Search Results (649)

Background/Objectives: The aim of this study was to translate the Dietary Fat and Free Sugar-Short Questionnaire (DFS) into Turkish (DFS-TR) and to establish its construct validity and reliability. Methods: Quota sampling was used to ensure demographic homogeneity across gender and age groups. Participant distribution by age categories was proportionally aligned with the demographic statistics of the adult Turkish population. The study comprised 314 participants aged 19–64 years (38.78 ± 12.10), of which 54.5% were female. The data collection form consisted of demographic characteristics, anthropometric measurements, information on eating habits, DFS-TR, the Food Frequency Questionnaire (FFQ), and the Power of Food Scale (PFS). Results: Test–retest reliability was confirmed in the 314 participants with a 4-week interval (r = 0.997, p < 0.01). The Cronbach α reliability coefficient was α = 0.777. Using the split-half method, the correlation coefficient between the two halves was 0.681, the Spearman–Brown coefficient was 0.811, and the Guttman coefficient was 0.809. Participants’ total DFS-TR scores and sub-dimension scores varied according to age, education level, income level, anthropometric characteristics, physical activity, and dietary habits, but did not vary according to gender or marital status. To investigate convergent validity, participants’ DFS-TR scores were correlated with the FFQ and PFS. DFS-TR scores showed a significant correlation with the percentage of energy from saturated fat and free sugar assessed by the FFQ. Positive relationships were found between DFS-TR scores and the total PFS score, particularly with the sub-dimension scores for food available and food present. Conclusions: The DFS-TR can be used as a reliable and valid measurement tool for estimating saturated fat and free sugar intake among Turkish adults. Full article

Background: Calcium (Ca) and magnesium (Mg) are essential micronutrients integral to metabolic processes and cardiovascular health. Emerging evidence suggests that the dietary Ca:Mg ratio may influence chronic disease risk, yet variability in this ratio across diverse demographic groups and its relationship to body composition and vitamin D status remain unclear. Methods: Dietary intakes of Ca and Mg were assessed using validated Food Frequency Questionnaires (FFQs) and body composition was quantified via Dual-energy X-ray Absorptiometry (DXA) scans. Relationships between dietary Ca:Mg ratios and demographics, body composition parameters (lean and fat mass), and vitamin D and parathyroid hormone (PTH) levels were examined statistically using SPSS ver. 29.0 and R ver. 4.5.1 (2025) employing Kruskal–Wallis, regression, and moderated mediation analyses. Results: We examined 155 healthy adults with a mean age of 36.6 ± 12.5 years. Only 16.8% had adequate intakes of Mg compared with 45.8% who had adequate dietary Ca intakes. Significant differences in the Ca:Mg ratio were observed across racial groups (p = 0.023) and age groups (p = 0.017). South Asian Indians exhibited the highest median Ca:Mg ratio (4.83), whereas African Americans exhibited the lowest (2.67). Interestingly, our moderated mediation analysis indicated that African Americans were the most sensitive to the impact of PTH changes on the balance of Ca:Mg (indirect effect = −0.762, 95% CI [−1.298, −0.234]), indicating that even slight shifts in their Ca:Mg balances cause significant elevation in the PTH, which, in turn, leads to lowering of their vitamin D levels. Young adults (ages 18–29) had the highest median Ca:Mg ratio (4.73). No statistically significant differences were detected based on Gender (p = 0.425 and BMI (p = 0.744) on Ca:Mg ratios. Additionally, dietary Ca:Mg ratios were positively associated with sPTH in males (r = 0.203, p < 0.05), but not with body composition. Conclusion: Important variations in dietary Ca:Mg ratios exist across racial and age demographics, notably among young adults, and specific ethnic groups exhibited elevated ratios. Tailored nutritional interventions may be necessary for these populations to optimize Ca:Mg balance and support metabolic and cardiovascular health outcomes in these populations. Full article

