Nutrients

21 pages, 833 KB

Open AccessArticle

Food Allergy and Foodservice: A Comparative Study of Allergic and Non-Allergic Consumers’ Behaviors, Attitudes, and Risk Perceptions

by Fatemeh Shirani, Silvia Dominguez, Jérémie Théolier, Jennifer Gerdts, Kate Reid, Sébastien La Vieille and Samuel Godefroy

Nutrients 2025, 17(18), 2916; https://doi.org/10.3390/nu17182916 (registering DOI) - 9 Sep 2025

Abstract

Background: Food-allergic reactions in restaurants often result from miscommunication between customers with allergies and staff, or from staff members’ insufficient knowledge of food allergies. This study examined the behaviors, attitudes, and risk perceptions of food-allergic consumers when dining out or ordering from foodservice [...] Read more.

Background: Food-allergic reactions in restaurants often result from miscommunication between customers with allergies and staff, or from staff members’ insufficient knowledge of food allergies. This study examined the behaviors, attitudes, and risk perceptions of food-allergic consumers when dining out or ordering from foodservice establishments (FSEs) compared to consumers without food allergies. Methods: A representative pan-Canadian survey was conducted amongst three groups: one of individuals without food allergies (n = 500) and two of food-allergic individuals (allergic-convenience sample [n = 500] and allergic-general population [n = 500]). The convenience sample comprised members of Food Allergy Canada, a national patient advocacy organization. Some participants with food allergies had experienced reactions linked to an FSE (43% convenience, 27% general). Weighted responses from food-allergic groups were compared to those of non-allergic ones using chi-square (p < 0.05). Statistical comparison between allergic groups was not attempted due to inherent differences in their allergic condition. Results: In several questions, responses from the non-allergic group differed significantly from those of the allergic-convenience sample, but not from those of the allergic-general population. Food-allergic-convenience respondents were more likely to avoid ordering food or dining out than non-allergic ones, with the highest avoidance (66%) noted for third-party platforms. Cost was the main barrier for non-allergic and allergic-general populations, whereas the allergic-convenience sample prioritized allergy-related concerns. Although at a lower rate than for participants with food allergies, food allergies influenced restaurant selection for 44% of participants without food allergies when dining with individuals outside their household. Most allergic respondents perceived that FSEs underestimate the seriousness of food allergies (82% convenience, 71% general), yet they felt safe while dining out (60% convenience, 85% general), pointing at loyalty to specific FSEs as a risk mitigation strategy. Conclusions: This study highlights a potentially higher burden of disease (psychological and social strain, reduced quality of life) among a subgroup of the food-allergic population (convenience sample), as reflected in their behaviors, attitudes, and risk perceptions towards meals prepared in FSEs. Nevertheless, both allergic groups expressed shared concerns and needs related to safety (e.g., ingredient disclosure for all menu items, prevention of allergen cross-contact, ability of an FSE to offer a safe meal, establishing clear communication processes for allergy-related information), which FSEs and regulators should consider when designing risk management strategies. Full article

(This article belongs to the Special Issue Adopting Sustainable Dietary Patterns: Effects of Food Labeling, Food Choices, and Eating Behaviors (2nd Edition))

► Show Figures

Figure 1

13 pages, 315 KB

Open AccessArticle

Prevalence and Predictors of Self-Prescribed Vitamin D Supplementation Among University Students in the UAE

by Aaesha H. Alnaqbi, Rubina Sabir, Hafiz M. Shahbaz, Zahra Khan and Mo’ath F. Bataineh

Nutrients 2025, 17(18), 2915; https://doi.org/10.3390/nu17182915 (registering DOI) - 9 Sep 2025

Abstract

Background/Objectives: Vitamin D deficiency is widespread globally, including in the Middle East. In the UAE, vitamin D deficiency contributes to 78% of bone losses because of cultural and lifestyle factors, which limit sun exposure. Although supplementation is effective, increasing rates of self-prescribed [...] Read more.

Background/Objectives: Vitamin D deficiency is widespread globally, including in the Middle East. In the UAE, vitamin D deficiency contributes to 78% of bone losses because of cultural and lifestyle factors, which limit sun exposure. Although supplementation is effective, increasing rates of self-prescribed use raise concerns about safety and efficacy, particularly among university students. Therefore, this study aims to assess the prevalence, patterns, and predictors of self-prescribed vitamin D supplementation among university students in the United Arab Emirates. Methods: A descriptive cross-sectional survey was conducted among 450 university students aged 18–39 who had used vitamin D supplements in the past 12 months. Data were collected using an online questionnaire and analyzed using chi-square tests and binary logistic regression. Results: Among participants, 44.9% reported self-prescribed vitamin D use. Males were more likely to self-prescribe (p = 0.010). Self-prescribers used supplements for shorter durations (p < 0.001) and were more likely to report motivations like physical performance (p = 0.005). Predictors of self-prescription included short-term use (OR = 2.57), non-daily intake (OR = 3.49), use for performance (OR = 2.72), and concurrent vitamin C use (OR = 1.85). Conclusions: Self-prescription of vitamin D is common among university students and associated with irregular use and non-clinical motivations, primarily to improve overall health and wellness. While such practices are unlikely to result in toxicity, they may not adequately address the widespread problem of vitamin D deficiency. These findings suggest the need for clear, locally relevant guidance to promote safe and effective supplementation among young adults. Full article

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

15 pages, 1050 KB

Open AccessReview

The Impact of the Alternate Mediterranean Diet (aMED) on the Prevention of Chronic Liver Disease: A Meta-Analysis of Observational Studies

by Linjie Zhang, Jing Sui, Hanlin Yin, Qun Zhao, Yajie Zhou and Hui Xia

Nutrients 2025, 17(18), 2914; https://doi.org/10.3390/nu17182914 (registering DOI) - 9 Sep 2025

Abstract

Conventional research mainly focuses on individual nutrients or specific foods in relation to chronic liver disease, but the cumulative effects of dietary patterns are underexplored. This study aimed to assess current evidence on the alternate Mediterranean Diet (aMED) and chronic liver disease risk [...] Read more.

