Nutrients

17 pages, 269 KB

Open AccessArticle

Knowledge, Attitude, and Practice Regarding Water Intake Among University Students in China’s Seven Geographical Divisions: A Cross-Sectional Analysis

by Haiyue Yang, Jianfen Zhang, Shuyi Zhou, Yongye Song, Yi Zhang, Yunxia Zhu and Na Zhang

Nutrients 2026, 18(2), 225; https://doi.org/10.3390/nu18020225 (registering DOI) - 10 Jan 2026

Abstract

Background: Inadequate water intake is prevalent among Chinese college students, a group at a critical stage for establishing lifelong health habits. However, nationwide data on their knowledge, attitudes, and practices (KAP) regarding water intake remain scarce. This study aims to describe regional [...] Read more.

Background: Inadequate water intake is prevalent among Chinese college students, a group at a critical stage for establishing lifelong health habits. However, nationwide data on their knowledge, attitudes, and practices (KAP) regarding water intake remain scarce. This study aims to describe regional variations in water-related KAP among undergraduates across seven major geographical regions of China, providing evidence for developing targeted health promotion strategies. Methods: A cross-sectional survey employed multistage stratified convenience sampling to recruit undergraduate students (N = 3161) from one university in each of China’s seven regions. Participants completed a KAP questionnaire. Data analysis utilized chi-square tests with Bonferroni correction, reporting effect sizes and confidence intervals. Results: A total of 3161 valid responses were obtained (response rate: 98.3%). Students in South China demonstrated the lowest awareness of regular water intake (52.0%) but the highest awareness of daily recommended water intake (32.9%). South China and Northeast China exhibited weaker recognition of water’s importance (65.6% and 94.0%, respectively) and the lowest prevalence of “thirst-driven” drinking behavior (21.7% and 32.4%, respectively). Conclusions: The knowledge, attitude, and practice (KAP) status regarding water consumption among Chinese university students is concerning and exhibits significant regional disparities. Key issues include knowledge gaps, disconnect between attitudes and behaviors, and deeply ingrained unscientific drinking habits. Analysis based on KAP theory indicates that future health promotion strategies must move beyond mere knowledge dissemination and adopt region-specific, multilevel comprehensive interventions. Full article

(This article belongs to the Special Issue Food Literacy and Public Health Nutrition)

20 pages, 347 KB

Open AccessArticle

Vitamin D Deficiency Mediates the Link Between Dietary Patterns, Inflammatory Biomarkers, and Iron Status Indicators (Ferritin and Hemoglobin) in Metabolic Syndrome

by Salma I. Cortes-Álvarez, Iván Delgado-Enciso, Gustavo A. Hernández-Fuentes, José Guzmán-Esquivel, Janet Diaz-Martinez, Alejandrina Rodríguez-Hernández, Margarita L. Martinez-Fierro, Iram P. Rodríguez-Sánchez, Valery Melnikov, Yunue Flores-Ruelas, Idalia Garza-Veloz, Miriam De la Cruz-Ruiz, Ángel A. Ramos-Organillo and Carmen A. Sánchez-Ramírez

Nutrients 2026, 18(2), 224; https://doi.org/10.3390/nu18020224 (registering DOI) - 10 Jan 2026

Abstract

Background/Objectives: Chronic low-grade inflammation and nutritional deficiencies, particularly vitamin D deficiency, have emerged as important contributors to Metabolic syndrome (MetS) pathogenesis but remain underexplored. This study aimed to comprehensively evaluate the associations between dietary intake, vitamin D status, and inflammatory biomarkers (high-sensitivity [...] Read more.

Background/Objectives: Chronic low-grade inflammation and nutritional deficiencies, particularly vitamin D deficiency, have emerged as important contributors to Metabolic syndrome (MetS) pathogenesis but remain underexplored. This study aimed to comprehensively evaluate the associations between dietary intake, vitamin D status, and inflammatory biomarkers (high-sensitivity C-reactive protein -CRP- and ferritin) in patients with MetS. Methods: A cross-sectional observational study was conducted on 141 adult MetS patients at a Mexican hospital. Clinical, anthropometric, dietary (using a validated food frequency questionnaire), and biochemical data including serum 25-hydroxyvitamin D, CRP, ferritin, and neutrophil-to-lymphocyte ratio (NLR) were collected. Vitamin D deficiency was defined as serum 25(OH)D < 20 ng/mL, and high inflammation as CRP ≥ 3 mg/L. Logistic regression models adjusted for confounders were used to analyze associations. Mediation analysis assessed whether vitamin D deficiency mediated the link between dietary intake and high CRP or ferritin. Results: Patients with elevated CRP had significantly lower serum vitamin D levels (14.0 ± 5.1 vs. 22.1 ± 7.0 ng/mL; p < 0.001). Multivariable analysis showed vitamin D deficiency (adjusted OR 7.1; 95% CI 2.5–19.4; p < 0.001) and hyperferritinemia (ferritin ≥ 200 μg/L; aOR 8.0, 95% CI 3.5–18.2, p < 0.001) as predictors of high CRP. Conversely, hyperferritinemia was predicted by vitamin D deficiency (aOR 24.69; 95% CI 3.76–162.16; p = 0.001), elevated CRP (aOR 5.06; p = 0.014), Hb (aOR 63.23; p < 0.001), and inversely by grade 2 obesity (aOR 0.11; 95% CI 0.02–0.60; p = 0.03), confirming bidirectional CRP-ferritin associations and hyperferritinemia as an inflammation marker rather than iron overload indicator. Although Hb > 14.3 g/dL associated with hyperferritinemia, it did not independently predict CRP in multivariate analyses. Frequent consumption of vitamin D-rich foods (milk, fish, Manchego and Oaxaca cheese) was associated with lower inflammation. Mediation analysis confirmed that vitamin D deficiency mediated dietary intake-CRP and dietary intake-ferritin links (Sobel test p < 0.05). Conclusions: Vitamin D deficiency is a key mediator linking inadequate dietary vitamin D intake to systemic inflammation in MetS. Nutritional strategies emphasizing vitamin D repletion and consumption of vitamin D fortified foods may effectively reduce chronic inflammation and improve metabolic outcomes. Full article

(This article belongs to the Special Issue Assessment of Vitamin Deficiency and Benefits of Vitamin Supplementation for Human Health)

15 pages, 1498 KB

Open AccessArticle

Bioenhancer Assessment of Black Pepper with Turmeric on Self-Reported Pain Ratings in Adults: A Randomized, Cross-Over, Clinical Trial

by Leandra Durham, Robert A. Oster, Matthew Ithurburn, Chelsi Reynolds, James O. Hill and Daniel L. Smith, Jr.

