Nutrients

14 pages, 843 KB

Open AccessArticle

by Oznur Aydin, Selcuk Dagdelen, Hasan Ozen and Hulya Gokmen-Ozel

Nutrients 2026, 18(13), 2099; https://doi.org/10.3390/nu18132099 (registering DOI) - 27 Jun 2026

Background/Objectives: Hepatic glycogen storage diseases (GSDs) are rare inherited metabolic disorders requiring lifelong nutritional management and strict metabolic control, which may adversely affect the health-related quality of life (HRQoL). This study aimed to evaluate the HRQoL in children with hepatic GSD using [...] Read more.

Background/Objectives: Hepatic glycogen storage diseases (GSDs) are rare inherited metabolic disorders requiring lifelong nutritional management and strict metabolic control, which may adversely affect the health-related quality of life (HRQoL). This study aimed to evaluate the HRQoL in children with hepatic GSD using both child and parent reports, compare findings with normative data, and explore associations with biochemical, anthropometric, and nutritional management-related parameters. Methods: The study included 23 children with hepatic GSD and their parents. HRQoL was assessed using the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scale. Child and parent reports were compared with normative data for healthy and chronically ill children. Agreement between child and parent reports was evaluated with intraclass correlation coefficients, and exploratory associations between variables were assessed using partial Spearman correlation analyses. Results: Total and most subscale PedsQL scores reported by both children and parents were significantly lower than those of healthy peers and children with chronic diseases (p < 0.05). Parents reported lower HRQoL scores than children, particularly in psychosocial, social, and school functioning domains, with low to moderate agreement between reports. Exploratory analyses suggested that body composition and nutritional treatment burden indicators were correlated with selected HRQoL domains. Conclusions: Children with hepatic GSD experience impaired HRQoL from both child and parent perspectives. Integrating HRQoL assessment into routine clinical and nutritional follow-up may help identify unmet psychosocial and dietary support needs and support more individualized nutritional management in children with hepatic GSD. Full article

(This article belongs to the Section Pediatric Nutrition)

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23 pages, 5398 KB

Open AccessSystematic Review

Fortified Human Milk Compared with Unfortified Human Milk in Preterm Low Birth Weight Neonates: A Systematic Review and Meta-Analysis

by Dimitrios Rallis, Maria Lithoxopoulou, Efstratios Saliakellis, Theodora Delaporta, Konstantina Kapetaniou, Eftychia Drogouti, Georgios Kerpiniotis, Evangelia Aggeli, Athina Goulordava and Christos Tsakalidis

Nutrients 2026, 18(13), 2098; https://doi.org/10.3390/nu18132098 (registering DOI) - 26 Jun 2026

Abstract

Background/Objectives: Our aim was to assess the benefits and risks of fortified vs. unfortified human milk in preterm/low birth weight neonates and to incorporate the INSPECT-SR tool to enhance evidence appraisal. Methods: PubMed and Scopus were searched from inception to 30 November 2025, [...] Read more.

Background/Objectives: Our aim was to assess the benefits and risks of fortified vs. unfortified human milk in preterm/low birth weight neonates and to incorporate the INSPECT-SR tool to enhance evidence appraisal. Methods: PubMed and Scopus were searched from inception to 30 November 2025, limited to human studies published in English. Randomized controlled trials in neonates ≤ 34 weeks’ gestation or ≤2500 g birth weight were included. Data extraction followed PRISMA guidelines. Risk of bias was assessed using Cochrane RoB 2, and trustworthiness using the INSPECT-SR tool. Random-effects models were used to pool mean differences (MDs) and odds ratios (ORs); heterogeneity was assessed with I². Outcomes included weight, length, and head circumference gain velocities, feeding intolerance, necrotizing enterocolitis, late-onset sepsis, chronic lung disease, time to full enteral feeding, length of stay, and mortality. Results: Fifteen randomized controlled trials involving 1079 neonates (546 receiving fortified human milk and 533 receiving unfortified human milk) were included in the analysis. Fortified human milk was associated with significantly greater weight gain (MD 2.74 [1.27–4.22] g/kg/d; I² = 95%), length gain (MD 0.08 [0.02–0.14] cm/week; I² = 90%), and head circumference gain (MD 0.06 [0.03–0.10] cm/week; I² = 87%). No significant differences were observed in feeding intolerance, necrotizing enterocolitis, late-onset sepsis, chronic lung disease, time to full enteral feeding, length of stay, or mortality. Subgroup analyses suggested that the publication era partially contributed to heterogeneity, although substantial residual heterogeneity remained. According to INSPECT-SR, two trials were judged as having no concerns, twelve as having some concerns, and one as having serious concerns regarding trustworthiness. Conclusions: Low-certainty evidence suggests that human milk fortification improves short-term anthropometric growth parameters in preterm and low birth weight infants without increasing major neonatal morbidities. However, the certainty of these findings is limited by substantial heterogeneity and concerns regarding study trustworthiness. Future adequately powered trials using contemporary fortification strategies and long-term follow-up are required to establish the clinical significance of these growth benefits. Full article

(This article belongs to the Section Nutrition in Women)

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16 pages, 378 KB

Open AccessArticle

The Impact of Dietary Guidance During Cancer Treatment on Quality of Life

by Vera Ósk Guðjónsdóttir, Lára Kristjánsdóttir, Kristjana Sigurðardóttir and Jóhanna Eyrún Torfadóttir

Nutrients 2026, 18(13), 2097; https://doi.org/10.3390/nu18132097 - 26 Jun 2026

Abstract

Background/Objectives: We examined whether guidance on dietary habits or nutrition-related problems from healthcare professionals during cancer treatment was associated with quality of life, after treatment. Methods: Cross-sectional data were drawn from the Icelandic Compass study, conducted in 2020–2021 among adults diagnosed [...] Read more.

