Dietary Collagen Supplementation as a Strategy for Skin Health: A Narrative Review of Clinical Effects on Skin, Hair, Nails, and Wound Healing
Shifting to Plant-Based Protein Diets Alters Nutrient Adequacy Across Age Groups: A Dutch Dietary Modeling Study
Dietary Carbohydrates and ADHD

Journal Description

Nutrients

Nutrients is an international, peer-reviewed, open access journal of human nutrition published semimonthly online by MDPI. The Asia Pacific Nutrigenomics Nutrigenetics Organisation (APNNO), Italian Society for Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP), Nutrition Society of New Zealand (NSNZ), Ocular Wellness & Nutrition Society (OWNS) and others are affiliated with Nutrients and their members receive discounts on article processing charges.

Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, MEDLINE, PMC, Embase, PubAg, AGRIS, and other databases.
Journal Rank: JCR - Q1 (Nutrition and Dietetics) / CiteScore - Q1 (Nutrition and Dietetics)
Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 15.8 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the first half of 2026).
Recognition of Reviewers: Reviewers whose reports are timely and of high quality receive an APC discount voucher for a future publication in an MDPI journal. Become a reviewer.
Companion journal: Dietetics.
Journal Cluster of Food, Nutrition, and Health Science: Beverages, Dietetics, Foods, Nutraceuticals, Nutrients and Obesities.

Impact Factor: 5.8 (2025); 5-Year Impact Factor: 6.5 (2025)

Imprint Information Journal Flyer Open Access ISSN: 2072-6643

Latest Articles

21 pages, 1660 KB

Open AccessReview

GLP-1 Receptor Agonists, Gut Microbiota, and Chronic Pain: Nutritional Signaling at the Gut–Brain Axis

by Charles A. Odonkor, Mustafa R. Dodurgali, Fiona R. Cox, Ian J. Klimov and Alaa Abd-Elsayed

Nutrients 2026, 18(19), 3120; https://doi.org/10.3390/nu18193120 - 22 Sep 2026

Abstract

Background/Objectives: Chronic pain affects more than one in five adults worldwide and is increasingly conceptualized as a disorder of the gut–brain axis. Gut microbial dysbiosis, characterized by reduced alpha-diversity and depletion of short-chain fatty acid (SCFA)-producing taxa such as Faecalibacterium prausnitzii, Lachnospiraceae, and Roseburia, has been mechanistically linked to pain sensitization. Glucagon-like peptide-1 (GLP-1), a nutrient-sensing enteroendocrine hormone, and its pharmacological receptor agonists (GLP-1RAs) both reshape the gut microbiota and modulate pain across multiple phenotypes. This review synthesizes preclinical and clinical evidence positioning the gut microbiota as a proposed nutritional intermediary that links GLP-1RA pharmacology to chronic pain modulation. Methods: We conducted a narrative synthesis of studies retrieved from PubMed, Embase, and Web of Science from inception through 30 June 2026, spanning GLP-1 nutrient sensing, gut microbial alterations in pain, GLP-1RA effects on the microbiome, microbiota-dependent mechanisms, and clinical pain outcomes. Results: GLP-1 is secreted by L-cells in response to nutrients and microbial SCFAs, signaling to the brain through vagal and humoral routes. GLP-1RAs enrich the same anti-inflammatory, SCFA-producing taxa that are depleted in chronic pain, and their anti-inflammatory actions require an intact microbiota. Mechanistically, GLP-1RAs suppress pain through spinal microglial GLP-1 receptor (GLP-1R)/interleukin-10/beta-endorphin signaling, Nucleotide-binding oligomerization domain (NOD)-, Leucine-rich repeat (LRR)-, and pyrin domain-containing protein 3 (NLRP3) inflammasome inhibition, and receptor-independent transient receptor potential vanilloid 1 (TRPV1) blockade, largely independent of glycemic control or weight loss. Clinically, evidence is strongest for knee osteoarthritis and idiopathic intracranial hypertension headache, with emerging signals in fibromyalgia, visceral pain, and reduced opioid use. Conclusions: The gut microbiota is proposed to act as both a therapeutic target and a mechanistic intermediary in GLP-1RA-mediated analgesia, a model that awaits direct confirmation in humans. Pain-specific trials incorporating dietary and microbiome endpoints are needed. Full article

(This article belongs to the Special Issue Dietary Modulation of the Microbiota–Gut–Brain Axis: From Mechanisms to Precision Nutrition)

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18 pages, 1246 KB

Open AccessArticle

Assessment of Vitamin D Status and Calcium–Phosphate Metabolism in Patients with Hypophosphatasia—A Single-Center Cohort Study

by Izabela Michałus, Marta Pejska, Aleksandra Jóźwiak-Markiewicz, Agnieszka Konopka, Ewa Starostecka, Aneta Gwozdowska and Arkadiusz Zygmunt

