Search Results (377)

Background: Frailty is known to elevate the risk of all-cause mortality and shorten life expectancy. Although the effects of diet on health are well documented, the specific interaction between diet quality and frailty remains unexplored. This research aims to examine the combined effects of various diet quality scores and frailty on all-cause mortality and life expectancy among middle-aged and older adults. Methods: A total of 151,628 participants were sourced from the UK Biobank for analysis. Frailty phenotype (FP) and frailty index (FI), as two different approaches, were used to assess frailty status. Diet quality was evaluated through seven diet quality scores: the Alternate Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH) score, Mediterranean diet (MED) score, Dietary Inflammatory Index (DII), and three plant-based diet indices (overall PDI, healthful PDI, and unhealthful PDI). Cox proportional hazards models were applied to calculate adjusted hazard ratios (HRs) for overall mortality and predict life expectancy differences. Results: Over a median follow-up period of 12.2 years, 8231 deaths were identified. After accounting for potential confounding factors, frail individuals in the unhealthier tertile of diet scores exhibited markedly elevated mortality risks, ranging from 1.99 to 2.07 based on the frailty index and 2.79 to 3.06 based on the frailty phenotype, compared to their robust counterparts in the healthier tertile. Regardless of frailty categories, a healthier diet was associated with longer life expectancy and with lower mortality risk in a dose–response relationship. Conclusions: The healthier tertile of diet scores was found to mitigate the detrimental effects of frailty, emphasizing diet quality as a modifiable factor in promoting healthier aging. Evidence suggests that it is never too late to adopt healthier dietary habits for significant health benefits. Full article

Background: The progression of cognitive decline is accelerated in older adults with sarcopenia, but the protective dietary factors have remained uncertain. Objective: This study aims to investigate the association between dietary factors and cognitive decline in older adults, and to explore the potential mediating effects of sarcopenic components. Methods: Data from the Mr. OS and Ms. OS cohort study in Hong Kong (N = 3146, aged ≥65 years) were used. Cognitive function was assessed based on the Mini-Mental State Examination (MMSE). Sarcopenic status was assessed according to the Asian Working Group for Sarcopenia 2019 updated consensus. Dietary protein intake and adherence to dietary patterns were assessed using a food frequency questionnaire. Linear regression was used to examine the associations between dietary factors and MMSE scores. Mediation analysis was conducted to identify the possible mediators in the diet–cognition associations. Results: Sarcopenia and its components were associated with baseline MMSE and MMSE changes. Positive associations were observed for plant protein intake (β = 0.79, 95% CI 0.24–1.35) and dietary patterns such as the Dietary Approaches to Stop Hypertension (DASH) diet (β = 0.14, 95% CI 0.02–0.26) and diets with lower Dietary Inflammatory Index (DII) scores (β = −0.18, 95% CI −0.26–−0.09) with better MMSE outcomes. Protective effects were more profound in participants with sarcopenia/severe sarcopenia. The effects of the DASH diet and DII were more profound in female participants, while higher adherence to the Mediterranean–DASH Intervention for Neurodegenerative Delay (MIND) diet was associated with an increment in MMSE score in male participants with sarcopenia. Handgrip strength and physical performance are significant mediators in the diet–cognition associations. Conclusions: The protective effects of healthy dietary patterns were beneficial, especially for participants with sarcopenia, while handgrip strength and walking speed potentially mediated the associations. Full article

