Nutrients

17 pages, 3890 KB

Open AccessArticle

Lacticaseibacillus rhamnosus AC1 Aggravates Bone Loss in a Male Rat Model of Deoxycorticosterone Acetate (DOCA)-Salt-Induced Osteoporosis

by Xiaoqing Kuang, Haicui Wu, Tim Fat Shum, Chunyi Wen and Jiachi Chiou

Nutrients 2025, 17(20), 3198; https://doi.org/10.3390/nu17203198 (registering DOI) - 11 Oct 2025

Abstract

Background/Objectives: Osteoporosis is a prevalent and debilitating skeletal disease characterized by a progressive loss of bone mass and deterioration of bone microarchitecture. Probiotics have emerged as a potential therapeutic tool for treating osteoporosis through modulation of the gut microbiota. In this study, [...] Read more.

Background/Objectives: Osteoporosis is a prevalent and debilitating skeletal disease characterized by a progressive loss of bone mass and deterioration of bone microarchitecture. Probiotics have emerged as a potential therapeutic tool for treating osteoporosis through modulation of the gut microbiota. In this study, we aimed to examine the effects of live Lacticaseibacillus rhamnosus AC1 (LR-AC1), isolated from a fecal sample from a newborn in Hong Kong, on deoxycorticosterone acetate (DOCA)-induced bone loss in a rat model. Methods: Bone mass and microarchitecture were assessed using micro-computed tomography (micro-CT). Immunostaining for CD31⁺ and osterix, markers of endothelial cells and osteoblast precursors, respectively, was performed. Gut microbiota composition was analyzed via 16S rRNA sequencing. The effects of an LR-AC1 cell-free conditioned supernatant (CCS) on osteoclastogenesis, angiogenesis, and migration of bone marrow mesenchymal stem cells (BMSCs) were evaluated in vitro using RT-qPCR and wound healing assays. Results: LR-AC1 administration did not induce adverse effects in healthy rats; however, it exacerbated bone loss in rats with DOCA-salt-induced osteoporosis. Correspondingly, the number of CD31-positive endothelial cells and osterix-positive osteoprogenitors decreased with bone loss. In vitro, LR-AC1 CCS promoted osteoclastogenesis and angiogenesis, while in the presence of DOCA, LR-AC1 CCS inhibited BMSC migration. Gut microbiota analysis revealed that the relative abundances of the genera g_RF39 and g_Clostridia_UCG-014 correlated with the severity of bone loss. Conclusions: While several studies suggest that probiotics can prevent and treat osteoporosis, our findings indicate that in a male rat model of DOCA-salt-induced osteoporosis, live LR-AC1 aggravated bone loss. This effect is associated with alterations in gut microbiota and disruption of the coupling process in bone remodeling. Full article

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

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12 pages, 507 KB

Open AccessReview

Avoidant/Restrictive Food Intake Disorder in Celiac Disease

by Ridhima Kaul, Claire Jansson-Knodell, Madison L. Simons, Kendra Weekley, David Gardinier and Alberto Rubio-Tapia

Nutrients 2025, 17(20), 3197; https://doi.org/10.3390/nu17203197 (registering DOI) - 11 Oct 2025

Abstract

Celiac disease (CeD) is an autoimmune disorder where adherence to a lifelong gluten-free diet (GFD) is the only available treatment. While this approach is rather effective, some patients experience ongoing symptoms, and this factor, along with the rigidity of the GFD, may predispose [...] Read more.

Celiac disease (CeD) is an autoimmune disorder where adherence to a lifelong gluten-free diet (GFD) is the only available treatment. While this approach is rather effective, some patients experience ongoing symptoms, and this factor, along with the rigidity of the GFD, may predispose some to disordered eating behaviors, including Avoidant/Restrictive Food Intake Disorder (ARFID). ARFID is characterized by persistent food avoidance that is not driven by body image concerns, resulting in nutritional, psychological, and social impairment. This scoping literature review explores the emerging intersection between ARFID and CeD, examining prevalence, pathophysiology, clinical features, complications, and management strategies. Recent studies report that 14–57% of individuals with CeD may meet the criteria for ARFID, depending on the population and screening tools used. Factors contributing to ARFID in CeD may include ongoing gastrointestinal symptoms, anxiety over gluten exposure, negative conditioned responses to food, social challenges related to GFD adherence, and psychiatric co-morbidities. ARFID in CeD is associated with worsened nutritional deficiencies, anxiety, depression, and impaired social functioning, making the diagnosis of ARFID challenging due to symptom overlap with CeD and other psychiatric conditions. Management requires a multidisciplinary approach, including medical, nutritional, and psychological interventions. Routine screening, early intervention, and integrated care models may improve outcomes and quality of life. Full article

(This article belongs to the Special Issue Diet on Gut Health and Celiac Disease)

18 pages, 582 KB

Open AccessArticle

Integrated Behavioral Profiles of Physical Activity and Dietary Intake in Young Adults and Their Associations with Lower Limb Injury Occurrence

by Jarosław Domaradzki

Nutrients 2025, 17(20), 3196; https://doi.org/10.3390/nu17203196 (registering DOI) - 11 Oct 2025

Abstract

Background/Objectives: To delineate integrated lifestyle profiles combining physical activity (PA) and dietary intake (DI) and test their links with lower limb injury in physically active young adults. Methods: We analyzed a cross-sectional convenience sample of university students (men: n = 91, [...] Read more.