Nutrients 2026, 18(2), 223; https://doi.org/10.3390/nu18020223 (registering DOI) - 10 Jan 2026

Abstract

Background: Chronic pain, which affects over 50 million adults in the United States, has stimulated growing interest in natural and nutrition-based remedies as adjuncts to pharmacologic therapies. Evidence suggests that turmeric and related extracts (i.e., curcuminoids) may provide pain relief, albeit often at [...] Read more.

Background: Chronic pain, which affects over 50 million adults in the United States, has stimulated growing interest in natural and nutrition-based remedies as adjuncts to pharmacologic therapies. Evidence suggests that turmeric and related extracts (i.e., curcuminoids) may provide pain relief, albeit often at levels above dietary ranges, while piperine from black pepper exhibits bioenhancer characteristics of relevance with dietary exposures. Objective: To test the effectiveness of dietarily relevant amounts of turmeric with and without black pepper on self-reported pain ratings among adults with chronic pain. Methods: A randomized, crossover clinical trial tested the effectiveness of turmeric only (one of three amounts within culinary ranges) or turmeric with black pepper to influence pain in adults ≥ 40 years of age. Participants (n = 30, with moderate pain: 4–7 on 0–10-point scale) were enrolled in a 21-day trial, and an experience sampling methodology approach was used. Participants were prompted to report current pain using the numeric pain rating scale (NPRS; 0–10) via text message three times per day for the full study period. Data were averaged and analyzed via linear mixed effects models for repeated measurements. Results: Pain ratings from baseline to week 3 were reduced and statistically significant (p < 0.001) but not statistically different between groups. The provided turmeric, both with and without black pepper, and varying amounts of turmeric (300 mg, 1 g, and 3 g, n = 10 participants/amount) did not show statistically significant differences in pain ratings (p = 0.157 and p = 0.338, respectively). Conclusions: Consuming dietarily relevant amounts of turmeric, either alone or with black pepper, appears to improve average pain ratings. This result suggests a feasible dietary option for further study of nutritional interventions for chronic pain management. Full article

(This article belongs to the Special Issue Therapeutic Potential of Dietary Bioactives: From Bioavailability to Chronic Diseases Prevention and Treatment)

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19 pages, 699 KB

Open AccessArticle

Good Dietary Control Significantly Improves Anthropometric and Metabolic Parameters and Liver Function in Patients with Type 2 Diabetes Mellitus—A Pilot Study

by Bogusława Luzak, Patrycja Szymańska and Marcin Kosmalski

Nutrients 2026, 18(2), 222; https://doi.org/10.3390/nu18020222 (registering DOI) - 10 Jan 2026

Abstract

Background/Objectives: The aim of the study was to analyze dietary and lifestyle adherence in patients with type 2 diabetes mellitus (T2DM) under the care of a diabetes clinic. Methods: The study included two groups: patients under the close control of a [...] Read more.

Background/Objectives: The aim of the study was to analyze dietary and lifestyle adherence in patients with type 2 diabetes mellitus (T2DM) under the care of a diabetes clinic. Methods: The study included two groups: patients under the close control of a dietitian (n = 50) who followed a standard (DD) or fiber-enriched diabetic diet (FD), and patients under the care of a diabetes clinic without close supervision of a dietitian (n = 50). Results: After 3 months, both DD and FD significantly improved metabolic control in the patients under the care of a dietitian. However, FD was slightly better compared to DD (BMI reduction by an average of 2.4% (95% CI: 1.6%; 3.1%) for DD vs. 4.8% (95% CI: 3.6%; 6.0%) for FD; waist circumference decreasing 2.0% (95% CI: 1.2%; 3.4%) for DD vs. 3.5% (95% CI: 2.6%; 4.3%) for FD, p < 0.01; glycemia reduction 19.9% (95% CI: 14.8%; 25.0%) for FD vs. 5.6% (95% CI: 1.9%; 9.3%) for DD, p < 0.001; GGTP activity reduction 35.7% (95% CI: 28.9%; 42.5%) for FD vs. 1.8% (95% CI: −15.2%; 18.3%) for DD, p < 0.001). In addition, only half of the patients without the close supervision of a dietitian declared adherence to the diet. Most respondents had a satisfactory level of nutritional knowledge, but the analysis indicates the weakly marked influence of the protective features of nutrition as well as evidence of the low contribution of an unhealthy diet. Conclusions: Considering the level of nutritional knowledge and low awareness of their health condition in many patients, visits to the doctor and brief nutrition education are not enough for dietary care in T2DM patients. A dietitian’s care is necessary to improve their health. Full article

(This article belongs to the Special Issue Dietetic Care in Primary Care and Prevention)

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15 pages, 992 KB

Open AccessReview

Identifying Chronotype for the Preservation of Muscle Mass, Quality and Strength

by Roberto Barrientos-Salinas, Norma Dahdah, Jorge Alvarez-Luis, Nuria Vilarrasa and Pablo M. Garcia-Roves

Nutrients 2026, 18(2), 221; https://doi.org/10.3390/nu18020221 (registering DOI) - 10 Jan 2026

Abstract

Chronotype, an individual’s preferred timing of sleep and activity within a 24 h cycle, significantly influences metabolic health, muscle function, and body composition. This review explores the interplay between circadian rhythms, hormonal fluctuations, and behavioral patterns—such as nutrition timing, physical activity and sleep [...] Read more.

