Nutrients

9 pages, 330 KB

Open AccessArticle

Anemia Profile in Elite Israeli Olympic-Level Athletes—Is Screening Necessary?

by Ori Abulafia, Alon Eliakim, Tahel Shilat, Yoram Epstein and Dan Nemet

Nutrients 2025, 17(24), 3827; https://doi.org/10.3390/nu17243827 (registering DOI) - 6 Dec 2025

Background: Screening blood tests are often collected from elite athletes in an effort to optimize performance. The purpose of the current study was to evaluate the yield of screening for anemia and anemia-related factors in elite athletes entering the Israeli Olympic team. Methods: [...] Read more.

Background: Screening blood tests are often collected from elite athletes in an effort to optimize performance. The purpose of the current study was to evaluate the yield of screening for anemia and anemia-related factors in elite athletes entering the Israeli Olympic team. Methods: We investigated hemoglobin levels, red blood cell count and indices and serum levels of iron, transferrin, ferritin, B12 and folic acid in 407 members of the Israeli Olympic team (179 females, 228 males) upon joining the team. Results: Forty-four (10.8%) athletes had abnormally lower Hb level (8.9% females and 12.3% males). Forty-two athletes (10.3%) had low RBC concentration (9.5% females and 11% males). Twenty-one athletes (5.2%) had low iron levels (7.9% in males and 1.7% in females) and only 14 athletes (7 males) had low ferritin levels (3.4%). Fourteen female athletes (7.8%) had ferritin levels of less than 20ng/mL, and 43 (24%) had levels of less than 30 ng/mL. There were no cases of both anemia and low ferritin levels together. Twenty-five athletes (6.1%) had low levels of folic acid with higher prevalence (7%) in males. Only five athletes (1.2%) had low levels of vitamin B12, while 29 (7.1%) had levels higher than normal. None of them had abnormal Hb. In a multiple regression analysis, combat sports had significantly lower Hb levels. Conclusions: The yield of anemia screening and especially anemia-related biochemical abnormalities in adult elite athletes may be relatively low. Clearly, anemia should not be missed in the elite athlete, yet, if there are no signs or symptoms, Hb levels are close to normal and dilution is diagnosed, further frequent biochemical evaluation may be unnecessary. Full article

(This article belongs to the Section Sports Nutrition)

19 pages, 552 KB

Open AccessReview

The Role of Nutrition in the Development, Management, and Prevention of Rheumatoid Arthritis: A Comprehensive Review

by Maria Polyzou, Andreas V. Goules and Athanasios G. Tzioufas

Nutrients 2025, 17(24), 3826; https://doi.org/10.3390/nu17243826 (registering DOI) - 6 Dec 2025

Abstract

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease, with key features being synovial hyperplasia, autoantibody production, and ultimately cartilage and bone destruction. The pathogenesis of rheumatoid arthritis (RA) is not fully understood, but it is estimated that genetic factors account for [...] Read more.

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease, with key features being synovial hyperplasia, autoantibody production, and ultimately cartilage and bone destruction. The pathogenesis of rheumatoid arthritis (RA) is not fully understood, but it is estimated that genetic factors account for 50–60% of the risk, with the remainder attributed to environmental factors, including infectious agents, smoking, gut microbiota, and diet. Given that most current clinical trials on RA and nutrition are limited in sample size and duration, there is an unmet need for higher-quality studies in the future, a need that EULAR has already recognized. Objective: This article aims to investigate the impact of diet and nutritional factors on the development, progression, and potential prevention of RA. Specifically, it provides a comprehensive review of certain foods, such as alcohol, gluten, red meat, and saturated and trans fats, and their contribution to the onset and progression of rheumatoid arthritis (RA). In addition, it examines the effect of key anti-inflammatory nutrients in reducing the risk of RA, including olive oil, fatty fish, juices, and certain fruits. Finally, it discusses the potential protective effects of certain dietary patterns, such as the Mediterranean diet (MD) and diets rich in omega-3 polyunsaturated fatty acids (PUFAs). Methods: A comprehensive literature search was conducted in the PubMed/Medline, Science Direct, and Scopus databases (1990–2025). English-language observational studies, clinical trials, and systematic reviews addressing the relationship between diet and dietary patterns and RA were included. Results: High consumption of red and processed meat, saturated and trans fats, sugary drinks, and gluten (in vulnerable individuals) is associated with increased RA risk and greater disease activity, partly through pro-inflammatory pathways and gut dysbiosis. In contrast, regular intake of olive oil, fatty fish rich in omega-3 polyunsaturated fatty acids, fruit juices, cocoa, certain fruits, and vitamin D appears protective and may reduce disease activity and symptom severity. Adherence to anti-inflammatory dietary patterns, particularly the Mediterranean diet and diets rich in omega-3 fatty acids, is consistently associated with a lower incidence of RA, reduced inflammatory markers, and improved clinical outcomes. However, most available studies are limited by small sample sizes, short duration, heterogeneous methodologies, and potential confounding by other lifestyle factors (e.g., smoking, obesity). Conclusions: Although an appropriate diet and dietary habits cannot replace pharmacological therapy, current knowledge supports the inclusion of an anti-inflammatory diet as an adjunct strategy in the prevention and management of RA. The relatively limited studies that have been conducted suggest that high-quality, large-scale, prospective studies are needed to prevent and treat RA. These studies should incorporate genetic, microbiome, and long-term clinical endpoints, so as to establish definitive dietary recommendations and allow for personalized nutritional interventions for patients with RA. Full article

(This article belongs to the Special Issue Rheumatoid Arthritis and Nutrition: Bridging Diet and Disease Management)

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23 pages, 664 KB

Open AccessArticle

“What Do You Need?” Formative Research to Develop a Comprehensive Maternal Needs Assessment Tool for Infant and Young Child Nourishment and Care in the United States

by Mercy Eloho Sosanya, Laura Birgit Mueller, Caleb Martin and Jennifer L. Temple

Nutrients 2025, 17(24), 3825; https://doi.org/10.3390/nu17243825 (registering DOI) - 6 Dec 2025

Abstract

Background/Objectives: Despite substantial healthcare spending, U.S. mothers encounter fragmented support systems for infant feeding, care, and maternal mental health. While existing needs assessment instruments target parents of ill or preterm infants, no validated tool captures the full range of informational, psychosocial, and [...] Read more.

