Nutrients

23 pages, 2170 KiB

Open AccessReview

Dietary Polyphenols: Luteolin, Quercetin, and Apigenin as Potential Therapeutic Agents in the Treatment of Gliomas

by Weronika Justyńska, Mikołaj Grabarczyk, Ewa Smolińska, Aleksandra Szychowska, Andrzej Glabinski and Piotr Szpakowski

Nutrients 2025, 17(13), 2202; https://doi.org/10.3390/nu17132202 - 1 Jul 2025

Abstract

Polyphenols are a group of plant-derived compounds that possess a wide range of possible industrial and pharmaceutical applications. Their mechanisms of action are often enabled by their multifaceted anti-inflammatory and antioxidant properties. As a result of their promising biological profile, they have been [...] Read more.

Polyphenols are a group of plant-derived compounds that possess a wide range of possible industrial and pharmaceutical applications. Their mechanisms of action are often enabled by their multifaceted anti-inflammatory and antioxidant properties. As a result of their promising biological profile, they have been the focus of extensive research, which has examined their potential in the treatment of various diseases. These studies have observed that polyphenols may be associated with decreased neoplastic cellular growth, therefore offering valuable potential in oncological therapies. Quercetin, luteolin, and apigenin belong to the group of polyphenols with the most documented efficacy in this regard, particularly against tumors of glial origin. This review gathers information from a multitude of in vitro investigations and animal-model-based research that explore the molecular pathways and biochemical mechanisms engaged by polyphenols which enable their anti-tumoral activity in the central nervous system. Ultimately, this article aims to summarize this research and use this data to comment on the influence of polyphenols on glioma-affected subjects, in addition to exploring methods for increasing their bioavailability for the purposes of clinical application. Full article

(This article belongs to the Special Issue Bioactive Compounds and Functional Foods in Human Health—2nd Edition)

28 pages, 7091 KiB

Open AccessArticle

Dynamic Microbiome Responses to Structurally Diverse Anthocyanin-Rich Foods in a Western Diet Context

by Mohammed F. Almatani, Giovanni Rompato, Eliza C. Stewart, Marcus Hayden, Jeremy Case, Samuel Rice, Korry J. Hintze and Abby D. Benninghoff

Nutrients 2025, 17(13), 2201; https://doi.org/10.3390/nu17132201 - 1 Jul 2025

Abstract

Background/Objectives: Anthocyanin (ACN)-rich foods are known to influence the gut microbiota composition, but the temporal dynamics and structural specificity of these effects remain poorly understood. This study investigated how distinct ACN-rich fruit supplements impact the gut microbiome over time in the context of [...] Read more.

Background/Objectives: Anthocyanin (ACN)-rich foods are known to influence the gut microbiota composition, but the temporal dynamics and structural specificity of these effects remain poorly understood. This study investigated how distinct ACN-rich fruit supplements impact the gut microbiome over time in the context of a Western-style diet. We hypothesized that ACN-induced microbial shifts would occur rapidly, differ by ACN source, and require continued intake to persist. Methods: C57BL/6J mice were fed the total Western diet (TWD) supplemented with freeze-dried powders from bilberry (BB), tart cherry (TC), chokeberry (CB), elderberry (EB), black currant (BC), or black raspberry (BRB) for 0, 1, 3, or 7 days. Cocoa polyphenols (CPs) were included as a comparator with a distinct polyphenol profile. Fecal microbiota were collected at 0, 1, 3, and 7 days post exposure and analyzed by 16S rRNA sequencing. Results: ACN-rich supplements induced rapid microbial shifts detectable within one day of exposure. However, most changes reverted toward the baseline within days of supplement withdrawal, indicating limited persistence. Among the ACNs, BRB produced the most sustained microbiome alterations. Microbial responses varied by ACN source, suggesting that differences in glycoside and aglycone structures influence the community composition. Conclusions: ACN-rich foods can induce rapid but largely transient alterations in the gut microbiome, with variability linked to the polyphenol structure. These findings highlight the ecological sensitivity of the microbiome to specific dietary components and underscore the importance of sustained intake for maintaining microbial shifts. Full article

(This article belongs to the Special Issue Dietary Patterns and Gut Microbiota)

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17 pages, 477 KiB

Open AccessSystematic Review

E-Health and M-Health in Obesity Management: A Systematic Review and Meta-Analysis of RCTs

by Manuela Chiavarini, Irene Giacchetta, Patrizia Rosignoli and Roberto Fabiani

Nutrients 2025, 17(13), 2200; https://doi.org/10.3390/nu17132200 - 1 Jul 2025

Abstract

Background: Obesity in adults is a growing health concern. The principal interventions used in obesity management are lifestyle-change interventions such as diet, exercise, and behavioral therapy. Although they are effective, current treatment options have not succeeded in halting the global rise in the [...] Read more.