Nutrients 2026, 18(19), 3119; https://doi.org/10.3390/nu18193119 - 22 Sep 2026

Abstract

Background: Hypophosphatasia (HPP) is a rare genetic disorder caused by a loss-of-function mutation in the ALPL gene, which encodes tissue-nonspecific alkaline phosphatase (TNSALP). Reduced TNSALP activity in HPP primarily leads to bone mineralization disorders. Given the complex and challenging nature of issues related to vitamin D and HPP, it is essential to evaluate each patient individually and adjust the appropriate dose of vitamin D according to their specific needs in order to maintain calcium phosphate homeostasis and normal vitamin D levels. Maintaining proper vitamin D homeostasis in patients with hypophosphatasia is one of the greatest challenges. Objective: The objective of this study was to conduct a retrospective, comprehensive assessment of calcium–phosphate metabolism, with particular emphasis on vitamin D status in patients with genetically confirmed hypophosphatasia (HPP), and to identify potential correlations between 25(OH)D concentrations and other parameters of calcium–phosphate in this group of patients. Methods: A single-center, retrospective pilot study was conducted in a small cohort (n = 36) of patients suffering from an ultra-rare genetic disorder, hypophosphatasia. The small sample size reflects the ultra-rare nature of the disease; so far, HPP has been diagnosed in approximately 50 patients in Poland (prevalence 1:300,000). The analysis included medical records of patients. Results: Vitamin D deficiency was not observed in the majority of patients with hypophosphatasia in the study group. The initiation of long-term enzyme replacement therapy (with asfotase alfa) did not significantly affect the annual change in mean serum vitamin D concentration. As established in the literature, growth disorders are an inherent feature of the clinical picture of hypophosphatasia. This was reflected in our study group, where nearly half of the pediatric patients achieved a height below the 10th percentile. Conclusions: Within this limited sample, these growth issues did not appear to be associated with disturbances in calcium and phosphate metabolism or vitamin D deficiency. Full article

(This article belongs to the Special Issue Vitamin D, Nutrition, and Bone and Immune Function—Implications for Health and Disease from Infancy Through Adolescence)

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25 pages, 365 KB

Open AccessReview

Sugar-Sweetened Beverages and Childhood Obesity: A Life-Course Perspective

by Bianca Simionescu, Ancuța Lupu, Alexandra Sidoreac, Vasile Valeriu Lupu, Elena Roxana Buzilă, Raluca Olariu, Bogdan Novac, Ileana Ioniuc, Mihaela Monica Alexoae, Roxana Șerban, Otilia Novac, Emil Anton and Oana Raluca Temneanu

Nutrients 2026, 18(19), 3118; https://doi.org/10.3390/nu18193118 - 22 Sep 2026

Abstract

Background/Objectives: Childhood obesity represents a major global health challenge. Sugar-sweetened beverages (SSBs) remain an important modifiable dietary exposure; however, adolescent beverage behavior is often examined independently of dietary patterns established earlier in life. This narrative review examines SSB consumption and adiposity across the life course, particularly during the first 1000 days as a sensitive period for developing dietary habits. Methods: Targeted literature searches were conducted in PubMed, Scopus, and Web of Science (January 2021–13 August 2026). We prioritized systematic reviews, meta-analyses, prospective cohort studies, randomized trials, and mechanistically informative studies. Study selection was purposive, and causal language was reserved for rigorous designs. Results: SSB intake is associated with higher body mass index, waist circumference, body fat percentage, and pediatric obesity. Potential mechanistic pathways include incomplete energy compensation for liquid calories, fructose-related hepatic de novo lipogenesis under conditions of high exposure, and insulin resistance; however, the independent contribution of fructose remains difficult to disentangle from excess energy intake, beverage form, and the broader dietary matrix. SSB consumption patterns may emerge early and track through childhood, influenced by family, socioeconomic, and commercial determinants. Evidence does not consistently support the hypothesis that repeated sweetness exposure increases subsequent sweetness liking. Metabolic consequences include dyslipidemia, hypertension, and metabolic dysfunction-associated steatotic liver disease (MASLD). Prevention approaches include family- and school-based interventions, beverage reformulation, and fiscal policies. Conclusions: A life-course perspective supports shaping beverage environments early, strengthening healthy home food environments, and implementing structural public-health interventions rather than addressing unhealthy patterns only after they become established. However, policy effects may vary across pediatric subgroups. Full article

(This article belongs to the Special Issue Optimizing Nutrition in Pediatrics: From Preterm Infants to Adolescents)

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34 pages, 630 KB

Open AccessReview

Iron Supplementation and Copper Homeostasis: Evidence for Potential Copper Depletion, Biomarker Challenges, and Clinical Implications

by Jisu Lee and Jung-Heun Ha

Nutrients 2026, 18(19), 3117; https://doi.org/10.3390/nu18193117 - 22 Sep 2026

Abstract

Iron deficiency remains a major nutritional problem, particularly among women of reproductive age, pregnant women, infants, and children. Oral iron supplementation is the principal strategy for prevention and treatment, but the biological interdependence of iron and copper metabolism raises concern that prolonged or excessive iron exposure may impair copper availability in susceptible individuals. This review summarizes human and animal evidence linking iron supplementation or high dietary iron intake to altered copper homeostasis, with emphasis on underlying mechanisms, biomarker limitations, and clinical implications. Human studies report inconsistent changes in serum copper and ceruloplasmin, suggesting that baseline mineral status, physiological demand, iron dose, treatment duration, inflammation, and biomarker selection may influence responses. Animal studies provide stronger mechanistic evidence that high iron intake can reduce intestinal copper absorption and copper-dependent ferroxidase activity, promote tissue iron sequestration, and contribute to anemia, impaired growth, cardiac enlargement, dyslipidemia, gastrointestinal alterations, and disrupted maternal–offspring copper transfer. However, the clinical relevance of these findings remains uncertain because standardized diagnostic criteria and sensitive biomarkers for marginal copper deficiency are lacking. Iron intervention should remain guided by confirmed iron status, while dose, duration, and treatment response warrant careful consideration. Evaluation of copper status may be particularly relevant when hematological recovery is inadequate despite sufficient iron stores or when additional risk factors for copper deficiency are present. Prospective human studies incorporating functional biomarkers are needed to identify susceptible populations and clinically relevant exposure conditions. Full article

(This article belongs to the Special Issue Iron Deficiency Anemia: Global Burden, Dietary and Other Risk Factors, Diagnostic Biomarkers and Novel Treatment Strategies)

