5; Group D: 0.3, IQR 0.2–0.3). After adjusting, both Na and the Na/K ratio remained significantly elevated in milk from obstructed ducts compared to non-obstructed samples (p < 0.001). Donor milk exhibited the lowest and most stable electrolyte levels. Na demonstrated excellent discriminative performance (area under the curve = 0.96), slightly outperforming the Na/K ratio (area under the curve = 0.92). Conclusions: Na concentration and the Na/K ratio in human milk are sensitive and practical biomarkers of mammary gland integrity. Given that Na alone can be measured without additional calculations, its simplicity and strong performance support its application as a potential biomarker for ductal obstruction, with implications for both lactation support and nutritional science. Full article

(This article belongs to the Section Pediatric Nutrition)

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14 pages, 1152 KB

Open AccessArticle

Age-Stratified Trends in Nutrition and Lifestyle Transitions in Korea: Findings from KNHANES 2013–2022

by Seongryu Bae and Hyuntae Park

Nutrients 2025, 17(20), 3282; https://doi.org/10.3390/nu17203282 - 19 Oct 2025

Abstract

Background: Rapid aging and dietary Westernization in Korea have raised concerns about shifting nutrition and lifestyle patterns. Objectives: This study examined 10-year trends in nutrient intake, biochemical indicators, meal-related behaviors, and sedentary time among Korean adults, stratified by age group. Methods: Data [...] Read more.

Background: Rapid aging and dietary Westernization in Korea have raised concerns about shifting nutrition and lifestyle patterns. Objectives: This study examined 10-year trends in nutrient intake, biochemical indicators, meal-related behaviors, and sedentary time among Korean adults, stratified by age group. Methods: Data were drawn from the 6th–9th waves (2013–2022) of the Korea National Health and Nutrition Examination Survey (KNHANES) for a cross-sectional analysis, including 61,688 participants (18–39 years: 17,225; 40–64 years: 28,045; ≥65 years: 16,218). Survey-weighted linear and logistic regression analyses were used to test linear trends and between-period contrasts (2013–2015 vs. 2020–2022). Results: Total energy intake declined significantly from 2087 kcal in 2013–2015 to 1823 kcal in 2022 (p for trend < 0.001), accompanied by a decrease in carbohydrate share (62.8% to 58.3%, p < 0.001) and increases in protein (13.8% to 15.4%, p < 0.001) and fat (19.0% to 23.4%, p < 0.001). Saturated fat and cholesterol intake increased significantly, particularly among older adults (+50.9% and +46.4%, respectively; both p < 0.001). The proportion of breakfast skippers increased significantly, more than 35% in 2022 (p < 0.001). Conversely, the frequency of eating out decreased (p < 0.001), with a particularly pronounced decline during the COVID-19 period. Sedentary time steadily and significantly increased over the decade (p < 0.001). Conclusions: Over the past decade, Korean adults have shifted toward lower energy and carbohydrate intake, higher protein and fat consumption, and more sedentary lifestyles. Differences in vulnerability by age emphasize the need for personalized public health strategies: promoting protein intake and reducing sedentary time for older adults, while improving dietary patterns and managing weight for younger generations. Full article

(This article belongs to the Special Issue Promotion of a Healthy Nutrition and an Active Lifestyle Across the Lifespan and in Different Settings)

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26 pages, 3292 KB

Open AccessArticle

Circadian Phase Determines Tissue-Specific Adaptations to Long-Term Exercise in Obese Mice

by Shuo Wang, Ziwei Zhang, Jiapeng Huang, Yishan Tong, Cong Wu, Haruki Kobori, Sihui Ma and Katsuhiko Suzuki

Nutrients 2025, 17(20), 3281; https://doi.org/10.3390/nu17203281 - 18 Oct 2025

Abstract

Background: Exercise interacts closely with the circadian system; however, whether long-term training elicits time-of-day-dependent metabolic adaptations in the context of obesity remains unclear. Methods: Male C57BL/6 mice were fed a high-fat diet and trained on a treadmill for 8 weeks during [...] Read more.