Background/Objectives: We examined whether guidance on dietary habits or nutrition-related problems from healthcare professionals during cancer treatment was associated with quality of life, after treatment. Methods: Cross-sectional data were drawn from the Icelandic Compass study, conducted in 2020–2021 among adults diagnosed with cancer in 2015–2019. The analysis included participants who had completed treatment for breast cancer (n = 341), prostate cancer (n = 137), or colorectal cancer (n = 132), for a total sample of 610 participants. Quality of life (QL) was assessed using the EORTC QLQ-C30 global health status/quality of life scale. Associations were examined using regression models adjusted for age, marital status, education, number of cancer treatments, stage at diagnosis, body mass index, tobacco and alcohol use, and comorbidities. Results: Overall, 26% of participants reported receiving sufficient guidance on general dietary habits during treatment and 19% on nutrition-related problems. On average, three years had passed since diagnosis. Among all participants, guidance on general dietary habits was associated with higher QL scores (β = 5.6; 95% CI: 0.8 to 10.5), as was guidance on nutrition-related problems (β = 5.7; 95% CI: 0.3 to 11.1). In subgroup analyses, statistically significant associations were observed among prostate cancer survivors for both dietary guidance (β = 12.4) and guidance on nutrition-related problems (β = 14.0), and among breast cancer survivors for guidance on nutrition-related problems (β = 8.4). Conclusions: Patient-reported sufficient discussions about dietary habits or nutrition-related problems during treatment were associated with slightly higher post-treatment QL scores. Full article

(This article belongs to the Special Issue Nutrition and Metabolic Health Across the Cancer Continuum: From Prevention Through Treatment and Survivorship)

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15 pages, 5653 KB

Open AccessSystematic Review

The Effects of Time-Restricted Eating in Women with Polyendocrine Metabolic Ovarian Syndrome: A Systematic Review and Meta-Analysis

by Mohammed Hamsho, Meriem Bensaoua, Wijdan Shkorfu, Yazan Ranneh and Faiza Kalam

Nutrients 2026, 18(13), 2096; https://doi.org/10.3390/nu18132096 (registering DOI) - 26 Jun 2026

Abstract

Background: Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is a complex endocrine–metabolic disorder strongly associated with insulin resistance, hyperandrogenism, and obesity. Time-restricted eating (TRE) has emerged as a promising dietary strategy for improving metabolic health; however, evidence regarding [...] Read more.

Background: Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is a complex endocrine–metabolic disorder strongly associated with insulin resistance, hyperandrogenism, and obesity. Time-restricted eating (TRE) has emerged as a promising dietary strategy for improving metabolic health; however, evidence regarding its efficacy in women with PMOS remains limited. Objective: To systematically evaluate the effects of TRE on metabolic, hormonal, anthropometric, and adherence-related outcomes in women with PMOS. Methods: PubMed, Embase, Scopus, and Web of Science were systematically searched through 25 April 2026, for randomized controlled trials evaluating TRE interventions in women with PMOS. Random-effects meta-analyses were performed to pool mean differences (MD) with 95% confidence intervals for specific metabolic, hormonal, and anthropometric outcomes. Results: Four randomized controlled trials comprising 216 women with PMOS were included; three trials compared TRE with calorie restriction and one with ad libitum intake. Compared with control interventions, TRE significantly improved HOMA-IR (MD = −0.58, 95% CI: −0.87 to −0.30), QUICKI (MD = 0.08, 95% CI: 0.04 to 0.13), and HDL (MD = 1.97 mg/dL, 95% CI: 0.96 to 2.99). TRE was generally associated with high adherence across the included studies, with some trials reporting higher compliance than calorie restriction. Conclusions: Current evidence from four RCTs suggests that TRE may serve as a promising alternative dietary strategy for women with PMOS, particularly for improving insulin sensitivity. However, the evidence remains limited by the small number of available studies, modest sample sizes, and heterogeneity across interventions. Therefore, these findings should be considered preliminary and require confirmation in a larger, longer-term randomized controlled trial. Full article

(This article belongs to the Special Issue Lifestyle, Chrononutrition, and Behavioral Determinants of Metabolic Health and Quality of Life)

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14 pages, 241 KB

Open AccessArticle

Age, Allostatic Load, Residential Setting, and Self-Reported Diet Choices Among Older Poles

by Douglas E. Crews, Jan Jeszka, Tatsuya Koyama and Yoshiaki Sone

Nutrients 2026, 18(13), 2095; https://doi.org/10.3390/nu18132095 - 26 Jun 2026

Abstract

Background: During life, all organisms experience multiple stressful events capable of disrupting their somatic integrity. As mammals, humans respond to environmental, sociocultural, and cognitive stressors via allostasis, a systemic neurophysiological response that supports physiological homeostasis. Unfortunately, allostatic mechanisms are incapable of countering all [...] Read more.

Background: During life, all organisms experience multiple stressful events capable of disrupting their somatic integrity. As mammals, humans respond to environmental, sociocultural, and cognitive stressors via allostasis, a systemic neurophysiological response that supports physiological homeostasis. Unfortunately, allostatic mechanisms are incapable of countering all stressors, and systemic physiological damage accumulates with age; thereby contributing to physiological dysregulation and an increasing allostatic load (AL). Previously, we reported that a ten-factor allostatic load index (ALI) varied significantly by age, gender, and rural–urban residence in a sample of Polish citizens ages 55+ years but a five-biomarker frailty index did not. Here we determine whether an estimated ALI covaries with self-reported food intakes across age, residential setting, and gender. Methods: Two hundred and ten residents of Greater Poland ages 55–91 years, residing in either the Nekla commune (N = 103) or the capital of Greater Poland, Poznan (N = 107), participated in research designed to estimate a study-specific 10-biomarker ALI and its possible associations with their self-reported dietary choices, age, gender, and residential location. Of these, 206 completed study protocols including a food frequency questionnaire, verifying their age, self-reporting their gender, and allowing research personnel to obtain data for assessing 10 physiological biomarkers of allostatic load for inclusion in a study-specific ALI. Statistical significance for nominal measures was estimated using chi-square analyses; those for continuous measures, t-tests. Results: In the full sample, self-reported higher red meat and snack intakes were significantly associated with higher ALI at younger ages (55–69 years). No food item was significantly associated with estimated ALI at older ages (70+ years). Further, low self-reported intakes of fish and seafood consumption were significantly associated with a higher ALI in Poznan, but not Nekla residents. Within the full sample, average ALI was almost identical between younger and older women. Conclusions: In this cross-sectional sample of older Nekla and Poznan residents allostatic load not only varied by age, sex, and residential location, but also with self-reported consumption of red meat, snacks, fish and seafood. Observed differences in biomarkers of AL between younger and older residents of Poland across this sample suggest possible higher incidences of chronic disease occur among women residing in Nekla than those in Poznan. Similarly, the significant associations of red meat and snack consumption with ALI at younger ages in both settings may portend increasing vascular disease and related complications among those ages 55–69 years in this sample as they age. As does the higher estimated ALI among Poznan residents reporting low fish and seafood consumption. Full article

