Nutrients

Background: Iron deficiency anemia is a recognized pregnancy risk, but excessive iron may also have adverse effects. Few studies, particularly in Asian populations, have examined elevated maternal ferritin in relation to birth outcomes. Objectives: To investigate the dose–response relationships between maternal serum ferritin concentrations in late pregnancy and birth outcomes, including preterm birth, small for gestational age (SGA), and placental characteristics. Methods: A retrospective study of 362 mother–infant pairs were analyzed. Maternal serum ferritin levels measured at 30–34 weeks’ gestation were divided into quintiles, using 30.1–43.0 µg/L as the reference. Logistic and linear regression models were applied to examine associations with preterm birth, SGA, and placental indices. Results: Preterm birth rates ranged 7.3–18.8% across ferritin quintiles, but no significant association was observed. In contrast, SGA prevalence increased from 20.8% to 47.2% (p-trend = 0.001). Women in the highest ferritin quintile had 3.31-fold higher adjusted odds of SGA (95% CI: 1.51–7.28, p = 0.003). Each SD increase in ferritin corresponded to 31% higher odds of SGA (OR = 1.31, 95% CI: 1.01–1.71). Elevated ferritin (>43.0 µg/L) was also associated with reduced placental weight (<415 g) (adjusted OR = 3.02, 95% CI: 1.61–5.69, p = 0.001). Conclusions: Increasing maternal ferritin levels in the third trimester were associated with a dose-dependent rise in SGA risk and reduced placental weight. These findings suggest that excessive iron status may adversely influence placental function and fetal growth, underscoring the need for individualized nutrition management during pregnancy.

Background: Lipedema is a progressive disorder of subcutaneous connective tissue, predominantly affecting women, and characterized by an increase in subcutaneous adipose tissue, particularly in the lower body. This study aims to explore the gut microbiota (GM) profile in lipedema patients to characterize the associated GM and compare it with the control group. Methods: A prospective randomized case–control pilot study was conducted from September 2023 to May 2024, involving 55 Caucasian women, aged 20–60. The participants were divided into two groups: 35 with lipedema (LIPPY) and 20 controls (CTRL). Body composition was assessed using Dual X-ray Absorbimetry (DXA), and GM analysis was performed through 16S rRNA gene sequencing. Results: LIPPY subjects showed increased Intramuscular Adipose Tissue (IMAT) and reduced Lean Mass (LM)/Fat Mass (FM) ratios. While alpha and beta diversity metrics did not differ significantly between groups, differential abundance analysis identified a significant reduction in Eggerthellaceae (Log Fold Change (LFC) = −0.19, p = 0.04) and enrichment of Propionibacteriaceae (LFC = +0.18, p = 0.009) and Acidaminococcaceae (LFC = +0.32, p = 0.013) in the LIPPY group. Genus-level analysis showed a significant reduction in Blautia and Ruminiclostridium (LFC = −0.32 and −0.02; p = 0.02 and 0.04) and enrichment of Anaerostipes, Propionibacterium, and Phascolarctobacterium (LFC = +0.07, +0.17, and +0.34; p = 0.02, 0.005, 0.005, respectively). In correlation analyses, within LIPPY, Eggerthellaceae correlated negatively with Body Mass Index (BMI) (ρ = −0.61, p < 0.05) and positively with Appenicular (Appen) LM/Weight and AppenLM/BMI (ρ = +0.43 and +0.41, p < 0.05), while Anaerostipes correlated positively with these lean mass indices (ρ = +0.40, p < 0.05). In CTRL, only Anaerostipes showed a significant negative correlation with BMI (ρ = −0.64, p < 0.05). Conclusions: This study provides the first evidence of a distinct GM profile in LIPPY, with notable links to adverse body composition markers such as IMAT. Trial Registration: Trial registered on 24 June 2013 with ClinicalTrial.gov (NCT01890070).

Background: Type 2 diabetes mellitus (T2DM) is a growing global health challenge requiring effective dietary management strategies. While the Mediterranean diet shows promise for cardiovascular and metabolic health, the last comprehensive meta-analysis of randomized controlled trials (RCTs) examining its effects on glycemic control and body mass index (BMI) in T2DM was published in 2015. Multiple RCTs, including culturally adapted interventions with extended follow-up, have since been completed, but remain unsynthesized. Methods: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines (PROSPERO: CRD420251147035), searching PubMed, Web of Science, and Embase from inception through 17 August 2025. Unlike previous syntheses that combined observational cohorts or mixed dietary approaches, our analysis focused strictly on RCTs in adults with established T2DM and incorporated trials published after 2015. We included RCTs comparing Mediterranean diet interventions against non-Mediterranean control diets in adults with T2DM. Primary outcomes included glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body mass index (BMI). Secondary outcomes comprised low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Pooled effects were estimated using random-effects models. Results: Eleven RCTs (10 publications) involving diverse populations met inclusion criteria. Compared with control diets, Mediterranean diet interventions showed reductions in HbA1c (mean difference [MD] −0.307%, 95% CI: −0.451 to −0.163), FPG (MD −0.845 mmol/L, 95% CI: −1.307 to −0.384), and BMI (MD −0.828 kg/m², 95% CI: −1.4 to −0.256). Secondary analyses revealed reductions in LDL-C (MD −8.060 mg/dL, 95% CI: −14.213 to −1.907), SBP (MD −5.130 mmHg, 95% CI: −10.877 to 0.617), and DBP (MD −2.008 mmHg, 95% CI: −3.027 to −0.989). Sensitivity analyses supported stability of findings, with no substantial publication bias detected. Subgroup analyses revealed geographic variation in blood pressure responses, with greater benefits observed in non-Mediterranean populations. Conclusions: Mediterranean dietary patterns were associated with modest improvements in glycemic control, body composition, and cardiometabolic risk factors among adults with T2DM. The cultural adaptability of this approach may support implementation in clinical practice, though larger multicenter trials with standardized protocols and extended follow-up remain necessary.