Background: Exercise interacts closely with the circadian system; however, whether long-term training elicits time-of-day-dependent metabolic adaptations in the context of obesity remains unclear. Methods: Male C57BL/6 mice were fed a high-fat diet and trained on a treadmill for 8 weeks during either the early rest phase (ZT3, Zeitgeber time) or the early active phase (ZT15). Sedentary mice served as controls. After the last session, animals were fasted for 4 h and sampled 48–49 h later. Plasma triglycerides (TGs) and glucose, as well as liver and epididymal white adipose tissue (EPI), were analyzed. Results: Plasma TGs showed a significant phase × exercise interaction (F(1, 25) = 5.25, p = 0.0307), with the lowest levels in ZT15-exe (27.22 mg/dL) compared with ZT15-sed (39.47 mg/dL, p < 0.01) and ZT3-exe (41.80 mg/dL, p < 0.01). Hepatic TG content was markedly lower in ZT3 than in ZT15 mice (F(1, 25) = 15.49, p < 0.001), and Oil Red O staining was associated with reduced lipid accumulation in exercised groups (p < 0.05). In EPI, Fasn expression was robustly decreased by exercise (F(1, 25) = 16.43, p = 0.0004, q = 0.0059), indicating long-term suppression of lipogenesis. In the liver, Cpt1a showed significant main effects of both phase (F(1, 25) = 10.11, p = 0.0039, q = 0.0158) and exercise (F(1, 25) = 13.42, p = 0.0012, q = 0.0353), being higher in ZT3 and under sedentary conditions, suggesting a circadian-dominant oxidative advantage in hepatic metabolism. Conclusions: Long-term exercise induced phase-dependent adaptations in lipid metabolism. Active-phase exercise promoted adipose lipid mobilization and lowered plasma TGs, while rest-phase training enhanced hepatic oxidative capacity. These results suggest a “tissue × time” framework of circadian-specific exercise responses, providing hypothesis-generating evidence for optimizing exercise timing in metabolic disorders. Full article

(This article belongs to the Special Issue Nutritional Modulation in Aging and Metabolic Syndrome: Combating Obesity, Vascular Disease and Frailty)

13 pages, 2126 KB

Open AccessArticle

Dietary Branched-Chain Amino Acids and Hyper-LDL-Cholesterolemia: A Case–Control Study Using Interpretable Machine-Learning Models in Chinese Children and Adolescents

by Zeping Zang, Shixiu Zhang, Changqing Liu, Yiya Liu, Meina Tian, Xiaoyan Luo, Qianrang Zhu, Lei Liu and Lianlong Yu

Nutrients 2025, 17(20), 3280; https://doi.org/10.3390/nu17203280 - 18 Oct 2025

Abstract

Background: Plasma branched-chain amino acid (BCAA) concentrations are positively associated with low-density lipoprotein cholesterol (LDL-C) levels. However, the relationship between dietary branched-chain amino acids and hyper-LDL-cholesterolemia is unclear in children and adolescents. Methods: This study explored the correlation between BCAAs and [...] Read more.

Background: Plasma branched-chain amino acid (BCAA) concentrations are positively associated with low-density lipoprotein cholesterol (LDL-C) levels. However, the relationship between dietary branched-chain amino acids and hyper-LDL-cholesterolemia is unclear in children and adolescents. Methods: This study explored the correlation between BCAAs and hyper-LDL-cholesterolemia risk through propensity score matching and conditional logistic regression. Machine learning based on LightGBM indicated the important role of BCAAs in the prediction of hyper-LDL-cholesterolemia. To examine the dose–response relationship, Restricted Cubic Splines (RCS) and receiver operating characteristic curves (ROC) were employed. The causal link between BCAA and cardiovascular disease (CVD) was explored via mediation Mendelian randomization. Results: For every 1 g/day increment in the intake of isoleucine, leucine, and valine, there was a corresponding 30%, 11%, and 16% rise in the risk of hyper-LDL-cholesterolemia, respectively. The optimal cut-off values stood at 5.53, 6.40, and 4.18 g/day, respectively. Utilizing the inverse variance weighted method for estimation revealed that the total effect of BCAA on CVD was OR = 1.06 (95% CI: 1.02~1.11), with p = 0.005. The indirect effect, mediated by LDL-C, was OR = 1.02 (95% CI: 1.00~1.02), with p = 0.026. The direct effect was noted at OR = 1.05 (95% CI: 1.01~1.09), with p = 0.017. Conclusions: Dietary BCAAs are positively correlated with hyper-LDL-cholesterolemia in children and adolescents. LDL-C serve as a mediator of CVD caused by BCAAs. Full article

