Nutrients

18 pages, 303 KB

Open AccessArticle

Dairy Products Are Not Adversely Associated with Depressive Symptoms over 6 Years in the Hispanic Community Health Study/Study of Latinos

by Anne Bodenrader, Daniela Sotres-Alvarez, Maria Carlota Dao, Tammy M. Scott, Semra A. Aytur, Sabrina E. Noel, Qibin Qi, Linda C. Gallo, Martha Daviglus, Wassim Tarraf, Robert Kaplan and Sherman J. Bigornia

Nutrients 2026, 18(11), 1805; https://doi.org/10.3390/nu18111805 - 3 Jun 2026

Abstract

Background/Objectives: Current evidence suggests that Hispanic/Latino adults experience a disproportionate burden of depression. Dairy consumption has been associated with fewer depressive symptoms, but examinations in Hispanic/Latino cohorts are unavailable. Our objective was to measure the 6-year prospective associations between dairy consumption and [...] Read more.

Background/Objectives: Current evidence suggests that Hispanic/Latino adults experience a disproportionate burden of depression. Dairy consumption has been associated with fewer depressive symptoms, but examinations in Hispanic/Latino cohorts are unavailable. Our objective was to measure the 6-year prospective associations between dairy consumption and depressive symptoms among Hispanic/Latino adults. Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective population-based cohort study of 16,415 Hispanic/Latino adults residing in the US. We estimated daily dairy product consumption from two 24 h baseline dietary recalls using the National Cancer Institute method. The 10-item Center for Epidemiological Studies Depression Scale (CESD10) administered at baseline and follow-up assessed depressive symptoms. Survey multiple linear regression models adjusted for baseline CESD10 and other covariates, including sociodemographic, dietary and health factors. Standardized β coefficients represent the standard deviation difference in 6-year CESD10 score per one standard deviation increase in daily dairy intake at baseline. Complete data were available among 10,618 participants. Results: Neither baseline total dairy consumption (standardized β (95% CI); −0.019 (−0.048, 0.011)), nor milk (−0.006 (−0.029, 0.018)), cheese (0.038 (−0.006, 0.081)), or cream (−0.005 (−0.037, 0.028), p > 0.05 for all) consumption was significantly associated with the follow-up CESD10 score. Conversely, we observed a significant and inverse association between yogurt (−0.036 (−0.058, −0.013), p = 0.002) and butter (−0.049 (−0.092, −0.006), p = 0.027) with the CESD10 score. Conclusions: Total dairy, fat-based dairy groupings, milk, cheese, and cream were not associated with CESD10 score at 6-year follow-up; yogurt and butter showed inverse associations that require cautious interpretation due to very small effect sizes. Although additional prospective analyses in other diverse cohorts are needed to confirm these results, our findings suggest that dairy consumption is not adversely associated with depressive symptoms in Hispanic/Latino adults. Full article

(This article belongs to the Section Nutritional Epidemiology)

15 pages, 284 KB

Open AccessArticle

Nutritional Status and Physical Activity Levels in Adult Patients with Phenylketonuria

by Damla Kalkan, Yılmaz Yıldız, Yiğitcan Karanfil, Feza Korkusuz, Ali Dursun, Serap Sivri and Hülya Gökmen Özel

Nutrients 2026, 18(11), 1804; https://doi.org/10.3390/nu18111804 - 3 Jun 2026

Abstract

Background/Objectives: Phenylketonuria (PKU) is a rare autosomal recessive disorder caused by phenylalanine hydroxylase (PAH) deficiency, impairing the conversion of phenylalanine (Phe) to tyrosine. Although early diagnosis and intervention yield excellent outcomes, dietary adherence often declines in adulthood, potentially leading to poor metabolic control [...] Read more.

Background/Objectives: Phenylketonuria (PKU) is a rare autosomal recessive disorder caused by phenylalanine hydroxylase (PAH) deficiency, impairing the conversion of phenylalanine (Phe) to tyrosine. Although early diagnosis and intervention yield excellent outcomes, dietary adherence often declines in adulthood, potentially leading to poor metabolic control and adverse nutritional consequences. This study aimed to evaluate physical activity levels, nutritional status, metabolic control, and anthropometric outcomes in adults with classic PKU, which have not been sufficiently researched in the current literature. Methods: This cross-sectional study included 100 adults with classical PKU (cPKU; baseline phenylalanine levels ≥ 1200 µmol/L) under regular follow-up at the Division of Metabolism, Hacettepe İhsan Doğramacı Childrens’ Hospital. Sociodemographic traits and dietary behaviors were evaluated through structured interviews carried out by a dietitian. Dietary intake was assessed by using a 24 h dietary recall method, and nutrient analyses were performed with the Bebis 7.2 software program. Using the short version of the International Physical Activity Questionnaire (IPAQ), physical activity levels were specified, and participants were categorized according to established scoring criteria. Results: A hundred adults with classical PKU took part in the study, including 47 males and 53 females, with a mean age of 23.84 ± 5.41 years; 5% of participants were underweight, 40% had normal weight, 39% were overweight, and 16% were listed as obese. The intake of mean daily energy is 2443.8 ± 384.6 kcal for men and 1822.5 ± 312.7 kcal for women. Carbohydrates contributed approximately 61% of total daily energy intake in both genders, whereas protein accounted for 12–13% and fat for approximately 26–27% of total energy intake; 17% of participants were physically inactive, 40% were minimally active, and 43% met criteria for sufficient physical activity according to IPAQ-based classification. Energy intake, the use of Phe-free protein substitutes, and BMI were significantly higher in the sufficiently active group compared to the low-active group in men, while no significant differences were observed between physical activity groups among women. Conclusions: Adults with classical PKU showed a high prevalence of overweight and obesity, together with differences in dietary intake and physical activity patterns. Physical activity levels were associated with several nutritional and metabolic characteristics; however, further long-term research is required to fully understand these connections. Full article

(This article belongs to the Special Issue Dietary Amino Acid Metabolism in Human Health and Disease)