19 pages, 1345 KB

Open AccessArticle

Changes in Mood and Tryptophan Metabolism Following a 12-Week Endurance Exercise Combined with Time-Restricted Eating in Healthy Adults

by Ulana Juhas, Dagmara Budnik-Przybylska, Andżelika Borkowska, Jakub Antoni Kortas, Joanna Reczkowicz, Ewa Ziemann, Katarzyna Prusik, Damian Flis, Grażyna Gałęzowska, Konrad Kowalski, Malgorzata Zychowska, Barbara Kaczorowska-Hać and Jędrzej Antosiewicz

Nutrients 2026, 18(19), 3116; https://doi.org/10.3390/nu18193116 - 22 Sep 2026

Abstract

Background: The interplay between time-restricted eating (TRE), endurance exercise, mood, and tryptophan (TRP) metabolism has not been thoroughly examined. This study evaluated whether changes in psychological well-being co-occurred with changes in serum kynurenine metabolites during a combined TRE and exercise intervention and performed exploratory analyses of kynurenine metabolism. Methods: Seventy-one healthy adults participated in a 12-week endurance training program combined with a 10 h TRE window. Assessments included the State-Trait Anxiety Inventory, Mood Adjective Checklist, body composition, inflammatory markers, and serum kynurenine profiling, conducted at baseline and post-intervention. The pre-specified analysis was performed in the entire cohort, whereas subsequent analyses stratified by age and changes in anxiety were conducted post hoc and should be considered exploratory. Results: The pre-specified analysis of the entire cohort did not reveal statistically significant or clinically meaningful changes in psychological well-being, kynurenine metabolites, or inflammatory biomarkers. In exploratory post hoc analyses, participants were stratified into older (OE-TRE) and younger (YE-TRE) groups. Both groups showed significantly lower body mass and BMI at the second measurement. In the OE-TRE group, serum anthranilic acid (AA) levels increased (Δ = +7.85 nmol/L), while in the YE-TRE group, a decrease was observed (Δ = −2.62 nmol/L). In a separate exploratory post hoc analysis, participants with complete psychological assessment data were stratified according to the direction of change in anxiety scores. Among these participants, 66.7% showed lower anxiety scores in the second measurement, and this anxiety-defined subgroup also showed lower serum 3-hydroxykynurenine (3-HK) concentrations. This observation was confined to the exploratory subgroup analysis and should not be interpreted as a general reduction in 3-HK in the study cohort. The OE-TRE group also showed an increase in the xanthurenic acid (XANA) + picolinic acid (PA) to 3-HK ratio and a reduction in TNF-α. Notably, differences between groups in the 3-hydroxyanthranilic acid (3-HAA)/3-HK and XANA + PA/3-HK ratios observed at baseline were no longer present at the second measurement. In the exploratory subgroup of participants whose 3-HAA concentrations increased over time, soluble gp130 (sgp130) concentrations were lower at the second measurement. Conclusions: The pre-specified whole-cohort analysis did not demonstrate statistically significant or clinically meaningful changes in the primary psychological and biochemical outcomes. Exploratory post hoc analyses suggest that changes in psychological well-being and peripheral kynurenine metabolism may co-occur during a combined TRE and endurance exercise intervention. The observed decrease in 3-HK was restricted to an anxiety-defined exploratory subgroup and was not observed in the study cohort as a whole. These findings are associative and hypothesis-generating and do not establish an intervention effect or causality. The trial was registered as a clinical trial (NCT05229835, date of first registration: 8 February 2022). Full article

(This article belongs to the Section Nutrition and Metabolism)

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23 pages, 2022 KB

Open AccessArticle

Behavioral, Psychological, and Metabolic Characteristics of Adults with Co-Occurring Generalized Anxiety Disorder and Obesity: A Cross-Sectional Study

by Natasha Kim de Oliveira da Fonseca, Gabriela Rocha dos Santos, Gabrielle Terezinha Foppa, Gabriella Nunes da Luz Morelo, Artur Zanelatto Santos, Adele Lanziani Faé, Natan Pereira Gosmann, Carolina Blaya Dreher, Luciana Conceição Antunes, Elisa Brietzke and Gisele Gus Manfro

Nutrients 2026, 18(19), 3115; https://doi.org/10.3390/nu18193115 - 22 Sep 2026

Abstract

Background: Generalized Anxiety Disorder (GAD) and obesity are highly prevalent and often co-occur, yet it remains unclear how the presence of both conditions relates to biological, behavioral, and psychological outcomes compared with either condition alone. Understanding this subgroup is crucial to improving assessments and treatment outcomes. Objective: To characterize biological, psychological, and behavioral parameters among individuals living with obesity (LWO) and GAD (GAD + LWO), compared with those with only one condition (GAD or LWO) and healthy controls. The primary outcome was to characterize binge eating severity, assessed using the Binge Eating Scale (BES). All remaining behavioral, psychological, and biological outcomes were considered secondary evaluated outcomes. Methods: This cross-sectional study included 232 adults: GAD + LWO (n = 73), GAD only (n = 52), LWO only (n = 53), and controls (n = 54). Participants completed validated psychological measurements and eating behavior assessments and underwent clinical and metabolic evaluations, including insulin resistance (HOMA-IR) and C-Reactive Protein (CRP). Statistical analyses were performed using analysis of covariance (ANCOVA) for group comparisons and additional interaction analyses between GAD diagnosis and obesity status, adjusted for age and sex. Results: Binge eating severity was significantly higher in the GAD + LWO group than in all other groups, with the group mean exceeding the screening threshold for moderate binge eating. This group also showed significantly higher levels of depressive symptoms, emotional eating and impulsivity compared to all other groups. Factorial analyses showed a significant GAD diagnosis × obesity interaction only for depressive symptom severity. Compared to the LWO group, individuals with GAD + LWO also exhibited higher emotional dysregulation, neuroticism, and shame. Biologically, this group showed elevated insulin resistance and higher proportions of systemic inflammation (CRP > 3.0 mg/L) in comparison with the GAD group, but similar to the LWO group. Conclusions: The co-occurrence of GAD and LWO was associated with greater severity across several behavioral and psychological outcomes compared with either condition alone. These findings highlight the potential role of tailored, integrated interventions that extend beyond standard obesity treatment to address eating behavior and self-regulation difficulties. Future prospective studies are needed to confirm these exploratory findings and determine their relevance for long-term treatment outcomes and relapse risk. Full article