Conventional research mainly focuses on individual nutrients or specific foods in relation to chronic liver disease, but the cumulative effects of dietary patterns are underexplored. This study aimed to assess current evidence on the alternate Mediterranean Diet (aMED) and chronic liver disease risk via a meta-analysis of observational studies. A systematic search of PubMed, Web of Science, Cochrane, and Embase (up to February 2025) identified studies on aMED and chronic liver disease, using predefined criteria for screening, quality assessment, and data extraction. A total of 20 articles (3 cross-sectional, 15 cohort, and 2 case–control; 1,286,480 participants) were analyzed using a random-effects model. The analysis showed that aMED was significantly negatively correlated with chronic liver disease (OR = 0.65, 95% CI: 0.56–0.75), indicating that adherence reduces risk. Subgroup analysis showed aMED’s protective effects in North America (OR = 0.67, 95% CI: 0.54–0.83) and Europe (OR = 0.54, 95% CI: 0.44–0.66). The results suggest aMED adherence may lower chronic liver disease risk, emphasizing dietary modifications for prevention. Full article

(This article belongs to the Special Issue Nutrition, Diet, and Eating Behaviors in the Prevention and Management of Cancer and Chronic Diseases)

► Show Figures

Figure 1

16 pages, 1598 KB

Open AccessArticle

Caffeinated Energy Drink Formulations Differentially Impact Hydration Versus Water: Does Habitual Caffeine Intake or Biological Sex Matter?

by Melinda Millard-Stafford, Brian Hack, Alec Harp and Ella Smith

Nutrients 2025, 17(18), 2913; https://doi.org/10.3390/nu17182913 (registering DOI) - 9 Sep 2025

Abstract

Background/Objectives: The beverage hydration index (BHI) assesses the relative hydration properties of beverages. Commercially available caffeinated energy drinks (with and without electrolytes or carbohydrates) were compared to water. Methods: Fourteen men and fourteen women completed four trials: 500 mL water plus either [...] Read more.

Background/Objectives: The beverage hydration index (BHI) assesses the relative hydration properties of beverages. Commercially available caffeinated energy drinks (with and without electrolytes or carbohydrates) were compared to water. Methods: Fourteen men and fourteen women completed four trials: 500 mL water plus either 500 mL water or caffeinated energy drink beverage (CAF) with 280 mg, CAF (280 mg) plus electrolytes (CAF + E), or CAF (106 mg) + E and carbohydrates (CAF + CE). Participants’ habitual caffeine intake (0–535 mg/day) was used to stratify users into naïve (<25 mg/day, n = 19) or regular users. Results: BHIs at 240 min for CAF (0.86 ± 0.16) and CAF + E (0.91 ± 0.16) were lower (p < 0.001) versus water (1.0 ± 0.0) and CAF + CE (1.01 ± 0.12). Urine mass with CAF and CAF + E was significantly greater (p < 0.01) by 244 g and 162 g versus CAF + CE. The % fluid retained at 240 min was lower (p < 0.001) for CAF (−71.2 ± 21.5%) and CAF + E (−65.1 ± 26.3%) versus CAF + CE (−46.4 ± 18.8%). Habitual intake status had no effect on the BHI (p = 0.827) between the naïve (0.92 ± 0.1) and habitual user group (0.93 ± 0.1) averaged across all three caffeinated beverages for 120 and 240 min. At 240 min, the drink (p < 0.001) and drink x sex interaction (p = 0.042) indicated women had higher BHI than men (p = 0.03) for caffeinated drinks despite higher relative fluid and caffeine dosages. Conclusions: A low-carbohydrate–electrolyte beverage with moderate caffeine had similar hydration properties compared to water; however, this differs from beverages with higher caffeine containing limited carbohydrate and/or electrolytes, which were inferior to water. Habitual caffeine intake had no apparent influence, but men and women exhibited differences in the diuretic response to energy drink consumption. Full article

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

► Show Figures

Figure 1

12 pages, 254 KB

Open AccessArticle

Impact of Preoperative Malnutrition on Postoperative Quality of Life in Older Adults Undergoing Surgery for Degenerative Cervical Myelopathy: A Retrospective Cohort Study

by Yuki Taniguchi, Hideki Nakamoto, So Kato, Hiroyuki Nakarai, Kosei Nagata, Kenichi Kono, Yuhei Saito, Reo Inoue, Hiroshi Okawa, Sakae Tanaka, Yasushi Oshima and Kazuhiko Fukatsu

Nutrients 2025, 17(18), 2912; https://doi.org/10.3390/nu17182912 (registering DOI) - 9 Sep 2025

Abstract

Background/Objectives: Malnutrition, which is closely associated with frailty and sarcopenia, is common in older adults and is linked to adverse perioperative complications in musculoskeletal surgery. However, its influence on postoperative health-related quality of life (HRQOL) remains unclear. This study aimed to investigate the [...] Read more.