15 pages, 3900 KB

Open AccessArticle

Omega Fatty Acid and Protein Profiles of Colostrum and Transitional Milk in Mexican Women With and Without Gestational Diabetes: A Cross-Sectional Study

by Larissa Martínez-Ortega, Carlos A. Ibáñez, Isabel Omaña-Guzmán, Consuelo Lomas Soria, José Leopoldo Aguilar Faisal, Omar Granados Portillo, Ana Méndez Carballo, Emilia Lozano González, Fausto Coronel Cruz, José Carranco Martínez, Víctor Carmona Ornelas, Nayely Garibay-Nieto and Elena Zambrano

Nutrients 2026, 18(11), 1803; https://doi.org/10.3390/nu18111803 - 3 Jun 2026

Abstract

Background/Objectives: Gestational Diabetes Mellitus (GDM) involves metabolic alterations that may affect breast milk composition. Imbalances in protein and fatty acid (FA) profiles have been reported in mature milk from mothers with GDM. However, evidence for colostrum and transitional milk is limited, despite [...] Read more.

Background/Objectives: Gestational Diabetes Mellitus (GDM) involves metabolic alterations that may affect breast milk composition. Imbalances in protein and fatty acid (FA) profiles have been reported in mature milk from mothers with GDM. However, evidence for colostrum and transitional milk is limited, despite the key role of ω-3 and ω-6 Polyunsaturated fatty acids (PUFAs) in neonatal neurodevelopment. This study compared ω-3 and ω-6 PUFAs and protein concentrations in colostrum and transitional milk from women with and without GDM. Methods: This cross-sectional study was conducted from January 2023 to December 2024. Women aged ≥ 18 years with GDM and non-GDM pregnancies recruited at Hospital General de México “Dr. Eduardo Liceaga” were included. Colostrum and transitional milk samples were collected at 0–5 and 6–14 days postpartum, respectively. To assess whether postpartum time (hours) and maternal group (non-GDM vs. GDM) affected milk volume, an analysis of covariance (ANCOVA) was performed. Differences in milk composition between the GDM and non-GDM groups were assessed using Student’s t test or the Mann–Whitney U test, according to variable distribution. Results: A total of 71 milk samples were analyzed: 51 colostrum samples (25 from women with GDM and 26 from women with non-GDM) and 20 transitional milk samples (10 from women with GDM and 10 from women with non-GDM). A moderate correlation was observed between milk volume and postpartum time, with no significant differences between the GDM and non-GDM groups. Colostrum from women with GDM had lower protein content compared with milk from women with non-GDM (3.8 ± 0.4 vs. 5.2 ± 0.5 g/dL, p = 0.02) and transitional milk (1.4 ± 0.2 vs. 2.2 ± 0.2 g/dL, p = 0.02). Transitional milk from GDM group showed higher total fat (5.7 ± 1.8 vs. 2.0 ± 0.4 g/100 g, p = 0.05) and fat-to-protein ratio (3.9 ± 1.1 vs. 1.0 ± 0.3, p = 0.02), along with an increased ω-6/ω-3 ratio driven by higher linoleic acid and lower α-linolenic acid concentrations. Conclusions: GDM was associated with variations in breast milk protein and FA profiles with a potential negative impact on the newborn’s neurodevelopment. Full article

(This article belongs to the Special Issue Breast Milk Composition and Feeding Strategies for Healthy Infant Growth)

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14 pages, 511 KB

Open AccessFeature PaperArticle

Effect of Oat Flakes on Glycemic Variability, Dyslipidemia, and Pancreatic Duodenum Homeobox-1 (PDX-1) Level Among Adolescents with Type 1 Diabetes: A Randomized Crossover Study

by Mohamed Abu El Asrar Afify, Sara Ibrahim Taha, Eman Mohamed El Kholy and Nouran Yousef Salah

Nutrients 2026, 18(11), 1802; https://doi.org/10.3390/nu18111802 - 3 Jun 2026

Abstract

Aims: Murine studies show a promising effect of high-fiber β-glucan on glycemic control and serum lipids. In addition, β-glucan has recently been found to have strong antioxidant and immunomodulatory effects. Oat flakes are a natural source of β-glucan. However, the effects of [...] Read more.

Aims: Murine studies show a promising effect of high-fiber β-glucan on glycemic control and serum lipids. In addition, β-glucan has recently been found to have strong antioxidant and immunomodulatory effects. Oat flakes are a natural source of β-glucan. However, the effects of oat flakes on glycemic variability, dyslipidemia, and pancreatic duodenum homeobox-1 (PDX-1) levels in type 1 diabetes (T1D) remain unclear. Hence, this study assessed the effect of oat flakes on glycemic variability, dyslipidemia, and PDX-1 among adolescents with T1D. Materials and Methods: Sixty adolescents with T1D were divided into 2 equally matched groups. Group A received oat flakes ß-glucan 6 g per day for 3 months in addition to an ordinary diet and insulin regimen. Group B received an ordinary diet and insulin regimen. This was followed by crossing over both arms for another 3 months after a two-week washout period. All participants underwent auxological assessment, continuous glucose monitoring (CGM), hemoglobin A1c (HbA1c), fasting lipids, and PDX-1 measurements at baseline, 3 months, and 6 months. Results: Oat flakes consumption resulted in a significant decrease in the coefficient of variation, HbA1c, serum cholesterol, triglycerides, and LDL-C levels (p < 0.001), with a significant increase in TIR, HDL-C, and PDX-1 levels (p < 0.001). However, all these effects waned after the stoppage of the oat flakes, except for HDL-C. Conclusions: Oat flakes have a favorable outcome on glycemic metrics, lipid profile, and PDX-1 in adolescents with T1D. Full article

(This article belongs to the Special Issue Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes)

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23 pages, 1306 KB

Open AccessArticle

Efficacy and Safety of Sakurajima Radish in Patients with Metabolic Syndrome: A Phase IIb Randomized, Three-Period Crossover Trial

by Akihiro Tokushige, Yuichi Akasaki, Keisuke Shibata, Takashi Sakoda, Akari Tajima, Takashi Kajiya, Naohiro Shirasawa, Narisato Hamada, Akiko Yoshikawa, Kazuyuki Kubota, Tsuminori Yamashita, Kenjuro Higo, Takuro Kubozono, Kouta Funakoshi, Ryota Kawai, Hisako Yoshida, Ayumi Shintani, Katsuko Kajiya and Mitsuru Ohishi

Nutrients 2026, 18(11), 1801; https://doi.org/10.3390/nu18111801 - 3 Jun 2026

Abstract

Background/Objectives: We aimed to evaluate the efficacy and safety of a short-term dietary intervention using trigonelline-rich Sakurajima radish on vascular endothelial function in patients with metabolic syndrome (MetS). Methods: In this multicenter, open-label, randomized, three-period crossover phase IIb trial, 21 patients with MetS [...] Read more.