Background/Objectives: Hypertension control remains a global challenge. Evidence on the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and blood pressure (BP) control in older Mediterranean populations is limited. We aimed to assess this association in Spanish older adults. Methods: This cross-sectional analysis included 371 participants (69 ± 9 years). Dietary intake was assessed using a validated 146-item food frequency questionnaire (FFQ), and DASH diet adherence was categorized as low, medium, or high. Multivariable logistic regression models were used to examine associations with BP control. Results: Among participants with hypertension (n = 218), 52.8% achieved adequate BP control and consumed significantly more low-fat dairy products (+56%) and less sodium (−11%) than those with uncontrolled BP. The low adherence group had lower proportion of participants with controlled BP (21%) than the medium and high adherence groups (36% and 39%, respectively) (p < 0.05). Across increasing DASH diet adherence categories, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 4–5 mmHg and 3–4 mmHg lower, respectively. Medium adherence to the DASH diet was independently associated with substantially lower odds of uncontrolled BP (OR = 0.37; 95% CI: 0.16–0.82; p = 0.015). High adherence showed a similar magnitude of association but did not reach statistical significance. Conclusions: In this cohort of older Spanish adults, moderate adherence to the DASH diet was associated with meaningful improvements in BP control, suggesting that achievable, intermediate levels of DASH diet adherence may be sufficient to improve hypertension management in real-world settings. Longitudinal studies are needed to confirm causality and long-term cardiovascular benefits. Full article

Background and aims: Amid global aging, the role of diet in cognitive health is crucial. The healthful plant-based diet index (hPDI) is linked to cardiometabolic benefits, but its association with cognitive function in older adults, particularly through nutritional status and across different socio-geographic contexts, remains unclear. This study investigated the association between hPDI and multidimensional cognitive function, the mediating role of nutritional status, and potential associated modifications by urban–suburban location and gender. Methods: A community-based cross-sectional study was conducted in Shanghai, China, involving 2079 older adults (aged ≥60). Dietary intake was assessed by a validated food frequency questionnaire (FFQ) to calculate hPDI. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment-Basic (MoCA-B), and Clinical Dementia Rating (CDR). Nutritional status was measured by the Mini Nutritional Assessment (MNA). Hierarchical regression, interaction, and mediation analyses were performed, adjusting for comprehensive covariates based on social determinants of health (SDoH). Results: Higher hPDI was significantly associated with better cognitive scores (MMSE: β = 0.083, p < 0.001; MoCA-B: β = 0.069, p < 0.001) and lower odds of worse CDR (OR = 0.944, p < 0.001) in fully adjusted models. In the cross-sectional mediation analysis, MNA statistically mediated a significant proportion of the observed associations (MMSE: 41.25%; MoCA-B: 53.68%; CDR: 38.98%). The protective association was consistent across urban and suburban areas. However, a significant three-way interaction (hPDI × Gender × Area, p < 0.01) was found, with no cognitive benefit observed for males in suburban areas. Conclusions: Adherence to a healthful plant-based diet is associated with better cognitive function in older adults, partly statistically mediated by improved nutritional status. While this association is geographically equitable in Shanghai, suburban males do not appear to benefit, highlighting the need for gender- and context-sensitive dietary interventions. Full article

