Search Results (230)

Background/Objectives: Occupational stress is a common issue among academics. This study aims to determine the level of work stress experienced by academics depending on their titles and the relationship between this stress and eating behaviors. Methods: The data for the study were collected through an online survey from 649 academicians working in universities in Türkiye between January and February 2025. This is a cross-sectional study, and the snowball sampling method was used to facilitate high participation rates. Data were collected using a demographic questionnaire, the General Work Stress Scale (GWSS) to assess work stress levels, and the Turkish version of the Adult Eating Behavior Questionnaire (AEBQ-TR) to evaluate eating behaviors. Results: Among the participants, 47.6% were of normal weight, with an average BMI of 25.85 ± 4.56 kg/m². The median work stress score of male academicians (17.00) was significantly lower than that of female academicians (21.00) (p < 0.001). Similarly, the median eating behavior score was lower in male academicians (18.55) compared to females (19.78) (p < 0.001). Work stress levels decreased with increasing academic title, with professors reporting the lowest levels of stress (p < 0.001). Conclusions: The findings indicate that female academics are more likely to engage in emotional eating under stress, whereas male academics tend to alter their dietary preferences by avoiding certain foods. These results underscore the importance of stress management and the promotion of healthy eating habits among academics. Full article

Background/Objectives: This study assessed Knowledge and Practices related to Food Safety (KPFS) among nutrition services employees in hospitals across the Al-Ahsa Governorate, Kingdom of Saudi Arabia. The objective was to evaluate the staff’s understanding of key food safety principles, including foodborne illness prevention, food handling, personal hygiene, and food storage and preparation practices. Methods: A descriptive survey method was used, and data were collected using an electronic questionnaire, which was either self-administered by the participants or completed with the assistance of the researcher in cases involving employees who did not speak Arabic or English. This study included 302 staff members involved in the preparation, service, and supervision of food provided to hospital patients. Results: The results indicated a high level of knowledge among nutrition services employees regarding food safety principles, critical temperature control, cross-contamination prevention, and proper hygiene practices. The employees also demonstrated a strong commitment to personal hygiene behaviors, such as handwashing, wearing appropriate clothing, and avoiding unsafe practices. Additionally, a high degree of knowledge and understanding was found regarding food storage procedures and contamination prevention. The study also highlighted a very high level of awareness concerning the cleaning and sterilization of equipment, tools, and food storage surfaces, as well as maintaining a clean and healthy environment. These findings emphasize the importance of continuous training in enhancing food safety knowledge among nutrition services employees. Conclusions: It is recommended that all employees, regardless of education level, experience, or role, participate regularly in food safety training programs to sustain and improve food safety practices within hospital environments. Full article

Background and Objectives: Excessive social media use is repeatedly linked to negative body image outcomes, yet its association with muscle dysmorphia, especially in athletic youth, remains underexplored. We investigated how social media exposure, comparison behavior, and platform engagement relate to muscle dysmorphia symptomatology in young German athletes. Materials and Methods: An anonymous, web-based cross-sectional survey was conducted (July–October 2024) of 540 individuals (45% female; mean age = 24.6 ± 5.3 years; 79% ≥ 3 h sport/week) recruited via Instagram. The questionnaire comprised demographics, sport type, detailed social media usage metrics, and the validated German Muscle Dysmorphic Disorder Inventory (MDDI-1, 15 items). Correlations (Spearman’s ρ, Kendall’s τ) were calculated; multivariate importance was probed with classification-and-regression trees and CatBoost gradient boosting, interpreted via SHAP values. Results: Median daily social media time was 76 min (IQR 55–110). Participants who spent ≥ 60 min per day on social media showed higher MDDI scores (mean 38 ± 7 vs. 35 ± 6; p = 0.010). The strongest bivariate link emerged between perceived social media-induced body dissatisfaction and felt pressure to attain a specific body composition (Spearman ρ = 0.748, Kendall τ = 0.672, p < 0.001). A CatBoost gradient-boosting model out-performed linear regression in predicting elevated MDDI. The three most influential features (via SHAP values) were daily social media time, frequency of comparison with fitness influencers, and frequency of “likes”-seeking behavior. Conclusions: Intensive social media exposure substantially heightens muscle dysmorphia risk in young German athletes. Machine-learning interpretation corroborates time on social media and influencer comparisons as primary drivers. Interventions should combine social media literacy training with sport-specific psychoeducation to mitigate maladaptive comparison cycles and prevent downstream eating disorder pathology. Longitudinal research is warranted to clarify causal pathways and to test targeted digital media interventions. Full article