Background/Objectives: Malnutrition, which is closely associated with frailty and sarcopenia, is common in older adults and is linked to adverse perioperative complications in musculoskeletal surgery. However, its influence on postoperative health-related quality of life (HRQOL) remains unclear. This study aimed to investigate the impact of preoperative malnutrition on HRQOL one year after surgery in elderly patients with degenerative cervical myelopathy (DCM). Methods: We retrospectively analyzed 188 patients aged ≥ 65 years who underwent elective surgery for DCM between 2017 and 2024. Preoperative nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI), with GNRI ≤ 98 indicating malnutrition risk. Patient-reported outcome measures were assessed using the EuroQol Five-Dimension Questionnaire (EQ-5D) both preoperatively and at one year postoperatively. The minimum clinically important difference (MCID) threshold was applied to evaluate significant changes. Multivariate logistic regression was used to identify independent risk factors for postoperative deterioration in EQ-5D score. Results: Of the 188 patients, 35 were classified as having malnutrition risk. While preoperative EQ-5D scores were comparable between the two groups, the postoperative EQ-5D score was significantly lower in the malnutrition risk group than in the no-risk group (0.58 vs. 0.67, p = 0.003). Deterioration in EQ-5D scores exceeding the MCID threshold occurred more frequently in the malnutrition risk group (37.1% vs. 21.2%, p = 0.049). Furthermore, multivariate analysis identified preoperative GNRI ≤ 98 as an independent risk factor for deterioration in EQ-5D score exceeding the MCID threshold (OR 2.40, 95% CI 1.03–5.52). Conclusions: Preoperative malnutritional status was significantly associated with impaired postoperative HRQOL in elderly patients with DCM. These findings highlight the need for preoperative nutritional assessment and optimization in this vulnerable population. Full article

(This article belongs to the Section Geriatric Nutrition)

24 pages, 2076 KB

Open AccessSystematic Review

The Effect of Portion Size Interventions on Energy Intake and Risk of Obesity in School-Aged Children: A Systematic Review and Meta-Analysis

by Salma Luthfiyah Sani, Sara Alfaraidi, Yongqi Mu, Gideon Hot Partogi Sinaga and Atul Singhal

Nutrients 2025, 17(18), 2911; https://doi.org/10.3390/nu17182911 - 9 Sep 2025

Abstract

Objectives: An increase in food portion size offered to children over recent decades has been suggested to contribute to the rise in childhood obesity. This review investigated the effect of interventions that manipulated portion size on energy intake and risk of obesity [...] Read more.

Objectives: An increase in food portion size offered to children over recent decades has been suggested to contribute to the rise in childhood obesity. This review investigated the effect of interventions that manipulated portion size on energy intake and risk of obesity in school-aged children. Methods: A systematic search was performed using MEDLINE, Embase, and Cochrane Library databases (from inception to 2025). Included studies were original articles in English, involving children aged 5–17 years, that focused on portion size interventions using an experimental or controlled study design, with energy intake, body weight, or body mass index (BMI) as the study outcome. The risk of bias was evaluated using the Quality Criteria Checklist (QCC). Results: From 514 articles identified, 10 met the inclusion criteria, including a total of 1765 participants. Larger portion sizes increased food intake (grams) and/or energy intake (kcal) in eight studies but did not affect energy intake in one study. Another study focusing on fruit and vegetable portions found inconsistent results. The meta-analysis found that larger portion sizes were associated with higher energy intake compared to the reference portion (mean difference = 86.0 kcal/meal, 95% CI [62.2, 109.9], p < 0.00001). Conclusions: Offering children larger portions increases energy intake. However, this finding was limited by being based mainly on studies which manipulated portion size at a single meal, in a laboratory setting, and with only short-term measures of energy intake. Future studies need to investigate the long-term effects of portion size interventions on energy intake and risk of childhood obesity. Full article

(This article belongs to the Section Pediatric Nutrition)

► Show Figures

Figure 1

18 pages, 1483 KB

Open AccessArticle

Protective Role of Multiple Essential Minerals Against Cadmium-Related Cognitive Decline in Middle-Aged and Older Adults: A Prospective Study

by Jing Yang, Zongyao Li, Yongbin Zhao, Yanzhen Hu, Xinyang Guo, Xi Kang, Zhenyu Wu, Chang Su and Tao Zhang

Nutrients 2025, 17(18), 2910; https://doi.org/10.3390/nu17182910 - 9 Sep 2025

Abstract

Background: Cadmium (Cd) exposure is linked to cognitive decline in middle-aged and older adults, but the modifying role of essential minerals is unclear. This study aimed to identify key protective minerals and quantify their joint antagonistic effect against Cd neurotoxicity. Methods: Baseline serum [...] Read more.

Background: Cadmium (Cd) exposure is linked to cognitive decline in middle-aged and older adults, but the modifying role of essential minerals is unclear. This study aimed to identify key protective minerals and quantify their joint antagonistic effect against Cd neurotoxicity. Methods: Baseline serum minerals and urinary Cd were measured in 6795 adults (≥40 years) from the 2015 China Health and Nutrition Survey. Cognitive function (MMSE) was assessed after 3 years. Associations were analyzed using multiple linear regression and Quantile g-computation (QGC) for joint effects. Combined exposure groups and interaction terms were assessed. Restricted cubic spline (RCS) models explored potential nonlinear dose–response relationships. Results: Participants in the highest urinary Cd quartile had significantly lower MMSE score (β = −0.09, 95% CI: −0.15, −0.02) than the lowest quartile. Serum calcium (Ca), ferrum (Fe), magnesium (Mg), selenium (Se), and phosphorus (P) were positively associated with MMSE. QGC revealed that the joint effect of Cd and the 5-mineral mixture (β = 0.10, 95% CI: 0.05, 0.14) was weaker than the protective effect of the 5-mineral mixture. Any high-mineral group had significantly higher MMSE score compared to the high-Cd/low-mineral group. Conclusions: Essential minerals Ca, Fe, Mg, Se, and P effectively antagonize Cd-associated cognitive decline. Their combined exposure demonstrates significant protective effects, providing key evidence for precision nutrition and environmental health risk management in Cd-exposed populations. Full article