Background: Obesity in adults is a growing health concern. The principal interventions used in obesity management are lifestyle-change interventions such as diet, exercise, and behavioral therapy. Although they are effective, current treatment options have not succeeded in halting the global rise in the prevalence of obesity or achieving sustained long-term weight maintenance at the population level. E-health and m-health are both integral components of digital health that focus on the use of technology to improve healthcare delivery and outcomes. The use of eHealth/mHealth might improve the management of some of these treatments. Several digital health interventions to manage obesity are currently in clinical trials. Objective: The aim of our systematic review is to evaluate whether digital health interventions (e-Health and m-Health) have effects on changes in anthropometric measures, such as weight, BMI, and waist circumference and behaviors such as energy intake, eating behaviors, and physical activity. Methods: A search was conducted for randomized controlled trials (RCTs) conducted through 4 October 2024 through three databases (Medline, Web of Science, and Scopus). Studies were included if they evaluated digital health interventions (e-Health and m-Health) compared to control groups in overweight or obese adults (BMI ≥ 25 kg/m²) and reported anthropometric or lifestyle behavioral outcomes. Study quality was assessed using the Cochrane Risk of Bias Tool (RoB 2). Meta-analyses were performed using random-effects or fixed-effects models as appropriate, with statistical significance set at p < 0.05. Results: Twenty-two RCTs involving diverse populations (obese adults, overweight individuals, postpartum women, patients with eating disorders) were included. Digital interventions included biofeedback devices, smartphone apps, e-coaching systems, web-based interventions, and mixed approaches. Only waist circumference showed a statistically significant reduction (WMD = −1.77 cm; 95% CI: −3.10 to −0.44; p = 0.009). No significant effects were observed for BMI (WMD = −0.43 kg/m²; p = 0.247), body weight (WMD = 0.42 kg; p = 0.341), or lifestyle behaviors, including physical activity (SMD = −0.01; p = 0.939) and eating behavior (SMD = −0.13; p = 0.341). Body-fat percentage showed a borderline-significant trend toward reduction (WMD = −0.79%; p = 0.068). High heterogeneity was observed across most outcomes (I² > 80%), indicating substantial variability between studies. Quality assessment revealed predominant judgments of “Some Concerns” and “High Risk” across the evaluated domains. Conclusions: Digital health interventions produce modest but significant benefits on waist circumference in overweight and obese adults, without significant effects on other anthropometric or behavioral parameters. The high heterogeneity observed underscores the need for more personalized approaches and future research focused on identifying the most effective components of digital interventions. Digital health interventions should be positioned as valuable adjuncts to, rather than replacements for, established obesity treatments. Their integration within comprehensive care models may enhance traditional interventions through continuous monitoring, real-time feedback, and improved accessibility, but interventions with proven efficacy such as behavioral counseling and clinical oversight should be maintained. Full article

(This article belongs to the Special Issue Dietary Approaches and Exercise in the Management of Overweight and Obesity)

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22 pages, 940 KiB

Open AccessReview

Sucralose: A Review of Environmental, Oxidative and Genomic Stress

by Volodymyr V. Tkach, Tetiana V. Morozova, Isabel O’Neill de Mascarenhas Gaivão, Natasha Gomes de Miranda, Yana G. Ivanushko, José Inácio Ferrão de Paiva Martins and Ana Novo Barros

Nutrients 2025, 17(13), 2199; https://doi.org/10.3390/nu17132199 - 1 Jul 2025

Abstract

This review explores current knowledge on the environmental, oxidative, and genomic effects of sucralose (E955), an artificial sweetener widely used in food products, including those for children, and known to cross both the placental barrier and into breast milk. Although initially considered safe, [...] Read more.

This review explores current knowledge on the environmental, oxidative, and genomic effects of sucralose (E955), an artificial sweetener widely used in food products, including those for children, and known to cross both the placental barrier and into breast milk. Although initially considered safe, research conducted over the past two decades has presented conflicting evidence regarding its long-term impact, particularly on ecosystems and biological systems. Structurally similar to chlorinated compounds such as perfluoralkyl substances (PFAS), sucralose is highly persistent in the environment, which complicates its degradation and removal, especially from aquatic systems. Several studies have reported behavioral, metabolic, and even genomic alterations in aquatic organisms exposed to sucralose, raising concerns about its broader ecological safety. In addition, its presence has been linked to shifts in microbiota composition in both environmental and human contexts. Reports of sucralose-induced oxidative stress further highlight the need for caution in its continued use, particularly in sensitive formulations. Given its widespread presence and resistance to degradation, further investigation into the environmental and biological safety of sucralose is urgently needed. Full article

(This article belongs to the Special Issue Towards Healthy and Sustainable Diets: Environmental and Nutritional Perspectives)

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11 pages, 421 KiB

Open AccessReview

Dietary Interventions for Short Bowel Syndrome in Adults

by Cassandra Pogatschnik and Lindsey Russell

Nutrients 2025, 17(13), 2198; https://doi.org/10.3390/nu17132198 - 1 Jul 2025

Abstract

Short bowel syndrome (SBS) is a rare but complex medical condition that requires expertise in management. The etiology in adults is commonly surgical resection for Crohn’s disease or mesenteric ischemia and is classified based on the anatomy of the remaining bowel. An accurate [...] Read more.

Short bowel syndrome (SBS) is a rare but complex medical condition that requires expertise in management. The etiology in adults is commonly surgical resection for Crohn’s disease or mesenteric ischemia and is classified based on the anatomy of the remaining bowel. An accurate assessment of the anatomy and nutritional and hydration status is necessary. Dietary therapy is essential to induce adaptation in SBS, provide adequate nutritional needs, and manage symptoms including stool burden. As general SBS guidelines on nutritional support and dietary interventions exist, SBS is unique to the individual and nutrition must also be personalized to the individual to improve quality of life. This review will highlight the principles of adaptation, dietary interventions in SBS, as well as future directions for this field. Full article

(This article belongs to the Special Issue Dietary and Nutritional Therapies to Improve Digestive Disorders)

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14 pages, 463 KiB

Open AccessArticle

Association of Parental Feeding Styles with Body Composition Among Children in Two Regions in China

by Chao Li, Sha Liu, Dingkang Wang, Mengzi Sun, Jie You, Bizhong Che, Wen Zhang, Wei Wei, Yaling Zhao and Youfa Wang

Nutrients 2025, 17(13), 2197; https://doi.org/10.3390/nu17132197 - 30 Jun 2025

Abstract

Background: This study aimed to investigate the correlation between parental feeding practices and children’s body composition in two Chinese regions with distinct socioeconomic characteristics. Methods: A cross-sectional study was conducted in Shenzhen (economically developed) and Yulin (economically underdeveloped) regions. Data were collected in [...] Read more.