Background/Objectives: We aimed to evaluate the efficacy and safety of a short-term dietary intervention using trigonelline-rich Sakurajima radish on vascular endothelial function in patients with metabolic syndrome (MetS). Methods: In this multicenter, open-label, randomized, three-period crossover phase IIb trial, 21 patients with MetS were assigned to three 14-day sequences (Sakurajima radish powder, Aokubi radish powder, and a usual diet), separated by 14-day washouts. The primary outcome was flow-mediated dilation (FMD). Key Secondary outcomes included blood pressure (BP), urinary nitric oxide metabolites (NOx), and the oxidative stress marker 8-hydroxy-2′-deoxyguanosine (8-OHdG). Results: Sakurajima radish did not improve FMD versus the usual diet (p = 0.58) or Aokubi radish (p = 0.59), although a significant negative carryover effect following the Aokubi period likely confounded this estimation. Despite successfully stimulating NO production (elevated urinary NOx, p = 0.03), the intervention paradoxically increased oxidative stress (elevated 8-OHdG/creatinine, p = 0.02) and significantly elevated systolic BP compared with the usual diet (+9.67 mmHg, p = 0.03) and Aokubi radish (+8.86 mmHg, p = 0.04). Conclusions: Sakurajima radish does not appear to improve endothelial function in patients with MetS within the constraints of this short-term crossover design. Importantly, the unexpected negative carryover effect inherently limits the interpretability of this primary FMD outcome, as it may have masked potential physiological benefits. Despite boosting NO production, the intervention paradoxically exacerbated systemic oxidative stress and elevated systolic BP. These findings suggest that in the pro-oxidant environment of MetS, NO-boosting functional foods may induce unintended adverse hemodynamic responses, underscoring the need for careful risk–benefit evaluation and parallel-group trial designs in this specific population. Full article

(This article belongs to the Section Clinical Nutrition)

18 pages, 910 KB

Open AccessArticle

Psychological Determinants of Purchasing Behavior Among Individuals Indifferent to Reduced-Salt Products

by Yasunori Akamatsu, Misako Nakadate, Nanae Tanemura and Masuko Kobori

Nutrients 2026, 18(11), 1800; https://doi.org/10.3390/nu18111800 - 3 Jun 2026

Abstract

Background/Objectives: To promote salt reduction before health problems arise, it is important to understand factors associated with reduced-salt product purchasing among consumers with low interest in such products. This study examined psychological determinants of intention to purchase reduced-salt products among Japanese adults who [...] Read more.

Background/Objectives: To promote salt reduction before health problems arise, it is important to understand factors associated with reduced-salt product purchasing among consumers with low interest in such products. This study examined psychological determinants of intention to purchase reduced-salt products among Japanese adults who were not actively purchasing them. Methods: An exploratory sequential mixed-methods design was used, including qualitative interviews followed by a cross-sectional web-based survey of 800 men and women aged 18–59 years in Japan. Participants were categorized into precontemplation and contemplation stages based on the transtheoretical model. Associations between purchase intention and three Integrated Behavioral Model categories—attitude, perceived norm, and personal agency—were examined. Percentage-to-gain values were calculated for each belief item. Results: All three category scores were significantly associated with purchase intention, with attitude showing the strongest association (OR = 12.56, 95% CI: 6.93–22.79). In stratified analysis, attitude showed a stronger association in the precontemplation stage (OR = 18.40, 95% CI: 8.51–39.78), whereas no category score was significantly associated with purchase intention in the contemplation stage. In the precontemplation stage, relatively high percentage-to-gain values were observed for holistic wellness-oriented beliefs and product availability in usual supermarkets. Conclusions: Attitude was most strongly associated with intention to purchase reduced-salt products, particularly in the precontemplation stage. Holistic wellness-oriented beliefs and product availability may represent promising targets for future communication or food environment interventions. These findings may provide a basis for future studies testing strategies to increase actual purchases of reduced-salt products and reduce salt intake. Full article

(This article belongs to the Special Issue Food Environments, Dietary Behaviors, and Population Health)

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25 pages, 2643 KB

Open AccessReview

Age-Specific Analysis of the Effects of Intermittent Fasting on Body Composition and Cardiometabolic Markers in Healthy Adults and Individuals with Overweight or Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Kaijun Xing, Ruihan Liu, Shenglin Peng, Xuanxuan Zi, Linxi Lian, Bowen Yang, Yangyang Cen, Yichao Li, Yi Zhao and Yannan Zhang

Nutrients 2026, 18(11), 1799; https://doi.org/10.3390/nu18111799 - 3 Jun 2026

Abstract

Background: Intermittent fasting (IF) is a popular dietary strategy for improving weight and cardiometabolic health. However, its effectiveness and potential risks across different adult age trajectories remain unclear. This systematic review and meta-analysis evaluated the age-specific effects of IF on body composition [...] Read more.