(This article belongs to the Special Issue A New Perspective: The Effect of Trace Elements on Human Health)

► Show Figures

Figure 1

11 pages, 517 KB

Open AccessArticle

Association Between Diet and Emotional Symptoms in Early Childhood: Cross-Sectional Results from the Piccolipiù Cohort

by Federica Concina, Giulia Zamagni, Eleonora Maurel, Claudia Carletti, Alessandra Knowles, Martina Culasso, Franca Rusconi, Maja Popovic, Luca Ronfani, Lorenzo Monasta, Deborah N. Ashtree and Paola Pani

Nutrients 2025, 17(18), 2909; https://doi.org/10.3390/nu17182909 - 9 Sep 2025

Abstract

Background/Objectives: Emerging evidence suggests the critical role of diet in shaping mental health outcomes, which are increasingly prevalent among children and adolescents worldwide. This study aims to investigate whether the dietary habits of children in the Italian multicenter Piccolipiù birth cohort at four [...] Read more.

Background/Objectives: Emerging evidence suggests the critical role of diet in shaping mental health outcomes, which are increasingly prevalent among children and adolescents worldwide. This study aims to investigate whether the dietary habits of children in the Italian multicenter Piccolipiù birth cohort at four years of age were associated with anxiety and depression symptoms. This analysis was conducted within the framework of the Global burden of disease Lifestyle And mental Disorder (GLAD) Project (DERR2-10.2196/65576). Methods: Data from 1726 children were analyzed. Emotional symptoms were assessed with the Child Behavior Checklist (CBCL), and diet was assessed using a food frequency questionnaire. Sociodemographic data, including per capita income, were also collected. Associations between food intake (grams per day) and clinical anxiety/depression (T-scores > 70) or total symptom scores were examined using univariate and multivariable logistic and robust linear regressions adjusted for sex and income. Results: In 1726 children (median age 4.4 years; 50% female), 3% exhibited clinical anxiety and 2% clinical depression. Higher grain intake was associated with increased odds of clinical anxiety (OR = 1.004; 95% CI: 1.001–1.007), while greater fish consumption reduced odds of clinical depression (OR = 0.946; 95% CI: 0.903–0.992). Vegetable intake was associated with lower anxiety and depression scores. Multivariable analyses confirmed that grain intake is positively associated with anxiety, while fish consumption is inversely associated with depression. Conclusions: Higher intake of vegetables, fruits, and fish may be associated with better emotional health in preschoolers, although effect sizes were modest. Early dietary interventions may offer a practical approach to improving children’s long-term mental health. Longitudinal studies are needed to confirm these associations and clarify underlying mechanisms. Full article

(This article belongs to the Section Pediatric Nutrition)

► Show Figures

Figure 1

219 KB

Open AccessEditorial

Eat Well, Sleep Well: Exploring the Association Between Eating Behavior and Sleep Quality

by Andrea Bazzani and Ugo Faraguna

Nutrients 2025, 17(17), 2908; https://doi.org/10.3390/nu17172908 - 8 Sep 2025

Abstract

Eating and sleeping are two vital physiological functions occupying a significant portion of our daily routines and influencing numerous preparatory behaviors [...] Full article

(This article belongs to the Special Issue Eat Well, Sleep Well: Exploring the Association between Eating Behaviour and Sleep Quality)

2047 KB

Open AccessArticle

C-Reactive Protein/Albumin Ratio vs. Prognostic Nutritional Index as the Best Predictor of Early Mortality in Hospitalized Older Patients, Regardless of Admitting Diagnosis

by Cristiano Capurso, Aurelio Lo Buglio, Francesco Bellanti and Gaetano Serviddio

Nutrients 2025, 17(17), 2907; https://doi.org/10.3390/nu17172907 - 8 Sep 2025

Abstract

Background: Malnutrition and systemic inflammation are major determinants of poor outcomes in hospitalized older adults, such as length of hospital stay (LOS), mortality, and readmission risk. The C-reactive protein to albumin ratio (CRP/Alb) and the Prognostic Nutritional Index (PNI) are simple biomarkers reflecting [...] Read more.