Background: This study aimed to investigate the correlation between parental feeding practices and children’s body composition in two Chinese regions with distinct socioeconomic characteristics. Methods: A cross-sectional study was conducted in Shenzhen (economically developed) and Yulin (economically underdeveloped) regions. Data were collected in 2023 from 1298 (age 8–10 years) children and their parents in two regions. Overweight/obesity was defined by Chinese national standards (WS/T 586-2018), and parental feeding practices were assessed using a 26-item child feeding questionnaire (CFQ). Multivariable regression analysis was performed to assess whether the association between parental feeding practices and obesity in children differs by regions. Results: A total of 1298 participants were included, with 678 male students (52.23%) and a mean age of 10.65 ± 0.86 years. In two regions, children with higher pressure to eat (PE) scores had lower rates of overweight, obesity and central obesity. Significant positive associations were observed between children’s body composition and parental feeding practices, including PE, perceived child weight (PCW), and concern about child weight (CN) (all p < 0.001). In regional interaction analysis, PCW had significant positive associations with fat mass index (FMI) (β = 0.32, 95% CI = 0.18, 0.46). Meanwhile, CN also had significant positive associations with both FMI (β = 0.44, 95% CI = 0.34, 0.54) and fat-free mass index (FFMI) (β = 0.07, 95% CI = 0.02, 0.11) (all p < 0.001). Conclusions: Obesity, central obesity, and body composition in children were associated with parental feeding practices in the two regions. CN was associated with higher risk of obesity and central obesity in the two regions. Future efforts to prevent obesity in children may optimize parental feeding practices, especially more scientific awareness of children’s weight status while reducing undue concern. Full article

(This article belongs to the Section Pediatric Nutrition)

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25 pages, 1369 KiB

Open AccessArticle

2D Prediction of the Nutritional Composition of Dishes from Food Images: Deep Learning Algorithm Selection and Data Curation Beyond the Nutrition5k Project

by Rachele Bianco, Sergio Coluccia, Michela Marinoni, Alex Falcon, Federica Fiori, Giuseppe Serra, Monica Ferraroni, Valeria Edefonti and Maria Parpinel

Nutrients 2025, 17(13), 2196; https://doi.org/10.3390/nu17132196 - 30 Jun 2025

Abstract

Background/Objectives: Deep learning (DL) has shown strong potential in analyzing food images, but few studies have directly predicted mass, energy, and macronutrient content from images. In addition to the importance of high-quality data, differences in country-specific food composition databases (FCDBs) can hinder [...] Read more.

Background/Objectives: Deep learning (DL) has shown strong potential in analyzing food images, but few studies have directly predicted mass, energy, and macronutrient content from images. In addition to the importance of high-quality data, differences in country-specific food composition databases (FCDBs) can hinder model generalization. Methods: We assessed the performance of several standard DL models using four ground truth datasets derived from Nutrition5k—the largest image–nutrition dataset with ~5000 complex US cafeteria dishes. In light of developing an Italian dietary assessment tool, these datasets varied by FCDB alignment (Italian vs. US) and data curation (ingredient–mass correction and frame filtering on the test set). We evaluated combinations of four feature extractors [ResNet-50 (R50), ResNet-101 (R101), InceptionV3 (IncV3), and Vision Transformer-B-16 (ViT-B-16)] with two regression networks (2+1 and 2+2), using IncV3_2+2 as the benchmark. Descriptive statistics (percentages of agreement, unweighted Cohen’s kappa, and Bland–Altman plots) and standard regression metrics were used to compare predicted and ground truth nutritional composition. Dishes mispredicted by ≥7 algorithms were analyzed separately. Results: R50, R101, and ViT-B-16 consistently outperformed the benchmark across all datasets. Specifically, when replacing it with these top algorithms, reductions in median Mean Absolute Percentage Errors were 6.2% for mass, 6.4% for energy, 12.3% for fat, and 33.1% and 40.2% for protein and carbohydrates. Ingredient–mass correction substantially improved prediction metrics (6–42% when considering the top algorithms), while frame filtering had a more limited effect (<3%). Performance was consistently poor across most models for complex salads, chicken-based or eggs-based dishes, and Western-inspired breakfasts. Conclusions: The R101 and ViT-B-16 architectures will be prioritized in future analyses, where ingredient–mass correction and automated frame filtering methods will be considered. Full article

(This article belongs to the Special Issue Artificial Intelligence in Nutrition Research: Current and Future Perspectives and Applications)

14 pages, 779 KiB

Open AccessArticle

Identifying Early Metabolic Risks of Obesity in Mexican Children and Adolescents from a Semi-Rural Community in Mexico: Beyond BMI and into Biochemical and Nutritional Markers

by Nurit Bistre, Sara Guillén-López, Isabel Medina-Vera, Miriam E. Reyna-Fabián, Nancy L. Hernández-Martínez, Lilian Castro-Monroy, René Cerritos-Flores, Ana Karen Arias-Basilio, Diana González-Santiesteban, Cynthia Fernández-Lainez, Marcela Vela-Amieva and Liliana Fernández-Hernández

Nutrients 2025, 17(13), 2195; https://doi.org/10.3390/nu17132195 - 30 Jun 2025

Abstract

Background: Childhood and adolescent obesity often coexist with micronutrient deficiencies and metabolic alterations, particularly in marginalized communities. Objectives: This cross-sectional study evaluated the biochemical, anthropometric, and dietary characteristics of 55 children and adolescents (ages 4–13) from Tlaltizapán, Mexico, to identify the early metabolic [...] Read more.

