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14 pages, 258 KB  
Article
Dietary Patterns and Depressive Symptom Severity in the Hungarian Adult Population: Evidence from a Nationally Representative Survey
by Battamir Ulambayar and Attila Csaba Nagy
Nutrients 2026, 18(1), 159; https://doi.org/10.3390/nu18010159 - 3 Jan 2026
Viewed by 207
Abstract
Background: Depression represents a major public health burden in Hungary, where prevalence remains higher than the global average. Although diet is an increasingly studied factor associated with mental health, evidence from Central and Eastern Europe is scarce. Methods: This cross-sectional study analyzed data [...] Read more.
Background: Depression represents a major public health burden in Hungary, where prevalence remains higher than the global average. Although diet is an increasingly studied factor associated with mental health, evidence from Central and Eastern Europe is scarce. Methods: This cross-sectional study analyzed data from the Hungarian wave of the European Health Interview Survey (EHIS) 2019, a nationally representative sample of 5603 adults aged ≥15 years. Depressive symptom severity was assessed using the Patient Health Questionnaire-8 (PHQ-8) and categorized as none (0–4), mild (5–9), and moderate-to-severe (≥10). Self-reported frequency of consumption of fruits, vegetables, fruit juice, dairy products, fish, processed meat, sweetened beverages, coffee, and sweeteners was examined. Multivariable ordinal logistic regression models, adjusted for gender, age, education, income, physical activity, smoking, and alcohol consumption, were used to estimate associations with depressive symptom severity. Results: Overall, 77.9% of participants had no depression, 17.0% mild, and 5.1% moderate-to-severe symptoms. After full adjustment, lower consumption of fruits and vegetables, less frequent fruit juice intake, and lower processed meat consumption were associated with higher odds of more severe depressive symptoms. Moderate coffee intake (1–2 cups/day) was associated with lower odds than heavier consumption. Conclusions: In the Hungarian adult population, poorer dietary patterns, particularly low intake of fruits, vegetables, and paradoxically lower processed meat consumption, are significantly associated with greater depressive symptom severity, independent of major sociodemographic and lifestyle factors. These findings underscore the potential role of diet quality in mental health and support public health efforts to promote nutrient-rich dietary patterns in Hungary. Full article
(This article belongs to the Special Issue Lifestyle, Dietary Surveys, Nutrition Policy and Human Health)
17 pages, 1054 KB  
Article
Food Intake and Physical Activity Patterns Among University Undergraduate Students at Risk of Eating Disorders
by Maria Antònia Amengual-Llofriu, Antoni Aguiló and Pedro Tauler
Nutrients 2026, 18(1), 155; https://doi.org/10.3390/nu18010155 - 2 Jan 2026
Viewed by 238
Abstract
Background/Objectives: University students are particularly vulnerable to unhealthy eating patterns and body image dissatisfaction. The association between lifestyle factors and eating disorders (EDs) can be ambiguous as healthier lifestyle choices may paradoxically be related to ED risk. In this study, we aimed [...] Read more.
Background/Objectives: University students are particularly vulnerable to unhealthy eating patterns and body image dissatisfaction. The association between lifestyle factors and eating disorders (EDs) can be ambiguous as healthier lifestyle choices may paradoxically be related to ED risk. In this study, we aimed to analyze physical activity (PA) and dietary patterns—specifically food type and diet quality—as lifestyle indicators in university students with and without ED risk. Motivations for engaging in PA and the association between PA levels and diet quality were also examined. Methods: A descriptive cross-sectional study was conducted on a convenience sample of 1982 undergraduate students aged 18–30 years from the University of the Balearic Islands. Dietary intake, diet quality, PA levels, and motivations were self-reported using a questionnaire. Results: Students at risk of EDs reported higher diet quality, including greater adherence to the Mediterranean diet (p < 0.001) and more adequate consumption of fruits (p < 0.001), vegetables (p < 0.001), and red and processed meat (p < 0.001). Regarding PA, participants with ED risk engaged in more weekly PA sessions (p < 0.001) and accumulated a longer total weekly duration (p = 0.019), with physical appearance being the main motivation. In participants without ED risk, PA levels were positively associated with adherence to the Mediterranean diet (p < 0.001); however, no such association was observed in participants with ED risk (p = 0.538). Conclusions: Students at risk for EDs exhibited comparatively healthier diet and PA patterns, seemingly driven by concerns related to body image and an aversion to energy-dense foods. Therefore, apparent health behaviors should not be used to rule out ED risk. Full article
(This article belongs to the Section Nutrition and Public Health)
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16 pages, 743 KB  
Article
Emotional and Uncontrolled Eating Mediate the Well-Being–Adiposity Relationship in Women but Not in Men
by Maria Diez-Hernández, Isabella Parilli-Moser, María Fernanda Zerón-Rugerio and Maria Izquierdo-Pulido
Nutrients 2026, 18(1), 111; https://doi.org/10.3390/nu18010111 - 29 Dec 2025
Viewed by 397
Abstract
Background/Objectives: Sex and gender influence dietary habits, eating behaviors, mental health, and obesity risk. Women exhibit a higher prevalence of emotional eating and mental health problems, which may contribute to sex-specific differences in adiposity. This study aimed to explore the associations between [...] Read more.