Chronotype, an individual’s preferred timing of sleep and activity within a 24 h cycle, significantly influences metabolic health, muscle function, and body composition. This review explores the interplay between circadian rhythms, hormonal fluctuations, and behavioral patterns—such as nutrition timing, physical activity and sleep quality—and their impact on muscle mass, strength, and quality. Evening chronotypes (ETs) are consistently associated with poorer sleep, irregular eating habits, reduced physical activity, and increased risk of obesity, sarcopenia and metabolic disorders compared to morning types (MTs). At the molecular level, disruptions in circadian clock gene expression (e.g., BMAL1, PER2, CRY1) affect protein synthesis, insulin sensitivity, and energy metabolism, contributing to muscle degradation and impaired recovery. The review highlights critical components—targeting chrono-nutrition, sleep quality, and exercise timing—to align lifestyle behaviors with circadian biology, thereby preserving muscle health and improving overall metabolic outcomes. Full article

(This article belongs to the Special Issue Nutritional Strategies for Preserving Fat-Free Mass during Intentional Weight Loss)

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19 pages, 931 KB

Open AccessReview

Plant-Forward Dietary Approaches to Reduce the Risk of Cardiometabolic Disease Among Hispanic/Latinx Adults Living in the United States: A Narrative Review

by Franze De La Calle, Joanna Bagienska and Jeannette M. Beasley

Nutrients 2026, 18(2), 220; https://doi.org/10.3390/nu18020220 (registering DOI) - 10 Jan 2026

Abstract

Background: Cardiometabolic risk (CMR), including obesity, dyslipidemia, hypertension, and impaired glucose regulation, disproportionately affects Hispanic/Latinx adults in the United States (U.S.). Although plant-forward dietary patterns are established as cardioprotective, less is known about how dietary patterns within Hispanic/Latinx subgroups relate to CMR. [...] Read more.

Background: Cardiometabolic risk (CMR), including obesity, dyslipidemia, hypertension, and impaired glucose regulation, disproportionately affects Hispanic/Latinx adults in the United States (U.S.). Although plant-forward dietary patterns are established as cardioprotective, less is known about how dietary patterns within Hispanic/Latinx subgroups relate to CMR. Methods: A narrative review was conducted of observational studies among U.S. Hispanic/Latinx adults (≥18 years) examining defined dietary patterns (a priori, a posteriori, or hybrid) in relation to CMR outcomes (e.g., BMI, waist circumference, blood pressure, glucose, lipids). Risk of bias was assessed using an adapted version of the Newcastle–Ottawa Scale. Results: Ten studies met the inclusion criteria, including Seventh-day Adventist Latinx, Puerto Rican adults, Mexican American adults, Hispanic women, and a national Hispanic cohort. Plant-forward dietary patterns were associated with lower BMI and waist circumference, lower triglycerides and fasting glucose, and higher HDL-C. In contrast, energy-dense patterns characterized by refined grains, added sugars, processed meats, fried foods, solid fats, and sugar-sweetened beverages were associated with greater adiposity, poorer lipid profiles, and higher blood pressure. Traditional rice-and-beans–based patterns observed in Puerto Rican and Mexican American groups were associated with central adiposity and higher metabolic syndrome prevalence, despite modestly higher intakes of fruits, vegetables, and fiber. Study quality ranged from good (n = 4) to very good (n = 6). Conclusions: Across Hispanic/Latinx subgroups, plant-forward dietary patterns were associated with favorable cardiometabolic profiles, whereas refined and animal-based patterns aligned with higher CMR. Given the predominance of cross-sectional evidence, these findings should be interpreted as associative rather than causal. Culturally grounded dietary counseling, along with additional longitudinal and intervention studies, is needed to support cardiometabolic health in these populations. Full article

(This article belongs to the Special Issue Plant-Forward Dietary Approaches Among Populations at High Risk of Metabolic Disease)

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14 pages, 1920 KB

Open AccessArticle

Intestinal Microbiota of Older Japanese Females Adhering to a Traditional Japanese Brown Rice-Based Diet Pattern

by Kouta Hatayama, Aya Ebara, Chihiro Hirano, Kanako Kono, Hiroaki Masuyama and Iyoko Ashikari

Nutrients 2026, 18(2), 219; https://doi.org/10.3390/nu18020219 - 9 Jan 2026

Abstract

Background/Objectives: Some Japanese people still adhere to a systematic traditional Japanese diet pattern (the Shokuyo diet) consisting mainly of brown rice, vegetables, legumes, and small amounts of fish. We investigated the impact of this dietary pattern on the intestinal microbiota of its [...] Read more.

Background/Objectives: Some Japanese people still adhere to a systematic traditional Japanese diet pattern (the Shokuyo diet) consisting mainly of brown rice, vegetables, legumes, and small amounts of fish. We investigated the impact of this dietary pattern on the intestinal microbiota of its female consumers. Methods: The intestinal microbiota of 19 Japanese females in their 60s and 70s consuming the Shokuyo diet (Shokuyo diet group) and 50 females of the same age consuming a normal Japanese diet (NJ diet group) were compared. The NJ diet group was further subdivided into a healthy NJ diet H subgroup, comprising females (n = 19) without any diseases, and an unhealthy NJ diet UH subgroup (n = 31) consisting of females with certain diseases, and a subgroup analysis was performed. Intestinal microbiota analysis was performed using 16S rRNA gene amplicon sequencing. Results: The β-diversity of the intestinal microbiota significantly differed between the Shokuyo diet and NJ diet groups. Similarly, in the subgroup analysis, β-diversity also significantly differed between the NJ diet UH subgroup and the Shokuyo diet group. However, no significant difference was observed between the NJ diet H and Shokuyo diet groups. These results indicate that the intestinal microbial composition of the Shokuyo diet group resembled that of the healthy participants, and that differences in intestinal microbial composition between the Shokuyo and NJ diet groups were strongly influenced by the presence of participants with diseases in the NJ diet group. That is, differences in β-diversity may have been strongly mediated by the health status of the participants. Conclusions: Consumption of the Shokuyo diet may be associated with a healthy intestinal microbial composition in older Japanese female, suggesting its potential as a viable dietary intervention option. Full article

