Search Results (735)

Background/Objectives: Rural communities in Guatemala face a growing double-burden of malnutrition. Women of reproductive age are a key population to address, as their health and nutritional status influence not only their own well-being but also that of their children and families. However, they often experience greater exposure to nutritional risks due to gendered inequalities in access to resources, education, and health care. This small-scale observational study aimed to describe the dietary habits and nutritional status of a sub-group of women living in a rural area of Bárcena Villa Nueva, Guatemala. Methods: An observational study was conducted between March and April 2025 among women aged ≥18 years from two rural communities. Dietary data were collected through structured interviews, 24 h dietary recall (24-hR), and a validated food frequency questionnaire (FFQ). Anthropometric and biochemical measurements were also collected. Results: A total of 22 women were included (mean age: 41.3 ± 16.3 years). The prevalence of obesity and central obesity was 45.5% and 86.0%, respectively. Quantitative dietary assessment based on the 24 h recall showed a mean energy intake approximately 35% higher than the recommended values, with a high contribution from fats and carbohydrates and an excessive sodium intake. In contrast, intakes of potassium, zinc, and folic acid were below the recommended levels. The qualitative analysis of the food frequency questionnaire indicated a dietary pattern characterized by high consumption of carbohydrates, animal-based protein sources, traditional energy-dense foods, and ultra-processed products, alongside a limited intake of vegetables and fruits. Datary diversity was low (4.9, SD: 1.1). Conclusions: This small-scale observational scale study provides a preliminary overview of dietary patterns and nutritional status among women living in a rural community in Guatemala. Although the findings are not generalizable, they suggest the coexistence of excessive energy intake, suboptimal micronutrient intake, and low dietary diversity. These results underscore the need for further research using larger and more representative samples and may help inform the development of context-specific nutrition education initiatives in similar underserved settings. Full article

Event-based sensors provide sparse, motion-centric measurements that can reduce data bandwidth and enable always-on perception on resource-constrained edge devices. This paper presents an event-based machine vision framework for smart-home AIoT that couples a Dynamic Vision Sensor (DVS) with compute-efficient algorithms for (i) human/object detection, (ii) 2D human pose estimation, (iii) hand posture recognition for human–machine interfaces. The main methodological contributions are timestamp-based, polarity-agnostic recency encoding that preserves moving-edge structure while suppressing static background, and task-specific network optimizations (architectural reduction and mixed-bit quantization) tailored to sparse event images. With a fixed downstream network, the recency encoding improves action recognition accuracy over temporal accumulation (0.908 vs. 0.896). In a 24 h indoor monitoring experiment (640 × 480), the raw DVS stream is about 30× smaller than conventional CMOS video and remains about 5× smaller after standard compression. For human detection, the optimized event processing reduces computation from 5.8 G to 81 M FLOPs and runtime from 172 ms to 15 ms (more than 11× speed-up). For pose estimation, a pruned HRNet reduces model size from 127 MB to 19 MB and inference time from 70 ms to 6 ms on an NVIDIA Titan X while maintaining a comparable accuracy (mAP from 0.95 to 0.94) on MS COCO 2017 using synthetic event streams generated by an event simulator. For hand posture recognition, a compact CNN achieves 99.19% recall and 0.0926% FAR with 14.31 ms latency on a single i5-4590 CPU core using 10-frame sequence voting. These results indicate that event-based sensing combined with lightweight inference is a practical approach to privacy-friendly, real-time perception under strict edge constraints. Full article