Background/Objectives: To delineate integrated lifestyle profiles combining physical activity (PA) and dietary intake (DI) and test their links with lower limb injury in physically active young adults. Methods: We analyzed a cross-sectional convenience sample of university students (men: n = 91, 20.5 ± 1.0 years; women: n = 118, 20.3 ± 0.8 years). PA (IPAQ) and DI (QEB) were assessed alongside self-reported injuries. Latent class modeling derived PA–DI profiles. Injury prevalence across profiles was compared (χ²), and logistic regression examined injury odds adjusting for sex, age, and BMI. Results: Four profiles emerged. Two reflected less healthy patterns (Profiles 2–3) and two healthier ones (Profiles 1, 4). Profile 4 showed higher vegetables/legumes/fermented milk and lower fast food/sugary drinks; Profile 3 combined greater sitting and fried/sweetened items with lower walking/milk intake. Overall injury prevalence was 56.9%, ranging from 44.1% (Profile 2) to 66.7% (Profile 4 exceeded Profile 2 in pairwise comparison (χ² (1) = 5.08, p = 0.024)). In adjusted models, men had higher injury odds (OR = 1.94, 95% CI: 1.09–3.48, p = 0.025); profile membership was not independently predictive, and profile × sex interactions were null. Conclusions: Young adults cluster into distinct PA–DI patterns that differ behaviorally, but sex—rather than profile—was the most consistent correlate of injury. Prevention should integrate lifestyle screening with sex-specific strategies. Full article

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

18 pages, 615 KB

Open AccessArticle

FokI Polymorphism of the VDR Gene Is Associated with Vitamin D Insufficiency in Elite Male Power Athletes of Kazakhstan

by Aidana Gabdulkayum, Saya Amangeldikyzy, Adil Yerezhepov, Sayipzhamal Khassanova, Kenes R. Akilzhanov, Ulan Kozhamkulov, Saule Rakhimova, Ulykbek Kairov, Ainur Akilzhanova and Dauren Yerezhepov

Nutrients 2025, 17(20), 3195; https://doi.org/10.3390/nu17203195 (registering DOI) - 11 Oct 2025

Abstract

Background/Objectives: We aimed to investigate the association between VDR gene variants and vitamin D levels in elite male power athletes of Kazakhstan. Methods: We recruited 92 elite male power athletes of Kazakhstan. Concentrations of serum 25(OH)D were measured with the Access [...] Read more.

Background/Objectives: We aimed to investigate the association between VDR gene variants and vitamin D levels in elite male power athletes of Kazakhstan. Methods: We recruited 92 elite male power athletes of Kazakhstan. Concentrations of serum 25(OH)D were measured with the Access 25(OH) Vitamin D Total Assay on the Unicel Dxl 800 Access Immunoassay System. Gene polymorphisms were determined by a real-time polymerase chain reaction (RT-PCR) allelic discrimination assay using TaqMan™ probes. Results: Vitamin D insufficiency was registered in 63% of athletes. Age (χ² = 6.83, p < 0.01), BMI (χ² = 6.83, p < 0.01), and sport experience (χ² = 4.44, p < 0.04) showed a statistically significant association with vitamin D insufficiency and deficiency (age, χ² = 7.93, p < 0.01; BMI, χ² = 5.11, p < 0.03; sport experience, χ² = 6.19, p = 0.01). The A/A genotype of the VDR FokI polymorphism (rs2228570) showed a strong correlation with vitamin D insufficiency (G/G-G/A vs. A/A, OR = 9.25, 95% CI = 2.01–42.51, p < 0.01) but not deficiency. Conclusions: Our study reveals a significant prevalence of vitamin D insufficiency and deficiency among elite male power athletes of Kazakhstan. Age, BMI, and sport experience are essential factors in developing personalized strategies to address vitamin D insufficiency. The A/A genotype of the VDR FokI polymorphism can be used as a potential biomarker for vitamin D inadequacy in elite male power athletes of Kazakhstan. Full article

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

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12 pages, 651 KB

Open AccessArticle

Dietary Modification with Food Order and Divided Carbohydrate Intake Improves Glycemic Excursions in Healthy Young Women

by Yuki Higuchi, Takashi Miyawaki, Shizuo Kajiyama, Kaoru Kitta, Shintaro Kajiyama, Yoshitaka Hashimoto, Michiaki Fukui and Saeko Imai

Nutrients 2025, 17(20), 3194; https://doi.org/10.3390/nu17203194 (registering DOI) - 10 Oct 2025

Abstract

Background/Objectives: Previous studies show that allocating carbohydrates earlier and vegetables/protein later in late-evening meals improves glycemic control in both healthy individuals and those with type 2 diabetes. However, evidence remains insufficient regarding the effects of distributing carbohydrate intake across the day by dividing [...] Read more.

Background/Objectives: Previous studies show that allocating carbohydrates earlier and vegetables/protein later in late-evening meals improves glycemic control in both healthy individuals and those with type 2 diabetes. However, evidence remains insufficient regarding the effects of distributing carbohydrate intake across the day by dividing three regular meals into five smaller meals. Methods: We conducted a randomized, controlled, crossover trial to compare the effects of two dietary patterns: (1) a conventional three-meal pattern with simultaneous intake of all food components, and (2) a five-meal pattern incorporating divided carbohydrate portions and a fixed food order—vegetables first, followed by protein, and then carbohydrates. Eighteen healthy young women consumed the same test meals under both patterns. Glucose fluctuations were monitored using an intermittently continuous glucose monitoring system. Results: The five-meal pattern with food sequencing significantly improved the mean amplitude of glycemic excursions (MAGE; 2.56 ± 0.13 vs. 3.49 ± 0.32 mmol/L, p < 0.01), glucose peak, and incremental area under the glucose curve for breakfast, lunch, and dinner, and the time above the target glucose range [>7.8 mmol/L; 1.4 ± 0.6 vs. 4.2 ± 1.0%, p < 0.01] compared to the three-meal pattern. Conclusions: These findings suggest that divided carbohydrate intake and food order ameliorates the MAGE in healthy young women. Full article