Background/Objectives: As the global population ages, cardiovascular disease (CVD) emerges as a critical challenge for public health, with chronic inflammation identified as a key contributing risk factor. As a modifiable lifestyle factor, diet plays a critical role in the prevention of CVD. Given the established link between diet and inflammation, clarifying the relationship between dietary inflammatory potential and cardiovascular health (CVH) is of significant public health importance. This study aimed to evaluate the association between dietary inflammatory potential and CVH in an elderly population, and to explore the related role of the gut microbiota. Methods: Dietary inflammatory potential was quantified using the Dietary Inflammatory Index (DII), CVH was assessed by the American Heart Association’s Life’s Essential 8 (LE8) score, and gut microbiome analysis was profiled by 16S rRNA gene sequencing. Results: Results showed that higher DII scores, indicative of a pro-inflammatory dietary pattern, were significantly linked to reduced LE8 scores, suggesting an inverse association between dietary inflammatory potential and CVH. Based on the gut microbiome, participants with high CVH exhibited greater α diversity compared with those with low CVH, while both α and β diversity were higher in the anti-inflammatory diet group than in the pro-inflammatory diet group. These results indicate that anti-inflammatory diets may be associated with better CVH, possibly through the preservation of the ecological balance of the gut microbiota. Correlation analyses further pointed to several genera potentially associated with both dietary inflammatory potential and CVH. Functional predictions suggested that variation in dietary inflammatory potential could be linked to differences in microbial metabolic functions relevant to energy, lipid and glucose metabolism, and inflammatory processes. Conclusions: In conclusion, this study provides novel evidence linking dietary inflammatory potential, gut microbiota, and CVH in older adults, and offers preliminary insights for dietary interventions and microbiota-targeted strategies in CVD prevention. Full article

Background/Objectives: Lipedema is a chronic adipose tissue disorder characterized by disproportionate fat accumulation and inflammation, predominantly affecting women. While recent evidence suggests a systemic pro-inflammatory state in lipedema, the role of diet in modulating inflammation remains underexplored. This study assessed the anti-inflammatory potential of a Mediterranean-style ketogenic diet and its effects after 7 months of adherence on systemic inflammation markers (CRP and IL-6) in women with lipedema (n = 24) and a control group with overweight/obesity (n = 24). Methods: The Dietary Inflammatory Index (DII) was used to characterize the inflammatory potential of the diet throughout the intervention. Dietary intake was analyzed pre- and post-intervention, and anthropometric, body composition, and biochemical parameters were measured. Results: Beyond its beneficial effects on body composition (significant reductions in body weight, fat, leg circumferences, and visceral fat), the intervention diet also demonstrated anti-inflammatory potential. In lipedema, baseline diet showed a pro-inflammatory DII profile (DII/day = 3.04), which was reduced by about 1.5 points after the intervention (p = 0.008). When expressed per 1000 kcal, the DII values were markedly lower for both baseline (DII = 0.22) and intervention diet (DII = ~0.01). Following the intervention diet, reduction in CRP (−0.39, p = 0.016) and IL-6 levels (−0.33, p = 0.034) in lipedema were observed. A significant positive association was observed between the intervention diet’s DII and CRP (r = 0.55, p = 0.005), and between the baseline diet’s DII and IL-6 (r = 0.50, p = 0.013) in lipedema group. Conclusions: These findings suggest that ketogenic diet rich in anti-inflammatory and antioxidant nutrients can reduce systemic inflammation in lipedema patients, independently of caloric restriction. Full article

Background: The primary treatment for inborn errors of metabolism (IEM) involves restricted intake of natural protein. Inadequate diets can lead to an increased risk of inflammation and susceptibility to infections. The Dietary Inflammatory Index (DII) is used to estimate whether a diet has anti-inflammatory or pro-inflammatory properties. This study aimed to investigate the relationship between the inflammatory index score of natural protein-restricted diets used in medical nutrition therapy for IEM intoxication, the anthropometric measurements and nutritional status of affected children. Method: The study included 20 patients (5 organic acidemia, 5 urea cycle disorders, 10 phenylketonuria) and 20 healthy children. Patients followed a natural protein-restricted diet, while the healthy control group maintained their usual dietary habits. Dietary records were collected for both groups, and the DII and macro-micronutrient intakes were calculated. Result: DII scores were similar between the patient and control groups. Anthropometric measurements did not differ significantly between the groups. However, carbohydrate and fat intakes were higher in the patient group compared to the control group (p < 0.05). Additionally, comparative analyses revealed that vitamin B1, C and E, iron, and magnesium intakes were higher in the patient group than in the control group. Conclusions: Children on a natural protein-restricted diet showed growth patterns comparable to their healthy peers. This study demonstrated that nutritional deficiencies can be prevented in amino acid metabolism disorders treated with a natural protein-restricted diet by carefully controlling nutrition with vitamin and mineral-fortified formulas. Full article