(This article belongs to the Section Nutrition in Women)

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14 pages, 643 KB

Open AccessArticle

Trajectory of Body Mass Index and Frailty Among Older People in Southern Brazil: A Longitudinal Study

by Cecília F. Fernandes, Karla P. Machado, Andréa D. Bertoldi, Elaine Tomasi, Flávio Fernando Demarco, Maria Cristina Gonzalez and Renata M. Bielemann

Nutrients 2026, 18(2), 218; https://doi.org/10.3390/nu18020218 - 9 Jan 2026

Abstract

Background/Objectives: Frailty is a common geriatric syndrome associated with adverse outcomes such as disability, hospitalization, and mortality. This study aimed to assess the association between body mass index (BMI) trajectories over ten years and frailty among community-dwelling older adults in Brazil. Methods [...] Read more.

Background/Objectives: Frailty is a common geriatric syndrome associated with adverse outcomes such as disability, hospitalization, and mortality. This study aimed to assess the association between body mass index (BMI) trajectories over ten years and frailty among community-dwelling older adults in Brazil. Methods: This population-based longitudinal study used data from the COMO VAI? cohort, conducted with individuals aged ≥60 years in Pelotas, southern Brazil. Frailty was defined in 2024 using Fried’s phenotype, which evaluates weight loss, exhaustion, low physical activity, slowness, and weakness. BMI categories were defined as underweight (BMI < 22.0 kg/m²), eutrophy (22.0–27.0 kg/m²) and overweight (>27.0 kg/m²). BMI trajectories were identified using group-based trajectory modeling for 789 participants with data from at least two of three assessments (2014, 2019, 2024). Only trajectory groups comprising at least 5% of the sample were retained. Associations of baseline BMI and BMI trajectories with frailty were analyzed using Poisson regression with robust variance, adjusted for confounders and calf circumference. Results: Baseline underweight and overweight prevalence were 9.2% and 56.2%, respectively. Trajectory modeling identified three BMI groups: eutrophic (31.6%), overweight (56.4%), and obesity (12.0%). Obesity emerged as a distinct longitudinal trajectory rather than a baseline BMI category. Underweight did not emerge as a distinct BMI trajectory due to its low prevalence over time. Frailty prevalence in 2024 was 36.5%. Overweight trajectory participants had lower frailty prevalence after ten years (PR = 0.73; 95% CI: 0.54–0.99), while baseline underweight was associated with higher frailty ten years later (PR = 1.73; 95% CI: 1.05–2.84), consistent with the known risk of underweight and the potential protective effect observed in overweight older adults. Conclusions: Baseline underweight increased frailty risk, whereas an overweight trajectory showed a potential protective effect, consistent with the “obesity paradox” in older populations. Full article

(This article belongs to the Special Issue Changes in Diet, Physical Activity, and Anthropometric Parameters During Aging: What to Focus On?)

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13 pages, 1051 KB

Open AccessReview

The Role of Vitamin D in Autoimmune Thyroid Diseases: From Immunomodulation to Clinical Implications

by Giulia Bendotti, Chiara Mele, Luisa Costantini, Alberto Ragni, Paola Leporati, Emilia Biamonte and Marco Gallo

Nutrients 2026, 18(2), 217; https://doi.org/10.3390/nu18020217 - 9 Jan 2026

Abstract

Vitamin D is involved in immune regulation through effects on innate and adaptive immune responses mediated by vitamin D receptor activation within immune cells. Experimental and translational studies support its role in promoting regulatory T-cell activity, modulating Th1/Th17 responses, and influencing autoantibody production. [...] Read more.

Vitamin D is involved in immune regulation through effects on innate and adaptive immune responses mediated by vitamin D receptor activation within immune cells. Experimental and translational studies support its role in promoting regulatory T-cell activity, modulating Th1/Th17 responses, and influencing autoantibody production. At the population level, low serum 25-hydroxyvitamin D concentrations are consistently associated with an increased risk of autoimmune diseases, including autoimmune thyroid disorders such as Hashimoto’s thyroiditis (HT) and Graves’ disease (GD), suggesting a potential preventive association. In contrast, clinical evidence from interventional studies in patients with established disease is heterogeneous. Although vitamin D supplementation has been associated with reductions in thyroid autoantibody titers in some studies—particularly in patients with HT and baseline vitamin D deficiency—consistent effects on thyroid function, disease progression, or relapse prevention have not been demonstrated. Overall, current evidence supports vitamin D deficiency as a potentially modifiable risk marker rather than a confirmed disease-modifying therapeutic target in autoimmune thyroid diseases, highlighting the need for further studies focused on clinically meaningful outcomes. Full article

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

15 pages, 2303 KB

Open AccessArticle

Towards Simplification of Ketogenic Diet in Epilepsy: Effect of Caprylic (C8) and Capric (C10) Acid on the Mitochondrial Respiratory Chain in Murine Hippocampal Neurons In Vitro

by Miriam Rebekka Rühling, Hans Hartmann and Anibh Martin Das

Nutrients 2026, 18(2), 216; https://doi.org/10.3390/nu18020216 - 9 Jan 2026

Abstract

Background: Pharmacotherapy is the therapeutic mainstay in epilepsy, but in about 30% of patients, the epilepsy is pharmacoresistant. A ketogenic diet (KD) is an alternative therapeutic option. The mechanisms underlying the anti-seizure effect of KD are not fully understood. An enhanced energy metabolism [...] Read more.