Background/Objectives: Blood donation is essential to health systems and represents a valuable epidemiological model for studying physiological adaptation to controlled blood loss. Regular blood donors constitute a distinct, health-screened population whose biological responses offer unique insight into mechanisms of resilience and key determinants of population health. Hypoxia-inducible factor 1-alpha (HIF-1α) is a key regulator of erythropoiesis and cellular response to hypoxia, and its modulation following blood donation may inform donor safety and the sustainability of blood donation programs. This study aimed to characterize the sociodemographic, lifestyle, and anthropometric profiles of blood donors in relation to hematopoietic biomarkers (vitamin B12 and folic acid) and to evaluate changes in serum HIF-1α concentration after donation, emphasizing the public health relevance of voluntary blood donation. Methods: A cross-sectional study was conducted among 324 voluntary blood donors (159 regular and 165 occasional). Serum HIF-1α was measured before and 30 min after donation, together with vitamin B12 and folic acid levels. Sociodemographic and lifestyle characteristics (physical activity, smoking, dietary habits) were collected through standardized questionnaires (EHIS-3, FFQ), and anthropometric parameters were assessed. Results: Regular donors were older and predominantly male, with comparable socioeconomic indicators between groups. Both regular and occasional donors showed favorable lifestyle profiles, including low smoking prevalence and moderate physical activity. Skinfold thickness was significantly greater in regular donors (p < 0.001). The main biological finding was a robust post-donation increase in HIF-1α concentrations (≈80%, p < 0.001), independent of donation frequency or lifestyle. No significant associations were found between lifestyle factors and vitamin B12 or folate levels. Conclusions: Blood donation induces a rapid elevation in HIF-1α, reflecting activation of hypoxia-responsive pathways and short-term hematopoietic adaptation. Beyond its biomedical relevance, voluntary blood donation represents a meaningful epidemiological and public health model for studying physiological resilience and the health benefits of altruistic behavior. These findings underscore the importance of donor surveillance and motivation as components of broader preventive health and health equity strategies. 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: Mood disturbances, often accompanied by cognitive deficits, represent a major public health challenge. Diet is increasingly recognized as a modifiable factor in mental health, with specific nutrients such as omega-3 polyunsaturated fatty acids (PUFAs) showing therapeutic potential. This study investigated whether dietary omega-3 intake moderates variations in cognitive performance associated with psychological symptoms in non-clinical samples. Method: A total of 313 healthy adults completed a food frequency questionnaire (FFQ) to assess dietary intake. Psychological symptoms were measured using the depression screening questionnaire (PHQ-9) and the stress assessment instrument (PSS-10), while cognitive performance, including short-term and episodic memory, was evaluated using Sternberg and Old/New recognition tests. A subgroup of 52 older adults completed a detailed in-person FFQ to enable the precise quantification of EPA, DHA, and alpha-linolenic acid (ALA) intake. Results: Diets rich in omega 3, particularly nuts, seeds, fish and seafood, were associated with lower depression and stress scores. EPA and DHA, but not ALA, were specifically linked to those mood benefits. However, dietary omega-3 intake was not significantly associated with cognitive performance and did not moderate the relationship between mood and memory. Self-reported omega-3 supplementation was linked to fewer depressive symptoms and better episodic memory. Conclusions: While dietary omega-3 is associated with improved well-being, its role in cognition in healthy adults is not well-established and warrants further investigation. Full article

Background: Despite the growing interest in the relationship of diet and women’s health conditions, a limited number of Food Frequency Questionnaires (FFQs) have been specifically developed and/or validated for use among women, and those that exist have been primarily developed and validated in non-European countries. This study aimed to evaluate the reproducibility and validity of the FFQ-NutriForHer among young and older Polish women. Methods: The reproducibility and validity of the 138-item FFQ-NutriForHer were evaluated in 121 young (18–30 years) and 88 older women (70–90 years). Reproducibility was assessed using energy-adjusted Pearson and intraclass correlation coefficients (PCCs, ICCs) from two FFQ administrations. Validity was evaluated by comparing energy-adjusted and de-attenuated PCCs between FFQ-mean and 3-day dietary records. The Bland–Altman method estimated mean differences and limits of agreement. Results: The mean PCCs and ICCs for macronutrient reproducibility were 0.69 ± 0.12 and 0.69 ± 0.11 among young women and 0.67 ± 0.06 and 0.65 ± 0.11 among older women, respectively, indicating moderate correlation and reliability in both groups. For micronutrients, the mean PCCs were 0.72 ± 0.05 among young women and 0.69 ± 0.05 among older women, while ICCs were 0.71 ± 0.05 and 0.69 ± 0.09, respectively, indicating a good and moderate correlation and moderate reliability. Mean PCCs for macronutrient validity indicated good concordance with values of 0.51 ± 0.25 among young women and 0.46 ± 0.13 among older women. For micronutrients, the mean PCC for validity was 0.63 ± 0.13 among young women and 0.44 ± 0.14 among older women. Bland–Altman analysis indicated good overall agreement between methods in both groups. Conclusions: Given its high reproducibility and satisfactory validity in both age groups, the FFQ-NutriForHer is a reliable tool for assessing dietary intake and exploring its links to women’s health across different ages. Full article

