Nutrients

27 pages, 1336 KB

Open AccessSystematic Review

Effects of Strength Training on Body Composition, Physical Performance, and Protein or Calcium Intake in Older People with Osteosarcopenia: A Meta-Analysis

by Jordan Hernandez-Martinez, Braulio Henrique Magnani Branco, Edgar Vasquez-Carrasco, Izham Cid-Calfucura, Tomás Herrera-Valenzuela, Eduardo Guzmán-Muñoz, Pedro Delgado-Floody, Yeny Concha-Cisternas and Pablo Valdés-Badilla

Nutrients 2025, 17(17), 2852; https://doi.org/10.3390/nu17172852 - 2 Sep 2025

Abstract

Objective: this systematic review with a meta-analysis aimed to evaluate the available body of published peer-reviewed randomized controlled trial (RCT) studies on the effects of different doses and types of strength training (ST) on body composition, physical performance, and protein or calcium intake [...] Read more.

Objective: this systematic review with a meta-analysis aimed to evaluate the available body of published peer-reviewed randomized controlled trial (RCT) studies on the effects of different doses and types of strength training (ST) on body composition, physical performance, and protein or calcium intake in older people with osteosarcopenia. Method: a systematic literature search was conducted between July 2024 and August 2025 using five databases: PubMed, Medline, CINAHL Complete, Scopus, and Web of Science. PRISMA, TESTEX, RoB 2, and GRADE tools assessed methodological quality and certainty of evidence. Hedge’s g effect sizes were calculated for the abovementioned variables for the meta-analysis. Results: the protocol was registered in PROSPERO (code: CRD42025643858). Of 141 registers, seven RCTs with 349 participants were included. Seven overall and two subgroup meta-analyses showed significant increases in skeletal muscle mass index (SMMI; p < 0.01), maximal isometric handgrip strength (MIHS; p = 0.03), and protein intake (p = 0.03). There were no significant differences in bone mineral density (BMD), body fat percentage (BFP), gait speed, and calcium intake. However, meta-analysis by subgroups showed significant decreases in BFP (p = 0.01) in favor of elastic band training versus resistance training, with no significant differences in BMD. Conclusions: ST in older people with osteosarcopenia conditions increases SMMI, MIHS, and protein intake. Full article

(This article belongs to the Special Issue The Benefits of Diet, Physical Activity and Lifestyle Habits in Older Adults for Longevity)

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12 pages, 1242 KB

Open AccessArticle

Positive Impact of Breastfeeding on Nutritional Status and Metabolic Control in Infants with PKU: A Retrospective Study

by Lizbeth López-Mejía, Sara Guillén-López, Marcela Vela-Amieva, Cynthia Fernández-Lainez and Lilian Castro-Monroy

Nutrients 2025, 17(17), 2851; https://doi.org/10.3390/nu17172851 - 2 Sep 2025

Abstract

Background/Objectives: Dietary treatment in phenylketonuria consists of a phenylalanine-restricted diet supplemented with a phenylalanine-free medical formula (Phe-FF). During the first six months of life, phenylalanine requirements can be met with breast milk (BM) or infant formula (IF). Despite all the benefits breastfeeding confers, [...] Read more.

Background/Objectives: Dietary treatment in phenylketonuria consists of a phenylalanine-restricted diet supplemented with a phenylalanine-free medical formula (Phe-FF). During the first six months of life, phenylalanine requirements can be met with breast milk (BM) or infant formula (IF). Despite all the benefits breastfeeding confers, it is often discontinued upon diagnosis of phenylketonuria, so more evidence is needed to support it. This study aimed to compare the assessments of nutritional status and metabolic control in infants with hyperphenylalaninemia/phenylketonuria who received BM, IF, or a combination of both as sources of intact protein, in addition to Phe-FF. Methods: A retrospective observational study was conducted in hyperphenylalaninemia/phenylketonuria patients between 0 and 6 months of age. Three groups were compared depending on the source of intact protein ingested: (1) BM + Phe-FF; (2) IF + Phe-FF; (3) mixture of BM and IF (BM + IF + Phe-FF). At each clinic visit, an anthropometric assessment and phenylalanine blood levels were analyzed. Results: 185 nutritional and metabolic assessments were included. The lowest median phenylalanine blood concentration was observed in the BM + Phe-FF group (129 µmol/L, interquartile range [IQR]: 39.5–232.5). In the BM + Phe-FF group all assessments were classified as eutrophic: −0.09 (SD ± 0.78); a statistically significant difference was observed between the BMI Z-Score of BM + Phe-FF and BM + IF-Phe-FF (p = 0.036). No statistically significant differences were observed in length/age Z-Score. Conclusions: Our results indicate that BM is the best option as a source of intact protein for children under 6 months of age with hyperphenylalaninemia/phenylketonuria, to maintain an adequate nutritional status and metabolic control. Full article

(This article belongs to the Special Issue Dietary Practices and Dietary Treatment in Phenylketonuria)

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10 pages, 240 KB

Open AccessArticle

The Association Between Nutritional Status and Muscle Strength of Shoulder, Hip, and Knee, and the Timed Up and Go Test in Older Adults

by Abrar Melebari, Dara Aldisi, Mahmoud M. A. Abulmeaty and Adel Alhamdan

Nutrients 2025, 17(17), 2850; https://doi.org/10.3390/nu17172850 - 1 Sep 2025

Abstract

Background/Objectives: This study examined the relationship between nutritional status and muscle strength in the upper and lower large muscles, with a specific focus on shoulder, hip, and knee muscle strength in community-dwelling older adults. It also investigated the relationship between nutritional status and [...] Read more.