(This article belongs to the Section Clinical Nutrition)

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12 pages, 225 KB

Open AccessArticle

Safety of FEES Performed by Speech-Language Pathologists and Physicians–Evidence Supporting Task Sharing from a Retrospective Observational Study of 964 Consecutive Examinations

by Małgorzata Polit, Joanna Chmielewska-Walczak, Maria Sobol, Izabela Domitrz and Kazimierz Niemczyk

Nutrients 2025, 17(20), 3193; https://doi.org/10.3390/nu17203193 - 10 Oct 2025

Abstract

(1) Background: Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is one of the two gold-standard tools for assessing oropharyngeal dysphagia (alongside Videofluoroscopic Swallowing Study). Although generally considered safe, concerns about complications persist, particularly in systems where FEES is not routine and professional roles differ. [...] Read more.

(1) Background: Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is one of the two gold-standard tools for assessing oropharyngeal dysphagia (alongside Videofluoroscopic Swallowing Study). Although generally considered safe, concerns about complications persist, particularly in systems where FEES is not routine and professional roles differ. The aim of this study was to evaluate the safety of FEES performed by both speech-language pathologists (SLPs) and physicians, in order to provide evidence of its safety in a healthcare system where the procedure is not yet widely established and to identify patient subgroups potentially at higher risk of procedure-related complications. (2) Methods: This retrospective study analyzed 964 consecutive FEES procedures. Examinations were carried out by trained SLPs or physicians. Data included demographics, clinical status, operator qualifications, setting, and complications, classified as minor (vomiting, poor tolerance, early termination) or major (laryngospasm, epistaxis). (3) Results: The overall complication rate was 1.14% (11/964): 0.6% minor and 0.5% major. All events were self-limiting. Complication rates did not differ between SLPs (1.05%) and physicians (1.23%) or by experience, setting, drug use, penetration–aspiration scale score, or nasogastric tube. Four complications occurred in amyotrophic lateral sclerosis patients, suggesting higher risk. (4) Conclusions: FEES is safe and well tolerated when performed by either physicians or SLPs. These findings underscore the value of task sharing in dysphagia diagnostics, demonstrating that a shared model increases service capacity, reduces delays, and facilitates timely management of dysphagia. Full article

(This article belongs to the Section Geriatric Nutrition)

11 pages, 442 KB

Open AccessArticle

Integrating Nutrition, Inflammation, and Immunity: The CALLY Index as a Novel Prognostic Biomarker in Acute Geriatric Care

by Francesca Mancinetti, Anna Giulia Guazzarini, Martina Gaspari, Michele Francesco Croce, Rocco Serra, Patrizia Mecocci and Virginia Boccardi

Nutrients 2025, 17(20), 3192; https://doi.org/10.3390/nu17203192 - 10 Oct 2025

Abstract

Background/Objectives: Malnutrition, systemic inflammation, and immune dysfunction are key determinants of adverse outcomes in older adults following acute illness. Composite biomarkers integrating these domains could enhance early risk stratification. This study investigates, for the first time in acute geriatric care, the prognostic value [...] Read more.

Background/Objectives: Malnutrition, systemic inflammation, and immune dysfunction are key determinants of adverse outcomes in older adults following acute illness. Composite biomarkers integrating these domains could enhance early risk stratification. This study investigates, for the first time in acute geriatric care, the prognostic value of the C-reactive protein–albumin–lymphocyte (CALLY) index—a composite marker of nutritional, inflammatory, and immune status—in predicting short-term survival. Methods: We retrospectively analyzed 264 patients admitted to the acute geriatrics ward of Santa Maria della Misericordia Hospital in Perugia. The CALLY index was calculated as: (Albumin × Lymphocytes)/(CRP × 10⁴). The optimal prognostic cut-off was determined using receiver operating characteristic (ROC) curve analysis. Three-month survival was assessed by Kaplan–Meier analysis. Results: The cohort included 167 women (63.3%) and 97 men (36.7%), with a mean age of 88.0 ± 6.4 years. At 3-month follow-up, 80 patients (30.3%) had died. The CALLY index showed an area under the ROC curve of 0.647 (95% CI: 0.576–0.718; p < 0.001), with a cut-off of 0.055 (sensitivity: 68.5%, specificity: 46.3%). Among deceased patients, 42.5% had a CALLY index <0.055. After multivariable adjustment, a lower CALLY index remained independently associated with increased mortality (B = −0.805; OR = 0.45; 95% CI: 0.215–0.930; p = 0.031). Kaplan–Meier analysis demonstrated significantly higher survival in patients with a CALLY index ≥ 0.055 (Log-rank test: 13.71; p < 0.001). Conclusions: The CALLY index shows a modest but statistically significant discriminative ability for predicting short-term mortality in acutely ill older adults. As a simple, low-cost marker derived from routine laboratory tests, it holds potential for integration into clinical workflows to guide nutritional, metabolic, and prognostic management strategies in geriatric acute care. Full article

(This article belongs to the Special Issue Nutritional Support for Critically Ill Patients)

11 pages, 570 KB

Open AccessArticle

Exploring CALD and Non-CALD Women’s Behavioral and Dietary Responses to a Low-Intensity Intervention for Gestational Diabetes

by Kai Liu, Georgia S. Clarke, Melissa Oxlad and Jessica A. Grieger

Nutrients 2025, 17(20), 3191; https://doi.org/10.3390/nu17203191 - 10 Oct 2025

Abstract

Background/Objectives: Cultural backgrounds can shape dietary beliefs, food preferences, and attitudes toward health interventions. However, limited research has explored adherence or behavioral responses following a dietary intervention in women from culturally and linguistically diverse (CALD) backgrounds. This secondary analysis of a randomized controlled [...] Read more.

