Nutrients

29 pages, 2640 KB

Open AccessReview

Lepidium Meyenii Walp. (Maca) and Blood Biomarkers of Muscle Damage and Post-Exertion Protein Degradation: A Systematic Review and Meta-Analysis of Preclinical Studies

by Javiera Rodríguez Rojas, Álvaro Huerta Ojeda, Guillermo Barahona-Fuentes, Carlos Jorquera-Aguilera, Jorge Cancino-López, María-Mercedes Yeomans-Cabrera, Leonardo Pavez, Carlos Jara-Gutiérrez and Luis Javier Chirosa-Ríos

Nutrients 2026, 18(12), 2009; https://doi.org/10.3390/nu18122009 (registering DOI) - 20 Jun 2026

Abstract

Background: Lepidium meyenii Walp (L. meyenii), traditionally known as maca, is widely recognized for its health-promoting properties, including potential protection against exercise-induced muscle damage (EIMD). However, its precise effect on post-exercise blood biomarkers remains unclear. Objective: This study aimed [...] Read more.

Background: Lepidium meyenii Walp (L. meyenii), traditionally known as maca, is widely recognized for its health-promoting properties, including potential protection against exercise-induced muscle damage (EIMD). However, its precise effect on post-exercise blood biomarkers remains unclear. Objective: This study aimed to qualitatively review research published until April 2026 examining L. meyenii supplementation to reduce blood markers of muscle damage and protein degradation post-exertion in animal studies. Specifically, the effect size (ES) of L. meyenii supplementation on post-exercise levels of creatine kinase (CK), lactate dehydrogenase (LDH), and blood urea nitrogen (BUN) was estimated. Methods: This systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. The certainty of the evidence was assessed using the GRADE framework. Relevant studies were identified through Web of Science, Scopus, SPORTDiscus, PubMed, and MEDLINE. Eligible studies included in vivo experiments in animals with controlled designs and pre-/post-intervention assessments. Methodological quality and risk of bias were evaluated using the CAMARADES tool. Statistical analysis involved standardized mean differences (SMD) using Hedges’ g with 95% confidence intervals. Results: 15 studies were included in the systematic review, and 14 studies in animals in the meta-analysis. The CAMARADES scores ranged from 5 to 7 points, indicating moderate methodological quality. Supplementation with L. meyenii was not associated with statistically significant changes in LDH (SMD = −1.37; 95% CI −3.34 to 0.59), BUN (SMD = −0.37; 95% CI −2.16 to 1.42) nor CK (SMD = 0.29; 95% CI −5.45 to 6.03), with very high heterogeneity (I² > 97%). Exploratory subgroup analyses and meta-regression analyses by formulation type and dose did not identify any moderators that could robustly explain this heterogeneity. Conclusions: The available evidence does not support a robust overall effect of L. meyenii supplementation on blood biomarkers of muscle damage or protein catabolism in animals subjected to physical stress. The high degree of heterogeneity could not be robustly explained by either the type of formulation or the dose. These findings, which are exploratory and hypothesis-generating in nature, highlight the need for standardized, well-characterized formulations and trials with adequate statistical power. Full article

(This article belongs to the Section Sports Nutrition)

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18 pages, 271 KB

Open AccessArticle

Elimination Diets, Not Food Selectivity, Are Associated with Reduced Nutritional Status in Children with Autism Spectrum Disorder

by Paula Grębska, Anna Fedorczak, Tomasz Pytrus, Anna Dębińska and Anna Kofla-Dłubacz

Nutrients 2026, 18(12), 2008; https://doi.org/10.3390/nu18122008 (registering DOI) - 20 Jun 2026

Abstract

Background/Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication, restricted and repetitive behaviors, and sensory processing abnormalities, including food selectivity. Due to the lack of effective causal therapies, alternative approaches such as dietary interventions are increasingly being [...] Read more.

Background/Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication, restricted and repetitive behaviors, and sensory processing abnormalities, including food selectivity. Due to the lack of effective causal therapies, alternative approaches such as dietary interventions are increasingly being explored. This study aimed to assess the impact of dietary factors on the nutritional status of children with ASD. Methods: A total of 103 children (75 with ASD and 28 controls) were included. Nutritional status was assessed using biochemical markers and standardized anthropometric measurements. Associations between nutritional status and dietary factors, particularly elimination diets implemented either on medical indications or in the absence of clinical justification, were analyzed. Results: ASD diagnosis was independently associated with lower height SDS (Standard Deviation Score). Food selectivity was significantly associated with growth patterns: children with food selectivity showed a higher prevalence of short stature compared with the control group (15.2% vs. 0%, p = 0.033). Children following elimination diets had significantly lower BMI SDS compared with those without dietary restrictions (−0.35 [−1.29 to 0.05] vs. −0.22 [−0.78 to 1.14], p = 0.046), although only 11.1% had medical indications for such interventions. Among non-supplemented participants, vitamin D deficiency was significantly more prevalent in the ASD group (84.6% vs. 33.3%, p < 0.001). Conclusions: Elimination diets were the only dietary factor associated with a clinically relevant reduction in BMI SDS in children with ASD. Food selectivity alone was not associated with impaired nutritional status. Most elimination diets were implemented without confirmed medical indications. These findings highlight the importance of evidence-based dietary management and routine vitamin D supplementation in this population. Full article

(This article belongs to the Section Pediatric Nutrition)

20 pages, 629 KB

Open AccessArticle

Psychospiritual Profiles Differentiate Dietary and Lifestyle Behaviors

by Sebastian Binyamin Skalski-Bednarz, Loren L. Toussaint, Magdalena Piegza, Monika Bidzan-Wiącek and Mariola Bidzan

Nutrients 2026, 18(12), 2007; https://doi.org/10.3390/nu18122007 (registering DOI) - 20 Jun 2026

Abstract

Background/Objectives: Previous literature has linked nutrition with both psychological distress and well-being. However, less is known about how psychological and spiritual resources cluster within individuals or whether distinct psychospiritual profiles are associated with dietary and lifestyle behaviors. This study examined these associations using [...] Read more.