(This article belongs to the Special Issue Nutrition and Lifestyle Influences on Age-Related Frailty and Sarcopenia)

17 pages, 717 KB

Open AccessArticle

The “Hidden Hunger” Paradox Amidst a High-Energy Diet: A Cross-Sectional Assessment of an Adult Cohort Evaluated via a Professional Digital Dietary Tool in Russia

by Murat A. Kade, Inna Yu. Tarmaeva, Dmitry B. Nikityuk and Irina A. Lapik

Nutrients 2026, 18(13), 2094; https://doi.org/10.3390/nu18132094 - 26 Jun 2026

Abstract

Background/Objectives: The obesity epidemic coexists with the phenomenon of “hidden hunger” (Type B malnutrition)—a micronutrient deficiency amidst a caloric excess. Traditional dietary assessment methods often distort the actual picture by ignoring technological losses during cooking, which necessitates the use of digital tools. [...] Read more.

Background/Objectives: The obesity epidemic coexists with the phenomenon of “hidden hunger” (Type B malnutrition)—a micronutrient deficiency amidst a caloric excess. Traditional dietary assessment methods often distort the actual picture by ignoring technological losses during cooking, which necessitates the use of digital tools. Methods: A cross-sectional study (N = 3267) was conducted using the digital platform “NIAP”. The analysis was based on valid 3–7-day dietary records with algorithmic accounting for nutrient retention factors during thermal processing. The nutrient profiles of individuals with a normal body mass index (BMI) and obesity (BMI ≥ 30 kg/m²) were compared. Results: The epidemiology of intake shortfalls was highly prevalent and pronounced: 99.9% of the cohort had ≥1 inadequacy (with a mean negative deviation of −77.3% for vitamin D and −59.2% for Omega-3), and 61.5% exhibited ≥10 simultaneous multiple intake shortfalls. These inadequacy rates remained robust in a sensitivity analysis excluding under-reporters. The obesity group consumed significantly more energy, saturated fatty acids, added sugars, cholesterol, and sodium, but demonstrated a lower relative macronutrient intake (g/kg of body weight). Absolute fiber intake did not differ between the groups, indicating a decrease in its density per 1000 kcal in the diet of individuals with obesity; the intake of Omega-3 polyunsaturated fatty acids (PUFAs) showed a downward trend. The Na:K ratio was significantly higher in the obesity group (1.19 vs. 1.04, p < 0.001). Correlation analysis confirmed an inverse relationship between BMI and the overall nutrient density of the diet. Conclusions: A high-energy diet does not compensate for systemic micronutrient inadequacy among the evaluated cohort. Obesity is associated with a dietary imbalance favoring “empty calories” and pro-inflammatory components against a background of severe multiple dietary inadequacies. The integration of algorithmic dietary assessment that accounts for cooking losses is critical for objective diagnosis and personalized nutritional intervention. Full article

(This article belongs to the Section Nutritional Epidemiology)

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18 pages, 1592 KB

Open AccessReview

Effect of Myo-Inositol Supplementation in Polycystic Ovary Syndrome—Scoping Review

by Julia Habryka, Maja Ławniczek and Sabina Krupa-Nurcek

Nutrients 2026, 18(13), 2093; https://doi.org/10.3390/nu18132093 - 26 Jun 2026

Abstract

Objectives: Polycystic ovary syndrome (PCOS) is a widespread and complex endocrine disorder affecting women of childbearing potential, characterized by reproductive dysfunction, hyperandrogenism, and metabolic disorders, including insulin resistance. Insulin resistance is a key pathogenetic factor contributing to ovarian dysfunction and reduced fertility. [...] Read more.

Objectives: Polycystic ovary syndrome (PCOS) is a widespread and complex endocrine disorder affecting women of childbearing potential, characterized by reproductive dysfunction, hyperandrogenism, and metabolic disorders, including insulin resistance. Insulin resistance is a key pathogenetic factor contributing to ovarian dysfunction and reduced fertility. Myo-inositol (MI), a ubiquitous polyol, has earned a reputation as a promising dietary supplement due to its vital role in insulin signaling pathways. This scoping review aimed to map the available scientific literature on the effects of MI supplementation in women with PCOS, with particular emphasis on fertility and ovarian function, and to identify gaps in the current evidence base. Methods: This scoping review was conducted in accordance with the methodology developed by the Joanna Briggs Institute (JBI) and presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. A literature search was conducted against six electronic databases: PubMed, Scopus, Web of Science, EBSCO (MEDLINE Complete), Cochrane Library and Google Scholar. Searches were conducted between 10 January and 20 February 2026. Eligibility sources included original articles (observational and randomized controlled trials), meta-analyses, systematic and narrative reviews, published in English with full text available, focusing on adult women with PCOS. Data extraction was performed independently by two reviewers using the Population–Concept–Context (PCC) framework. In accordance with the scope review methodology, no formal critical appraisal of study quality and no quantitative synthesis were performed. This is consistent with JBI methodology, which does not require critical appraisal for scoping reviews unless explicitly justified. Results: Of the 77 records initially identified, 13 studies were included in the review, and no duplicates were found. These potential benefits should be interpreted cautiously, as the available evidence is heterogeneous and varies across study designs. Potential benefits were also reported for hormonal and metabolic parameters, including reductions in hyperandrogenism and the improvement of insulin sensitivity. Some studies suggest benefits for oocyte and embryo quality, but results remain inconsistent. Conclusions: MI supplementation may support PCOS management, particularly in fertility-related outcomes. Its ability to improve ovulation, increase pregnancy rates, optimize ART outcomes, and mitigate the risk of OHSS highlights its clinical utility. However, the evidence remains heterogeneous, and some outcomes, particularly oocyte and embryo quality, remain inconclusive. Full article