Background: Pharmacotherapy is the therapeutic mainstay in epilepsy, but in about 30% of patients, the epilepsy is pharmacoresistant. A ketogenic diet (KD) is an alternative therapeutic option. The mechanisms underlying the anti-seizure effect of KD are not fully understood. An enhanced energy metabolism may have a protective effect; C8 and C10 fatty acids were previously shown to activate mitochondrial function in vitro. In the present study, we investigated whether ß-hydroxybutyrate (HOB), C8, C10 or a combination of C8 and C10 fatty acids, which all increase under KD, could activate mitochondrial respiratory chain enzymes in murine hippocampal neurons (HT22). Methods: Cells were incubated for one week in the presence of the different metabolites. Respiratory chain enzyme activities as well as citrate synthase as a mitochondrial marker enzyme were determined spectrophotometrically in these cells. We observed that enzyme activities of complexes I and III, II and III, and IV (cytochrome c-oxidase) and V (ATP synthase) significantly increased in response to incubation with C8 and C10 fatty acids and a combination of both. Results: This activation of the respiratory chain enzymes was not inferior to an incubation with HOB, the key metabolite in KD. The activity of the mitochondrial marker enzyme citrate synthase increased under incubation with the fatty acids, showing that the mitochondrial content increased. Conclusions: In murine hippocampal cells, C8, C10 and combined C8 and C10 fatty acids led to variable increases in activities of mitochondrial respiratory chain enzymes and citrate synthase. This indicates that both C8 and C10 fatty acids may be important for the antiepileptic effect of KD, as they enhance energy production. Full article

(This article belongs to the Section Proteins and Amino Acids)

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17 pages, 129848 KB

Open AccessArticle

Therapeutic Effect and Underlying Mechanism of Blue Mussel (Mytilus galloprovincialis) Oil on Adjuvant-Induced Rheumatoid Arthritis in Rats

by Xin Yu, Xueyuan Fu, Fen Du, Chuyi Liu, Changwei Wang, Xiaomei Feng, Wanxiu Cao and Qingjuan Tang

Nutrients 2026, 18(2), 215; https://doi.org/10.3390/nu18020215 - 9 Jan 2026

Abstract

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovitis. The prevalence of RA is estimated to be 0.5–1% worldwide. Methods: This work investigated the therapeutic effects and underlying mechanisms of blue mussel (Mytilus galloprovincialis) oil (BMO) on RA [...] Read more.

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovitis. The prevalence of RA is estimated to be 0.5–1% worldwide. Methods: This work investigated the therapeutic effects and underlying mechanisms of blue mussel (Mytilus galloprovincialis) oil (BMO) on RA in rats, using green-lipped mussel oil (GMO) and Antarctic krill oil (KO) as controls. Results: The results suggested that BMO, GMO, and KO all alleviated paw swelling in rats and reduced serum levels of rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibody, and pro-inflammatory cytokines such as TNF-

α

and IL-17. Histopathological assessment further revealed that BMO, GMO, and KO prevented synovial fibroplasia, mitigated inflammatory cell infiltration, and improved cartilage damage in ankle joints. Overall, BMO exhibited slightly superior alleviating effects compared with GMO and KO. Plasma lipidomics analysis revealed that the lipid metabolites altered by BMO showed significant correlations with RA-related indicators, particularly pro-inflammatory cytokines. Functional enrichment analysis suggested the involvement of inflammation-related pathways, particularly the NF-

κ

B signaling pathway. Further validation demonstrated that BMO effectively suppressed the production of inflammatory cytokines (TNF-

α

, IL-17) and the expression of NF-

κ

B p65, JAK2, and STAT3 proteins in synovial tissue. And IL-17 production in footpad tissues is closely associated with CD3-positive T cells. Similar effects were also observed for GMO and KO. Conclusions: Collectively, BMO might ameliorate RA by inhibiting NF-

κ

B and JAK2/STAT3 signaling pathways. Full article

(This article belongs to the Section Nutritional Immunology)

26 pages, 2059 KB

Open AccessReview

Integrating Sensory Perception and Wearable Monitoring to Promote Healthy Aging: A New Frontier in Nutritional Personalization

by Alessandro Tonacci, Francesca Gorini, Francesco Sansone and Francesca Venturi

Nutrients 2026, 18(2), 214; https://doi.org/10.3390/nu18020214 - 9 Jan 2026

Abstract

Aging involves progressive changes in sensory perception, appetite regulation, and metabolic flexibility, which together affect dietary intake, nutrient adequacy, and health-related outcomes. Meanwhile, current wearable technologies allow continuous, minimally invasive monitoring of physiological and behavioral markers relevant to metabolic health, such as physical [...] Read more.

Aging involves progressive changes in sensory perception, appetite regulation, and metabolic flexibility, which together affect dietary intake, nutrient adequacy, and health-related outcomes. Meanwhile, current wearable technologies allow continuous, minimally invasive monitoring of physiological and behavioral markers relevant to metabolic health, such as physical activity, sleep, heart rate variability, glycemic patterns, and so forth. However, digital nutrition approaches have largely focused on physiological signals while underutilizing the sensory dimensions of eating—taste, smell, texture, and hedonic response—that strongly drive dietary intake and adherence. This narrative review synthesizes evidence on the following: (1) age-related sensory changes and their nutritional consequences, (2) metabolic adaptation and markers of resilience in older adults, and (3) current and emerging wearable technologies applicable to nutritional personalization. Following this, we propose an integrative framework linking subjective (implicit) sensory perception and objective (explicit) wearable-derived physiological responses into adaptive feedback loops to support personalized dietary strategies for healthy aging. In this light, we discuss practical applications, technological and methodological challenges, ethical considerations, and research priorities to validate and implement sensory–physiological integrated models. Merging together sensory science and wearable monitoring has the potential to enhance adherence, preserve nutritional status, and bolster metabolic resilience in aging populations, moving nutrition from one-size-fits-all prescriptions toward dynamic, person-centered, sensory-aware interventions. Full article

(This article belongs to the Special Issue Nutrient Interaction, Metabolic Adaptation and Healthy Aging)

36 pages, 1016 KB

Open AccessReview

Vitamin Supplementation in Sports: A Decade of Evidence-Based Insights

by Magdalena Wiacek, Emilia Nowak, Piotr Lipka, Remigiusz Denda and Igor Z. Zubrzycki

Nutrients 2026, 18(2), 213; https://doi.org/10.3390/nu18020213 - 9 Jan 2026

Abstract

Background: Vitamins are micronutrients involved in multiple physiological processes critical for athletic performance. Because athletes are often exposed to increased oxidative stress, higher metabolic turnover, and greater nutritional demands, which can potentially lead to deficiencies in vitamins, understanding vitamin supplementation as a [...] Read more.