Background/Objectives: Previous literature has linked nutrition with both psychological distress and well-being. However, less is known about how psychological and spiritual resources cluster within individuals or whether distinct psychospiritual profiles are associated with dietary and lifestyle behaviors. This study examined these associations using a person-centered approach. Methods: A community sample of 522 adults from the United States completed measures of perceived stress, depressive symptoms, coping self-efficacy, gratitude, forgiveness, religiousness/spirituality, daily spiritual experiences, religious/spiritual meaning and beliefs, and dietary and lifestyle behaviors. Latent profile analysis was conducted to identify psychospiritual profiles. Results: Four profiles were identified: Moderate (n = 195), Flourishing (n = 199), Vulnerable (n = 70), and Maladaptive (n = 58). The Flourishing profile demonstrated the most adaptive psychological functioning and was associated with healthier dietary behaviors, including lower breakfast skipping and fast-food consumption, greater whole-grain and vegetable intake, lower salt use, and lower sweets and dessert intake. The Vulnerable profile demonstrated the highest levels of perceived stress and depressive symptoms together with relatively elevated religiousness/spirituality, whereas the Maladaptive profile was characterized by elevated distress and consistently low levels of psychological and spiritual resources. Overall, the Vulnerable and Maladaptive profiles demonstrated less favorable dietary patterns relative to the Flourishing and Moderate profiles. However, the observed effects were generally modest and selective. Conclusions: Dietary and lifestyle behaviors may be associated with broader psychospiritual configurations rather than isolated psychological characteristics alone. The findings additionally highlight the heterogeneous nature of religiousness and spirituality within psychological functioning. Full article

(This article belongs to the Special Issue Nutrition, Stress, and Psychological Well-Being Across the Lifespan)

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20 pages, 840 KB

Open AccessReview

Impact of Moderate Wine Consumption on Type 2 Diabetes

by Attilio Giacosa, Josep Masip, Ursula Fradera, Ramon Estruch and Mariangela Rondanelli

Nutrients 2026, 18(12), 2006; https://doi.org/10.3390/nu18122006 (registering DOI) - 20 Jun 2026

Abstract

Type 2 diabetes (T2D) is a prevalent disease worldwide that increases the risk of cardiovascular (CV) complications, disability and mortality. While excessive alcohol consumption is harmful, the effects of moderate wine consumption remain debated. This review evaluates whether moderate wine intake affects the [...] Read more.

Type 2 diabetes (T2D) is a prevalent disease worldwide that increases the risk of cardiovascular (CV) complications, disability and mortality. While excessive alcohol consumption is harmful, the effects of moderate wine consumption remain debated. This review evaluates whether moderate wine intake affects the risk of developing T2D and its impact on subjects with T2D. Twenty-eight studies were analysed. Evidence suggests an association between moderate wine consumption and the risk of developing T2D, with a J-shaped relationship, and reduced risk observed at low levels. This effect appears more pronounced with red wine, likely related to its higher polyphenol content, and when consumed with meals. On the other side, in patients with T2D, moderate wine consumption has been associated with a reduced risk of CV complications, nephropathy and mortality. It has also been linked to improved lipid profiles and reduced inflammatory markers, without adversely affecting body weight or glycaemic control in well-managed patients. These effects may be enhanced within a Mediterranean dietary pattern, suggesting synergistic actions. However, alcohol intake may increase the risk of hypoglycemia, particularly in patients receiving glucose-lowering therapies. It should be avoided by vulnerable individuals, and those with comorbidities such as MASLD and other significant liver diseases, peripheral neuropathy or other severe conditions. In conclusion, moderate wine consumption may be associated with a reduction in the risk of developing T2D and with several CV benefits in patients with T2D. Vulnerable patients should abstain and individuals who currently do not drink alcohol should not start drinking. If wine is consumed, intake should always remain moderate (as low as possible), within healthy meals and only after individual clinical assessment. Full article

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

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21 pages, 6689 KB

Open AccessArticle

The Effect of Zinc Sulfate Treatment on Diabetic Cardiomyopathy in an Aged Female Rat Model of Type 2 Diabetes

by Nilufer Akgun-Unal, Omer Unal, Gamze Altun, Elif Gulbahce-Mutlu, Ahmet Akkoca and Mustafa Ayyildiz

Nutrients 2026, 18(12), 2005; https://doi.org/10.3390/nu18122005 (registering DOI) - 20 Jun 2026

Abstract

Background/Objectives: Diabetic cardiomyopathy (DCM) is largely driven by severe oxidative stress and calcium dyshomeostasis. We examined the targeted antioxidant and therapeutic effects of zinc sulfate (ZnSO₄) on contractile dynamics, oxidative damage, calcium turnover, and apoptosis/fibrosis in aged female rats with [...] Read more.

Background/Objectives: Diabetic cardiomyopathy (DCM) is largely driven by severe oxidative stress and calcium dyshomeostasis. We examined the targeted antioxidant and therapeutic effects of zinc sulfate (ZnSO₄) on contractile dynamics, oxidative damage, calcium turnover, and apoptosis/fibrosis in aged female rats with type 2 diabetes. Methods: Thirty-two aged female Wistar rats were divided into Control, Control + ZnSO₄, Diabetes (DM), and DM + ZnSO₄ groups. DM was induced via high-fat diet and 30 mg/kg streptozotocin. After a 4-week complication period, treatment groups received 10 mg/kg/day ZnSO₄ (i.p.) for 6 weeks. Left ventricular papillary muscle contraction, oxidative/antioxidant markers (MDA/GSH), and gene expressions (SIRT1, GLUT4, SERCA2a, RyR2, Cav1.2, PLN) were evaluated. Myocardial architecture, fibrosis, and apoptosis were analyzed immunohistochemically. In DM rats, contractile force (CF) and velocities (±dF/dtmax) significantly declined. Results: Concurrently, SIRT1, GLUT4, SERCA2a, RyR2, Cav1.2, and antioxidant GSH decreased, while oxidative lipid damage (MDA), PLN, Caspase-3 activity, Collagen I, and fibrosis increased (p < 0.001). ZnSO₄ treatment in diabetic rats acted as a potent antioxidant modulator; it restored redox balance, activated the SIRT1/GLUT4 pathway, protected calcium-handling proteins from oxidative degradation, and significantly improved contractile dynamics. It also preserved myocardial architecture by reducing apoptosis and fibrosis. In healthy rats, ZnSO₄ caused mild stress and early fibrosis. Conclusions: In conclusion, while inducing mild stress in healthy myocardium, zinc supplementation provides robust antioxidant protection in diabetic hearts. It activates SIRT1, suppresses oxidative damage, maintains calcium homeostasis, and restores contractile dynamics, demonstrating strong antioxidant therapeutic potential against DCM. Full article