Background/Objectives: Despite substantial healthcare spending, U.S. mothers encounter fragmented support systems for infant feeding, care, and maternal mental health. While existing needs assessment instruments target parents of ill or preterm infants, no validated tool captures the full range of informational, psychosocial, and structural needs among mothers of healthy, full-term infants. This formative mixed-methods study sought to identify and prioritize maternal needs across multiple socioecological levels to guide the development of a comprehensive Maternal Needs Assessment Tool (MNAT). Methods: Guided by the socioecological model, six virtual focus groups were conducted with U.S. mothers of healthy infants < 2 years (analytic sample = 28). Thematic analysis in ATLAS.ti (Version 25) identified key needs, which informed the creation of a 10-domain Maternal Needs Assessment Ranking Questionnaire (MNARQ). Participants (n = 22) rated each domain’s importance on a five-point scale; weighted mean ranks were calculated in SPSS (Version 30). Results: Seven overarching themes across ten domains emerged: infant and young child feeding and care, maternal psychosocial wellbeing, parenting knowledge and skills, interpersonal and community support, institutional assistance, and work-policy environments. The highest-ranked domains of need were complementary feeding, child development, care and health, social norms, networking and support, maternal mental health, and breastfeeding guidance. Mothers described pervasive informational confusion, inadequate professional and peer support, and institutional barriers such as limited postpartum follow-up, inflexible daycare policies, and WIC hurdles in formula substitution for infants with allergies. Conclusions: Maternal needs encompass intersecting personal, social, and structural factors. Findings will inform the development and validation of a national Maternal Needs Assessment Tool to guide integrated maternal and child health programs. Full article

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

19 pages, 471 KB

Open AccessArticle

Validity and Reliability of the Danish Version of the Adult Eating Behavior Questionnaire—Results from the South Danish Obesity Initiative

by Mikkel Emil Iwanoff Kolind, Tobias Midtvedt Windedal, Barbara Vad Andersen, Nina Drøjdahl Ryg, Gabriele Berg-Beckhoff and Claus Bogh Juhl

Nutrients 2025, 17(24), 3824; https://doi.org/10.3390/nu17243824 (registering DOI) - 6 Dec 2025

Abstract

Objective: Appetitive traits influence obesity risk, yet no validated Danish tool exists to assess these traits in adults. We translated the Adult Eating Behavior Questionnaire (AEBQ) into Danish and evaluated reliability and validity. Methods: Adults (n = 1257) from the [...] Read more.

Objective: Appetitive traits influence obesity risk, yet no validated Danish tool exists to assess these traits in adults. We translated the Adult Eating Behavior Questionnaire (AEBQ) into Danish and evaluated reliability and validity. Methods: Adults (n = 1257) from the South Danish Obesity Initiative completed the Danish AEBQ; a subsample took part in test–retest analysis (n = 256). Content validity was assessed via Three-Step Test Interviews (n = 5). Test–retest reliability was examined by intraclass correlation (ICC). Confirmatory factor analysis (CFA) tested structural validity (with an ancillary eight- vs. seven-factor comparison). Internal consistency was evaluated by Cronbach’s α and McDonald’s ω. Pearson correlations and regression models (adjusted for age, sex, and education) related subscales to BMI, waist-to-hip ratio (WHR), and body fat percentage (fat%). Results: Three-Step Test Interviews supported content validity. Test–retest reliability was good for most subscales (ICCs ≈ 0.80–0.88) and moderate for Emotional Undereating (ICC = 0.640). Both CFA models showed acceptable fit; information criteria favored the seven-factor solution, with small differences on other indices. Internal consistency was acceptable for most subscales (α and ω ≥ 0.70), borderline for Hunger (α = 0.70; ω = 0.71), and below threshold for Satiety Responsiveness (α = 0.69; ω = 0.69). Food Responsiveness and Emotional Overeating were positively associated with BMI/WHR/fat%, while Emotional Undereating showed inverse associations; other subscales showed no associations. Conclusions: The Danish AEBQ shows adequate psychometric performance, and both seven- and eight-factor structures appear applicable in a Danish setting, with the caveat that internal consistency for Hunger and Satiety Responsiveness fell just below conventional cut-offs. Full article

(This article belongs to the Section Nutrition Methodology & Assessment)

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14 pages, 441 KB

Open AccessArticle

Exploring Obesity Subtypes: Cluster Analysis of Eating Behaviors, Food Addiction, and Psychopathology in Turkish Adults Seeking Obesity Treatment

by Orçun Ortaköylü, Ayşe Gökçen Gündoğmuş and Sibel Örsel

Nutrients 2025, 17(24), 3823; https://doi.org/10.3390/nu17243823 (registering DOI) - 6 Dec 2025

Abstract

Background/Objectives: Obesity results from the complex interplay of biological, psychological, and sociocultural factors. Psychiatric comorbidities and maladaptive eating attitudes are possible contributors to this complexity. Despite accumulating research, current treatment approaches often fail to achieve lasting success, possibly due to the tendency [...] Read more.

Background/Objectives: Obesity results from the complex interplay of biological, psychological, and sociocultural factors. Psychiatric comorbidities and maladaptive eating attitudes are possible contributors to this complexity. Despite accumulating research, current treatment approaches often fail to achieve lasting success, possibly due to the tendency to approach obesity as a uniform condition despite its heterogeneity. This study aimed to identify distinct subgroups of adults with obesity based on their eating behaviors, psychopathology, and food addiction (FA). Methods: The study included 202 adults seeking obesity treatment at Ankara Dışkapı Training and Research Hospital, Turkey. Participants completed the Three Factor Eating Questionnaire-R18, Yale Food Addiction Scale, Night Eating Questionnaire, and Symptom Checklist-90-R (SCL-90-R). Psychiatric diagnoses were confirmed through clinician-administered semi-structured interviews (SCID-5-CV). Two-step cluster analysis was performed using z-standardized variables of eating and psychopathology measures. Subsequent comparisons were conducted between the identified subgroups. Results: Two distinct clusters were identified and described in terms of adaptive and maladaptive eating traits: an Adaptive group (n = 92, 45.5%) and a Maladaptive group (n = 110, 54.5%). The Maladaptive cluster exhibited higher levels of emotional eating, uncontrolled eating, night eating, FA, and general psychopathology (all p < 0.001), along with a greater prevalence of major depressive disorder and binge eating disorder. Conclusions: Our findings indicate that psychopathology and maladaptive eating behaviors meaningfully distinguish two obesity phenotypes. Nearly half of individuals with obesity, characterized by maladaptive eating traits, FA, or elevated psychopathology, may constitute a subgroup that would particularly benefit from psychoeducation or targeted psychiatric intervention. Full article