Background: Malnutrition and systemic inflammation are major determinants of poor outcomes in hospitalized older adults, such as length of hospital stay (LOS), mortality, and readmission risk. The C-reactive protein to albumin ratio (CRP/Alb) and the Prognostic Nutritional Index (PNI) are simple biomarkers reflecting inflammation and nutritional status. Additionally, the PNI offers a straightforward method to assess both the nutritional state and mortality risk in older patients. Objective: The objective of this study was to compare the predictive accuracy of the CRP/Alb ratio and PNI for early in-hospital mortality at 7 and 30 days after admission in older patients, independent of admitting diagnosis. Methods: We retrospectively analyzed 2776 patients aged 65 years and older, admitted to the Internal Medicine and Aging Unit of the “Policlinico Riuniti” University Hospital in Foggia, Italy, between 2019 and 2025. Laboratory data at admission included CRP, albumin, and total lymphocyte count (TLC). The CRP/Alb ratio and PNI were calculated. Prognostic performance for 7- and 30-day mortality for both the CRP/Alb ratio and PNI was assessed using ROC curves, Cox regression, Kaplan–Meier survival analyses, and positive predictive value (PPV) comparisons, stratified by rehospitalization status and length of stay (LOS). The likelihood-ratio test was also performed to compare the 7- and 30-day mortality PPVs of the CRP/Alb ratio and the PNI, both for all patients and for re-hospitalized patients. Results: In-hospital mortality occurred in 444 patients (16%). Deceased patients showed significantly higher CRP/Alb ratios and lower PNI values than survivors (p < 0.001). Both the CRP/Alb ratio and PNI independently predicted 7- and 30-day mortality. A CRP/Alb ratio > 8 strongly predicted very early mortality (HR 10.46 for 7-day death), whereas a PNI < 38 predicted both 7- and 30-day mortality (HR 8.84 and HR 3.54, respectively). Among non-rehospitalized patients, the PNI demonstrated superior predictive performance regardless of LOS (p < 0.001). Among rehospitalized patients, the PNI was a more accurate predictor for short LOS (<7 days), while the CRP/Alb ratio performed better for longer LOS (≥7 days). Conclusions: Both the CRP/Alb ratio and PNI are inexpensive, readily available biomarkers for early risk stratification in hospitalized older adults. The CRP/Alb ratio is particularly effective in detecting very early mortality risk, while the PNI offers refined prognostic value across selected subgroups. Integrating these markers at admission may support personalized geriatric care and timely interventions. Full article

(This article belongs to the Special Issue Featured Reviews on Geriatric Nutrition)

► Show Figures

Figure 1

291 KB

Open AccessArticle

Loneliness, Food Practices, and Ageing: The Inclusion of Qualitative Evidence in Health Promotion Programmes

by Elena Freire Paz, Borja Rivero Jiménez, David Conde Caballero and Lorenzo Mariano Juárez

Nutrients 2025, 17(17), 2906; https://doi.org/10.3390/nu17172906 - 8 Sep 2025

Abstract

Background/Objectives: Social sciences have described the 21st century as the ‘era of loneliness’, a time marked by the subjective and often distressing experience of lacking meaningful social connections. While loneliness has been linked to poorer health outcomes, its relationship with dietary practices [...] Read more.

Background/Objectives: Social sciences have described the 21st century as the ‘era of loneliness’, a time marked by the subjective and often distressing experience of lacking meaningful social connections. While loneliness has been linked to poorer health outcomes, its relationship with dietary practices remains underexplored. Methods: This ethnographic study examines the impact of loneliness on the eating habits of older adults, based on fieldwork conducted in Galicia and Extremadura (Spain) between November 2024 and April 2025. Using semi-structured interviews (n = 25) and participant observation in domestic settings, we examined everyday food practices. Data were examined using thematic analysis. Results: Participants acknowledged the connection between diet and health, although their dietary practices often failed to meet nutritional recommendations. Loneliness and social isolation influenced food choices and cooking routines, often leading to less nutritious diets. These effects were shaped by gender and social class. Many participants associated the decline of shared meals and food-related sociability with a diminished quality of life. The absence of a meaningful companion was experienced as a profound loss, prompting various coping strategies. Conclusions: The findings highlight that food holds both nutritional and symbolic value. Health promotion strategies should address the social and emotional dimensions of eating. Loneliness disrupts food practices at multiple levels, calling for public health responses that integrate biological, cultural, and care perspectives. Full article

(This article belongs to the Special Issue Nutrition and Care Strategies to Promote Healthy Aging and Prevent Chronic Diseases in Older Adults)

562 KB

Open AccessArticle

The Effect of a Four-Month Low-Carbohydrate Diet on Visceral Adipose Tissue in Obese Subjects with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

by Ornella Rotolo, Caterina Bonfiglio, Rosa Reddavide, Anna Maria Cisternino, Rosa Inguaggiato and Gianluigi Giannelli

Nutrients 2025, 17(17), 2905; https://doi.org/10.3390/nu17172905 - 8 Sep 2025

Abstract

Background: Previous studies have shown a relationship between Visceral Adipose Tissue (VAT) and Hepatic Fat Content (HFC), and increases in HFC are linked to metabolic abnormalities similar to those associated with elevated VAT. Several short-term and long-term studies have supported these findings. Lifestyle [...] Read more.

Background: Previous studies have shown a relationship between Visceral Adipose Tissue (VAT) and Hepatic Fat Content (HFC), and increases in HFC are linked to metabolic abnormalities similar to those associated with elevated VAT. Several short-term and long-term studies have supported these findings. Lifestyle interventions remain the cornerstone of treatment for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), although the ideal dietary regimen is still under debate. Methods: Data on 2040 patients were extracted from the Clinical Nutrition Unit database between 2017 and 2019. Of these, 474 subjects with MASLD and Body Mass Index (BMI) ≥ 35 kg/m² were treated with a four-month low-carbohydrate dietary intervention called the “Strong Diet” (StD). VAT and liver stiffness were measured at baseline and after four months of treatment using ultrasound. Results: Our study demonstrates the significant efficacy of StD in reducing VAT in MASLD patients with moderate hepatic steatosis. In subjects with severe steatosis, there is no statistically significant response to dietary intervention. This may be attributed to several irreversible molecular mechanisms that fundamentally alter the hepatic microenvironment and limit the liver’s capacity for regeneration and metabolic recovery. Conclusions: Improvements were largely confined to patients with moderate MASLD, with limited benefit in severe disease. Although dietary intervention remains the cornerstone of MASLD management, patients with severe steatosis should be informed about the potential limited resolution of steatosis, even with optimal metabolic control. Full article