(This article belongs to the Special Issue Dietary Patterns and Lifestyle Interventions in Diabetes and Its Complications: From Prevention to Cardiovascular Protection)

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23 pages, 2075 KB

Open AccessReview

Ketogenic Diet in Obesity and Diabetes: A Narrative Review

by Yousun An, Nicholas Norris, Donglai Li and Jenny E. Gunton

Nutrients 2026, 18(12), 2004; https://doi.org/10.3390/nu18122004 (registering DOI) - 20 Jun 2026

Abstract

A ketogenic diet (KD) is a low-carbohydrate, high-fat dietary approach. Beyond treating neurologic disorders, KDs have attracted significant media attention for their potential to improve obesity and diabetes. The diet induces a metabolic shift from glucose toward fatty acid oxidation and ketone body [...] Read more.

A ketogenic diet (KD) is a low-carbohydrate, high-fat dietary approach. Beyond treating neurologic disorders, KDs have attracted significant media attention for their potential to improve obesity and diabetes. The diet induces a metabolic shift from glucose toward fatty acid oxidation and ketone body production. This shift leads to ketosis, which may reduce hunger, partly through the anorexigenic effects of ketone bodies, thereby contributing to weight loss and improved metabolic parameters, including glycaemic control and insulin sensitivity. In particular, the positive effects of KDs lower insulin demand and may thereby improve β-cell function. However, the long-term efficacy, safety, and sustainability of KDs, especially for diabetes, remain debated. This review offers current insights into the effects of ketogenesis and ketosis, as well as the potential mechanisms underlying them. We explore the metabolic effects of KDs in obesity and diabetes, drawing on preclinical and clinical studies, and suggest that combining KDs with antidiabetic agents may provide synergistic benefits. However, combining KDs with these pharmacotherapies, particularly SGLT-2 inhibitors, requires careful clinical supervision because of potential risks, including euglycaemic diabetic ketoacidosis. We explore how a KD alters the composition of the gut microbiota, thereby affecting host health. We conclude by highlighting challenges and future directions for optimising KD-based therapies and by outlining the limitations of the current review. Full article

(This article belongs to the Special Issue The Effect of Ketogenic Diet on Human Health)

39 pages, 1005 KB

Open AccessReview

Sarcopenia and Frailty in COPD: Mechanisms, Relationship with Malnutrition and Potential Therapeutic Interventions

by Saoussen Naas, Mónika Fekete, Riad Bejta, Regina Bakos, Borbála Szalai and János Tamás Varga

Nutrients 2026, 18(12), 2003; https://doi.org/10.3390/nu18122003 (registering DOI) - 20 Jun 2026

Abstract

Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable [...] Read more.

Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable driver of muscle deterioration in COPD. Nutritional deficits impair anabolic signaling, exacerbate proteolysis, worsen mitochondrial dysfunction, and contribute to frailty progression. Methods: This narrative review synthesizes evidence from PubMed, Embase, Scopus, and Web of Science up to 2025, integrating mechanistic, metabolic, nutritional, and biomarker-related pathways underlying muscle dysfunction in COPD. Studies examining inflammation, hypoxemia, oxidative stress, hormonal imbalance, nutrition, and emerging biomarkers were included. Results: COPD-related sarcopenia results from converging inflammatory (TNF-α, IL-6), catabolic (FOXO, UPS), metabolic, and vascular mechanisms, compounded by energy deficiency, protein insufficiency, and micronutrient deficits. Inadequate intake of protein, vitamin D, antioxidants, and omega-3 fatty acids increase anabolic resistance, enhance muscle catabolism, and worsen frailty. Nutritional interventions, particularly high-protein supplementation, leucine-enriched formulas, vitamin D repletion, omega-3 fatty acids, and multimodal nutrition–exercise programs, demonstrate benefits in muscle mass, strength, and physical performance. Biomarkers such as GDF-15, CAF22, and specific microRNAs reflect nutritional status and correlate with muscle health in COPD. Conclusions: Sarcopenia and frailty in COPD arise from a complex interplay of inflammatory, metabolic, nutritional, and lifestyle-related factors. Integrating nutritional assessment and targeted dietary interventions with exercise and pulmonary rehabilitation is essential to counteract anabolic resistance and improve functional outcomes. Advances in biomarker research may support earlier diagnosis and personalized nutrition-based therapeutic strategies. Full article

(This article belongs to the Special Issue Nutrition and Exercise Tolerance in Chronic Diseases and Sport: From Basic Research to Clinical Trials)

32 pages, 969 KB

Open AccessReview

Stevia Rebaudiosides Usage as a Sugar Reduction Tool: A Narrative Review of Their Metabolic, Gut Microbiome and Weight Management Effects in Human Clinical Studies

by Corey Scott, Nikoleta Stamataki and John McLaughlin

Nutrients 2026, 18(12), 2002; https://doi.org/10.3390/nu18122002 (registering DOI) - 20 Jun 2026

Abstract

Background/Objectives: Stevia rebaudiosides represent a class of compounds extracted from the Stevia rebaudiana Bertoni plant or produced via yeast fermentation, which provide a sweet taste with little to no calories. These compounds are commercially referred to as stevia and are used in the [...] Read more.