Background/Objectives: The phase angle (PhA) is an emerging biomarker reflecting the cellular integrity and nutritional status. This study aimed to explore potential associations between the PhA, clinical severity scores, and 60-day survival outcomes following an admission to the Intensive Care Unit (ICU). Methods: This prospective, single-center study included 43 critically ill patients admitted to the ICU at Evangelismos General Hospital between May and November 2024. Patients were stratified by their PhA (≤5.4° vs. >5.4°). The PhA was measured at admission and subsequently on days 5–7, 10–11, 13–14, and until discharge. Severity scores (SOFA and APACHE II) were recorded. Between-group differences were assessed using independent samples t-tests and Mann–Whitney U tests, as appropriate. Survival was analyzed using Kaplan–Meier curves and Cox proportional hazards models. Results: The mean age was 54.6 ± 17 years; 63.6% were male. At ICU admission, patients with a PhA > 5.4° were significantly younger (p < 0.001) and had a higher fat-free mass (p < 0.001), greater calf circumference (p < 0.001), higher extracellular water (p < 0.001), larger mid-upper arm circumference (p = 0.009), and higher resting energy expenditure per kilogram (27.4 vs. 23.1 kcal/kg, p = 0.002). The PhA declined significantly during the ICU stay (p < 0.001). The Kaplan–Meier analysis showed a significantly shorter survival in patients with a PhA ≤ 5.4° (HR: 6.32, p = 0.019), which remained significant after adjusting for sepsis (p = 0.017). In a multivariable Cox regression, both PhA and APACHE II scores independently predicted mortality. Conclusions: While limited by a small sample size and single-center design, these findings support the further exploration of the PhA as a monitoring tool in critical care. Full article

Background/Objectives: Research on oral dysfunctions as contributing factors to obstructive sleep apnea (OSA) is needed to prevent and treat OSA. This study aimed to explore the association of OSA with oral dysfunction and examine its impact on nutrient intake, physical activity, and handgrip strength. Methods: This cross-sectional study analyzed data from the Eighth cycle Korea National Health and Nutrition Examination Survey (KNHANES, 2019–2021). The OSA group included diagnosed individuals and those over 40 years with symptoms such as snoring, fatigue, or witnessed breathing pauses during sleep. The non-OSA group included individuals not meeting these criteria. Using 1:1 propensity score matching to control for confounders (sex, age, lifestyle factors), 7636 participants were included. Oral dysfunction was assessed based on chewing problems, complaints of chewing discomfort, and speech difficulties. Nutrient intake, physical activity, and handgrip strength were analyzed using the Rao–Scott χ² test, complex sample t-test, and complex sample logistic regression. Results: The OSA group demonstrated significantly more oral dysfunction elements than the non-OSA group (p < 0.001). Higher energy intake was observed in the OSA group, with no significant differences in macronutrient intake. Physical activity levels were similar between groups; however, OSA participants without oral problems had higher handgrip strength (p < 0.05). Regression analysis showed increased OSA risk correlated with greater oral dysfunction and lower protein intake. Conclusions: This study revealed a strong association between oral dysfunction and OSA risk. Focusing on the assessment and early intervention of oral dysfunctions that influence OSA risk factors may aid in the early detection and prevention of OSA. Full article