Background: Intermittent fasting (IF) is a popular dietary strategy for improving weight and cardiometabolic health. However, its effectiveness and potential risks across different adult age trajectories remain unclear. This systematic review and meta-analysis evaluated the age-specific effects of IF on body composition and cardiometabolic markers. Methods: Following PRISMA 2020 guidelines, PubMed, Scopus, and Web of Science were searched for randomized controlled trials (RCTs) up to September 2025. Participants were stratified into three cohorts: <30 years, 30–44 years, and ≥45 years. Random-effects meta-analyses and leave-one-out sensitivity analyses were conducted on body composition, lipid profiles, glycemic markers, and blood pressure. Additionally, a conservative methodological sensitivity analysis (imputed correlation r = 0.5) and subgroup analyses by fasting modality (TRF vs. intermittent energy restriction) were performed. Risk of bias was assessed using the RoB 2 tool. Results: Analysis of 28 RCTs (N = 1833) demonstrated that IF significantly reduced body weight and BMI across all age groups. Notably, subgroup analyses revealed comparable physiological responses between TRF and intermittent energy restriction modalities. Cardiometabolic adaptations were highly age-dependent. Young adults exhibited significant reductions in fasting insulin and HOMA-IR, alongside a robust reduction in fat mass. However, a significant loss of fat-free mass (FFM) was observed in both young and older cohorts. While early middle-aged and middle-aged and older adults experienced the most pronounced improvements in triglycerides, systolic blood pressure, and insulin sensitivity, our conservative sensitivity analysis unmasked a significant elevation in low-density lipoprotein cholesterol (LDL-C) in this group, mirroring the robust LDL-C increase observed in young adults. Early middle-aged adults exhibited highly variable responses with no significant overall improvements in cardiometabolic parameters. Conclusions: IF is an effective weight-management tool, but elicits distinct, age-specific metabolic trajectories. While early middle-aged and middle-aged and older adults derive pronounced cardiometabolic benefits, they face critical risks of lean mass depletion, necessitating a combined “IF+” strategy (adequate protein and resistance training). Crucially, the generalized risk of LDL-C elevation across age strata dictates a mandate for vigilant lipid monitoring. Given that the certainty of evidence was rated as low to very low per GRADE criteria, these age-specific patterns should be interpreted as hypothesis-generating, warranting validation in future large-scale trials. Full article

(This article belongs to the Section Nutrition and Metabolism)

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17 pages, 285 KB

Open AccessArticle

Assessment of a Non-Randomized Education Intervention for Primary School Aimed to Promote the Inclusion of People with Celiac Disease: Zeliakide Project (Part II)

by Maialen Vázquez-Polo, Virginia Navarro, Arrate Lasa, Idoia Larretxi, Gesala Perez-Junkera, Silvia Matias, Edurne Simón and Itziar Churruca

Nutrients 2026, 18(11), 1798; https://doi.org/10.3390/nu18111798 - 3 Jun 2026

Abstract

Background and Aim: The gluten-free diet (GFD) can have a huge impact on the quality of life of people with celiac disease (CD), especially on a social level. The objective of this work is to evaluate a structured nutrition education program focused on [...] Read more.

Background and Aim: The gluten-free diet (GFD) can have a huge impact on the quality of life of people with celiac disease (CD), especially on a social level. The objective of this work is to evaluate a structured nutrition education program focused on CD and GFD that aims to increase knowledge and improve inclusion attitudes about the disease in children. Methods: This is a one-month intervention for school children aged 10–12 years called Zeliakide (8 sessions). It was carried out through a STEAM methodology, using inquiry-based learning. The participants responses were evaluated through questionnaires before and after the intervention, and participants were also followed up one month later. The control group was a similar group of students who followed their regular school curriculum. Results: 299 children from one school of Vitoria-Gasteiz took part in the study (155 intervention group; 144 control group). Zeliakide significantly improved knowledge about CD and GFD in children, and this knowledge was retained for one month. Concretely, students increased their ability to explain what CD is, to assess gluten, and to classify food groups according to gluten content. The intervention contributed to augmenting the selection of behaviors to overcome differences between individuals, assessed one month after the intervention. In addition, the program allowed students to understand the work of scientists. Conclusions: Zeliakide can contribute to nutrition education initiatives that aim to improve knowledge of CD and GFD in the general population, while promoting empathetic behavior towards people with CD. Registration: clinicaltrials.gov, NCT05467865 on 21 July 2022. Full article

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

20 pages, 1994 KB

Open AccessReview

Essential Trace Elements Zinc, Iron, Copper and Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Systematic Review and Meta-Analysis of Case–Control Studies

by Wei Wang, Lei Tian, Huiqiong Xu, Jixing Zhou and Menglong Geng

Nutrients 2026, 18(11), 1797; https://doi.org/10.3390/nu18111797 - 2 Jun 2026

Abstract

Essential trace elements such as zinc (Zn), iron (Fe), and copper (Cu) play a critical role in neurodevelopment, influencing key processes like neurotransmitter regulation and neuronal signaling. To synthesize the existing evidence, we conducted a systematic review and meta-analysis of case–control studies investigating [...] Read more.

Essential trace elements such as zinc (Zn), iron (Fe), and copper (Cu) play a critical role in neurodevelopment, influencing key processes like neurotransmitter regulation and neuronal signaling. To synthesize the existing evidence, we conducted a systematic review and meta-analysis of case–control studies investigating the associations between these trace elements and Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. A comprehensive literature search was performed up to March 2026 across multiple databases, including Web of Science, PubMed, and the Chinese National Knowledge Infrastructure. A total of 46 studies involving 5515 ADHD cases and 8166 controls were included. The results showed that Zn (SMD = −1.01, 95% CI: −1.51 to −0.52), Fe (SMD = −0.82, 95% CI: −1.52 to −0.11) and Ferritin (SMD = −0.54, 95% CI: −1.00 to −0.27) levels were significantly lower in children with ADHD than in controls, while no significant difference was observed for Cu levels (SMD = −0.55, 95% CI: −1.12 to 0.02). When the research subjects are limited to children ≤12 years old, the differences in Zn are more pronounced. Moreover, the differences in the levels of Zn, Fe, and Cu were more pronounced among children and adolescents from developing countries. These findings suggest that imbalances in Zn and Fe may be involved in the pathogenesis of ADHD. Further research is needed to validate early biomarkers of ADHD risk and to explore their potential application in clinical diagnosis and management, especially considering the high heterogeneity of the studies included in this study. Full article

(This article belongs to the Section Micronutrients and Human Health)

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61 pages, 2605 KB

Open AccessReview

Herbal Neurotherapeutics for Cognitive Disorders: Integrative Mechanisms Linking Neurotransmitter Systems, Neurodegeneration, and the Gut-Brain Axis

by Muntajin Rahman, Khadija Akter, Amama Rani, Moon Nyeo Park and Bonglee Kim

Nutrients 2026, 18(11), 1796; https://doi.org/10.3390/nu18111796 - 2 Jun 2026

Abstract

Cognitive disorders, including Alzheimer’s disease, Parkinson’s disease, schizophrenia, depression, and vascular dementia, are associated with dysregulation of neurotransmitter systems, including acetylcholine, dopamine, serotonin, glutamate, and γ-aminobutyric acid (GABA). These disorders are increasingly recognized as multifactorial conditions involving oxidative stress, neuroinflammation, mitochondrial dysfunction, synaptic [...] Read more.