Background/Objectives: Stevia rebaudiosides represent a class of compounds extracted from the Stevia rebaudiana Bertoni plant or produced via yeast fermentation, which provide a sweet taste with little to no calories. These compounds are commercially referred to as stevia and are used in the food industry to reduce sugar in foods and beverages. Stevia is a non-nutritive sweetener (NNS), which is a class of ingredients which represent both artificial and plant-based sweeteners. NNSs are widely used and have been well studied. However, their effects on efficacy for weight management as a sugar reduction tool and overall metabolic effects are inconsistent. Of the approved NNSs for use, stevia is relatively new and one of the least studied. However, recent human clinical research has provided insights into stevia’s metabolic effects, effects on the gut microbiome and effects on weight management when used to replace sugar. The objective of this narrative review of human clinical studies is to provide an overview of the effects of stevia rebaudiosides (largely rebaudioside A) on glucoregulatory and cardiometabolic functions, as well as their effects on gut microbiome and weight management. These studies were typically short term (acute to three months) and heterogeneous by design, and they contained stevia rebaudiosides as lone sweeteners and as part of a binary blend with other NNSs. The majority of metabolic studies on stevia rebaudiosides have evaluated the effects on glucose homeostasis and, to a lesser extent, the effects on cardiometabolic function, the gut microbiome, and weight management. These studies suggest that stevia rebaudiosides have no statistically significant effects on glycemia, insulinemia, blood lipids, appetite hormones, or the gut microbiome. Limited studies suggest that, particularly when compared to sucrose, stevia produces very modest body weight and BMI changes, while studies on subjective appetite and food intake have had inconsistent results. Conclusions: longer-term studies are needed, with more consistent and rigorous design protocols across various populations. However, current human clinical studies suggest that stevia rebaudiosides have a limited impact on metabolic functions, and the observed effects on gut microbiome and changes in body weight, particularly when used to replace sugar, warrant further study. Full article

(This article belongs to the Special Issue Advances in Sweeteners and Human Health: Metabolic, Molecular, and Epidemiological Perspectives on Safety, Efficacy, and Public Health Impact)

23 pages, 1901 KB

Open AccessArticle

Prognostic Nutritional Index and In-Hospital Mortality After Coronary Artery Bypass Grafting: An Exploratory Analysis in Relation to Surgical Risk Scores

by Burak Toprak, Nihat Söylemez, Menaf Akın Sert, Özkan Karaca, Mustafa Ekici, Ali Orçun Sürmeli, Abdulkadir Bilgiç, Samet Yımaz, Sonay Oğuz, Mehmet Ballı and Rıdvan Bora

Nutrients 2026, 18(12), 2001; https://doi.org/10.3390/nu18122001 (registering DOI) - 20 Jun 2026

Abstract

Background: Coronary anatomical complexity is commonly used for perioperative risk assessment in patients undergoing coronary artery bypass grafting (CABG), although it may not fully reflect systemic biological vulnerability. This study aimed to evaluate the association between the Prognostic Nutritional Index (PNI), a nutritional–immune [...] Read more.

Background: Coronary anatomical complexity is commonly used for perioperative risk assessment in patients undergoing coronary artery bypass grafting (CABG), although it may not fully reflect systemic biological vulnerability. This study aimed to evaluate the association between the Prognostic Nutritional Index (PNI), a nutritional–immune marker derived from serum albumin and lymphocyte counts, and in-hospital mortality after CABG in relation to coronary anatomical complexity and established surgical risk scores. Methods: In this single-center retrospective cohort study, 324 consecutive patients who underwent isolated CABG between April 2024 and April 2025 were analyzed. The PNI was calculated according to the standard Onodera formula using preoperative serum albumin and total lymphocyte count. Associations with in-hospital mortality were evaluated using univariable and multivariable logistic regression analyses. Discriminative performance was assessed using receiver operating characteristic curve analysis, while exploratory analyses evaluating the additional prognostic contribution of the PNI beyond surgical risk scores were performed using nested model comparison and reclassification analyses. Internal validation and calibration analyses were also performed. Results: In-hospital mortality occurred in 26 patients. Preoperative and postoperative PNI values were significantly lower in patients who experienced in-hospital mortality. In multivariable analysis, the postoperative PNI remained independently associated with in-hospital mortality, whereas the preoperative PNI lost statistical significance after adjustment for clinical, renal, and surgical risk parameters. Receiver operating characteristic analysis demonstrated modest discriminative ability for the preoperative PNI (AUC: 0.742, 95% CI: 0.661–0.823). Exploratory analyses suggested a modest improvement in model discrimination and risk classification after the addition of the PNI to STS-based models; however, the overall incremental prognostic contribution remained limited. Calibration and internal validation analyses demonstrated acceptable agreement between predicted and observed mortality risk. Conclusions: The postoperative PNI demonstrated a stronger and independent association with in-hospital mortality than the preoperative PNI, suggesting that early postoperative nutritional–immune deterioration may reflect the magnitude of perioperative physiological stress and evolving clinical deterioration after CABG. Although lower preoperative PNI values were associated with mortality in univariable analyses, this association was no longer statistically significant after adjustment for clinical, renal, and surgical risk parameters. These findings indicate that postoperative nutritional–immune status may provide complementary biological information beyond conventional risk models; however, its clinical utility requires confirmation in larger prospective multicenter studies. Full article

(This article belongs to the Section Clinical Nutrition)

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19 pages, 3438 KB

Open AccessReview

Eating Behavior and Eating Habits: From Infancy to Adolescence

by Ivie Maneschy, María L. Miguel-Berges, Andrea Jimeno-Martínez, Guiomar Masip and Luis A. Moreno

Nutrients 2026, 18(12), 2000; https://doi.org/10.3390/nu18122000 (registering DOI) - 19 Jun 2026

Abstract

Eating behavior and eating habits are shaped from the earliest stages of life through interactions among biological, familial, social, and environmental factors. The aim of this narrative review is to integrate evidence on the early-life determinants of eating behavior and their influence on [...] Read more.