Background/Objectives: This study examined the relationship between nutritional status and muscle strength in the upper and lower large muscles, with a specific focus on shoulder, hip, and knee muscle strength in community-dwelling older adults. It also investigated the relationship between nutritional status and functional performance as measured by the Timed Up and Go (TUG) test. Methods: A secondary analysis of a cross-sectional study involving 2045 older adults (aged 60 years or older) from 15 randomly selected primary health care centers in Riyadh was conducted between January 2015 and April 2017. After excluding participants with specific medical conditions, 1741 individuals were included in the analysis. Nutritional status was assessed using the Arabic version of the Mini-Nutritional Assessment (MNA). Handgrip strength (HGS) and large muscle strength (shoulder, hip, knee) were measured using a hydraulic hand dynamometer and the Nicholas Manual Muscle Tester, respectively. The TUG test was also assessed to evaluate physical performance. Results: The study revealed that well-nourished older adults had significantly greater upper and lower muscle strength than those who were malnourished or at risk (p ≤ 0.001), with males generally exhibiting stronger muscle strength than females. Furthermore, in both genders, older adults showed significant positive correlations between MNA scores and upper and lower muscle strength. Additionally, longer times on the TUG test indicated a higher risk of malnutrition (OR: 1.135, CI: 1.087–1.186; p ≤ 0.001). Conclusions: this study breaks new ground by being the first to explore the relationship between nutritional status and the muscular strength in the shoulder and hip regions. Findings indicate that muscle strength and physical performance were associated with malnutrition. Full article

(This article belongs to the Special Issue Nutritional Risk in Older Adults in Different Healthcare Settings)

18 pages, 745 KB

Open AccessArticle

Effects of Raspberry Leaf Tea Polyphenols on Postprandial Glucose and Insulin Responses in Healthy Adults

by Hind Mesfer S. Alkhudaydi and Jeremy P. E. Spencer

Nutrients 2025, 17(17), 2849; https://doi.org/10.3390/nu17172849 - 1 Sep 2025

Abstract

Background: Dietary polyphenols, particularly flavonoids, have been associated with improved glycemic control and reduced risk of type 2 diabetes. Raspberry leaf (RL) is a rich but underexplored source of such bioactives, including ellagitannins, flavonoids, and phenolic acids. While raspberry fruit has received some [...] Read more.

Background: Dietary polyphenols, particularly flavonoids, have been associated with improved glycemic control and reduced risk of type 2 diabetes. Raspberry leaf (RL) is a rich but underexplored source of such bioactives, including ellagitannins, flavonoids, and phenolic acids. While raspberry fruit has received some attention in nutritional science, the metabolic effects of raspberry leaf—especially its influence on postprandial glucose and insulin responses—remain largely unstudied. Objective: This study is the first to investigate the acute effects of RL tea consumption on postprandial blood glucose and insulin levels in healthy individuals following intake of common dietary carbohydrates (sucrose and glucose). Methods: In a randomized crossover study, 22 healthy adults (12 males, 10 females) consumed 50 g of glucose or sucrose with or without 10 g of RL tea in four separate sessions. Blood glucose and insulin levels were measured at fasting and at 15, 30, 60, 90, and 120 min post-ingestion. A total of 37 polyphenolic compounds were identified in the RL infusion using LC–MS, following a 5-minute hot water extraction. The contents of ellagitannins, flavonoids, and phenolic acids were 38 mg, 7 mg, and 4 mg per 10 g of RL, respectively, contributing to a total polyphenol content of 50 mg per 10 g. Results: When RL tea was consumed with sucrose, postprandial blood glucose levels were significantly reduced at 15 and 30 min by 1.19 ± 0.88 mmol/L (25.59% reduction, p = 0.001) and 2.03 ± 1.05 mmol/L (43.57% reduction, p = 0.0004), respectively. Insulin concentrations were also significantly lower at 15 min (113.90 ± 59.58 pmol/L, p = 0.019), 30 min (161.76 ± 91.96 pmol/L, p = 0.0008), and 60 min (139.44 ± 75.96 pmol/L, p = 0.025). No significant differences were observed with glucose ingestion. Conclusions: This study provides the first clinical evidence that RL tea can blunt early postprandial glycemic and insulinemic responses to sucrose in healthy individuals. The data suggest that these effects are likely mediated by relatively low levels of polyphenols—particularly ellagic acid—through inhibition of carbohydrate-digesting enzymes such as α-glucosidase and β-fructofuranosidase. These findings support the potential of RL tea as a simple, dietary approach to modulate glucose metabolism and warrant further investigation in populations at risk for metabolic disorders. Full article

(This article belongs to the Special Issue Natural Active Compounds in Inflammation and Metabolic Diseases)

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25 pages, 1991 KB

Open AccessArticle

Dietary Intakes and Exposures to Minerals and Trace Elements from Cereal-Based Mixtures: Potential Health Benefits and Risks for Adults

by Martina Mrázková, Daniela Sumczynski, Lenka Šenkárová and Richardos Nikolaos Salek

Nutrients 2025, 17(17), 2848; https://doi.org/10.3390/nu17172848 - 31 Aug 2025

Abstract

Background: Foods containing nutraceuticals from the mineral element group are being developed to compensate for the problem of deficiency in billions of people around the world. This research focuses on essential elements of patented cereal-based mixtures to complement the deficiencies of these elements [...] Read more.