(This article belongs to the Section Nutrition and Obesity)

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9 pages, 191 KB

Open AccessArticle

Mixed Nut Challenge Test (MixNut) as an Efficient Procedure in the Management of Lipid Transfer Protein Allergy

by Diana Betancor, Elisa Haroun, Manuel De las Heras Gozalo, Carlos Pastor-Vargas and Javier Cuesta-Herranz

Nutrients 2025, 17(24), 3822; https://doi.org/10.3390/nu17243822 (registering DOI) - 6 Dec 2025

Abstract

Background/Objectives: Lipid transfer protein (LTP) syndrome is a leading cause of primary food allergy in Mediterranean countries, often associated with severe reactions. Due to in vitro cross-reactivity among plant foods, clinical manifestations are unpredictable, frequently requiring multiple oral food challenges (OFC) to [...] Read more.

Background/Objectives: Lipid transfer protein (LTP) syndrome is a leading cause of primary food allergy in Mediterranean countries, often associated with severe reactions. Due to in vitro cross-reactivity among plant foods, clinical manifestations are unpredictable, frequently requiring multiple oral food challenges (OFC) to assess nut tolerance. These procedures increase healthcare burden and patient anxiety. This study evaluated the safety and utility of a mixed-nut oral food challenge (MixNut) in LTP-sensitized patients. Methods: In this prospective observational multi-center study, patients with LTP syndrome were enrolled. Group A included individuals allergic to fruits or vegetables who had avoided nuts; Group B included patients with suspected or confirmed nut allergy. Participants underwent a MixNut challenge comprising 2–4 nuts (≥3 g protein per nut). Results: Nineteen patients (73.7% male; median age 32.5 years) underwent MixNut, testing 52 individual nuts. All challenges were negative. The MixNut approach reduced the number of OFC by 63% (from 52 to 19) and total testing time from 208 to 76 h. Specific IgE levels to LTP allergens (Pru p 3, Cor a 8, Ara h 9) varied widely and did not predict clinical reactivity. Conclusions: MixNut is an efficient diagnostic tool for LTP syndrome, significantly reducing testing time, costs, and patient burden. It facilitates accurate dietary management and prevents unnecessary food avoidance. Further studies should optimize MixNut protocols and identify predictive markers for clinical reactivity. Full article

(This article belongs to the Section Nutritional Immunology)

15 pages, 646 KB

Open AccessArticle

Redox Response in Postoperative Metabolic and Bariatric Surgery: New Insights into Cardiovascular Risk Markers

by Ruanda Pereira Maia, Sandra Fernandes Arruda, Ariene Silva do Carmo, Patrícia Borges Botelho and Kênia Mara Baiocchi de Carvalho

Nutrients 2025, 17(24), 3821; https://doi.org/10.3390/nu17243821 (registering DOI) - 6 Dec 2025

Abstract

Background/Objectives: Metabolic and bariatric surgery (MBS) promotes improved redox response and weight loss and reduced cardiovascular risk. However, there is still no consensus on whether some of these results may be affected years after the surgery. This study evaluated the association between redox [...] Read more.

Background/Objectives: Metabolic and bariatric surgery (MBS) promotes improved redox response and weight loss and reduced cardiovascular risk. However, there is still no consensus on whether some of these results may be affected years after the surgery. This study evaluated the association between redox response and cardiovascular risk markers following MBS. Methods: Patients (n = 91) of both sexes who underwent MBS 2–7 years ago were evaluated. Antioxidant enzymatic activity (catalase, superoxide dismutase, glutathione-S-transferase, and glutathione peroxidase) and oxidative damage (malondialdehyde and carbonylated protein) were quantified. Blood pressure, glucose, insulin, triglyceride/glucose (TyG) index, LDL-C, HDL-C, non-HDL-C, triglyceride (TG), and cholesterol were analyzed. Principal component analysis (PCA) and generalized linear models were used. Results: The participants had a mean age of 39.82 ± 7.87 years, and a current body mass index of 29.53 ± 5.01 kg/m². The PCA identified two patterns: enzymatic antioxidant activity (PC1) and oxidative damage (PC2). No association was found between PC1 and cardiovascular risk markers. A positive association was observed between PC2 and diastolic blood pressure (β: 6.79, 95% confidence intervals [CI]: 1.97; 11.61), TyG index (β: 0.13, 95% CI: 0.05; 0.21), total cholesterol (β: 15.17, 95% CI: 3.61; 26.72), TG (β: 25.88, 95% CI: 8.58; 43.18; p = 0.003), and non-HDL-C (β: 10.91, 95% CI: 0.02; 21.88). Conclusions: Oxidative damage markers were positively associated with diastolic blood pressure, TyG index, TG, total cholesterol, and non-HDL-C levels after MBS. However, further studies are required to confirm and elucidate these findings. Full article

(This article belongs to the Section Nutrition and Obesity)

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14 pages, 330 KB

Open AccessArticle

Association Between Dietary Adherence and Cognitive Function Among Rural Older Patients with Cardiometabolic Multimorbidity: The Moderating Role of Health Management

by Fangfang Hu, Lingzhong Xu and Wenzhe Qin

Nutrients 2025, 17(24), 3820; https://doi.org/10.3390/nu17243820 (registering DOI) - 6 Dec 2025

Abstract

Background: Cardiometabolic multimorbidity (CMM) among rural older adults is becoming increasingly prevalent. Although previous studies have confirmed that dietary adherence significantly affects cognitive function, the mechanisms underlying this relationship remain insufficiently explored. This cross-sectional study aimed to examine the association between dietary adherence [...] Read more.