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15 pages, 655 KB

Open AccessArticle

Association Between Texture-Modified Diet Intake Rate and Functional Outcomes After Acute Stroke: A Retrospective Observational Study

by Rie Motoyama, Tomotaka Tanaka, Kazuki Fukuma, Shinsaku Nakazawa, Tetsuya Chiba, Shuichi Tonomura and Masafumi Ihara

Nutrients 2026, 18(19), 3114; https://doi.org/10.3390/nu18193114 - 22 Sep 2026

Abstract

Background/Objectives: Texture-modified diets (TMDs) are commonly prescribed after stroke, but the clinical significance of the amount actually consumed remains unclear. We examined the association between TMD intake rate and functional status at discharge and 90 days after stroke. Methods: This retrospective single-center study included 406 patients with ischemic stroke or intracerebral hemorrhage who received TMDs for suspected or confirmed dysphagia between 2012 and 2017. Overall TMD intake was calculated as the meal-count-weighted mean consumption proportion across four TMD levels and analyzed per 10% increase. Ordinal logistic regression models for modified Rankin Scale (mRS) scores were adjusted for age, sex, admission National Institutes of Health Stroke Scale (NIHSS) score, premorbid mRS, stroke type, and admission Geriatric Nutritional Risk Index (GNRI). Binary logistic regression for a favorable outcome (mRS 0–2) was performed as a secondary analysis. Results: Each 10% increase in TMD intake was associated with lower odds of a higher mRS category at discharge (adjusted OR, 0.85; 95% CI, 0.77–0.94) and at 90 days (adjusted OR, 0.88; 95% CI, 0.80–0.96). Higher intake was associated with higher odds of a favorable outcome at discharge (adjusted OR, 1.31; 95% CI, 1.03–1.66), whereas the 90-day association was not statistically significant (adjusted OR, 1.15; 95% CI, 0.98–1.35). Diet-specific associations were inconsistent. Conclusions: Higher TMD intake rates were associated with better functional status after multivariable adjustment. Because TMD intake may also reflect swallowing impairment, clinical condition, and early recovery, these observational findings do not establish causality. Monitoring TMD intake may help identify patients who warrant closer nutritional and swallowing assessment. Full article

(This article belongs to the Section Clinical Nutrition)

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4 pages, 170 KB

Open AccessEditorial

Infant and Toddler Feeding and Development: Habits for a Lifetime

by Maureen M. Black and Jigna M. Dharod

Nutrients 2026, 18(19), 3113; https://doi.org/10.3390/nu18193113 - 22 Sep 2026

Abstract

This Special Issue of Nutrients on Infant and Toddler Feeding and Development features feeding as a key element in young children’s early development [...] Full article

(This article belongs to the Special Issue Infant and Toddler Feeding and Development)

14 pages, 244 KB

Open AccessArticle

Nutrition Knowledge, Information Sources, and Self-Perceived Ability to Provide Nutrition Counseling Among Medical Students: A Cross-Sectional Study

by Eva Luyufeng Yáñez-Izquierdo, Ana Presa-Carrera, Carlos Enrique Adán-Failde and Juan Manuel Vázquez-Lago

Nutrients 2026, 18(19), 3112; https://doi.org/10.3390/nu18193112 - 22 Sep 2026

Abstract

Background/Objectives: Nutrition is an important component of health promotion and disease prevention, yet medical students may not feel sufficiently prepared to translate nutritional knowledge into patient counseling. This study aimed to assess nutrition knowledge among undergraduate medical students, identify factors associated with knowledge, and examine self-perceived ability to provide nutrition counseling and its associated factors. Methods: A cross-sectional study was conducted among medical students at the University of Santiago de Compostela, Spain, between February and April 2026. Nutrition knowledge and dietary and health-related behaviors were assessed using the refined 46-item version of a validated multidimensional questionnaire. Overall nutrition knowledge was calculated from 29 retained knowledge items. Bivariable analyses, multivariable linear regression, and multivariable logistic regression were performed. Results: A total of 413 students participated. Mean overall nutrition knowledge was 74.9 ± 14.4 points. Scores increased across academic stages, from 70.8 ± 13.6 in years 1–2 to 81.0 ± 13.3 in years 5–6 (p < 0.001). In the adjusted linear model, years 5–6 were associated with higher knowledge scores (β = 6.07; 95% CI 2.43–9.71; p = 0.001), as were reporting the medical curriculum (β = 3.42; 95% CI 0.29–6.54; p = 0.032) and media/social networks (β = 3.33; 95% CI 0.31–6.35; p = 0.031) as information sources. Overall, 37.3% of students considered themselves currently capable of providing nutrition counseling. In the adjusted logistic model, students in years 5–6 had greater odds of reporting current counseling ability (aOR = 3.20; 95% CI 1.63–6.29; p = 0.001), whereas women had lower odds of reporting current self-perceived counseling ability than men (aOR = 0.28; 95% CI 0.16–0.49; p < 0.001), despite no significant gender difference in objective nutrition knowledge. Healthier dietary and health-related behaviors were positively associated with counseling ability (aOR per 10-point increase = 1.63; 95% CI 1.21–2.20; p = 0.001), while overall nutrition knowledge was not independently associated with it (p = 0.437). Conclusions: Students in later academic years had higher nutrition knowledge scores, but greater knowledge did not independently translate into greater self-perceived counseling ability. These findings support longitudinal, practical, and competency-based nutrition education that addresses both knowledge acquisition and counseling preparedness. Full article