Cognitive disorders, including Alzheimer’s disease, Parkinson’s disease, schizophrenia, depression, and vascular dementia, are associated with dysregulation of neurotransmitter systems, including acetylcholine, dopamine, serotonin, glutamate, and γ-aminobutyric acid (GABA). These disorders are increasingly recognized as multifactorial conditions involving oxidative stress, neuroinflammation, mitochondrial dysfunction, synaptic impairment, blood–brain barrier disruption, metabolic imbalance, and gut–brain axis dysregulation. Current pharmacological therapies may provide symptomatic relief; however, their clinical benefits are often limited and associated with adverse effects. Herbal medicines have gained increasing attention as potential complementary approaches for cognitive support and neuroprotection. Preclinical evidence and emerging clinical studies suggest that herbal bioactive compounds may exert neuroprotective effects through antioxidants, anti-inflammatory, and neurotransmitter-modulating mechanisms. Medicinal herbs such as Bacopa monnieri, Withania somnifera, Ginkgo biloba, Glycyrrhiza glabra, Moringa oleifera, and ginseng have shown potential cognitive benefits in experimental models and selected human studies. Advanced delivery systems, including nanoparticles and phytosomes, may further improve the bioavailability and brain-targeting efficiency of herbal compounds. However, current clinical evidence remains heterogeneous and limited by insufficient standardization, small sample sizes, and short study durations. Further large-scale clinical studies and standardized safety assessments are essential before herbal neurotherapeutics can be widely applied in cognitive and neurological disorders. Full article

(This article belongs to the Special Issue Dietary Factors and Interventions for Cognitive Neuroscience)

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16 pages, 6748 KB

Open AccessArticle

The Effect of Mobile Health Intervention on Prelacteal Feeding Among Mothers in the First Month After Birth in South Ethiopia: A Cluster-Randomized Controlled Trial

by Girma Gilano, Andre Dekker and Rianne Fijten

Nutrients 2026, 18(11), 1795; https://doi.org/10.3390/nu18111795 - 2 Jun 2026

Abstract

Introduction: Prelacteal feeding, the practice of giving newborns substances other than breast milk within the first few days of life, remains a common yet harmful practice in many low- and middle-income countries, including Ethiopia. No evidence in Ethiopia indicates that mHealth can help [...] Read more.

Introduction: Prelacteal feeding, the practice of giving newborns substances other than breast milk within the first few days of life, remains a common yet harmful practice in many low- and middle-income countries, including Ethiopia. No evidence in Ethiopia indicates that mHealth can help improve prelacteal feeding. This study aimed to evaluate the effect of mobile health (mHealth) intervention on reducing prelacteal feeding practices and improving antenatal care (ANC) and postnatal care (PNC) utilization among mothers in South Ethiopia. Methods: A cluster-randomized controlled trial (CRT) was conducted in rural areas of South Ethiopia. A total of 20 clusters were selected using simple random sampling for intervention (mHealth) and control groups, each containing 340 women. Mothers in the intervention group received automated weekly SMS messages and reminders on exclusive breastfeeding, prelacteal feeding risks, ANC, and PNC. Mothers were only selected if they could read, write, and use mobile phones. Results: The mHealth intervention significantly reduced prelacteal feeding practice (AOR = 0.19, 95% CI: 0.06–0.58); p < 0.05). Higher ANC visits related to decreased prelacteal feeding (AOR = 0.28, 95% CI: 0.21–0.39; p < 0.001). The log count of ANC visit increased by 0.14 among intervention groups (IRR = 1.15, 95% CI: 1.06–1.25; p < 0.001). The PNC time was delayed 2.05 days among controls (β = −2.05, 95% CI: −2.66–−1.42; p < 0.001). Maternal and partner education, postnatal time, and ANC visits influenced prelacteal feeding. Conclusions: This finding might suggest that mHealth can reduce prelacteal feeding practices and improve maternal healthcare behaviors such as ANC attendance and timely PNC. These findings highlight the potential of mobile health interventions in promoting healthy maternal and infant practices in rural settings, where healthcare access is limited. Further research is needed to explore the long-term impacts of such interventions on maternal and child health outcomes. Multi-level analysis reduced variability. However, an unexplained variance could be reduced by including more cluster-level variables. Full article

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

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32 pages, 4980 KB

Open AccessReview

Fungal β-1,3-glucans: Cell Wall Constituents That Promote Gut Health Through Innate Immune Modulation

by Fnu Samiksha, Drishtant Singh, Sudi Shatha Harbool, Luca Di Martino, Caroline Kruithoff, Thomas S. McCormick and Mahmoud Ghannoum

Nutrients 2026, 18(11), 1794; https://doi.org/10.3390/nu18111794 - 2 Jun 2026

Abstract

Fungal β-1,3-glucans are structurally conserved polysaccharide components of the fungal cell wall that exhibit potent immunomodulatory activity. These molecules are recognized by pattern recognition receptors, Toll-like receptors, complement receptor 3, lactosylceramide, scavenger receptors, and EphA2. Binding of β-1,3-glucans through these receptors triggers coordinated [...] Read more.