Background/Objectives: There is a lack of food frequency questionnaires (FFQs) specifically designed to assess food consumption based on processing levels in younger populations. This study evaluates the validity and the reliability of a 107-item FFQ (NFFQ-Kids) in estimating the intake (g/day) and the weight and energy ratios of Nova groups in Italian children and adolescents aged 2–18 years. Methods: The NFFQ-Kids was administered twice (T0 and T1), with a four-week interval. A total of 73 participants completed the questionnaire at T0, and 53 completed it at T1. Participants were selected from the ICARO Study (December 2023–April 2024), a web-based cohort study in Southern Italy. Questionnaire validity was assessed by comparison with a 3-day food record (two weekdays and one weekend day) collected between the two NFFQ-Kids administrations. Test–retest reliability was evaluated to assess the consistency of the questionnaire over time. Results: A moderate correlation was found between the NFFQ-Kids and the 3-day food record for the energy ratio of ultra-processed foods (UPFs) (r = 0.48; p < 0.001; ICC = 0.46; 95% CI 0.29–0.64) and the weight ratio for both unprocessed or minimally processed foods (r = 0.49; p < 0.001; ICC = 0.50; 95%CI 0.33–0.66) and ultra-processed foods (UPFs) (r = 0.58; p < 0.001; ICC = 0.58; 95%CI 0.42–0.72). Overall, the NFFQ-Kids showed good test–retest reliability across all Nova group intakes, total food, and relative energy and weight ratios of UPFs (r = 0.71, ICC = 0.67; and r = 0.79, ICC = 0.67, respectively), indicating stable measurements over time. Conclusions: The NFFQ-Kids demonstrated acceptable validity and good reliability, proving useful for assessing food intake by processing level in Italian youth. Full article

Background/Objectives: The nutrition and lifestyle choices made during pregnancy significantly impact the long-term health of both mother and child. This observational study, conducted at the Jersey Maternity Unit, investigated how maternal diet and weight influence delivery outcomes and newborn feeding methods among 81 pregnant women. The aim of the study was to assess whether maternal diet, weight changes, and infant feeding practices vary according to ethnicity and duration of residence in Jersey, in order to inform culturally sensitive health improvement strategies. Methods: The FFQ was used to characterise the diet before and during pregnancy. Diet quality was assessed by the 9-item aMED score. Data on anthropometric measurements (including gestational weight gain, GWG), socioeconomic characteristics, and infant feeding methods (including breastfeeding rates) were collected. Results: The statistical analyses evaluate differences and distribution of data in the groups of women based on the ethnicity and period the mothers had lived on the island. For all the women, there were significant changes in the weight gained at week 28 compared to weeks 8 and 12 (+8.0 (4.0; 12.1) kg, p ≤ 0.001), as well as the period before pregnancy until the 34th week of gestation (+11.9 (8.0; 12.1) kg, p ≤ 0.001). The intake of low-fat dairy, whole grains, and fruit changed through the gestation period and differed between pregnant women with different periods of island residence. There were no changes in the aMED score and adherence. Conclusions: Maternal weight gain followed a consistent pattern during pregnancy, whereas dietary behaviours—particularly the consumption of key food groups—varied by cultural background and length of residence. These findings emphasise the need for culturally sensitive antenatal care and tailored nutrition strategies to improve maternal outcomes, support breastfeeding, and reduce long-term health risks for mothers and children in Jersey’s multicultural population. Full article