Background/Objectives: The weight-adjusted waist index (WWI), a novel measure of abdominal obesity independent of overall weight, has shown promise in assessing health risks. However, its relationship with dementia remains unclear. This study investigates the association between the WWI and dementia risk in British older adults. Methods: Employing data from the United Kingdom Biobank, we conducted a prospective cohort study focusing on 155,683 elderly participants. Multivariable logistic regression models were employed to investigate the linear association between the WWI and all-cause dementia. Restricted cubic spline analysis was used to evaluate non-linear relationships, while subgroup analyses and interaction tests were performed to examine the stability of findings across different populations. Results: Among participants (mean age: 63.2 years; 52.2% male), 3211 dementia cases were identified during 13.1 years of follow-up (2.06% prevalence). The analysis revealed a significant inverse relationship between the WWI and dementia risk. In fully adjusted models, higher WWI was associated with a reduced risk of dementia (β = −0.274, p < 0.001). When the WWI was categorized into quartiles, participants in the highest quartile exhibited a 47% lower risk of dementia compared to those in the lowest quartile. This inverse association was particularly pronounced among non-current smokers (p < 0.05 for interaction). Restricted cubic spline analysis confirmed a non-linear relationship, with the protective effect of the WWI becoming more evident at higher values. Conclusions: The WWI is inversely associated with dementia risk in British older adults. These findings reveal that the WWI may serve as a potential predictor for dementia risk, highlighting its potential in risk stratification and prevention strategies. Full article

Background: The prevalence of diabetes among young individuals has reached concerning levels, posing significant public health risks and exacerbating the economic burden on healthcare systems. The health outcomes of individuals with diabetes are heavily influenced by malnutrition and unhealthy dietary habits, which not only hamper effective blood glucose management but also negatively affect overall health perceptions. Introduction: This study analyzes the factors influencing malnutrition, food habits, and health perceptions among diabetic patients. Methods: A well-structured questionnaire was designed to collect data. A cross-sectional survey of 503 diabetic patients across various regions in India was conducted. Additionally, structural equation modeling, as well as mediation and moderation analyses, were performed. Results: The study findings revealed that dietary knowledge, dietitian-led interventions, and economic factors significantly influenced malnutrition and health outcomes. Conversely, nutritional quality did not emerge as a significant predictor. Discussions: The study will help pharmaceutical companies, governments, and healthcare practitioners in marketing dietary supplements, design focused dietary programs, and develop health education campaigns to improve diabetes patients’ quality of life. The findings illuminated the critical roles of dietary knowledge, dietitian-led interventions, economic factors, and lifestyle modifications in managing malnutrition and enhancing health outcomes. Conclusions: The study demonstrated significant mediation and moderation effects, emphasizing the complex interplay between food habits and malnutrition on health perceptions. However, nutritional quality was not a significant predictor, and the research underscored the necessity of holistic, personalized interventions. This will also help medical marketers in devising their marketing strategies. Full article

Background/Objectives: This paper aims to assess the unhealthy dietary habits and sedentary behaviours among adolescents and young adults simultaneously. Methods: The sample consists of 682 participants aged 10–24 years old (58.9% males and 68.2% aged 15–19 years old), recruited for the ALIMA (ALImentazione Multiculturale negli Adolescenti) study in both secondary schools and youth aggregation centres, located in Rome. The study utilizes structured questionnaires to gather data on anthropometric measurements, eating habits, alcohol consumption, physical activity, and sedentary behaviours. Data are analyzed by using the Pearson chi-squared test. Results: Excessive screen time (>3 h/day) and inadequate dietary habits (insufficient consumption of fruit, vegetables, and legumes, skipping breakfast, and a high consumption of sugar-sweetened beverages and alcohol) are observed in the total sample, but mainly in older adolescents aged 15–19 years old. The adherence to the MD, measured via the KIDMED index, is significantly different among the three age groups (p = 0.001); 47.8% of the sample has a medium adherence, while among those with a low adherence, the highest percentage is represented by older adolescents (39.8%); those with foreign-born parents have healthier diets, whereas lower parental education correlates with unhealthy behaviours. Conclusions: These results highlight the need for targeted interventions tailored to adolescents and young adults to encourage healthier lifestyle choices. Full article