Background: Foods containing nutraceuticals from the mineral element group are being developed to compensate for the problem of deficiency in billions of people around the world. This research focuses on essential elements of patented cereal-based mixtures to complement the deficiencies of these elements and, at the same time, assesses their safety in terms of toxic elements in the human diet. Methods: The mineral and trace element contents in the mixtures were determined using the ICP-MS method with a subsequent evaluation of the contributions of the mixtures to the essential and toxic reference values based on dietary intakes and exposures for adults at 60, 80 and 100 kg of adult body weight and a portion size of 50 g. The potential health risk was evaluated using a metal pollution index. Results: The concentrations of minerals and trace elements in the cereal-based mixtures analyzed were as follows: K (up to 4150 µg/g) ≥ P > Mg > Ca > Na > Fe > Zn > Mn > Cu > Al > Ba (up to 4.40 µg/g) > Sr (up to 480 ng/g) ≥ Ti ≥ Ni > Ce ≥ Co > As ≥ Cs > Ag ≥ Li > Se > Be > Cr > Tl > Pb ≥ Hg > Ho > Cd > Sn (up to 1.12 ng/g). The mixtures contribute significantly to the reference values for Mn, Cu, Zn, Fe, and P for adults. Individual dietary exposure values of toxic elements for adults weighing 60 kg decrease in this order: Al (10.1 µg/kg bw/day) > Ni (362 ng/kg bw/day) > As ≥ Pb > Ag > Hg > Cd > and Sn (0.93 ng/kg bw/day). Conclusions: In terms of Regulation (EU) No 1924/2006 of the European Parliament and of the Council on nutrition and health claims made on foods, the cereal-based mixtures could be labelled “source of” Mn, Cu, Zn, Fe, and P when their contributions to the reference values exceeded 15%; in addition, “low sodium/salt” or “very low sodium/salt” can be applied. The mixtures contribute insignificantly to the toxic reference values of Al, Sn, Hg, Cd, Ni, and Ag, and the exposure values of Pb for developmental neurotoxicity, nephrotoxicity, and cardiovascular effects were considered safe. Regarding the metal pollution index of mixtures, there is no concern for potential health effects. Cereal-based mixtures are suitable for use in the food industry as a potential source of beneficial micronutrients for the human diet, although bioaccessible studies should not be neglected. Full article

(This article belongs to the Special Issue Functional Foods: Exploring the Health Benefits of Bioactive Compounds)

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17 pages, 293 KB

Open AccessArticle

Differences in Neurocognitive Development Between Children Who Had Had No Breast Milk and Those Who Had Had Breast Milk for at Least 6 Months

by Neil Goulding, Kate Northstone, Caroline M. Taylor, Pauline Emmett, Yasmin Iles-Caven, Jacqueline Gregory, Steven Gregory and Jean Golding

Nutrients 2025, 17(17), 2847; https://doi.org/10.3390/nu17172847 - 31 Aug 2025

Abstract

Background: There is considerable evidence that breast feeding has a beneficial effect on the neurocognition of a child. However, most studies have confined their attention to the Intelligence Quotient (IQ), tending to ignore other aspects of neurodevelopment. Methodology: Here we present [...] Read more.

Background: There is considerable evidence that breast feeding has a beneficial effect on the neurocognition of a child. However, most studies have confined their attention to the Intelligence Quotient (IQ), tending to ignore other aspects of neurodevelopment. Methodology: Here we present the relationship between breast feeding for at least 6 months with 373 neurocognitive outcomes measured from infancy through to late adolescence using data collected in the Avon Longitudinal Study of Parents and Children (ALSPAC). We first examined unadjusted regression associations with breast feeding at age 6 months. Where the unadjusted p-value was < 0.0001 (n = 152 outcomes), we adjusted for social and other factors. Results: This resulted in 42 outcomes with adjusted associations at p < 0.001. Specifically, these included associations with full-scale IQ at ages 8 and 15 years (adjusted mean differences [95% confidence interval (CI)] +4.11 [95% CI 2.83, 5.39] and +5.12 [95% CI 3.57, 6.67] IQ points, respectively, compared to not breastfeeding for 6 months). As well as the components of IQ, the other phenotypes that were strongly related to breast feeding for at least 6 months were measures of academic ability (reading, use of the English language and mathematics). In accordance with the literature, we show that children who are breast fed are more likely to be right-handed. The one association that has not been recorded before concerned aspects of pragmatic speech at 9 years where the children who had been breast fed were shown to perform more appropriately. Conclusions: We conclude that breast feeding for at least 6 months has beneficial effects on a number of neurocognitive outcomes that are likely to play a major part in the offspring’s future life course. We point out, however, the possibility that by using such stringent p-value criteria, other valid associations may have been ignored. Full article

(This article belongs to the Special Issue The Role of Nutrients in Child Neurodevelopment)

32 pages, 2283 KB

Open AccessReview

Diet and Depression During Peri- and Post-Menopause: A Scoping Review

by Alexandra M. Bodnaruc, Miryam Duquet, Denis Prud’homme and Isabelle Giroux

Nutrients 2025, 17(17), 2846; https://doi.org/10.3390/nu17172846 - 31 Aug 2025

Abstract

Background/Objectives: While the prevalence of depression increases during the peri- and post-menopausal periods, the potential of diet as both a modifiable risk factor and complementary treatment option has received limited research attention in this population. To address this gap, we conducted a [...] Read more.

Background/Objectives: While the prevalence of depression increases during the peri- and post-menopausal periods, the potential of diet as both a modifiable risk factor and complementary treatment option has received limited research attention in this population. To address this gap, we conducted a scoping review aiming to map and synthesize the existing literature on diet and depression in peri- and post-menopause. Methods: Studies were identified through Medline, EMBASE, PsycINFO, CENTRAL, Web of Science, and Scopus. After deduplication in Covidence, two reviewers independently screened titles, abstracts, and full texts using predefined eligibility criteria. Data were extracted using standardized forms and presented in tables and figures. Methodological quality was assessed using the Cochrane RoB-2 for intervention studies and NHLBI tools for observational studies. Results: Thirty-eight studies met the inclusion criteria, including 29 observational and 9 interventional studies. Dietary patterns showed the most consistent associations with depressive symptoms, whereas findings for foods, nutrients, and other food components were inconsistent. Most observational studies had a moderate to high risk of bias, while over half of experimental studies were rated as low risk. Conclusions: Although limited by volume and poor methodological quality, existing evidence suggests that healthy diets may be protective against depressive symptoms in peri- and post-menopausal women, while unhealthy diets may increase risk. High-quality cohort studies and clinical trials are needed to guide future research and inform professionals working at the intersection of nutrition, psychiatry, and women’s health. Protocol registration: osf.io/b89r6. Full article