Background/Objectives: Cultural backgrounds can shape dietary beliefs, food preferences, and attitudes toward health interventions. However, limited research has explored adherence or behavioral responses following a dietary intervention in women from culturally and linguistically diverse (CALD) backgrounds. This secondary analysis of a randomized controlled feasibility trial in women with gestational diabetes (GDM) explored differences in adherence, satisfaction, and behavior change between CALD and White (non-CALD) women. Methods: Thirty-eight participants were randomized to the dietary intervention (individualized, culturally tailored dietary advice) or standard care. Data collected at baseline (26–32 weeks’ gestation) and end of study (close to delivery) included a behavior change questionnaire, a 10-point Likert scale for adherence and satisfaction with the intervention, and 24-h dietary recall. Results: Eighteen participants self-reported as CALD and 20 self-reported as non-CALD. All intervention group participants, irrespective of cultural background, were motivated to make dietary changes, with similar mean [95% CI] adherence scores (CALD: 8.10 [7.27, 8.94] vs. non-CALD: 7.58 [6.66, 8.51]), and satisfaction scores to the intervention (CALD: 7.85 [6.96, 8.74] vs. non-CALD 6.88 [5.89, 7.86]). Within the intervention or standard care groups there were no differences in dietary intake between CALD and non-CALD participants. Conclusions: A low-intensity individualized dietary intervention for GDM was similarly acceptable and feasible for our small group of CALD and non-CALD participants. Findings support the potential for broadly applicable dietary strategies in antenatal care but also highlight the need for more culturally nuanced research to ensure inclusive interventions. Full article

(This article belongs to the Section Nutrition in Women)

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13 pages, 563 KB

Open AccessArticle

Breakfast Skipping Among Dormitory- and Home-Residing High School Students: Insights from the Korea Youth Risk Behavior Survey 2018–2024

by Jeong Mi Lee and Jee-Seon Shim

Nutrients 2025, 17(20), 3190; https://doi.org/10.3390/nu17203190 - 10 Oct 2025

Abstract

Background/Objectives: Skipping breakfast is common among adolescents. Providing breakfast at school is a potential solution; however, its effectiveness remains unclear. This study aimed to compare breakfast skipping between dormitory- and home-residing high school students, analyze trends over time, and identify reasons for [...] Read more.

Background/Objectives: Skipping breakfast is common among adolescents. Providing breakfast at school is a potential solution; however, its effectiveness remains unclear. This study aimed to compare breakfast skipping between dormitory- and home-residing high school students, analyze trends over time, and identify reasons for skipping breakfast. Methods: This study analyzed data from high school students who participated in the Korea Youth Risk Behavior Survey between 2018 and 2024, and who lived either in dormitories (n = 11,394) or at home (n = 164,446). The frequency of breakfast consumption over the previous seven days was surveyed; breakfast skipping was defined as missing breakfast on at least five of these seven days. Results: Students living in dormitories had more breakfast days than those living at home (4.6 ± 0.04 vs. 3.7 ± 0.01, p < 0.001). The prevalence of breakfast skipping among students living in dormitories was approximately half of that among students living at home. The association between breakfast skipping and residence type remained significant after adjusting for potential confounders (odds ratio: 0.37; 95% confidence interval: 0.34–0.39). The prevalence of breakfast skipping increased more rapidly between 2018 and 2024 among students living in dormitories (15.1–25.0%, annual percent change = 8.7%, p < 0.05) than in those living at home (35.3–45.3%, annual percent change = 4.0%, p < 0.05). In 2022, the main reasons for skipping breakfast among students living in dormitories and at home were oversleeping (32.2%) and lack of time (39.6%), respectively. Conclusions: Students living in dormitories were less likely to skip breakfast than those living at home. However, even when breakfast is provided, a substantial and increasing proportion of adolescents skip breakfast. These findings suggest that creating a supportive environment alone is insufficient and that strategies are needed to enhance awareness of the importance of breakfast. Full article

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

15 pages, 1146 KB

Open AccessArticle

Association Between the Jiangnan Diet and Mild Cognitive Impairment Among the Elderly

by Mengjie He, Yan Zou, Ronghua Zhang, Danting Su and Peiwei Xu

Nutrients 2025, 17(20), 3189; https://doi.org/10.3390/nu17203189 - 10 Oct 2025

Abstract

Background/Objectives: The Jiangnan diet—a traditional dietary pattern prevalent in Eastern China—is a newly proposed dietary pattern. This study provides additional epidemiological evidence for the promotion of the Jiangnan diet through examining the association between the Jiangnan diet and mild cognitive impairment (MCI). [...] Read more.

Background/Objectives: The Jiangnan diet—a traditional dietary pattern prevalent in Eastern China—is a newly proposed dietary pattern. This study provides additional epidemiological evidence for the promotion of the Jiangnan diet through examining the association between the Jiangnan diet and mild cognitive impairment (MCI). Methods: A multicenter cross-sectional study was carried out during 2020 among 1084 community-dwelling adults aged 55 years and above across multiple sites in Zhejiang Province, China. Data collection encompassed basic information of the population, cognition (using the Montreal Cognitive Assessment), dietary intake information (using the Food Frequency Questionnaire, FFQ), life pattern, depressive symptoms (using the Mental Health Assessment Scale for the Elderly), and physical examinations (e.g., height, weight). The dietary patterns were assessed using a validated semi-quantitative FFQ. Factor analysis was used to analyze the 16 categories of food intake of the participants, and dietary patterns and the “Jiangnan diet” were extracted. The Jiangnan diet scores were categorized into quartiles: Q1 (lowest) to Q4 (highest). Multivariate logistic regression was employed to examine the association between adherence to the Jiangnan diet and the prevalence of MCI, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results: The estimated prevalence of MCI in the study population was 24.6%. The dietary pattern characterized by whole grains, low salt, and low oil was identified as the “Jiangnan diet”. Participants with the highest adherence to the “Jiangnan diet” pattern had 79.2% lower odds of MCI than those with the lowest adherence (odds ratio = 0.208, 95% CI = 0.120~0.362, p < 0.0001) after adjusting for age, frequency of social activities, depression, hypertension, alcohol consumption, and energy intake. Conclusions: High adherence to the Jiangnan diet was associated with lower odds of MCI. To further verify the relationship between the Jiangnan diet and MCI, future studies will focus on longitudinal research exploring different dietary patterns and disease outcomes across various regions. Full article