Background/Objectives: Sex and gender influence dietary habits, eating behaviors, mental health, and obesity risk. Women exhibit a higher prevalence of emotional eating and mental health problems, which may contribute to sex-specific differences in adiposity. This study aimed to explore the associations between adiposity, diet quality, eating behaviors, mental health, and well-being, and to examine whether eating behaviors mediate the relationship between mental health and adiposity, stratified by sex. Methods: One hundred twenty-three adults (35.6 ± 7.9 years; 63.4% women) with overweight and obesity participated in this cross-sectional study. Adiposity parameters (BMI, body fat, waist and hip circumferences), biochemical parameters, eating behaviors (Three-Factor Eating Questionnaire-R21), well-being (WHO-5), perceived stress (Perceived Stress Scale), diet quality (17-item MedDiet questionnaire), and physical activity (International Physical Activity Questionnaire) were evaluated. Linear regression and path analyses were used to examine associations and mediation effects. Results: Women reported higher emotional eating and cognitive restraint scores (p = 0.017 and p = 0.034, respectively) and greater adherence to the Mediterranean diet (p < 0.001) than men. In men, well-being was positively associated with diet quality, while higher stress, cognitive restraint, and poorer diet quality were linked to greater adiposity. In women, well-being and diet quality were inversely associated with adiposity, while emotional and uncontrolled eating were related to higher adiposity and poorer biochemical markers. Emotional and uncontrolled eating mediated the relationship between well-being and adiposity only in women. Conclusions: Our results underscore the importance of incorporating sex- and gender-sensitive approaches in obesity prevention and treatment. For women, interventions should focus on emotional regulation and coping strategies, whereas for men, improving diet quality may be more effective. Full article
(This article belongs to the Special Issue Eating Behaviors and Lifestyle in Body Weight and Health)
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16 pages, 321 KB  
Article
Adaptation and Validation of the Nova-UPF Screener for the Assessment of Ultra-Processed Food Intake in Portuguese Adults
by Sandra Abreu, Caroline dos Santos Costa and Margarida Liz Martins
Nutrients 2026, 18(1), 90; https://doi.org/10.3390/nu18010090 - 27 Dec 2025
Viewed by 374
Abstract
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 [...] Read more.
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
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11 pages, 428 KB  
Article
Dihomo-γ-Linolenic Acid Elevation with Desaturase Imbalance in Metabolic Dysfunction-Associated Steatotic Liver Disease in a Japanese Health Checkups Cohort: HOZUGAWA Study, a Multi-Omic, Diet Adjusted Analysis
by Sayaka Kawai, Hiroshi Okada, Hideto Okamoto, Ren Yashiki, Megumi Minamida, Natsuko Shinagawa, Takahiro Ichikawa, Shinta Yamamoto, Noriyuki Kitagawa, Yoshitaka Hashimoto, Ryoichi Sasano, Kunimasa Yagi, Masahide Hamaguchi and Michiaki Fukui
Nutrients 2026, 18(1), 57; https://doi.org/10.3390/nu18010057 - 23 Dec 2025
Viewed by 329
Abstract
Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to dietary fat quality and polyunsaturated fatty-acid metabolism. We evaluated whether dietary n-6 fatty-acid intake, serum dihomo-γ-linolenic acid (DGLA), and desaturase-based indices for Δ5-desaturase (D5D) and Δ6-desaturase (D6D) are associated with MASLD. [...] Read more.
Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to dietary fat quality and polyunsaturated fatty-acid metabolism. We evaluated whether dietary n-6 fatty-acid intake, serum dihomo-γ-linolenic acid (DGLA), and desaturase-based indices for Δ5-desaturase (D5D) and Δ6-desaturase (D6D) are associated with MASLD. Methods: We conducted a cross-sectional analysis within the HOZUGAWA health checkup cohort in Japan (n = 289; 100 MASLD, 189 non-MASLD). Participants underwent hepatic ultrasonography, dietary assessment using the Brief Self-Administered Diet History Questionnaire, and fasting serum metabolomics by gas chromatography–mass spectrometry with solid-phase dehydration derivatization. Enzyme indices were defined as the D5D index = arachidonic acid/DGLA and the D6D proxy index = DGLA/linoleic acid (hereafter referred to as the D6D index) because γ-linolenic acid was not measured. Natural-log-transformed D5D index, D6D index, DGLA, and total dietary n-6 fatty-acid intake were entered into multivariable logistic regression models for MASLD adjusted for age, sex, BMI, alcohol intake, and total energy. Results: Compared with non-MASLD, MASLD showed higher serum DGLA, lower D5D index, and higher D6D index (all p ≤ 0.005), with no between-group differences in total energy intake, linoleic acid, total polyunsaturated fatty acids, or total dietary n-6 fatty-acid intake. Higher ln D5D was independently associated with lower odds of MASLD (OR 0.62, 95% CI 0.42–0.86), whereas higher ln D6D index (OR 1.42, 95% CI 1.04–1.95) and ln DGLA (OR 1.62, 95% CI 1.13–2.43) were each positively associated. Total dietary n-6 fatty-acid intake was not independently associated with MASLD. Conclusions: In this Japanese health examination cohort, an imbalance in estimated desaturase activities—lower D5D index and higher D6D index—together with higher serum DGLA was independently associated with MASLD, whereas n-6 intake showed no group difference or independent association. These findings suggest that enzyme-linked endogenous n-6 metabolic status may be more closely related to the MASLD phenotype than intake quantity alone. Full article
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14 pages, 278 KB  
Article
Polyphenol Consumption and Its Association with Physical and Mental Health in Adults with Major Depressive Disorder
by Joanna Rog, Paulina Pawlikowska, Małgorzata Futyma-Jędrzejewska, Paulina Wróbel-Knybel, Ryszard Maciejewski, Kinga Kulczycka and Hanna Karakula-Juchnowicz
Nutrients 2026, 18(1), 47; https://doi.org/10.3390/nu18010047 - 22 Dec 2025
Viewed by 425
Abstract
Background/Objectives: Research confirms that diet can influence the onset or course of depression. Polyphenols are bioactive plant compounds with proven beneficial effects on health. The aim of this study was to assess the relationship between polyphenol intake and the health status of [...] Read more.
Background/Objectives: Research confirms that diet can influence the onset or course of depression. Polyphenols are bioactive plant compounds with proven beneficial effects on health. The aim of this study was to assess the relationship between polyphenol intake and the health status of individuals with major depressive disorder (MDD). Methods: The study included 44 participants. Health status was assessed using questionnaires adapted into Polish, body composition analysis, and laboratory blood tests. Polyphenol intake was estimated using the Phenol-Explorer program. Results: Among men, polyphenol intake was positively associated with glycated hemoglobin levels (R = 0.70; p = 0.038). Lower polyphenol intake in women was associated with poorer physical health (p = 0.014) and overall quality of life (p = 0.013). Polyphenol intake enhanced the effects of visceral fat content, muscle mass, severity of depressive symptoms (positive), and severity of stress symptoms (negative) on triglyceride levels. Polyphenol intake was positively associated with LDL cholesterol levels, and this relationship was attenuated by body water and fat content. Polyphenol intake weakened the relationship between fat content (negative) and quality of life (positive) with cortisol levels (R2 = 0.61; p < 0.001). Conclusions: Polyphenols act both directly and mediate the effects of other factors on the health status of individuals with MDD. Despite their proven beneficial effects, further research is needed to explore their potential impact and mechanisms of action in patients with MDD. Full article
(This article belongs to the Special Issue Phytonutrients in Diseases of Affluence)
22 pages, 5154 KB  
Article
Application of the China Diet Balance Index (DBI-2022) in a Region with a High-Quality Dietary Pattern and Its Association with Hypertension: A Cross-Sectional Study in the Lingnan Population
by Weihua Dong, Jian Wen, Xiaona Zhang, Weiyi Gong, Ping Gan, Panpan Huang, Jiaqi Li, Rongzhen Li, Pengkun Song and Gangqiang Ding
Nutrients 2026, 18(1), 43; https://doi.org/10.3390/nu18010043 - 22 Dec 2025
Viewed by 508
Abstract
Background: The China Diet Balance Index 2022 (DBI-2022), released in 2024, is the latest dietary quality assessment tool developed in alignment with the updated Dietary Guidelines for Chinese Residents (2022). However, its association with hypertension in the Lingnan region—a geographic area distinguished by [...] Read more.