Eating behavior and eating habits are shaped from the earliest stages of life through interactions among biological, familial, social, and environmental factors. The aim of this narrative review is to integrate evidence on the early-life determinants of eating behavior and their influence on dietary intake from infancy to adolescence. A narrative review was conducted with a structured search approach prioritized on longitudinal studies, intervention trials, and policy evaluations when available, and using cross-sectional evidence mainly to describe patterns and sociodemographic factors. Synthesizing the current evidence, our framework proposes that breastfeeding, responsive complementary feeding, and self-regulatory parenting are associated with higher responsiveness to internal hunger, satiety cues, and preference for nutrient-dense foods. Conversely, coercive practices, early exposure to highly palatable foods, and the influence of food marketing are linked to dominant hedonic responses and impulsive consumption patterns. Furthermore, family environments characterized by stress or food insecurity, together with high access to low-nutrient foods, may increase vulnerability to poor eating habits and emotional eating during adolescence. Overall, the evidence highlights the need for preventive interventions that integrate parenting support, school food education, digital marketing regulation policies, and the promotion of healthy food environments across multiple sectors. Understanding the biological, psychological, and social factors linking early determinants to dietary intake and eating behaviors across development is essential for promoting a balanced relationship with food and preventing chronic diseases from an early age. Full article

(This article belongs to the Special Issue Dietary and Nutritional Influences on Childhood Obesity: Mechanisms, Prevention, and Public Health Implications)

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17 pages, 890 KB

Open AccessArticle

Evaluating Carotenoids Intake of Pregnant Women: A FFQ-Based Approach to Dietary Patterns

by Andreea-Maria Mitran, Alina-Delia Popa, Catalin-Mihail Chiru, Cornelia Mircea, Ionut Iulian Lungu, Ioana-Cezara Caba, Andreea Lungu, Cristina Arsene, Dumitru Gafitanu, Florina Crivoi, Monica Hancianu, Cristina Elena Dobre and Oana Cioanca

Nutrients 2026, 18(12), 1999; https://doi.org/10.3390/nu18121999 (registering DOI) - 19 Jun 2026

Abstract

Background: Pregnancy is a vital period during which maternal nutrition profoundly influences both maternal health and fetal development. Carotenoids, predominantly found in fruits and vegetables, are bioactive compounds that enhance antioxidant defenses and facilitate vitamin A metabolism throughout pregnancy. However, assessing carotenoids intake [...] Read more.

Background: Pregnancy is a vital period during which maternal nutrition profoundly influences both maternal health and fetal development. Carotenoids, predominantly found in fruits and vegetables, are bioactive compounds that enhance antioxidant defenses and facilitate vitamin A metabolism throughout pregnancy. However, assessing carotenoids intake presents challenges due to the lack of dietary assessment tools capable of quantifying individual carotenoids, coupled with limited data from populations in Eastern Europe. Methods: A cross-sectional study involving 621 pregnant women in Romania was conducted to estimate dietary carotenoids intake and investigate associations with dietary patterns and overall diet quality. Dietary data were obtained using the EPIC Food Frequency Questionnaire (EPIC-FFQ), adapted for Romanian populations. A dedicated carotenoid estimation model was developed utilizing the USDA Carotenoid Database. Principal component analysis (PCA) was employed to identify dietary patterns, and diet quality was evaluated using the Diet Quality Index during Pregnancy (DQI-P). Results: The findings revealed significant individual variability. The median intake was highest for β-carotene (2464 μg), and lycopene (1664 μg), followed by lutein and zeaxanthin (908 μg), α-carotene (615 μg), and β-cryptoxanthin (121 μg). The Vegetable-meal pattern exhibited the strongest positive correlation with carotenoids intake, whereas the Energy-dense pattern was primarily associated with vitamin E and tocopherols/tocotrienols, and the Mixed pattern with vitamins A and D. Higher DQI-P scores were consistently correlated with increased carotenoids consumption. Conclusions: Overall, maternal carotenoids intake during pregnancy was frequently insufficient and showed considerable variation among women. A diet rich in vegetables and higher overall diet quality were associated with elevated carotenoids intake levels. These findings enhance the understanding of dietary carotenoids intake among pregnant women in Eastern Europe. Full article

(This article belongs to the Special Issue Women’s Special Issue Series: Nutrients)

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16 pages, 689 KB

Open AccessArticle

Dynamic Nutritional Decline During the Diagnostic-to-Treatment Interval Is Associated with Treatment Resilience and Survival in Unresectable Pancreatic Ductal Adenocarcinoma

by Nobuhiko Shinohara, Shinji Oe, Koichiro Miyagawa, Yuichi Honma, Kenta Kajitani, Tsuyoshi Ueda, Noriyoshi Ogino, Shinsuke Kumei, Tatsuyuki Watanabe, Michihiko Shibata and Masaru Harada

Nutrients 2026, 18(12), 1998; https://doi.org/10.3390/nu18121998 (registering DOI) - 19 Jun 2026

Abstract

Background/Objectives: Patients with unresectable pancreatic ductal adenocarcinoma (UR-PDAC) are vulnerable to rapid nutritional deterioration. The clinical relevance of short-term nutritional change during the diagnostic-to-treatment interval (DTI) remains unclear. In this study, we evaluated whether a dynamic change in the Geriatric Nutritional Risk Index [...] Read more.

Background/Objectives: Patients with unresectable pancreatic ductal adenocarcinoma (UR-PDAC) are vulnerable to rapid nutritional deterioration. The clinical relevance of short-term nutritional change during the diagnostic-to-treatment interval (DTI) remains unclear. In this study, we evaluated whether a dynamic change in the Geriatric Nutritional Risk Index (ΔGNRI) during the DTI is associated with treatment tolerability, treatment continuity, and survival. Methods: This single-center retrospective study included 120 patients with histologically confirmed UR-PDAC who initiated first-line palliative chemotherapy between January 2016 and April 2024. ΔGNRI was defined as the GNRI immediately before chemotherapy minus the GNRI at the initial visit. ΔGNRI was primarily analyzed as a continuous variable, and an exploratory cut-off value of −6.8 was determined by receiver operating characteristic analysis. One-to-one propensity score matching was performed as a sensitivity analysis. Clinically significant adverse events (AEs) were defined as grade ≥3 AEs or AEs requiring treatment modification, hospitalization, or treatment discontinuation. Results: Patients in the GNRI-decreased group had more frequent clinically significant non-hematologic AEs, including gastrointestinal AEs, higher hospitalization rates due to AEs, and more frequent early treatment discontinuation. ΔGNRI remained independently associated with early treatment discontinuation and failure to transition to second-line therapy in multivariable analyses. Patients in the GNRI-decreased group also had significantly shorter times to treatment failure and overall survival. These findings were consistent in propensity score-matched analyses. Conclusions: Dynamic nutritional decline during the DTI was associated with impaired treatment resilience and poor survival outcomes in UR-PDAC. ΔGNRI may help identify patients with emerging nutritional vulnerability before chemotherapy. Full article