Aim: To assess the prevalence of constipation, dietary fiber intake, and their association with QoL among HD patients. Methods: A cross-sectional study was conducted among 35 adults undergoing maintenance HD at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Constipation was assessed using the Rome IV criteria and Bristol Stool Form Scale (BSFS). QoL was evaluated using the Kidney Disease Quality of Life Short Form (KDQOL-36), and dietary fiber intake was estimated from three 24-h dietary recalls and a validated Dietary Fiber Intake Short Food Frequency Questionnaire (DFI-FFQ). Data were analyzed using Fisher’s exact test, the Mann–Whitney U test, and correlation coefficients (p < 0.05). Results: Constipation prevalence was 32%. Stool frequency was <3 per week in 14% of participants, 3–4 per week in 23%, and 7 per week in 63%. Mean fiber intake was 9.8 ± 4.8 g/day (24-h recall) and 8.6 ± 4.3 g/day (DFI-FFQ), with all participants classified as low fiber consumers. KDQOL-36 domain scores were highest for “effect of kidney disease” (80.4 ± 16.1) and lowest for “physical health” (40.4 ± 12.4). No significant associations were found between constipation, fiber intake, demographic or clinical variables, or any QoL domain (p > 0.05). Conclusions: Constipation is common among Saudi HD patients, yet not significantly linked to fiber intake or QoL in this small cohort. Larger multicenter studies are needed to identify determinants and guide evidence-based interventions. Full article

Background: Diabetic neuropathy (DN) may impair balance and gait, increasing the risk of falls in elderly patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate whether the presence and severity of DN are associated with balance and mobility impairment as well as with increased fear of falling in patients with T2DM. Methods: A total of 124 adults with T2DM underwent neuropathy assessment with the Michigan Neuropathy Screening Instrument (MNSI) and sudomotor testing (SUDOSCAN). Balance and fall risk were evaluated using the Berg Balance Scale (BBS), Timed Up and Go (TUG), Falls Efficacy Scale—International (FES-I), and Fear of Falling Questionnaire—Revised (FFQ-R). Comparison of parameters between patients with vs. without DN, correlations, and multivariable linear regressions (DN components as predictors) were performed. Results: Compared with those without DN, participants with DN had higher FES-I (31.0 vs. 21.0) and FFQ-R (56.0 vs. 42.0) scores and lower BBS (42.0 vs. 46.0). TUG did not differ significantly (11.8 vs. 11.25 s). In multivariable models, higher MNSI questionnaire and objective scores independently predicted lower BBS (β = −0.74 and −1.1, respectively) while only the MNSI questionnaire predicted higher TUG (β = 0.43). For fear of falling, the MNSI questionnaire predicted higher FES-I (β = 1.66) and both MNSI components predicted higher FFQ-R (β = 2.31 and 1.7, respectively). Leg SUDOSCAN values were not associated with BBS, TUG, FES-I, or FFQ-R. Conclusions: DN is associated with impaired balance and greater fear of falling. Neuropathy burden, particularly patient-reported symptoms, relates to worse performance and confidence, whereas sudomotor impairment alone does not. Full article