(This article belongs to the Special Issue The Role of Different Dietary Patterns on Anxiety and Depression)

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17 pages, 810 KB

Open AccessArticle

Caffeine Intake Mediates the Relationship Between Problematic Overstudying and Psychological Distress

by Oliwia Kosecka, Edyta Charzyńska, Stanisław K. Czerwiński, Agata Rudnik and Paweł A. Atroszko

Nutrients 2025, 17(17), 2845; https://doi.org/10.3390/nu17172845 - 31 Aug 2025

Abstract

Background: Problematic overstudying has been conceptualized as an addictive behavior (study addiction) and an early form of work addiction. The majority of students showing compulsive studying behaviors experience chronic and high stress and symptoms of generalized anxiety disorder. Caffeine is a widely used [...] Read more.

Background: Problematic overstudying has been conceptualized as an addictive behavior (study addiction) and an early form of work addiction. The majority of students showing compulsive studying behaviors experience chronic and high stress and symptoms of generalized anxiety disorder. Caffeine is a widely used stimulant that enhances alertness and cognitive performance, especially under fatigue. University students, particularly those exhibiting problematic overstudying, may consume more caffeine to improve academic performance. Previous research has shown that caffeine consumption is positively associated with perceived stress and anxiety. This study examined the mediating role of caffeine consumption in the relationship between problematic overstudying and psychological distress (perceived stress, anxiety, and depression) among university students. Methods: Sample 1 consisted of 436 university students, and Sample 2 included 3421 students. The Bergen Study Addiction Scale, Perceived Stress Scale-4, and a measure of average daily caffeine consumption were used. Results: Results showed that caffeine consumption partially mediated the relationship between problematic overstudying and perceived stress. Students who study compulsively tended to consume more caffeine, which was, in turn, associated with higher perceived stress. This finding was replicated across both samples, and in the second, larger sample, caffeine intake also mediated between problematic overstudying and anxiety and depression. Conclusions: Excessive caffeine use among students who manifest problematic overstudying may increase their risk of developing, or aggravate existing, symptoms of anxiety or mood disorders. Limiting caffeine intake and promoting healthy alternatives, such as rest and recovery, is recommended to support mental health in this population. Full article

(This article belongs to the Section Nutritional Epidemiology)

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15 pages, 5483 KB

Open AccessArticle

Modulation of the Gut Microbiota by Nopalea cochenillifera (Prickly Pear Cactus) Contributes to Improved Lipid Metabolism and Immune Function

by Sayaka Yokoyama, Amane Kikuchi, Hideaki Takahashi, Hinako Ushimaru, Hibiki Yamaguchi, Chikako Yamada, Kotoyo Fujiki, Hana Kozai, Suzuno Ota, Tadashi Fujii, Yoshiki Hirooka, Takumi Tochio and Mamoru Tanaka

Nutrients 2025, 17(17), 2844; https://doi.org/10.3390/nu17172844 - 31 Aug 2025

Abstract

Background/Objectives: Nopalea cochenillifera (L.) Salm-Dyck cladodes are rich in dietary fiber, polyphenols, and minerals, which are known to exert antioxidant and immunomodulatory effects. However, the mechanisms and active constituents have not been fully elucidated. In this study, we investigated the effects of [...] Read more.

Background/Objectives: Nopalea cochenillifera (L.) Salm-Dyck cladodes are rich in dietary fiber, polyphenols, and minerals, which are known to exert antioxidant and immunomodulatory effects. However, the mechanisms and active constituents have not been fully elucidated. In this study, we investigated the effects of continuous N. cochenillifera consumption on lipid metabolism, immune function, and the gut microbiota in mice. Methods: The feed was made using freeze-dried and powdered cladodes of N. cochenillifera. Male C57BL/6J mice were assigned to four groups: control diet (C), control diet plus 10% N. cochenillifera (CN), high-fat diet (FC), and high-fat diet plus 10% N. cochenillifera (FN). Results: Cactus supplementation reduced the body and liver weights that were elevated by the high-fat diet. Serum total cholesterol and free fatty acids were increased in the FC group compared with the C group, while cactus intake lowered these levels and enhanced fecal cholesterol excretion. Cactus consumption also elevated fecal total IgA and mucin contents. IL-4 expression in Peyer’s patches was significantly increased in the FN group compared with the FC group. Gut microbiota analysis showed significant differences in β-diversity, along with increased α-diversity and higher abundance of Lachnospiraceae, following cactus intake. Conclusions: These findings suggest that N. cochenillifera intake increases gut microbiota diversity, which enhances intestinal barrier function and thereby contributes to improved lipid metabolism and immune regulation. Full article

(This article belongs to the Special Issue Functional Foods and Sustainable Health (2nd Edition))

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18 pages, 978 KB

Open AccessArticle

Oncologists’ Perspectives on Ketogenic Diets in Pediatric Brain Cancer: Potential, Challenges, and the Path Forward

by Hanan AlMutairi, Madhumita Dandapani, Khawar Siddiqui and Fiona McCullough

Nutrients 2025, 17(17), 2843; https://doi.org/10.3390/nu17172843 - 31 Aug 2025

Abstract

Background/objectives: Treating pediatric brain tumors remains challenging due to the limitations of conventional therapies, which often damage healthy cells. Ketogenic diets (KDs)—high in fat and low in carbohydrates—have emerged as potential adjunct therapies by limiting glucose availability and offering ketones as an [...] Read more.