(This article belongs to the Section Nutrition in Women)

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16 pages, 295 KB

Open AccessReview

Glutathione Supplementation in Parenteral Nutrition to Prevent Oxidative Stress Related Complications in Preterm Infants: A Narrative Review of Preclinical Efficacy and Safety Profile

by Jean-Claude Lavoie and Ibrahim Mohamed

Nutrients 2026, 18(13), 2092; https://doi.org/10.3390/nu18132092 - 26 Jun 2026

Abstract

Numerous adverse effects caused by oxidative stress are commonly observed in preterm infants. This stress is caused by the oxidative burden resulting mainly from supplemental oxygen and parenteral nutrition (PN), and by their precarious antioxidant defense. The natural antioxidant defense against these oxidant [...] Read more.

Numerous adverse effects caused by oxidative stress are commonly observed in preterm infants. This stress is caused by the oxidative burden resulting mainly from supplemental oxygen and parenteral nutrition (PN), and by their precarious antioxidant defense. The natural antioxidant defense against these oxidant molecules relies on glutathione, levels of which are low in preterm infants. Given that several short- and long-term biological complications are associated with this oxidative stress, the aim of this narrative review was to discuss glutathione supplementation as a method for reducing it. Consequently, after briefly discussing the effectiveness of partially reducing oxidative stress through adequate photoprotection of PN, it is proposed to correct premature infants’ glutathione deficiency by adding glutathione to PN. To justify the proposed intervention, this article will discuss the scientific evidence related to the (1) importance of glutathione, (2) causes of glutathione deficiency and ways to prevent it, (3) reasons why the disulfide form (GSSG) is recommended over the reduced form (GSH) for PN supplementation, (4) efficacy of parenteral GSSG in preventing oxidative stress, and (5) safety profile of glutathione infusion. In conclusion, we believe that the time has come to improve the health of premature infants by providing GSSG-supplemented PN. Full article

(This article belongs to the Special Issue Pediatric Parenteral Nutrition: Advances and Challenges)

14 pages, 1070 KB

Open AccessArticle

Baseline Nutritional Status and Early Treatment Response in Oropharyngeal Cancer: A Prospective Cohort Study by HPV Status (FIS 19 Study)

by Maryam Choulli, Sara Tous, Gonzalo Peón Peña, Beatriz Cirauqui, Anna Sumarroca, Elisenda Climent, Laia Fontane, Isabel Cots, Jesús Brenes, Marisa Mena, Marc Oliva, Laia Alemany, Ricard Mesia and Lorena Arribas

Nutrients 2026, 18(13), 2091; https://doi.org/10.3390/nu18132091 - 26 Jun 2026

Abstract

Background/Objectives: Human papillomavirus (HPV) is a well-established prognostic marker in oropharyngeal squamous cell carcinoma (OPSCC); however, the short-term treatment response remains heterogeneous, particularly among HPV-positive patients. Given the high prevalence of malnutrition in head and neck cancer, this study examined whether baseline [...] Read more.

Background/Objectives: Human papillomavirus (HPV) is a well-established prognostic marker in oropharyngeal squamous cell carcinoma (OPSCC); however, the short-term treatment response remains heterogeneous, particularly among HPV-positive patients. Given the high prevalence of malnutrition in head and neck cancer, this study examined whether baseline nutritional status, body composition and functional status were associated with early treatment response in OPSCC according to HPV status. Methods: A prospective observational multicenter cohort study of newly diagnosed OPSCC patients eligible for curative-intent treatment was conducted at three tertiary hospitals in Barcelona, Spain. Baseline assessments comprised anthropometry, computed tomography (CT)-based body composition at L3, functional performance tests, systemic inflammatory biomarkers and nutritional diagnosis by the Patient-Generated Subjective Global Assessment (PG-SGA). Early treatment response, assessed around 12 weeks post-therapy, was classified as complete remission (CR) or non-complete remission (NCR). Classification tree analyses were performed separately by HPV status. Results: Of 101 enrolled patients, 97 completed post-treatment assessment, of whom 51% were HPV-positive. Among HPV-positive patients, PG-SGA score was the main discriminating variable for early response within the classification tree model, with CR achieved in 74% of patients scoring <6 versus 33% of those scoring ≥6 (AUC 0.68, 95% CI 0.55–0.82). Conversely, Eastern Cooperative Oncology Group Performance Status (ECOG PS) and age were the primary discriminating variables in HPV-negative patients (AUC 0.81, 95% CI 0.70–0.93). In both HPV subgroups, body composition and inflammatory markers were not retained in the analysis once nutritional and functional status were considered. Conclusions: PG-SGA-defined nutritional status was associated with early treatment response in HPV-positive patients, while functional status was the main variable retained in HPV-negative patients. These findings support the potential clinical value of standardized nutritional assessment in OPSCC and suggest that early identification of poor nutritional status or functional impairment may help refine supportive care planning at treatment initiation. Full article

(This article belongs to the Section Clinical Nutrition)

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22 pages, 1330 KB

Open AccessSystematic Review

Vitamin D Supplementation, Total Testosterone, and Androgen Bioavailability Markers in Adult Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Loreto Paez-Allendes, Juan José Valenzuela-Fuenzalida, María P. Moya, Gustavo Oyanedel, Gloria Cifuentes-Suazo, Julio Figueroa-Puig, Mathias Orellana-Donoso, Eduardo Mateluna-Valls, Juan Jose Cabezas-Salgado, Juan Sanchis-Gimeno and Alejandro Bruna-Mejias

Nutrients 2026, 18(13), 2090; https://doi.org/10.3390/nu18132090 - 26 Jun 2026

Abstract

Background: Vitamin D has traditionally been recognized for its role in calcium homeostasis and skeletal health, but vitamin D receptor expression and vitamin D-metabolizing enzymes have also been identified in extra-skeletal tissues, including components of the male reproductive tract. Observational evidence has suggested [...] Read more.