(This article belongs to the Section Nutritional Policies and Education for Health Promotion)

16 pages, 4090 KB

Open AccessArticle

Synbiotic HQP08 Supplementation for Hair Loss and Depressive Symptoms: An Open-Label Pilot Study of Clinical Outcomes and Gut Microbiome Changes

by Zhilu Xu, Raphaela I. Lau, Haoyu Qi, Martin C. S. Wong, Kingsley H. N. Chan, Ivan S. F. Lau, Jessica Y. L. Ching, Pui Kuan Cheong, Francis K. L. Chan and Siew C. Ng

Nutrients 2026, 18(19), 3111; https://doi.org/10.3390/nu18193111 - 22 Sep 2026

Abstract

Background: Gut microbiota dysregulation has been implicated in hair loss via the gut–skin axis, but human interventional data are limited. We previously showed that Bifidobacterium longum HK003 reverses alopecia-like phenotypes in mice. Methods: We conducted an open-label, single-arm pilot study to evaluate an HK003-containing synbiotic (HQP08) in 32 adults with self-reported hair loss over 8 weeks. The primary endpoint was the proportion of participants reporting improvement on the Patient Global Impression of Change (PGI-C) scale at week 8. Secondary outcomes included changes in hair loss severity, 60 s hair count, depressive symptoms (PHQ-9), safety, and gut microbiome composition (Chinese Clinical Trial Registry ChiCTR2500112698). Results: At week 8, 62.5% (20/32) of participants reported PGI-C improvement. Significant reductions were observed in hair loss severity (p = 0.0008), 60 s hair count (p = 0.0048), and PHQ-9 scores (p = 0.002). Younger age was associated with PGI-C response (OR per year 0.86, 95% CI: 0.73–0.98, p = 0.037). Metagenomic analysis identified engraftment of B. longum HK003-like profiles in a subset of participants at week 12. Changes in microbial pathways related to thiamine metabolism, vitamin B12 salvage, and lipopolysaccharide biosynthesis were associated with ΔPHQ-9 (FDR-adjusted p < 0.05), but not with hair-related endpoints. No serious adverse events occurred. Conclusions: This first-in-human pilot study suggests that HQP08 was well tolerated and was associated with within-participant changes in hair-loss measurements and PHQ-9 scores. Randomized controlled trials are warranted to confirm efficacy and further elucidate mechanisms within the gut–brain–skin axis. Full article

(This article belongs to the Section Nutrition and Metabolism)

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14 pages, 270 KB

Open AccessArticle

Soy Consumption and the Risk of Developing Bladder Cancer: A Pooled Analysis of Cohort Studies from the International Pooled Bladder Cancer Epidemiology and Nutritional Determinants (BLEND) Study

by Yue-Wei Wu, Evan Yi-Wen Yu, Ya-Ting Chen, Meng-Han Li and Yu-Ting Liang

Nutrients 2026, 18(19), 3110; https://doi.org/10.3390/nu18193110 - 22 Sep 2026

Abstract

Background: Epidemiological studies have shown inconsistent results in associations between soy consumption and bladder cancer (BC). Therefore, this research aims to find more conclusive answers on the influence of soy consumption on the development of BC risk by bringing together 12 worldwide available cohort studies on this topic. Materials and Methods: The risk of developing BC was investigated in a pooled analysis of 12 cohort studies comprising 549,458 participants, including 3164 incident BC cases. Cox proportional hazard regression analysis was used to obtain the pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Results: No association between total soy intake and risk of development of BC was observed. However, after adjustment for potential confounders, soybean oil intake was associated with an increased risk (HR_model2 = 1.49, 95% CI 1.03–2.16) comparing never consumption with ever consumption as well as with moderate (HR_model2 1.69, 95% CI 1.08–2.67; HR_model3 1.65, 95% CI 1.03–2.64) and high (HR_model2 1.57, 95% CI 1.06–2.33; HR_model3 1.50, 95% CI 1.00–2.26) consumption. Overall, no significant associations were observed for soybean, soy milk or unfermented soy paste intake. For females a significant decreased BC risk for moderate soybean consumption was observed (HR = 0.46, 95% CI 0.22–0.89). For males a significant increased BC risk in ever soybean oil consumers as well as in high soy consumers was found (HR = 1.63, 95% CI 1.00–2.66; HR = 1.69, 95% CI 1.02–2.80, respectively). Conclusions: This research suggests that different sub-categories of soy consumption may have different associations with BC risk, showing differences between sexes exist. Full article

(This article belongs to the Section Clinical Nutrition)

4 pages, 714 KB

Open AccessCorrection

Correction: Lawson et al. Assessing Performance of Contemporary Plant-Based Diets Against the UK Dietary Guidelines: Findings from the Feeding the Future (FEED) Study. Nutrients 2024, 16, 1336

by Izabella Lawson, Caroline Wood, Nandana Syam, Holly Rippin, Selina Dagless, Kremlin Wickramasinghe, Birdem Amoutzopoulos, Toni Steer, Timothy J. Key and Keren Papier