Hillside buildings are particularly vulnerable to earthquakes owing to their structural configuration; however, research addressing this issue remains limited. This study investigates the effectiveness of high-damping rubber bearings (HDRBs) in enhancing the seismic resilience of hillside structures. Five numerical models were analyzed using non-linear time-history (NTH) analysis, including two flat-plane structures (one isolated and one with a fixed base) and three dropped-layer structures on hillside terrain (one with base isolation, one with inter-story isolation, and one with a fixed base). Deformation history integral (DHI) modeling was employed to simulate the HDRBs. Six earthquake ground motions from the PEER database and one scaled from 0.2–0.8 g were used to assess the seismic responses of the buildings. The results indicate that HDRBs significantly improved the seismic performance. The flat-plane isolated system (FIS) model achieved a nearly 90% reduction in peak roof acceleration compared to fixed-base structures. The dropped-layer isolated system (DIS) and dropped-layer inter-story isolated system (DIIS) models exhibited reductions of approximately 80% in the peak roof acceleration. Furthermore, the isolated structures demonstrated up to 78% reduction in the maximum inter-story drift, along with significant decreases in the story shear forces and overturning moments. Compared with non-isolated dropped-layer structures, the DIS and DIIS models showed reductions of 70% and 55% in the base shear force, respectively. The results highlight the efficacy of HDRBs in energy dissipation and their significant role in enhancing the seismic resilience of mountain structures. Full article

Background/Objectives: While some dietary indices have been developed to assess diet quality and chronic disease risk, their comparative effectiveness within the same population remains unclear due to methodological limitations in observational studies. This study employs a causal inference framework to compare nine dietary indices for reducing all-cause and cardiovascular mortality, while investigating inflammatory pathways through multiple mediation analysis. Methods: Using dietary data from 33,881 adults (aged ≥ 20 years, median follow-up 92 months), we applied a causal directed acyclic graph to identify the minimum sufficient adjustment set and implemented generalized propensity score matching to address confounding. Robust Cox proportional hazards regression assessed associations between nine dietary indices—Dietary Inflammatory Index (DII), Composite Dietary Antioxidant Index (CDAI), Healthy Eating Index 2015/2020 (HEI-2015/2020), Alternate Healthy Eating Index (AHEI), Alternate Mediterranean Diet (aMED), Mediterranean Diet Index (MEDI), and Dietary Approaches to Stop Hypertension (DASH/DASHI)—and mortality outcomes. Multiple additive regression trees (MART) algorithm was used for multiple mediation analysis to examine inflammatory markers (PAR, SII, NPR, TyG, LMR, PLR, ELR, CRP) as mechanistic mediators. Results: Among 33,881 participants (mean age 47.07 years, 51.34% women), 4,230 deaths occurred, including 827 cardiovascular deaths. Under the causal inference framework, higher DII scores increased both all-cause (HR: 1.07; 95% CI: 1.02–1.12) and cardiovascular mortality risk (HR: 1.07; 95% CI: 1.04–1.10) by 7%. The aMED demonstrated the strongest protective association, reducing all-cause mortality by 12% (HR: 0.88; 95% CI: 0.80–0.97) and cardiovascular mortality by 11% (HR: 0.89; 95% CI: 0.80–0.98), followed by MEDI with similar magnitude effects. Other healthy dietary indices showed modest 1–3% risk reductions. Multiple mediation analysis revealed that inflammatory markers, particularly neutrophil-to-platelet ratio (NPR) and systemic immune-inflammation index (SII), significantly mediated diet–mortality associations across all indices, with C-reactive protein (CRP) serving as the most frequent mediator. Conclusions: Using causal inference methodology, the Mediterranean dietary pattern (aMED) shows the strongest causal association with reduced mortality risk, with inflammatory pathways serving as key mediating mechanisms. These findings provide robust evidence for prioritizing Mediterranean dietary patterns in public health interventions and clinical practice, while highlighting inflammation as a critical therapeutic target for dietary interventions aimed at reducing mortality risk. Full article