Background: Vitamin D has traditionally been recognized for its role in calcium homeostasis and skeletal health, but vitamin D receptor expression and vitamin D-metabolizing enzymes have also been identified in extra-skeletal tissues, including components of the male reproductive tract. Observational evidence has suggested associations between vitamin D status and androgen-related markers; however, whether vitamin D supplementation has a measurable effect on androgen bioavailability remains uncertain. Objective: This systematic review and meta-analysis evaluated the effects of vitamin D supplementation on total testosterone (TT) and androgen bioavailability markers in adult men, including sex hormone-binding globulin (SHBG), free androgen index (FAI), calculated free testosterone (calculated FT), and bioactive testosterone (BAT) where methodologically compatible. Methods: The review was registered in PROSPERO (CRD420261365005) and conducted according to PRISMA 2020 and Cochrane methodological guidance. Searches were conducted from database inception to April 2026 in PubMed, Web of Science, Scopus, ClinicalTrials.gov, and the WHO ICTRP. Embase was initially planned but was not searched because institutional access was unavailable; this amendment was made before screening, extraction, risk-of-bias assessment, and synthesis. Records were deduplicated in Zotero, screened in a structured matrix, and converted from report-level records into independent comparison-level datasets where appropriate. Meta-analyses used random-effects REML models with Hartung–Knapp adjustment. Results: The official search set comprised 2854 records, of which 703 duplicates were removed, leaving 2151 records for title and abstract screening. The full-text screening file was reconciled to 162 PRISMA-countable reports/records: 135 reports were assessed, 27 reports could not be assessed because the full text was unavailable or had not been obtained for review, and 27 reports/studies were retained for qualitative synthesis. Eighteen reports were considered candidate sources for quantitative synthesis and were operationalized into 21 comparison-level records. The primary TT model included 11 comparisons and showed no clear effect of vitamin D supplementation on final TT (MD 0.47 nmol/L, 95% CI −0.50 to 1.44; I² = 24.1%). No clear effects were observed for SHBG (MD 0.27 nmol/L, 95% CI −2.14 to 2.68), FAI (MD −0.37, 95% CI −4.28 to 3.55), calculated FT sensitivity evidence (MD −0.0096 nmol/L, 95% CI −0.0525 to 0.0332), or BAT exploratory evidence (MD −0.47 nmol/L, 95% CI −1.77 to 0.83). GRADE certainty was low for TT, SHBG, and FAI, and very low for calculated FT and BAT. Conclusions: Current randomized evidence does not demonstrate a statistically clear or reproducible effect of vitamin D supplementation on total testosterone or androgen bioavailability markers in adult men. GRADE certainty was low for total testosterone, SHBG, and FAI, and very low for calculated free testosterone and bioactive testosterone. Because directly measured and calculated free testosterone are not analytically equivalent, free testosterone was not pooled as a primary outcome; method-compatible calculated FT was handled as sensitivity evidence and BAT as exploratory evidence. Full article

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

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33 pages, 954 KB

Open AccessReview

Effect of Caffeine on the Skeletal System—A Review of Experimental Studies

by Paulina Stańczak, Wiktor Krzysztofik, Wiktoria Rudolf, Kacper Grzywnowicz and Joanna Folwarczna

Nutrients 2026, 18(13), 2089; https://doi.org/10.3390/nu18132089 - 26 Jun 2026

Abstract

Background: Caffeine is one of the most widely consumed bioactive compounds worldwide. The available data regarding its effects on bone metabolism and skeletal health remain inconsistent. The aim of this study was to review experimental studies on the effects of caffeine on the [...] Read more.

Background: Caffeine is one of the most widely consumed bioactive compounds worldwide. The available data regarding its effects on bone metabolism and skeletal health remain inconsistent. The aim of this study was to review experimental studies on the effects of caffeine on the skeletal system. Methods: A literature search was conducted using PubMed to identify original experimental studies investigating the effects of caffeine on the skeletal system published up to December 2025. The reviewed studies included in vivo studies on different animal models and in vitro studies on bone-related cells. Due to data heterogeneity, a narrative analysis was performed. Results: Fifty-three studies on caffeine effects were included in the review. The findings indicate that the effects of caffeine are dose-dependent and bidirectional. Low-to-moderate doses in vivo generally exerted neutral or sometimes beneficial effects on the skeletal system, whereas higher doses were associated with impaired bone development, reduced mineralization, and increased bone loss. In estrogen-deficient animals, moderate doses showed potential protective effects, while high doses exacerbated bone loss. In vitro studies demonstrated concentration-dependent effects, with high concentrations often reducing cell viability and osteogenic activity. Conclusions: The effects of caffeine on the skeletal system are complex and context-dependent. While high exposure may adversely affect bone, low-to-moderate intake appears to be safe and may exert beneficial effects under specific conditions. Full article

(This article belongs to the Section Nutrition and Metabolism)

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19 pages, 15033 KB

Open AccessArticle

A Fiber- and Polyphenol-Enriched Diet Enhances Humoral Immunity, Reshapes Cecal Microbiota, and Improves Short-Chain Fatty Acid Production in Female Wistar Rats

by Sergi Casanova-Crespo, Daniela Ceballos-Sánchez, Anna Vallverdú-Queralt, Maria José Rodríguez-Lagunas, Malen Massot-Cladera, Margarida Castell and Francisco José Pérez-Cano

Nutrients 2026, 18(13), 2088; https://doi.org/10.3390/nu18132088 (registering DOI) - 26 Jun 2026

Abstract

Background/Objectives: Dietary fiber and polyphenols are recognized modulators of intestinal and immune homeostasis; however, evidence regarding their combined impact under physiological conditions remains limited. This study aimed to evaluate whether a diet enriched with fermentable fiber and polyphenols modulates mucosal and systemic [...] Read more.