Background: Vitamins are micronutrients involved in multiple physiological processes critical for athletic performance. Because athletes are often exposed to increased oxidative stress, higher metabolic turnover, and greater nutritional demands, which can potentially lead to deficiencies in vitamins, understanding vitamin supplementation as a function of sport discipline is of fundamental importance. Methods: This narrative review synthesizes research findings from the past decade, supplemented with earlier studies where necessary, focusing on vitamins A, C, D, E, and the B-complex vitamins. Peer-reviewed literature was evaluated for evidence on the prevalence of deficiencies in athletes, physiological mechanisms, supplementation strategies, and their effects on performance, injury prevention, and recovery. Results: Vitamin D deficiency is highly prevalent among athletes, particularly in indoor sports and during the winter months. Supplementation has been shown to improve musculoskeletal health and potentially reduce injury risk. The antioxidant vitamins C and E can attenuate exercise-induced oxidative stress and muscle damage; however, excessive intake may impair adaptive responses such as mitochondrial biogenesis and protein synthesis. Vitamin A contributes to immune modulation, metabolic regulation, and mitochondrial function, while B-complex vitamins support energy metabolism and red blood cell synthesis. Conclusions: Vitamin supplementation in athletes should be individualized, targeting confirmed deficiencies and tailored to sport-specific demands, age, sex, and training intensity. Dietary optimization should remain the primary strategy, with supplementation serving as an adjunct when intake is insufficient. Further high-quality, sport-specific, and long-term studies are needed to establish clear dosing guidelines and to assess the balance between performance benefits and potential risks associated with over-supplementation. Full article

(This article belongs to the Special Issue Vitamins and Human Health: 3rd Edition)

13 pages, 499 KB

Open AccessArticle

Prevalence of Clinical and Pre-Clinical Obesity at Six Months Postpartum Following Gestational Diabetes Mellitus

by Cristina Gómez Fernández, Laura A. Magee, Marietta Charakida, Tanvi Mansukhani, Peter von Dadelszen, Cristina Fernández Pérez, Francesco Rubino and Kypros H. Nicolaides

Nutrients 2026, 18(2), 212; https://doi.org/10.3390/nu18020212 - 9 Jan 2026

Abstract

Background/Objectives: A number of initiatives have refocused attention from obesity to adiposity-related organ dysfunction. In this prospective observational study, we examined this paradigm postpartum. Methods: At King’s College Hospital, London, UK, we invited for review by six months postpartum, consecutive women [...] Read more.

Background/Objectives: A number of initiatives have refocused attention from obesity to adiposity-related organ dysfunction. In this prospective observational study, we examined this paradigm postpartum. Methods: At King’s College Hospital, London, UK, we invited for review by six months postpartum, consecutive women with GDM (N = 1442, September 2023–August 2025) and without GDM (N = 646, January 2025–August 2025). Those with excess adiposity (BMI ≥ 30 kg/m² and waist-to-height ratio > 0.5) were assessed for organ dysfunction, using criteria from a recent Commission: anovulation, metabolism or renal clusters, raised blood pressure, or elevated end-diastolic left ventricular filling pressure. Multiple regression determined predictors of adiposity-related organ dysfunction, the prevalence of which was calculated as a range (highest estimate: absolute organ dysfunction prevalence; lowest estimate: adiposity-adjusted, as highest estimate minus prevalence of organ dysfunction in women without excess adiposity). Results: Of those invited for review, 1086/1442 (75.3%) GDM and 562/646 (87.0%) non-GDM women attended, at median 5.8 months after birth (interquartile range 4.8–6.7). Excess adiposity was observed in 385/1086 (35.5%) GDM and 117/562 (20.8%) non-GDM women, among whom organ dysfunction was seen in 61.0% GDM (235/385), 51.3% non-GDM (60/117). 35.9% (408/1137) of women without excess adiposity. Organ dysfunction attributable to excess adiposity was estimated to be 22.9% (58.8% minus 35.9%), and was poorly predicted by the multivariable model (AUC 0.64, 95%CI 0.60–0.69). Conclusions: Among women with prior GDM, organ dysfunction attributable to excess adiposity affects at least 20% of those with excess adiposity postpartum, and is not currently predictable. Full article

(This article belongs to the Section Nutrition and Metabolism)

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19 pages, 2471 KB

Open AccessArticle

Modulation of the Kynurenine Pathway in Obese Mexican Navy Women Following a Structured Weight Loss Program: A Pre–Post-Intervention Study

by Laura Sánchez-Chapul, Daniela Ramírez-Ortega, María Alejandra Samudio-Cruz, Elizabeth Cabrera-Ruiz, Alexandra Luna-Angulo, Gonzalo Pérez de la Cruz, Jesús F. Valencia-León, Paul Carillo-Mora, Carlos Landa-Solís, Edgar Rangel-López, Abril Morraz-Varela, Marco Tulio Romero-Sánchez and Verónica Pérez de la Cruz

Nutrients 2026, 18(2), 211; https://doi.org/10.3390/nu18020211 - 9 Jan 2026

Abstract

Background: Obesity is characterized by chronic low-grade inflammation and metabolic disturbances, including an altered tryptophan (Trp) catabolism through the kynurenine pathway (KP). Since the KP is closely linked to immune activity, energy metabolism, and hepatic function, modulating its flux through lifestyle interventions has [...] Read more.