Background: Cardiometabolic multimorbidity (CMM) among rural older adults is becoming increasingly prevalent. Although previous studies have confirmed that dietary adherence significantly affects cognitive function, the mechanisms underlying this relationship remain insufficiently explored. This cross-sectional study aimed to examine the association between dietary adherence and cognitive function among rural older patients with CMM and further explored the moderating role of health management. Methods: The sample was selected using a multi-stage cluster random sampling method and a total of 1487 rural older patients with CMM were ultimately included. Hierarchical regression analysis was employed to examine the association between dietary adherence and cognitive function and test the moderating role of health management. Simple slope analysis was further employed to explore the moderation effect. Results: The cognitive function and dietary adherence scores of rural older patients with CMM were 20.790

\pm

6.278 and 2.157

\pm

0.286, respectively. Dietary adherence was significantly and positively associated with cognitive function (

β

= 2.000, p < 0.001) and health management moderated this relationship (

β

= 4.287, p = 0.009). Compared with rural older patients with CMM who did not receive health management, the positive predictive effect of dietary adherence on cognitive function was significantly stronger among those who received health management. Conclusions: Higher dietary adherence was positively associated with better cognitive function among rural older patients with CMM, and receiving health management further strengthened this association. These findings emphasized the importance of integrating dietary guidance within community-based health management interventions to promote cognitive function. Full article

(This article belongs to the Special Issue Nutrition, Physical Activity, Frailty, and Cognitive Decline in Older Adults: Addressing Age-Related Health)

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16 pages, 12040 KB

Open AccessArticle

Milk Powder Fortified with Folic Acid and Colostrum Basic Protein Promotes Linear Growth and Improves Bone Microarchitecture in Juvenile Mice Without Adverse Metabolic Effects

by Hongjuan Liu, Yixin Zhang, Yuanjue Wu, Wenbo Wan, Jiawen Liang, Hui Xiong, Liping Hao and Ting Xiong

Nutrients 2025, 17(24), 3819; https://doi.org/10.3390/nu17243819 - 5 Dec 2025

Abstract

Background: The juvenile-pubertal period is a critical window for linear growth and bone mass accumulation. This study investigated the joint effects of folic acid (FA) and colostrum basic protein (CBP)-fortified milk powder on growth, bone health, and metabolic safety in juvenile mice. Methods: [...] Read more.

Background: The juvenile-pubertal period is a critical window for linear growth and bone mass accumulation. This study investigated the joint effects of folic acid (FA) and colostrum basic protein (CBP)-fortified milk powder on growth, bone health, and metabolic safety in juvenile mice. Methods: Three-week-old C57BL/6J mice (n = 120) were acclimatized for 1 week and then randomly assigned to three isocaloric diet groups for an 8-week intervention starting at 4 weeks of age: Control (AIN-93M), Milk (AIN-93M + FA/CBP-fortified milk powder), and Positive Control (AIN-93G). Body length and weight were measured twice weekly. Bone microarchitecture was assessed by micro-computed tomography, and bone remodeling was evaluated through histology and serum biomarkers. The GH–IGF-1 axis and related metabolic parameters were also assessed. Results: FA–CBP–fortified milk powder significantly accelerated linear growth at intervention week 2, with body length higher in the Milk group than in the Control group (p < 0.01). After 8 weeks, the Milk group showed improved trabecular bone mass and microarchitecture compared with Control, especially in males (p < 0.01). Bone remodeling was transiently elevated at intervention week 4, as indicated by higher serum osteocalcin and CTX-I, and by increased osteoclast and cartilage matrix formation versus Control (p < 0.05). The GH–IGF-1 axis was also temporarily activated at week 4, with elevated serum GH and IGF-1/IGFBP-3 ratio compared with Control (p < 0.05). These skeletal benefits occurred without excess weight gain or adverse metabolic effects compared with Control (all p > 0.05). Conclusions: FA-CBP-fortified milk significantly enhanced linear growth during puberty and improved bone mass and microstructure in early adulthood. These skeletal benefits are consistent with the transient activation of the GH–IGF-1 axis. Importantly, no adverse metabolic effects were detected from early intervention through adulthood, supporting its potential application in growth-promoting nutritional strategies. Full article

(This article belongs to the Special Issue Nutrition in Children's Growth and Development)

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17 pages, 641 KB

Open AccessReview

Health and Nutrition Interventions to Prevent Childhood Overweight and Obesity in Mexico and Latin America: A Systematic Review

by Teresa Shamah-Levy, Marti Yareli Del Monte-Vega, Danae Gabriela Valenzuela-Bravo, Carmen Morales-Ruán, Lidia Moreno-Macías, Carlos Galindo-Gómez, Ileana Fajardo-Niquete and Javier Troconis-Cervera

Nutrients 2025, 17(24), 3818; https://doi.org/10.3390/nu17243818 - 5 Dec 2025

Abstract

Background: Childhood obesity is a pressing global health challenge. Analyzing the efficacy of interventions is crucial to mitigate its impact and inform effective public health policies. This study aimed to conduct a systematic review of interventions (SRI) targeting school-aged children with obesity. Our [...] Read more.