Background/objectives: Treating pediatric brain tumors remains challenging due to the limitations of conventional therapies, which often damage healthy cells. Ketogenic diets (KDs)—high in fat and low in carbohydrates—have emerged as potential adjunct therapies by limiting glucose availability and offering ketones as an alternative energy source proposed to hinder tumor growth. However, due to limited awareness, there is hesitancy to recommend KDs. Methods: This study assessed oncologists’ knowledge and perceptions in Saudi Arabia regarding KD use in pediatric brain cancer patients. A cross-sectional survey was conducted with 94 oncologists from five major Riyadh healthcare centers, examining their knowledge, safety concerns, feasibility, and perceived efficacy of KDs. Results: Results showed that 67% correctly identified the basic composition of KDs, though 43% were neutral about its safety. Concerns about malnutrition and side effects were common and 53% found adherence to the diet challenging in pediatric patients. While 48.9% believed KDs could improve outcomes when combined with standard therapies, many stressed the importance of tailoring recommendations to individual medical conditions, including patient age, treatment stage, and overall nutritional status. Participants’ responses revealed variability in knowledge and perception levels regarding KDs, with consultants and internationally educated oncologists generally expressing more favorable views compared to fellows, who showed greater hesitancy. Conclusions: This study shows a mixed level of knowledge and perceptions among oncologists, reflecting a lack of consensus about KDs’ safety, feasibility, and potential benefits. These findings suggest the need for further education, clearer guidelines, and interdisciplinary collaboration to support informed decision-making, particularly in the local context. Full article

(This article belongs to the Section Pediatric Nutrition)

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19 pages, 910 KB

Open AccessReview

An Integrated Nutritional and Physical Activity Approach for Osteosarcopenia

by Edoardo Mocini, Ludovica Cardinali, Olivia Di Vincenzo, Antimo Moretti, Carlo Baldari, Giovanni Iolascon and Silvia Migliaccio

Nutrients 2025, 17(17), 2842; https://doi.org/10.3390/nu17172842 - 31 Aug 2025

Abstract

Osteoporosis is a skeletal disorder characterized by decreased bone strength, which leads to an increased risk of developing fractures. Interestingly, this metabolic disorder is often related to sarcopenia, defined as decreased muscle mass, strength, and function. These two conditions appear to be closely [...] Read more.

Osteoporosis is a skeletal disorder characterized by decreased bone strength, which leads to an increased risk of developing fractures. Interestingly, this metabolic disorder is often related to sarcopenia, defined as decreased muscle mass, strength, and function. These two conditions appear to be closely connected, leading to a clinical condition named osteosarcopenia (OS). Aging may explain the link between muscle and bone loss through genetic, mechanical, endocrine, and nutritional factors. Further, aging increases the amount of adipose tissue, often due to sedentary behavior and unbalanced nutritional pattern, leading to a clinical condition defined as osteosarcopenic obesity, characterized by concurrent obesity, sarcopenia, and osteoporosis, where each condition exacerbates the others. Moreover, sarcopenia leads to decreased physical (PA) activity, worsening skeletal homeostasis, and creating a vicious cycle, which increases falls, fracture risk, and disability. This review underscores the importance of a systemic approach, focusing on nutritional therapy integrated with PA and, eventually, pharmacological interventions to efficiently manage (OS). Full article

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

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18 pages, 782 KB

Open AccessReview

The Role of Hydration in Children and Adolescents—A Theoretical Framework for Reviewing Recommendations, Models, and Empirical Studies

by Marek Zborowski and Magdalena Skotnicka

Nutrients 2025, 17(17), 2841; https://doi.org/10.3390/nu17172841 - 31 Aug 2025

Abstract

Proper hydration is essential for maintaining homeostasis and the effective functioning of physiological systems, including the nervous and circulatory systems. During adolescence, a period characterized by rapid somatic growth, hormonal maturation, and increased physical and mental activity, the demand for water increases significantly. [...] Read more.

Proper hydration is essential for maintaining homeostasis and the effective functioning of physiological systems, including the nervous and circulatory systems. During adolescence, a period characterized by rapid somatic growth, hormonal maturation, and increased physical and mental activity, the demand for water increases significantly. Hydration affects not only the health of young people, but also their cognitive abilities, concentration, mood, and general well-being. Despite clear recommendations from institutions such as EFSA and IOM regarding daily fluid intake, numerous studies indicate that a significant proportion of young people do not achieve the recommended level of hydration. The school environment is particularly worrying, as young people spend a significant part of their day there, and the availability of water, health knowledge, and social conditions may contribute to dehydration or promote unhealthy choices (e.g., sweetened drinks). The aim of this article is to review the current state of knowledge on the importance of hydration in school-age adolescents. The physiological basis of hydration, the impact of insufficient fluid intake on the functioning of the young body, current guidelines, as well as the results of selected epidemiological studies and obstacles to ensuring optimal hydration in the school environment are discussed. Full article

(This article belongs to the Section Pediatric Nutrition)

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20 pages, 2842 KB

Open AccessSystematic Review

Impact of Arabinoxylan Consumption on Glycemic Control: A Systematic Review and Meta-Analysis of Preclinical and Clinical Studies

by Yujing Xu, Yuxin Liang and Jung Eun Kim

Nutrients 2025, 17(17), 2840; https://doi.org/10.3390/nu17172840 - 31 Aug 2025

Abstract

Background/Objectives: Arabinoxylan (AX) has shown potential benefits in glycemic control; however, findings remain inconclusive. This systematic review and meta-analysis aimed to assess the impact of AX intake on glycemic control in preclinical and clinical studies. Methods: A database search was conducted [...] Read more.