(This article belongs to the Section Geriatric Nutrition)

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16 pages, 353 KB

Open AccessArticle

Early Maladaptive Schemas, Emotion Regulation, Stress, Social Support, and Lifestyle Factors as Predictors of Eating Behaviors and Diet Quality: Evidence from a Large Community Sample

by Małgorzata Obara-Gołębiowska

Nutrients 2025, 17(20), 3188; https://doi.org/10.3390/nu17203188 (registering DOI) - 10 Oct 2025

Abstract

Background: Psychological vulnerabilities, including early maladaptive schemas (EMSs), emotion regulation difficulties, perceived stress, and limited social support, are increasingly recognized as drivers of maladaptive eating and obesity. These findings underscore the need for health education and health promotion strategies that address psychological determinants [...] Read more.

Background: Psychological vulnerabilities, including early maladaptive schemas (EMSs), emotion regulation difficulties, perceived stress, and limited social support, are increasingly recognized as drivers of maladaptive eating and obesity. These findings underscore the need for health education and health promotion strategies that address psychological determinants of eating behavior. However, few studies integrate these psychological mechanisms with dietary and lifestyle indicators in both community and medical populations. Methods: A total of 1500 adults (aged 18–65 years; 53% women) recruited from community and medical settings participated in the study. Data were collected between January 2018 and February 2025 using standardized paper-based questionnaires. Participants completed validated measures of EMSs (YSQ-S3), emotion regulation (DERS), stress (PSS-10), social support (MSPSS), eating-related behaviors (QERB), diet (FFQ-6; Unhealthy Diet Index [UDI]), and physical activity (IPAQ-SF). Anthropometric indices included body mass index (BMI) and waist circumference (WC) as an indicator of central adiposity. Analyses involved multivariate regression, mediation, and moderation models. Results: EMSs were associated with emotional overeating and higher UDI scores. Difficulties in emotion regulation mediated the EMS–eating relationship (β_indirect = 0.27, p < 0.001). Perceived stress amplified, while social support attenuated, the association between EMSs and emotion regulation difficulties. UDI was inversely related to physical activity (β = −0.14, p < 0.01) and positively to sedentary time (β = 0.12, p < 0.01). Both BMI and WC were higher among participants reporting greater stress, emotion dysregulation, and unhealthy eating. All effects remained robust after adjustment for age, gender, and BMI. Conclusions: Early maladaptive schemas and emotion regulation difficulties contribute to unhealthy dietary patterns and central adiposity, with stress and social support acting as contextual moderators. Integrating psychological assessment with validated dietary and lifestyle measures provides a comprehensive framework for obesity prevention and schema-informed interventions. From a lifespan perspective (18–65 years), these findings highlight the need for multidomain strategies targeting cognitive–emotional and behavioral mechanisms of weight regulation. Full article

(This article belongs to the Special Issue Advances in Disordered Eating Behaviours Across the Life Spectrum)

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15 pages, 284 KB

Open AccessArticle

Maternal Dietary Anthocyanidin, Dietary Inflammatory Potential, and Risk of Small-for-Gestational-Age in China

by Binyan Zhang, Kun Xu, Baibing Mi, Hong Yan, Duolao Wang, Shaonong Dang and Ke Men

Nutrients 2025, 17(20), 3187; https://doi.org/10.3390/nu17203187 - 10 Oct 2025

Abstract

Background: The interaction between anthocyanidin intake and dietary inflammatory potential might influence small-for-gestational-age (SGA), but the available evidence has been limited. This study aims to examine the associations of anthocyanidin with SGA and whether these associations change with dietary inflammatory potential. Methods: Data [...] Read more.

Background: The interaction between anthocyanidin intake and dietary inflammatory potential might influence small-for-gestational-age (SGA), but the available evidence has been limited. This study aims to examine the associations of anthocyanidin with SGA and whether these associations change with dietary inflammatory potential. Methods: Data were derived from 2244 pregnant women enrolled in a community-based, randomized controlled trial between 2015 and 2019 in China. Anthocyanidin intake was calculated with the use of validated food-frequency questionnaires. The energy-adjusted dietary inflammatory index (EDII) was determined by aggregating data from 33 food parameters. Infant birth outcome measurements were obtained from hospital records. Associations were assessed by generalized estimating equations with adjustment for confounding factors. Results: During 39.7 gestational weeks of follow-up, 234 SGA cases occurred. The median intake of anthocyanidin was 28.7 mg/d. Higher consumption of total anthocyanidins (OR: 0.96, 95% CI: 0.95 to 0.97), cyanidin (OR: 0.96, 95% CI: 0.95 to 0.97), and peonidin (OR: 0.96, 95% CI: 0.96 to 0.97) subclasses was associated with a reduced risk of SGA. EDII was associated with an increased risk of SGA (OR: 1.08, 95% CI: 1.03 to 1.12). In addition, we observed that higher anthocyanidin intake was inversely associated with EDII (β: −0.40, 95% CI: −0.46 to −0.34). The inverse anthocyanidin-SGA association was mostly greater among women in the highest tertile of EDII (OR: 0.67, 95% CI: 0.65 to 0.68) compared with the lowest tertile. Conclusions: Higher anthocyanidin intake was inversely associated with SGA, especially among women with higher EDII scores. Full article