Background: Childhood obesity is a pressing global health challenge. Analyzing the efficacy of interventions is crucial to mitigate its impact and inform effective public health policies. This study aimed to conduct a systematic review of interventions (SRI) targeting school-aged children with obesity. Our goal was to identify the key components that contribute to the success of integrated interventions addressing diet/nutrition (D/N), physical activity (PA), and socioemotional skills. Methods: The Cochrane Collaboration methodology and the PRISMA statement were followed. The SRI included the following criteria, established a priori: studies that addressed obesity in school-aged children, including one or more interventions related to physical activity (PA), diet/nutrition (D/N), or socioemotional skills. Following the PICO (Population, Intervention, Comparison, and Outcome) framework, we searched six digital databases using relevant keywords and MeSH terms. The Mixed-Methods Appraisal Tool (MMAT) was used to assess article quality via “function group string” methods. Finally, a thematic synthesis of the SRI findings was conducted. The protocol for this study was registered in PROSPERO (CRD4202454214). Results: Initial screening yielded 127 articles. Following critical appraisal with the MMAT, studies with inadequate methodology, solely descriptive designs, unclear results, or interventions shorter than six months were excluded. Ultimately, 10 studies remained, eight of which included two of the three components of interest (D/N or PA). Conclusions: In this overview, many interventions were presented for the prevention of overweight and obesity in school-age children; however, methodological and standardized limitations still exist that hinder the establishment of effective interventions. Engaging families and teachers as active participants in interventions significantly enhanced effectiveness in both the D/N and PA domains. However, an analysis of current interventions highlights a stark gap in multisectoral and integrated approaches to tackling childhood obesity. This presents a remarkable opportunity for future initiatives to move beyond fragmented efforts and embrace a holistic model that unites families, schools, and communities to promote healthy lifestyles. Full article

(This article belongs to the Special Issue Community, School and Family-Based Nutritional Research)

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17 pages, 994 KB

Open AccessArticle

Assessment of Health Status, Emotional Well-Being, and the Prevalence of Overweight and Obesity in Children and Adolescents in the PICTURE Study (Wroclaw, Poland)

by Klaudia Konikowska, Krzysztof Kujawa, Agnieszka Matera-Witkiewicz, Katarzyna Połtyn-Zaradna, Katarzyna Zatońska, Tomasz Zatoński and Katarzyna Kiliś-Pstrusińska

Nutrients 2025, 17(24), 3817; https://doi.org/10.3390/nu17243817 - 5 Dec 2025

Abstract

Objective: The aim of the study was to analyze the assessment of the health and emotional well-being of children and adolescents from Wroclaw, including the frequency of diseases, health symptoms, overweight, and obesity. Methods: The study was conducted as a cross-sectional [...] Read more.

Objective: The aim of the study was to analyze the assessment of the health and emotional well-being of children and adolescents from Wroclaw, including the frequency of diseases, health symptoms, overweight, and obesity. Methods: The study was conducted as a cross-sectional study between 2019–2023, ultimately involving 1232 children aged 7–17 years. The data were collected in the form of interviews with caregivers. The study used a health questionnaire, anthropometric measurements and laboratory tests. Overweight and obesity were determined based on Polish body mass index (BMI) percentile tables in accordance with pediatric society guidelines. For the purposes of analysis, participants were divided into three age groups: 6–9, 10–12, and 13–17 years old. Results: The most common diagnosis was allergies, affecting about 36% of those surveyed. In total, 32.8% of children reported difficulties with concentration, memory, and learning. Emotionally, over one-third of children experienced anxiety or fear and outbursts of anger, 26% experienced inadequate sadness, and about 22% complained of chronic fatigue and excessive agitation. About 15% of participants reported symptoms of depression. Overweight and obesity were present in about 18% of children, with the frequency increasing with age. Moreover, it was shown that gender and age were the most important factors differentiating the risk of emotional symptoms, while body weight had no significant effect on any of the analyzed symptoms. Conclusions: The study revealed a significant prevalence of emotional disorders among children and adolescents, an increasing prevalence of allergies with age, and the growing problem of overweight and obesity. The results indicate the need for the implementation of systematic preventive measures and the early diagnosis of chronic diseases. An effective response to these challenges requires the development of an interdisciplinary healthcare model that integrates pediatric, psychologist, dietary, and social support. Full article

(This article belongs to the Special Issue The Impact of Children’s and Adolescents’ Diet, Nutrition and Lifestyle Habits on Physical and Mental Health: From the Latest Perspective)

22 pages, 839 KB

Open AccessReview

Different Paths, One Goal: Milk Ladders in IgE- and Non-IgE-Mediated Cow’s Milk Protein Allergy—A Narrative Review

by Daria Wiszniewska, Agata Stróżyk, Andrea Horvath and Adam J. Sybilski

Nutrients 2025, 17(24), 3816; https://doi.org/10.3390/nu17243816 - 5 Dec 2025

Abstract

Cow’s milk protein allergy (CMPA) is one of the most common food allergies in early childhood. Although a strict elimination diet effectively prevents allergic symptoms, it does not promote the development of tolerance to cow’s milk proteins (CMPs). The milk ladder is a [...] Read more.

Cow’s milk protein allergy (CMPA) is one of the most common food allergies in early childhood. Although a strict elimination diet effectively prevents allergic symptoms, it does not promote the development of tolerance to cow’s milk proteins (CMPs). The milk ladder is a stepwise approach to the reintroduction of CMPs, starting with extensively heated forms and gradually progressing to unheated cow’s milk, according to the individual tolerance levels. The rationale for this approach lies in the reduced allergenicity of heated forms, mainly due to the food matrix effect. The milk ladder was originally developed to gradually expand the diet in children with non-IgE-mediated CMPA. However, recent evidence suggests that it can also be applied in IgE-mediated CMPA to accelerate tolerance development. In children with high-risk IgE-mediated CMPA, this approach may be more challenging. Even minor recipe modifications, particularly those affecting composition or heating conditions, can alter the allergenicity of heated foods. Moreover, barriers to reintroducing food allergens, including parental anxiety or the child’s food aversion, may be more pronounced in this group. Although for high-risk patients, reintroduction is usually performed in hospital settings, increasing evidence indicates that, in selected cases, it may also be safely conducted at home. Several emerging strategies, including early low-dose exposure and oral immunotherapy, show promise in further enhancing tolerance development. Despite these challenges, early reintroduction of CMPs appears to play a crucial role in modulating the immune response and promoting tolerance. This review provides the summary of evidence and practical insights into the implementation of the milk ladder in children with IgE-mediated CMPA. Full article

(This article belongs to the Section Pediatric Nutrition)

11 pages, 599 KB

Open AccessArticle

Supplementation with Bromelain, Troxerutin, and Escin to Support Postoperative Recovery After Hip or Knee Arthroplasty in Older Adults: A Pilot Study

by Francesco Landi, Matteo Tosato, Roberta Terranova, Giulia Rubini, Federica Mammarella, Stefano Cacciatore, Emanuele Marzetti, Anna Picca, Hélio José Coelho-Júnior and Riccardo Calvani

Nutrients 2025, 17(24), 3815; https://doi.org/10.3390/nu17243815 - 5 Dec 2025

Abstract

Background: Bromelain, a proteolytic enzyme extracted from Ananas comosus, exhibits anti-edematous and anti-inflammatory properties that may facilitate postoperative recovery. Troxerutin and escin, respectively, a vasoactive flavonoid and a saponin derivative, also provide anti-edematous and microcirculatory benefits that could enhance tissue repair and functional [...] Read more.