The human papillomavirus type 16 (HPV 16) is a high-risk human papillomavirus strain commonly associated with oropharyngeal cancers, including lymph node involvement. The treatment for HPV 16-related tonsil cancer, commonly involving surgery, radiation, and chemotherapy, presents significant challenges. Complications such as oral mucositis, xerostomia, dysphagia, dysgeusia, hypogeusia, impaired gustatory function, and significant weight loss frequently arise, leading to reduced nutritional intake, impaired healing, and recovery progression. These challenges underscore the need for supportive interventions to enhance rehabilitation and the post-recovery period, improve treatment tolerance, and maintain quality of life. Objective: This single-subject study examines a 67-year-old male patient diagnosed with a T1N3b (small primary tumor with advanced lump node involvement) associated with HPV 16 positivity, indicating a virus-associated oncogenesis. Methods: The patient underwent radiation therapy and chemotherapy, leading to treatment-associated side effects. After having dietary drinks for daily nourishment, the patient routinely incorporated oral bio extra virgin olive oil (BEVOO) to cope with indicated challenges. Results: Body composition and metabolic parameters showed treatment-induced declines, followed by substantial but not complete recovery during follow-up examination. Visual Analog Scale (VAS) scores reflected gradual improvements in dysphagia, xerostomia, mucositis, and subtle but ongoing enhancement of the dysgeusia, gustatory perception, and oral palatability. The BEVOO supplementation and mindfulness were associated with positive recovery trends. Additional variables could have impacted the outcomes, preceding and throughout treatment, including the patient’s cognitive and somatic health, environmental conditions, dietary habits, individual attitudes toward recovery, physical activity, and patient way of life. Conclusions: These results emphasize the need for additional research employing a comprehensive, multi-factorial framework that accounts for the complex interplay of physiological, psycho-social, and environmental contributors. More extensive, more diverse studies are essential to confirm these observations and substantiate the role of BEVOO as a supportive intervention in cancer recovery. Full article

Background: The aim of this prospective follow-up study was to evaluate changes in body composition parameters and Mediterranean diet (MeDi) adherence among kidney transplant recipients (KTRs) over a three-year period. Additionally, this study sought to investigate the associations between these changes and clinical parameters, including laboratory parameters, new onset of diseases, and death outcome. Methods: A total of 116 KTRs were initially assessed in 2019 and subsequently re-evaluated in 2022. The Mediterranean Diet Serving Score (MDSS) was used to assess dietary adherence to the MeDi at baseline and follow-up assessments. Bioelectrical impedance analysis was used to assess body composition and clinical outcomes were assessed by the data available from medical charts. Results: After three years, MeDi adherence significantly decreased (p = 0.028) from 15 (18.29%) to 5 (6%), with dominantly lower adherence for vegetable, fruit, legume, red meat, olive oil and fish intake. Regarding body composition parameters, the most prominent change was seen in muscle mass, which deteriorated from 41.77% (IQR 6.46) to 39% (IQR 6.14; p = 0.004). However, changes in fat mass level were not significant in the follow-up period. Furthermore, cereal intake, fasting blood glucose (FBG), cholesterol level, level of low-density lipoprotein cholesterol (LDL), triglyceride leve and presence of diabetes mellitus lwere shown to be predictive for the decline of skeletal muscle mass. There were no significant changes in the estimated glomerular filtration rate (eGFR) or albuminuria level during the follow-up period. Associations with the death outcome were found for the MeDi-advised intake of eggs (β = −1.06, HR = 0.35, CI (0.14–0.87), p = 0.023), phase angle (PhA) (β = −2.68, HR = 0.07, CI (0.01–0.43), p = 0.004), cholesterol level (β = 0.95, HR = 2.60, CI (1.40–4.70), p = 0.001) and calcium level (β = −7.21, HR = 0.00, CI (0.00–1.50), p = 0.063). Conclusions: This study highlights a significant decline in MeDi adherence and skeletal muscle mass among KTRs over a three-year follow-up period, with no notable changes in fat mass or kidney function. The predictors of muscle mass loss and associations with mortality underscore the importance of dietary and clinical management in this population. Full article