(This article belongs to the Special Issue Effects of Plant Extracts on Human Health—2nd Edition)

15 pages, 702 KB

Open AccessReview

The Role of Nutritional Therapy in the Treatment of Adults with Crohn’s Disease: A Review

by Raffaele Li Voti, Fabio Salvatore Macaluso, Elena Banci, Angelo Campanozzi, Giulia D’Arcangelo, Alessia De Blasi, Salvatore Oliva, Elena Sofia Pieri, Sara Renzo, Cosimo Ruggiero, Giusy Russo, Luca Scarallo, Paolo Lionetti and Ambrogio Orlando

Nutrients 2025, 17(20), 3186; https://doi.org/10.3390/nu17203186 - 10 Oct 2025

Abstract

Crohn’s disease (CD) is an immune-mediated inflammatory bowel disease (IBD) with a multifactorial pathogenesis involving genetic predisposition, immune dysregulation, and environmental triggers. Dietary patterns have recently garnered growing attention for their potential benefits and risks in patients with IBD. Nutritional therapy has been [...] Read more.

Crohn’s disease (CD) is an immune-mediated inflammatory bowel disease (IBD) with a multifactorial pathogenesis involving genetic predisposition, immune dysregulation, and environmental triggers. Dietary patterns have recently garnered growing attention for their potential benefits and risks in patients with IBD. Nutritional therapy has been established as an effective option in pediatric populations, but its role in adults remains less defined. The available studies indicate that while no single diet can be universally recommended, adherence to a Mediterranean diet is associated with multiple health benefits. Nutritional therapy appears promising in inducing clinical remission in adults with mild to moderate CD, particularly when partial enteral nutrition is combined with food-based modifications. Tailoring these strategies to cultural contexts and providing support from qualified dietitians may improve adherence, clinical outcomes, and overall quality of life. This review highlights the growing role of nutritional therapy in adult CD and its potential integration into routine management alongside conventional treatments. Full article

(This article belongs to the Section Nutritional Immunology)

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14 pages, 872 KB

Open AccessArticle

Associations Between Dietary Iron, SNP rs2794720, and Metabolic Syndrome Risk in Chinese Males and Females: A Community-Based Study in a Chinese Metropolis

by Zihan Hu, Hongwei Liu, Zhengyuan Wang, Jiajie Zang, Fan Wu and Zhenni Zhu

Nutrients 2025, 17(20), 3185; https://doi.org/10.3390/nu17203185 - 10 Oct 2025

Abstract

Background: Metabolic syndrome, a cardiovascular risk cluster, is recognized as a global health priority influenced by gene–diet interactions. The rs2794720 polymorphism has not been previously reported in relation to metabolic syndrome. This study examined the associations between dietary iron, SNP rs2794720, and metabolic [...] Read more.

Background: Metabolic syndrome, a cardiovascular risk cluster, is recognized as a global health priority influenced by gene–diet interactions. The rs2794720 polymorphism has not been previously reported in relation to metabolic syndrome. This study examined the associations between dietary iron, SNP rs2794720, and metabolic syndrome in Chinese metropolitan population, with a focus on sex-specific and genotype-specific effects. Methods: A community-based cross-sectional study enrolled 2639 adults (1254 males, 1385 females) from Shanghai, China. Anthropometric measurements, laboratory analyses, and genotyping for the participants were performed. Dietary assessment utilized the 3-day 24 h dietary recall method. Metabolic syndrome was identified by the presence of at least three out of five metabolic abnormalities according to the NCEP—ATP III criteria. Results: After adjusting for confounders, in males, metabolic syndrome risk was associated with dietary iron (p = 0.002) but not with rs2794720 (p = 0.731). In females, metabolic syndrome risk was associated with rs2794720 (p = 0.014) and dietary iron (p = 0.016), with a significant interaction observed between rs2794720 and dietary iron (p = 0.047). Stratified by rs2794720, among females lacking the C allele, there was a linear trend between dietary iron and metabolic syndrome risk (p = 0.048). Compared to the reference group (lowest-intake GG homozygotes), the Q2–Q4 Ors (95% CI) were 5.31 (1.08, 39.52), 5.50 (1.16, 40.28), and 8.40 (1.80, 41.44)), while the major allele carriers did not show this trend (p = 0.704); compared to the reference group, the Q1–Q4 ORs(95% CI) were 6.13 (1.68, 39.66), 7.53 (2.06, 48.86), 8.10 (2.20, 52.60), and 7.84 (2.07, 51.70)). Conclusions: Our study first identified rs2794720 as a novel SNP associated with metabolic syndrome in Chinese females. The association between dietary iron and metabolic syndrome risk was unique to GG homozygotes (the minority), whereas CC/CG genotypes (the majority) showed no such association. Full article

(This article belongs to the Section Nutrition and Metabolism)

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15 pages, 3782 KB

Open AccessArticle

Consequences of Dietary Manganese Deficiency or Mn₂O₃ Nanoparticles Supplementation on Rat Manganese Biodistribution and Femur Morphology

by Ewelina Cholewińska, Wojciech Dworzański, Jerzy Juśkiewicz, Piotr Listos and Katarzyna Ognik

Nutrients 2025, 17(19), 3184; https://doi.org/10.3390/nu17193184 - 9 Oct 2025

Abstract

Objectives: The study aimed to determine the effect of manganese (Mn) exclusion from the dietary mineral mixture and the dietary replacement of the recommended level of MnCO₃ with Mn₂O₃ nanoparticles (Mn₂O₃NPs) on the Mn [...] Read more.