Fungal β-1,3-glucans are structurally conserved polysaccharide components of the fungal cell wall that exhibit potent immunomodulatory activity. These molecules are recognized by pattern recognition receptors, Toll-like receptors, complement receptor 3, lactosylceramide, scavenger receptors, and EphA2. Binding of β-1,3-glucans through these receptors triggers coordinated innate and adaptive immune responses such as cytokine production, phagocytosis, and trained immunity. In addition to receptor-mediated immune activation, dietary β-1,3-glucans function as fermentable prebiotic fibers that modulate gut microbiota composition, increase short-chain fatty acid production, and strengthen epithelial barrier integrity. These combined immunological and microbiome-mediated effects position β-1,3-glucans as key regulators of gut homeostasis. Preclinical and emerging clinical evidence supports broad therapeutic potential across multiple disease domains, including inflammatory bowel disease, metabolic disorders, respiratory infections, and cancer. In oncology, β-1,3-glucans enhance anti-tumor immunity, improve responses to monoclonal antibodies and chemotherapy, and serve as promising adjuvants in vaccine-based strategies. Additionally, β-1,3-glucan is widely used as a biomarker for invasive fungal infections and represents a validated target of antifungal therapies such as echinocandins. Despite these advances, clinical translation remains limited by heterogeneity in glucan source, structure, and formulation, as well as a lack of appropriately powered, standardized human clinical trials. Future efforts should focus on clarifying mechanisms of action, as well as rigorous clinical evaluation, to fully define the therapeutic utility of fungal β-1,3-glucans. Full article

(This article belongs to the Special Issue Metabolic Benefits of Dietary Prebiotics in Humans)

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21 pages, 22250 KB

Open AccessArticle

Yam Protects Immunocompromised Mice from Influenza Infection via the Gut–SCFA–GPCR–Immune Axis

by Qingjun Li, Xinyan Qu, Menglin Li, Yingying Song, Qi Xu, Quanbo Wang, Hongjing Dong, Xiao Wang and Qian Liu

Nutrients 2026, 18(11), 1793; https://doi.org/10.3390/nu18111793 - 2 Jun 2026

Abstract

Background/Objectives: Immunodeficiency can be induced by a variety of factors, such as aging, stress and poor nutrition, and leads to increased susceptibility to infection and disease. The current research was conducted to determine the immunoenhancing potential of yam and its underlying mechanism [...] Read more.

Background/Objectives: Immunodeficiency can be induced by a variety of factors, such as aging, stress and poor nutrition, and leads to increased susceptibility to infection and disease. The current research was conducted to determine the immunoenhancing potential of yam and its underlying mechanism in a murine model of cyclophosphamide (CTX)-induced immunosuppression. Methods: The gut microbial community and generation of short-chain fatty acids (SCFAs) in response to yam were analyzed by 16S rRNA sequencing and GC-MS. The immune cells in the spleen were analyzed using flow cytometry. GPR41/GPR43/GPR109A triple-knockout mice were used to demonstrate the critical involvement of SCFAs in mediating the protective effect of yam, and RNA-sequencing technology was applied to investigate the potential mechanism by which yam orchestrated the observed metabolic, immune and reparative responses. Results: Yam alleviated the decline in spleen and thymus indices and modulated the frequency of B cells and CD4⁺ and CD8⁺ T cells and promoted the production of IgA, IgG and IgM. Yam increased the secretion of cytokines in the intestine and upregulated the levels of claudin and ZO-1. Yam also increased the content of SCFAs and induced beneficial modifications to the gut microbiota composition. The immune-enhancing activity of yam was confirmed, as evidenced by a notable decrease in viral load in immunosuppressed mice inoculated with influenza virus and its capacity to mitigate inflammatory response in pulmonary tissues. Conclusions: This study suggests that yam enhances immunity by synergistically regulating the gut–immune axis, supporting its development as a functional food intervention in managing immunodeficiency conditions. Full article

(This article belongs to the Section Nutritional Immunology)

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29 pages, 2326 KB

Open AccessReview

Effects of Herbal and Natural Product Interventions on Gut Microbiota and Clinical Outcomes in Patients Receiving PPI-Containing Therapy: A Systematic Review and Meta-Analysis

by Ji Hye Hwang and You-Kyung Choi

Nutrients 2026, 18(11), 1792; https://doi.org/10.3390/nu18111792 - 2 Jun 2026

Abstract

Proton pump inhibitor (PPI)-containing regimens, including bismuth quadruple therapy, may perturb gut microbiota through combined exposure to acid suppression, antibiotics, bismuth, and underlying disease context. Herbal medicines and natural products have been proposed as adjunctive interventions to mitigate treatment-related microbiota perturbations; however, systematic [...] Read more.

Proton pump inhibitor (PPI)-containing regimens, including bismuth quadruple therapy, may perturb gut microbiota through combined exposure to acid suppression, antibiotics, bismuth, and underlying disease context. Herbal medicines and natural products have been proposed as adjunctive interventions to mitigate treatment-related microbiota perturbations; however, systematic synthesis of the clinical evidence remains limited. This systematic review and meta-analysis evaluated the effects of herbal and natural product interventions on gut microbiota and clinical outcomes in patients receiving PPI-containing therapy. Six databases (PubMed, EMBASE, Web of Science, Scopus, CENTRAL, and CNKI) were searched from their inception to March 2026. Risk of bias was assessed using RoB 2.0 and ROBINS-I. This review was prospectively registered in PROSPERO (CRD420261346672). Eighteen studies (17 randomized controlled trials, 1 observational study; n = 1984 participants) were included in the final analysis. Meta-analysis demonstrated significantly higher Helicobacter pylori eradication rates (pooled relative risk (RR) = 1.20, 95% confidence interval (CI) 1.14–1.27; I² = 33%). Chinese-style total effective rate was also higher in the herbal groups (RR = 1.19, 95% CI 1.14–1.25; I² = 0%), but this non-standardized outcome should be interpreted cautiously. Exploratory microbiome meta-analyses suggested higher post-treatment Bifidobacterium and Lactobacillus levels; however, substantial heterogeneity limited interpretability. Narrative synthesis revealed potential preservation of α-diversity and attenuation of pathobiont proliferation in herbal groups. Overall, herbal and natural product interventions may be associated with favorable clinical outcomes and potential microbiota-modulating effects in patients receiving PPI-containing therapy, but certainty remains limited due to methodological concerns, outcome indirectness, and heterogeneity. High-quality trials stratified by antibiotic exposure are warranted. Full article