Background/Objectives: Dietary fiber and polyphenols are recognized modulators of intestinal and immune homeostasis; however, evidence regarding their combined impact under physiological conditions remains limited. This study aimed to evaluate whether a diet enriched with fermentable fiber and polyphenols modulates mucosal and systemic immune biomarkers, as well as microbiota composition and function in healthy adult female rats. Methods: Wistar rats were fed either a reference diet (REF group) or a fiber- and polyphenol-enriched diet (FP group) for nine weeks. At the end of the intervention, plasma lipid profile, systemic and mucosal immune status (assessed by immunoglobulin (Ig) content in several compartments), cecal microbiota composition (determined by 16S rRNA sequencing), cecal short-chain fatty acids (SCFAs) and cecal Ig-coated bacteria, among other variables, were quantified. Results: The FP group exhibited a higher IgG concentration in plasma and elevated IgG2c levels in mucosal compartments compared with REF animals. The FP diet did not alter either intestinal morphology or hematologic and lipid variables; however, FP rats exhibited increased fecal moisture and reduced fecal pH. With regard to cecal microbiota, the FP group displayed higher microbial evenness, distinct β-diversity clustering, and shifts in the abundance of multiple genera. In addition, elevated cecal SCFA concentrations, particularly for acetate and propionate, were found in the FP group. Conclusions: Long-term intake of fermentable fiber and polyphenols promotes microbial fermentation and enhances humoral immunity without inducing structural or systemic physiological alterations. These findings support the role of plant-based foods in promoting immune and gut microbiota homeostasis under healthy conditions. Full article

(This article belongs to the Special Issue Research Progress on Immune and Anti-Inflammatory Effects of Food Active Substances)

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12 pages, 238 KB

Open AccessArticle

Hunger Tradeoffs and Coping Strategies Among Families with Food Insecurity in Massachusetts

by Cara F. Ruggiero, Man Luo, Meghan Perkins, Catherine D. Lynn, Daniel Taitelbaum, Cheryl Schondek, Christopher R. Long, Stephanie Ettinger De Cuba, Elena Byhoff and Lauren Fiechtner

Nutrients 2026, 18(13), 2087; https://doi.org/10.3390/nu18132087 (registering DOI) - 26 Jun 2026

Abstract

Background/Objectives: Many individuals facing food insecurity make tradeoff decisions between spending money on food or other basic needs. In addition, many engage in coping strategies to stretch food budgets or make food last longer. There is limited data on how participation in [...] Read more.

Background/Objectives: Many individuals facing food insecurity make tradeoff decisions between spending money on food or other basic needs. In addition, many engage in coping strategies to stretch food budgets or make food last longer. There is limited data on how participation in food assistance programs is associated with use of tradeoffs or coping strategies among households experiencing food insecurity. Methods: A secondary analysis of 2021, 2022 and 2023 cross-sectional state-wide survey on food access, including questions on use of tradeoffs and coping mechanisms, and participation in food assistance programs (Special Supplemental Nutrition Program for Women, Infants, and Children, Supplemental Nutrition Assistance Program, school meals or food pantries). Prevalences of tradeoffs and coping strategies by food assistance use were determined. Multivariable logistic regression models determined odds of tradeoffs and coping strategies reported by food-insecure households. Results: Overall, 85% of respondents reported making any tradeoffs and 90% reported any coping strategy use in the prior year. Any food assistance program participation was associated with higher prevalences of making any tradeoff compared to not participating in food assistance programs (89% vs. 78%, p < 0.001) and a higher prevalence of engaging in any coping strategy (92% vs. 84%, p < 0.001). Food assistance participation was associated with increased odds of making any tradeoff (OR 1.82 95% CI 1.39, 2.39) or any coping strategy (1.85, 95% CI 1.22, 2.80). Conclusions: Meeting food assistance program income eligibility requirements is likely a marker of poverty that extends beyond food insecurity. Food assistance is necessary but insufficient to meet family needs. Full article

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

15 pages, 286 KB

Open AccessArticle

Dietary Determinants of Mental Well-Being Among Cardiometabolic High-Risk Adults in Hungary

by Battamir Ulambayar, Bashar Shehab, Attila Sárváry and Attila Csaba Nagy

Nutrients 2026, 18(13), 2086; https://doi.org/10.3390/nu18132086 (registering DOI) - 26 Jun 2026

Abstract

Background: Mental well-being is an important yet often overlooked component of cardiometabolic health. Dietary habits may influence psychological outcomes, but evidence among high-risk populations in Central and Eastern Europe remains limited. This study investigated the association between dietary behaviors and mental well-being [...] Read more.

Background: Mental well-being is an important yet often overlooked component of cardiometabolic health. Dietary habits may influence psychological outcomes, but evidence among high-risk populations in Central and Eastern Europe remains limited. This study investigated the association between dietary behaviors and mental well-being among adults with cardiometabolic risk in Hungary. Methods: A cross-sectional analysis was conducted using data from the European Health Interview Survey (EHIS) 2019. The study included 2785 adults with cardiometabolic high risk (obesity, hypertension, or hypercholesterolemia). Mental well-being was assessed using the WHO-5 Well-Being Index and categorized as poor (≤50) or better (>50). Dietary habits, sociodemographic factors, and lifestyle factors were analyzed. Weighted multivariable logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Overall, 25.9% of participants had poor mental health. In multivariable analyses, low intake of vegetables (OR = 1.15), fruits (OR = 1.55), fruit juice (OR = 1.26), and fish (OR = 1.17), as well as inadequate water intake (OR = 1.38), were each independently associated with higher odds of poor mental health after adjustment for sex, education, income levels, self-perceived health status, physical activity, and alcohol consumption. Conclusions: Healthier dietary behaviors, particularly higher consumption of vegetables, fish, and adequate hydration, are associated with better mental well-being among individuals with cardiometabolic risk. These results underscore the need for comprehensive intervention strategies that simultaneously address physical health and psychological well-being among vulnerable populations. Full article