Objectives: The study aimed to determine the effect of manganese (Mn) exclusion from the dietary mineral mixture and the dietary replacement of the recommended level of MnCO₃ with Mn₂O₃ nanoparticles (Mn₂O₃NPs) on the Mn biodistribution and the femur histology. Methods: The experiment was conducted on twenty seven Wistar rats divided into three groups (n = 9): a control group receiving the recommended level of Mn (65 mg/kg) in standard form (MnCO₃); a manganese deficient group (Mn deprived from dietary mineral mixture), and a group receiving diet supplemented Mn₂O₃NPs (65 mg/kg) instead of MnCO₃. During the 12-week experiment, a balance test was performed. After the experiment period, blood and femur were collected from sacrificed rats. The content of Mn in water, diet, urine, feces, plasma, and femur was measured. Results: In the Mn-deficient rats, a reduction in Mn intake and excretion, Mn retention index, and blood Mn level, but an increase in Mn digestibility index was noted. In rats supplemented with Mn₂O₃NPs, Mn intake and excretion and blood Mn levels were decreased, while Mn retention and digestibility indexes were increased. In both experimental groups, deterioration of femur morphology was noted, but these changes were more severe in the Mn-deficient group. Conclusions: The obtained research results indicate that manganese deficiency significantly disturbed the biodistribution of this element and led to the deterioration of the architecture and histological parameters of the femur, emphasizing the key role of manganese in maintaining bone homeostasis. It has also been shown that replacing MnCO₃ with Mn₂O₃NPs allows the maintenance of the correct Mn level in the femur but causes unfavorable changes in its morphology. Full article

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

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14 pages, 605 KB

Open AccessArticle

Association Between Adiposity Rebound and the Frequency of Balanced Meals Among Japanese Preschool Children: A Cross-Sectional Study

by Yuki Tada, Kemal Sasaki, Tomomi Kobayashi, Yasuyo Wada, Daisuke Fujita and Tetsuji Yokoyama

Nutrients 2025, 17(19), 3183; https://doi.org/10.3390/nu17193183 - 9 Oct 2025

Abstract

Background: The Healthy Japan 21-Phase III dietary recommendations comprise a staple food, main dish, and side dish to maintain nutritional balance and support healthy child growth. The relationship between the frequency of such balanced meals and early adiposity rebound (AR), a predictor of [...] Read more.

Background: The Healthy Japan 21-Phase III dietary recommendations comprise a staple food, main dish, and side dish to maintain nutritional balance and support healthy child growth. The relationship between the frequency of such balanced meals and early adiposity rebound (AR), a predictor of obesity, remains unclear. Objective: This study aimed to examine the association between the frequency of balanced meals (staple food, main dish, and side dish) and early AR in preschool children. Methods: In this cross-sectional secondary analysis of nationwide online survey data of 688 mothers of children aged 3–6 years, dietary habits were assessed using a validated NutriSTEP-based 22-item Japanese Nutrition Screening Questionnaire. AR constituted a body mass index (BMI) increase from the 18- to 36-month health checkups recorded in the Maternal and Child Health Handbook. Risk scores reflecting lower frequency of balanced meals were calculated for staple foods, main dishes, and side dishes. Logistic regression evaluated associations between dietary risk scores and AR, adjusting for the child’s sex, age, gestational age, birth weight, daycare attendance, and parental obesity. Results: Among 688 children, 193 (28.1%) exhibited early AR and had significantly higher BMI at age 3 and the most recent measurement (both p < 0.01). A higher total dietary risk score was independently associated with AR (adjusted odds ratio; 2.58 [95% CI: 1.08–6.16]). In addition, the absolute risk difference between high- and low-risk groups was 8.5% (95% CI: 1.7–15.2%). Conclusions: A lower frequency of balanced meals is associated with early AR. These findings suggest that a simple, meal-balance screening tool could potentially aid in the early identification of the risk of later obesity and timely nutritional guidance. Full article

(This article belongs to the Special Issue Nutritional Intervention and Physical Activity in Adolescents and Children with Obesity)

17 pages, 2353 KB

Open AccessArticle

AI-Based Facial Emotion Analysis in Infants During Complimentary Feeding: A Descriptive Study of Maternal and Infant Influences

by Murat Gülşen, Beril Aydın, Güliz Gürer and Sıddika Songül Yalçın

Nutrients 2025, 17(19), 3182; https://doi.org/10.3390/nu17193182 - 9 Oct 2025

Abstract

Background/Objectives: Infant emotional responses during complementary feeding offer key insights into early developmental processes and feeding behaviors. AI-driven facial emotion analysis presents a novel, objective method to quantify these subtle expressions, potentially informing interventions in early childhood nutrition. We aimed to investigate [...] Read more.