Background: Bromelain, a proteolytic enzyme extracted from Ananas comosus, exhibits anti-edematous and anti-inflammatory properties that may facilitate postoperative recovery. Troxerutin and escin, respectively, a vasoactive flavonoid and a saponin derivative, also provide anti-edematous and microcirculatory benefits that could enhance tissue repair and functional outcomes. Evidence on their combined use in older adults undergoing rehabilitation after major orthopedic surgery remains limited. Methods: We conducted retrospective observational study in adults aged 65 years or older admitted to a post-acute rehabilitation unit after total hip or total knee arthroplasty. Half of the participants received an oral supplement containing bromelain (400 mg/day), troxerutin (300 mg/day), and escin (40 mg/day) for up to 21 days alongside usual care and standard medications. The primary outcome was pain reduction assessed through the Visual Analog Scale (VAS). Secondary outcomes included changes in postoperative edema and functional recovery, evaluated through range of motion, the Barthel Index, and gait performance. Result: Forty participants were enrolled (mean age 69.4 ± 7.2 years; 58 percent women). Individuals receiving the combined supplement achieved significantly greater pain improvement than controls. At day 10 (T1), VAS scores declined from 6.8 ± 1.0 to 3.2 ± 0.9 in the supplemented group versus 6.7 ± 1.1 to 4.5 ± 1.0 in controls (p < 0.01). At day 21 (T2), VAS further decreased to 1.8 ± 0.7 in the supplemented group and to 3.1 ± 0.8 with standard treatment (p < 0.001). Functional performance also improved more markedly with supplementation, with earlier mobilization and faster recovery of autonomy. No significant side effects were reported. Conclusion: In this pilot study, combined bromelain, troxerutin, and escin supplementation was associated with meaningful reductions in postoperative pain and edema and with faster functional recovery. Larger controlled trials are warranted to confirm these effects and elucidate underlying mechanisms. Full article

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

19 pages, 825 KB

Open AccessArticle

Orthorexia Profiles in Athletes: A Multidimensional Analysis Using the Eating Habits Questionnaire (EHQ) and the Teruel Orthorexia Scale (TOS)

by María Manzanares-Cabrera, María Dolores Onieva-Zafra, Alberto Bermejo-Cantarero, Raúl Expósito-González, Daniel Lerma-García and María Laura Parra-Fernández

Nutrients 2025, 17(24), 3814; https://doi.org/10.3390/nu17243814 - 5 Dec 2025

Abstract

Background: Orthorexia nervosa (OrNe) and healthy orthorexia (HeOr) are two distinct but related dimensions of interest in eating behavior research. Evidence regarding their associations with sociodemographic, dietary, and sport-related variables in physically active young adults remains limited. Methods: A cross-sectional study was conducted [...] Read more.

Background: Orthorexia nervosa (OrNe) and healthy orthorexia (HeOr) are two distinct but related dimensions of interest in eating behavior research. Evidence regarding their associations with sociodemographic, dietary, and sport-related variables in physically active young adults remains limited. Methods: A cross-sectional study was conducted in 190 physically active young adults (53.2% women; mean age = 23.16 ± 5.13 years). Participants practiced a variety of sports including fitness (25.3%), soccer (13.7%), handball (10.5%), athletics, martial arts, cycling, and other individual or team sports. Although all participants belonged to organized sports teams or structured training groups, 38.9% were not actively competing at the time of data collection. Participants completed validated instruments assessing OrNe, HeOr, and eating-related cognitions, alongside questionnaires on sociodemographic data, dietary habits, sport discipline, training frequency, and supplement use. Hierarchical and K-means clustering were applied using the standardized scores of HeOr, OrNe, and the EHQ total score. Group differences were assessed using t-tests and ANOVA with effect sizes (η²p) reported. Results: Age correlated positively with OrNe, HeOr, and eating-related cognitions, indicating greater consolidation of rigid eating patterns in young adulthood. BMI was associated with OrNe only among men. Vegetarian participants showed higher nutritional knowledge but lower overall orthorexia scores. Supplement users in fitness-related sports reported higher OrNe, whereas participants in collective sports reported lower scores. Three distinct orthorexia profiles were identified, characterized by lower, slightly above-average, and higher scores on orthorexia-related variables. Participants in the higher-scoring profile showed significantly higher EHQ total, OrNe, and HeOr scores compared with the other groups (η²p range = 0.11–0.19). Correlations among orthorexia dimensions were positive and moderate to large. Differences between clusters in sport modality, training frequency, and supplement use underscored the influence of the sporting context. Conclusions: Orthorexia in young physically active adults reflects heterogeneous patterns shaped by the interplay of individual (age, sex, BMI), dietary, and sport-related factors. The identification of differentiated profiles reinforces the multidimensional nature of orthorexia and underscores the relevance of considering specific sport environments when interpreting orthorexic tendencies. Longitudinal research is warranted to examine the stability or variability of these patterns over time and to enable the use of more robust multivariate approaches that further clarify the characterization of orthorexia. Full article

(This article belongs to the Section Sports Nutrition)

25 pages, 1740 KB

Open AccessArticle

Analysis of Determinants of Dietary Iodine Intake of Adolescents from Northern Regions of Poland: Coastal Areas and Lake Districts

by Katarzyna Lachowicz and Małgorzata Stachoń

Nutrients 2025, 17(24), 3813; https://doi.org/10.3390/nu17243813 - 5 Dec 2025

Abstract

Background/Objectives: Iodine plays a central role in thyroid hormone synthesis and neurodevelopment. Its deficiency and excessive intake have been identified as risk factors for thyroid diseases and their consequences. The objective of the study was to analyze dietary iodine intake (dIi) and the [...] Read more.