(This article belongs to the Section Pediatric Nutrition)

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25 pages, 4450 KB

Open AccessSystematic Review

Marine-Based Omega-3 Fatty Acids and Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Arghavan Basirat and Juan Francisco Merino-Torres

Nutrients 2025, 17(20), 3279; https://doi.org/10.3390/nu17203279 - 18 Oct 2025

Abstract

Background: Metabolic syndrome (MetS) is a set of cardiometabolic abnormalities, including central obesity, dyslipidemia, hypertension, and hyperglycemia, that substantially increases the risk of cardiovascular disease and type 2 diabetes. Marine-derived omega-3 polyunsaturated fatty acids (n-3 PUFAs), especially eicosapentaenoic acid (EPA) and [...] Read more.

Background: Metabolic syndrome (MetS) is a set of cardiometabolic abnormalities, including central obesity, dyslipidemia, hypertension, and hyperglycemia, that substantially increases the risk of cardiovascular disease and type 2 diabetes. Marine-derived omega-3 polyunsaturated fatty acids (n-3 PUFAs), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may improve MetS components through triglyceride-lowering, anti-inflammatory, and insulin-sensitizing effects; however, randomized controlled trial (RCT) results remain inconsistent, and the influence of dose and intervention duration is unclear. Methods: Following PRISMA guidelines, PubMed, Embase, Scopus, and Web of Science were searched to June 2024 for RCTs in adults with MetS or its components. Eligible trials assessed marine-derived omega-3 supplementation (EPA/DHA) versus placebo or control and reported at least one MetS diagnostic criterion (triglycerides, HDL cholesterol, fasting plasma glucose, blood pressure, or waist circumference) or related parameter (LDL cholesterol, HOMA-IR, or HbA1c). Data were extracted in duplicate and quality assessed using the Cochrane Risk-of-Bias Tool. Trials were categorized by dose—low (<1000 mg/day), medium (1000–2000 mg/day), and high (>2000 mg/day)—and duration: short-term (ST; ≤8 weeks), medium-term (MT; >8–12 weeks), and long-term (LT; >12 weeks). Meta-regression using ordinary least squares estimated dose–duration effects. Publication bias was assessed with funnel plots and Egger’s test for outcomes with ≥3 studies. Results: Twenty-one RCTs (n ≈ 1950) were included. For triglycerides, the largest reductions occurred in the high-dose LT (−56.78 mg/dL ± 3.44) and ST (−50.873 mg/dL ± 3.04) groups, and MT duration (−41.536 mg/dL ± 4.12), showing that in high doses of omega-3, the beneficial effect of reducing TGs was more prominent in long-term and short-term treatment other than with medium-term duration of treatment. In comparison, the result for medium-dose with MT duration was (−24.93 mg/dL ± 0.464) and for LT duration was (−31.843 mg/dL ± 0.46), all p < 0.001. In LDL cholesterol, an increase in the low-dose ST group (+7.04 mg/dL ± 4, p < 0.001) and low-dose LT group (+35.525 mg/dL ± 4.33, p < 0.001) was observed. In other subgroups, either there were no data available or the number of studies was limited and could not be considered as statistically significant in meta-analysis due to low power. As for HDL cholesterol, FBS, SBP, DBP, waist circumference, BMI, and HOMA-IR, the data extracted from the included studies were not sufficient to be eligible for the meta-analysis. Conclusions: Marine-derived omega-3 supplementation produces substantial triglyceride reductions, especially at doses >2000 mg/day for ≥8 weeks. HDL cholesterol and blood pressure benefits are not consistent, fasting glycemia is largely unaffected, and LDL cholesterol may increase, especially in low doses. High-dose marine omega-3s can be considered as part of dietary strategies for MetS management, with monitoring for LDL changes. Standardized intervention protocols and long-term RCTs are needed to clarify dose and duration–response relationships. Full article