Background/Objectives: Infant emotional responses during complementary feeding offer key insights into early developmental processes and feeding behaviors. AI-driven facial emotion analysis presents a novel, objective method to quantify these subtle expressions, potentially informing interventions in early childhood nutrition. We aimed to investigate how maternal and infant traits influence infants’ emotional responses during complementary feeding using an automated facial analysis tool. Methods: This multi-center study involved 117 typically developing infants (6–11 months) and their mothers. Standardized feeding sessions were recorded, and OpenFace software quantified six emotions (surprise, sadness, fear, happiness, anger, disgust). Data were normalized and analyzed via Generalized Estimating Equations to identify associations with maternal BMI, education, work status, and infant age, sex, and complementary feeding initiation. Results: Emotional responses did not differ significantly across five food groups. Infants of mothers with BMI > 30 kg/m² showed greater surprise, while those whose mothers were well-educated and not working displayed more happiness. Older infants and those introduced to complementary feeding before six months exhibited higher levels of anger. Parental or infant food selectivity did not significantly affect responses. Conclusions: The findings indicate that maternal and infant demographic factors exert a more pronounced influence on infant emotional responses during complementary feeding than the type of food provided. These results highlight the importance of integrating broader psychosocial variables into early feeding practices and underscore the potential utility of AI-driven facial emotion analysis in advancing research on infant development. Full article

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

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17 pages, 772 KB

Open AccessSystematic Review

Effectiveness of Interventions to Improve Malnutrition Among Older Adults Living with Frailty Who Are Discharged from the Acute Setting: A Systematic Review

by Cerenay Sarier, Siobhan Walsh, Sheila Bowers, Margaret O’Connor, Ahmed Mohamed, Heather Keller, Katherine L. Ford, Rose Galvin and Anne Griffin

Nutrients 2025, 17(19), 3181; https://doi.org/10.3390/nu17193181 - 9 Oct 2025

Abstract

Background & Aim: Malnutrition and frailty are prevalent among older adults following discharge from acute care, including emergency departments. This transition period presents a critical window for targeted nutrition interventions. This systematic review synthesises evidence on the effectiveness of nutrition interventions for malnourished, [...] Read more.

Background & Aim: Malnutrition and frailty are prevalent among older adults following discharge from acute care, including emergency departments. This transition period presents a critical window for targeted nutrition interventions. This systematic review synthesises evidence on the effectiveness of nutrition interventions for malnourished, frail older adults and incorporates analyses of stakeholders’ perspectives, including those of patients, caregivers, and healthcare professionals. By integrating clinical outcomes with stakeholder experiences, the review aims to identify strategies that can optimise nutritional care and support recovery in the post-acute setting. Methods: Searches were conducted in Scopus, CINAHL, EBSCO, EMBASE, and PubMed for randomised controlled trials (RCTs) of nutrition interventions in participants ≥65 years living with frailty and identified as malnourished on discharge from acute care. The primary outcome was assessing the effects of nutrition interventions on malnutrition, nutrition status, physical function and frailty, food intake, and quality of life. Secondary outcomes were hospital readmission and mortality. The quality of studies was assessed using the Cochrane Risk of Bias Tool (V2). Results: Five RCTs with 551 participants were included. Nutrition interventions, including counselling, oral nutrition supplements, and multidisciplinary strategies, improved dietary intake, weight, frailty, physical function, BMI, and quality of life in older adults post-discharge. Some studies also reported reduced hospital stays, readmissions, and mortality. However, none explored stakeholder perspectives, highlighting a gap in person-centred transitional care design. Conclusion: This systematic review highlights a critical gap in evidence for nutrition interventions targeting frail older adults at hospital discharge. While short-term benefits were observed, long-term sustainability and real-world feasibility remain uncertain. The absence of stakeholder involvement further limits person-centred design. These findings underscore the need for integrated nutrition care pathways that embed effective interventions into transitional care models. Full article

(This article belongs to the Section Geriatric Nutrition)

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16 pages, 2018 KB

Open AccessArticle

Nutritional Adequacy and Day-to-Day Energy Variability: Impacts on Outcomes in Severe Trauma Patients

by Jovana Stanisavljevic, Nikola N. Grubor, Sergej Marjanovic, Ivan Palibrk, Mihailo Bezmarevic, Jelena Velickovic, Adi Hadzibegovic, Marija Milenkovic, Sanja Ratkovic and Bojan Jovanovic

Nutrients 2025, 17(19), 3180; https://doi.org/10.3390/nu17193180 - 9 Oct 2025

Abstract

Background: Optimal energy and protein delivery during the early phase of severe trauma remains unclear. Observational studies frequently contradict the findings of randomized controlled trials, raising concerns about confounding factors. The aim of this study is to assess nutritional adequacy and daily variability [...] Read more.

Background: Optimal energy and protein delivery during the early phase of severe trauma remains unclear. Observational studies frequently contradict the findings of randomized controlled trials, raising concerns about confounding factors. The aim of this study is to assess nutritional adequacy and daily variability in the energy gaps and its impact on outcomes using innovative statistical methods. Methods: Prospective observational study enrolled severely injured patients in the ICU at the Level 1 trauma center between October 2023 to April 2025. To describe the evolution of calorie and protein deficits during the first 10-day ICU stay, we utilized a linear mixed-effects model to estimate each patient’s individual energy gap trajectory. Results: 286 patients were analyzed. Median APACHE II and ISS score was 16.0 (12.0–20.0) and 22.0 (18.0–27.0), respectively. Mortality rate was 35.3%. Patients received 68.3% of prescribed calories and 76.8% of proteins. Admission energy deficit, rate of caloric intake, and their interaction are associated with ICU mortality. Increased day-to-day energy variability was associated with longer duration of mechanical ventilation (HR = 0.55, 95% CI: 0.31–0.99; p = 0.047). Patients who achieved better caloric (HR = 0.68, 95% CI: 0.48–0.98, p = 0.036) and protein (HR = 0.29, 95% CI: 0.09–0.96, p = 0.043) nutrition had a lower hazard of developing nosocomial infection. Conclusions: This study supports the 2023 ESPEN guidelines, showing that achieving the recommended energy and protein intake during the early phase of severe trauma is linked to lower mortality rates, shorter mechanical ventilation time, and reduced risk of nosocomial infections. Full article

(This article belongs to the Section Clinical Nutrition)

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