Background/Objectives: Arabinoxylan (AX) has shown potential benefits in glycemic control; however, findings remain inconclusive. This systematic review and meta-analysis aimed to assess the impact of AX intake on glycemic control in preclinical and clinical studies. Methods: A database search was conducted in PubMed, Embase, Cochrane Library, and CINAHL. A total of 133 studies were included for systematic review and extracted data from 46 clinical studies and 25 preclinical studies were further analyzed for meta-analysis. Results: The AX consumption improved overall postprandial glycemic control in clinical studies, as evidenced by reductions in glucose iAUC (SMD: −0.41; 95% CI: [−0.57, −0.25]), insulin iAUC (SMD: −0.28; 95% CI: [−0.44, −0.12]), glucose iPeak (SMD: −0.52; 95% CI: [−0.80, −0.25]), and insulin iPeak (SMD: −0.24; 95% CI: [−0.41, −0.06]) compared to the control. For chronic glycemic control, fasting glucose (Hedges’ g: −1.18; 95% CI: [−1.56, −0.80]), insulin (Hedges’ g: −1.07; 95% CI: [−1.92, −0.23]), HbA1c (Hedges’ g: −2.93; 95% CI: [−5.48, −0.38]), and HOMA-IR (Hedges’ g: −2.44; 95% CI: [−3.66, −1.22]) reduced in preclinical studies, while improvements were limited to fasting glucose (MD: −0.10; 95% CI: [−0.16, −0.03]) in clinical studies. Subgroup analyses revealed that AX exerted a greater glycemic-lowering effect in metabolically impaired animals and individuals compared to healthy counterparts. Furthermore, extracted AX was found to be more effective than intrinsic AX in optimizing glycemic control. Conclusions: The consumption of AX improves glycemic control, particularly in metabolically impaired animals and human participants. Moreover, the benefit appears more pronounced with extract AX interventions. Full article

(This article belongs to the Special Issue Recent Advances in Dietary Polysaccharides for Human Health and Diseases)

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16 pages, 873 KB

Open AccessArticle

Vitamin D Status and Response to Supplementation as Predictive Factors for Early Remission in Polymyalgia Rheumatica: A Retrospective Longitudinal Investigation

by Elvis Hysa, Serena Balito, Giulia Davoli, Elisa Caratto, Giulia Bernardi, Emanuele Gotelli, Rosanna Campitiello, Carmen Pizzorni, Sabrina Paolino, Alberto Sulli, Vanessa Smith and Maurizio Cutolo

Nutrients 2025, 17(17), 2839; https://doi.org/10.3390/nu17172839 - 31 Aug 2025

Abstract

Background/Objectives: Polymyalgia rheumatica (PMR) is a relatively common inflammatory rheumatic disease of the elderly. The role of vitamin D remains unclear in this condition. The endpoints of this study were to assess 25-hydroxyvitamin D [25(OH)D] serum concentrations in PMR patients with active disease [...] Read more.

Background/Objectives: Polymyalgia rheumatica (PMR) is a relatively common inflammatory rheumatic disease of the elderly. The role of vitamin D remains unclear in this condition. The endpoints of this study were to assess 25-hydroxyvitamin D [25(OH)D] serum concentrations in PMR patients with active disease compared to elderly controls and to determine if baseline levels or changes following supplementation [delta 25-hydroxyvitamin D, Δ25(OH)D] were associated with improved clinical outcomes. Methods: In this retrospective, case–control study, 29 PMR patients (55% males, 75.24 ± 9.6 years old, disease duration of 3.8 ± 3 months) were included, meeting the 2012 EULAR/ACR classification criteria, with 29 age- and sex-matched controls without systemic inflammatory rheumatic diseases. We assessed demographic, clinical and laboratory features for PMR patients, including baseline 25(OH)D serum concentrations, disease activity (polymyalgia rheumatica activity score), and serum inflammatory biomarkers. A subgroup of them (n = 25) was followed longitudinally, for an average period of 21.1 ± 17.7 months, to evaluate the association between Δ25(OH)D and clinical outcomes at follow-up using multivariate logistic regression. Results: Although lower than the normal reference values, baseline 25(OH)D concentrations did not differ significantly between PMR patients and controls (21.6 ± 9.2 vs. 22.7 ± 11.3 ng/mL, p = 0.66) and did not predict long-term clinical outcomes. However, after only 3 months of supplementation, the increase in 25(OH)D concentrations was significantly associated with a remission status, and patients in remission showed a significant increase in 25(OH)D compared to those with persistent disease activity (+22.02 vs. +1.33 ng/mL, respectively; p = 0.044). Notably, in the multivariate model, this Δ25(OH)D was the strongest independent predictor of remission (OR = 2.89; 95% CI [1.60–4.11]), an effect independent of prednisone dosage prescribed at first visit (p = 0.32) and glucocorticoid exposure at third month (p = 0.12). Conclusions: Individual’s response of PMR patients to supplementation of vitamin D seems to be a robust independent predictor of early clinical remission achievement. Interestingly, optimizing vitamin D supplementation based on individual responsiveness may represent a valuable adjunctive strategy in PMR management. Full article

(This article belongs to the Special Issue Micronutrients and Bioactive Molecules: Their Development, Interaction, and Impact on Human Health)

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27 pages, 1653 KB

Open AccessReview

Protective Role of Key Micronutrients in Chemotherapy-Induced Organ Toxicity: A Comprehensive Review of Mechanistic Insights and Clinical Implications

by Ioannis Konstantinidis, Sophia Tsokkou, Eleni Gavriilaki, Georgios Delis and Theodora Papamitsou

Nutrients 2025, 17(17), 2838; https://doi.org/10.3390/nu17172838 - 31 Aug 2025

Abstract

Background/Objectives: Systemic toxicities to key organs like the heart, liver, and kidneys impair the efficacy of chemotherapy in cancer treatment. These toxicities are caused by oxidative stress, inflammation, mitochondrial malfunction and ferroptosis, causing clinical morbidity and possibly impaired adherence to treatment. This review, [...] Read more.