Proper management of water resources in agriculture is of utmost importance for sustainable productivity, especially under the current context of climate change. However, many smart agriculture systems, including for managing irrigation, involve costly, complex tools for most farmers, especially small/medium-scale producers, despite the availability of user-friendly and community-accessible tools supported by well-established providers (e.g., Google). Hence, this paper proposes an irrigation management system integrating low-cost Internet of Things (IoT) sensors with community-accessible cloud-based data management tools. Specifically, it resorts to sensors managed by an ESP32 development board to monitor several agroclimatic parameters and employs Google Sheets for data handling, visualization, and decision support, assisting operators in carrying out proper irrigation procedures. To ensure reproducibility for both digital experts but mainly non-technical professionals, a comprehensive set of guidelines is provided for the assembly and configuration of the proposed irrigation management system, aiming to promote a democratized dissemination of key technical knowledge within a do-it-yourself (DIY) paradigm. As part of this contribution, a market survey identified numerous e-commerce platforms that offer the required components at competitive prices, enabling the system to be affordably replicated. Furthermore, an irrigation management prototype was tested in a real production environment, consisting of a 2.4-hectare yellow kiwi orchard managed by an association of producers from July to September 2021. Significant resource reductions were achieved by using low-cost IoT devices for data acquisition and the capabilities of accessible online tools like Google Sheets. Specifically, for this study, irrigation periods were reduced by 62.50% without causing water deficits detrimental to the crops’ development. Full article

Background: The etiopathogenesis of IBD is not fully known; however, both genetic and environmental risk factors, including diet, are contributors to the disease. The present study aimed to determine the effect of dietary inflammatory potential, assessed using the Dietary Inflammatory Index (DII), on disease activity and inflammatory markers, such as IL-6, IL-1β, and IL-10, in patients with IBD. Methods: The study enrolled 90 patients with IBD. Dietary intake was assessed based on a 24 h questionnaire interview conducted in each subject three times. Based on these data, the DII for each subject was calculated. The serum levels of IL-6, IL-1 β, and IL-10 were determined with the quantitative sandwich enzyme-linked immunosorbent assay (ELISA). Results: The mean DII value was −0.39 ± 0.52 and did not differ significantly between the groups with CD and UC (−0.42 ± 0.47 vs. −0.37 ± 0.54, p = 0.6452, respectively); however, it was remarkably lower among patients in remission and with mild disease compared to those in the active phase of the disease (−0.45 ± 0.61 vs. −0.23 ± 0.65, p = 0.0217). Considering the DII tertiles, the subjects differed significantly in terms of age and disease activity. Logistic regression analysis of disease severity and DII in the crude model revealed that the probability of severe disease in IBD patients increased with higher DII scores. Conclusions: The results of the present study revealed a significant association between pro-inflammatory diet and IBD severity, which indicates a need to formulate an anti-inflammatory diet to reduce disease severity in patients with CD and UC. Full article

Background/Objectives: This study investigated the correlation of oxidative stress biomarkers with the activity of idiopathic nephrotic syndrome (INS) in Slovenian children. Methods: In this prospective study, sequential plasma and urine samples from 20 children with INS in different phases of disease activity were taken: at first disease presentation or relapse (before glucocorticoid (GC) treatment), at time of remission achievement, and after discontinuation of GC treatment. This study measured oxidative stress biomarkers, such as 8-hydroxy-2′-deoxyguanosine (8-OHdG), hexanoyl-lysine (HEL) adduct, dityrosine (DiY), and 15-isoprostane F2t, using competitive enzyme-linked immunosorbent assay (ELISA) and assessed oxidative status using the FRAS 5 analytical system, which enables rapid photometric measurement of both oxidative and antioxidant capacity from biological fluids. Two complementary tests were performed: the d-ROMs test (derivatives of reactive oxygen metabolites) and the PAT (plasma antioxidant test). The oxidative stress index (OSI) was calculated as the ratio between them. Results: Concentrations of isoprostanes in urine were statistically significantly lower in patients at first disease presentation or relapse compared to time of remission achievement. Values of PAT test in serum were significantly highest after GC treatment. Values of d-ROMs test in serum were significantly lower at time of remission achievement compared to first disease presentation or relapse. Values of 8-OHdG, HEL, DiY (in plasma and urine), isoprostanes, and OSI in plasma did not statistically significantly differ in various phases of disease activity. Conclusions: Isoprostanes in urine and PAT in serum could serve as potential biomarkers of oxidative stress and disease activity in children with INS. Full article