Background: Atrial fibrillation (AF) is common among intensive care unit (ICU) patients and is associated with increased mortality, prolonged length of stay (LOS), and greater resource utilization. Widely used AF risk scores were developed for stable outpatient populations and have limited applicability in critically ill patients. This study aimed to (1) characterize ICU patients with AF, (2) develop and temporally externally validate machine learning models to predict ICU mortality and ICU LOS, and (3) identify early clinical factors associated with these outcomes using interpretable methods. Methods: Adult ICU patients with AF from MIMIC-IV (n = 20,058) were used for model development with grouped cross-validation, and MIMIC-III (n = 11,475) served as a temporal external validation cohort. Predictors included demographics, admission characteristics, vital signs, laboratory values, vasoactive support, and AF-related medications available within the first 24 h of ICU admission. Eight classification algorithms were evaluated for ICU mortality, and six regression algorithms were evaluated for ICU LOS. Discrimination was primarily assessed using the area under the receiver operating characteristic curve (AUC) and average precision (AP), with additional threshold-dependent metrics reported to characterize operating-point behavior under low event prevalence. Probability-threshold optimization using out-of-fold predictions was applied to the primary mortality model. LOS performance was evaluated using mean absolute error (MAE), root mean squared error (RMSE), and the coefficient of determination (R²). Model interpretability was assessed using SHapley Additive exPlanations (SHAP). Results: The median age was 75 years, and ICU mortality was 8.9%. For mortality prediction, the XGBoost model demonstrated preserved discrimination on temporal external validation (MIMIC-III) (AUC = 0.743; AP = 0.226). At the default probability threshold (0.50), recall and F1 scores were low due to low event prevalence; applying a prespecified F1-optimized threshold derived from the development cohort improved sensitivity while maintaining overall discrimination. For ICU LOS, models explained little variance on temporal validation; LightGBM performed best, but the explained variance was low (MAE = 88.9 h; RMSE = 163.9 h; R² = 0.038), indicating that the first 24-h structured data provide an insufficient signal to accurately predict ICU LOS, likely due to downstream clinical and operational factors. SHAP analysis identified clinically plausible predictors of mortality and prolonged ICU stay, including reduced urine output, renal dysfunction, metabolic derangement, hypoxemia, early vasopressor use, advanced age, and admission pathways. Full article

Background/Objectives: Adherence to the EAT-Lancet Planetary Health Diet (PHD) may promote human health and environmental sustainability, yet evidence regarding adherence and nutritional adequacy in Australia is limited. Globally, no research to date has used the recently updated 2025 PHD guidelines. We benchmarked the compatibility of Australian adults’ dietary patterns with the 2025 PHD and examined its associations with nutritional adequacy and sociodemographic factors. Methods: This was a cross-sectional analysis of dietary data from 5655 adults who participated in the National Nutrition and Physical Activity Survey. Usual intakes were estimated from two 24 h recalls using the Multiple Source Method. PHD adherence was measured using the Healthy Reference Diet Score (0–130 points). Nutrient adequacy was assessed using the full probability method for iron and the Australian/New Zealand Estimated Average Requirement Cut-Point Method for all other nutrients. Survey-weighted regression models examined associations with nutritional adequacy and sociodemographic factors. Results: The mean PHD adherence score was 50 (SE 0.3) points. Higher adherence was associated with lower odds of inadequate intakes of several micronutrients, but with higher odds of inadequacy for vitamin B12 (OR: 1.24; 95% CI: 1.06, 1.45) and calcium (OR: 1.09; 95% CI: 1.01, 1.17). PHD adherence was higher among females, older adults, those with higher educational attainment, those born in countries where English is not the main language, two-person households and non-smokers; adherence was non-linearly associated with alcohol and was lower among those with a Body Mass Index ≥ 30 kg/m². Conclusions: PHD adherence in Australia was low. Higher adherence was associated with improved adequacy for several micronutrients. Trade-offs for vitamin B12 and calcium warrant consideration. Equity-conscious strategies will be needed to support the adoption of nutritionally adequate, environmentally sustainable diets. Full article