Background/Objectives: Iodine plays a central role in thyroid hormone synthesis and neurodevelopment. Its deficiency and excessive intake have been identified as risk factors for thyroid diseases and their consequences. The objective of the study was to analyze dietary iodine intake (dIi) and the factors that determine its intake among post-primary school students from northern Poland, specifically those from coastal areas and lake districts. Methods: The study was conducted on a sub-national sample of 3102 adolescents (1751 females and 1351 males) aged 14–20 years, recruited from schools located in the Northern (N) and North-Western (N-W) macroregions of Poland. Dietary iodine intake was assessed using the Iodine Dietary Intake Evaluation-Food Frequency Questionnaire. Based on the data obtained, the adequacy of the intake of this micronutrient was assessed. Statistical analysis was performed using the Shapiro-Wilk, U Mann-Whitney, and Kruskal-Wallis tests and Spearman’s correlation analysis. Results: The median dIi was 66.83 µg daily, including 53 µg from natural sources. This value was below the recommended dietary allowance of 150 µg and below the estimated average requirement of 95 µg of iodine in 85% and 68% of the study participants, respectively. Milk and dairy products provided the highest iodine intake (26.4%). Iodine-enriched salt (16.2%) also significantly impacted iodine intake. However, 60% of respondents did not use iodized salt. The median iodine levels from natural sources were found to be low (dairy products: 15.02 µg, fish and fish products: 2.38 µg, and eggs: 2.10 µg). Dietary iodine intake was significantly lower in adolescents from the N than N-W macroregion of Poland (median: 65.63 vs. µg daily, 74.2 p < 0.001). However, dIi did not depend on sex (p = 0.10), age (p = 0.80), school location (p = 0.80), body mass index classification (p = 0.76), or iodine supplementation (p = 0.90). Conclusions: The study results indicate that insufficient iodine intake among adolescents in northern Poland can be attributed to a limited intake of iodine from natural food sources. A pressing need exists to closely monitor iodine intake and status among Polish adolescents and to implement nutritional education, focusing on the role of iodine, potential risks associated with iodine deficiency, and dietary sources of iodine. Full article

(This article belongs to the Special Issue Selenium and Iodine in Human Health and Disease)

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19 pages, 1700 KB

Open AccessArticle

Clinical Outcomes of Oat Beta-Glucan Nutritional Intervention in Ulcerative Colitis: Case Reports of a Female and a Male Patient

by Alicja Zalecińska, Joanna Harasym, Katarzyna Dziendzikowska, Katarzyna Sikorska and Joanna Gromadzka-Ostrowska

Nutrients 2025, 17(24), 3812; https://doi.org/10.3390/nu17243812 - 5 Dec 2025

Abstract

Background: Inflammatory bowel diseases include Crohn’s disease (CD) and ulcerative colitis (UC). These diseases are characterized by periods of exacerbated inflammation of the gastrointestinal mucosa, interspersed with periods of remission. Current pharmacological interventions are only partially effective. There is a need for effective [...] Read more.

Background: Inflammatory bowel diseases include Crohn’s disease (CD) and ulcerative colitis (UC). These diseases are characterized by periods of exacerbated inflammation of the gastrointestinal mucosa, interspersed with periods of remission. Current pharmacological interventions are only partially effective. There is a need for effective dietary therapies and interventions involving plant substances that can alleviate the course of this disease. Objectives: This study aimed to determine the effects of a 28-day dietary intervention involving a 3% solution of chemically pure, low-molar-mass oat beta-glucan (OBG) in patients diagnosed with de novo UC. Similar-aged men and women were compared. Methods: The OBG was isolated and prepared for consumption as a sterile aqueous suspension. This solution had previously been evaluated for in vitro toxicity using 3D intestinal co-cultures comprising Caco-2, HT29-MTX and THP-1 cells. Before and after the dietary intervention, endoscopic colon examinations were performed and blood hematological, biochemical and immunological parameters, as well as stool calprotectin concentrations, were analyzed. The Disease Activity Index (DAI), endoscopic Mayo score, the Lichtiger Colitis Activity Index (LCAI) and the neutrophil-to-lymphocyte ratio (NLR) were also determined. Following dietary intervention, the Mayo score, DAI, fecal calprotectin levels, and indices of peripheral blood white cells, CRP, and pro-inflammatory cytokine concentrations were decreased. Results/Conclusions: The obtained results demonstrated the beneficial effect of dietary intervention with OBG in accelerating the achievement of clinical remission in patients with UC. Full article

(This article belongs to the Special Issue Phytonutrients in Diseases of Affluence)

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20 pages, 2118 KB

Open AccessArticle

FFQ-NutriForHer: Reproducibility and Validity of a Semi-Quantitative Food Frequency Questionnaire for Young and Older Women

by Maria Karolina Szmidt, Ewa Sicinska, Olga Januszko and Joanna Kaluza

Nutrients 2025, 17(24), 3811; https://doi.org/10.3390/nu17243811 - 5 Dec 2025

Abstract

Background: Despite the growing interest in the relationship of diet and women’s health conditions, a limited number of Food Frequency Questionnaires (FFQs) have been specifically developed and/or validated for use among women, and those that exist have been primarily developed and validated [...] Read more.