(This article belongs to the Special Issue Disease-Associated Gut Microbiota Patterns, Nutritional Factors, and Host Immunity)

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14 pages, 1530 KB

Open AccessArticle

Post-Diagnostic Lifestyle Adaptations in Fibromyalgia: A Network and Cluster Analysis of Real-World Behavioral Patterns

by Matylda Kosiorz, Małgorzata Muc-Wierzgoń, Katarzyna Weronika Walkiewicz and Sylwia Dzięgielewska-Gęsiak

Nutrients 2026, 18(11), 1791; https://doi.org/10.3390/nu18111791 - 2 Jun 2026

Abstract

Background: Fibromyalgia is a chronic pain disorder. Patients often introduce lifestyle changes, including dietary modifications and physical activity, after diagnosis to alleviate symptoms. However, real-world patterns of these post-diagnostic adaptations remain poorly understood. Methods: An exploratory cross-sectional study was conducted in 88 patients [...] Read more.

Background: Fibromyalgia is a chronic pain disorder. Patients often introduce lifestyle changes, including dietary modifications and physical activity, after diagnosis to alleviate symptoms. However, real-world patterns of these post-diagnostic adaptations remain poorly understood. Methods: An exploratory cross-sectional study was conducted in 88 patients with fibromyalgia using a study-specific questionnaire. Spearman correlation and network analysis were applied to assess relationships between lifestyle changes. K-means clustering was used to identify adaptation patterns. Differences in symptom severity were evaluated using the Kruskal–Wallis test and regression analysis. Results: Participants most frequently increased vegetable and water intake and reduced consumption of meat, alcohol, and sugar-sweetened beverages. Network analysis revealed structured co-occurrence patterns among dietary changes. Three clusters were identified: minimal (n = 47), selective (n = 27), and comprehensive (n = 14). No significant association was found between adaptation patterns and symptom severity (p = 0.53). Conclusions: Patients with fibromyalgia may adopt structured, non-random lifestyle changes following diagnosis. These findings provide a data-driven perspective on real-world behavioral adaptation patterns and highlight the need for longitudinal research to better understand their potential role in disease management. Full article

(This article belongs to the Special Issue Nutritional Intervention and Clinical Management for Musculoskeletal Diseases)

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21 pages, 674 KB

Open AccessSystematic Review

Patient Experiences of Nutrition in Enhanced Recovery After Colorectal Surgery: A Systematic Review

by Kimberly Yee Hooi Ang, Georgia Stringer, Jorja Collins and Lisa A. Barker

Nutrients 2026, 18(11), 1790; https://doi.org/10.3390/nu18111790 - 1 Jun 2026

Abstract

Background and Objectives: Perioperative nutrition is a core component of Enhanced Recovery After Surgery (ERAS) pathways. Understanding the patient experience of nutrition recommendations provides insight into the acceptability of perioperative nutrition care and facilitates the achievement of ERAS targets. This systematic review aimed [...] Read more.

Background and Objectives: Perioperative nutrition is a core component of Enhanced Recovery After Surgery (ERAS) pathways. Understanding the patient experience of nutrition recommendations provides insight into the acceptability of perioperative nutrition care and facilitates the achievement of ERAS targets. This systematic review aimed to synthesise patients’ experiences of nutrition within ERAS pathways for colorectal surgery. Methods: A systematic search of Ovid MEDLINE, Embase, Emcare, and CINAHL was conducted to identify studies published up until July 2025. Eligible studies included qualitative, mixed-methods, or descriptive survey designs. Data were extracted and synthesised using an inductive thematic analysis. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Results: Fifteen studies were included (40% qualitative, 33% quantitative, 27% mixed-methods), representing data from 1431 patients. Eleven studies met all quality criteria. Five themes were identified. Information gaps and misconceptions about nutrition (Theme 1) resulted from unclear advice across care settings. Oral intake post-surgery (Theme 2) was limited by nausea, reduced appetite, early satiety, and dissatisfaction with hospital food. Experiences with oral nutritional supplements (Theme 3) were variable, with palatability affecting acceptability. Healthcare professionals (Theme 4) were central in shaping patient confidence in nutrition care. The transition to home (Theme 5) was a vulnerable period where follow-up support was highly valued. Heterogeneous reporting of nutrition in ERAS contexts was a limitation. Conclusions: Patient engagement with ERAS nutrition is shaped by individual and healthcare system factors. Addressing information gaps, providing nutrition support, and integrating patient perspectives through codesigned education and research initiatives may enhance perioperative nutrition experiences and optimise recovery outcomes. Full article

(This article belongs to the Section Clinical Nutrition)

15 pages, 1014 KB

Open AccessArticle

Acute Creatine Ingestion Before Resistance Training Enhances Strength Performance More than Ingestion During or After Training: A Randomized Crossover Pilot Trial

by Khouloud Ben Maaoui, Slaheddine Delleli, Arwa Jebabli, Nourhène Mahdi, Juan Del Coso, Hamdi Chtourou, Luca Paolo Ardigò and Ibrahim Ouergui

Nutrients 2026, 18(11), 1789; https://doi.org/10.3390/nu18111789 - 1 Jun 2026

Abstract

Background/Objectives: Although creatine (Cr) supplementation is well established for enhancing strength exercise adaptations, limited evidence exists regarding whether the timing of a single Cr dose relative to exercise acutely influences performance and related physiological and perceptual responses. This study examined whether the [...] Read more.