Parental perceptions of healthy eating often diverge from children’s actual diets, but this gap is poorly documented in Central Asia. We examined how parents’ priorities for key food groups relate to nutrient intakes in 390 urban children aged 1–6 years in Central Kazakhstan. In a cross-sectional study, parents completed a 24 h multiple-pass dietary recall and rated the importance of fats and sweets, meat and fish, dairy, vegetables and fruits, and bread and potatoes on 5-point scales. Nutrient intakes were calculated using software, compared with national DRIs, and analyzed using rank-based tests and Spearman correlations. Parents reported near-ceiling priority for restricting fats and sweets and consistently high priority for bread and potatoes, whereas vegetables, fruits, meat/fish, and dairy were rated moderately important, with dairy under-prioritized in 1–2-year-olds. On the recalled day, median intakes of fat, dietary fiber, vitamin C, and calcium were below national recommendations at all ages, and median intakes of iron, thiamine, and niacin were particularly low at 3–4 years, while sodium intake exceeded recommended levels; the 3–4-year group showed the most pronounced clustering of shortfalls. Prevalence estimates indicated that most children had intakes below recommendations for dietary fiber and calcium and above recommendations for sodium, underscoring population-wide nutritional imbalance. Across all scales, parental priorities showed only weak, non-significant associations with nutrient intakes (|r| < 0.11). These findings indicate a perception–intake gap and support interventions that ensure adequate fats, fiber, vitamin C, calcium, and bioavailable iron in preschool diets. Full article

Background: Ultra-processed foods (UPFs) have emerged as a critical component of diet quality, yet data on the associations between UPF and nutrient intakes remain limited. This study aimed to evaluate nutrient consumption in relation to UPF intake and adherence to international dietary guidelines for non-communicable disease (NCD) prevention. Methods: Data from 469 individuals aged 2–18 years enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were analyzed. Intakes were assessed using two 24 h recalls, and foods were classified according to the NOVA system. Participants were categorized by UPF energy intake tertiles. Nutrient adequacy was assessed using Nordic Nutrition Recommendations, European Society of Cardiology guidelines for macronutrients, and the Institute of Medicine’s Estimated Average Requirements and Adequate Intake values for micronutrients. Results: Children in the highest UPF tertile had significantly higher intakes of energy, carbohydrates, added sugars, saturated fats, polyunsaturated fats, and cholesterol, but lower intakes of protein compared to those in the lowest tertile. Fiber intake remained inadequate across all tertiles, with no significant differences. Regarding adherence to NCD prevention guidelines, children in the 3rd UPF tertile had a 2.3 times higher prevalence ratio for exceeding added sugar recommendations, while their protein intake prevalence ratio was 0.8 times lower. For micronutrients, the highest UPF tertile showed significantly elevated intakes of vitamins E, B₁, folate, calcium, iron, copper, and sodium, but lower potassium intake compared to the lowest tertile. Conclusions: Our results underscore the need for effective public health strategies to improve diet quality in children and adolescents and prevent diet-related NCDs. Full article

Background: Sepsis-associated liver injury (SALI) is a serious complication of sepsis that increases the risk of organ dysfunction and mortality; however, early identification of high-risk patients remains difficult due to nonspecific clinical features and complex pathophysiology. This study aimed to develop machine learning (ML) models to predict 28-day mortality in SALI patients within the first 24 h of intensive care unit (ICU) admission. Methods: A total of 1157 patients were included, comprising 826 from the MIMIC-IV (v2.2) database, 225 from MIMIC-III (v1.4), and 106 from eICU (v2.0). Data from MIMIC-IV were split into training and internal validation sets (7:3), while MIMIC-III and eICU served as external validation cohorts. Thirty clinically relevant features were selected. Eight ML models were evaluated using AUROC, accuracy, precision, recall, F1-score, and specificity. SHapley Additive exPlanations (SHAP) and Local Interpretable Model-Agnostic Explanations (LIME) enhanced interpretability. Results: XGBoost model achieved the best performance, with an AUROC of 0.8556 (95% CI: 0.807–0.898), accuracy of 0.7702, recall of 0.8469, and specificity of 0.7200. SHAP identified lactate, blood urea nitrogen, heart rate, hemoglobin, and diastolic blood pressure as key predictors, while LIME provided patient-level interpretability. Conclusions: The XGBoost-based model may facilitate early mortality risk stratification and support clinical decision-making for SALI patients in ICU settings. Full article