(This article belongs to the Special Issue Personal Dietary and Lifestyle Interventions in MASLD: Clinical and Experimental Perspectives)

► Show Figures

Figure 1

789 KB

Open AccessReview

Gut Microbiome-Derived Short-Chain Fatty Acids in Glomerular Protection and Modulation of Chronic Kidney Disease Progression

by Maria Szrejder and Agnieszka Piwkowska

Nutrients 2025, 17(17), 2904; https://doi.org/10.3390/nu17172904 - 8 Sep 2025

Abstract

Chronic kidney disease (CKD) is a progressive disorder that is characterized by the gradual loss of kidney function, often leading to end-stage renal failure. Recent research has highlighted the role of gut dysbiosis and its metabolic byproducts in the pathogenesis of CKD, with [...] Read more.

Chronic kidney disease (CKD) is a progressive disorder that is characterized by the gradual loss of kidney function, often leading to end-stage renal failure. Recent research has highlighted the role of gut dysbiosis and its metabolic byproducts in the pathogenesis of CKD, with a particular focus on short-chain fatty acids (SCFAs). SCFAs, including acetate, propionate, and butyrate, are primarily produced by the fermentation of dietary fibers by the gut microbiota and are known for their systemic anti-inflammatory and immunomodulatory properties. In CKD, gut dysbiosis results in a reduction in SCFA-producing bacteria and an increase in uremic toxin-producing microorganisms, contributing to systemic inflammation, oxidative stress, and renal fibrosis. The depletion of SCFAs has been shown to exacerbate glomerular injury, whereas their presence supports integrity of the glomerular barrier and confers protection against damage. These protective effects are mediated by several mechanisms, including the modulation of immune responses, preservation of epithelial barrier function, and activation of specific receptors, such as G protein-coupled receptor 41 (GPR41), GPR43, and GPR109A. The present review provides a comprehensive overview of current understanding of SCFA-mediated pathways in glomerular protection during CKD progression. It highlights the therapeutic potential of targeting the gut–kidney axis to mitigate CKD progression by examining the complex interplay between gut microbiota and disease development, with a particular focus on strategies to protect the glomerular structure and function. Full article

(This article belongs to the Section Nutrition and Metabolism)

► Show Figures

Figure 1

3464 KB

Open AccessArticle

A Hypoglycemic Peptide from Pinus pumila Nut Oil Meal Improves Glycolipid Metabolism via Multi-Dimensional Regulation in Type 2 Diabetic Mice

by Zhe-Xuan Mu, Zhen-Zhou Li, Bing-Xiao Liu, Zhen-Yu Wang, Xiao-Hong Lv, Lin Yang and Hua Zhang

Nutrients 2025, 17(17), 2903; https://doi.org/10.3390/nu17172903 - 8 Sep 2025

Abstract

Background and Methods: To address the need for dietary interventions in sub-healthy populations and promote sustainable utilization of agricultural by-products, we isolated Pinus pumila hypoglycemic peptide (PHP) from nut oil meal through enzymatic extraction, ion exchange and gel chromatography purification, and simulated gastric [...] Read more.

Background and Methods: To address the need for dietary interventions in sub-healthy populations and promote sustainable utilization of agricultural by-products, we isolated Pinus pumila hypoglycemic peptide (PHP) from nut oil meal through enzymatic extraction, ion exchange and gel chromatography purification, and simulated gastric digestion. Results: PHP exhibited significant inhibitory activity against α-amylase and α-glucosidase. In type 2 diabetic mice, PHP significantly ameliorated the “three-more-one-less” syndrome, reduced glycosylated hemoglobin and insulin levels, mitigated liver and kidney tissue lesions, and improved glucose and lipid metabolic disorders—effects partly supported by its enhancement of intestinal barrier function via restoring gut microbiota diversity. Gut microbiota analysis revealed that PHP exerts hypoglycemic effects by regulating gut microbial composition: increasing SCFA-producing taxa, reducing pro-inflammatory/metabolic disorder-associated taxa, and normalizing the Firmicutes/Bacteroidetes ratio. KEGG pathway analysis demonstrated that PHP mediates synergistic hypoglycemic effects by regulating carbohydrate metabolism, amino acid metabolism, and cofactor/vitamin metabolism. Conclusions: This work provides a theoretical foundation for developing natural functional foods from agricultural by-products, supporting PHP’s potential as a dietary supplement for metabolic regulation. Full article

(This article belongs to the Special Issue Bioactive Proteins and Peptides: Insights and Applications for Functional Foods and Health)

► Show Figures

Figure 1

21 pages, 5556 KB

Open AccessArticle

Shiitake Mushroom-Derived Vesicle-like Nanoparticles Improve Cognitive Function and Reshape Gut Microbiota and Fecal Metabolome in Aged Mice

by Xingzhi Li, Baolong Liu, Deekshika Sekar, Meghna Sur, Jay Reddy, Sathish Kumar Natarajan, Peder J. Lund and Jiujiu Yu

Nutrients 2025, 17(17), 2902; https://doi.org/10.3390/nu17172902 - 8 Sep 2025

Abstract

Background/Objectives: Population aging and its associated chronic conditions have become an unprecedented challenge in the United States and worldwide. Many aged individuals experience certain forms of cognitive decline, which increases their risk of developing a pre-dementia condition called mild cognitive impairment and even [...] Read more.