Background: Childhood and adolescent obesity often coexist with micronutrient deficiencies and metabolic alterations, particularly in marginalized communities. Objectives: This cross-sectional study evaluated the biochemical, anthropometric, and dietary characteristics of 55 children and adolescents (ages 4–13) from Tlaltizapán, Mexico, to identify the early metabolic risk factors associated with excess weight. Methods: Nutritional intake was assessed through six-day dietary recalls and analyzed for adequacy against the national reference values. Anthropometric and biochemical indicators—including the BMI-for-age Z-score, waist-to-height ratio (WHtR), lipid profile, and plasma amino acid levels—were stratified by age and weight status. Results: Overall, 36.4% of participants were overweight or obese. Alarmingly, 89.4% of children and 94.1% of adolescents had low HDL levels, regardless of their BMIs. Several participants with a normal BMI showed elevated WHtR, triceps skinfold, and plasma branched-chain amino acids, suggesting hidden metabolic risks. The dietary analysis revealed an excess intake of sugars, proteins, and fats, alongside insufficient fiber, vitamins, and minerals. The adolescents had poorer adherence to dietary recommendations than children. Conclusions: These findings underscore the limitations of BMI alone and support the use of WHtR, skinfolds, and biochemical markers to detect preclinical obesity. Urgent, targeted nutritional strategies are needed in semi-rural areas to address the double burden of obesity and undernutrition. Full article

(This article belongs to the Special Issue Food Habits, Nutritional Knowledge, and Nutrition Education)

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26 pages, 632 KiB

Open AccessReview

Use of Nutritional Strategies, Bioactive Compounds, and Dietary Supplements in Young Athletes: From Evidence to Potential Risks—A Narrative Review

by Diego De Zan, Francesca Eletti, Giulia Fiore, Elisa Di Girolamo, Gaia Giulia Maria Bozzini, Veronica Perico, Martina Tosi, Lorenzo Norsa, Gianvincenzo Zuccotti and Elvira Verduci

Nutrients 2025, 17(13), 2194; https://doi.org/10.3390/nu17132194 - 30 Jun 2025

Abstract

Young athletes face unique nutritional challenges due to their simultaneous engagement in intensive physical training and ongoing growth and development. Standard adult-based dietary recommendations often fail to meet the specific needs of this population. While the role of macronutrients and micronutrients is well [...] Read more.

Young athletes face unique nutritional challenges due to their simultaneous engagement in intensive physical training and ongoing growth and development. Standard adult-based dietary recommendations often fail to meet the specific needs of this population. While the role of macronutrients and micronutrients is well recognized, increasing attention is being paid to bioactive compounds—non-essential food-derived elements with potential health benefits. This review aims to summarize current evidence regarding the efficacy, safety, and potential benefits of bioactive compounds in the nutritional management of young athletes. Methods: A narrative review of the literature published over the last 30 years was conducted across PubMed/Medline, Embase, and Scopus databases to identify relevant studies published in English. The inclusion criteria covered original research articles, clinical trials, cohort and case-control studies, and meta-analyses focusing on individuals aged 8–20 years. Studies addressing supplementation strategies, physiological effects, and safety concerns of bioactive compounds in young athletes were selected. Preclinical data and adult-based studies were also included to contextualize molecular mechanisms and support clinical findings. Results: The review highlights that bioactive compounds such as omega-3 fatty acids, curcumin, caffeine, and creatine as well as antioxidant vitamins may play a beneficial role in improving recovery, immune function, and performance in young athletes. Of these 21 studies, 8 focused on recovery and muscle soreness, 6 addressed immune function or antioxidant/anti-inflammatory effects, and 7 investigated direct performance enhancement. However, most of the available evidence derives from adult populations, and pediatric-specific data remain limited. Concerns remain about the misuse of supplements, lack of professional guidance, and potential contamination with banned substances. Conclusions: While some bioactive compounds show promising potential to support the health and performance of young athletes, current evidence is insufficient to support routine use in this population. More pediatric-specific research is necessary to establish safety, efficacy, and appropriate supplementation protocols tailored to young athletes’ unique physiological needs. Full article

(This article belongs to the Special Issue Nutritional Supplementation in Health and Sports Performance)

22 pages, 7613 KiB

Open AccessArticle

Impact of Probiotic/Synbiotic Supplementation on Post-Bariatric Surgery Anthropometric and Cardiometabolic Outcomes: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Mohamed Saad Rakab, Rahma Mogahed Rateb, Alaa Maamoun, Nada Radwan, Abdalhakim Shubietah, AlMothana Manasrah, Islam Rajab, Giorgia Scichilone, Lisa Tussing-Humphreys and Abeer M. Mahmoud

Nutrients 2025, 17(13), 2193; https://doi.org/10.3390/nu17132193 - 30 Jun 2025

Abstract

Background/Objectives: Bariatric surgery improves weight and metabolic health in individuals with severe obesity; however, challenges like gut dysbiosis and nutrient deficiencies persist postoperatively. Probiotic supplementation may enhance recovery by modulating gut microbiota. This updated meta-analysis aimed to assess the effects of probiotics/synbiotics on [...] Read more.