Background/Objectives: Older adults are particularly susceptible to undernutrition and conditions that can aggravate it, such as frailty and conditions associated with swallowing difficulties or dysphagia. To address these challenges, it is important to consider the perspectives of older adults and their caregivers, especially those with conditions such as frailty or cognitive impairment, as they can provide valuable insights on supporting nutrition in these vulnerable populations. This participatory approach requires structures formed by scientific research committees working together with other stakeholders, involving various actors at all stages of the research process. The aim of this study is to analyze the methodology for involving patients aged 65 and older with malnutrition or at risk of malnutrition as co-investigators in research. Methods: This protocol has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) checklist. A literature search will be carried out in the following electronic databases: PubMed/MEDLINE, EMBASE and CINAHL. Through the COVIDENCE program, the research team will independently review the different screening phases of the identified studies for possible inclusion or exclusion. Expected Results: This systematic review will provide up-to-date evidence on the use of non-scientific actors at different stages of research. The main limitation stems from the use of non-scientific agents in a topic as specific as adults with or at risk of undernutrition, which may make it difficult to extrapolate the results to other settings. The registration number in PROSPERO is CRD42024444374. Full article

Background/Objectives: Little is known about the relationship between obesity, the triglyceride–glucose (TyG) index, and insulin resistance (IR). This cross-sectional study of Korean children investigated whether the TyG index mediates the relationship between the waist-to-hip ratio (WHtR) and homeostatic model assessment for IR (HOMA-IR). Methods: Six-hundred-and-thirteen Korean children (320 boys and 293 girls) aged 9–12 years old participated in this study. The participants were classified as insulin-sensitive or insulin-resistant based on gender-specific cut-off values of HOMA-IR. The TyG index was calculated as follows: ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Results: Children with IR were older, more likely to be girls, and had fewer favorable metabolic risk factors than children without IR. A mediation analysis revealed that while WHtR has a direct effect on HOMA-IR, it also has an indirect effect on HOMA-IR through the TyG index. The bootstrapped 95% confidence interval (CI) confirmed that the TyG index had an indirect effect on the relationship between the WHtR and HOMA-IR (effect = 0.349, SE = 0.075, 95% CI [0.210, 0.504]). The interaction effect between the WHtR and sex for the TyG index was statistically significant (β = −1.369, SE = 0.631, 95% CI [−2.608, −0.129]), but it was no longer significant when vigorous physical activity was considered as a covariate. Conclusions: Our findings suggest that girls are more vulnerable than boys to an increase in the TyG index caused by an increase in WHtR. This gender disparity observed in the study needs to be investigated causally. Full article