(This article belongs to the Special Issue Relationship Between Dietary Habits and Physical Activity in Modern Lifestyles)

24 pages, 1504 KB

Open AccessArticle

Effects of Probiotic–Phytonutrient Blends on Defecation, Intestinal Barrier Function, and Gut Microbiota: A Randomized, Placebo-Controlled Trial

by Ah Young Hwang, Sunyoung Lee, JungHyun Yoon, Kyu Yeon Lee, Dong Ho Suh, Sungjae Myung, Jihye Song, Hae Jo, Dmitri Sitnikov, Jong Hoon Won, Hyun Young Park, Matthew K. Runyon, Donghyun Cho, Wilhelm H. Holzapfel, Yosep Ji and Eun Sung Jung

Nutrients 2026, 18(13), 2085; https://doi.org/10.3390/nu18132085 - 25 Jun 2026

Abstract

Background/Objectives: Probiotic interventions are widely used to improve intestinal health; however, comparative evidence on multi-strain formulations with different potencies, particularly when combined with plant-based complexes, remains limited. This study evaluated the effects of two probiotic blends containing phytonutrients: PBP1, comprising Lacticaseibacillus strains, [...] Read more.

Background/Objectives: Probiotic interventions are widely used to improve intestinal health; however, comparative evidence on multi-strain formulations with different potencies, particularly when combined with plant-based complexes, remains limited. This study evaluated the effects of two probiotic blends containing phytonutrients: PBP1, comprising Lacticaseibacillus strains, and PBP2, comprising Lacticaseibacillus, Lactobacillus, and Bifidobacterium strains. The effects on bowel function, microbial metabolites, and gut barrier-related markers were investigated. Methods: In this randomized, double-blind, placebo-controlled trial, participants received PBP1, PBP2, or placebo for 8 weeks. Stool patterns (7-day Bristol Stool Form Scale (BSFS) diary), fecal short-chain fatty acids (SCFAs), tryptophan metabolites, zonulin, and gut microbiota were assessed at baseline and Week 8. Efficacy was evaluated by comparing each intervention group with the placebo group. Results: Both PBP1 and PBP2 significantly increased the proportion of normal stool types (BSFS types 3–5) compared with placebo (p < 0.05). Fecal SCFA levels, including acetate, propionate, and butyrate, were significantly increased in both intervention groups. Notably, butyrate levels were significantly elevated compared with placebo. Fecal tryptophan levels decreased, while indole metabolites showed increasing trends, with an inverse correlation observed between tryptophan and indole, particularly in the PBP2 group. Fecal zonulin showed a decreasing trend, with significant reductions in participants with 25.0 ≤ BMI < 30.0 kg/m². Microbiome analysis revealed preserved alpha diversity with selective compositional shifts, including enrichment of Lactobacillus-related taxa. Conclusions: Supplementation with PBP1 and PBP2 improved bowel function and was associated with changes in microbiome-derived metabolites, including SCFAs and tryptophan–indole metabolism, with BMI-dependent changes in barrier markers. These findings suggest a potential role of microbiome-mediated metabolic modulation in intestinal health. Full article

(This article belongs to the Section Prebiotics, Probiotics and Postbiotics)

27 pages, 865 KB

Open AccessReview

Tomato (Solanum lycopersicum L.) as a Source of Bioactive Compounds: Functional Properties and Technological Aspects—A Review

by Anna Bajon, Marcin Kidoń and Joanna Kobus-Cisowska

Nutrients 2026, 18(13), 2084; https://doi.org/10.3390/nu18132084 - 25 Jun 2026

Abstract

Tomato (Solanum lycopersicum L.), a member of the Solanaceae family, originates from South America and is currently cultivated worldwide. In tropical regions, it grows as a perennial plant, whereas in temperate and subtropical climates, it is cultivated as an annual because of [...] Read more.

Tomato (Solanum lycopersicum L.), a member of the Solanaceae family, originates from South America and is currently cultivated worldwide. In tropical regions, it grows as a perennial plant, whereas in temperate and subtropical climates, it is cultivated as an annual because of its sensitivity to frost. Tomato fruits are an important source of bioactive compounds, including carotenoids, polyphenols, minerals, and vitamins. Their widespread consumption and status as one of the most commonly consumed horticultural crops worldwide make tomatoes an important dietary source of these compounds. Tomatoes are commonly consumed fresh, but they are also an important raw material for the food industry. The main tomato products include juices, concentrates, purées, and sauces. The chemical composition and concentration of bioactive compounds in tomato fruits depend on several factors, including cultivar, stage of ripeness, environmental conditions, and cultivation and processing technologies. Numerous studies indicate that compounds present in tomatoes exhibit antioxidant properties and have been associated with potential health-promoting effects. Among these, carotenoids, particularly lycopene, play a key role. This review summarizes current knowledge on the nutritional value, composition, and functional properties of tomatoes. It also addresses the antinutritional aspects of tomato compounds, as well as the influence of agrotechnical, environmental, and technological factors on the content of bioactive compounds. Furthermore, this review may support the design of future research by critically analyzing existing studies and highlighting inconsistencies and knowledge gaps. Full article

(This article belongs to the Special Issue Dietary Polyphenols in Health and Disease: New Insights in Bioactivity, Bioavailability and Personalized Nutrition)

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16 pages, 502 KB

Open AccessSystematic Review

Liquid Cow’s Milk Consumption and Linear Growth Outcomes in Infancy and Childhood: A Systematic Review

by Jacksaint Saintila and Youmi Paz-Olivas

Nutrients 2026, 18(13), 2083; https://doi.org/10.3390/nu18132083 - 25 Jun 2026

Abstract

Background: Linear growth during childhood is a key indicator of health status and child development, and liquid cow’s milk has been proposed as a potentially relevant dietary component for this outcome. In this systematic review, we aimed to synthesize the available evidence [...] Read more.