Nutrients 2026, 18(19), 3109; https://doi.org/10.3390/nu18193109 - 22 Sep 2026

Abstract

The original publication [...] Full article

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14 pages, 281 KB

Open AccessReview

Probiotics in Celiac Disease: Current Evidence and Future Directions

by Christopher McLaughlin and Suneeta Krishnareddy

Nutrients 2026, 18(19), 3108; https://doi.org/10.3390/nu18193108 - 22 Sep 2026

Abstract

Celiac disease is often associated with gut microbiome alterations, which may play a role in autoimmunity to gluten peptides and upregulation of other autoinflammatory pathways. Probiotics of various formulations have been evaluated in attempts to normalize the gut microbiome and/or improve symptoms in Celiac disease, and even to potentially prevent Celiac disease in at-risk individuals. These studies have shown mixed results at best, and conclusions about the effectiveness of probiotics to these ends are limited by the variations across studies’ probiotic formulation, dietary regimen, and clinical outcome markers. This leaves many encouraging future directions for further investigation into the potential beneficial role of probiotics on a pathophysiological and clinical level in Celiac disease. Full article

(This article belongs to the Special Issue The Implications of Celiac Disease and the GFD on Health Outcomes)

13 pages, 746 KB

Open AccessReview

Primary Hyperparathyroidism in Celiac Disease: Diagnostic Challenges and Therapeutic Strategies

by Quyen V. Luong, Kadiyatu Fofana, Abdul W. Paracha, Ayesha Siddiqui and Kofi Clarke

Nutrients 2026, 18(18), 3107; https://doi.org/10.3390/nu18183107 - 21 Sep 2026

Abstract

Celiac disease (CD) is a primary immune-mediated enteropathy triggered by gluten ingestion in genetically predisposed individuals. Gluten ingestion results in villous atrophy of the small intestine and can lead to impaired absorption of multiple vitamins and nutrients, including vitamin D and calcium. This may result in vitamin D deficiency, a physiologic stimulus for parathyroid hormone (PTH) secretion, subsequently causing secondary hyperparathyroidism. Malabsorption and hyperparathyroidism in CD can contribute to metabolic bone disease (MBD), including osteopenia or osteoporosis. Correction of CD with a gluten-free diet (GFD) does not always reverse MBD. Although malabsorption in CD is a well-recognized cause of secondary hyperparathyroidism, some case reports have also suggested a potential association between CD and primary hyperparathyroidism (PHPT). In this literature review, we present evidence from observational studies, case series, and case reports that suggest a potential association or coexistence of CD and PHPT. Although the exact relationship between CD and PHPT remains unclear, limited evidence suggests that the two conditions may be related or may coexist independently of one another, with GFD treatment potentially unmasking underlying PHPT in patients with CD. One proposed mechanism is that vitamin D deficiency in CD reduces the vitamin D-mediated suppression of parathyroid cell proliferation, potentially contributing to the development of PHPT; however, current evidence remains insufficient to establish a causal relationship. PHPT and CD can contribute to MBD with increased fracture risk and adversely affect quality of life and overall health. Monitoring PTH, vitamin D, and calcium levels is important to identify persistent hyperparathyroidism and unmask underlying PHPT after correction of malabsorption. The literature review highlights a gap in our understanding of the pathogenesis linking these two conditions and underscores the need for future studies to elucidate their potential relationship. Because surgery is the only curative treatment modality for PHPT, patients with persistent hyperparathyroidism despite correction of malabsorption should be evaluated for possible concomitant PHPT, as they may require interdisciplinary management involving gastroenterologists, endocrinologists, and endocrine surgeons. Full article

(This article belongs to the Special Issue Diet on Gut Health and Celiac Disease)

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15 pages, 284 KB

Open AccessArticle

Domain-Dependent Performance of Human Experts and AI Systems in Pediatric Menu Evaluation

by Roxana Maria Martin-Hadmaș, Rebeca Sovea, Diana Pol, George Mihăiță Gavra, Monica Tarcea, Adriana Neghirlă and Ștefan Adrian Martin

Nutrients 2026, 18(18), 3106; https://doi.org/10.3390/nu18183106 - 21 Sep 2026

Abstract

Background/Objectives: Artificial intelligence (AI) tools are increasingly used for dietary assessment, but their reliability in pediatric nutrition remains uncertain. This study compared AI systems and human evaluators in pediatric menu assessment against expert-defined reference ratings. Methods: This observational cross-sectional study used anonymized dietary and clinical information from three healthy pediatric cases. A multidisciplinary panel of pediatric nutrition specialists established standard evaluations. Assessments were completed by 84 AI evaluations, 116 nutrition specialists, 56 pediatric-focused physicians, and 88 physicians from other specialties. Outcomes included absolute error in total energy estimation, deviations in portion and qualitative ratings, standardized scores, and binary adequacy accuracy. Groups were compared using ANOVA or Kruskal–Wallis tests with post hoc analyses. Results: A total of 344 assessments were included. Energy-estimation error differed between groups (Kruskal–Wallis = 12.85, p = 0.0016), but this analysis was based on a limited and highly unbalanced subset of 77 assessments. AI had the largest mean absolute error (260.3 ± 194.3 kcal), followed by nutrition specialists (148.4 ± 81.5 kcal); physicians with other specialties had the lowest error (60.4 ± 53.3 kcal); these subgroup comparisons should be interpreted cautiously because of the small and unequal numbers of available energy estimates. AI showed greater portion-rating deviation (0.488; 95% CI: 0.38–0.60) than nutrition specialists (0.310; 95% CI: 0.20–0.42; p = 0.0019, q = 0.0059) and pediatric-focused physicians (0.286; 95% CI: 0.16–0.41; p = 0.0181, q = 0.019). Conversely, AI showed the lowest deviations for variety (0.37 ± 0.49) and processing (0.33 ± 0.47), compared with 1.15–1.36 and 1.22–1.57, respectively, among human groups (both p = 0.0001). Conclusions: AI may support structured pediatric menu screening for descriptive qualitative features; however, lower precision for energy and portion assessment supports, under these specific conditions, its use as an adjunct, for qualified nutrition professionals. Full article