(This article belongs to the Section Clinical Nutrition)

23 pages, 9691 KB

Open AccessArticle

Broccoli-Derived Peptides and Leucine in Combination Ameliorate D-Galactose-Induced Sarcopenia in Mice

by Kexin Yuan, Wenbin Wu, Ning Su, Mingyang Cui, Jingyi Qi, Yang Zhang, Zhengyang Zhang, Peng An, Junjie Luo and Yongting Luo

Nutrients 2026, 18(12), 1997; https://doi.org/10.3390/nu18121997 (registering DOI) - 19 Jun 2026

Abstract

Background: Sarcopenia is an age-related disorder characterized by loss of muscle mass, strength, and function, driven by oxidative stress, chronic inflammation, and protein imbalance. Broccoli-derived peptides (BDP) exert anti-inflammatory and myofiber-protective effects, while leucine regulates energy metabolism and redox balance. Methods: We established [...] Read more.

Background: Sarcopenia is an age-related disorder characterized by loss of muscle mass, strength, and function, driven by oxidative stress, chronic inflammation, and protein imbalance. Broccoli-derived peptides (BDP) exert anti-inflammatory and myofiber-protective effects, while leucine regulates energy metabolism and redox balance. Methods: We established a D-galactose aging mouse model and treated mice with BDP alone, leucine alone, or their combination for 8 weeks. Lean mass, muscle index, grip strength, endurance, and treadmill capacity were detected, and atrophic, disorganized myofibers were observed through histology. RNA-seq was applied to screen differential signaling pathways, and qPCR was used to verify related gene expression levels. Results: D-galactose caused marked deficits in lean mass, muscle index, grip strength, endurance, and treadmill capacity, accompanied by atrophic and disorganized myofibers. Single BDP or leucine partially reversed these deficits, but the combination produced the most robust improvements. RNA-seq revealed that BDP enriched actin, chemokine, and TNF pathways; leucine enriched Apelin and ECM pathways; while the combination uniquely regulated MAPK signaling. qPCR confirmed that co-administration optimally upregulated myogenic drivers (Myod1, Myog, Mef2c), suppressed catabolic/inflammatory mediators (Mstn, Tnf, Cxcl10), and restored metabolic/adhesive regulators (Sirt3, Aplnr, Icam1). Conclusions: BDP and leucine show superior efficacy in ameliorating sarcopenia, through multimodal regulation of multiple signaling pathways, offering a promising plant-based nutritional strategy against age-related muscle decline. Full article

(This article belongs to the Special Issue Metabolic Features and Nutritional Interventions in Chronic Diseases—2nd Edition)

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14 pages, 245 KB

Open AccessArticle

Assessing the Nutritional and Neurodevelopmental Status in Children Attending Preschools in a Neighborhood in Bogotá, Colombia

by Laura Sofia Aguilera-Ariño, Claudia Talero-Gutiérrez, Alberto Velez-Van-Merbeeke, Natalia Pedraza-López, Maria Patiño-Rattiva, Isabella Pastrana-Bustamante, Juan Andrés Ospina-Arias, Mariana Quijano-Zauner, María José Velásquez, Sara Sofia Carvajal-Rincón and Angela María Pinzón-Rondón

Nutrients 2026, 18(12), 1996; https://doi.org/10.3390/nu18121996 (registering DOI) - 19 Jun 2026

Abstract

Background: Early childhood nutrition is strongly associated with neurodevelopmental outcomes, particularly in socially vulnerable settings. Limited evidence is available describing the relationship between nutritional status, food security, and neurodevelopment among preschool children in low-income urban areas of Colombia. This study aimed to evaluate [...] Read more.

Background: Early childhood nutrition is strongly associated with neurodevelopmental outcomes, particularly in socially vulnerable settings. Limited evidence is available describing the relationship between nutritional status, food security, and neurodevelopment among preschool children in low-income urban areas of Colombia. This study aimed to evaluate nutritional status, household food insecurity, and neurodevelopmental outcomes in children attending early childhood centers in El Codito, Bogotá, and to explore the association between anthropometric indicators and neurodevelopmental performance. Methods: A cross-sectional study was conducted in children enrolled in community childcare centers. Nutritional status was assessed using anthropometric indicators according to World Health Organization growth standards, including weight for age, height for age, and body mass index for age. Neurodevelopment was evaluated using the Escala Abreviada de Desarrollo (EAD). Household food insecurity was measured through a validated questionnaire. Descriptive statistics were performed, and associations between variables were analyzed using correlation tests and group comparisons according to data distribution. Results: Most participants presented adequate nutritional status; however, a proportion of children showed risk of stunting or excess weight. Neurodevelopmental scores were generally within expected ranges, although variability was observed across developmental domains. Significant associations were identified between certain anthropometric indicators and neurodevelopmental outcomes. Moderate to severe household food insecurity was identified in 21.4% of participating households. Conclusions: Nutritional status and household food insecurity represent important contextual factors for child health in vulnerable urban populations. These findings highlight the importance of integrated nutritional and developmental monitoring strategies within early childhood programs. Further longitudinal studies are required to clarify causal pathways and to guide targeted public health interventions in similar contexts. Full article

(This article belongs to the Special Issue Early Nutrition and Neurodevelopment)

13 pages, 4117 KB

Open AccessArticle

Establishing Murine Intestinal Organoids to Study Nutrient- and Tastant-Evoked Gut Signaling

by Praveen Kumar, Florian Ziegler and Maik Behrens

Nutrients 2026, 18(12), 1995; https://doi.org/10.3390/nu18121995 (registering DOI) - 19 Jun 2026

Abstract

Background/Objectives: Numerous studies have investigated the responses of the gastrointestinal tract to tastants, particularly in specialized enteroendocrine and other chemosensory cells. However, many of these investigations used various taste stimuli often at high concentrations or relied on immortalized cell lines or heterogeneous [...] Read more.