Background/Objectives: Bariatric surgery improves weight and metabolic health in individuals with severe obesity; however, challenges like gut dysbiosis and nutrient deficiencies persist postoperatively. Probiotic supplementation may enhance recovery by modulating gut microbiota. This updated meta-analysis aimed to assess the effects of probiotics/synbiotics on metabolic, anthropometric, and nutritional outcomes after bariatric surgery. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted using PubMed, SCOPUS, Web of Science, and CENTRAL through December 2024. Studies comparing probiotics/synbiotics (which contain both probiotics and prebiotics) versus a placebo in adults post-bariatric surgery were included. Meta-analyses were conducted, with subgroup analyses by surgery type, the timing of the intervention, and probiotic formulation (PROSPERO ID: CRD420251019199). Results: Thirteen RCTs involving 809 patients were included in the analysis. Probiotic use significantly reduced BMI (MD = 0.67, 95% CI: 0.33 to 1.00), HbA1c (MD = −0.19%, 95% CI: −0.36 to −0.01), triglycerides (MD = −16.56 mg/dL), and AST levels (MD = −3.68 U/L), while increasing ALP (MD = 8.12 U/L) and vitamin D (MD = 13.68 pg/mL). Ferritin levels were significantly lower (MD = −18.89 µg/L) in the probiotic group. A subgroup analysis showed enhanced benefits in patients undergoing mini-gastric bypass, with perioperative or synbiotic interventions specifically improving triglycerides, total cholesterol, and HbA1c. Conclusions: Probiotics may offer modest but significant improvements in BMI, glycemic control, lipid profile, liver enzymes, and vitamin D levels after bariatric surgery. These findings support the potential role of probiotics/synbiotics as an adjunct therapy, though further large-scale trials are warranted to confirm long-term benefits. Full article

(This article belongs to the Section Prebiotics and Probiotics)

15 pages, 1134 KiB

Open AccessArticle

Analyzing the Caloric Variability of Bites in a Semi-Naturalistic Dietary Setting

by Mohammad Junayed Bhuyan, Luca Vedovelli, Corrado Lanera, Daniele Gasparini, Paola Berchialla, Ileana Baldi and Dario Gregori

Nutrients 2025, 17(13), 2192; https://doi.org/10.3390/nu17132192 - 30 Jun 2025

Abstract

Background: Obesity is a major public health issue in developed countries, primarily managed through dietary interventions and physical activity. Food portion sizes influence the estimation of energy intake, particularly through bites, of which characteristics remain insufficiently defined. This study investigates the variability in [...] Read more.

Background: Obesity is a major public health issue in developed countries, primarily managed through dietary interventions and physical activity. Food portion sizes influence the estimation of energy intake, particularly through bites, of which characteristics remain insufficiently defined. This study investigates the variability in bite energy content. Methods: This observational study was conducted over 14 months. Thirteen types of packaged food were provided to 30 Italian healthy volunteers (mean age 26.8 ± 8.5 years) in a semi-naturalistic dietary feeding setting. Participants’ anthropometric measurements were recorded. A total of 1850 bites were weighed and 420 bites were assessed for volume and energy content. Results: Bite volume and mass explained bite energy content at different rates. The most influential anthropometric feature was waist circumference. Gender modified the association between waist circumference and bite characteristics; males showed increased bite volume, mass, and energy content as waist circumference increased, whereas females showed little or no association. Age was inversely associated with bite volume and mass, with younger participants having larger bites. Gender significantly influenced average bite size, with females showing lower values than males. The use of a fork was associated with higher bite volume, mass, and energy compared to a spoon. Food eaten with bare hands had lower mass but higher energy content compared to food eaten with a spoon. The variability in bite energy was considerably greater per bite than per gram, reflecting the combined influence of food texture, bite size, and cutlery used. Conclusions: Bite energy variability, influenced by intrinsic factors (gender, age, waist circumference) and extrinsic factors (cutlery, food texture), significantly impacts portion size effect. Future bite counters should consider these elements for accurate dietary assessment. Full article

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

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22 pages, 935 KiB

Open AccessReview

Zinc Deficiency in Chronic Kidney Disease and Hemodialysis: Insights from Basic Research to Clinical Implications

by Shinya Nakatani, Tomoaki Morioka, Fumiyuki Morioka, Katsuhito Mori and Masanori Emoto

Nutrients 2025, 17(13), 2191; https://doi.org/10.3390/nu17132191 - 30 Jun 2025

Abstract

Zinc is an essential trace element involved in diverse physiological processes in humans. Zinc deficiency is common in patients with chronic kidney disease (CKD), including those undergoing hemodialysis. This narrative review synthesizes both experimental and clinical findings on zinc status in CKD patients. [...] Read more.

Zinc is an essential trace element involved in diverse physiological processes in humans. Zinc deficiency is common in patients with chronic kidney disease (CKD), including those undergoing hemodialysis. This narrative review synthesizes both experimental and clinical findings on zinc status in CKD patients. Literature was primarily retrieved from PubMed using the keywords “zinc” AND (“CKD” OR “hemodialysis”) AND at least one of the following: “cardiovascular disease (CVD)”, “vascular calcification”, “anemia”, “blood pressure”, OR “infection”. In vitro, studies have shown that zinc suppressed phosphate-induced vascular calcification while zinc deficiency directly promoted calcification. Clinically, serum zinc levels were positively correlated with calcification propensity in patients with CKD. In vivo zinc deficiency has been implicated in elevated blood pressure, Moreover, zinc supplementation enhanced erythropoiesis and improved responsiveness to erythropoiesis-stimulating agents in both animal models and humans. We recently reported that low serum zinc levels are associated with increased mortality in hemodialysis patients with hypoalbuminemia. Previous randomized controlled trials (RCTs) suggest a daily dose of approximately 45 mg of zinc for 2 months mitigates inflammation, oxidative stress, and malnutrition in patients undergoing hemodialysis. Emerging evidence suggests that vascular calcification, hypertension, and renal anemia are newly recognized features of zinc deficiency and are established risk factors for CKD progression, CVD, and mortality. However, the impact of zinc supplementation on these clinical outcomes remains inconclusive. Further RCTs are required to establish zinc supplementation as an effective therapeutic strategy for improving various outcomes in patients with CKD including hemodialysis. Full article

(This article belongs to the Special Issue Effects of Diet and Nutrition on Chronic Kidney Disease (CKD)—"Greedy Kidney" in Health and Diseases)

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14 pages, 2341 KiB

Open AccessArticle

Global Drinking Water Standards Lack Clear Health-Based Limits for Sodium

by Juliette Crowther, Aliyah Palu, Alicia Dunning, Loretta Weatherall, Wendy Spencer, Devanshi Gala, Damian Maganja, Katrina Kissock, Kathy Trieu, Sera Lewise Young, Ruth McCausland, Greg Leslie and Jacqui Webster

Nutrients 2025, 17(13), 2190; https://doi.org/10.3390/nu17132190 - 30 Jun 2025

Abstract

Background/Objectives: High sodium consumption increases the risk of hypertension and cardiovascular disease. Although food remains the primary source of intake, elevated sodium levels in drinking water can further contribute to excessive intake, particularly in populations already exceeding recommendations. This review examines the extent [...] Read more.