Background/Objectives: Population aging and its associated chronic conditions have become an unprecedented challenge in the United States and worldwide. Many aged individuals experience certain forms of cognitive decline, which increases their risk of developing a pre-dementia condition called mild cognitive impairment and even dementia. No effective pharmacological treatments are available to treat normal age-associated cognitive decline or mild cognitive impairment. Our previous study has shown the potent anti-inflammatory effects of shiitake mushroom-derived vesicle-like nanoparticles (S-VLNs) in vitro and in an acute inflammatory disease model. In this study, we aimed to investigate the potential benefits of orally administered S-VLNs in aged mice. Methods: S-VLNs were extracted from fresh shiitake mushrooms. S-VLNs in phosphate-buffered saline (PBS) or vehicle only was orally administered to 13-month-old male C57BL/6J mice weekly for 9 months. These mice were subjected to a series of physiological tests, followed by euthanasia at 22 months of age. Their fecal samples were subjected to 16S rRNA and untargeted metabolomics analyses, followed by comprehensive bioinformatics analyses. Results: The long-term oral administration of S-VLNs significantly improved the cognitive function of aged mice. Orally administered S-VLNs did not travel to the brain. Instead, they impacted the composition of the gut microbiota and reshaped the fecal metabolome. Functional predictions of the gut microbiota and fecal metabolome suggested that S-VLNs regulated tryptophan metabolism. Specifically, S-VLNs markedly decreased the tryptophan-related metabolite kynurenic acid (KYNA). The integrative analyses of omics data identified a strong correlation between 18 gut bacterial genera and 66 fecal metabolites. KYNA was found to highly correlate with five genera positively and twelve genera negatively. Conclusions: The oral intake of S-VLNs represents a new and superior dietary approach with the ability to modulate the gut microbiota and fecal metabolome and to improve cognitive function during aging. Full article

(This article belongs to the Section Geriatric Nutrition)

► Show Figures

Figure 1

15 pages, 1139 KB

Open AccessArticle

Association of Chrono-Nutritional Profiles with Weight Loss and Comorbidity Remission After Bariatric Surgery in Patients with Severe Obesity

by Silvia Bettini, Enrico Carraro, Anna Pilatone, Sami Schiff, Paolo Girardi, Matteo D’Angelo, Anxhela Begolli, Fatemeh Mansouri, Saba Toosinezhad, Sara Sandri, Beatrice Gusella, Gabriella Milan, Mirto Foletto, Paola Fioretto and Luca Busetto

Nutrients 2025, 17(17), 2901; https://doi.org/10.3390/nu17172901 - 8 Sep 2025

Abstract

Background/Objectives: A disruption of eating habits is related to obesity and obesity-related complications (ORCs), including diabetes and cardiovascular disease. We previously described chrono-nutritional profiles considering the eating habits of patients with severe obesity during the 24 h cycle. Our present study aims to [...] Read more.

Background/Objectives: A disruption of eating habits is related to obesity and obesity-related complications (ORCs), including diabetes and cardiovascular disease. We previously described chrono-nutritional profiles considering the eating habits of patients with severe obesity during the 24 h cycle. Our present study aims to determine, first, whether belonging to a specific eating profile is associated with greater or lesser weight loss in patients with obesity who have undergone bariatric surgery, and second, whether chrono-nutritional profiles are associated with the remission of ORCs after surgery. We also investigated whether there were differences between the original baseline profile and the new profile derived from the 24 h recall on dietary patterns. Methods: The study included 75 patients with obesity who had undergone bariatric surgery and were followed up for a period of 36 ± 11 months. Data were collected from patients’ medical records and telephone interviews. R software (v4.4.0; R Core Team, 2024) was used. Results: Significant weight loss from baseline was observed at follow-up for all profiles (p < 0.0001); however, there were no significant differences in weight loss % among profiles. Using a linear regression model, Profile 3 (characterized by irregular eating patterns) demonstrated less weight loss at follow-up compared to other profiles (p = 0.0487). There was a significant remission of ORCs from baseline to follow-up, but there were no significant differences among profiles. Conclusions: Chrono-nutritional profiles may play a role in weight regulation in patients with severe obesity who are candidates for bariatric surgery. Further studies with a larger sample size are needed. Full article

(This article belongs to the Special Issue Bidirectional Link between Eating Habits, Lifestyle, Physical Exercise and Depression and Other Mental Disorders)

► Show Figures

Figure 1

8 pages, 213 KB

Open AccessPerspective

Perspective: Vitamin D Deficiency Relationship to Initiation of Diseases

by David R. Fraser

Nutrients 2025, 17(17), 2900; https://doi.org/10.3390/nu17172900 - 8 Sep 2025

Abstract

Vitamin D is converted to a steroid hormone by 25-hydroxylation in the liver and then by 1-hydroxylation in the kidney to produce the circulating hormone 1,25-dihydroxy vitamin D [1,25(OH₂D]. This hormone then functions in cells of the intestinal mucosa and in [...] Read more.