Background/Objectives: Numerous studies have investigated the responses of the gastrointestinal tract to tastants, particularly in specialized enteroendocrine and other chemosensory cells. However, many of these investigations used various taste stimuli often at high concentrations or relied on immortalized cell lines or heterogeneous cell populations, which can limit their physiological relevance and reproducibility. To establish a stable, physiologically representative model system for consistently investigating gut epithelial responses to tastants, our study developed 3D murine intestinal organoids (MIOs). Methods: Murine intestinal organoids were generated from isolated intestinal crypts and cultured under defined conditions to maintain epithelial differentiation. Organoids were stimulated with selected nutrients and tastants, and downstream signaling responses were assessed using hormone secretion assays. Results: The 3D MIO culture system was successfully established, providing a robust in vitro platform for studying extraoral bitter sensing and release of the enteroendocrine hormone cholecystokinin. Moreover, 5 mM denatonium benzoate and 30 mM L-glutamic acid specifically induced cholecystokinin secretion in MIOs, whereas other bitter or non-bitter stimuli did not. Conclusions: Murine intestinal organoids provide a stable model for studying nutrient- and tastant-evoked signaling in the gut. This approach enables precise investigation of underlying mechanisms and may advance our understanding of gut chemosensation and metabolic regulation. Full article

(This article belongs to the Special Issue The Taste–Nutrition Interface: How Gustatory Signaling Modulates Metabolic Responses)

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17 pages, 1369 KB

Open AccessReview

Nutrition and Exercise Interventions During Hospitalization in Frail or Sarcopenic Patients: A Scoping Review of Intervention Configurations and Evidence Gaps

by Shinichi Watanabe, Takayasu Koike, Kenji Tsujimoto, Ryoma Tahara, Tomohiko Kamo, Katsuyoshi Suzuki and Keisuke Suzuki

Nutrients 2026, 18(12), 1994; https://doi.org/10.3390/nu18121994 (registering DOI) - 19 Jun 2026

Abstract

Background/Objectives: Frailty and sarcopenia are common among hospitalized patients and are associated with poor clinical outcomes. Nutritional and exercise interventions are widely used to prevent muscle loss and functional decline; however, their independent and incremental effects remain unclear. This scoping review aimed [...] Read more.

Background/Objectives: Frailty and sarcopenia are common among hospitalized patients and are associated with poor clinical outcomes. Nutritional and exercise interventions are widely used to prevent muscle loss and functional decline; however, their independent and incremental effects remain unclear. This scoping review aimed to systematically map the characteristics and reported effects of these interventions during hospitalization. Methods: This scoping review followed the Joanna Briggs Institute methodology and the PRISMA-ScR guidelines. A comprehensive literature search was conducted in PubMed/MEDLINE, EMBASE, CENTRAL, and PEDro. Eligible studies included adult hospitalized patients receiving nutritional interventions, exercise interventions, or both. Interventions were categorized into four groups: no intervention, nutrition alone, exercise alone, and combined interventions. Data regarding study characteristics, intervention details, and clinical outcomes were extracted and descriptively summarized. Results: Thirty-three studies were included. Considerable heterogeneity was observed in patient populations, intervention characteristics, and outcome measures. Most studies evaluated configurations including an exercise component (exercise alone or combined nutrition–exercise), whereas studies isolating nutrition or providing direct head-to-head comparisons between combined and single-component configurations were limited. Intervention dose and reporting were highly variable across studies. Conclusions: Current evidence on the effects of nutritional and exercise interventions during hospitalization remains heterogeneous and limited. Future studies should adopt standardized intervention reporting and directly compare combined and single-component strategies to determine additive and synergistic effects in patients with frailty or sarcopenia. Full article

(This article belongs to the Special Issue Nutritional Strategies for Muscle Recovery and Exercise Adaptations)

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19 pages, 1785 KB

Open AccessArticle

Effect of Prenatal Vitamin D and Selenium Supplementation on Minipuberty in Male Offspring of Women with Autoimmune Thyroiditis

by Karolina Kowalcze, Joanna Kula-Gradzik, Giuseppe Gullo, Simone Ferrero, Vito Chiantera and Robert Krysiak

Nutrients 2026, 18(12), 1993; https://doi.org/10.3390/nu18121993 (registering DOI) - 19 Jun 2026

Abstract

Background/Objectives: Minipuberty represents the second phase of physiological activation of the reproductive axis and may play a role in postnatal genital development. Its course has been shown to be affected by untreated or inadequately treated maternal hypothyroidism. The aim of the present [...] Read more.

Background/Objectives: Minipuberty represents the second phase of physiological activation of the reproductive axis and may play a role in postnatal genital development. Its course has been shown to be affected by untreated or inadequately treated maternal hypothyroidism. The aim of the present study was to investigate minipuberty in the sons of women with euthyroid autoimmune thyroiditis during pregnancy. Methods: This prospective matched cohort study included three groups of apparently healthy infant boys. Two groups comprised the male offspring of levothyroxine-naive, euthyroid women with autoimmune thyroiditis: one group was unsupplemented, and the other received vitamin D and selenium supplementation. The control group consisted of boys born to healthy women. Salivary concentrations of testosterone, androstenedione, DHEA-S, estradiol, and progesterone, along with urinary FSH and LH levels, were assessed longitudinally over the first 12 months of life. These hormonal measurements were evaluated in relation to genital development, including testicular volume and penile length, which were recorded at each study visit. Results: Compared with the offspring of healthy mothers, sons of women with autoimmune thyroiditis who did not receive supplementation exhibited lower concentrations of LH and testosterone, without a distinct peak, while the duration of hormone detectability did not differ between the groups. These hormonal alterations were accompanied by reduced penile length, with no differences observed in testicular volume. This group also exhibited lower DHEA-S concentrations, whereas levels of other hormones were comparable. In contrast, in the group receiving vitamin D and selenium supplementation, the dynamics of hormonal changes and genital organ growth did not differ from those observed in the control group. LH concentrations were inversely correlated with thyroid peroxidase antibody titers, which were lower in the supplemented group. Conclusions: The findings indicate an altered course of minipuberty in the sons of women with euthyroid autoimmune thyroiditis during pregnancy and suggest a potential benefit of exogenous vitamin D and selenium supplementation in this population. Full article

(This article belongs to the Special Issue The Role of Vitamin D in Endocrine Diseases: Pathophysiology and Treatment)

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28 pages, 567 KB

Open AccessSystematic Review

Effects of Curcumin Supplementation on Exercise Recovery, Oxidative Stress, Inflammation, Muscle Damage, and Performance in Exercise and Sport Contexts: A Systematic Review

by Jesús Lloret-Gil, Desirée Victoria-Montesinos and Francisco Javier Martínez-Noguera

Nutrients 2026, 18(12), 1992; https://doi.org/10.3390/nu18121992 (registering DOI) - 19 Jun 2026

Abstract

Background/Objectives: Curcumin has been proposed as a nutritional strategy to support exercise recovery through antioxidant and anti-inflammatory actions. However, trials differ in sport context, training status, supplementation timing, dose, formulation, and methodological control. This systematic review evaluated its effects on recovery outcomes in [...] Read more.