(This article belongs to the Special Issue Smart Nutrition: Harnessing AI for Personalized Nutrition)

13 pages, 802 KB

Open AccessArticle

Associations Between Maternal and Cord Blood Leptin Levels and Anthropometry of Mothers and Infants

by Hans Demmelmair, Johanna Bruder, Sultan Nilay Can, Jeannie Horak, Martin Klingenspor, Oraporn Dumrongwongsiri and Berthold Koletzko

Nutrients 2026, 18(18), 3105; https://doi.org/10.3390/nu18183105 - 21 Sep 2026

Abstract

Background/Objectives: As birth weight is related to later obesity risk, its associations with maternal pre-pregnancy body mass index (BMI) and leptin values in serum during pregnancy are of interest for obesity prevention. This study aimed to describe the association of leptin levels in maternal circulation and cord blood as well as pre-pregnancy BMI (pBMI) with infant anthropometry at birth and until the age of four months. Methods: Data on maternal pBMI, at delivery and four months after birth, and on infant weight and length at delivery and at age four months were collected in an observational study in Bangkok, Thailand. In a subgroup of 38 mother–infant dyads, leptin was measured in maternal blood serum at delivery and infant age 4 months and in cord and infant serum at 4 months. Associations were tested with correlation and multiple linear regression analyses in this explorative study. Results: The maternal serum leptin was 32.4 ± 17.8 ng/mL at delivery and 11.1 ± 8.9 ng/mL at four months (p < 0.001 for difference) and correlated (r = 0.45). Cord serum leptin was significantly higher in female than male infants (17.5 ± 9.8 ng/mL vs. 7.7 ± 4.9 ng/mL, p < 0.05) and not related to infant leptin at age four months. There was no significant association between maternal and cord serum leptin levels. Birth weight was strongly associated with pBMI (standardized β = 0.77, p < 0.001) and inversely related to maternal delivery leptin levels (standardized β = −0.44, p = 0.008), while the association with cord serum leptin was not significant. Conclusions: Our findings indicate that pBMI is strongly related to birth weight, while higher maternal leptin concentrations were independently associated with lower birth weight after accounting for pBMI. Cord serum leptin did not significantly correlate with maternal leptin levels and only tended to be positively associated with birth weight. Full article

(This article belongs to the Section Pediatric Nutrition)

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13 pages, 798 KB

Open AccessOpinion

Modifiable Lifestyle Factors in Cardiovascular Disease Prevention: Current Evidence and Future Directions

by Patrick Benjamin and Luc Djoussé

Nutrients 2026, 18(18), 3104; https://doi.org/10.3390/nu18183104 - 21 Sep 2026

Abstract

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide despite substantial advances in pharmacologic and interventional therapies. Modifiable lifestyle behaviors are major determinants of cardiovascular risk and essential targets for primary and secondary prevention. This narrative review summarizes contemporary evidence on smoking cessation, physical activity and exercise, nutrition, alcohol consumption, sleep health, sedentary behavior, and integrated lifestyle strategies. Evidence from randomized trials supports cardiovascular risk-factor and event reduction with selected dietary and exercise interventions (i.e., Mediterranean and Dietary Approaches to Stop Hypertension (DASH)), whereas many estimates for sleep, sedentary behavior, alcohol and composite lifestyle scores derive from observational studies and should be interpreted as associations rather than causal effects. Conversely, unhealthy dietary habits, tobacco use, excessive alcohol consumption, poor sleep quality, and prolonged sedentary behavior contribute to endothelial dysfunction, inflammation, metabolic dysregulation, and accelerated atherosclerosis and subsequent increased risk of CVD. Emerging evidence further underscores the importance of considering lifestyle behaviors collectively rather than individually, as their effects may be synergistic. Comprehensive lifestyle modification remains one of the most effective and cost-effective approaches to reducing cardiovascular risk and should be integrated into routine clinical practice and public health initiatives. Full article

(This article belongs to the Special Issue Lifestyle, Diet, Wine and Health)

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19 pages, 2393 KB

Open AccessArticle

Gastric Residual Volume as a Candidate Brain–Gut Signal in Neurocritical Care: An Exploratory, Hypothesis-Generating Retrospective Cohort Study

by Geun-Hee Lee, Jeong-Hyun Park, Su-Min Kim, Joon-Ho Lee, Kyeong-Won Ryu and Jeong-Am Ryu

Nutrients 2026, 18(18), 3103; https://doi.org/10.3390/nu18183103 - 21 Sep 2026

Abstract

Background/Objectives: Elevated gastric residual volume (GRV) is traditionally read as feeding intolerance, and randomized trials in general intensive care units (ICUs) have discredited its routine use. Whether this holds in neurocritical patients is unknown. Methods: This exploratory, hypothesis-generating single-center retrospective cohort study comprised 355 neurosurgical ICU adults with documented GRV (2022–2026)—the exposure was a peak GRV ≥ 250 mL, the institutional feeding-hold threshold (n = 32). Three explanations were examined: prognosis (Firth penalized regression for in-hospital mortality), nutrition (standardized mean differences with causal mediation), and intracranial pathology (rank-based partial correlation between patient-level maxima of GRV and intracranial pressure (ICP) in the same early ICU window, plus trajectory phenotyping). Results: Elevated GRV was not significantly associated with in-hospital mortality (adjusted odds ratio 1.46; 95% confidence interval (CI) 0.52–3.65) and was not associated with greater deterioration in laboratory-based systemic inflammatory/nutritional indices than in comparators, with null mediation. The patient-level maxima of GRV and ICP were correlated before adjustment (ρ = 0.28) and 0.19 after full adjustment (95% CI −0.001 to 0.37, p = 0.051; 10 exposed of 109), and intracranial hypertension (ICP > 22 mmHg) occurred in 90% of exposed versus 61% of unexposed monitored patients. A high-GRV trajectory phenotype was the youngest class yet showed the most frequent intracranial hypertension, although its membership and persistence were highly sensitive to missing-data handling. Conclusions: In neurocritical patients receiving enteral tube feeding with documented GRV monitoring, elevated GRV was not associated with greater deterioration in laboratory-based systemic inflammatory/nutritional indices, whereas a possible association with higher early ICP was observed in a small, monitored subset. Because the ICP-monitored subset was small, these exploratory, hypothesis-generating findings do not establish a brain–gut signal. They raise the hypothesis that elevated GRV in this setting may reflect intracranial rather than solely gastrointestinal processes and require prospective confirmation with temporally paired measurements. Full article