Background/Objectives: Systemic toxicities to key organs like the heart, liver, and kidneys impair the efficacy of chemotherapy in cancer treatment. These toxicities are caused by oxidative stress, inflammation, mitochondrial malfunction and ferroptosis, causing clinical morbidity and possibly impaired adherence to treatment. This review, also, examines how magnesium, selenium, zinc and vitamin D protect against chemotherapy-induced cardiotoxicity, hepatotoxicity and nephrotoxicity. Methodology: A complete literature search of PubMed (MEDLINE), Scopus, Cochrane Library and Embase was used to synthesize data till 29 June 2025. Studies included randomized and non-randomized trials, cohort studies, case series (≥3 patients), and relevant systematic reviews. To contextualize pathways, preclinical in vivo and in vitro studies were studied independently. Patients undergoing systemic chemotherapy and magnesium, selenium, zinc or vitamin D therapies were eligible. Supplementation’s safety and organ-specific toxicity were investigated. Results: Magnesium protected against cisplatin-induced nephrotoxicity via modulating renal transporters and oxidative defenses across chemotherapy regimens. Selenium supplementation has strong antioxidant and anti-inflammatory characteristics, especially in avoiding cardiac and hepatic injury, although its nephroprotective potential was formulation-dependent. Zinc’s activity was connected to metallothionein-mediated redox stabilization, inflammatory regulation, and cardiac and hepatic resilience. Vitamin D and its analogs reduced cardiotoxicity and nephrotoxicity through mitochondrial preservation and immunomodulatory signaling. Conclusions: To date, magnesium, selenium, zinc, and vitamin D have been shown to reduce chemotherapy-related organ toxicities. Preclinical studies are promising, but randomized clinical trials are needed to prove therapeutic effectiveness and oncologic safety. Full article

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

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21 pages, 3847 KB

Open AccessArticle

Individual and Combined Effects of Medium- and Long-Chain Triacylglycerol and 2′-Fucosyllactose on Small Intestinal Morphology, Barrier Function, and Gut Microbiota in Growing C57BL/6 Mice

by Xinyuan Jin, Mengfan Shen, Mengdi Zhang, Haoqi Chen, Yufeng Jin, Yupeng Zeng, Zhijun Pan, Ziling Wang, Pan Wang, Yuting Yang, Zhiyuan Yan, Huilian Zhu and Dan Li

Nutrients 2025, 17(17), 2837; https://doi.org/10.3390/nu17172837 - 31 Aug 2025

Abstract

Background/Objectives: Medium- and long-chain triacylglycerol (MLCT) and 2′-fucosyllactose (2′-FL) are functional ingredients abundant in human milk; however, their effects on small intestinal development and health remain largely unknown, and no research has explored their potential combined effects. Methods: In this study, growing C57BL/6 [...] Read more.

Background/Objectives: Medium- and long-chain triacylglycerol (MLCT) and 2′-fucosyllactose (2′-FL) are functional ingredients abundant in human milk; however, their effects on small intestinal development and health remain largely unknown, and no research has explored their potential combined effects. Methods: In this study, growing C57BL/6 mice (3 weeks old) were fed diets without or with 2.5 g/100 g of MLCT, 2′-FL, or the combination (MLCT + 2′-FL; 5:1) for 21 days. Body weight, major organ indices, small intestinal morphology-related indicators (small intestinal length, villus height, crypt depth, villus height/crypt depth (V/C) ratio, and epithelial cell proliferation), and intestinal barrier function markers (goblet cell and Paneth cell count, protein expression of ZO-1 and occludin, and levels of sIgA and LPS) were measured. Results: In addition to the shared promotion of epithelial cell proliferation, MLCT intervention raised villus height and crypt depth, while 2′-FL intervention elevated Paneth cell count and sIgA levels. Notably, MLCT + 2′-FL intervention offered additional advantages (increasing the V/C ratio, goblet cell count, and expression of ZO-1 and occludin) without affecting crypt depth. 16S rRNA sequencing analysis of cecal contents revealed that all three interventions mainly affected beta diversity rather than alpha diversity, and enriched differentially abundant bacterial taxa: Erysipelotrichaceae, Faecalibaculum, UBA1819, and Faecalitalea in the MLCT group; Enterobacteriaceae, Escherichia, and Allobaculum in the 2′-FL group; Bifidobacterium, Romboutsia, Clostridia, and several other bacterial taxa in the MLCT + 2′-FL group. Conclusions: These results indicate that MLCT and 2′-FL interventions alone appear to provide different benefits for small intestinal development, and their combination may confer more comprehensive advantages. Full article

(This article belongs to the Section Prebiotics and Probiotics)

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27 pages, 1171 KB

Open AccessReview

A Narrative Hypothesis: The Important Role of Gut Microbiota in the Modulation of Effort Tolerance in Endurance Athletes

by Jesus Álvarez-Herms, Martin Burtscher, Francisco Corbi, Adriana González and Adrián Odriozola

Nutrients 2025, 17(17), 2836; https://doi.org/10.3390/nu17172836 - 31 Aug 2025

Abstract

Background: Regulating sensations of fatigue and discomfort while performing maximal endurance exercise becomes essential for making informed decisions about persistence and/or failure during intense exercise. Athletes with a higher effort capacity have competitive advantages over those with a lower one. The microbiota–brain axis [...] Read more.