Background: The China Diet Balance Index 2022 (DBI-2022), released in 2024, is the latest dietary quality assessment tool developed in alignment with the updated Dietary Guidelines for Chinese Residents (2022). However, its association with hypertension in the Lingnan region—a geographic area distinguished by a unique dietary culture—has not been fully examined. Objective: This study aimed to systematically evaluate the dietary quality of Lingnan residents using DBI-2022 and explore its association with hypertension. Methods: We analyzed cross-sectional data from the 2015 China Adults Chronic Diseases and Nutrition Surveillance, focusing on 2982 Lingnan residents aged 45 years and older. Dietary information was collected via 3 consecutive days of 24-h dietary recalls and food frequency questionnaires, supplemented by standardized anthropometric measurements. We assessed the contribution of specific dietary components to overall quality and investigated the association between DBI-2022 indices and hypertension using multivariable regression models. Results: Among the 2982 participants, 821 (27.5%) were identified with hypertension. The primary dietary imbalances in the Lingnan population were characterized by moderate insufficient consumption (Low Bound Score [LBS] = 40.48) and moderate excessive intake (High Bound Score [HBS] = 22.58), with insufficient intake being the more prominent concern. Cereals, cooking oils, and salt emerged as key contributors to poor dietary quality, whereas soybeans, fruits, adequate water consumption, and dietary diversity were associated with better dietary quality. After adjusting for potential confounders, participants in the highest quartile of Diet Quality Distance (DQD) had significantly higher odds of hypertension (OR = 1.57, 95% CI: 1.05–2.35) compared to those in the lowest quartile. Similarly, the odds were elevated for those with high LBS (OR = 1.88, 95% CI: 1.24–2.87). Conclusions: Dietary insufficiency appears to be a more critical issue than excessive consumption among the Lingnan population. Poor dietary quality, particularly insufficient intake of protective foods, is significantly associated with elevated odds of hypertension. These findings support the applicability of DBI-2022 for regional dietary surveillance and highlight key priorities for targeted nutritional intervention strategies. Full article
(This article belongs to the Section Nutrition and Public Health)
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19 pages, 1164 KB  
Article
Investigating Chronic Toxicity, Diet, Patient-Reported Outcomes and the Microbiome in Immunotherapy-Treated Metastatic Melanoma Survivors: A New Frontier
by Margaux Robert, Satabdi Saha, Nazli Dizman, Michelle Rohlfs, Elizabeth Sirmans, Julie Simon, Rodabe N. Amaria, Isabella C. Glitza Oliva, Hussein A. Tawbi, Michael A. Davies, Alexandra Ikeguchi, Karen Basen-Engquist, Keri Schadler, Michael E. Roth, Wenye Song, Xiaotao Zhang, Nadim J. Ajami, Lorenzo Cohen, Jennifer A. Wargo, Christine B. Peterson, Jennifer L. McQuade and Carrie R. Danieladd Show full author list remove Hide full author list
Nutrients 2026, 18(1), 40; https://doi.org/10.3390/nu18010040 - 22 Dec 2025
Viewed by 485
Abstract
Background/Objectives: Immune checkpoint blockade (ICB) therapies have significantly improved outcomes in metastatic melanoma. However, immune-related adverse events (irAEs) and persistent chronic toxicities (CTs) among this emerging survivor population likely influence different facets of quality of life. This study characterized CT, patient-reported outcomes [...] Read more.