Background: Linear growth during childhood is a key indicator of health status and child development, and liquid cow’s milk has been proposed as a potentially relevant dietary component for this outcome. In this systematic review, we aimed to synthesize the available evidence on the association between liquid cow’s milk consumption and linear growth outcomes in infants and children aged 6 months to 12 years. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Observational and experimental studies published in peer-reviewed journals, with no language restrictions, were included if they assessed habitual liquid cow’s milk consumption as the main exposure and reported linear growth outcomes such as height, growth velocity, or height-for-age z-scores. Searches were performed in PubMed (MEDLINE) and Scopus from database inception to 15 January 2026. Study selection, data extraction, and risk-of-bias assessment were carried out systematically. Due to methodological heterogeneity among the included studies, results were synthesized narratively. Results: Twelve studies conducted across diverse geographic and socioeconomic contexts were included. Most studies reported positive associations between liquid cow’s milk consumption and indicators of linear growth, including greater height, higher growth velocity, or improved height-for-age z-scores. Experimental studies showed significant increases in linear growth among children who received milk regularly, whereas some observational studies reported non-significant associations or results dependent on statistical adjustment. One study assessing complete cow’s milk exclusion observed deceleration in linear growth. Overall, the risk of bias was predominantly moderate. Conclusions: Habitual consumption of liquid cow’s milk during childhood appears to be predominantly associated with favorable linear growth outcomes, although variability exists according to study design, age at exposure, milk type, and exposure assessment. Further research using more robust designs is warranted to clarify the magnitude of the association, potential mechanisms, and implications for weight-related outcomes. Full article

(This article belongs to the Section Pediatric Nutrition)

22 pages, 3920 KB

Open AccessReview

Vitamin D Signaling in Neurodegenerative Disorders: Mechanisms, Therapeutic Potential, and Clinical Implications

by Naveen Soni, Nabendu Debnath, Ella Rekapally, Ayaan Jabbar, Suresh C. Tyagi, Bhawana Bissa and Neetu Tyagi

Nutrients 2026, 18(13), 2082; https://doi.org/10.3390/nu18132082 - 25 Jun 2026

Abstract

Vitamin D has long been recognized for its role in calcium homeostasis and bone metabolism; however, it is now emerging as an important regulator of central nervous system (CNS) function. Recent evidence suggests that vitamin D signaling contributes to the pathogenesis and progression [...] Read more.

Vitamin D has long been recognized for its role in calcium homeostasis and bone metabolism; however, it is now emerging as an important regulator of central nervous system (CNS) function. Recent evidence suggests that vitamin D signaling contributes to the pathogenesis and progression of several neurodegenerative disorders. Vitamin D exerts neuroprotective effects through multiple mechanisms, including regulation of calcium homeostasis, modulation of immune responses, reduction in oxidative stress, stimulation of neurotrophic factors, and maintenance of blood–brain barrier (BBB) integrity. Vitamin D receptors and metabolizing enzymes are widely distributed across several brain regions, highlighting their direct involvement in neuronal function. This review summarizes the biosynthesis, metabolism, and signaling pathways of vitamin D. It explores its role in neurodegenerative diseases such as Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), stroke, and traumatic brain injury (TBI). Evidence from experimental and clinical studies indicates that vitamin D deficiency is associated with an increased risk and severity of these conditions, while supplementation may provide therapeutic benefits. Full article

(This article belongs to the Special Issue Impacts of Nutrition on Cognitive Function and Nervous System Health)

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18 pages, 318 KB

Open AccessArticle

Psychosocial Functioning, Dietary Patterns and Socioeconomic Determinants of Quality of Life in Polish Women with Fibromyalgia: A Cross-Sectional Study

by Robert Gajda and Marzena Jeżewska-Zychowicz

Nutrients 2026, 18(13), 2081; https://doi.org/10.3390/nu18132081 - 25 Jun 2026

Abstract

Background: Fibromyalgia is a chronic pain syndrome associated with impaired psychosocial functioning, reduced quality of life, and substantial socioeconomic burden. Although nutritional approaches to fibromyalgia management are increasingly investigated, the relationships between dietary patterns, socioeconomic determinants, and quality of life remain unclear. This [...] Read more.

Background: Fibromyalgia is a chronic pain syndrome associated with impaired psychosocial functioning, reduced quality of life, and substantial socioeconomic burden. Although nutritional approaches to fibromyalgia management are increasingly investigated, the relationships between dietary patterns, socioeconomic determinants, and quality of life remain unclear. This study aimed to assess associations between fibromyalgia severity, psychosocial functioning, dietary patterns (DPs), socioeconomic factors, and self-rated quality of life among Polish women with fibromyalgia. Methods: A cross-sectional online survey was conducted between March and April 2026 among members of nationwide Polish Facebook support groups for individuals with fibromyalgia. The final analysis included 201 women who self-reported a physician diagnosis of fibromyalgia. Fibromyalgia severity was assessed using the Modified Fibromyalgia Assessment Status (FAS), disease impact using the Revised Fibromyalgia Impact Questionnaire (FIQR), and quality of life using selected WHOQOL-BREF domains. Dietary patterns were identified using principal component analysis (PCA) based on the frequency of consumption of 33 food groups from the KomPAN questionnaire. Hierarchical linear regression models were applied to identify predictors of self-rated quality of life. Results: Four dietary patterns were identified: traditional, meat-and-fat, pro-healthy, and dairy-based. Participants reported low overall quality of life and moderate fibromyalgia severity. A better self-rated financial situation was associated with a higher quality of life only in the initial regression model (β = 0.325; p < 0.001). After adjustment for clinical and psychosocial variables, socioeconomic factors and dietary patterns were no longer significant predictors. Functional limitations (FIQR Functioning: β = −0.202; p = 0.022) and overall disease impact (FIQR Overall Impact: β = −0.189; p = 0.026) were negatively associated with quality of life, whereas psychological (β = 0.234; p < 0.001) and social functioning (β = 0.162; p = 0.023) were positive predictors. The final model explained 40.3% of the variance in quality of life. Conclusions: These findings support a comprehensive biopsychosocial model of fibromyalgia care. Full article

(This article belongs to the Special Issue Association Between Nutrition, Diet Quality, Dietary Patterns, and Human Health and Diseases—3rd Edition)

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