Background/Objectives: Although creatine (Cr) supplementation is well established for enhancing strength exercise adaptations, limited evidence exists regarding whether the timing of a single Cr dose relative to exercise acutely influences performance and related physiological and perceptual responses. This study examined whether the timing of a single dose of Cr ingestion relative to a strength exercise session influences acute strength and power performance, cognitive function, perceptual responses, and selected blood biomarkers in physically active men. Methods: In a randomized, placebo-controlled crossover design, 11 physically active men (26.09 ± 4.39 years) completed five experimental conditions: Cr ingested before exercise (CrB), during exercise (CrD), and after exercise (CrF), placebo (PL), and a no-supplement control. Participants ingested 0.1 g·kg⁻¹ body mass of monohydrate Cr or placebo. Each condition included a standardized strength training session, where bench press (BP) and back squat (BSQ) performance was assessed as the total external load lifted (kg) across six sets performed at 80% of 1-RM for each exercise. Countermovement jump (CMJ) performance, Profile of Mood States (POMS), cognitive performance (digit cancelation test), perceived exertion (RPE), perceived recovery scale (PRS), Delayed-Onset Muscle Soreness (DOMS), and blood markers of muscle damage and renal function were assessed after the resistance training session. Data were analyzed using repeated-measures ANOVA or non-parametric equivalents, with post hoc comparisons adjusted for multiple testing. Results: There was a significant main effect of condition for both BP (F = 4.91, ηp² = 0.33, p = 0.035) and BSQ performance (F = 33.22, ηp² = 0.77, p < 0.001), with greater performance under the CrB condition compared with PL and control (p < 0.05). A significant effect of condition was also observed for creatine kinase (χ² (4) = 12.22, p = 0.016) and creatinine concentrations (χ² (4) = 17.75, p = 0.001). Blood creatine kinase concentrations were greater under CrF conditions than control (p = 0.013) and PL (p = 0.041). Moreover, creatinine concentration was lower under the CrB condition compared to CrD (p = 0.033), CrF (p = 0.003), and the control (p = 0.021). No differences were observed for CMJ performance, cognitive performance, POMS, RPE, PRS, DOMS, or the remaining biochemical markers across treatments. Conclusions: Pre-exercise creatine ingestion (without loading phase) was associated with greater acute strength performance compared with other timing conditions. However, the findings are exploratory and have to be confirmed with a higher sample size and robust placebo/control structures. Full article

(This article belongs to the Special Issue Nutrition Strategy and Resistance Training)

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17 pages, 701 KB

Open AccessArticle

Comparison of Risk Profiles, Nutrient Intake, and Kidney Function of Calcium Oxalate Stone Formers with and Without Enteric Hyperoxaluria. A Matched Case-Control Study

by Charlotte Ernsten, Nikolai Spuck, Albrecht Hesse and Roswitha Siener

Nutrients 2026, 18(11), 1788; https://doi.org/10.3390/nu18111788 - 1 Jun 2026

Abstract

Objectives: This study compared the risk profiles, nutrient intake, and kidney function of calcium oxalate stone formers with and without enteric hyperoxaluria. Methods: Thirty-seven patients with calcium oxalate stone disease and enteric hyperoxaluria (cases) and 37 sex- and age-matched idiopathic calcium [...] Read more.

Objectives: This study compared the risk profiles, nutrient intake, and kidney function of calcium oxalate stone formers with and without enteric hyperoxaluria. Methods: Thirty-seven patients with calcium oxalate stone disease and enteric hyperoxaluria (cases) and 37 sex- and age-matched idiopathic calcium oxalate stone formers (controls) were enrolled. Patients did not receive any nutritional counseling prior to the start of the study, and they discontinued medications affecting urinary parameters four weeks before their study participation. Anthropometric, clinical, and metabolic parameters were recorded. Dietary and 24-h urinary variables were measured under the habitual diet and under a balanced, standardized diet. The ¹³C₂ oxalate absorption and calcium loading tests were carried out. Results: The median ¹³C₂ oxalate absorption was significantly higher in cases (14.8%) than in controls (8.9%). Under the balanced diet, hypocitraturia, hypomagnesuria, low urine volume and pH value were significantly more common in the case group, whereas hypercalciuria occurred more frequently in the control group, affecting 45.9% of controls and 5.4% of cases. Furthermore, the control group exhibited a greater reduction in urinary calcium excretion under the balanced diet. Urinary oxalate excretion and the ion-activity product index of calcium oxalate were significantly higher under both diets, with a greater decline observed in the case group under the balanced diet. The estimated glomerular filtration rate (eGFR) was lower in cases. A multivariable linear regression analysis revealed a significant association between urine pH and eGFR. Conclusions: Calcium oxalate stone formers with and without enteric hyperoxaluria benefit from a balanced diet and sufficient fluid intake. The reduction in urinary oxalate excretion and the biochemical risk of recurrent calcium oxalate stone formation were even more pronounced in patients with enteric hyperoxaluria. Particular attention should be paid to low urine pH, as it is hypothesized to be a potential indicator of impaired kidney function. Full article

(This article belongs to the Section Clinical Nutrition)

32 pages, 943 KB

Open AccessReview

Dietary Therapies for Gastrointestinal Disorders

by Berkeley N. Limketkai, Andrea Shin, Natalie Manitius, Sameeha Rau, Janelle Smith and Neha D. Shah

Nutrients 2026, 18(11), 1787; https://doi.org/10.3390/nu18111787 - 1 Jun 2026

Abstract

Alterations in gastrointestinal function (digestion, absorption, motility, secretion, and elimination) play important roles in the pathophysiology of many gastrointestinal disorders. Food also strongly influences gastrointestinal health and disease. Some foods act as antigens that trigger an enteric immune response, while others can serve [...] Read more.

Alterations in gastrointestinal function (digestion, absorption, motility, secretion, and elimination) play important roles in the pathophysiology of many gastrointestinal disorders. Food also strongly influences gastrointestinal health and disease. Some foods act as antigens that trigger an enteric immune response, while others can serve as substrates with direct or indirect biological effects. Food can also be metabolized by gut microbes into bioactive molecules that alter physiology. This review discusses the current research evidence and the clinical use of “food as medicine” through dietary therapies for the management of various gastrointestinal conditions, including disorders of gut–brain interaction, eosinophilic esophagitis, celiac disease, inflammatory bowel disease, gastroparesis, and short bowel syndrome with intestinal failure. Full article

(This article belongs to the Special Issue Nutritional Approaches for Digestive Disorders and Gastrointestinal Symptoms—2nd Edition)

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