Background: Regulating sensations of fatigue and discomfort while performing maximal endurance exercise becomes essential for making informed decisions about persistence and/or failure during intense exercise. Athletes with a higher effort capacity have competitive advantages over those with a lower one. The microbiota–brain axis is a considered the sixth sense and a modulator of the host’s emotional stability and physical well-being. Objectives: This narrative review aims to explore and evaluate the potential mechanisms involved in regulating perceptions during endurance exercise, with a focus on the possible relationship between the gut microbiota balance and the neural system as an adaptive response to high fatigue chronic exposure. Methods: Electronic databases (PubMed, Web of Science, Google Scholar, and Scopus) were used to identify studies and hypotheses that had documented predefined search terms related to endurance exercise, gut microbiota, the central nervous system, pain, discomfort, fatigue, and tolerance to effort. Results: This narrative review shifts the focus concerning the symbiotic relationship between the gut microbiota, the vagus nerve, the central/enteric nervous system, and the regulation of afferences from different organs and systems to manage discomfort and fatigue perceptions during maximal physical effort. Consequently, the chronicity supporting fatigued exercise and nutritional stimuli could specifically adapt the microbiota–brain connection through chronic efferences and afferences. The present hypothesis could represent a new focus to be considered, analysing individual differences in tolerating fatigue and discomfort in athletes supporting conditions of intense endurance exercise. Conclusions: A growing body of evidence suggests that the gut microbiota has rapid adaptations to afferences from the brain axis, with a possible relationship to the management of fatigue, pain, and discomfort. Therefore, the host–microbiota relationship could determine predisposition to endurance performance by increasing thresholds of sensitive afferences perceived and tolerated. A richer and more diverse GM of athletes in comparison with sedentary subjects can improve the bacteria-producing metabolites connected to brain activity related with fatigue. The increase in fatigue thresholds directly improves exercise performance, and the gut–brain axis may contribute through the equilibrium of metabolites produced for the microbiota. Full article

(This article belongs to the Special Issue Physical Exercise and Nutrition on the Gastrointestinal Pathophysiology)

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26 pages, 1536 KB

Open AccessReview

Generalized Anxiety Disorder and Obesity: Overlapping Neuroendocrine, Metabolic, and Behavioral Pathways

by Agnieszka Dymek, Magdalena Zielińska, Anna Englert-Bator, Katarzyna Dereń and Edyta Łuszczki

Nutrients 2025, 17(17), 2835; https://doi.org/10.3390/nu17172835 - 31 Aug 2025

Abstract

Background/Objectives: Generalized anxiety disorder (GAD) is one of the most commonly diagnosed anxiety disorders in primary care. The global lifetime prevalence of GAD is estimated at 3.7%, ranging from 1.6% in low-income countries to 5.0% in high-income countries, underscoring its widespread impact. [...] Read more.

Background/Objectives: Generalized anxiety disorder (GAD) is one of the most commonly diagnosed anxiety disorders in primary care. The global lifetime prevalence of GAD is estimated at 3.7%, ranging from 1.6% in low-income countries to 5.0% in high-income countries, underscoring its widespread impact. Given the frequent co-occurrence of GAD with obesity, this association has important clinical implications, particularly for screening, prevention, and treatment strategies. The aim of this review is to identify potential biological mechanisms linking obesity and GAD, summarize the current state of knowledge in this area, and highlight existing research gaps, as well as directions for future research. Methods: This narrative review is based on the literature published between 2015 and 2025 concerning the co-occurrence of GAD and obesity, with a focus on potential shared mechanisms including HPA axis dysregulation, chronic inflammation, oxidative stress, insulin resistance, gut–brain axis and microbiota dysbiosis, sleep disturbance, and maladaptive eating behaviors. Results/Conclusions: A growing body of evidence suggests an important, albeit still ambiguously defined, relationship between obesity and GAD. GAD and obesity may reinforce each other, leading to a mutually reinforcing relationship. Despite growing interest, high-quality prospective and interventional studies focusing specifically on GAD are lacking. A potentially effective therapeutic approach should be integrated and multidisciplinary, combining psychological, pharmacological, and lifestyle interventions. It may also be beneficial for clinicians to consider routine assessment of anxiety in patients with obesity and, conversely, to monitor metabolic risk in individuals with GAD. Such an approach, targeting both mental and metabolic domains, holds promise for improving outcomes. Full article

(This article belongs to the Special Issue Impact of Eating Disorders and Obesity on Quality of Life and Mental Health)

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35 pages, 825 KB

Open AccessSystematic Review

Unraveling the Role of Foods on Chronic Anti- and Pro-Inflammatory Cytokines: A Systematic Review of Chronic Dietary Intervention Trials in Humans

by Veronica D’Antonio, Marina Ramal-Sanchez, Chiara Bravo-Trippetta, Elena Corvaglia, Mauro Serafini and Donato Angelino

Nutrients 2025, 17(17), 2834; https://doi.org/10.3390/nu17172834 - 30 Aug 2025

Abstract

Background/Objectives: Unbalanced diets contribute to a rise in low-grade systemic inflammation, a risk factor for metabolic diseases. The aim of this study is to systematically review evidence from chronic intervention studies to understand the role of foods in modulating inflammatory responses in humans. [...] Read more.

Background/Objectives: Unbalanced diets contribute to a rise in low-grade systemic inflammation, a risk factor for metabolic diseases. The aim of this study is to systematically review evidence from chronic intervention studies to understand the role of foods in modulating inflammatory responses in humans. Methods: A literature search was conducted on PubMed using specific keywords. Risk of bias was assessed using Cochrane guidelines. Inclusion criteria required chronic dietary intervention studies measuring cytokine levels in humans. Results: In the 75 studies selected, results revealed extremely high variability both in outcomes, study design, and participant selection criteria. Studies with fruits and vegetables showed a reduction in circulating cytokine levels and/or an increase in anti-inflammatory cytokines in 80% of studies (8/10), followed by fish (78%; 7/9), dairy (67%; 4/6), cereals (64%; 7/11), and oils (57%; 4/7). Beverages and hot beverages showed a decrease in circulating cytokines in 50% of cases (10/20 and 4/8, respectively). An increase in pro-inflammatory cytokines was observed in dietary interventions with beverages. As further findings, we also observed greater effectiveness from fruits and vegetables (87.5%; 7/8), fish (75%; 6/8), and cereals (62.5%; 5/8) when studies were conducted in subjects with pathologies or risk factors. Conclusions: Fruits and vegetables, fish, and cereals reduce systemic inflammation mainly in subjects with pathologies or risk factors. However, the limited number of studies do not allow us to draw solid conclusions on individual foods. Standardized dietary intervention trials are urgently needed to understand the role of foods in modulating inflammatory responses and to deliver findings to the general public. Full article

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

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