Objective: This study aims to investigate the dietary assessment and trends of preschoolers aged 3 to 5 years in Korea from 2012 to 2021 and to provide basic data for early childhood dietary education and policy development. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2012 to 2021 were analyzed for 2510 children in the 3–5 age group. Dietary intake was assessed using a 24 h recall. Intakes of food groups, dishes, and nutrients were calculated, and trends across years were tested using generalized linear models adjusted for gender, age, household income, energy intake, mother’s age, and mother’s education. Results: Over the tenyear period, intakes of carbohydrates, phosphorus, iron, sodium, potassium, carotene, thiamine, niacin, and vitamin C, as well as the carbohydrate energy ratio, showed significant declines. Meanwhile, protein, fat, retinol, and riboflavin increased, as did the protein and fat energy ratios. Fruit intake decreased by approximately 42 g among food group intakes. Analysis of foods contributing to total food intake revealed that milk, white rice, apples, and eggs consistently accounted for a high proportion of total intake in all survey years. Average calcium intake was approximately 100 mg below the estimated average requirement. Conclusions: The results of this study showed that preschoolers exhibit insufficient intake of certain nutrients, such as calcium, and a decrease in fruit intake. Interventions are needed to establish regular meal patterns, promote plant food intake such as fruit, and improve calcium intake. These results provide valuable evidence for designing dietary education programs and dietary guidelines tailored to early childhood. Full article

Beverages, particularly sugar-sweetened beverages (SSBs), pose a significant public health concern globally. Changing eating habits among Pakistani young adults have led to higher sugary drink consumption, underscoring the need for a suitable cultural assessment tool. A cross-sectional study was conducted among 381 university students aged 18–26 years from three major cities of Pakistan. Following World Health Organization (WHO) guidelines, the original Beverage Intake Questionnaire (BEVQ-15) was modified by removing four items (including alcoholic beverages), adding two culturally relevant types (flavored milk and refreshing drinks), and converting measurement units to milliliters, resulting in a 13-item Beverage Intake Questionnaire-Pakistan (BEVQ-PK). Validity was assessed by comparing BEVQ-PK1 (test) with three 24 h dietary recalls. Test–retest reliability was evaluated after a 14-day interval by comparing BEVQ-PK1 (test) and BEVQ-PK2 (retest). Analyses included descriptive statistics, paired sample t-tests, Intraclass Correlation Coefficients (ICC), Bland–Altman plots, and Spearman’s correlations. The BEVQ-PK (13-item) demonstrated moderate to strong validity (r = 0.2–0.8, p < 0.001) and strong reliability (r = 0.5–0.9, p < 0.001). Most beverage categories showed no significant intake differences between test and retest. Tea/coffee with milk was the most frequently consumed beverage, followed by soft drinks and green/black tea. Overall, BEVQ-PK is a valid and reliable tool for assessing SSB intake among Pakistani university students and can support future nutrition and public health research. Full article

Background/Objectives: This cross-sectional study aimed to evaluate the relationship between nutritional intake (energy, protein, calcium, number of meals, number of dairy products) and other factors (physical activity, past fractures, body composition) with forearm bone parameters in adolescent boys with myelomeningocele (MMC). Methods: This study included 63 boys with MMC aged 11.9 ± 1.8 years, 30 active boys with MMC and 33 inactive boys with MMC. Bone mineral density (BMD) and bone mineral content (BMC) in the distal (dis) and proximal (prox) parts of the forearm were measured by densitometry. Diet was assessed using an FFQ and 24 h dietary recalls. Energy, protein, and calcium intake were calculated using the Diet 6.0 software. Data were collected on past fractures and physical activity (PA min/day). Results: The active MMC group, compared to the inactive group, had significantly higher BMD dis and prox, BMC dis, and Z-scores (Hedges’ g: medium effect). Significant relationships between BMD dis were demonstrated with the number of dairy products (n/day) (F = 6.66; η² = 0.116) and protein intake (g/day) (F = 15.27; η² = 0.230). BMC dis was affected only by PA (min/day) (F = 9.80; η² = 0.161). The parameters affecting BMD prox were the number of dairy products (n/day) (F = 9.95; η² = 0.163) and protein (g/day) (F = 12.95; η² = 0.202). BMC prox was affected only by PA (min/day) (F = 4.39; η² = 0.079). Conclusions: Overall, bone health in boys with MMC appears to be primarily influenced by nutritional factors—particularly dairy intake and protein—as well as by physical activity. These results underscore the need for early nutritional screening and further research on additional bone-related dietary components to optimize nutritional recommendations for this population. Full article