Background/Objectives: High sodium consumption increases the risk of hypertension and cardiovascular disease. Although food remains the primary source of intake, elevated sodium levels in drinking water can further contribute to excessive intake, particularly in populations already exceeding recommendations. This review examines the extent to which national drinking water standards account for sodium-related health risks and aims to inform discussion on the need for enforceable, health-based sodium limits. Methods: National standards for unbottled drinking water in 197 countries were searched for using the WHO 2021 review of drinking water guidelines, the FAOLEX database, and targeted internet and AI searches. For each country, data were extracted for the document name, year, regulatory body, regulation type, sodium limit (if stated), and rationale. Socio-geographic data were sourced from World Bank Open Data. A descriptive analysis was conducted using Microsoft Excel. Results: Standards were identified for 164 countries. Of these, 20% (n = 32), representing 30% of the global population, had no sodium limit. Among the 132 countries with a sodium limit, 92% (n = 121) adopted the WHO’s palatability-based guideline of 200 mg/L. Upper limits ranged from 50 to 400 mg/L. Only twelve countries (9%) cited health as a rationale. Three countries—Australia, Canada, and the United States—provided a separate recommendation for at-risk populations to consume water with sodium levels below 20 mg/L. Conclusions: Globally, drinking water standards give inadequate attention to sodium’s health risks. Most either lack sodium limits or rely on palatability thresholds that are too high to protect health. Updating national and international standards to reflect current evidence is essential to support sodium reduction efforts. Health-based sodium limits would empower communities to better advocate for safe water. Amid rising water salinity, such reforms must be part of a broader global strategy to ensure universal and equitable access to safe, affordable drinking water as a basic human right. Full article

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

35 pages, 591 KiB

Open AccessReview

Steatotic Liver Disease in Older Adults: Clinical Implications and Unmet Needs

by Daniel Clayton-Chubb, William W. Kemp, Ammar Majeed, Peter W. Lange, Jessica A. Fitzpatrick, Karl Vaz, John S. Lubel, Alexander D. Hodge, Joanne Ryan, John J. McNeil, Alice J. Owen, Robyn L. Woods and Stuart K. Roberts

Nutrients 2025, 17(13), 2189; https://doi.org/10.3390/nu17132189 - 30 Jun 2025

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the commonest cause of chronic liver disease worldwide. Its incidence has been increasing rapidly, alongside the growing epidemics of type 2 diabetes mellitus and overweight/obesity. Global population age has also been increasing in parallel, and predictions [...] Read more.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the commonest cause of chronic liver disease worldwide. Its incidence has been increasing rapidly, alongside the growing epidemics of type 2 diabetes mellitus and overweight/obesity. Global population age has also been increasing in parallel, and predictions indicate there will be more than 2 billion persons aged over 65 by the year 2050. The interplay between MASLD and other health conditions of older persons has been a focus of recent research. In this narrative review, we aim to describe its prevalence; clinical and sociodemographic associations; and outcomes for older persons, all of which are of significant importance when considering public health messaging as well as screening and counselling individual older adults. Full article

(This article belongs to the Special Issue Dietary Intake and Health Status in Older Adults—2nd Edition)

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29 pages, 1867 KiB

Open AccessReview

Should Grain-Based Staple Foods Be Included in Admonitions to “Avoid Processed and Ultra-Processed Food”?

by Julie Miller Jones

Nutrients 2025, 17(13), 2188; https://doi.org/10.3390/nu17132188 - 30 Jun 2025

Abstract

Background/Objectives: The nutritional importance of grain-based foods (GBFs) and whole grains (WGs) is underscored by their central position in dietary guidance worldwide. Many jurisdictions recommend consumers increase WG intake because they are associated with multiple health benefits, with evidence quality rated as moderate [...] Read more.

Background/Objectives: The nutritional importance of grain-based foods (GBFs) and whole grains (WGs) is underscored by their central position in dietary guidance worldwide. Many jurisdictions recommend consumers increase WG intake because they are associated with multiple health benefits, with evidence quality rated as moderate to high. High intakes of ultra-processed foods (UPFs), as defined by NOVA that classifies food by level of processing, are associated with numerous negative health outcomes, with evidence less convincing than for WGs. Yet, some dietary guidance recommends consumers to avoid UPFs. This creates two divergent guidelines since NOVA designates most commonly eaten grain-based foods (GBFs) as UPFs. These contradictory guidelines fail to comply with recommended principles of dietary guidance and generate questions about underlying assumptions and definitions that classify WG staples and colas together. Methods: Definitions and assumptions for systems ostensibly categorizing foods by level of processing were evaluated for validity by various methods. Special attention was paid to the ability of different classifications to differentiate between WGs, RGs staples, and indulgent GBFs. Findings from meta-analyses associating high intakes of WGs with numerous health benefits were compared with those associating high intakes of UPFs. Menus and modeling studies were assessed for ability to meet recommendations for WGs and the grain food group with customary GBFs while avoiding UPFs. Advice to “avoid UPFs” was tested against principles for effective dietary guidance. Results: Definitions and categorizations of foods by levels of processing vary markedly. Assumptions for NOVA and other systems are questionable. While meta-analyses consistently show high intakes of UPFs are associated with adverse health outcomes, high intake of WG foods, nearly all designated as UPFs, are associated with better health outcomes, although evidence quality for the latter is rated stronger. These findings add to the body of evidence suggesting flawed assumptions behind categorizing WG staples in terms of level of processing. Conclusions: NOVA deems 90% of WGs as UPFs. Adding statements to dietary guidance to “Avoid UPFs”, while asking consumers to increase WG intakes, confuses. Further, it jeopardizes efforts to increase intake of fiber and WG foods because it excludes top sources of fiber and WG-based breads, rolls, tortillas, or cold cereals in Western diets. NOVA advice to avoid UPFs challenges principles for usable dietary guidance and the construction of culturally appropriate, healthy dietary patterns containing WG staples from all levels of processing. Full article