Background/Objectives: Immune checkpoint blockade (ICB) therapies have significantly improved outcomes in metastatic melanoma. However, immune-related adverse events (irAEs) and persistent chronic toxicities (CTs) among this emerging survivor population likely influence different facets of quality of life. This study characterized CT, patient-reported outcomes (PROs), diet, physical activity and gut microbiome features in a cohort of long-term survivors with a history of ICB-treated metastatic melanoma. Methods: Forty-eight patients with a history of metastatic melanoma who initiated ICB treatment at least 3 years earlier and were not currently on treatment were prospectively enrolled from a melanoma survivorship clinic. Participants completed screening questionnaires for depression, anxiety, diet and physical activity. The gut microbiome was characterized via metagenomic sequencing in a subsample (n = 39). Patients’ clinicopathological characteristics and experience of irAEs (during treatment) and CT (persisting >6 months after completion of therapy) were extracted retrospectively from the medical record. Results: In the overall cohort, 60% were experiencing CT, while 16% and 20% reported clinically relevant levels of depression and anxiety symptoms, respectively. We observed significant differences in overall gut microbiome composition between survivors with and without CT (p = 0.02). Consumption of fruit and vegetables was inversely associated with anxiety (ρ = 0.3, p = 0.038). Added sugar consumption was correlated with the severity of experienced symptoms (ρ = 0.4, p = 0.003), with pronounced associations across the spectrum of symptoms, including pain, fatigue and shortness of breath (p < 0.05). Conclusions: These results suggest that CT is experienced by a substantial proportion of ICB-treated metastatic melanoma survivors. Patients experiencing CT also showed distinct microbiome features. However, additional research in prospective settings is needed to confirm these hypotheses. Full article
(This article belongs to the Section Clinical Nutrition)
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21 pages, 1413 KB  
Article
Sex Moderates the Mediating Effect of Physical Activity in the Relationship Between Dietary Habits and Sleep Quality in University Students
by Jarosław Domaradzki
Nutrients 2026, 18(1), 26; https://doi.org/10.3390/nu18010026 - 20 Dec 2025
Viewed by 528
Abstract
Background/Objectives: Diet and physical activity are key lifestyle behaviours associated with sleep quality, yet their combined and sex-specific associations remain insufficiently understood. This study examined the associations between dietary behaviours and sleep quality among university students and assessed whether physical activity formed [...] Read more.
Background/Objectives: Diet and physical activity are key lifestyle behaviours associated with sleep quality, yet their combined and sex-specific associations remain insufficiently understood. This study examined the associations between dietary behaviours and sleep quality among university students and assessed whether physical activity formed part of an indirect statistical association between these variables, with sex considered as a moderator. Methods: A cross-sectional study was conducted among 418 students (199 males, 219 females) from the Wroclaw University of Health and Sport Sciences. Body height and body mass were measured using standard anthropometric procedures. Sleep quality (SQ) was registered with the Pittsburgh Sleep Quality Index (PSQI), dietary habits were assessed with the Questionnaire of Eating Behaviours (QEB) and physical activity (PA) was assessed with the International Physical Activity Questionnaire (IPAQ). Data-driven feature-selection methods were applied to identify dietary behaviours associated with sleep quality, which were combined into a Synthetic Dietary Behaviour Index (SDBI). A moderated mediation model, adjusted for body mass index (BMI), was then used to examine the statistical associations between dietary behaviours, physical activity, sleep quality, and sex. Sleep quality was modelled as a continuous PSQI score in mediation analyses, while the dichotomised PSQI category was used only for feature selection. Results: Machine-learning feature selection identified nine dietary behaviours statistically associated with sleep quality. Unfavourable behaviours—fast food, fried meals, sweetened beverages, energy drinks and alcohol—were linked to poorer sleep, whereas vegetables, curd cheese and wholegrain bread were associated with better sleep. Poor sleep was more prevalent among females (45.2% vs. 14.6%, χ2 (1) = 65.4, p < 0.001). The mediation model indicated that physical activity formed part of a statistically significant but modest indirect association between dietary behaviour and sleep quality, with sex moderating the IPAQ → PSQI path (β = −0.45, p = 0.006). Indirect associations were significant for both sexes but stronger among females (males: β = 0.032, p = 0.021; females: β = 0.102, p = 0.004). Conclusions: Unfavourable dietary patterns and lower physical activity were statistically associated with poorer sleep quality, with a stronger indirect statistical effect observed among females. These findings support the relevance of integrated, sex-sensitive lifestyle approaches addressing both dietary behaviours and physical activity, while acknowledging the cross-sectional nature of the data. Full article
(This article belongs to the Section Nutritional Epidemiology)
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15 pages, 277 KB  
Article
Adherence to the Mediterranean Diet and Sustainable Nutrition: The Role of Nutrition Literacy Across Generations
by Çağla Pınarlı Falakacılar, Merve Terzi and Merve Özvar Kütük
Sustainability 2026, 18(1), 61; https://doi.org/10.3390/su18010061 - 20 Dec 2025
Viewed by 402
Abstract
Background: Sustainable diets, particularly the Mediterranean diet, are associated with improved human and planetary health. Nutrition literacy influences food choices, yet intergenerational differences in literacy and adherence to sustainable diets remain underexplored. This study examined the relationship between nutrition literacy, adherence to [...] Read more.