Background/Objectives: Introduction: Food selectivity is highly prevalent in children with autism spectrum disorder (ASD) and is associated with sensory hypersensitivity, particularly in oral, olfactory, and tactile domains. Although international evidence exists, little is known about this phenomenon in Latin American populations. This study aimed to explore the relationship between sensory hypersensitivity and food selectivity in Chilean children with and without ASD. Methods: A cross-sectional study was conducted with 57 children aged 6–12 years, including 32 with ASD and 25 neurotypical controls. Sensory processing was assessed using the Dunn Sensory Profile 2, while food selectivity was evaluated with the Brief Autism Mealtime Behaviour Inventory (BAMBI) and a Food Frequency Questionnaire (FFQ). Statistical analyses included intergroup comparisons and correlation tests. Results: Children with ASD obtained significantly higher scores across all domains of sensory hypersensitivity (p < 0.001). Selective eating behaviours were more frequent, with texture (78%) and colour (53%) being the most common, and were strongly associated with ritualistic eating (OR 29.39; 95% CI 5.47–136.2; p < 0.0001). BAMBI scores were correlated with oral (p = 0.002), socio-emotional (p = 0.003), and somatic hypersensitivity (p = 0.025). Additionally, children with ASD reported lower intake of vegetables, dairy products, animal proteins, and legumes compared with controls. Conclusions: Food selectivity in Chilean children with ASD is closely related to sensory hypersensitivity, particularly in oral, socio-emotional, and somatic domains. These findings underscore the need for culturally adapted, sensory-based interventions to broaden dietary variety and reduce mealtime difficulties in this population. Full article

Background/Objectives: This study aims to evaluate whether the Dietary Guidelines for Americans (DGA) are effective for maintaining a healthy diet among Mexican-descent populations in the US or if a more culturally tailored policy approach is warranted. Methods: As a first outcome, 20 healthy women of Mexican descent from the Seattle area participated in a pilot randomized controlled trial. They were randomly assigned (10 participants each) to either a group receiving instruction on the standard 2015 DGA or a group receiving an adaptation of the DGA focused on traditional Mexican cuisine and culture. In this 12-week study (with follow-ups at 3 and 6 months), participants’ acceptability of the cultural adaptation of the DGA was compared with that of the standard DGA with end-of-study surveys. Ten blood-based metabolic biomarkers were assessed at baseline and 3 months. Dietary changes at 3 months were assessed with a Food Frequency Questionnaire (FFQ) that was translated into Spanish but not culturally adapted. The secondary outcome was dietary change at 6 months. Results: The primary findings at 3 months showed that serum free fatty acids were reduced for the standard DGA arm. Carbohydrate consumption was reduced in the standard DGA arm only. The end-of-study survey results suggested that both interventions were well received by participants. Conclusions: The preliminary findings from this small sample size suggest that depending on a person’s priorities, either intervention could be offered, with each arm showing slightly different dietary and biomarker outcomes. Full article

Background/Objectives: Coenzyme Q 10 is a lipid molecule that works as a mobile electron transporter in the mitochondrial respiratory chain and, in addition, plays the role of an antioxidant. Interestingly, CoQ10 synthesis in human cells derives from the mevalonate pathway, the same metabolic route that delivers endogenous cholesterol. Mutations leading to Familial Hypercholesterolemia (FH) alter the levels of CoQ10 production and remarkably, statin therapy associated muscular symptoms (SAMSs) might also be modulated by CoQ10 supplementation. CoQ10 is also provided by diet and only a few studies have calculated the dietary intake of this metabolite among populations. Methods: Here, we present our Spanish FH cohort (n = 261) and characterized relevant clinical, metabolic, and anthropometric parameters. Results: A cohort of 75.1% followed lipid-lowering treatment at inclusion, being the most prescribed drugs statin alone (32.7%) and statins combined with ezetimibe (56.6%). The average time on statin treatment was 3.7 years. Interestingly, 22% of cohort patients presented with SAMS. In addition, we performed an exhaustive literature review to define for the first time the CoQ10 content present in food typically found in Spain or other southern-European countries and classified them from very rich (over 50 mg/kg) to very poor (<1 mg/kg). With this information, we calculated the daily intake of CoQ10 from a small group (12) of selected FH patients using a validated food-frequency questionnaire (FFQ) and determined a daily intake 9.72 ± 2.64 mg/day, different to other described populations. Conclusions: we discussed the relevance of exogenous CoQ10 for FH development and potential SAMS. Interestingly, this information can be extrapolated to define the regular CoQ10 intake of the Spanish population, especially when following the MedDiet. Full article