Background: Obesity is characterized by chronic low-grade inflammation and metabolic disturbances, including an altered tryptophan (Trp) catabolism through the kynurenine pathway (KP). Since the KP is closely linked to immune activity, energy metabolism, and hepatic function, modulating its flux through lifestyle interventions has gained interest as a potential therapeutic strategy. Objective: This exploratory study aimed to investigate the impact of a structured 12-week weight loss program (WLP) on serum KP metabolites in a sample of Mexican women with obesity. Methods: This study involved a pre–post-intervention design conducted in twenty-four women with clinically diagnosed obesity from the Mexican Navy who underwent a structured 12-week weight loss program combining a hypocaloric diet with moderate-intensity aerobic exercise; no control group was included. Anthropometric parameters, serum biochemistry, and circulating levels of Trp, kynurenine (KYN), kynurenic acid (KYNA), and 3-hydroxykynurenine (3-HK) were assessed before and after intervention. Psychological assessments of anxiety and depression were also conducted in a subset of participants. Results: The WLP significantly reduced body weight, BMI, fat mass, fasting insulin, and C-reactive protein levels. Serum concentrations of Trp, KYN, and KYNA decreased, while 3-HK showed a non-significant upward trend. Enzymatic indexes revealed a significant increase in the 3-HK/KYN ratio and a decrease in the KYNA/3-HK ratio, suggesting a shift toward kynurenine monooxygenase (KMO) branch. Notably, higher KYNA-related ratios were inversely associated with depressive symptoms. Conclusions: These findings position the KP as a responsive metabolic interface potentially linking improvements in body composition, liver function, and psychological status during structured weight loss efforts. Full article

(This article belongs to the Special Issue Dietary and Exercise Interventions to Target Obesity and Chronic Diseases)

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20 pages, 3010 KB

Open AccessArticle

N-Acetylglucosamine and Immunoglobulin Strengthen Gut Barrier Integrity via Complementary Microbiome Modulation

by Emma De Beul, Jasmine Heyse, Michael Jurgelewicz, Aurélien Baudot, Lam Dai Vu and Pieter Van den Abbeele

Nutrients 2026, 18(2), 210; https://doi.org/10.3390/nu18020210 - 9 Jan 2026

Abstract

Background: Gut barrier dysfunction and altered gut microbial metabolism are emerging signatures of chronic gut disorders. Considering growing interest in combining structurally and mechanistically distinct bioactives, we investigated the individual and combined effects of serum-derived bovine immunoglobulin (SBI) and N-acetylglucosamine (NAG) [...] Read more.

Background: Gut barrier dysfunction and altered gut microbial metabolism are emerging signatures of chronic gut disorders. Considering growing interest in combining structurally and mechanistically distinct bioactives, we investigated the individual and combined effects of serum-derived bovine immunoglobulin (SBI) and N-acetylglucosamine (NAG) on the gut microbiome and barrier integrity. Methods: The validated ex vivo SIFR^® (Systemic Intestinal Fermentation Research) technology, using microbiota from healthy adults (n = 6), was combined with a co-culture of epithelial/immune (Caco-2/THP-1) cells. Results: While SBI and NAG already significantly improved gut barrier integrity (TEER, transepithelial electrical resistance, +21% and +29%, respectively), the strongest effect was observed for SBI_NAG (+36%). This potent combined effect related to the observation that SBI and NAG each induced distinct, complementary shifts in microbial composition and metabolite output. SBI most selectively increased propionate (~Bacteroidota families) and health-associated indole derivatives (e.g., indole-3-propionic acid), while NAG most specifically boosted acetate and butyrate (~Bifidobacteriaceae, Ruminococcaceae, and Lachnospiraceae). The combination of SBI_NAG displayed effects of the individual ingredients, thus, for instance, enhancing all three short-chain fatty acids (SCFA) and elevating microbial diversity (CMS, community modulation score). Conclusions: Overall, SBI and NAG exert complementary, metabolically balanced effects on the gut microbiota, supporting combined use, particularly in individuals with gut barrier impairment or dysbiosis linked to lifestyle or early-stage gastrointestinal disorders. Full article

(This article belongs to the Special Issue The Role of Diet and Medication in Shaping Gut Microbiota in Disease)

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21 pages, 1610 KB

Open AccessReview

The Impact of Nutritional Status on Survival and Development of Sarcoidosis: A Scoping Review of Current Evidence and Research Gaps

by Jacek Kobak, Angelika Szymańczyk, Martyna Liśkiewicz-Jankowska, Monika Cichoń-Kotek and Mateusz Szczupak

Nutrients 2026, 18(2), 209; https://doi.org/10.3390/nu18020209 - 9 Jan 2026

Abstract

Background: Sarcoidosis is a heterogeneous, multisystem inflammatory disease with an unpredictable clinical course and limited prognostic markers. Increasing attention has focused on nutritional and metabolic factors—particularly obesity, body composition, and calcium–vitamin D metabolism—as potentially modifiable elements associated with disease development and clinical [...] Read more.

Background: Sarcoidosis is a heterogeneous, multisystem inflammatory disease with an unpredictable clinical course and limited prognostic markers. Increasing attention has focused on nutritional and metabolic factors—particularly obesity, body composition, and calcium–vitamin D metabolism—as potentially modifiable elements associated with disease development and clinical phenotype. However, the available literature remains fragmented and methodologically heterogeneous. Objective: To systematically map current evidence on the relationship between nutritional status and the development, clinical course, and prognosis of sarcoidosis, and to identify key gaps requiring further research. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute methodology and the PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, Cochrane Library, EBSCO, and Google Scholar were searched for studies published between 2015 and 2025. Eligible studies included adult patients with sarcoidosis and addressed nutritional status broadly defined, encompassing anthropometric measures, body composition, immunonutritional indices, nutrition-related biomarkers, dietary factors, and supplementation practices. Due to substantial heterogeneity in exposure definitions and outcome measures, no quantitative synthesis or formal methodological quality appraisal was performed. Results: Eighteen studies, predominantly observational, were included. The most consistent findings concerned anthropometric parameters, with overweight and obesity showing the strongest association with an increased risk of sarcoidosis and, in selected studies, with reduced exercise capacity and greater disease burden. Evidence linking nutritional status to prognosis was indirect, while direct data on sarcoidosis-specific survival were lacking. Disturbances in calcium–vitamin D metabolism were frequent and clinically relevant, particularly in the context of supplementation-related hypercalcemia. Conclusions: Current evidence suggests that nutritional status—particularly excess body weight—and selected metabolic and immunonutritional factors are associated with sarcoidosis. However, given the largely observational nature of the available data and the lack of formal assessment of methodological quality, these results should be interpreted as association mapping and hypothesis generation rather than as evidence of causality. Well-designed prospective and interventional studies using standardized nutritional assessment tools and clinically relevant endpoints are needed to clarify the role of nutritional factors in sarcoidosis. Full article