Background: Sustainable diets, particularly the Mediterranean diet, are associated with improved human and planetary health. Nutrition literacy influences food choices, yet intergenerational differences in literacy and adherence to sustainable diets remain underexplored. This study examined the relationship between nutrition literacy, adherence to the Mediterranean diet, and sustainable nutrition behaviors among Generation X, Y, and Z adults living in Istanbul. Methods: A cross-sectional online survey was conducted among adults aged 18–60 years. Data were collected through a demographic questionnaire, the E-Healthy Nutrition Literacy Scale, and the Short Questionnaire for Mediterranean Diet Adherence and Sustainable Nutrition. Parametric statistical analyses were performed. Results: Among 1395 participants, adherence to the Mediterranean diet did not significantly differ by generation or gender (p > 0.05). Participants with prior nutrition education were significantly more likely to achieve high nutrition literacy scores and adhere to sustainable eating practices. Adherence to sustainable nutrition increased across generations, with Generation Z exhibiting the highest proportion of low adherence (53%), while Generations Y and X demonstrated progressively higher rates of moderate (39%) and high adherence (31.6%) (p < 0.05). Correlation analyses indicated that adherence to sustainable nutrition was positively associated with the application dimension of nutrition literacy, suggesting that both knowledge and practical skills may influence sustainable nutrition behaviors. Conclusion: Older and more educated participants achieved higher nutrition literacy and sustainable nutrition adherence scores. Knowledge alone is insufficient to ensure healthy or sustainable eating. Enhancing practical skills and providing sustainability-focused nutrition education may improve diet quality and public health. Full article
11 pages, 419 KB  
Article
Short-Term Changes in Depressive Symptoms Among Patients with Alzheimer’s Disease Following a Precision Medicine Intervention
by Rammohan V. Rao, Alan Boyd, Sho Okada, William Lipa, Lance Kelly, Christine Coward, Aida L. Bredesen, Julie Gregory and Dale E. Bredesen
Brain Sci. 2026, 16(1), 2; https://doi.org/10.3390/brainsci16010002 - 19 Dec 2025
Viewed by 402
Abstract
Background/Objectives: The ReCODE (Reversal of Cognitive Decline) protocol, a precision medicine program for patients with Alzheimer’s disease (AD), has demonstrated promising results in improving cognitive function. However, its impact on mood, specifically depressive symptoms, has been less explored. Depression is highly prevalent [...] Read more.
Background/Objectives: The ReCODE (Reversal of Cognitive Decline) protocol, a precision medicine program for patients with Alzheimer’s disease (AD), has demonstrated promising results in improving cognitive function. However, its impact on mood, specifically depressive symptoms, has been less explored. Depression is highly prevalent in individuals with mild cognitive impairment and AD, shares common risk factors (e.g., systemic inflammation), and negatively affects quality of life and disease trajectory. This study evaluated whether participation in the ReCODE program is associated with measurable improvement in depressive symptoms, as assessed by the Patient Health Questionnaire-9 (PHQ-9). Methods: This retrospective, observational analysis utilized de-identified data from 170 individuals diagnosed with mild to moderate AD enrolled in the ReCODE program. Participants received initial consultations and program orientation. Follow-up visits occurred 31 days post-enrollment, including further guidance on diet, lifestyle, medications, and supplements, along with mood assessment using the PHQ-9. Pre- and post-intervention PHQ-9 scores were analyzed using the non-parametric Wilcoxon signed-rank test. Results: Participants showed a statistically and clinically significant reduction in PHQ-9 scores. Improvement was observed across all baseline depression categories (mild, moderate, and severe). Critically, the proportion of participants scoring above the clinical threshold for depression decreased substantially following the intervention. Conclusions: These findings suggest that the ReCODE precision-medicine framework offers concurrent benefits for both mood and cognition. Extending prior work, our results indicate that the ReCODE program not only benefits cognitive and biological measures but also significantly alleviates depressive symptoms. While the results highlight ReCODE’s potential as a successful multifaceted therapeutic approach addressing both cognitive decline and mental health in Alzheimer’s disease, given the retrospective, uncontrolled design, the findings should be interpreted as associative and hypothesis-generating rather than causal. Full article
(This article belongs to the Special Issue Novel Therapeutic Approaches for Treatment-Resistant Depression)
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14 pages, 239 KB  
Article
New Tools for Health: COMUNI Questionnaire to Measure Dietary Quality of University Menus
by Beatriz de Mateo Silleras, Laura Carreño Enciso, Sandra de la Cruz Marcos, Emiliano Quinto Fernández and Paz Redondo del Río
Nutrients 2025, 17(24), 3873; https://doi.org/10.3390/nu17243873 - 11 Dec 2025
Viewed by 347
Abstract
Background/Objectives: The university stage is a critical period for consolidating dietary habits that influence future health. University canteens therefore play a key role in providing menus aligned with nutritional recommendations. As menu composition shapes students’ access to healthy food, its evaluation also [...] Read more.