Vitamin D is converted to a steroid hormone by 25-hydroxylation in the liver and then by 1-hydroxylation in the kidney to produce the circulating hormone 1,25-dihydroxy vitamin D [1,25(OH₂D]. This hormone then functions in cells of the intestinal mucosa and in bone to maintain whole-body calcium homeostasis. Classical vitamin D deficiency thus results in defective calcium homeostasis. Yet vitamin D deficiency is often reported in people with various diseases not associated with whole-body calcium homeostasis. Because of these associations with vitamin D deficiency, clinical trials have been undertaken to determine whether raising vitamin D status could be an effective treatment for such diseases. However, the results of such clinical trials have largely been inconclusive. The steroidal autocrine or paracrine role of locally produced 1,25(OH)₂D in many nonrenal cells throughout the body is protective against a range of pathological changes. In vitamin D deficiency such protection becomes defective. A disease process may thus be initiated, and then progress, while vitamin D status is inadequate, as in the months of winter in temperate regions of the world. The subsequent correction of vitamin D deficiency may no longer be able to protect patients when the disease process has already become established. To maintain the many protective roles of vitamin D against disease, it is important that public health strategies aim to maintain adequate vitamin D status throughout the year. Full article

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

► Show Figures

Graphical abstract

15 pages, 957 KB

Open AccessArticle

Effectiveness of a Nutritional Intervention in Patients with Chronic Heart Failure at Risk of Malnutrition: A Prespecified Subanalysis of the PACMAN-HF Trial

by Carolina Ortiz-Cortés, Purificación Rey-Sánchez, Paula Gómez-Turégano, Ramón Bover-Freire, Julián F. Calderón-García, Jose Javier Gómez-Barrado and Sergio Rico-Martín

Nutrients 2025, 17(17), 2899; https://doi.org/10.3390/nu17172899 - 8 Sep 2025

Abstract

Background and objectives: Nutritional disorders are common in patients with heart failure (HF) and are associated with reduced functional capacity and poor prognosis. In this study, we evaluated the prognostic, nutritional and functional impact of a structured nutritional intervention in patients with [...] Read more.

Background and objectives: Nutritional disorders are common in patients with heart failure (HF) and are associated with reduced functional capacity and poor prognosis. In this study, we evaluated the prognostic, nutritional and functional impact of a structured nutritional intervention in patients with chronic HF at risk of malnutrition. Methods: This is a prespecified subanalysis of the randomized controlled trial Prognostic And Clinical iMpAct of a Nutritional intervention in patients with chronic HF (PACMAN-HF). Ambulatory patients with chronic HF at risk of malnutrition were identified using the Mini Nutritional Assessment (MNA) questionnaire and randomized to receive either an individualised nutritional intervention (intervention group) or standard care (control group). We evaluated the frequency of malnutrition risk and the impact of the intervention on clinical outcomes, defined as a composite of all-cause mortality or time to first HF hospitalisation, as well as nutritional status and functional capacity at 3- and 12-month follow-ups. Results: A total of 225 patients were screened. Of these, 72 (32%) were identified as being at risk of malnutrition and 64 (28.4%) met the inclusion criteria and were randomized (31 in the intervention group and 33 in the control group). There were no significant differences between the groups in terms of all-cause mortality or time to first HF hospitalisation (HR = 0.34 [0.11–1.09]; p = 0.072). At 12 months, the intervention group demonstrated a significant improvement in functional capacity, with an increase of 31.3 metres in the 6-minute walk test (6MWT) (p = 0.002), whereas no significant change was observed in the control group. Nutritional status improved significantly in the intervention group (MNA score +4.12, p < 0.001) and declined in the control group (−1.15, p = 0.029). At 12 months, body mass index, tricipital skinfold thickness, arm circumference, and serum albumin levels increased in the intervention group. Conclusions: A structured and individualised nutritional intervention significantly improved nutritional status and functional capacity over 12 months, although it did not impact major clinical outcomes. Full article

(This article belongs to the Section Clinical Nutrition)

► Show Figures

Graphical abstract

40 pages, 2685 KB

Open AccessReview

The Microbiota–Diet–Immunity Axis in Cancer Care: From Prevention to Treatment Modulation and Survivorship

by Sabrina Tini, Jessica Baima, Stella Pigni, Valentina Antoniotti, Marina Caputo, Elena De Palma, Luigi Cerbone, Federica Grosso, Marta La Vecchia, Elisa Bona and Flavia Prodam

Nutrients 2025, 17(17), 2898; https://doi.org/10.3390/nu17172898 - 8 Sep 2025

Abstract

Growing evidence highlights the pivotal role of the gut microbiota in cancer development, progression, response to therapy, and survivorship. Diet plays a central role in shaping gut microbiota composition, influencing the immune system and overall host health. Plant-based diets and the Mediterranean diet [...] Read more.

Growing evidence highlights the pivotal role of the gut microbiota in cancer development, progression, response to therapy, and survivorship. Diet plays a central role in shaping gut microbiota composition, influencing the immune system and overall host health. Plant-based diets and the Mediterranean diet promote health-associated microbial communities that increase the production of several metabolic-end products, including short-chain fatty acids that support mucosal barrier integrity, anti-inflammatory effects, and modulation of the immunity of the host. Conversely, Western dietary patterns promote cancer progression and negatively impact the response to standard treatments. Furthermore, gut microbiota influences the effectiveness of cancer therapies, including chemotherapy, radiotherapy and, mainly, immunotherapy. Modulating microbial species, their metabolites, or their activities in the cancer microenvironment through dietary interventions, common or engineered probiotics, prebiotics, postbiotics, antibiotics or fecal microbial transplant are emerging as promising strategies for cancer prevention and tailored management in survivorship. In this review, we explore the intricate interplay between diet, gut microbiota, and cancer, focusing on how specific microbial communities’ impact therapeutic outcomes, and the challenges in the modulation of the microbiota environment through several interventions, including diet. This emerging paradigm paves the way for integrating nutrition and microbiota-targeted strategies as innovative tools in the context of precision medicine. Full article

(This article belongs to the Special Issue Nutrition 3.0: Between Tradition and Innovation)

► Show Figures

Figure 1

Journal Description

Nutrients

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Conference Reports

Further Information

Guidelines

MDPI Initiatives

Follow MDPI