(This article belongs to the Special Issue Fatty Acid, Obesity and Metabolic Syndrome)

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27 pages, 2710 KB

Open AccessReview

Hepatoprotective Effect of Silymarin Herb in Prevention of Liver Dysfunction Using Pig as Animal Model

by Prarthana Sharma, Varun Asediya, Garima Kalra, Sharmin Sultana, Nihal Purohit, Kamila Kibitlewska, Wojciech Kozera, Urszula Czarnik, Krzysztof Karpiesiuk, Marek Lecewicz, Paweł Wysocki, Adam Lepczyński, Małgorzata Ożgo, Marta Marynowska, Agnieszka Herosimczyk, Elżbieta Redlarska, Brygida Ślaska, Krzysztof Kowal, Angelika Tkaczyk-Wlizło, Paweł Grychnik, Athul P. Kurian, Kaja Ziółkowska-Twarowska, Katarzyna Chałaśkiewicz, Katarzyna Kępka-Borkowska, Ewa Poławska, Magdalena Ogłuszka, Rafał R. Starzyński, Hiroaki Taniguchi, Chandra Shekhar Pareek and Mariusz Pierzchała Show full author list Hide full author list

Nutrients 2025, 17(20), 3278; https://doi.org/10.3390/nu17203278 - 18 Oct 2025

Abstract

Silymarin, a flavonolignan-rich extract of Silybum marianum, is widely recognized for its hepatoprotective potential. While rodent studies predominate, pigs (Sus scrofa) offer a more translationally relevant model due to their hepatic architecture, bile acid composition, and transporter expression, which closely [...] Read more.

Silymarin, a flavonolignan-rich extract of Silybum marianum, is widely recognized for its hepatoprotective potential. While rodent studies predominate, pigs (Sus scrofa) offer a more translationally relevant model due to their hepatic architecture, bile acid composition, and transporter expression, which closely resemble those of humans. This narrative review synthesises current evidence on the chemistry, pharmacokinetics, biodistribution, and hepatoprotective activity of silymarin in porcine models. Available studies demonstrate that when adequate intrahepatic exposure is achieved, particularly through optimised formulations, silymarin can attenuate oxidative stress, suppress inflammatory signalling, stabilise mitochondria, and modulate fibrogenic pathways. Protective effects have been reported across diverse porcine injury paradigms, including toxin-induced necrosis, ethanol- and diet-associated steatosis, metabolic dysfunction, ischemia–reperfusion injury, and partial hepatectomy. However, the evidence base remains limited, with few long-term studies addressing fibrosis or regeneration, and methodological heterogeneity complicates the comparison of data across studies. Current knowledge gaps in silymarin research include inconsistent chemotype characterization among plant sources, limited reporting of unbound pharmacokinetic parameters, and variability in histological scoring criteria across studies, which collectively hinder cross-study comparability and mechanistic interpretation. Advances in analytical chemistry, transporter biology, and formulation design are beginning to refine the interpretation of exposure–response relationships. Advances in analytical chemistry, transporter biology, and formulation design are beginning to refine the interpretation of exposure–response relationships. In parallel, emerging computational approaches, including machine-learning-assisted chemotype fingerprinting, automated histology scoring, and Bayesian exposure modeling, are being explored as supportive tools to enhance reproducibility and translational relevance; however, these frameworks remain exploratory and require empirical validation, particularly in modeling enterohepatic recirculation. Collectively, current porcine evidence supports silymarin as a context-dependent yet credible hepatoprotective agent, highlighting priorities for future research to better define its therapeutic potential in clinical nutrition and veterinary practice. Full article

(This article belongs to the Special Issue Relationship Among Essential Fatty Acids, Medical Herbs and Human Health)

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14 pages, 699 KB

Open AccessArticle

Parental Intake of Eicosapentaenoic and Docosahexaenoic Acids in a Diverse, Urban City in the United States Is Associated with Indicators of Children’s Health Potential

by Daniel T. Robinson, Marie E. Heffernan, Anne Bendelow, Carly G. Menker, Mia Casale, Tracie Smith, Matthew M. Davis and Susan E. Carlson

Nutrients 2025, 17(20), 3277; https://doi.org/10.3390/nu17203277 - 18 Oct 2025

Abstract

Background/Objectives: Parents achieving recommended eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid intake can improve the health of parents and their children. Evidence links higher DHA intake to lower preterm birth (PTB) risk. With parental intake poorly defined, the objective is to characterize EPA and [...] Read more.