Background/Objectives: The university stage is a critical period for consolidating dietary habits that influence future health. University canteens therefore play a key role in providing menus aligned with nutritional recommendations. As menu composition shapes students’ access to healthy food, its evaluation also has equity implications. This study aimed to apply a newly designed questionnaire—the COMUNI questionnaire—intended to provide a rapid, user-friendly, and transferable method for evaluating the dietary quality of lunch menus offered in university canteens. Methods: Two versions of the 13-item COMUNI questionnaire were developed: COMUNI-1 for single-option menus and COMUNI-2 for menus offering multiple first- and second-course choices. The tool evaluates the frequency of key food groups, the availability of water and wholegrain bread, and the variety of foods and culinary techniques. To test the questionnaire, it was applied to 34 menu templates from university residences, colleges, and cafeterias. Results: 85.3% of menus showed deficient dietary quality, and 14.7% were rated as improvable; none achieved an optimal score. Menus managed by catering companies obtained significantly higher scores than those under direct management. Most frequently shortcomings included insufficient offerings of vegetables, legumes, fish, and wholegrain bread, alongside a frequent presence of refined carbohydrate sources and fried or ultra-processed foods. Conclusions: Universities should incorporate adherence to dietary recommendations as a key criterion in food-service procurement. The COMUNI questionnaire provides a simple and operational tool for assessing menu quality, supporting both diagnosis and monitoring of university food-service, once formally validated. Its use may also help identify structural disparities in access to healthy foods across campus settings, supporting more equitable food-service policies. Full article
13 pages, 2125 KB  
Article
Association of Diet Quality with Depression, Anxiety, and Comorbidity Symptoms in Chinese School-Aged Children
by Yuankai Zhao, Manman Chen, Jiahui Wang, Zichen Ye, Yimin Qu, Zhenghe Wang, Xijie Wang and Yu Jiang
Nutrients 2025, 17(24), 3842; https://doi.org/10.3390/nu17243842 - 9 Dec 2025
Viewed by 596
Abstract
Background: Depression and anxiety are prevalent mental health disorders among children and adolescents, with diet quality emerging as a modifiable risk factor. However, evidence regarding the association between comprehensive diet quality and mental health in school-aged children remains limited. Methods: This cross-sectional study [...] Read more.
Background: Depression and anxiety are prevalent mental health disorders among children and adolescents, with diet quality emerging as a modifiable risk factor. However, evidence regarding the association between comprehensive diet quality and mental health in school-aged children remains limited. Methods: This cross-sectional study included 400 Chinese children aged 8–12 years. Diet quality was assessed using the low-burden Diet Quality Questionnaire (DQQ), from which three Global Diet Recommendations (GDRs) scores were derived: GDR-Healthy, GDR-Limit, and total GDR. Depression and anxiety symptoms were evaluated using the Children’s Depression Inventory (CDI) and the Social Anxiety Scale for Children (SASC), respectively. Log-binomial regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for the associations between GDR scores and mental health symptoms (depression, anxiety, comorbidity). Subgroup analyses stratified by age and sex were conducted to explore heterogeneity. Results: Higher total GDR scores were associated with lower risks of depressive symptoms (RR = 0.90, 95% CI: 0.84–0.96), anxiety symptoms (RR = 0.93, 95% CI: 0.88–0.99), and their comorbidity (RR = 0.88, 95% CI: 0.79–0.97) after adjustment for age, sex, zBMI, physical activity, region of residence, only-child status and parental education. The GDR-Healthy score was independently associated with lower risks of depression symptoms (RR = 0.89, 95% CI: 0.83–0.96) and comorbidity (RR = 0.87, 95% CI: 0.79–0.95), while no significant associations between GDR-Limit score and mental health disorders were observed. Subgroup analyses indicated that the association was consistent across sex and age subgroups. Conclusions: Better diet quality and particularly higher intake of health-protective foods is associated with lower risks of depression, anxiety, and their comorbidity symptoms in Chinese school-aged children in this cross-sectional study. These findings support the integration of diet quality monitoring and nutritional interventions into public health strategies to promote mental health in children. Full article
(This article belongs to the Section Nutrition and Public Health)
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26 pages, 4461 KB  
Article
Dietary Benefits of Pistachio Consumption in Mexico Modeled Using National Health Survey System (ENSANUT) 2012 and 2016 Data
by Alfonso Mendoza Velázquez, Sonia Rodríguez-Ramírez, Ana Elena Pérez Gómez, María Concepción Medina-Zacarias, Leonardo Mendoza Martínez and Adam Drewnowski
Nutrients 2025, 17(23), 3767; https://doi.org/10.3390/nu17233767 - 30 Nov 2025
Viewed by 555
Abstract
Background: Energy-dense non-essential snacks are subject to 8% excise tax in Mexico. Objectives: To model the impact on diet quality of (1) replacing energy-dense snacks with pistachios and (2) adding small amounts of pistachios to the diet. Methods: Data came from the Mexico [...] Read more.