(This article belongs to the Special Issue Nutritional Support and Metabolic Strategies in Critical Illness: From Intensive Care to Recovery)

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19 pages, 636 KB

Open AccessArticle

Diet Quality and Weight Gain Among Women in the Aboriginal Family Birthing Program in South Australia

by Casey Cameron, Mohammad Radwanur Talukder, Jessica Reid, Philippa Middleton, Cathy Leane, Kim Morey, Fiona Kathleen Mensah, Alice Rumbold, Maria Makrides, Megan Warin, Deanna Stuart-Butler, Karen Hawke, Amanda Collins-Clinch, Janiene Deverix, Angela Cavallaro and Karen Glover

Nutrients 2026, 18(18), 3102; https://doi.org/10.3390/nu18183102 - 21 Sep 2026

Abstract

Background: This study assessed diet quality and the association between engagement with nutrition support bundles and weight gain among pregnant women having Aboriginal and Torres Strait Islander babies who participated in the Aboriginal Family and Baby Bundles implementation project at two South Australian maternity sites. Methods: Cross-sectional analysis of dietary data was performed using the Australian Recommended Food Score (ARFS) at enrolment, and 24-h food group servings were compared between enrolment and late pregnancy visits. A composite variable for engagement with nutrition support bundles (low vs. high engagement) used initiation, intensity, and duration of engagement criteria. Separate regression models were applied to examine associations between ARFS, adherence to 24-h food serve recommendations, and maternal characteristics at enrolment. An exploratory univariable association between engagement status and gestational weight gain was examined. Results: The median ARFS score at enrolment was 39 (maximum of 62 out of a total of 73). Women aged above 25 years showed significantly higher ARFS compared with those aged 25 years and below (adjusted β coefficient 3.28, 95% CI 0.38, 6.19, p = 0.027). The number of participants meeting the recommended intake of daily fruit serves increased significantly at the late pregnancy visit (McNemar test p value = 0.004). Across pregnancy, consumption of energy-dense soft drinks or snack foods was common (60–68%). Only 15.4% (8/52) of participants showed adequate weight gain, while 26.9% (14/52) showed inadequate weight gain, and 57.7% (30/52) showed excessive weight gain, as per the recommendations for total gestational weight gain. In the high nutrition support engagement group, a higher proportion of adequate weight gain (24.0% vs. 7.4%) and a lower proportion of excessive weight gain were observed (28.0% vs. 85.2%) (p ≤ 0.001) compared with the low engagement group. Conclusions: This study identified sub-optimal diet quality, including high intake of energy-dense food throughout pregnancy and high proportions of inadequate and excessive weight gain among women having Aboriginal babies in South Australia. Further research is needed to determine the most appropriate ways to support healthy eating in pregnancy among women in South Australia. Full article

(This article belongs to the Section Nutrition in Women)

16 pages, 3134 KB

Open AccessReview

Nutrigenomics and Epigenetic Regulation in Cancer Prevention: Molecular Mechanisms, Dietary Bioactives, and Translational Perspectives

by Grigoris Risvas and Stavros P. Derdas

Nutrients 2026, 18(18), 3101; https://doi.org/10.3390/nu18183101 - 21 Sep 2026

Abstract

Cancer development is influenced not only by genetic alterations but also by epigenetic dysregulation driven by environmental and lifestyle factors, particularly diet. Nutrigenomics investigates how dietary components interact with the genome to influence gene expression, while nutritional epigenetics focuses on diet-induced modifications such as DNA methylation, histone modifications and non-coding RNA regulation. Increasing evidence indicates that bioactive dietary compounds can modulate epigenetic mechanisms involved in carcinogenesis, highlighting their potential role in cancer prevention. This narrative review synthesizes recent evidence, with emphasis on literature published between 2015 and 2025 and an updated search through September 2026 on the molecular interplay between diet, epigenetic regulation and cancer risk. We examine how key dietary factors—including methyl donors involved in one-carbon metabolism, polyphenols, short-chain fatty acids and omega-3 fatty acids—modulate epigenetic regulators such as DNA methyltransferases and histone deacetylases. Particular emphasis is placed on the emerging Nutrigenomics–Microbiome–Epigenome Axis, whereby microbiota-derived metabolites influence host chromatin architecture and gene expression pathways relevant to tumor suppression and inflammation. In addition, we discuss current evidence linking dietary patterns, including Mediterranean and Western diets, with distinct epigenomic signatures associated with cancer susceptibility. The review further explores the potential of epigenetic biomarkers and epigenome-wide association studies to support precision nutrition strategies for cancer prevention. Collectively, accumulating evidence suggests that diet-driven epigenetic plasticity may contribute to cancer prevention. However, the human evidence remains heterogeneous, and large, well-designed intervention studies with standardized epigenetic endpoints are required before mechanistic findings can be translated into clinically actionable precision nutrition strategies. Full article

(This article belongs to the Special Issue Nutritional Genomics and Human Health: From Epigenetic Regulation to Personalized Nutrition)

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