Background: Despite the growing interest in the relationship of diet and women’s health conditions, a limited number of Food Frequency Questionnaires (FFQs) have been specifically developed and/or validated for use among women, and those that exist have been primarily developed and validated in non-European countries. This study aimed to evaluate the reproducibility and validity of the FFQ-NutriForHer among young and older Polish women. Methods: The reproducibility and validity of the 138-item FFQ-NutriForHer were evaluated in 121 young (18–30 years) and 88 older women (70–90 years). Reproducibility was assessed using energy-adjusted Pearson and intraclass correlation coefficients (PCCs, ICCs) from two FFQ administrations. Validity was evaluated by comparing energy-adjusted and de-attenuated PCCs between FFQ-mean and 3-day dietary records. The Bland–Altman method estimated mean differences and limits of agreement. Results: The mean PCCs and ICCs for macronutrient reproducibility were 0.69 ± 0.12 and 0.69 ± 0.11 among young women and 0.67 ± 0.06 and 0.65 ± 0.11 among older women, respectively, indicating moderate correlation and reliability in both groups. For micronutrients, the mean PCCs were 0.72 ± 0.05 among young women and 0.69 ± 0.05 among older women, while ICCs were 0.71 ± 0.05 and 0.69 ± 0.09, respectively, indicating a good and moderate correlation and moderate reliability. Mean PCCs for macronutrient validity indicated good concordance with values of 0.51 ± 0.25 among young women and 0.46 ± 0.13 among older women. For micronutrients, the mean PCC for validity was 0.63 ± 0.13 among young women and 0.44 ± 0.14 among older women. Bland–Altman analysis indicated good overall agreement between methods in both groups. Conclusions: Given its high reproducibility and satisfactory validity in both age groups, the FFQ-NutriForHer is a reliable tool for assessing dietary intake and exploring its links to women’s health across different ages. Full article

(This article belongs to the Special Issue The Role of Nutrition in Female Reproductive and Hormonal Health Across the Lifecourse)

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12 pages, 745 KB

Open AccessSystematic Review

The Association Between Nut Consumption and Risk of Depressive Symptoms: A Meta-Analysis of Observational Studies

by Sohyun Kim, Hyogyeong Lee, Qiao-Yi Chen, Yooheon Park and NaNa Keum

Nutrients 2025, 17(24), 3810; https://doi.org/10.3390/nu17243810 - 5 Dec 2025

Abstract

Background/Objectives: Accumulating evidence suggests that dietary factors such as nuts may play a role in depressive symptoms. Yet, existing evidence regarding the relationship between nut consumption and depressive symptoms remains inconsistent. To clarify this association, we conducted a meta-analysis. Methods: PubMed and Embase [...] Read more.

Background/Objectives: Accumulating evidence suggests that dietary factors such as nuts may play a role in depressive symptoms. Yet, existing evidence regarding the relationship between nut consumption and depressive symptoms remains inconsistent. To clarify this association, we conducted a meta-analysis. Methods: PubMed and Embase were searched for observational studies on the relationship between nut consumption and depressive symptoms published up to September 2025. Summary relative risks (SRRs) and 95% confidence intervals (CIs) were estimated using the DerSimonian–Laird random effects model. Results: A total of seven observational studies, comprising 70,136 participants, were included. Higher nut consumption was significantly associated with a lower risk of depressive symptoms (SRRs = 0.75, 95% CIs, 0.67–0.85; p < 0.001, I² = 15%, P_{heterogeneity} = 0.31). Compared to <1 time/week of nut consumption, the inverse relationship was significant for ≥3 times/week of nut consumption (SRRs = 0.75, 95% CIs = 0.63–0.89, p = 0.001, I² = 0%, P_{heterogeneity} = 0.93), but not for 1 to <3 times/week of nut consumption (SRRs = 0.93, 95% CIs = 0.69–1.24, p = 0.62, I² = 52%, P_{heterogeneity} = 0.10). Conclusions: Our meta-analysis of observational studies found that higher nut consumption was associated with a reduced risk of depressive symptoms, particularly when intake reached at least three servings per week. Further research, especially randomized controlled trials, is needed to understand the underlying mechanisms. Full article

(This article belongs to the Section Nutrition and Neuro Sciences)

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22 pages, 2230 KB

Open AccessArticle

Anthocyanin-Rich Blackcurrant Pomace Mitigates Oxidative Stress and Affects Steroid Metabolism in the Testes of Rats Exposed to Silver Nanoparticles

by Michał Oczkowski, Katarzyna Dziendzikowska, Marcin Kruszewski, Joanna Gromadzka-Ostrowska and Agnieszka Grzelak

Nutrients 2025, 17(24), 3809; https://doi.org/10.3390/nu17243809 - 5 Dec 2025

Abstract

Background/Objectives: Silver nanoparticles (AgNPs), used in industry and medicine, can have a negative impact on the human organism, particularly on the reproductive system, while polyphenolic supplementation may reduce oxidative stress (OS) and enhance male reproductive potential. The aim of this study was [...] Read more.

Background/Objectives: Silver nanoparticles (AgNPs), used in industry and medicine, can have a negative impact on the human organism, particularly on the reproductive system, while polyphenolic supplementation may reduce oxidative stress (OS) and enhance male reproductive potential. The aim of this study was to investigate the effects of anthocyanin-rich blackcurrant pomace (BC) on sex steroid hormone metabolism and the OS indicator in the testes of rats following exposure to AgNPs. Methods: Adult rats were fed with a control feed (CTR) or diet supplemented with a 2% BC (BC group). The rats from AgNano and AgNano+BC groups were treated with 20 nm AgNPs (30 mg/kg/day for 28 days by gavage). Results: The plasma testosterone (T) and plasma dihydrotestosterone (DHT) concentrations were decreased in all experimental groups compared to the control (CTR) animals. The co-treatment of animals with AgNPs and BC resulted in decreased oestrogen receptor (ESR2) levels in the testes as compared to rats fed with a diet with BC alone, and the up-regulation of mRNA level of genes involved in T synthesis and metabolism (StAr, Cyp11a1, Hsd17b3, Hsd3b3, Cyp19a1, and Srd5a1), and steroid hormone signalling (AR, ESR1, and ESR2) compared to the Ctr group. The addition of BC to the diet of rats treated with AgNPs resulted in decreased protein carbonyls in the testes as compared to AgNPs-treated animals. Conclusions: The study demonstrated that relatively low AgNPs administration to rats was associated with increased oxidative stress in the gonads. Incorporating BC into the animals’ feed mitigated AgNPs-induced oxidative stress and stimulated the expression of genes involved in steroid synthesis and metabolism in testes. The bioactive compounds in blackcurrant pomace have plausible mechanisms to influence reproductive health. Full article

(This article belongs to the Special Issue Antioxidant-Rich Natural Fruit and Vegetable Foods and Human Health)

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