Background/Objectives: Parents achieving recommended eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid intake can improve the health of parents and their children. Evidence links higher DHA intake to lower preterm birth (PTB) risk. With parental intake poorly defined, the objective is to characterize EPA and DHA intake by parents with children in households in a diverse, urban city. Methods: Parents with ≥1 child in the household completed a validated seven-question food frequency questionnaire to assess consumption of foods contributing most to EPA and DHA intake in American diets during the cross-sectional Voices of Child Health in Chicago Panel Survey (May–July 2022). Female respondents reported prior PTB. Home/residence information was linked to the Childhood Opportunity Index (COI). Multivariable linear regression and survey-weighted models evaluated parental characteristics associated with EPA+DHA intake. Pairwise comparisons estimated intake differences (mean (SE)) among groups. Results: Chicago parents (n = 1057) reported lower-than-recommended EPA+DHA intake and mothers consumed less compared to fathers (difference: 27.1 (11.4) mg/d; p = 0.02). Prior PTB was associated with lower EPA+DHA intake, yet DHA-containing supplement use, which occurred in ~25% of parents, was associated with higher intake (p < 0.05). Lower household income and a lower COI were associated with lower intake while parental race and ethnicity categories were also associated with intake (all p < 0.05); intake differed for mothers and fathers based on Black race and Hispanic ethnicity categories. Conclusions: The findings suggest that efforts aimed at improving parental EPA+DHA intake to improve the health of families should account for multidimensional influences on household food choices. Full article

(This article belongs to the Section Lipids)

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14 pages, 249 KB

Open AccessReview

Inclusive Nutrition Care for LGBT+ Patients: Challenges and Opportunities for Dietitians—A Narrative Review

by Michał Czapla and Anthony Dissen

Nutrients 2025, 17(20), 3276; https://doi.org/10.3390/nu17203276 - 18 Oct 2025

Abstract

Nutrition is a cornerstone of public health, yet the unique nutrition needs and considerations of lesbian, gay, bisexual, transgender, and others (LGBT+) communities remain largely invisible in the field of dietetics. These populations face disproportionate burdens of obesity, eating disorders, body dysmorphia, metabolic [...] Read more.

Nutrition is a cornerstone of public health, yet the unique nutrition needs and considerations of lesbian, gay, bisexual, transgender, and others (LGBT+) communities remain largely invisible in the field of dietetics. These populations face disproportionate burdens of obesity, eating disorders, body dysmorphia, metabolic risks, and food insecurity, often driven by stigma, minority stress, and structural inequities. This narrative review aimed to synthesize current evidence on nutrition-related disparities among LGBT+ populations and identify opportunities for dietitians to advance equity in care. A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies addressing diet quality, obesity, eating disorders, food insecurity, and metabolic health in sexual and gender minorities. Evidence indicates clear subgroup differences: lesbian and bisexual women are more likely to experience obesity and food insecurity; gay and bisexual men report lower BMI but greater body image concerns and disordered eating; transgender individuals face nutritional challenges linked to gender-affirming therapy and high rates of food insecurity; and people living with HIV encounter additional metabolic risks associated with treatment. Despite these findings, LGBT+ health remains rarely reflected in dietary guidelines or professional training. Embedding inclusivity into dietetic education and clinical encounters, adopting culturally competent and structurally aware practices, and tailoring interventions to subgroup-specific needs are key priorities. Inclusive, equity-driven, and person-centered nutrition care is essential to closing health gaps for LGBT+ populations and ensuring that every patient receives guidance that affirms their identity and lived experience. Full article

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

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