Background/Objectives: Curcumin has been proposed as a nutritional strategy to support exercise recovery through antioxidant and anti-inflammatory actions. However, trials differ in sport context, training status, supplementation timing, dose, formulation, and methodological control. This systematic review evaluated its effects on recovery outcomes in active individuals and athletes, with particular attention to the applicability of the evidence to real-world sport settings. Methods: PubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library/CENTRAL were searched from 2012 to June 2026. Randomized double-blind placebo-controlled trials were eligible when they evaluated oral curcumin, curcuminoids, Curcuma-derived preparations with a specified curcumin dose, or curcumin combined only with bioavailability enhancers. Studies using artificial muscle-damage protocols, clinical populations, non-randomized designs, or combined bioactive interventions were excluded. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale, supplemented by a Cochrane Risk of Bias 2 (RoB 2) assessment and a Grading of Recommendations Assessment, Development and Evaluation (GRADE) certainty-of-evidence evaluation. Owing to heterogeneity, findings were synthesized narratively by outcome domain, supplementation timing, formulation type, exercise context, and training status. Results: Fifteen trials were included. Favorable effects were reported in 6/7 studies assessing oxidative stress, 4/6 assessing muscle damage, 3/8 assessing inflammation, 3/7 assessing subjective recovery, soreness, or fatigue, and 4/8 assessing physical or athletic performance. However, effects varied substantially according to population, exercise context, biomarker selection, timing of assessment, and formulation type. The certainty of evidence was low for oxidative stress and very low for muscle damage, inflammation, subjective recovery/soreness/fatigue, and performance. Conclusions: Curcumin supplementation may support selected aspects of exercise recovery, particularly oxidative stress responses. However, these findings should be interpreted cautiously because the evidence derives mostly from small trials with heterogeneous populations, exercise protocols, supplementation regimens, formulations, biomarkers, and assessment time points. Evidence for muscle damage, inflammation, subjective recovery, fatigue, and performance remains inconsistent, and further well-controlled trials in trained and high-performance athletes are needed before practical recommendations can be established. Full article

(This article belongs to the Special Issue The Role of Nutritional Intake and Supplements in Improving Athletic Performance)

36 pages, 3690 KB

Open AccessReview

Multi-Axis Functional Mechanisms of the Milpa Diet in Obesity: A Scoping Review

by Josué Ramos, Rogelio Salas, Carolina Salazar-Guerrero, Jimena Gaspar, Mirna E. Santos, Marcelo Hernández-Salazar, Silvia García, Marina Ródenas-Munar, Sofía Montemayor, Daniela Rodrigues, Cristina Bouzas and Josep A. Tur

Nutrients 2026, 18(12), 1991; https://doi.org/10.3390/nu18121991 (registering DOI) - 19 Jun 2026

Abstract

Background: Obesity is a multifactorial metabolic disorder characterized by chronic low-grade inflammation, oxidative stress, mitochondrial dysfunction, lipotoxicity, dysregulated adipogenesis, and alterations in the gut microbiota, which collectively contribute to insulin resistance and cardiometabolic complications. In this context, dietary patterns rich in bioactive compounds [...] Read more.

Background: Obesity is a multifactorial metabolic disorder characterized by chronic low-grade inflammation, oxidative stress, mitochondrial dysfunction, lipotoxicity, dysregulated adipogenesis, and alterations in the gut microbiota, which collectively contribute to insulin resistance and cardiometabolic complications. In this context, dietary patterns rich in bioactive compounds have gained relevance as potential strategies to modulate these interconnected pathways. Objective: To assess the potential of the Milpa Diet (a sustainable, plant-dominant Mesoamerican eating pattern centered on the ancient three sisters’ polyculture of maize, beans, and squash, along with chili) as a culturally relevant, multi-axis functional dietary pattern, and to evaluate the molecular mechanisms underlying obesity-associated with metabolic dysfunction. Methods: A scoping review of preclinical and clinical studies was conducted using Medline via PubMed, Scopus, and Web of Science databases. The ChEMBL database was also used to identify chemical structures. The search focused on evidence related to inflammation, oxidative stress, adipogenesis, lipotoxicity, mitochondrial function, and gut microbiota modulation in the context of the main foods of the Milpa Diet, including maize, legumes, chili peppers, nopal, and quelites. Studies were selected based on peer-review status and their relevance to molecular, metabolic, and functional outcomes. Results: The current evidence shows that the core components of the Milpa Diet provide dietary fiber and a broad range of bioactive compounds, such as flavonoids, carotenoids, capsaicinoids, phenolic acids, pigments, and vitamins, which exhibit antioxidant and anti-inflammatory effects. These compounds have been associated with modulation of adipogenesis and lipotoxicity, preservation of mitochondrial function, and favorable regulation of gut microbiota composition and activity, collectively influencing metabolic pathways relevant to obesity. Conclusions: Overall, mechanistic and emerging clinical evidence suggests that the Milpa Diet represents a multi-axis nutritional strategy with potential to mitigate obesity-related metabolic dysfunction through coordinated effects on inflammation, oxidative stress, adipogenesis, lipotoxicity, mitochondrial function, and gut microbiota regulation. Although comprehensive clinical trials evaluating this dietary pattern as an integrated intervention remain limited, current evidence supports its relevance for future translational research, public health strategies, and the development of sustainable dietary models aimed at improving metabolic health. Full article

(This article belongs to the Section Nutrition and Obesity)

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