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

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14 pages, 1469 KB

Open AccessArticle

Therapeutic Effect of Arginine, Glutamine and β-Hydroxy β-Methyl Butyrate Mixture as Nutritional Support on DSS-Induced Ulcerative Colitis in Rats

by Elvan Yılmaz Akyüz, Cebrail Akyüz, Ezgi Nurdan Yenilmez Tunoglu, Meryem Dogan, Banu Bayram and Yusuf Tutar

Nutrients 2026, 18(2), 208; https://doi.org/10.3390/nu18020208 - 9 Jan 2026

Abstract

Background: Ulcerative colitis (UC) is characterized by chronic mucosal inflammation, oxidative stress, and disruption of intestinal metabolic homeostasis. Immunomodulatory nutrients such as arginine, glutamine, and β-hydroxy β-methylbutyrate (HMB) have shown potential benefits; however, their combined molecular effects on UC remain insufficiently defined. Objective: [...] Read more.

Background: Ulcerative colitis (UC) is characterized by chronic mucosal inflammation, oxidative stress, and disruption of intestinal metabolic homeostasis. Immunomodulatory nutrients such as arginine, glutamine, and β-hydroxy β-methylbutyrate (HMB) have shown potential benefits; however, their combined molecular effects on UC remain insufficiently defined. Objective: To investigate the individual and combined effects of arginine, glutamine, and HMB on inflammatory and metabolic gene expression, oxidative stress markers, and histopathological outcomes in a dextran sulfate sodium (DSS)-induced colitis model. Methods: Female Sprague Dawley rats were assigned to six groups: control, DSS, DSS + arginine, DSS + glutamine, DSS + HMB, and DSS + mixture. Colitis was induced using 3% DSS. Colon tissues were examined histologically, serum MDA, MPO, and GSH levels were quantified, and mRNA expression of IL6, IL10, COX2, NOS2, ARG2, CCR1, and ALDH4A1 was measured by RT-qPCR. Pathway enrichment analyses were performed to interpret cytokine and metabolic network regulation. Results: DSS induced severe mucosal injury, elevated MDA and MPO, reduced GSH, and significantly increased IL6, COX2, NOS2, ARG2, and CCR1 expression. Glutamine demonstrated the strongest anti-inflammatory and antioxidant effects by decreasing IL6 and COX2 and restoring GSH. Arginine primarily modulated nitric oxide–related pathways, whereas HMB increased ALDH4A1 expression and metabolic adaptation. The combination treatment produced more balanced modulation across inflammatory, chemokine, and metabolic pathways, consistent with enrichment results highlighting cytokine signaling and amino acid metabolism. Histopathological improvement was greatest in the mixture group. Conclusions: Arginine, glutamine, and HMB ameliorate DSS-induced colitis through coordinated regulation of cytokine networks, oxidative stress responses, and metabolic pathways. Their combined use yields broader and more harmonized therapeutic effects than individual administration, supporting their potential as targeted immunonutritional strategies for UC. Rather than targeting a single inflammatory mediator, this study was designed to test whether combined immunonutrient supplementation could promote coordinated regulation of cytokine signaling, oxidative stress responses, and metabolic adaptation, thereby facilitating mucosal repair in experimental colitis. Full article

(This article belongs to the Special Issue Dietary Interventions for Functional Gastrointestinal Disorders)

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21 pages, 842 KB

Open AccessReview

Caesarean Delivery Influences Breast Milk Composition—A Narrative Review

by Maciej Maj, Joanna Robaczyńska, Maja Owe-Larsson, Hubert Rytel, Bożena Kociszewska-Najman, Jacek Malejczyk and Izabela Róża Janiuk

Nutrients 2026, 18(2), 207; https://doi.org/10.3390/nu18020207 - 9 Jan 2026

Abstract

Delivery by caesarean section (CS) is increasingly common worldwide and has been associated with altered health outcomes in offspring, which can be partially mitigated with breastfeeding. Interestingly, the mode of delivery itself may influence the composition of human milk. The aim of this [...] Read more.

Delivery by caesarean section (CS) is increasingly common worldwide and has been associated with altered health outcomes in offspring, which can be partially mitigated with breastfeeding. Interestingly, the mode of delivery itself may influence the composition of human milk. The aim of this narrative review was to comprehensively examine current evidence on the impact of CS on breast milk composition and to discuss its potential implications for neonatal and infant health. A literature search of the MEDLINE database was conducted in July 2025. It identified 1212 studies addressing associations between mode of delivery and human milk components, of which 54 were included in the qualitative synthesis. Available evidence suggests that CS is associated with transient, lactation stage-dependent alterations in breast milk composition, most pronounced in colostrum and transitional milk. Reported changes include differences in macronutrients, mineral content, immune-related molecules, hormones, antioxidants, microbiota, microRNA profiles, and other bioactive components. Findings related to mature milk are less consistent and often influenced by confounding factors. While some CS-associated alterations may slightly reduce the beneficial effect of breastfeeding, e.g., reducing certain antimicrobial or nutritional components, other changes seem to be potentially advantageous for the neonate/infant after CS, in particular in immune-related factors. Overall, the clinical significance of these compositional differences remains unclear, as no studies have directly linked CS-related changes in milk composition to long-term infant outcomes. Further well-designed longitudinal studies are needed to clarify these associations. Regardless of delivery mode, breastfeeding remains the optimal feeding strategy and a key intervention to support infant health after CS. Full article

(This article belongs to the Special Issue Explore the Nutritional Composition of Human Milk and Its Impact on Infant Formula Development and Human Health)

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