(This article belongs to the Special Issue Effects of Dietary Grains on Human Health)

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25 pages, 1778 KiB

Open AccessSystematic Review

Postbiotics Formulation and Therapeutic Effect in Inflammation: A Systematic Review

by Kinga Zdybel, Angelika Śliwka, Magdalena Polak-Berecka, Paweł Polak and Adam Waśko

Nutrients 2025, 17(13), 2187; https://doi.org/10.3390/nu17132187 - 30 Jun 2025

Abstract

Background: Postbiotics are bioactive compounds derived from inactivated probiotic microorganisms that show potential for preventing and treating inflammatory diseases. This review aimed to evaluate the evidence on their therapeutic effects in inflammatory conditions. Methods: A search of PubMed, Scopus, and Web [...] Read more.

Background: Postbiotics are bioactive compounds derived from inactivated probiotic microorganisms that show potential for preventing and treating inflammatory diseases. This review aimed to evaluate the evidence on their therapeutic effects in inflammatory conditions. Methods: A search of PubMed, Scopus, and Web of Science databases from 2014 to 2024 identified 39 eligible studies. Article selection was conducted using the Rayyan platform, risk of bias was assessed with the Cochrane ROB 2 tool, and results were visualized with ROBVIS. Bibliometric networks were constructed using VOSviewer. Due to data heterogeneity, a meta-analysis was not performed; therefore, results were described and presented graphically. Results: The most commonly used microorganisms belonged to the Lactobacillaceae and Bifidobacteriaceae families, with heat inactivation as the predominant method. Postbiotics exert multifaceted anti-inflammatory effects by modulating cytokine expression, influencing immune cell signaling pathways, and strengthening epithelial barrier integrity. They regulate immune mechanisms such as the Th1/Th2 and Treg/Th17 balance, indicating their potential in treating inflammatory bowel diseases, autoimmune diseases, and metabolic syndrome. However, the heterogeneity of studies, their limitations, and risk of bias require cautious interpretation. Conclusions: Future research should focus on standardizing postbiotic preparations, conducting long-term clinical trials, and analyzing synergistic effects of different strains. Postbiotics offer a promising approach to managing inflammation, with potential applications in functional foods and nutraceuticals. Full article

(This article belongs to the Special Issue Effects of Probiotics, Prebiotics, and Postbiotics on Human Health (2nd Edition))

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16 pages, 396 KiB

Open AccessArticle

Malnutrition and Osteosarcopenia in Elderly Women with Rheumatoid Arthritis: A Dual Clinical Perspective

by Joan M. Nolla, Carmen Moragues, Lidia Valencia-Muntalà, Laia de Daniel-Bisbe, Laura Berbel-Arcobé, Diego Benavent, Paola Vidal-Montal, Antoni Rozadilla, Javier Narváez and Carmen Gómez-Vaquero

Nutrients 2025, 17(13), 2186; https://doi.org/10.3390/nu17132186 - 30 Jun 2025

Abstract

Background/Objectives: Rheumatoid arthritis (RA) is a chronic inflammatory disease frequently accompanied by comorbid conditions that contribute to disability and worsen long-term outcomes. Among these, malnutrition and osteosarcopenia remain under-recognised. This cross-sectional study aimed to assess the prevalence of malnutrition and osteosarcopenia among [...] Read more.

Background/Objectives: Rheumatoid arthritis (RA) is a chronic inflammatory disease frequently accompanied by comorbid conditions that contribute to disability and worsen long-term outcomes. Among these, malnutrition and osteosarcopenia remain under-recognised. This cross-sectional study aimed to assess the prevalence of malnutrition and osteosarcopenia among elderly women with RA and explore the clinical impact of these conditions. Methods: Sixty-five women over 65 years with RA were evaluated using Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition and EWGSOP2-based assessments for sarcopenia; bone status was measured by dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and three-dimensional DXA (3D-DXA). Results: Malnutrition was identified in 49.2% and osteosarcopenia in 52.3% of participants. A significant bidirectional association was observed: malnourished patients had higher rates of osteosarcopenia (65.6% vs. 34.4%; p < 0.05), and osteosarcopenic patients were more frequently malnourished (61.8% vs. 39.1%; p < 0.05). Both conditions were associated with older age, lower body mass index (BMI), impaired muscle parameters, and reduced bone mineral density. Malnourished and osteosarcopenic patients reported worse fatigue and lower physical quality of life, despite similar inflammatory activity. Significant correlations were found between muscle mass indices and bone quality metrics assessed by 3D-DXA. These findings highlight a substantial burden of malnutrition and osteosarcopenia in elderly women with RA, even with well-controlled disease despite similar inflammatory activity (mean Disease Activity Score 28: 2.8 ± 1.0; 43.1% in remission. Conclusions: There is a substantial burden of malnutrition and osteosarcopenia in elderly women with RA that support the integration of systematic nutritional and musculoskeletal screening into routine care. Future studies should evaluate age- and disease-specific mechanisms and assess the benefit of multidisciplinary strategies to prevent frailty and improve long-term outcomes. Full article