Background/Objectives: In hypertension (HTN), lifestyle modification is important for controlling blood pressure (BP) and lipidemic profile. The HINTreat trial showed that an anti-inflammatory diet was associated with improved endothelial function, after six months of intensive nutritional treatment. Methods: This post hoc analysis of the HINTreat trial examined how adherence to various nutritional patterns like the Mediterranean Diet (MedDiet), the Dietary Approaches to Stop Hypertension (DASH) diet, and anti-inflammatory diet, had impact on the blood lipids profile and the CVD risk. Patients with stage 1 HTN, allocated either on intensive lifestyle treatment (ILT) or usual care (UC) standard treatment, participated in the analysis. From the original sample size of the HINTreat trial, all patients that were prescribed lipid lowering medication at any time of the study period were excluded from the total analysis; thus, the intervention and the control groups consisted of 33 and 28 patients, respectively. Nutritional intakes were assessed with repeated 24 h recalls from the previous day, and dietary indexes and scores were calculated as follows: MedDiet score, DASH index, and Dietary Inflammatory Index (DII). After six months of intervention, changes in the nutritional indexes and their effect on the lipidemic profile and CVD risk were analyzed. Results: In the ILT group, reductions were noted in Ambulatory Blood Pressure Monitoring (ABPM) for day systolic BP (SBP) (−12.7 mmHg) and diastolic BP (DBP) (−8.4 mmHg), total cholesterol (TC) (−35.4 mg/dL), triglycerides (TG) (−21.4 mg/dL), LDL cholesterol (LDL-C) (−27.5 mg/dL) concentrations, and CVD risk score (−1.5%), p < 0.001 for all. Multiple regression analysis showed that dietary quality indices independently influenced improvements in blood lipid profile and cardiovascular disease (CVD) risk among patients receiving ILT. Specifically, a higher Mediterranean Diet (MedDiet) score was significantly associated with reductions in TC (B = −7.238, p < 0.001), TG (B = −4.103, p = 0.035), and LDL-C (B = −6.431, p = 0.004). The DASH index was positively associated with TG levels (B = 9.913, p = 0.010), suggesting a more complex relationship that may require further investigation. In addition, DII was positively associated with increased CVD risk (B = 0.973, p < 0.001). Conclusions: The findings suggest that ILT can improve BP levels, target blood lipids concentrations, and reduce CVD risk in patients with stage 1 HTN. Full article

Background/Objectives: Protecting students’ mental health during university is essential for their future quality of life. Therefore, diet should be emphasized as a complementary and preventive strategy in supporting and maintaining mental health. This study aimed to examine the association between dietary inflammatory and antioxidant indices and mental health indicators (depression, anxiety, stress, and well-being) in university students. Methods: This cross-sectional study included 907 university students. We collected dietary data using a 24 h recall. Based on this data, we used 33 food parameters to calculate the Dietary Inflammatory Index (DII) and 6 antioxidant nutrients to calculate the Dietary Antioxidant Index (DAI). We evaluated mental health using the Depression, Anxiety, and Stress Scales-21 (DASS-21), and assessed well-being using the World Health Organization Five Well-Being Index (WHO-5). Results: Overall, 62.4% of participants reported symptoms of depression, 56.2% anxiety, and 40.7% stress. Anxiety and stress levels were significantly higher among females compared to males (p < 0.001 and p = 0.005, respectively). In fully adjusted models, depression scores were significantly higher in the highest DII tertile compared to the lowest (B = 1.74; 95% CI: 0.24–3.26), while well-being was lower (B = −0.82; 95% CI: −1.65 to −0.00). For DAI, participants in tertile 2 had significantly lower anxiety (B = −1.38; 95% CI: −2.63 to −0.14), depression (B = −1.69; 95% CI: −3.19 to −0.19), and stress (B = −1.70; 95% CI: −3.22 to −0.18) scores compared to tertile 1. No significant association was found between DAI and well-being. Conclusions: In this study, university students’ pro-inflammatory diets were associated with poorer mental health profiles. Enhancing the diet’s anti-inflammatory potential may be a promising strategy to support mental health in this population. Full article