Background: Energy-dense non-essential snacks are subject to 8% excise tax in Mexico. Objectives: To model the impact on diet quality of (1) replacing energy-dense snacks with pistachios and (2) adding small amounts of pistachios to the diet. Methods: Data came from the Mexico National Health and Nutrition survey (ENSANUT, by its Spanish acronym) 2012 (n = 7132) and 2016 (n = 14,764). Dietary intakes were collected using a semi-quantitative food frequency questionnaire. Substitution analyses replaced energy-dense snack foods with equicaloric amounts of pistachios (Model 1) or with mixed nuts/seeds (Model 2). Additional analyses (Model 3) added small amounts of pistachios (10–28 g) to the daily diet. Added sugars, sodium, and saturated fat along with protein fiber, vitamins, and minerals were the main nutrients of interest. Dietary nutrient density was assessed using the Nutrient-Rich Food (NRF9.3) Index. Separate modeling analyses were performed for ENSANUT 2012 and 2016 and for children and adults. Results: Energy-dense foods, mostly sweet, accounted for about 20% of daily energy. Modeled diets with pistachios and mixed nuts/seeds were much lower in added sugars (<8% of dietary energy) and in sodium (<550 mg/day) and were higher in protein, fiber, mono- and polyunsaturated fats, potassium, and magnesium (p < 0.05). Significant improvements in dietary quality held across all socio-demographic strata. Adding small amounts of pistachios (10–28 g) to the diet (Model 3) increased calories but also led to better diets and higher NRF9.3 dietary nutrient density scores. Conclusions: Modeled diets with pistachios replacing energy-dense snack foods had less added sugars and sodium and more protein, fiber, vitamins, and minerals. Adding small amounts of pistachios also led to better diets. Pistachios are a healthy snack and can be an integral component of healthy diets. Full article
(This article belongs to the Section Nutrition and Public Health)
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14 pages, 468 KB  
Article
Assessment of Food Insecurity, Diet Quality, and Mental Health Status Among Syrian Refugee Mothers with Young Children
by Sedat Coşkunsu and Müge Yılmaz
Healthcare 2025, 13(23), 3083; https://doi.org/10.3390/healthcare13233083 - 27 Nov 2025
Viewed by 475
Abstract
Background: Although Türkiye hosts the largest population of Syrian refugees in the world, research on the vulnerability factors contributing to food insecurity among Syrian refugee mothers remains scarce. The aim of this study was to investigate the relationships between maternal food insecurity, diet [...] Read more.
Background: Although Türkiye hosts the largest population of Syrian refugees in the world, research on the vulnerability factors contributing to food insecurity among Syrian refugee mothers remains scarce. The aim of this study was to investigate the relationships between maternal food insecurity, diet quality, and mental health outcomes among Syrian refugee mothers with young children living in Türkiye. Methods: This cross-sectional study involved 285 Syrian mothers living in Türkiye with children under five years of age. Maternal food insecurity was assessed via the Food Insecurity Experience Scale (FIES), diet quality was evaluated via the Healthy Eating Index-2020 (HEI-2020), and the Patient Health Questionnaire-9 (PHQ-9) was used to evaluate mental health conditions. Data were collected through face-to-face surveys conducted by two native Arabic translators, and the analyses included sociodemographic characteristics, anthropometric measurements, diet quality, food insecurity status, and mental health status. Results: The prevalence of moderate/severe food insecurity and poor diet quality among refugee mothers amounted to 30% and 59.3%, respectively. Mothers experiencing food insecurity presented significantly lower levels of mental health and diet quality (p < 0.05). A one-unit increase in the food insecurity score was associated with an increase of 1.031 units in the total Patient Health Questionnaire-9 (PHQ-9) score. The model demonstrated that food insecurity accounted for 30.2% of the variance in PHQ scores (R2 = 0.302). Low income, lack of institutional aid, short length of stay, and number of children significantly increase the likelihood of poor dietary quality among refugee mothers. Conclusions: Food insecurity was found to be a widespread problem for mothers who are refugees from Syria. It was significantly associated with poorer nutritional quality and mental health issues in mothers. These findings suggest the need for expanding social support programs, implementing effective public health interventions for food security, and securing an overall improvement of maternal health. Full article
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