Background: Vietnam is undergoing a rapid nutrition transition, yet evidence on nutrient intake and inadequacy among adolescents and young adults remains limited. This study aimed to assess nutrient intakes and patterns of inadequacy among Vietnamese youth aged 16–25 years across population groups and regions. Methods: A cross-sectional study was conducted among 1005 participants from five provinces in northern, central, and southern Vietnam. Dietary intake was assessed using a two-stage 24 h recall, and nutrient inadequacy was evaluated using Estimated Average Requirement (EAR), Acceptable Macronutrient Distribution Range (AMDR), and Estimated Energy Requirement (EER) reference standards. Results: Energy and macronutrient intakes differed across groups. University students had the lowest energy intake, while young workers consumed the highest proportion of carbohydrates. Calcium inadequacy exceeded 95% in all subgroups. Regional disparities were observed, with lower intakes of several micronutrients in the South. Compared with high school students, university students showed higher risks of inadequate protein and vitamin A intake, whereas young workers exhibited lower risks of inadequate carbohydrate and folate intake but a higher risk of vitamin A inadequacy. Conclusions: Vietnamese youth exhibited substantial micronutrient inadequacies with marked variation across groups and regions. These findings underscore the need for targeted nutrition interventions tailored to specific youth contexts. Full article

Background/Objectives: With the increasing global concern about diet-related diseases associated with the consumption of ultra-processed foods (UPFs), there is an urgent need for practical and standardized tools to evaluate and monitor UPF intake. This study aimed to adapt and validate the Nova-UPF screener, a brief, food-based questionnaire originally developed in Brazil, for use among Portuguese adults. Methods: The adaptation process relied on data from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015–2016) and was refined using the DELPHI methodology. A validation study was carried out with a convenience sample of 304 adults through an electronic questionnaire. Dietary intake was evaluated using a 24 h dietary recall. Criterion validity was assessed by examining the relationship between the Nova-UPF score and the percentage of total energy intake (TEI) from UPFs, while construct validity was evaluated based on predefined hypotheses. Agreement between quintiles of Nova-UPF score and quintiles of UPF contribution to TEI was tested using the prevalence and bias-adjusted kappa (PABAK) index. Results: The final Portuguese version of the Nova-UPF screener includes 25 subgroups. The Nova-UPF score was positively associated with the percentage of UPF contribution to TEI (B = 6.224, p < 0.001). Participants in the highest quintiles of the Nova-UPF score had higher TEI but lower consumption of monounsaturated and polyunsaturated fats, potassium, and dietary fibre. There was a near-perfect agreement between quintile classifications of UPF and Nova-UPF score (PABAK = 0.86). Conclusions: The Portuguese Nova-UPF screener is a valid, simple, and quick tool for evaluating UPF consumption and dietary quality in adults. Full article