Background/Objectives: Recent research indicates a global transition from healthy and balanced diets to unhealthy Westernized dietary patterns (WDPs). This transition is linked to increased rates of non-communicable diseases (NCDs), e.g., obesity, type 2 diabetes, and cardiovascular diseases, often preceded by metabolic syndrome (MetS). Therefore, the objective of this study was to develop a diet quality index, termed Westernized Diet Index (WDI), to assess adherence to WDPs and its association with main cardiometabolic health issues, for which MetS and its components were chosen as representatives of NCDs. Methods: The development of the WDI was driven by a semi-systematic and comprehensive examination of the literature (n = 491 articles) that evaluated the influence of WDP components on health outcomes. The scoring algorithm involved multiple steps, assigning scores based on study design, sample size, and the direction of food effects on health outcomes. Results: The final developed index encompassed 30 food groups/items. It was revealed that soft drinks, processed foods, red meat, sodium, and hydrogenated fats had the most detrimental effects on health, significantly influencing the index’s coefficients. In contrast, dietary fiber, plant-based metabolites, vitamins, minerals, nuts/seeds, and fish had the most substantial beneficial impacts. Conclusions: The WDI aligns with the existing literature on the importance of specific food items and with other validated diet quality indices, e.g., the Dietary Inflammatory Index (DII) and Alternate Healthy Eating Index (AHEI). Thus, the WDI can provide evidence for clinicians and researchers in formulating evidence-based dietary guidelines as well as strategies for the prevention and treatment of diet-related health issues. However, further validation is proposed to verify the WDI’s capability across different contexts. Full article

To enhance the accuracy of SOC prediction in EVs, which often suffers from significant discrepancies between displayed and actual driving ranges, this study proposes a data-driven model guided by an energy consumption framework. The approach addresses the problem of inaccurate remaining range prediction, improving drivers’ travel planning and vehicle efficiency. A PCA-GA-K-Means-based driving cycle clustering method is introduced, followed by driving style feature extraction using a GMM to capture behavioral differences. A coupled library of twelve typical driving cycle style combinations is constructed to handle complex correlations among driving style, operating conditions, and range. To mitigate multicollinearity and nonlinear feature redundancies, a Pearson-DII-based feature extraction method is proposed. A stacking ensemble model, integrating Random Forest, CatBoost, XGBoost, and SVR as base models with ElasticNet as the meta model, is developed for robust prediction. Validated with real-world vehicle data across −21 °C to 39 °C and four driving cycles, the model significantly improves SOC prediction accuracy, offering a reliable solution for EV range estimation and enhancing user trust in EV technology. Full article

Background: Frailty is common in colorectal cancer (CRC) patients and is associated with poor prognosis and increased mortality. Anti-inflammatory dietary education is a promising and cost-effective strategy for frailty improvement. Methods: A prospective, assessor-blinded, two-arm randomized controlled trial was conducted to assess the effects of a 12-week dietary inflammatory index (DII)-based anti-inflammatory dietary education program on frailty in frail CRC patients. Participants in the intervention group received a DII-based anti-inflammatory dietary education, while the control group received a routine health education. Outcome measurements included the Fried frailty phenotype (FP), DII, plasma inflammatory biomarkers, body mass index (BMI), nutritional status, and quality of life (QoL), which were all assessed at baseline and post-intervention. Results: A total of 86.4% (57/66) of participants completed the follow-up. No statistically significant baseline differences were observed between groups. After the intervention, the intervention group showed significant improvements in DII (p = 0.029), BMI (p = 0.012), mini nutritional assessment (MNA) scores (p = 0.027), and QoL (p = 0.014) compared with the control group. Within-group comparisons revealed significant decreases in frailty status (p = 0.031), DII (p = 0.008), and interleukin (IL)-6 (p = 0.003), and significant increases in IL-10 (p = 0.021), MNA scores (p = 0.010), and QoL (p < 0.001) in the intervention group, with no significant changes in the control group. Conclusions: DII-based anti-inflammatory dietary education can improve the frailty, nutritional status, and QoL of frail CRC patients by modulating systemic inflammation. Given its acceptability and utility, this strategy may be incorporated into routine cancer health education. Full article