(This article belongs to the Section Clinical Nutrition)

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24 pages, 2746 KiB

Open AccessArticle

Hydration Status and Acute Kidney Injury Biomarkers in NCAA Female Soccer Athletes During Preseason Conditioning

by Daniel E. Newmire, Erica M. Filep, Jordan B. Wainwright, Heather E. Webb and Darryn S. Willoughby

Nutrients 2025, 17(13), 2185; https://doi.org/10.3390/nu17132185 - 30 Jun 2025

Abstract

Exercise training in extreme temperatures concurrent with hypohydration status may potentiate the development of acute kidney injury (AKI) in young, healthy persons. Background/Objectives: It is unknown how repeated training bouts in ambient higher temperatures and humidity may influence measures of AKI. The [...] Read more.

Exercise training in extreme temperatures concurrent with hypohydration status may potentiate the development of acute kidney injury (AKI) in young, healthy persons. Background/Objectives: It is unknown how repeated training bouts in ambient higher temperatures and humidity may influence measures of AKI. The purpose of this study was to investigate hydration status and renal biomarkers related to AKI in NCAA Division I female soccer athletes during preseason conditioning. Methods: A convenience sample of n = 21 athletes were recruited (mean ± SEM; age: 19.3 ± 0.25 y; height: 169.6 ± 1.36 cm; mass: 68.43 ± 2.46 kg; lean body mass: 45.91 ± 1.13 kg; fat mass: 22.51 ± 1.69 kg; body fat %: 32.22 ± 1.32%). The average temperature was 27.43 ± 0.19 °C, and the humidity was 71.69 ± 1.82%. Body composition, anthropometric, workload, and 14 urine samples were collected throughout the preseason training period for urine specific gravity (USG), creatinine (uCr), cystatin C (uCyst-C), and neutrophil gelatinase-associated lipocalin (uNGAL) analyses. Results: Our investigation showed that, when compared to baseline (D0), the athletes maintained a USG-average euhydrated status (1.019 ± 0.001) and were euhydrated prior to each exhibition game (D5-Pre: p = 0.03; 1.011 ± 0.001; D10-Pre: p = 0.0009; 1.009 ± 0.001); uCr was elevated on D8 (p = 0.001; 6.29 ± 0.44 mg·dL⁻¹·LBM⁻¹) and D10-Post (p = 0.02; 6.61 ± 0.44 mg·dL⁻¹·LBM⁻¹); uCyst-C was elevated on D6 through D10 (p = 0.001; ~0.42 ± 0.01 mg·dL⁻¹); no differences were found in uNGAL concentration. The highest distance (m) displaced was found during exhibition games (D5: p = <0.0001; ~8.6 km and D10: p = <0.0001; ~9.6 km). During the preseason conditioning, the athletes maintained a euhydrated status (~1.019) via USG, an increase in uCr that averaged within a normal range (208 mg·dL⁻¹), and an increase in uCyst-C to near AKI threshold levels (0.42 mg·L⁻¹) for several practice sessions, followed by an adaptive decline. No differences were found in uNGAL, which may be explained by athlete variation, chosen time sample collection, and variation in training and hydration status. Conclusions: The athletes maintained a euhydrated status, and this may help explain why urinary markers did not change or meet the reference threshold for AKI. Full article

(This article belongs to the Topic Exercise and Nutrition for Physical Performance, Mental Health and General Well-Being)

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14 pages, 2038 KiB

Open AccessSystematic Review

The Controversial Issue of Hypervitaminosis B12 as Prognostic Factor of Mortality: Global Lessons from a Systematic Review and Meta-Analysis

by Edith Valdez-Martínez, Horacio Márquez-González, Ricardo Ramírez-Aldana and Miguel Bedolla

Nutrients 2025, 17(13), 2184; https://doi.org/10.3390/nu17132184 - 30 Jun 2025

Abstract

Objective: To test whether hypervitaminosis B12 is useful for prognosis of all-cause mortality. Methods: Meta-analysis of longitudinal, observational, epidemiologic studies. PubMed, Scopus, Web of Science, Google Scholar, and ProQuest One Academic were searched from inception to 30 June 2024. Studies including humans aged [...] Read more.

Objective: To test whether hypervitaminosis B12 is useful for prognosis of all-cause mortality. Methods: Meta-analysis of longitudinal, observational, epidemiologic studies. PubMed, Scopus, Web of Science, Google Scholar, and ProQuest One Academic were searched from inception to 30 June 2024. Studies including humans aged ≥18 years with hypervitaminosis B12, and in whom the outcome variable was all-cause mortality, were included. Two reviewers screened, abstracted (using standardized data collection sheet), and appraised articles (ROBINS-E framework) independently. Frequentist and Bayesian approaches were used for the meta-analysis. Results: A total of 28 studies were included in the meta-analysis (among the 69,610 participants, 15,815 all-cause deaths were reported). High serum levels of B12 increased marginally the risk of all-cause mortality specifically among chronic diseases (RR = 1.40; 95% IC = 1.05 to 1.85) and hospitalized (RR = 1.57; 95% IC = 1.19 to 2.07). In the meta-regression, these results were not statistically significant. The Bayesian analysis confirmed the risks of the mentioned groups; however, it was limited by the number of studies that contained the necessary information. The methodology applied and the clinical heterogeneity of each included study bring up the idea that artefacts might be involved when mortality is found to be high for hypervitaminosis B12. Conclusions: This meta-analysis did not show that hypervitaminosis B12 represents a higher risk of all-cause mortality in adults. Full article

(This article belongs to the Section Clinical Nutrition)

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