Background/Objectives: The Fourth Italian National Food Consumption Survey (IV SCAI 2017–2020) provides updated and comprehensive data on the dietary habits of the Italian population. The study aimed to assess nutrient intakes and their main food sources among individuals aged 3 months to 74 years and to evaluate the adequacy of intakes against the Italian dietary reference values (DRVs). Methods: A nationally representative sample of 1969 participants were surveyed using two non-consecutive food diaries (ages 3 months–9 years) and 24 h recalls (ages 10–74 years) in accordance with the European Food Safety Authority’s EU Menu guideline. The multiple source method was used to estimate the usual intakes accounted for intra-individual variability. Nutrient adequacy was assessed against age- and sex-specific DRVs, and the main food sources of macro- and micronutrients were identified. Results: Energy intake was below DRVs for adults, particularly women, while protein intake exceeded recommendations across all ages, mainly from animal sources (67% of total). Total fat (38%En) and saturated fat (12%En) exceeded the recommendations, whereas carbohydrates (45%En) and dietary fibre were suboptimal. Vitamin D and calcium intake were markedly below DRVs for all age groups; iron inadequacy was prevalent among females. The main energy sources were cereals (39%), milk and dairy (15%), oils and fats (13%), and meat (10%). Vegetables and fruits were leading contributors to vitamins A and C, while meat, fish, and dairy provided vitamin B12 and D. Conclusions: The Italian diet remains cereal-based but shows nutritional imbalances: notably, excessive protein and fat intake and widespread deficiencies in vitamin D, calcium, iron, and fibre. These findings underline the need for targeted nutrition policies to realign dietary patterns with the national recommendations. Full article

Background: Adequate nutrition in long-term care (LTC) settings is critical for the health and well-being of institutionalised older adults, yet global evidence consistently reveals significant gaps in dietary provision. Methods: We conducted a systematic review of observational studies published between January 2004 and December 2024 in PubMed and Scopus, following PRISMA 2020 and JBI guidelines. The review assessed whether planned menus and residents’ actual intake met recognised dietary reference values, described dietary assessment methods, and identified common nutrient shortfalls. Results: 34 observational studies from 16 countries were included. The most frequently used assessment methods were weighed food records (50.0%), menu analyses (29.4%), and 24 h recalls or food diaries (20.6%). Among the 25 studies reporting mean daily energy intake, 68.0% documented values between 1250 and 1800 kcal/day, and 73.5% indicated intakes below established reference values. Additionally, 11 studies (32.4%) found that residents consumed less than 75% of the energy planned in menus. Protein intake was below 60 g/day or 0.83 g/kg body weight/day in 41.2% of studies. Across 22 studies assessing micronutrients, recurrent inadequacies included vitamin D (61.8%), calcium (55.9%), folate (50.0%), zinc (41.2%), and fibre (47.1%). In studies quantifying planned–served–consumed stages, actual intake represented approximately 64.0–87.0% of planned energy and protein. Conclusions: Nutrition in LTC settings frequently falls short of meeting the energy and nutrient requirements of institutionalised older adults. Persistent inadequacies in energy, protein, and key micronutrients were observed across studies, alongside substantial variability in dietary assessment methods and reference frameworks, limiting comparability of findings. Full article

Obesity is a significant global health challenge, with prevalence rising steadily worldwide. Effective management often involves bariatric surgery, such as sleeve gastrectomy (SG), which has proven effective in reducing weight and improving comorbid conditions. This study aimed to evaluate nutritional status and protein source awareness and its impact on muscle mass among patients post SG surgery in Saudi Arabia. A cross-sectional study was conducted among 98 adults (aged 18–51 years) who underwent SG at the Department of Metabolic and Bariatric Surgery (Badana Clinic)/Mouwasat Hospital in Dammam from December 2023 to February 2024. Data were collected using an electronic questionnaire that covered demographics, dietary habits, physical activity, protein knowledge (from food and supplements), and a 24 h dietary recall. Body composition, including muscle mass, was assessed using the InBody270 Body Composition Analyzer. The results revealed that participants exhibited a high level of awareness regarding the importance of protein sources. However, muscle mass decreased by an average of 4.11 kg after surgery. This decline was attributed to insufficient protein intake, which ranged between 30 and 60 g per day, below recommended levels. Taste aversion and dietary limitations post-surgery contributed to this inadequate protein consumption. In conclusion, while participants understood the significance of protein for muscle maintenance, practical challenges in achieving adequate protein sources led to muscle mass loss. These findings underscore the importance of tailored nutritional strategies and education to optimize recovery and long-term health outcomes for SG surgery patients. Full article