Background/Objectives: Current approaches to monitoring obstructive sleep apnea (OSA) risk primarily focus on structural or functional abnormalities, often neglecting systemic metabolic and physiological factors. Resource-intensive methods, such as polysomnography (PSG), limit their routine applicability. This study aimed to evaluate composite nutritional-inflammatory indices derived from routine blood markers to identify feasible indices for OSA management and explore their association with OSA risk. Methods: Data from 9622 adults in the NHANES (2015–2020) and GWAS datasets were analyzed using logistic regression, restricted cubic splines, machine learning, and Mendelian randomization (MR). These techniques were employed to identify nutritional-inflammatory indices associated with OSA risk. Random forest modeling identified body mass index (BMI) and albumin (ALB) as key components of the advanced lung cancer inflammation index (ALI). Causal relationships between ALI components and OSA were validated using MR. Results: ALI was significantly associated with OSA, with individuals in the highest ALI tertile exhibiting a 59% higher likelihood of OSA (OR = 1.59, 95% CI: 1.38–1.84; p < 0.001). BMI and ALB were identified as key contributors to ALI and confirmed as causal risk factors for OSA (BMI: OR = 1.91, 95% CI: 1.80–2.02; ALB: OR = 1.11, 95% CI: 1.04–1.19). Age, gender, and the neutrophil-to-lymphocyte ratio (NLR) were also significant predictors. Conclusions: This study identifies ALI as a potential composite index for assessing OSA risk. Integrating statistical modeling, machine learning, and causal inference techniques highlights the utility of nutritional-inflammatory indices in improving OSA monitoring and management in clinical practice. Full article

Background/Objectives: The prevalence of obesity is high among children living with disability. The present study aimed to examine the perceptions of parents and caregivers of children living with disability regarding children’s energy balance related behaviors (EBRBs) and their determinants. Methods: Parents/caregivers of children living with disability (n = 45) from Thessaly, Crete and Attica Regions of Greece, participated in semi-structured interviews between November and December 2023. The interviews were recorded, transcribed and transferred to N-VIVO software. The results were analyzed according to the framework of the socio-ecological model, using deductive thematic analysis. Results: Parents/caregivers reported that eating habits of children living with disability and their physical activity levels were poorer compared to the general population. At an individual level, certain disabilities may affect children’s food preferences and parents’ ability to prepare healthy foods. At a familial level, financial difficulties may influence healthy eating, whereas some parents/caregivers act as children’s role models to encourage them to be physically active. Home food environments may also influence children’s eating patterns and peer influence on their EBRBs. At a community level, lack of trained personnel, available amenities/equipment and food education initiatives and the availability of unhealthy foods in school canteens were described as major barriers to healthy EBRBs. At an organizational level, lack of accessible/safe facilities, the marginalization/stigma that children living with disability may experience and lack of dietitians/nutritionists in health centers were named as the main factors influencing children’s EBRBs. Conclusions: The findings of this study highlight the importance of designing multi-sectoral policy interventions to promote healthy EBRBs and tackle obesity in children living with disability in Greece. Full article

Background/Objectives: Anemia adversely affects children’s cognitive and motor development and remains a global public health problem. This study aimed to identify the individual, feeding, household, and community determinants of anemia among children in Mozambique. Methods: We used pooled datasets of two Mozambique representative population-based surveys: the 2011 and 2022–2023 Demographic and Health Surveys. A total sample of 8143 children aged 6–59 months with available hemoglobin testing was included. Multilevel mixed-effects analysis was performed using STATA (18.0). Results: Over a decade, the prevalence of anemia in children aged 6–59 months remained high, increasing slightly from 69.1% in 2011 to 72.9% in 2022. Children aged 6–11 months were less likely to have anemia than children from other age groups (aOR = 0.77, 95% CI = 0.62–0.96). Children who suffered from illnesses (aOR = 1.44, 95% CI = 1.18–1.75), received vitamin A supplements (aOR = 0.76, 95% CI = 0.63–0.93), lived in female-headed households (aOR = 1.16, 95% CI = 1.01–1.32), and who lived in households with unimproved drinking water sources (aOR = 1.40, 95% CI = 1.19–1.65) were more likely to have anemia than their peers. Overall, 16% of the variability in anemia prevalence was attributed to differences between clusters (ICC = 0.16). Conclusions: Childhood anemia remains a critical public health challenge in Mozambique, with prevalence rates exceeding the average for sub-Saharan Africa. Multisectoral approaches to enhance essential supplies’ provision and the primary healthcare monitoring of children at risk favored more investments in rural development and sustainable agriculture, water sanitation, and social care and gender-sensitive work policies that can help tackle childhood anemia. Full article